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The Practice of Hypnotism / Edition 2 available in Paperback
The field of hypnotism has greatly evolved in recent years. Since the publication of the successful award-winning first edition of this book, some 1,200 research and clinical articles on hypnotism have been published in American journals alone and a multitude of related books have been written. With so many important contributions in this field occurring in such a short time, there is great need for a resource that reflects the current thinking and incorporates the latest techniques.
The Practice of Hypnotism, Second Edition is that resource, providing the most up-to-date information available on hypnotism and hypnotherapy. Written by Andre Weitzenhoffer, PhD, a leading expert in the field for over forty-five years, the book examines the past and present thinking about hypnotic phenomena in an objective fashion. It provides valuable background information, ideas for future research, and a wealth of detailed, practical instruction for the production of hypnotic phenomena and the treatment of a large variety of health-related problems.
Like the first edition, this book aims to present hypnotism from a scientific perspective. It also includes the bases upon which the author and others in the field have made their judgments, enabling the reader to make independent determinations based on the most complete information.
The Practice of Hypnotism has evolved from the original two-volume set to a single, comprehensive volume in two parts: Foundations of Suggestion and Hypnosis; Clinical Hypnotism and Other Applications. Each chapter presents basic material at a relatively elementary level, gradually moving into the more advanced material at a comfortable pace.
This Second Edition features a wealth of new information that reflects the latest findings of research and clinical experience in using hypnotism, including:
• Complete rewrites of chapters on measurements relevant to and on the state of hypnosis
• New chapters on suggestion and suggestibility and the treatment of anxiety
• A revised chapter on self-hypnosis, includ ing a detailed training procedure
• Expanded and reorganized material on the Ericksonian approachMajor revisions regarding the socio-cognitive and the cognitive-behavioral positions on hypnotic phenomena
• Suggestions for future research
For the effective, safe, and well-informed practice of hypnotism, The Practice of Hypnotism, Second Edition is the definitive resource. It addresses the special interests and needs of practicing health care professionals, researchers, and other professionals; those new to hypnotism; and seasoned readers looking for accurate facts and a different scientific viewpoint on the subject. Like the first edition, this edition will also serve well as a textbook for self-study or to complement courses.
A newly revised, thoroughly updated edition of the most complete resource on hypnotism and hypnotherapy.
Designed to help researchers, health care providers, and other professionals safely and confidently produce and use hypnosis, The Practice of Hypnotism, Second Edition is filled with the most up-to-date information available on hypnotism and its techniques.
Offering the same comprehensive coverage as the very successful two-volume set of the first edition, it provides highly practical instruction on producing hypnotic effects and treating a wide variety of health and behavioral problems, and examines current thinking on these subjects. Written by a leading expert in the field, this book reports on the latest research findings and clinical experience, and includes many sections that have been extensively revised and expanded to cover recent developments.
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FOUNDATIONS: FACTS AND TECHNIQUES
By way of a preliminary definition, hypnotism is the production, study, and use of so-called hypnotic phenomena, that is, of those phenomena that have been thus labeled in the pre-1950 literature since at least 1843. The major phenomena are described and discussed in some detail in Chapters 2, 4, and especially 7. Except where the context calls for an otherwise different use, the term hypnosis will be reserved as the label for a peculiar state or condition of being that can presumably be brought about in some human beings. Hypnotism is, roughly speaking, the science and art of hypnosis. As we shall see, more accurately and scientifically speaking, since at least 1890, what has primarily been produced, studied, and practiced, and what is currently accepted, under the heading of hypnotism and hypnosis are explicitly and implicitly suggested phenomena, hypnosis, being itself a suggested effect and, at best, apparently playing only a secondary role. It was probably in keeping with this fact that Hypolyte Bernheim, whom this writer considers to be the father of twentieth-century hypnotism, used the term suggest ion and not hypnotism or hypnosis in the title of his seminal 1884 work. But the world was apparently not ready for the proposed shift in emphasis and even Bernheim found it impossible to follow through with it in his writings. It has been a basic assumption of modern (i.e., twentieth century) hypnotism that it is founded on the same phenomenology it historically evolved from. Such differences as exist between older versions of hypnotism and newer ones being reduced largely to a matter of interpretation of the facts. That there are common elements is not in question, but that there is a full identity is questionable and basically untestable.
Recognizing that there is probably more art than science in the practice of modern hypnotism, one aim of this work is to present a view of hypnotism as firmly founded on scientific facts as possible. It must also be emphasized that this work is about modern, that is, twentieth-century hypnotism. However, because it is best understood in the context of its historical roots, there will be frequent excursions into earlier hypnotism. Finally, as will be elucidated further on, there are at least three approaches, that is, ways of viewing and using hypnotic phenomena: the traditional, the semi-traditional/scientific, and the Ericksonian or nontraditional. While this work will emphasize the semi-traditional/scientific approach, both the traditional and nontraditional approaches will be given consideration.
HYPNOSIS PAST AND PRESENT
Science begins with basic observations and is solely about that which can be observed or reasonably inferred from observations, therefore, let us first review some of the basic observable "facts" from which twentieth-century hypnosis derives.
A. Dr. B, a surgeon is in his surgery with a patient who is seated. He has the patient steadily look at a small bright object the doctor holds above and slightly forward of the patient's eyes. Within a few minutes, the patient's eyes close. Taking the patient's right hand, Dr. B lifts it and eventually places the hand and attached arm in a horizontal position. Letting go, the arm and hand remain in position. This is repeated with the other arm. After waiting about ten minutes, Dr. B brings the arms back to their initial position. He now proceeds to excise a small cyst on the patient's neck. The wound is sutured and bandaged. Throughout the procedure, the patient shows no sign of pain. Using a fan, Dr. B next wafts a current of air toward the patient's face. The patient opens his eyes and acts as if nothing had happened.
B. Mr. S has come to see Dr. Y, a hypnotherapist, for his chronic back pain of long standing that apparently has no detectable physical basis. Having assured him that hypnosis can help, he has Mr. S visually fixate his raised right index finger, talks to him about presently going to sleep which he appears to do after a short while. Dr. Y now tells him the pain is going away. Mr. S begins to smile and presently, upon inquiry from Dr. Y, reports the pain is nearly gone. Dr. Y tells him it will shortly be completely gone and that upon waking he will continue to be pain free. Dr. Y now tells Mr. S to awaken, feeling fine. Mr. S opens his eyes, looks around, shifts in his chair and looking pleased comments on the absence of pain. A one-year follow-up by Dr. Y shows the patient still free of pain. Mr. S still remembers nothing more than having "gone to sleep."
C. Dr. A is attending a seminar on Ericksonian hypnosis and psychotherapy conducted by Dr. Z who has mentioned having had considerable success in treating cigarette smokers. Having a severe smoking problem, Dr. A volunteers as a demonstration patient. Dr. Z begins by gathering facts about the problem in a conversational manner. Having done this, he takes a few moments to ponder on the facts and plan his course of action. He now proposes to tell Dr. A a story and does so. The story is one that seems quite unrelated to the problem of smoking. End of session. For the next few days Dr. A is observed to be free of her smoking habit, but a year later it is back as heavy as ever.
D. K, a stage hypnotist, is giving a show. He calls for volunteers. He take each in turn and, with some, successfully causes them to fall backward on his say-so, to become unable to separate their clasped hands, and then to become unable to bend an arm. Not all succeed and these he thanks and sends back to their seats. He requests the others to seat themselves on nearby chairs and proceeds to hypnotize them. This is followed by K demonstrating various effects such as having a subject believe she is a famous singer giving a show and rendering a song, which she does in a rather realistic manner after being taken by K to a microphone on a stand on the stage. K terminates this action by simply commanding the subject to "sleep" and be back as herself in the current theater, leading her back to her chair. Another subject is told he is hacking his way through a dense jungle. He proceeds somewhat unrealistically but energetically to do so on the stage. On the sudden cry on the part of K to "Watch out for that lion on your left!" the subject stops in his tracks looking toward the audience which he does not appear to see. He first appears startled then fearful, and suddenly and unexpectedly goes through the motions of taking a gun off his shoulder, aiming at something nearby and shooting. Next he goes through the motions of prodding what must be a dead lion with his gun. K terminates this action as he did with his other subject. Another subject is told by K that he is a minister who is going to give a rousing sermon but who after a good start will suddenly find himself badly stuttering. Which all comes to pass. Another is told that she has forgotten the existence of the number seven. She is then placed in the position of having to make use of this number which she is unable to do, with surprising and sometimes funny results. Another effect shown is the production of analgesia followed by the transpiercing of a subject's large fold of skin with a very large hat pin. For final demonstration, a volunteer is turned into a solid plank that bridges two chairs. A two-hundred-pound spectator stands on top of him. Later, back in their seats, some of the volunteers can be overheard indicating that they have no memory of what happened on the stage and that they "went to sleep."
