Hynotism
Photographic Studies in Hypnosis, Abnormal Psychology (1938)
Hypnosis is a state of human consciousnessinvolving focused attention and reduced peripheral awareness and an enhanced capacity to respond to suggestion. The term may also refer to an art, skill, or act of inducing hypnosis.[1]
Theories explaining what occurs during hypnosis fall into two groups. Altered statetheories see hypnosis as an altered state of mind or trance, marked by a level of awareness different from the ordinary conscious state.[2][3] In contrast, nonstatetheories see hypnosis as a form of imaginative role enactment.[4][5][6]
During hypnosis, a person is said to have heightened focus and concentration. The person can concentrate intensely on a specific thought or memory, while blocking out sources of distraction.[7] Hypnotised subjects are said to show an increased response to suggestions.[8] Hypnosis is usually induced by a procedure known as ahypnotic induction involving a series of preliminary instructions and suggestion. The use of hypnotism for therapeutic purposes is referred to as "hypnotherapy", while its use as a form of entertainment for an audience is known as "stage hypnosis". Stage hypnosis is often performed by mentalists practicing the art form of mentalism.
Etymology
The term "hypnosis" comes from the ancient Greek word ὕπνος hypnos, "sleep", and thesuffix -ωσις -osis, or from ὑπνόω hypnoō, "put to sleep" (stem of aorist hypnōs-) and the suffix -is.[9][10] 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 1820. 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 Mesmerand his followers (which was called "Mesmerism" or "animal magnetism"), but differed in his theory as to how the procedure worked.
Characteristics
A person in a state of hypnosis is relaxed, has focused attention, and has increasedsuggestibility.[11]
It could be said that hypnotic suggestion is explicitly intended to make use of the placeboeffect. For example, in 1994, Irving Kirschcharacterised hypnosis as a "nondeceptive placebo", i.e., a method that openly makes use of suggestion and employs methods to amplify its effects.[13][14]
In Trance on Trial, a 1989 text directed at the legal profession, legal scholar Alan W. Scheflin and psychologist Jerrold Lee Shapiroobserved that the "deeper" the hypnotism, the more likely a particular characteristic is to appear, and the greater extent to which it is manifested. Scheflin and Shapiro identified 20 separate characteristics that hypnotized subjects might display:[15] "dissociation"; "detachment"; "suggestibility", "ideosensory activity";[16] "catalepsy"; "ideomotor responsiveness";[17] "age regression"; "revivification"; "hypermnesia"; "[automatic or suggested] amnesia"; "posthypnotic responses"; "hypnotic analgesia andanesthesia"; "glove anesthesia";[18]"somnambulism";[19] "automatic writing"; "time distortion"; "release of inhibitions"; "change in capacity for volitional activity"; "trance logic";[20] and "effortless imagination".
Definitions
Historical definitions
The earliest definition of hypnosis was given by Braid, who coined the term "hypnotism" as an abbreviation for "neuro-hypnotism", or nervous sleep, which he contrasted withnormal sleep, and defined as: "a peculiar condition of the nervous system, induced by a fixed and abstracted attention of the mental and visual eye, on one object, not of an exciting nature."[21]
Braid elaborated upon this brief definition in a later work, Hypnotic Therapeutics:[22]
Therefore, Braid defined hypnotism as a state of mental concentration that often leads to a form of progressive relaxation, termed "nervous sleep". Later, in his The Physiology of Fascination (1855), Braid conceded that his original terminology was misleading, and argued that the term "hypnotism" or "nervous sleep" should be reserved for the minority (10%) of subjects who exhibit amnesia, substituting the term "monoideism", meaning concentration upon a single idea, as a description for the more alert state experienced by the others.[23]
A new definition of hypnosis, derived from academic psychology, was provided in 2005, when the Society for Psychological Hypnosis, Division 30 of the American Psychological Association (APA), published the following formal definition:
Michael Nash provides a list of eight definitions of hypnosis by different authors, in addition to his own view that hypnosis is "a special case of psychological regression":
- Janet, near the turn of the century, and more recently Ernest Hilgard ..., have defined hypnosis in terms of dissociation.
- Social psychologists Sarbin and Coe ... have described hypnosis in terms of role theory. Hypnosis is a role that people play; they act "as if" they were hypnotised.
