Hypnosis

File:Charcot and Blanche Wittman.jpg

Professor Charcot was well-known for showing, during his lessons at the Salpêtrière hospital, "hysterical" woman patients – here, his favorite patient, "Blanche" (Marie) Wittman, supported by Joseph Babiński. The neurologist endorsed hypnotism for the treatment of hysteria.

Hypnosis is a natural psychological process in which critical thinking faculties of the mind are bypassed and a type of selective thinking and perception is established. Although some individuals experience an increase in suggestibility and subjective feelings of an altered state of consciousness, this is not true for everyone. In fact, some supposed hypnotic indicators and subjective changes can be achieved without relaxation or a lengthy induction by means of simple suggestion or waking hypnosis, a fact that increases the controversy and misunderstandings surrounding hypnosis and the hypnotic state.

Etymology

The words hypnosis and hypnotism both derive from the term neuro-hypnotism (nervous sleep), all of which were coined by Étienne Félix d'Henin de Cuvillers in the 1820s. The term hypnosis is derived from the ancient Greek ὑπνος hypnos, "sleep", and the suffix -ωσις -osis, or from ὑπνόω hypnoō, "put to sleep" (stem of aorist hypnōs-) and the suffix -is. These words were popularized in English by the Scottish surgeon James Braid (to whom they are sometimes wrongly attributed) around 1841. Braid based his practice on that developed by Franz Mesmer and his followers (which was called "Mesmerism" or "animal magnetism"), but differed in his theory as to how the procedure worked.

Definition

A formal definition of hypnosis and related terms, derived from academic psychology, was provided in 2014, when the Society for Psychological Hypnosis, Division 30 of the American Psychological Association (APA), published the following official definitions:

• Hypnosis: A state of consciousness involving focused attention and reduced peripheral awareness characterized by an enhanced capacity for response to suggestion.
• Hypnotic Induction: A procedure designed to induce hypnosis.
• Hypnotizability: An individual’s ability to experience suggested alterations in physiology, sensations, emotions, thoughts or behavior during hypnosis.
• Hypnotherapy: The use of hypnosis in the treatment of a medical or psychological disorder or concern.

History

Hypnosis has a long history from ancient times; people have been entering into hypnotic-type trances for thousands of years. In many cultures and religions, it was regarded as a form of meditation. The earliest record of a description of a hypnotic state can be found in the writings of Avicenna, a Persian physician who wrote about "trance" in 1027. Its current uses have been studied scientifically by a host of both practitioners and researchers.

Sleep temples

Hypnotism as a tool for health seems to have originated with the use of sleep temples. Hindus of India often took their sick to sleep temples to be cured by hypnotic suggestion. The Law of Manu, which was the ancient Sanskrit text on how society should be run, categorized different states of hypnosis: the "Sleep-Waking" state, the "Dream-Sleep" state, and the "Ecstasy-Sleep" state. Hypnotic-like inductions were used to place the individual in a sleep-like state.

In Egypt, sleep temples (also known as dream temples) functioned as hospitals, healing a variety of ailments, perhaps many of them psychological in nature. Patients were taken to an unlit chamber to sleep and be treated for their specific ailment.The treatment involved chanting, placing the patient into a trance-like or hypnotic state, and analyzing their dreams in order to determine treatment. Meditation, fasting, baths, and sacrifices to the patron deity or other spirits.

Sleep temples also existed in Ancient Greece where they were called Asclepieions, built in honor of Asclepios the Greek god of medicine. The Greek treatment was referred to as incubation and focused on prayers to Asclepios for healing. These sleep chambers were filled with snakes, the symbol of the rod of Asclepios, the serpent-entwined rod thay symbolizes medicine to this day.

Magnetism

Paracelsus (1493-1541) was the first physician to utilize magnets in his work. Many people claimed to be healed after he passed magnets (or lodestones) over their body. Around 1771, a Viennese Jesuit named Maximilian Hell (1720-1792) used magnets to heal by applying steel plates to the naked body. One of Father Hell's students was a young medical doctor from Vienna named Franz Anton Mesmer (1734-1815).

Western scientists first became involved in hypnosis around 1770, when Mesmer started investigating an effect he called "animal magnetism" or "mesmerism." Mesmer found that, after opening a patient's vein and letting the patient bleed for a while, by passing magnets over the wound it would stop bleeding. Mesmer held the opinion that hypnosis was a sort of mystical force that flows from the hypnotist to the person being hypnotized, but his theory was dismissed by critics who asserted that there is no magical element to hypnotism.

In the early nineteenth century, an Indo-Portuguese priest, Abbé Faria (1756-1819), revived public attention in animal magnetism by introducing hypnosis to Paris. Unlike Mesmer, Faria claimed that it 'generated from within the mind’ by the power of expectancy and cooperation of the patient.

Early medical research

The evolution of Mesmer's ideas and practices led James Braid (1795-1860) to coin the term and develop the procedure known as hypnosis in 1842. Popularly titled the "Father of Modern Hypnotism," Braid rejected Mesmer's idea of magnetism inducing hypnosis, and ascribed the creation of the 'mesmeric trance' to a physiological process—the prolonged attention on a bright moving object or similar object of fixation. He postulated that "protracted ocular fixation" fatigued certain parts of the brain and caused the trance, "nervous sleep." In 1843, he published his Neurypnology: or the Rationale of Nervous Sleep, calling the procedure "neuro-hypnosis." Believing sleep was involved, he used terms such as "hypnosis" and "hypnotist." Later, realizing that "hypnosis" was not sleep, he later tried to change the name to monoideaism but it was too late as the term "hypnosis" had stuck.