E. A student, J, has taken part in an experiment in which his hypnotizability was tested. As part of this test, and after undergoing an induction of hypnosis, he was told that a fly was annoyingly buzzing around his head. He was then given permission to use a hand to shoo it away and eventually he was told that the fly was gone. J reported having not experienced any buzzing fly, but did make a hand motion. Later in the day, J returned to the laboratory and asked to see the experimenter, E. He reported that since leaving the laboratory he has been bothered by buzzing flies. The subject seems to remember most everything he did except the episode with the fly. E reassures J that he can take care of the matter. J is rehypnotized and E proceeds to strongly affirm that J will no longer be experiencing buzzing flies. End of problem.
F. Dr. M, a psychiatrist, proposes to hypnotize a patient. He explains to her that it just all a matter of relaxation. He has the patient recline on a psychoanalytic-type couch. He has lightly tied a handkerchief about one of her ankles. He asks her to close her eyes, then proceeds to talk to her about the relaxation of various muscles. Every now and then, using a corner of the knotted handkerchief, he pulls up on it, lifting the ankle a few inches, then slowly lowers it. After some twenty minutes of doing this, he proceeds to the next step in his therapeutic work with his patient which will involve her modeling some plasticine.
G. As part of a seminar demonstration, Dr. P has been demonstrating various trance phenomena. The subject, a young woman, sits unmoving, eyes open, staring straight ahead, presumably hypnotized. P now states that some hypnotized persons can develop superpowers and will now show this. He takes an ordinary deck of cards and has a member of the audience select a card. The cards are indistinguishable from one another when viewed from their backs. He shows only the back of the selected card to the hypnotized subject telling her that this is the only card that has a black cross drawn across the back. The cards are then well mixed. Next the subject is asked to go through the deck, looking only at their backs, and to find the card, which the subject does repeatedly without fail. In his next demonstration, another member is asked to randomly select a card from a deck of ordinary cards. Dr. P asks the card holder to concentrate on the face value of the card and states that the subject will read his mind. A few moments later the subject calls out the card correctly.
What do we observe in these vignettes that leads to our identifying, first, something sufficiently unique to give it a special designation and, second, to use the term hypnosis for it?
There is some very unusual behavior in some of the vignettes. Some individuals could "act out" or fake most, if not all, of the described behaviors, but we have no reason to suspect they have. No more do we have any reasons to believe this behavior is part of their normal and natural everyday behavior. We are thus led to take special notice of it.
In most of these vignettes, the behavior appears to be consistently directly connected to certain verbal communications made by one person to another. In most cases, the communication seems to be a direct statement of what next takes place. Many of the individuals subsequently report much of their behavior as having taken place automatically, that is, not under their control. We also note the presence of amnesia in a number of cases. Last, we note that in all but three instances, sleep was mentioned; some subjects appeared momentarily to fall asleep and later indicated they had. In one case, no pertinent verbal communications appear to have been made. These are situations that are, to say the least, unusual. Furthermore, these behaviors have been repeatedly observed by many reliable observers. Reliability and repeatability of observations is an important requirement of science.
Were we limited to the observations in B, D, and E, we might attribute the whole matter to the existence of an induced sleep state, but we have to consider A, C, F, and G which constitute anomalies if we take this position. The situation described in C is further anomalous because of the form the communication takes in it, that of telling a story seemingly unrelated to the effect to be produced. And in A there are no communications that seem relevant to what occurs. As for G, we appear to be faced here with paranormal manifestations. The simplest, and certainly a reasonable solution to take here, would be that situations A, C, F, and G are other categories of induced behaviors than situations B, D, and E. Having taken this position, we could propose to temporarily speak of these three last groups of behaviors as induced sleep behaviors (effects, phenomena) or maybe more simply as hypnotic behavior, effects, or phenomena while we waited to decide what to do with the anomalous situations.
Lest I be misunderstood as having presented with case G evidence of or indicated a belief of the ability of hypnotized persons to read minds, I will point out that Dr. P is a magician as well as a hypnotist and has used a well-known procedure used by mentalists to simulate telepathic abilities. The explanation of his first demonstration will be found in Chapter 7.
Actually all of the behaviors considered in the vignettes and quite a few others have been pooled by a majority of workers in the field under the one broad heading of hypnosis. Historically speaking, the term started out with a much narrower denotation. As further detailed, the term neurohypnotism, from which the modern terms hypnotism and hypnosis were later derived, was first used in 1841 by James Braid (1843) for the induced behaviors partly described in vignette A. There is nothing to be found in the observations he then made regarding neurohypnotism, or even in the material of vignette A, that allows us to equate it with, for instance, the story-telling situation of vignette C. How then did this latter situation come about? More important, how valid is this last identification? As we shall see, it has no real foundation. The fact is that, at a descriptive level, and this is the only one at which we can at present work, what passes as hypnosis today is not necessarily what hypnosis has always consisted of in the past. Over the years its defining phenomenology has varied as has the way it has been interpreted and practiced. Some people have tried to expand what is covered by the term hypnosis. Others, such as those practicing what they call Ericksonian hypnosis and the New hypnosis, have arbitrarily taken the position that what they practice is radically different from the old, traditional hypnosis. There are other authorities who pass over differences as being only apparent and not real. There are also those who argue that the shift in what has been designated as "hypnosis" merely represents a recognition of what its phenomenology "really is," or our better understanding of it. Many practitioners of meditation, for instance, assert they are practicing hypnosis. Not a few authorities on hypnotism view the relaxation produced in certain biofeedback sessions, Jacobson Progressive Relaxation, the Lamaze procedure, and Benson's Relaxation Response as all reducible to hypnotism. There is an entire group of individuals who insist that there is no hypnosis but who continue to write extensively about it and openly practice clinical hypnosis. Finally, there are Ericksonian authorities who speak of doing hypnotherapy without trance induction and even of practicing hypnosis without hypnosis! A very basic scientific question becomes just how much of this hodgepodge should be associated with the term hypnosis and its derivatives, particularly when there is no evidence that anything like a state of sleep is present? Starting with James Braid, there has been an unfortunate tendency of workers in the domain of hypnotic phenomena to want to explain all kinds of behaviors as being hypnotic. Thus it was that Braid quickly went on record to the effect that the poorly authenticated reports of the ability of Indian fakirs to survive prolonged internments, the ability of serpents and other wild animals to "fascinate" their preys, and of certain forms of hexing by sorcerers, were all reducible to neurohypnotism. And not a few modern authorities will tell you that acupuncture is nothing more than hypnosis.
In this writer's opinion, there has been an unwarranted extension of the concept of hypnosis into a nearly meaningless term. This has been greatly detrimental to the study and utilization of hypnosis and is a source of a great deal of ambiguity. What are we to understand, for instance, when we are told that hypnosis can be medically useful? Are we talking here of the state per se, of a suggested effect (with or without presence of the state), or possibly of some other effect brought about through the mediation of a suggested effect, itself not being of a hypnosuggested nature?
There is a place for appropriate generalization, but also one for appropriate differentiation. Had those following in Newton's footsteps insisted on reducing all forms of attractions between bodies to gravitation, civilization might still be largely limited to steam engines and hydraulic power. Limiting the applications of the terms hypnosis and hypnotic is in order, and this work will take a more restricted view of the subject matter.
Much of that which follows, especially in Part One, is the result of this writer's efforts to bring about some kind of sensible order for himself, if not for others, in what otherwise is becoming an increasingly amorphous and chaotic field.
OF BEHAVIORS SAID TO BE HYPNOTIC: A CLOSER LOOK
At least part of the problem lies in the ubiquity of the slippery state of hypnosis. This inferred condition has been a focal point of all discussions and expositions dealing with the broader subject of so-called hypnotic phenomena or effects, the latter being said to be hypnotic because of having once been thought to be not only specific to this problematic state of hypnosis, but even specifically produced by it. But as T. X. Barber (1969) emphasized over and over in the late 1950s and early 1960s, there is probably no single so-called hypnotic manifestation that has not many times been seen to occur naturally and that had not been thus observed to take place long before the term hypnotism became a part of our language. That this fact was actually recognized by the earliest writers on and workers with these phenomena is partly shown by the fact that from the very beginning they chose to qualify these effects as being induced or artificial.
This last observation might provide a way around the difficulties that have grown by the introduction of the notion of a hypnotic state and defining hypnotic phenomena in terms of it. Examination of the extensive relevant literature on the subject matter, as well as experience with the phenomena, shows that, if one agrees to include physiological changes under "covert behavior," then all so-called hypnotic phenomena, including the state of hypnosis, consist of some form of natural behavior occurring on demand outside of its natural context of occurrence. In the latter sense, it can be said to be uncommon behavior. That is, on a purely actuarial, observational basis, hypnotic behavior is behavior that differs from that which one expects to see naturally take place at the moment of its occurrence. Writing to his brother after his first experience with that which was to be identified some fifty years later by James Braid (1843) as the condition of neurohypnotism, the Marquis de Puységur (1784) writes:
What a surprise it was to me to see this man gently fall asleep in my arms after half of a quarter of an hour without convulsions or pain! (p. 41)
When attempting a magnetic or mesmeric procedure for therapeutic purposes, de Puységur expected pain and convulsions to occur; instead a gentle sleep surprisingly appeared!