A report in 1842 described an amputation performed on a hypnotized participant without pain. The report was widely dismissed and there was strong resistance in the medical profession to hypnotism, but other successful reports followed. For example, James Esdaile (1805-1859) reported on 345 major operations performed using mesmeric sleep as the sole anesthetic in British India. However, the development of chemical anesthetics soon saw the replacement of hypnotism in this role.

The deaths of Braid and Esdaile curbed interest in hypnotism. Experimentation was revived into the 1880s, mainly in continental Europe where new translations of Braid's work were circulated.

Early psychological studies

For several decades Braid's work became more influential abroad than in his own country. The French neurologist Jean-Martin Charcot (1825-1893) endorsed hypnotism for the treatment of hysteria. La méthode numérique ("The numerical method") led to a number of systematic experimental examinations of hypnosis in France, Germany, and Switzerland. The process of post-hypnotic suggestion was first described in this period. Extraordinary improvements in sensory acuity and memory were reported under hypnosis.

France became the focal point for the study of Braid's ideas after the eminent neurologist Étienne Eugène Azam translated Braid's last manuscript (On Hypnotism, 1860) into French and presented Braid's research to the French Academy of Sciences. At the request of Azam, Paul Broca, and others, the French Academy of Science, which had investigated Mesmerism in 1784, examined Braid's writings shortly after his death. Azam's enthusiasm for hypnotism influenced Ambroise-Auguste Liébeault, a country doctor. Hippolyte Bernheim discovered Liébeault's enormously popular group hypnotherapy clinic in Nancy (known as the "Nancy School"), and subsequently became an influential hypnotist.

The study of hypnotism subsequently revolved around the fierce debate between Bernheim and Jean-Martin Charcot. Charcot argued that hypnotism was an abnormal state of nervous functioning found only in certain hysterical women. He claimed that it manifested in a series of physical reactions that could be divided into distinct stages. Bernheim argued that anyone could be hypnotized, that it was an extension of normal psychological functioning, and that its effects were due to suggestion.

Pierre Janet (1859–1947), Charcot's student, was appointed director of the psychological laboratory at the Salpêtrière in 1889, later he became a lecturer in psychology at the Sorbonne and then chair of experimental and comparative psychology at the Collège de France. Janet reconciled elements of Charcot's views with those of Bernheim and his followers, developing his own sophisticated hypnotic psychotherapy based upon the concept of psychological dissociation. Janet described dissociation as the splitting of mental aspects under hypnosis (or hysteria) so skills and memory could be made inaccessible or recovered. His work provoked interest in the subconscious and laid the framework for reintegration therapy for dissociated personalities.

Émile Coué (1857–1926) practiced the "hypnosis" of Liébeault and Bernheim's Nancy School. However, he abandoned their approach altogether and developed a new approach (c.1901) based on Braid-style direct hypnotic suggestion and ego-strengthening. Coué's method did not emphasize "sleep" or deep relaxation, but instead focused upon autosuggestion involving a specific series of suggestion tests. Coué's method became a renowned self-help and psychotherapy technique, which contrasted with psychoanalysis and prefigured self-hypnosis and cognitive therapy.

Sigmund Freud (1856–1939), the founder of psychoanalysis, studied hypnotism at the Paris School and briefly visited the Nancy School. At first, Freud was an enthusiastic proponent of hypnotherapy. He "initially hypnotised patients and pressed on their foreheads to help them concentrate while attempting to recover (supposedly) repressed memories", and he soon began to emphasize hypnotic regression and ab reaction (catharsis) as therapeutic methods. He published an influential series of case studies with his colleague Joseph Breuer entitled Studies on Hysteria (1895), which became the founding text of the subsequent tradition known as "hypno-analysis" or "regression hypnotherapy."

However, Freud gradually abandoned hypnotism in favor of psychoanalysis, emphasizing free association and interpretation of the unconscious. Struggling with the great expense of time that psychoanalysis required, Freud later suggested that it might be combined with hypnotic suggestion to hasten the outcome of treatment, but that this would probably weaken the outcome: "It is very probable, too, that the application of our therapy to numbers will compel us to alloy the pure gold of analysis plentifully with the copper of direct [hypnotic] suggestion."

The next major development came from behavioral psychology in American university research. Clark L. Hull (1884–1952), an eminent American psychologist, published the first major compilation of laboratory studies on hypnosis, Hypnosis & Suggestibility (1933), in which he proved that hypnosis and sleep had nothing in common. Hull published many quantitative findings from hypnosis and suggestion experiments and encouraged research by mainstream psychologists. Hull's behavioral psychology interpretation of hypnosis, emphasizing conditioned reflexes, rivaled the Freudian psycho-dynamic interpretation which emphasized unconscious transference.

Dave Elman (1900–1967), noted radio host, comedian, and songwriter, made a name for himself as a hypnotist. He led many courses for physicians, and in 1964 wrote the book Findings in Hypnosis, later to be retitled Hypnotherapy (published by Westwood Publishing). Perhaps the most well-known aspect of Elman's legacy is his method of induction, which was originally fashioned for speed work and later adapted for the use of medical professionals.

Milton Erickson (1901–1980), the founding president of the American Society for Clinical Hypnosis and a fellow of the American Psychiatric Association, the American Psychological Association, and the American Psychopathological Association, was one of the most influential post-war hypnotherapists. He wrote several books and journal articles on the subject. During the 1960s, Erickson popularized a new branch of hypnotherapy, known as Ericksonian therapy, characterized primarily by indirect suggestion, "metaphor" (actually analogies), confusion techniques, and double binds in place of formal hypnotic inductions. However, the difference between Erickson's methods and traditional hypnotism led contemporaries such as André Weitzenhoffer to question whether he was practicing "hypnosis" at all, and his approach remains in question:

Erickson had no hesitation in presenting any suggested effect as being "hypnosis", whether or not the subject was in a hypnotic state. In fact, he was not hesitant in passing off behaviour that was dubiously hypnotic as being hypnotic.

But during numerous witnessed and recorded encounters in clinical, experimental, and academic settings Erickson was able to evoke examples of classic hypnotic phenomena such as positive and negative hallucinations, anesthesia, analgesia (in childbirth and even terminal cancer patients), catalepsy, regression to provable events in subjects' early lives and even into infantile reflexology. Erickson stated in his own writings that there was no correlation between hypnotic depth and therapeutic success and that the quality of the applied psychotherapy outweighed the need for deep hypnosis in many cases. Hypnotic depth was to be pursued for research purposes.

At the outset of cognitive behavioural therapy during the 1950s, hypnosis was used by early behavior therapists such as Joseph Wolpe and also by early cognitive therapists such as Albert Ellis. Barber, Spanos, and Chaves introduced the term "cognitive-behavioural" to describe their "nonstate" theory of hypnosis in Hypnosis, imagination, and human potentialities. However, Clark L. Hull had introduced a behavioral psychology as far back as 1933, which in turn was preceded by Ivan Pavlov. Indeed, the earliest theories and practices of hypnotism, even those of Braid, resemble the cognitive-behavioral orientation in some respects.

Methodologies

Induction

Hypnosis is normally preceded by a "hypnotic induction" technique. Traditionally, this was interpreted as a method of putting the subject into a "hypnotic trance"; however, subsequent "nonstate" theorists have viewed it differently, seeing it as a means of heightening client expectation, defining their role, focusing attention, etc. The induction techniques and methods are depended on the depth of hypnosis trance level and for each stage of trance that in some sources ranges from 30 stages to 50 stages, there're different type of inductions. There are several different induction techniques. One of the most influential methods was Braid's "eye-fixation" technique, also known as "Braidism". Many variations of the eye-fixation approach exist, including the induction used in the Stanford Hypnotic Susceptibility Scale (SHSS), the most widely used research tool in the field of hypnotism. Braid's original description of his induction is as follows:

Take any bright object (e.g. a lancet case) between the thumb and fore and middle fingers of the left hand; hold it from about eight to fifteen inches from the eyes, at such position above the forehead as may be necessary to produce the greatest possible strain upon the eyes and eyelids, and enable the patient to maintain a steady fixed stare at the object.

The patient must be made to understand that he is to keep the eyes steadily fixed on the object, and the mind riveted on the idea of that one object. It will be observed, that owing to the consensual adjustment of the eyes, the pupils will be at first contracted: They will shortly begin to dilate, and, after they have done so to a considerable extent, and have assumed a wavy motion, if the fore and middle fingers of the right hand, extended and a little separated, are carried from the object toward the eyes, most probably the eyelids will close involuntarily, with a vibratory motion. If this is not the case, or the patient allows the eyeballs to move, desire him to begin anew, giving him to understand that he is to allow the eyelids to close when the fingers are again carried towards the eyes, but that the eyeballs must be kept fixed, in the same position, and the mind riveted to the one idea of the object held above the eyes. In general, it will be found, that the eyelids close with a vibratory motion, or become spasmodically closed.

Braid later acknowledged that the hypnotic induction technique was not necessary in every case, and subsequent researchers have generally found that on average it contributes less than previously expected to the effect of hypnotic suggestions. Variations and alternatives to the original hypnotic induction techniques were subsequently developed. However, this method is still considered authoritative.^{[citation needed]} In 1941, Robert White wrote: "It can be safely stated that nine out of ten hypnotic techniques call for reclining posture, muscular relaxation, and optical fixation followed by eye closure."

Suggestion

When James Braid first described hypnotism, he did not use the term "suggestion" but referred instead to the act of focusing the conscious mind of the subject upon a single dominant idea. Braid's main therapeutic strategy involved stimulating or reducing physiological functioning in different regions of the body. In his later works, however, Braid placed increasing emphasis upon the use of a variety of different verbal and non-verbal forms of suggestion, including the use of "waking suggestion" and self-hypnosis. Subsequently, Hippolyte Bernheim shifted the emphasis from the physical state of hypnosis on to the psychological process of verbal suggestion:

I define hypnotism as the induction of a peculiar psychical [i.e., mental] condition which increases the susceptibility to suggestion. Often, it is true, the [hypnotic] sleep that may be induced facilitates suggestion, but it is not the necessary preliminary. It is suggestion that rules hypnotism.