It is important to keep in mind here that "natural" is not a synonym for "normal." Natural behavior consists of both actuarially defined normal and abnormal behavior. As things turned out, de Puységur's "gentle sleep" soon became further identified by him with a naturally occurring abnormal form of sleep then known as somnambulism.
But all unexpected behavior is not hypnotic. The quote from de Puységur fails to describe five other already mentioned characteristic features that he would subsequently ascribe to what eventually came to be known as hypnotic behavior. One of these is that it is behavior on the part of a given individual not only produced out of context, but one consistently produced seemingly on demand, that is, at will at the instigation of another individual. Another feature is the seeming exquisite control this second person seems to have over the overall behavior of the first individual. Also, as reported by the subjects when they were aware of it, their behavior was seemingly experienced as being nonvolitional or involuntary and quite outside their control. Not only it is avolitional but at least some of it, such as hallucinations, is of a kind that presumably cannot be produced voluntarily. It can be argued that none can. And last, amnesia eventually seemingly followed these episodes. This last was probably largely the basis for the conclusion some form of sleep had occurred. Since the subjects were active, fainting had to be excluded. I have used the qualifications "seemingly" and "seeming" here for the following reason: While at the observational level the behavior in question appears to have these features, opinions have been divided regarding their actual reality, a matter that will be left for later discussion (see Chapter 2). The issue of possible simulation is nothing new and was seriously considered long before modern researchers such as Sarbin and T. X. Barber brought it up thinking they had been the first to do so. De Puységur was among the first to address this issue.
For the sake of completeness, it should be mentioned that starting with de Puységur and continuing to some degree to this day, hypnotic behavior has also been seen as characteristically including various paranormal manifestations. One that became a dominant feature during the nineteenth century, starting with de Puységur, was the notion that, when in a magnetically induced somnambulism, some individuals could diagnose illnesses and prescribe remedies for them. This became as much a part of what we might call clinical magnetism as the claimed curative effects of animal magnetism.
Although not a defining characteristic, the production of magnetic somnambulism, as it was first called, later of neurohypnotism, and last of hypnosis in individuals, was always limited to a relatively small number of persons. Itinerant magnetizers, such as Lafontaine, who gave public demonstrations usually brought with them a small number of subjects that they used over and over. Without this relative scarcity of occurrence, I would opine that hypnotic phenomena would have received no more special attention than such an everyday behavior as natural sleep.
The five defining features just discussed have consistently appeared in all past discussions and studies of hypnotic behavior. To summarize, the features are: (1) otherwise natural behavior consistently produced by one person out of its natural context of occurence, (2) on demand (i.e., induced) by another person, (3) experienced as totally non-volitional or involuntary, (4) not voluntarily possible and (5) followed by spontaneous amnesia. For convenience I will refer to this as the strict traditional view or understanding of what constitutes so-called hypnotic behavior. However, one should note that a somewhat less strict traditional view in which spontaneous amnesia has been essentially ignored has tended to dominate the twentieth-century conception of hypnotism.
However, it is possible to think of situations that satisfy these criteria that we might hesitate to call hypnotic. What is missing is the final criterion that the behavior in question is presumably brought about through the use of certain specific agents or procedures. In the case of de Puységur, it was a postulated magnetic influence. Later, with Braid, a special procedure of visual fixation. Still later, since Bernheim, it has been the use of suggestion. Because there is a strong overlap, indeed similarity, between the phenomenology elicited in these three instances, the tendency among most writers is to take the position that they involved one and the same thing. Possibly they did. But, without taking sides regarding its existence, let me point out that clairvoyance, for instance, was a widely reported spontaneous manifestation of the magnetic influence but has never been reported as spontaneously occurring with the use of suggestion or even being readily producible by suggestion. Could this be evidence we are not dealing with quite the same things here? Possibly. But leaving aside such exotic effects, whose existence is admittedly scientifically questionable, and leaving the elucidation of what a suggestion is until later, the rest of the phenomenology described by de Puységur and by Braid can essentially be duplicated through the use of suggest ion. At least sufficiently so that one can say one is most likely dealing with like if not identically the same effects. This has led most modern investigators to reduce all of the effects described in the earlier literature to the effects of suggestion. This has been essentially the twentieth-century position. But it must be emphasized this position remains based on a likelihood, not a certainty. Being able to produce an effect by one means does not preclude it also being producible by other means. Looked at from a practical standpoint, suggestion does appear to be the most effective way of producing most of the phenomenology in question and, if nothing else, this most likely has been a major influence in the predominant use of suggestion in the production of hypnotic phenomena in this century. Strictly speaking, they have been suggestion phenomena and this work is mainly about them, their production, nature, and uses. It is about the practice of suggestion more than about the practice of hypnosis. But as just seen, for historical reasons, it is also indirectly about hypnotic effects. Actually, it is also directly about hypnosis and its phenomenology because, if suggestions became the essential tool, hypnosis, the state, was retained as an important element, too, because of its potential enhancing action on the effects of suggestion, a matter to which we shall return in greater detail later.
Thus, while on scientific grounds hypnosis is not considered today to be responsible for the phenomena that have been associated with it in the past, it has remained a sufficiently important element that most uses of suggestion are preceded by an induction of hypnosis. As a reminder and recognition of this, I shall frequently and alternatively use the expressions hypnosuggestion and hypnosuggested in this work. To my knowledge there are no truly hypnotic phenomena, effects, or behaviors produced when using modern techniques and procedures for the production of so-called hypnotic phenomena. But for the sake of brevity and with no intention to denote anything different I will at times lapse back into the use of the qualificative hypnotic.
The traditional view of hypnotic behavior does not specifically relate it to suggestion and includes a subsequent, presumably spontaneous, amnesia associated with it. This amnesia is not a characteristic feature of suggested effects but is presumably one of the state of hypnosis, itself a suggested phenomenon. It should therefore not be a defining feature of hypnotic behavior as understood today. On the other hand, suggestion must now come into it. Thus, as seen in the context of the twentieth-century practice of hypnotism, and insofar as this work is concerned, we are led to now restate that hypnosuggested phenomena, the so-called hypnotic effects of the literature on hypnotism, are:
Otherwise natural behavior, consistently produced avolitionally by an individual, this behavior overall not being of a kind that one might otherwise expect from the individual, and being in response to communications made by another individual.
These communications have been technically spoken of as being suggestions. The qualification overall is used to recognize the fact that there usually are some elements of expected behaviors present.
Hypnosuggested effects are seen here as evolving in and out of a dyadic relationship. Some readers will unquestionably wonder where so-called "mass-" or "group-hypnotism" and "auto-" or "self-hypnotism" fit. Neither can be said to involve a dyadic relationship. Although the prefix hetero- is not restricted to dyads, where hypnotism is concerned, it has always been used to denote the use of hypnosuggestion in a dyad. We have been speaking of heterohypnotism and will continue mostly to do so. As for mass- and auto-hypnotism, we shall later see that they may be more apparent than real and that heterohypnotic phenomena are the rule.
Are the features of early hypnosuggested phenomena sufficient to account for the popular and scientific interest they generated? Probably not. Various sociohistorical factors have contributed to their interest, but that is a topic we will not address.
A FURTHER NOTE ON TERMINOLOGY
In light of what has been said, should we not just speak of suggestion and suggestion phenomena from here on? Not as long as hypnosis plays a part, even if it is only a suggested phenomenon. Furthermore, we shall have to refer to already well-established meaningful uses of the term hypnosis and various derivatives of it. We shall need to talk about such things as a person being hypnotized, of hypnotizability, of hypnotic depth, of hypnosis inductions, and so forth.
There is no question that terms such as hypnosis, hypnotism, and hypnotic are anachronisms. They are even inappropriate since those states of hypnosis that have been induced in this century and are discussed here have been shown not to have any semblance to sleep in any known form. But what other term can we use? Braid was one of the first to use trance as a synonym, and it has come into increasing use, especially by the Ericksonians, as a potential substitute. But this term has its own problems. It, too, has been a greatly overused term, and that which it denotes is vague and no better understood than what hypnosis refers to. There seems to be little to be gained by such a substitution. Furthermore, were a better designation available, would there be much use in offering it? The term hypnosis has a highly profitable mystique attached to it that even professionals would probably not want to give up. So hypnosis and its congeners are probably here to stay for a long time.
Even though all hypnotic phenomena are probably brought about by obvious and not so obvious suggestions, there are times when it is useful to distinguish between a suggestion given in the presence of hypnosis and one given in its absence. In such instances, one can speak of a hypnotic or preferably an intrahypnotic suggestion in distinction from a nonhypnotic one, often referred to as a waking suggestion. Posthypnotic suggestions are suggestions given during hypnosis to become effective after hypnosis is no longer present. Prehypnotic suggestions are suggestions given prior to an induction of hypnosis that are intended to become effective during hypnosis with this latter fact not being stated.