Bernheim's conception of the primacy of verbal suggestion in hypnotism dominated the subject throughout the 20th century, leading some authorities to declare him the father of modern hypnotism.

Contemporary hypnotism uses a variety of suggestion forms including direct verbal suggestions, "indirect" verbal suggestions such as requests or insinuations, metaphors and other rhetorical figures of speech, and non-verbal suggestion in the form of mental imagery, voice tonality, and physical manipulation. A distinction is commonly made between suggestions delivered "permissively" and those delivered in a more "authoritarian" manner. Harvard hypnotherapist Deirdre Barrett writes that most modern research suggestions are designed to bring about immediate responses, whereas hypnotherapeutic suggestions are usually post-hypnotic ones that are intended to trigger responses affecting behaviour for periods ranging from days to a lifetime in duration. The hypnotherapeutic ones are often repeated in multiple sessions before they achieve peak effectiveness.

Conscious and unconscious mind

Some hypnotists view suggestion as a form of communication that is directed primarily to the subject's conscious mind, whereas others view it as a means of communicating with the "unconscious" or "subconscious" mind. These concepts were introduced into hypnotism at the end of the 19th century by Sigmund Freud and Pierre Janet. Sigmund Freud's psychoanalytic theory describes conscious thoughts as being at the surface of the mind and unconscious processes as being deeper in the mind. Braid, Bernheim, and other Victorian pioneers of hypnotism did not refer to the unconscious mind but saw hypnotic suggestions as being addressed to the subject's conscious mind. Indeed, Braid actually defines hypnotism as focused (conscious) attention upon a dominant idea (or suggestion). Different views regarding the nature of the mind have led to different conceptions of suggestion. Hypnotists who believe that responses are mediated primarily by an "unconscious mind", like Milton Erickson, make use of indirect suggestions such as metaphors or stories whose intended meaning may be concealed from the subject's conscious mind. The concept of subliminal suggestion depends upon this view of the mind. By contrast, hypnotists who believe that responses to suggestion are primarily mediated by the conscious mind, such as Theodore Barber and Nicholas Spanos, have tended to make more use of direct verbal suggestions and instructions.

Ideo-dynamic reflex

The first neuropsychological theory of hypnotic suggestion was introduced early by James Braid who adopted his friend and colleague William Carpenter's theory of the ideo-motor reflex response to account for the phenomenon of hypnotism. Carpenter had observed from close examination of everyday experience that, under certain circumstances, the mere idea of a muscular movement could be sufficient to produce a reflexive, or automatic, contraction or movement of the muscles involved, albeit in a very small degree. Braid extended Carpenter's theory to encompass the observation that a wide variety of bodily responses besides muscular movement can be thus affected, for example, the idea of sucking a lemon can automatically stimulate salivation, a secretory response. Braid, therefore, adopted the term "ideo-dynamic", meaning "by the power of an idea", to explain a broad range of "psycho-physiological" (mind–body) phenomena. Braid coined the term "mono-ideodynamic" to refer to the theory that hypnotism operates by concentrating attention on a single idea in order to amplify the ideo-dynamic reflex response. Variations of the basic ideo-motor, or ideo-dynamic, theory of suggestion have continued to exercise considerable influence over subsequent theories of hypnosis, including those of Clark L. Hull, Hans Eysenck, and Ernest Rossi. In Victorian psychology the word "idea" encompasses any mental representation, including mental imagery, memories, etc.

Theories of Hypnosis

The central theoretical disagreement regarding hypnosis is known as the "state versus nonstate" debate. When Braid introduced the concept of hypnotism, he equivocated over the nature of the "state", sometimes describing it as a specific sleep-like neurological state comparable to animal hibernation or yogic meditation, while at other times he emphasised that hypnotism encompasses a number of different stages or states that are an extension of ordinary psychological and physiological processes. Overall, Braid appears to have moved from a more "special state" understanding of hypnotism toward a more complex "nonstate" orientation.^{[citation needed]}

State theorists interpret the effects of hypnotism as due primarily to a specific, abnormal, and uniform psychological or physiological state of some description, often referred to as "hypnotic trance" or an "altered state of consciousness". Nonstate theorists rejected the idea of hypnotic trance and interpret the effects of hypnotism as due to a combination of multiple task-specific factors derived from normal cognitive, behavioural, and social psychology, such as social role-perception and favorable motivation (Sarbin), active imagination and positive cognitive set (Barber), response expectancy (Kirsch), and the active use of task-specific subjective strategies (Spanos). The personality psychologist Robert White is often cited as providing one of the first nonstate definitions of hypnosis in a 1941 article:

Hypnotic behaviour is meaningful, goal-directed striving, its most general goal being to behave like a hypnotised person as this is continuously defined by the operator and understood by the client.

Put simply, it is often claimed that, whereas the older "special state" interpretation emphasises the difference between hypnosis and ordinary psychological processes, the "nonstate" interpretation emphasises their similarity.

Comparisons between hypnotised and non-hypnotised subjects suggest that, if a "hypnotic trance" does exist, it only accounts for a small proportion of the effects attributed to hypnotic suggestion, most of which can be replicated without hypnotic induction.{{ safesubst:#invoke:Unsubst||date=__DATE__ |$B=

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Hyper-suggestibility

Braid can be taken to imply, in later writings, that hypnosis is largely a state of heightened suggestibility induced by expectation and focused attention. In particular, Hippolyte Bernheim became known as the leading proponent of the "suggestion theory" of hypnosis, at one point going so far as to declare that there is no hypnotic state, only heightened suggestibility. There is a general consensus that heightened suggestibility is an essential characteristic of hypnosis. In 1933, Clark L. Hull wrote:

If a subject after submitting to the hypnotic procedure shows no genuine increase in susceptibility to any suggestions whatever, there seems no point in calling him hypnotised, regardless of how fully and readily he may respond to suggestions of lid-closure and other superficial sleeping behaviour.

Conditioned inhibition

Ivan Pavlov stated that hypnotic suggestion provided the best example of a conditioned reflex response in human beings; i.e., that responses to suggestions were learned associations triggered by the words used:

Speech, on account of the whole preceding life of the adult, is connected up with all the internal and external stimuli which can reach the cortex, signaling all of them and replacing all of them, and therefore it can call forth all those reactions of the organism which are normally determined by the actual stimuli themselves. We can, therefore, regard "suggestion" as the most simple form of a typical reflex in man.

He also believed that hypnosis was a "partial sleep", meaning that a generalised inhibition of cortical functioning could be encouraged to spread throughout regions of the brain. He observed that the various degrees of hypnosis did not significantly differ physiologically from the waking state and hypnosis depended on insignificant changes of environmental stimuli. Pavlov also suggested that lower-brain-stem mechanisms were involved in hypnotic conditioning.

Pavlov's ideas combined with those of his rival Vladimir Bekhterev and became the basis of hypnotic psychotherapy in the Soviet Union, as documented in the writings of his follower K.I. Platonov. Soviet theories of hypnotism subsequently influenced the writings of Western behaviourally oriented hypnotherapists such as Andrew Salter.

Neuropsychology

Changes in brain activity have been found in some studies of highly responsive hypnotic subjects. These changes vary depending upon the type of suggestions being given. The state of light to medium hypnosis, where the body undergoes physical and mental relaxation, is associated with a pattern mostly of alpha waves.Template:Better source needed However, what these results indicate is unclear. They may indicate that suggestions genuinely produce changes in perception or experience that are not simply a result of imagination. However, in normal circumstances without hypnosis, the brain regions associated with motion detection are activated both when motion is seen and when motion is imagined, without any changes in the subjects' perception or experience. This may therefore indicate that highly suggestible hypnotic subjects are simply activating to a greater extent the areas of the brain used in imagination, without real perceptual changes. It is, however, premature to claim that hypnosis and meditation are mediated by similar brain systems and neural mechanisms.

Another study has demonstrated that a colour hallucination suggestion given to subjects in hypnosis activated colour-processing regions of the occipital cortex.Template:Primary source inline A 2004 review of research examining the EEG laboratory work in this area concludes:

Hypnosis is not a unitary state and therefore should show different patterns of EEG activity depending upon the task being experienced. In our evaluation of the literature, enhanced theta is observed during hypnosis when there is task performance or concentrative hypnosis, but not when the highly hypnotizable individuals are passively relaxed, somewhat sleepy and/or more diffuse in their attention.

Studies have shown an association of hypnosis with stronger theta-frequency activity as well as with changes to the gamma-frequency activity.Template:Primary source inline Neuroimaging techniques have been used to investigate neural correlates of hypnosis.

The induction phase of hypnosis may also affect the activity in brain regions that control intention and process conflict. Anna Gosline claims:

Gruzelier and his colleagues studied brain activity using an fMRI while subjects completed a standard cognitive exercise, called the Stroop task. The team screened subjects before the study and chose 12 that were highly susceptible to hypnosis and 12 with low susceptibility. They all completed the task in the fMRI under normal conditions and then again under hypnosis. Throughout the study, both groups were consistent in their task results, achieving similar scores regardless of their mental state. During their first task session, before hypnosis, there were no significant differences in brain activity between the groups. But under hypnosis, Gruzelier found that the highly susceptible subjects showed significantly more brain activity in the anterior cingulate gyrus than the weakly susceptible subjects. This area of the brain has been shown to respond to errors and evaluate emotional outcomes. The highly susceptible group also showed much greater brain activity on the left side of the prefrontal cortex than the weakly susceptible group. This is an area involved with higher level cognitive processing and behaviour.

Dissociation

Pierre Janet originally developed the idea of dissociation of consciousness from his work with hysterical patients. He believed that hypnosis was an example of dissociation, whereby areas of an individual's behavioural control separate from ordinary awareness. Hypnosis would remove some control from the conscious mind, and the individual would respond with autonomic, reflexive behaviour. Weitzenhoffer describes hypnosis via this theory as "dissociation of awareness from the majority of sensory and even strictly neural events taking place."

Neodissociation

Ernest Hilgard, who developed the "neodissociation" theory of hypnotism, hypothesised that hypnosis causes the subjects to divide their consciousness voluntarily. One part responds to the hypnotist while the other retains awareness of reality. Hilgard made subjects take an ice water bath. None mentioned the water being cold or feeling pain. Hilgard then asked the subjects to lift their index finger if they felt pain and 70% of the subjects lifted their index finger. This showed that, even though the subjects were listening to the suggestive hypnotist, they still sensed the water's temperature.