Last, the term subject often denotes a person producing hypnotic behavior whether an experimental subject or not. The expression subject/ patient will also be used when the person falls in both categories or if it is not clear which, with the word patient reserved for situations in which the person in question is known or expected to be nothing else but a patient. The terms hypnotist and operator will denote the person eliciting the hypnotic behavior or giving a suggestion. More rarely the terms suggestor and suggestee will be used to denote the operator and subject, respectively. In clinical situations, the terms therapist and hypnotherapist will often be used instead.
Other terms will be defined as needed.
MORE REGARDING SUGGESTION AND HYPNOSIS
Before discussing hypnosis and suggestion in detail, we will summarize some basic material.
Of Hypnosis Proper
For the time being let us simply say that hypnosis is a hypothesized, inferred artificial or induced altered, alternate state of consciousness that differs sufficiently from an individual's normal and natural state of consciousness to be said to represent an alteration of it or, probably more correctly, to be another state of consciousness (see Chapter 5). The early notion that it is an induced abnormal, "lucid" sleep has long been abandoned, but the label hypnosis reflecting this belief has been preserved. However, while hypnosis cannot be said to generally be sleep, it can be shaped to look and feel like sleep by the procedures that are used to bring it about or subsequently, when other procedures are used.
The notion of altered states of consciousness and variations of it is a very inclusive one that, among others, encompasses a large class of "trances." Hypnosis can probably be said to be a trance, but all trances are not hypnosis. There may actually be a number of trances that also qualify as hypnosis. That is, one should consider that " hypnosis" is a generic class name and that there may be a number of different hypnoses, not just one.
The exact nature of hypnosis remains a subject of great controversy, as Chapter 5 will make it clear.
Except for the fact that hypnosis is believed to appreciably increase a person's suggestibility, and there is evidence that it does so in at least a small way, it would, appear to be otherwise of little importance for the modern practice of hypnotism, more specifically, of suggestion. Clinicians, in particular, should take note that there is no evidence hypnosis per se has any special or unusual therapeutic effects. This is not to say, however, that the relaxation that often goes along with many inductions does not have beneficial effects, nor that a patient's belief that being hypnotized will be therapeutic will not be beneficial in its own right, but these are other matters. The notion that hypnosis has been or is used may in itself have a placebo action.
Too little is known regarding the hypnotic state to allow one to devise induction of hypnosis procedures from scratch with any certainty that they will work. For this reason, the general practice has reasonably been to use procedures that have been known to be most often associated with the production of hypnotic effects. This falling back on tradition is the only way of scientifically guaranteeing that a comparable state will be produced, if any state at all comes about. But using an accepted induction procedure is no guarantee the state will occur and hypnotists in general fall back on various agreed-upon signs of hypnosis to decide whether or not a hypnotic state has been attained. As we shall see, these signs unfortunately are by no means sure things.
Not every one can be hypnotized. Those who can are said, on the basis of their suggestibility, to attain various degrees or depths of hypnosis. Inferring from this last that people vary in their capacity to become hypnotized, it has become customary to refer here to their "hypnotizability" and "hypnotic susceptibility." Depth of hypnosis, it should be added, although much referred to, is a rather ambiguous, fuzzy, and complex notion that will be discussed in detail in Chapter 6 with the other terms just listed. At that time we shall look at various psychological instruments that are said to measure depth and other, related, aspects of hypnosis.
Hypnosis was once considered to be the cause of its associated phenomena and, in particular, of the suggestibility shown by hypnotized individuals. This notion was eventually discarded to be replaced by the belief that hypnosis causes a remarkable increase in an already present suggestibility. Clark L. Hull (1933) was the first to show in the laboratory that an induction of hypnosis does bring about a rather limited increase in suggestibility not commensurate by far with past beliefs. However, this demonstration by Hull and that of later researchers is far from being conclusive regarding the extent of the increase and it seems probable that large increases are possible, but only in a limited number of individuals (see Chapter 6).
Of Suggestion Proper
In the contemporary literature on hypnotism, the term suggest ion usually denotes those statements that are made by the hypnotist to a subject and that appear to have a direct causal relationship to the ensuing responses of the subject. These statements often seem to take the form of instruction or commands or to be a mixture of both. But they may take other forms, such as being a question or a simple assertion. Thus, the hypnotist may ask the subject, "Do you see that blue vase on your right?" or "It is getting cold." According to some hypnotists, stories and metaphors can function as suggestions. In such cases, there is often no clear connection between what is said and what happens. While suggestions consist more often of verbal material, the literature also recognizes suggestions of a nonverbal nature. Whether verbal or nonverbal, suggestions are communications. But not all communications used in the context of hypnotism can be considered to be suggestions. For these to be so denoted, they must at the very least cause avolitional responses. That is, the elicited responses must be automatic, reflexlike, with no participation of the subject's will in their production. For this reason they are often referred to as being automatisms. This kind of communication is also said to be a suggestion in the technical sense in distinction to other, dictionary, meanings of the word "suggestion." There is somewhat more to the precise technical definition of a suggestion (Chapter 3), but this will do for the time being. Being avolitional does not necessarily mean the subject is not conscious of the suggestion having been made or of the action it has triggered.
There are many ways of classifying suggestions. We have already noted some of these and will add here two more kinds: direct and indirect. The former are clear, explicit statements of whatever is to happen. The latter nowadays are usually implicit statements of the same. As will later be seen, there are other kinds of indirect suggestions.
Whatever kind of suggestion a communication is, it is important to understand that the intent one may have that it function as a suggestion does not guarantee that it will. There is no way of knowing this a priori.
People vary in their capacity to respond to suggestion. This is usually referred to as their suggestibility. There are ways of measuring suggestibility (see Chapter 3). Actually what is usually directly measured is "suggestion responsiveness," as distinguished from suggestibility, a fact rarely recognized by researchers.
There is a general belief that the more suggestible a person is the more hypnotizable they are. This is a reasonable inference to make but this is not a well-demonstrated fact (see Chapter 6). At least the relationship is not that clear. One should really distinguish here between hypnotic responsiveness and hypnosis capacity, but we can leave it at that for the time being.
The term suggestion is actually used in the literature, as it will be in this work, to denote both an object and a process. This is exemplified by the fact that, on the one hand, one gives a suggestion, but on the other hand, we use suggestion to bring about a certain effect.
THREE FACES OF HYPNOTISM: TRADITIONAL, SEMI-TRADITIONAL (SCIENTIFIC), AND ERICKSONIAN (NONTRADITIONAL)
Today we hear a great deal about the fundamental differences between the Ericksonian view and the practice of hypnotism by traditional hypnotists. Leaving the detailed discussion of the Ericksonian view and practice to other chapters, I want to point out that the term traditional has been used by the Ericksonians in such a way that two quite different practices of hypnotism have been confounded by inappropriately placing them under this common label of traditional. It is the purpose of this section to clarify the matter.
According to dictionaries, traditional is a term that denotes beliefs and practices that have been handed down by word of mouth and by examples from generations to generations, and acted upon without concern about their reliability or truth-value.
There is indeed a view and practice of hypnotism that can be said to be traditional in this dictionary sense. I prefer to call it popular. It is that which has been perpetuated by stage hypnotists, lay practitioners, dilettante hypnotists, novelists, movies, tabloids, and various fringe groups or individuals who have too readily taken fiction and myths to be fact. And, unfortunately, it is also the case that a fair number of past and even current academically trained practitioners (psychologists, dentists, physicians, and, more recently, nurses and social workers) have incorporated many of the lores of tradition in their understanding and practice of hypnotism.
There is no question that when the Ericksonians use the term traditional they have had the above group in mind. But it is also clear that the main criteria used relegates and hides under this label a view and practice of hypnotism and a most important group of individuals who can hardly be said to be "traditional" in the dictionary sense. In my opinion, they constitute a separate group that I have in the past designated as being "semi-traditional" but which I feel are better designated as being semi-traditional/scientific. I particularly have in mind here possibly a hundred men and a few women in America including Lewis R. Wolberg, Harold Lindner, Frederick M. Marcuse, Milton V. Kline, Jerome M. Schneck, Herbert Spiegel, Leslie M. LeCron, Edith Klemperer, Merton Gill, Frank A. Pattie, Roy M. Dorcus, Jacob H. Conn, Bernard B. Raginsky, George Estabrooks, David Cheek, John G. Watkins, Clarence Leuba, William H. Kroger, Margarette Brenman, myself, and others, and including at one time Milton H. Erickson. These people have been the unquestionable recognized leading American scientific authorities on hypnotism during the first half of this century. Those listed include the founders of the Society for Clinical and Experimental Hypnosis and all were among the select group of its early members. Many were clinicians, some were researchers, and some both. If these people were "traditional," they certainly were far from being so in the dictionary sense of the word for each one of them had a concern for the truth value and the reliability of what they believed and practiced, although not all to the same degree. Not a few of these have passed on or retired, but a small number of new semi-traditionalists have replaced them and this particular group continues to exist spear-heading scientific hypnotism.
How did this group come to be inaccurately labeled "traditional" by the Ericksonians? According to the Ericksonians, irrespective of whether or not a hypnotist meets the criteria set by the dictionary definition, he is "traditional" if he does any number of the followings (See for instance Yapko, 1984):
- He (predominantly) uses "formal inductions" of hypnosis.
- He (predominantly) uses "direct suggestions."
- He takes the position that not everyone can be hypnotized.
- He inflexibly follows set rules and patters. (This is often compared to going strictly by a formula or cooking recipe and reciting litanies.)
- He is (predominantly) authoritarian in his use of hypnotism.
- Clinical hypnotism boils down for him to commanding symptom away.
Although not altogether true of all those practitioners of hypnotism who fall under the dictionary definition of traditional, this list generally applies to them, and results from their strictly going by tradition.
In the case of the semi-traditionalist, the story is somewhat different. Symptom removal (No. 6) has never been a major therapeutic intervention for the majority. Removing symptoms was a very controversial issue among them with many considering it strictly taboo. Others have seen it only as one among possible types of intervention to be judiciously used.
There is no question that 1, 2, and 3 in the list are applicable to the groups of practitioners I have mentioned, but they do not necessarily act so because of tradition.
Keeping in mind that twentieth-century hypnotism is founded upon Bernheim's views and practices, that there have been no reasons for wanting to produce any other condition, and not knowing of any better way to do so, what better way is there of insuring that one is producing the same condition of hypnosis as Bernheim did than by using his induction method or a similar one?
Next, regarding direct suggestions, contrary to Erickson who came to see the subject's "conscious" as the main source of potential resistance to inductions and to suggestions, those men and women I have mentioned and later semi-traditionalists have seen the source of potential resistance as mainly residing at some nonconscious level of mental functioning. There has thus been no need for them to try to circumvent or trick the conscious mind of the subject by using indirect means of communication, as Erickson later felt he needed to do (Chapter 3). Additionally, with direct suggestions being highly explicit, there is far less question regarding what is communicated to the subject than with indirect suggestions and far less question as to what will result or regarding what does happen. This has been an important feature for many of the clinical applications made by the semi-traditionalists, as well as for the proper standardization of experimental procedures.
As for Item 3, it is simply a matter of taking into account an undeniable, scientifically established fact that holds for the use of direct suggestions and formal inductions. Not everyone responds equally well to suggestions. Magnetizers, including de Puységur, were aware of this, likewise Braid and his followers, and so on down the line.
Regarding Item 4, there are really two distinct matters to consider. One is that of "patter." I do not know of any semi-traditional hypnotist that has ever told students in writings or otherwise that they had to do and speak exactly as they did or who believe that there is only one way to produce various hypnotic phenomena. But by experience, hypnotists find that for certain situations there is a sequence of steps, of words, of sentences, that works best, and it is not only natural but common sense to generally start out by doing what one has found to work best. I have found that most thoughtful, experienced, even truly traditional hypnotists, who have anything but a scientific outlook on hypnotism, do not completely stick to a fixed "patter " as the Ericksonians claim. The other "inflexibility" referred to has little to do with the way hypnotism per se is perceived or practiced by semi-traditional workers. In the clinical area, a careful examination shows inflexibility to be closely related to the nature of the therapeutic framework in which hypnotism is being used and to how it is being used in it. For instance, Joseph Wolpe, who actually made only incidental use of hypnotism in his therapeutic use of reciprocal inhibition, provides a good example of the kind of restrictions a particular therapeutic approach can impose upon hypnotic procedures. It is inflexibly used to produce relaxation. On the other hand, a reading of Volume II of Wolberg's Medical Hypnotism provides edifying material in regard to this apparent inflexibility which clearly is related to the nonhypnotic portions of the therapy. In the case of research, the very nature of this activity also demands inflexibility; keeping certain variables constant is essential while others must be varied in a highly controlled manner. The need for standardization is further cause of inflexibility.
Items 5 and 6 are often combined. As for being authoritarian in their approach to hypnotism, my impression is this has varied greatly with the practitioners involved. The fact that many of them have been physicians may have been an influence here. I suspect, too, that the nature of the relationship implicit in the hypnotic context may attract authoritarian individuals to the use of hypnosuggestion and incite others to unnecessarily act in an authoritarian manner.
Last, I would make two points. One, tradition and science both start with like observations and with the same truths about nature. There must of necessity be a sharing and overlap between the two. Tradition is bound to contain some truths and should thus not altogether be rejected! Second, without attempting to develop the matter further, I would remark that common sense and the scientific approach probably have a lot in common. The semi-traditional view is thus as much a common sense as a scientific one. Not every member of the semi-traditional group has carefully scientifically reasoned his or her approach to hypnosuggestion and its uses. Some people have a naturally scientific mind and others acquire one through experience and training. In either case, common sense leads them to perform scientifically viable actions as well as to the use of scientific methodology.
In brief, a number of men and women who have been labeled "traditional" hypnotists have appeared to be so, not because of being blind followers of tradition but, for the most part, because of their scientific or common sense approach to hypnotism. But even if the reverse were the case, it would not follow that they also espoused all of the unfounded traditional lore pertaining to hypnotism. This has been, also directly and indirectly, wrongly attributed to them by the Ericksonians (Yapko, 1984; Zeig, 1990). This is not to say that none have held or hold notions now fully outmoded, but certain facts available to writers such as Yapko and Zeig have not always been available to the group of individuals we are talking about. Far from espousing a traditional (dictionary sense) view and practice of hypnotism, they have practiced a scientifically founded one to the best of their ability and knowledge. They do use features belonging to tradition, but for good scientifically valid reasons, not because of tradition. It is for this reason I have used the qualifications "semi-traditional" and "scientific" in relation to them as well as in relation to the core material of the present work.
If "scientific" and "semi-traditional" are essentially synonymous in this book, and traditional not, where do the Ericksonian and other nontraditional approaches fit in? I regret to say they appear to be on a par with the traditional (dictionary sense) approach! There is very little science in them. Evidence in support of this latter claim will be presented when we examine the Ericksonian views and methods in later chapters.
In general I prefer to speak of the traditional, semi-traditional, scientific, Ericksonian, and nontraditional "approach" than of a traditional, Ericksonian, and so on, "hypnotism," "hypnotherapy." The reason is that the basic substratum is more or less the same, but the way of viewing and using it differs.
Last, my concern here has been solely with pointing out that there is a semi-traditional/scientific approach that is neither traditional or Ericksonian. The question of the relative superiority or inferiority of one approach with respect to others, especially at the clinical level, has not been an issue. I leave this matter to later chapters.
In writing this work, I have aimed at presenting the scientific facts of hypnotism and thereby also its fictions and lores. But scientific "truths" are relative, not absolute. Some are more reliable than others and truth-values vary for various reasons. Throughout this work, I have made many judgments in these regards, possibly erroneous ones, and I believe readers are entitled to, indeed, should know what are some of the considerations that have guided me. I hope they will want to know; a healthy skepticism is required for a proper scientific approach to any subject matter. One can be overskeptical, most people are not enough so. The most productive scientific approach is, in my opinion, one based on that which Humes called "mitigated skepticism" (Fogelin, 1985; Passmore, 1980), a sort of Buddhistic middle path. But also it has been my hope to promote a more scientific approach to the subject of this work and to guide present and future researchers toward doing more productive research in the area. This can best be done by insuring that each reader has access to a modicum of the basics of science. This is particularly important because there has been clear evidence, at least at this writing, that a majority of otherwise well-educated Americans are poorly trained in the sciences (including mathematics), this being particularly true of the many persons going into the mental health fields. 2 But it is also my impression that increasingly those going into psychological research, and in particular the research on hypnosuggested effects, are poorly prepared for doing truly productive scientific work. This is not intended to belittle any of my colleagues. As will be developed in Part Two, knowing the facts of hypnotism is fundamental to its proper applications. I offer here a limited sketch of what science is all about. Admittedly it is a personal view, but one that I think I share with many properly trained scientists.
There will be some readers who will feel this is superfluous material. Undoubtedly it will be for them if their training has included a solid grounding in the basic sciences, or scientific methodology. They can readily skip this section.
Why this emphasis on a scientific approach? It is because the scientific method, which in many instances, is just good plain common sense (Wartofsky, 1968), has been found thus far to be the best available method, certainly the most suitable, for the acquisition of useful, effective knowledge. For proof of this last assertion, look around and view the multitude of benefits applied science has provided. These are in the thousands. True, science has had its dark side, but not because it inherently has one, but because of humanity's frailties.
We can never know with any certainty what the ultimate realities of our world are, but is does appear that through the scientific approach we can approach a highly practical knowledge of this reality, one that allows us to interact with it in a beneficial manner. This has at least been well demonstrated with respect to the physical world. There is no reason to believe that the same cannot and should not hold true with respect to the world of behavior, inclusive of suggested phenomena. Besides, what better alternatives do we have?