Social role-taking theory

The main theorist who pioneered the influential role-taking theory of hypnotism was Theodore Sarbin. Sarbin argued that hypnotic responses were motivated attempts to fulfill the socially constructed roles of hypnotic subjects. This has led to the misconception that hypnotic subjects are simply "faking". However, Sarbin emphasised the difference between faking, in which there is little subjective identification with the role in question, and role-taking, in which the subject not only acts externally in accord with the role but also subjectively identifies with it to some degree, acting, thinking, and feeling "as if" they are hypnotised. Sarbin drew analogies between role-taking in hypnosis and role-taking in other areas such as method acting, mental illness, and shamanic possession, etc. This interpretation of hypnosis is particularly relevant to understanding stage hypnosis, in which there is clearly strong peer pressure to comply with a socially constructed role by performing accordingly on a theatrical stage.

Hence, the social constructionism and role-taking theory of hypnosis suggests that individuals are enacting (as opposed to merely playing) a role and that really there is no such thing as a hypnotic trance. A socially constructed relationship is built depending on how much rapport has been established between the "hypnotist" and the subject (see Hawthorne effect, Pygmalion effect, and placebo effect).

Psychologists such as Robert Baker and Graham Wagstaff claim that what we call hypnosis is actually a form of learned social behaviour, a complex hybrid of social compliance, relaxation, and suggestibility that can account for many esoteric behavioural manifestations.Template:Primary source inline

Cognitive-behavioral theory

Barber, Spanos, and Chaves (1974) proposed a nonstate "cognitive-behavioural" theory of hypnosis, similar in some respects to Sarbin's social role-taking theory and building upon the earlier research of Barber. On this model, hypnosis is explained as an extension of ordinary psychological processes like imagination, relaxation, expectation, social compliance, etc. In particular, Barber argued that responses to hypnotic suggestions were mediated by a "positive cognitive set" consisting of positive expectations, attitudes, and motivation. Daniel Araoz subsequently coined the acronym "TEAM" to symbolize the subject's orientation to hypnosis in terms of "trust", "expectation", "attitude", and "motivation".

Barber et al. noted that similar factors appeared to mediate the response both to hypnotism and to cognitive behavioral therapy, in particular systematic desensitization. Hence, research and clinical practice inspired by their interpretation has led to growing interest in the relationship between hypnotherapy and cognitive behavioral therapy.

Information theory

An approach loosely based on information theory uses a brain-as-computer model. In adaptive systems, feedback increases the signal-to-noise ratio, which may converge towards a steady state. Increasing the signal-to-noise ratio enables messages to be more clearly received. The hypnotist's object is to use techniques to reduce interference and increase the receptability of specific messages (suggestions).

Systems theory

Systems theory, in this context, may be regarded as an extension of Braid's original conceptualization of hypnosis as involving "the brain and nervous system generally".^:{{{1}}} Systems theory considers the nervous system's organisation into interacting subsystems. Hypnotic phenomena thus involve not only increased or decreased activity of particular subsystems, but also their interaction. A central phenomenon in this regard is that of feedback loops, which suggest a mechanism for creating hypnotic phenomena.

Applications

There are numerous applications for hypnosis across multiple fields of interest, including medical/psychotherapeutic uses, military uses, self-improvement, and entertainment. The American Medical Association currently has no official stance on the medical use of hypnosis.

Hypnosis has been used as a supplemental approach to cognitive behavioral therapy since as early as 1949. Hypnosis was defined in relation to classical conditioning; where the words of the therapist were the stimuli and the hypnosis would be the conditioned response. Some traditional cognitive behavioral therapy methods were based in classical conditioning. It would include inducing a relaxed state and introducing a feared stimulus. One way of inducing the relaxed state was through hypnosis.

Hypnotism has also been used in forensics, sports, education, physical therapy, and rehabilitation. Hypnotism has also been employed by artists for creative purposes, most notably the surrealist circle of André Breton who employed hypnosis, automatic writing, and sketches for creative purposes. Hypnotic methods have been used to re-experience drug states and mystical experiences. Self-hypnosis is popularly used to quit smoking, alleviate stress and anxiety, promote weight loss, and induce sleep hypnosis. Stage hypnosis can persuade people to perform unusual public feats.

Some people have drawn analogies between certain aspects of hypnotism and areas such as crowd psychology, religious hysteria, and ritual trances in preliterate tribal cultures.

Hypnotherapy

Hypnotherapy is a term to describe the use of hypnosis in a therapeutic context. Hypnotherapy can either be used as an addition to the work of licensed physicians or psychologists, or it can be used in a stand-alone environment where the hypnotherapist in question usually owns his or her own business. The majority of certified hypnotherapists (C.Hts in the US, Diploma. Hyp in the UK) today earn a large portion of their money through the cessation of smoking (often in a single session) and the aid of weight loss (body sculpting). There is no evidence that 'incurable' diseases are curable with hypnosis (such as cancer, diabetes, and arthritis), but pain and other body functions related to the diseases are controllable. Some of the treatments practiced by hypnotherapists, in particular so-called regression, have been viewed with skepticism.