In general, each science consists of a "pure" and an "applied" branch. An applied branch can be defined as the methodical, reasoned application within the context of the scientific method of the facts and principles of the corresponding pure branch to the control of our world. Clinical practice is fundamentally the applied branch of the science of health. In view of the success of the applied branches of other sciences, should we not seriously consider an applied branch for the science of health along the lines of the definition just given? Should that not then be what we as "clinicians" should practice? Can any psychotherapist seriously consider carrying out her work without giving due consideration to those scientifically established facts that pertain to her practice? But to do so requires being able to properly evaluate and apply the available reported facts, hence having some understanding of the scientific method. There are "facts" and then there are "facts." Some are not really facts, but suppositions that are mistaken as facts, and some are pure fiction. Unfortunately, and I shall not go into reasons why this is so, even available "scientific" information varies in quality. It behooves any one using such data, especially where this use affects others, to be prepared to evaluate it before using it. There is an amazing amount of nonsense that has been and continues to be peddled in all areas of knowledge and, particularly, in the health sciences by so-called "authorities." Hypnotism has had, currently has, and most likely will continue to have its share of such nonsense. I believe the reader is better off if she has an idea of the basis on which opinions are being stated and has an opportunity to decide whether or not to accept them. By doing this, it is this writer's hope that readers will have a better, productive understanding of the scientific method and make better use of it.
Facts and Their Place in Scientific Knowledge
If we always went by dictionary definitions, we would all understand the word fact denotes "that which is true and reality." To be precise, let us refer to these as facts proper or p-facts. Hereafter, unless otherwise indicated, the unqualified word fact will denote a p-fact. More specifically, we are going to be concerned with empirical facts, facts that have to do with the world we live in, hence of us, too, as a part of that world.
If this were a philosophical work we would go on and ask what is "reality"? What is "truth"? This not being the case as well as space limitations force me to take these notions as the undefined terms of this universe of discourse. Besides, truth or reality is an ideal and ultimately unknowable. That is, for most of us no bell rings to let us know when we have hit upon the truth. I do believe, however, that we can converge on it using the proper method of inquiry and at least get in the position where we can say "most probably this or that is . . ." This method of inquiry has been called the scientific method and its use has been best exemplified by the physical sciences. Being "true" and "most probable" I will take as synonymous.
Some facts, more precisely their truth, are self-evident. For example, everyone is not of the same height, in the Western hemisphere the sun always rises on the East, a rock held aloft always falls to the ground when released, men and women are anatomically different, and so on. Other facts require some degree of verification before we can actually say they are facts. At best we can say they are alleged facts or a-facts. Verification can be simple, it can also be extremely complex and difficult. The scientific method provides all sorts of ways of doing so. An alleged fact that is shown to be untrue, that is, false, falls in the class of fiction. One can never establish in an absolute way that an a-fact is false, but one can establish that it is most likely to be so just as, at best, we can only say that a p-fact is most probable. Scientifically speaking, what is accepted as a p-fact is never more than an a-fact that is considered well established or "proven." Conveniently then we can also take the "p" in p-fact as also standing for proven.
Alleged empirical facts originate in two ways. They can be observed and they can be inferred. Speaking broadly, scientific and traditional knowledge begin with observations. The raw, primitive data of observations are sense impressions. Observations are elaborations of these sense impressions as they are interpreted, hence perceived. How this last process takes place is still largely a matter of speculation. A typical observation, relevant to this work, for instance, might be that some communications elicit from some people behavior they report as having taken place of its own, that they did not (willfully) bring about. Another related observation would be that other individuals report they consciously and deliberately produced the behavior. From this then arises the further observation that there are in this regard at least two classes of individuals as well as two kinds of experienced behaviors. Another observation might be that of the existence of communications to the members of these two classes of individuals to which they all claim to respond volitionally. This new observation now serves as part of a basis for a classification of communications into those that evoke nonvoluntary and voluntary behavior. Observation and classification are the initial building blocks out of which any scientific enterprise grows. Observations may be of objects, events, the properties of objects, or relations that exist between objects and objects, events and events, and objects and events. One such relation is that of cause-and-effect.
Causality is both observed and inferred. It has been a topic of much discussion. Causality denotes an inferred relationship between events based upon a temporal observation: namely that a certain event, B, never occurs unless some other event, A, occurs first. Then it is agreed to say that A caused B. Like facts, causality is more or less probable and at best only denotes the if-and-only-if character of a certain temporal sequence.
Among important observations that can be made is that of regularities. These are the basis of what are known as scientific laws or principles.
Reliability and validity are two notions that frequently are confused. I prefer to reserve reliability for people who observe and infer and validity for the observations and inferences. Observers are more or less reliable, observations are more or less valid. The reliability of the observer is one of the factors considered in deciding on the validity of an observation. Establishing the validity, or more correctly the degree of validity of an observation is one of the important jobs of the scientific method. A fact is an observation that has been adequately validated. The truth-value of an accepted fact can change over time.
Validity and reliability as used in the present context should not be confused with the like-sounding concepts used in the domain of psychometrics (see Chapter 6).
From observations, we infer things about the world, that is, we arrive at the notion of the existence of other as yet unobserved a-facts and possibly never to be directly observed. These are hypothetical facts or h-facts, or simply hypotheses. There are two process through which this is done: deduction and induction. The first goes from the general to the particular, the other from the particular to the general. Hypotheses as used here should not be confused with the notion of a statistical or null hypothesis.
There are proper and improper ways of making inferences. Improperly deriving inferences leads to fallacies, of which not a few are to be found in the domain of the behavioral and social sciences, particularly hypnotism. It is beyond the scope of this chapter to go into details but I would call attention, in particular, to the specious use of analogy as a proof of identity. Thus, for instance, Ernest Rossi (Erickson, Rossi, & Rossi, 1976; Rossi & Lippincott, 1992) is in the habit of drawing up parallel tables in which he lines up somewhat similar sounding statements that can be made about two processes, events, and so on, and inferring from this that the latter are the same. In this way, he has "demonstrated" that there is a "therapeutic bind" that is a Batesonian "double-bind," and more recently that Milton Erickson's so-called "common everyday trance" is a part of the ultradian biological rhythms that control our daily lives. The trouble is that such tables prove nothing. By the same process one can prove, for instance, that the moon is a body that emits cold light, whereas the sun emits hot light.
Hypotheses and Theories
Observations are often followed by interpretations. There seems to be a need in many of us to go beyond mere observations.
Considering how basic theories are to science, it is remarkable how difficult it is to find a concise definition of what they are. One definition of theory that I have found to be fairly satisfactory is:
A formulation of apparent relationships or underlying principles of certain observed phenomena which has been verified to some degree. (Webster New World Dictionary, 1988)
Roughly, a hypothesis is a testable interpretation. To paraphrase Runes (1962), a hypothesis, more specifically, is a principle offered as a conditional explanation of a fact or a group of facts. It is a provisional assumption used as a guide in making observations and experiments until verified or disproved by subsequent evidence. Once adequately verified it becomes a theory or part of one.
A hypothesis is not just an arbitrary opinion, just a shot in the dark, but always has some foundation in facts and hence some justification for being made. This is most likely what is in mind when it is said that a hypothesis is an educated guess. One can distinguish different kinds of hypotheses. One distinction is between a working hypothesis and a scientific hypothesis. The latter should meet the following criteria:
- It must be formulated, a posteriori, after one has made the observations it is intended to explain.
- It should be founded on well-proven facts.
- It must be congruent with established theories.
- It must be reasonable and relevant.
- It must be fruitful in its applications and controllable.
- It must be general in terms and more fundamental than the statements it has to explain.
A working hypothesis is one that is formulated on a tentative, provisional basis to be used as a guide until a better, scientific hypothesis can be stated. It is still expected to meet some or all of the above criteria but to an appreciably lesser degree.
Among other things, hypotheses can be descriptive and explanatory. There are other classifications into which we need not go.
A theory can be a single verified hypothesis but more often is a group of these put together into a meaningful whole. In the latter case, the way the constituent hypotheses go together is itself a hypothesis.
Theories are essentially symbolic (linguistic, mathematical, etc.) models of various aspects of reality that have been shown to fit this reality to some degree.
Like p-facts, the extent to which a theory is verified can vary appreciably.
The natural course of any scientific inquiry begins with observations, moves on to hypotheses regarding some or all of them and then on to theories. To be acceptable as such, a scientific theory should be able to postdict, describe, and predict. That is, it should be able to account for past observations, for what is currently being observed, and foretell future observations. It should be able to do this in relatively fine detail. None of the so-called theories of hypnosis satisfy the above criteria to any extent. At best so-called theories of hypnosis are still hypotheses and are theories only in name. The term theory is often popularly used to refer to speculations and, yes, in that sense one does have theories of hypnosuggested behavior. A further weakness of these alleged theories is that they too often depend upon the concurrent use of weak theories borrowed from the behavioral and social sciences regarding other phenomena and which, themselves, are most often not much more than elaborate hypotheses, too.
Readers should be cautioned against a common mistake that is made by even well-trained professionals. This is to act on theories and especially hypotheses as if they were well established observed facts. Closely related to this is the error of confounding interpretations and inferences with observations. For instance, there is a common mistake made of confusing observed evidence of suggestibility as observed evidence of hypnotizability (Chapter 6). And again, as Clark Hull (1933) repeatedly did, interpreting a simple suggested closure of the eyelids as a sign of hypnosis having been induced.
The Scientific Method
The scientific method is simply a set of rules and procedures for gathering, analyzing, and utilizing those observations that we make of our world and ourselves. Many are obvious, others follow logically, and still others have evolved, probably largely by trial-and-error. Initially, the evolution of the method probably came out of humanity's efforts to survive and find comfort in a not always friendly environment. But it may also have grown out of what may be an innate human need to simply know and understand and the recognition that such knowing and understanding leads to a useful control of nature. It probably has some close relation to the problem-solving ability that is found in higher organisms and is found in its most evolved form in humans.
No attempt will be made in these pages to systematically detail the method. This alone would fill a large book and there already are plenty of these to which interested readers can go for more details (Carnap, 1938; Hempel, 1952; Wartofsky, 1968). Various elements of the scientific method have already been exemplified in previous pages and will continue to be shown in future pages. Much of it is really just plain common sense. Common sense can be seen as a precursor of the scientific method. It might be said to be its anlage, a German term that has been fruitfully used by embryologists.
I would, however, say a few words regarding "Occam's razor," also known as the law of parsimony, the latter having been put to great use by a certain group of investigators and theorists known as cognitive-behaviorists and sociocognitivists (see Chapter 3). This law states that the best explanation of an event is the one that is the simplest, using the fewer assumptions or hypotheses. This statement should be preceded by the words "All other things considered. . . " For who would deny that explaining will-o-the wisps as spirit manifestations is by far simpler and requires less hypotheses than that based on the production of marsh gases which is nevertheless the explanation that is now accepted. The principle of parsimony is nothing more than one of a number of rules that can and should be used in coming to scientific conclusions. It is rarely used alone and is best used in conjunction with the use of other like rules.
The possibility of replications, consistency of occurrence, repeatability, and having consensual validation are all among so-called rules or conditions that make up the scientific method. I shall not elaborate further on these.
How simple it is to apply the scientific method in an everyday situation is nicely demonstrated by the following example in which it actually was not used. Not too long ago one of my students preparing herself for a clinical career enthusiastically reported to me on her first and premature attempt to do hypnotherapy. Her account ran something like this: Her adult son had come down with the flu and was having bouts of diarrhea and vomiting. Even though he did not believe it would help him, he allowed her to "hypnotize" him. Apparently he is not a particularly suggestible person and the induction consisted simply in suggesting relaxation followed by suggesting the symptoms would cease. According to her, the diarrhea and vomiting miraculously stopped and so did the flu. Her conclusion: Hypnosis really worked! But let us examine the facts more closely using a little common sense and some knowledge about hypnotic effects.
To begin, we have reasons to doubt there was a miraculous alleviation of even the symptoms by hypnosuggestion for two reasons. First, it has been reasonably well-established by research that control of diarrhea and vomiting by suggestion or hypnosis alone is most unlikely (Weitzenhoffer, 1953). Second, to the extent it might be possible to do so it would require a degree of suggestibility that the man apparently did not have. Furthermore as far as hypnosis having had anything to do with the alleged results, there is no evidence the man was in a hypnotic state! Still this writer has no reason to question the observation that there was a relatively abrupt cessation of the symptoms. Is there a more reasonable alternative explanation? I think so. Did the son have the flu or simply a so-called 24-hour "bug"? This last seems likely inasmuch as, (1) the student had no medical training and making a differential diagnosis is not in her repertoire, (2) diarrhea and vomiting are not typical of true cases of the flu, and (3) other typical symptoms of flu (fever, chills, muscular aches, etc.) were absent. Conclusion: The attempted hypnotic treatment most likely had nothing to do with the outcome of the illness. It follows simply and naturally from the application of two bits of knowledge that any clinicians using hypnosuggestion should have. But even lacking the first bit, common everyday knowledge about flu symptoms and other virus infections should have guided my student to consider the experience as being by no means a clear demonstration of the power of suggestion over the flu.
The above is a common sense approach anyone can take to a situation like this. It also happens to be an application of the scientific method. To do this requires neither laboratory, fancy apparatus, nor complex statistical designs or analysis. It does, however, require wanting to know the truth and being willing to make the necessary effort to do so.
Another example I might give is that of a leading practitioner and teacher who accepted without question and used in a textbook the following tale borrowed from a reporter to show the "power " of suggestion, really "autosuggestion" in this case. According to the account, during quite balmy weather, a man accidentally became locked up in a refrigerator train car that was not in operation. The tale goes on to say that a few days later, the man was discovered dead with his body frozen solid! I do not think I need to go into details regarding the many failures that were made here in applying the scientific method. This tale became part of a fairly widely circulated work in French for professionals and I shudder at the thought of how many readers have gone on perpetuating this outrageous bit of obvious fiction.
We shall detail the nature of measurement in Chapter 6. Here we will mainly look at the place of and reason for measurement in science. A burgeoning science usually starts out as a qualitative science and, as such, has limited capacity for evolving. For a fuller evolution, quantification is a requirement. Measurement can be defined as consisting of an assignment of numbers to instances, that is, occurrences of the attributes of objects and events, in such a way that there exists a correspondence between some properties of the assigned numbers and some properties of the associated occurrences. In its most perfect known form measurement creates a unique assignment in which all properties of numbers have a unique correspondence in the properties of the associated instances and vice versa. This is the case for physical measurements such as those of length and weight. In turn, the existence of such a correspondence allows scientists to model, that is, represent various natural occurrences, especially, relations with mathematical expressions.
To the extent that it can be done, one advantage of being able to do this modeling is that it provides an effective way to check how well a theory postdicts, describes, and predicts. Another advantage is that by manipulating these derived mathematical expressions and by making use of various existing mathematical theorems, one can bring to light as yet undiscovered features relating to the measured objects as well as verify laws applying to them. It is in this manner, for instance, that the potential existence of positrons was first brought to light. Actually they had been observed, at least signs of them had, but no one had recognized them for what they were. And again, it can thus be shown that the hypotenuse of a right triangle, which usually appears to be bigger than either of the other sides is indeed always bigger. Another advantage in having these mathematical models is that when it is not feasible to study directly a certain situation to which a given mathematical expression applies, one can often study it indirectly by working with a more accessible situation (an analog) to which this mathematical expression also applies. Small-scale models of say an airplane can thus be used to study how the full-sized machine will behave. Due to the unavailability of the necessary electronic devices and as a student engineer in the early 1940s, this writer learned many things about the behavior of microwaves (radar) using acoustic pipes and sound waves. This was possible because some of the behavior of sound waves and microwaves are represented by the same mathematical expressions. Last, there are the obvious practical applications. Knowing all the other measurement values that enter into a mathematical expression that represents a concrete situation, one is able to calculate one that is as yet unknown. Thus having ready access to certain measurable quantities, a surveyor can calculate the otherwise directly unmeasurable height of a mountain.
In the case of hypnotic behavior, as has been the case for behavior in general, the measurements that thus far it has been possible to make have unfortunately been very limited and hence of limited value and use (see Chapter 6). That is, few of the properties on numbers can be used with them and useful mathematical representations have been essentially impossible.
Mathematical Representations, Modeling, and Mathematical Theories
The use of statistical formulas for the analysis of data represents a use of mathematics quite different from its use for modeling referred to in the previous section. Such a use does not constitute mathematical representations. There do, however, exist statistical models for certain behaviors that can be said to be mathematical representations. This is because they express intrinsic statistical properties possessed by the phenomena being observed and not something about data collection or the accuracy of the data.
In the earlier discussion, numerical representations, including those using numerical variables, were the only ones considered. There are many other mathematical entities beside numbers, such as vectors, tensors, spinors, groups, and so forth, with properties both analogous to but also different than those of numbers, that can be used to represent objects and events. The rules of assignment are essentially the same as were given for numbers. They have been quite useful in the mathematical representation of physical events and possibly have something to offer for the mathematical description of behavior although thus far this has not been the case. Attempts of this sort were made by the psychologist Kurt Lewin and his students and followers in the 1930s using concepts borrowed from vector theory and from topology. It led nowhere largely because these concepts were simply not applicable to the situations in question except in a very superficial and elementary way, a fact not recognized by Lewin whose mathematical training was quite inadequate for this kind of work. Some later advocates of Lewin's ideas, with no better training in mathematics, have tried to salvage these ideas with a totally unfounded reinterpretation of Lewin's vector and topological "theory" as really being a "metamathematical" theory. There is, indeed, a branch of logic known as meta-mathematics, but this is definitely not it.
Generally speaking, most behavioral and social scientists have a far too limited knowledge of mathematics to properly and productively use it in the study of behavior. Such knowledge they have is usually limited to basic algebra, routine curve fitting, and uses of more and more complex statistical methods, increasingly with the aid of appropriate software, and with less and less understanding of even the mathematics involved. There are many fundamental and relatively elementary mathematical facts of which they are greatly ignorant. As a consequence, when they try to go beyond this knowledge, they frequently, like Lewin, end up with impressive but misleading, often useless, meaningless results. Clark Hull's (1943) attempt to derive a calculus for habit strength is another good example of misapplied mathematical concepts that led to a misleading picture of the properties of habit strength. It may also have prevented Hull from anticipating W. K. Estes's statistical theory of learning, for he did not recognize the statistical implications of his addition rule for habit strengths.