It is used by licensed physicians, psychologists, and others. Physicians and psychologists may use hypnosis to treat depression, anxiety, eating disorders, sleep disorders, compulsive gambling, phobias and posttraumatic stress, while certified hypnotherapists who are not physicians or psychologists often treat smoking and weight management. Hypnotherapy was historically used in psychiatric and legal settings to enhance the recall of repressed or degraded memories, but this application of the technique has declined as scientific evidence accumulated that hypnotherapy can increase confidence in false memories.

The American Medical Association and the American Psychological Association have both cautioned against the use of repressed memory therapy in dealing with cases of alleged childhood trauma, stating that "it is impossible, without other corroborative evidence, to distinguish a true memory from a false one", and so the procedure is "fraught with problems of potential misapplication". (See also false memory). This is why forensic hypnosis is not widely used in many countries' legal systems. Hypnosis is used a lot in modern life and is very helpful to some people.

Hypnotherapy is viewed as a helpful adjunct by proponents, having additive effects when treating psychological disorders, such as these, along with scientifically proven cognitive therapies. The effectiveness of hypnotherapy has not yet been accurately assessed.

Menopause

There is evidence supporting the use of hypnotherapy in the treatment of menopause related symptoms, including hot flashes. The North American Menopause Society recommends hypnotherapy for the nonhormonal management of menopause-associated vasomotor symptoms, giving it the highest level of evidence.

Irritable bowel syndrome

Hypnotherapy has been studied for the treatment of irritable bowel syndrome. Hypnosis for IBS has received moderate support in the National Institute for Health and Clinical Excellence guidance published for UK health services. It has been used as an aid or alternative to chemical anesthesia, and it has been studied as a way to soothe skin ailments.

Pain management

A number of studies show that hypnosis can reduce the pain experienced during burn-wound debridement, bone marrow aspirations, and childbirth. The International Journal of Clinical and Experimental Hypnosis found that hypnosis relieved the pain of 75% of 933 subjects participating in 27 different experiments.

Hypnosis is effective in decreasing the fear of cancer treatment reducing pain from and coping with cancer and other chronic conditions. Nausea and other symptoms related to incurable diseases may also be managed with hypnosis. Some practitioners have claimed hypnosis might help boost the immune system of people with cancer. However, according to the American Cancer Society, "available scientific evidence does not support the idea that hypnosis can influence the development or progression of cancer."

Hypnosis has been used as a pain relieving technique during dental surgery, and related pain management regimens as well. Researchers like Jerjes and his team have reported that hypnosis can help even those patients who have acute to severe orodental pain. Additionally, Meyerson and Uziel have suggested that hypnotic methods have been found to be highly fruitful for alleviating anxiety in patients with severe dental phobia.

For some psychologists who uphold the altered state theory of hypnosis, pain relief in response to hypnosis is said to be the result of the brain's dual-processing functionality. This effect is obtained either through the process of selective attention or dissociation, in which both theories involve the presence of activity in pain receptive regions of the brain, and a difference in the processing of the stimuli by the hypnotised subject.

The American Psychological Association published a study comparing the effects of hypnosis, ordinary suggestion, and placebo in reducing pain. The study found that highly suggestible individuals experienced a greater reduction in pain from hypnosis compared with placebo, whereas less suggestible subjects experienced no pain reduction from hypnosis when compared with placebo. Ordinary non-hypnotic suggestion also caused reduction in pain compared to placebo, but was able to reduce pain in a wider range of subjects (both high and low suggestible) than hypnosis. The results showed that it is primarily the subject's responsiveness to suggestion, whether within the context of hypnosis or not, that is the main determinant of causing reduction in pain.

Entertainment/Stage application

Stage hypnosis is a form of entertainment, traditionally employed in a club or theatre before an audience. Due to stage hypnotists' showmanship, many people believe that hypnosis is a form of mind control. Stage hypnotists typically attempt to hypnotise the entire audience and then select individuals who are "under" to come up on stage and perform embarrassing acts, while the audience watches. However, the effects of stage hypnosis are probably due to a combination of psychological factors, participant selection, suggestibility, physical manipulation, stagecraft, and trickery. The desire to be the centre of attention, having an excuse to violate their own fear suppressors, and the pressure to please are thought to convince subjects to "play along". Books by stage hypnotists sometimes explicitly describe the use of deception in their acts; for example, Ormond McGill's New Encyclopedia of Stage Hypnosis describes an entire "fake hypnosis" act that depends upon the use of private whispers throughout.^{[citation needed]}

Professor G.F. Wagstaff, of the University of Liverpool, carried out research around the phenomenon of stage hypnotism or hypnotism for entertainment. He surmised that rather than the subject being in an 'altered state' rather they were affected significantly more by social factors and expectations.

Wagstaff's work explores how a hypnotist carefully chooses volunteers from the audience, puts them into a trance using hypnosis and then plants suggestions for them to perform. The critical factor in all stage hypnosis shows is the choice of enthusiastic and credulous individuals. Various techniques exist for discerning whether an individual is a likely candidate for a hypnosis stage act showing a higher than normal susceptibility. Often, the sheer willingness of audience members to volunteer is a sign that they will cooperate with the hypnotist's suggestions during the show, whether or not they ever really become hypnotized in the first place.

The process used to ensure participants presenting themselves as adequate for the stage starts with the initial call for volunteers from the audience. The hypnotist will use carefully selected terms in the initial call for volunteers. There will be a certain number of chairs, or spots on the stage which will usually be less than the number of initial volunteers. This will set up an unconscious sense of competition among those volunteers who *really do* want to participate.