A word regarding so-called "mathematical theories." In the domain of applied mathematics which is the only one we are concerned with here, a mathematical theory is merely a theory about nonmathematical entities that can be and is extensively expressed in mathematical terms. There are many advantages to being able to do so, which we cannot and need not go. Merely being able to broadly allude to a certain type of functional relation or even to refer to a potentially applicable mathematical expression is insufficient ground for speaking of the availability of a mathematical theory as, for instance, Ernest Rossi (1996) has recently done in connection with so-called " therapeutic hypnosis."
The Uses and Abuses of Statistics
There have been many outrageous abuses of the use of statistics that are so well-known that I need not take them up. My greater concern here is with the extreme use that statistics have been put to provide a false validation of social and behavioral research, hence, in particular, of hypnotism research. I can do no better here than to quote Lakatos (1970, p. 178) on the matter:
After reading Meehl (1967) and Lykken (1968), one wonders whether the function of statistical techniques in the social sciences is not primarily to provide a machinery for producing phony corroborations and thereby a semblance of "scientific progress" where, in fact, there is nothing but an increase in pseudo-intellectual garbage.
Three of the most widely misused statistical devices have been correlations, factor analysis, and tests of significance, especially in relation to the null hypothesis. 3 I will leave the fuller discussion of correlations and factor analysis to Chapter 6. Regarding statistical significance I would repeat here a quote taken from Lykken by Lakatos (1970):
Statistical significance [in psychology] is perhaps the least important attribute of a good experiment; it is never a sufficient condition for claiming that a theory has been usefully corroborated, that a meaningful empirical fact has been established, or that an experimental report ought to be published. (p. 178)
And to quote from Carver (1978):
In conclusion, a statistically significant result can be a trivial result: it should never be referred to as a "significant " result. A statistically significant result erroneously suggests that the probability is low that the result was caused by chance, and that the probability is high that the result is reliable, valid and important. Even without the fanciful interpretations, statistical significance testing usually involves a serious breach of the scientific method; therefore it is more accurate to say that statistical significance testing uses a corrupt form of the scientific method. (p. 307)
How trivial a statistically significant difference can be is nicely shown by the following. The difference between the average hypnotizability of men and women that favors women has consistently but never done better than approach the 5% level of statistical significance. With a properly done meta-analysis, it probably would at least reach this level. But the difference is of only a few points and this has certainly no practical significance. And considering the nature of the scales that have been used to obtain these results (Chapter 6) it is rather unlikely that it has any theoretical import either.
Inasmuch as we will have occasions to refer to correlations before (Chapter 6) where they are more fully treated, the following preliminary observations will be made. As most readers will know, conventional correlations have a number of interpretations. One of the most important and widely used is that of being a measure of the degree or strength of association that exists between two variables, or the degree to which one variable (dependent) depends upon the other (independent). Many investigators accept any correlation as having concrete significance, however small it may be, as long as it is statistically significant at least at the 5% level. Leaving the reasons for saying so until later, it is this writer's opinion that any Pearson correlation less than .80 approaches triviality. Correlational studies abound in the domain of hypnotism research, but most reported correlations relating to matters such as suggestibility and hypnotizability are usually well below .50 and thus might as well not be reported. They essentially tell us nothing of great utility. By the same token, the results of many factor analyses, another widely used tool by hypnotism researchers, are questionable for the simple reason of their dependence on correlations that frequently are much too small to be anything but trivial.
But there is more. I have several times qualified the term correlations with the word "conventional." By this I mean correlations as discussed in standard textbooks. As will be shown in Chapter 6, there are serious reasons for questioning the ability of such numbers as Pearson correlation coefficients to accurately reflect, no matter how large they are, the so-called "strength" of relationships between variables. It is the Pearson regression coefficient that can best do this, that is, when it can. This last may be infrequent because of the usually unjustified assumption of a linear relationship that goes with its calculation. The consequences of these observations for factor analyses are obvious.
Of the many measurements one might make of an object of discourse, some hold a special place as its basic or fundamental or primary dimensions. For instance, for a cylindrical body this could be its height and radius. These are particularly important for its mathematical representation. One of the great weaknesses of factor analysis is that the factors that are extracted rarely coincide with such dimensions and from this standpoint are relatively meaningless. Thus, when Thurstone (1947) did his famous factor analysis of a set of cylinders, he ended up with four characterizing factors: thickness, tallness, size, and a bipolar factor. Aside from the fact that one hardly needs go through a factor analysis to come up with such a set of characteristics, they are totally useless for purposes of working with the geometrical and physical properties of cylinders. Now if he had come up with the radius or diameter and the height as factors, that would have been another matter. Thurston did come up with "tallness" which one might take as a synonym for height. Also note that while in reality one needs only two dimensions to fully define a cylinder, factor analysis forces us to use four factors.
Other Aspects of Science and Its Methods
Aspects of scientific methodology that have not been directly touched upon in this section include induction and deduction, testability, verification, falsifiability, and still others. These are related to an important issue, that of the limits of knowledge and the limitations of the scientific method. There are fundamental limits to what we can know. I would say no more regarding the matter were it not for the fact that a number of my colleagues take this as an excuse to be unscientific. I believe there is a great deal of misunderstanding that has gone on here. True, for instance, Gödel has shown there are circumstances in which deriving certain truths logically is not possible. But he also showed in this very process that this can be circumvented. Likewise I would point out that while Heisenberg made it clear that a basic uncertainty must accompany some of the physical measurements we make, it is easily demonstrable that this uncertainty is far too small to affect the measurements we use in our daily life.
Falsifiability has gained a particular importance since Popper (1963) has made the case that one can never prove a hypothesis or theory is true, only that it is false. That is, the truthfulness of a theory depends on repeated failures to falsify it. Attempts to do so constitute that which is called a test of a hypothesis or theory.
Last, I would comment on the use or rather the extensive abusive use of the term paradigm by research psychologists writing on hypnosuggestion. This appears to have been given impetus by Thomas Kuhns' 1962 work on the nature of scientific revolutions. But what is a paradigm? Most dictionaries simply tell us it is a model. If so, what more are allusions to paradigms rather than to models supposed to convey to the reader? Nothing that I can see beside a measure of the possible erudition of the writer. Kuhn has apparently used the term in 21 different senses (Masterman, 1978). But knowing this does us no good when the user of the term does not tell us which of these senses she has adopted and she never does. Personally I will stick with the dictionary definition, forget about Kuhn's "paradigm shift " and go along with Masterman in viewing an actual, live swan as a "paradigm" (model) of the family of swans.
Tradition and Science
Like science, tradition begins with observations. However, in contrast to science, tradition does not distinguish between a-facts and p-facts and tends to treat all observations as p-facts. Interpretations are made but never tested. Both start from the same observations. Hypotheses and theories are confounded and hypotheses are rarely distinguished from p-facts. But because traditional and scientific knowledge begin with some of the same observations, they inevitably must share some basic truths and there has to be an overlap between scientific and traditional knowledge. The acquisition of scientific knowledge must necessarily be slower than that of traditional knowledge which should be expected to contain truths as yet to become a part of scientific knowledge.
Pure versus Applied Science
I have already discussed the distinction. The two are intimately related, each feeding into the other. Furthermore, the scientific method applies to both. Applied science is much more than just throwing a number into a formula. A great deal of experimentation still has to go on as well as hypothesis-making when working in its context.
The Making of a Scientist
With all this said about the scientific method, I would not want readers to think that using it is all there is to doing good science. There is a great deal more that goes into the making of a good scientist. I will list some of the ingredients without further discussion: Besides having appropriate specialized training, a scientist is a keen observer. Being curious (asking questions), flexible, keeping good records (including a good memory), having a broad knowledge, knowing one's limitations, initially taking everything with grain of salt (mitigated skepticism), and being creative are other important ingredients. I am inclined to believe some of it is inborn; some can be acquired.
Table of Contents
FOUNDATIONS: FACTS AND TECHNIQUES.
Using Suggestion without Hypnosis.
Suggestion and Suggestibility.
The Induction of Hypnosis.
"Hypnosis," The State.
The Depth of Hypnosis and Related Matters.
The Production of Hypnotic Phenomena.
Autosuggestion and Self-Hypnotism.
CLINICAL HYPNOTISM AND OTHER APPLICATIONS.
Introduction to Clinical Hypnotism and Other Applications.
General Overview and Principles of Clinical Hypnotism.
General Procedures in Clinical Hypnotism: Preparation of the Patient.
Specific Procedures in Clinical Hypnotism: Anxiety and Its Treatment.
Specific Procedures in Clinical Hypnotism: Somatic and Related Problems.
Specific Procedures in Clinical Hypnotism: Psychiatric and Psychological Problems.
Nonclinical Applications of Hypnotism.
Ericksonian Clinical Hypnotism.
The Future of Hypnotism.
For Further Reading.