For example, the volunteers may be made to believe they are drunk, aliens speaking a strange alien language, naked or seeing others naked, 6-year-old children, ballet dancers etc. Such suggestions are designed to be temporary, lasting the duration of the show. Stage hypnosis is a unique performance in that it involves "real" people from the audience responding in a variety of ways, making no two shows the same. There has been debate over the years as to whether some degree of fraud or collusion may be involved in some stage hypnosis acts.

Sometimes a stage hypnosis begins with an induction in which the hypnotist asks the entire audience to close their eyes and listen to his words. He lulls everyone participating into a relaxed state with which he may observe who is more susceptible to be hypnotized. Often people are simply unable to relax and "go with" the hypnotist's instructions due to inability to relax and allow the mind to follow instructions without conscious thought or simply determination to not be induced.

There are many observations that can be made of those who do "go under": slumping in their seat, head lolling to the side, falling into the lap of someone next to them, eye lids flickering, and inability to wake when spoken to or prodded unless done so by the hypnotist himself. For those who are simply watching this show and seeing the person next to them become induced, it can be frightening to witness.

The people whom the hypnotist saw to be easily induced the deepest are approached individually. He will speak briefly to the person and learn their name at which time he may say a few words to them and command them to sleep. For example: "Are you tired, Jane? Would you like to sleep now? Go ahead - SLEEP." Normally this action will cause the individual to immediately appear to have fallen asleep, accompanied by the individual falling to the side. The hypnotist will then speak once more to the person and in the same manner command the person to wake. If this person seems to have been deeply hypnotized but can also wake easily seems unaware of what happened, he or she will be asked to go on the stage.

Once several people are assembled, the hypnotist will begin with inducing each of them and testing them to make sure they are perfectly under. If someone is not working well enough they may be asked to leave. Those who remain are the ones who cannot be woken, even by loud audiences and shouts. They only respond to the hypnotist. He will begin with small commands for action and move up to grand requests. For example, the subjects may first be told to act as if they were cold in a relatively warm room, and by the end of the night, they are showing the audience what their first kisses were like.

Self-hypnosis

Self-hypnosis (or autosuggestion) hypnosis in which a person hypnotizes himself or herself without the assistance of another person to serve as the hypnotist — is a staple of hypnotherapy-related self-help programs. It is most often used to help the self-hypnotist stay on a diet, overcome smoking or some other addiction, or to generally boost the hypnotized person's self-esteem. It is rarely used for the more complex or controversial uses of hypnotism, which require the hypnotist to monitor the hypnotized person's reactions and responses and respond accordingly. Most people who practice self-hypnosis require a focus in order to become fully hypnotized; there are many computer programs on the market that can ostensibly help in this area, though few, if any, have been scientifically proven to aid self-hypnosis.

Some people use devices known as mind machines to help them go into self-hypnosis more readily. A mind machine consists of glasses with different colored flashing LEDs on the inside, and headphones. The LEDs stimulate the visual channel while the headphones stimulate the audio channel with similar or slightly different frequencies designed to produce a certain mental state. A common occurrence is the use of binaural beats in the audio which is said to produce hypnosis more readily.

Self-hypnosis happens when a person hypnotises oneself, commonly involving the use of autosuggestion. The technique is often used to increase motivation for a diet, to quit smoking, or to reduce stress. People who practise self-hypnosis sometimes require assistance; some people use devices known as mind machines to assist in the process, whereas others use hypnotic recordings.

Self-hypnosis is claimed to help with stage fright, relaxation, and physical well-being.

Popular culture

For over a century, hypnosis has been a popular theme in fiction – literature, film, and television. It features in movies almost from their inception and more recently has been depicted in television and online media. As Harvard hypnotherapist Deirdre Barrett points out in 'Hypnosis in Popular Media', the vast majority of these depictions are negative stereotypes of either control for criminal profit and murder or as a method of seduction. Others depict hypnosis as all-powerful or even a path to supernatural powers.

References

ISBN links support NWE through referral fees

• Braid, James. Neurypnology; or, The Rationale of Nervous Sleep. Ayer Co Publisher, 1976 (original 1843). ISBN 0405074182

External links

• Society of Clinical Hypnosis, Resources for Research and Teaching: Hypnosis and Related States Research Database
• HypnosisAndSuggestion.org Exploring the science behind hypnosis
• American Journal of Clinical Hypnosis
• Hypnosis, from the Skeptic's dictionary, skeptical review of the veracity of hypnosis.
• Scientific American Article on Hypnosis
• Hypnosis, from Howstuffworks.com
• The National Council for Hypnotherapy The only non-for-profit governing body in the UK
• The (British) National Register of Advanced Hypnotherapists
• American Psychotherapy and Medical Hypnosis Association
• American Society of Clinical Hypnosis, founded by Milton Erickson in 1957: "Promotes greater acceptance of hypnosis as a clinical tool with broad applications."
• National Guild of Hypnotists (USA)
• International Journal of Clinical and Experimental Hypnosis

British Society for Clinical Psychophysiology accreditation for clinical hypnotherapy courses and individual practitioners

• Society of Clinical Hypnosis, Resources for Research and Teaching: Hypnosis and Related States Research Database

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