- T. X. Barber ... defined hypnosis in terms of nonhypnotic behavioural parameters, such as task motivation and the act of labeling the situation as hypnosis.
- In his early writings, Weitzenhoffer ... conceptualised hypnosis as a state of enhanced suggestibility. Most recently ... he has defined hypnotism as "a form of influence by one person exerted on another through the medium or agency of suggestion."
- Psychoanalysts Gill and Brenman ... described hypnosis by using the psychoanalytic concept of "regression in the service of the ego".
- Edmonston ... has assessed hypnosis as being merely a state of relaxation.
- Spiegel and Spiegel... have implied that hypnosis is a biological capacity.[28]
- Erickson ... is considered the leading exponent of the position that hypnosis is a special, inner-directed, altered state of functioning.[28]
Joe Griffin and Ivan Tyrrell (the originators of the human givens approach) define hypnosis as "any artificial way of accessing the REM state, the same brain state in which dreaming occurs" and suggest that this definition, when properly understood, resolves "many of the mysteries and controversies surrounding hypnosis".[29] They see the REM state as being vitally important for life itself, for programming in our instinctive knowledge initially (after Dement[30] and Jouvet[31]) and then for adding to this throughout life. They explain this by pointing out that, in a sense, all learning is post-hypnotic, which explains why the number of ways people can be put into a hypnotic state are so varied: anything that focuses a person's attention, inward or outward, puts them into a trance.[32]
Hypnotic 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. 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.[33] Braid's original description of his induction is as follows:
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.[35] 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."[36]
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:
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.[38]
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.[39]
Conscious and unconscious mind
Some hypnotists view suggestion as a form of communication that is directed primarily to the subject's conscious mind,[40] whereas others view it as a means of communicating with the "unconscious" or "subconscious" mind.[40][41] 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.[42] 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 asTheodore Barber and Nicholas Spanos, have tended to make more use of direct verbal suggestions and instructions.[citation needed]
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 theideo-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.[40] It should be noted that in Victorian psychology the word "idea" encompasses any mental representation, including mental imagery, memories, etc.
Susceptibility
Braid made a rough distinction between different stages of hypnosis, which he termed the first and second conscious stage of hypnotism;[43] he later replaced this with a distinction between "sub-hypnotic", "full hypnotic", and "hypnotic coma" stages.[44]Jean-Martin Charcot made a similar distinction between stages which he named somnambulism, lethargy, and catalepsy. However, Ambroise-Auguste Liébeault and Hippolyte Bernheim introduced more complex hypnotic "depth" scales based on a combination of behavioural, physiological, and subjective responses, some of which were due to direct suggestion and some of which were not. In the first few decades of the 20th century, these early clinical "depth" scales were superseded by more sophisticated "hypnotic susceptibility" scales based on experimental research. The most influential were the Davis–Husband and Friedlander–Sarbin scales developed in the 1930s. André Weitzenhoffer and Ernest R. Hilgard developed the Stanford Scale of Hypnotic Susceptibility in 1959, consisting of 12 suggestion test items following a standardised hypnotic eye-fixation induction script, and this has become one of the most widely referenced research tools in the field of hypnosis. Soon after, in 1962, Ronald Shor and Emily Carota Orne developed a similar group scale called the Harvard Group Scale of Hypnotic Susceptibility (HGSHS).
Whereas the older "depth scales" tried to infer the level of "hypnotic trance" from supposed observable signs such as spontaneous amnesia, most subsequent scales have measured the degree of observed or self-evaluated responsiveness to specific suggestion tests such as direct suggestions of arm rigidity (catalepsy). The Stanford, Harvard, HIP, and most other susceptibility scales convert numbers into an assessment of a person's susceptibility as "high", "medium", or "low". Approximately 80% of the population are medium, 10% are high, and 10% are low. There is some controversy as to whether this is distributed on a "normal" bell-shaped curve or whether it is bi-modal with a small "blip" of people at the high end.[45]Hypnotizability Scores are highly stable over a person's lifetime. Research by Deirdre Barrett has found that there are two distinct types of highly susceptible subjects, which she terms fantasizers and dissociaters. Fantasizers score high on absorption scales, find it easy to block out real-world stimuli without hypnosis, spend much time daydreaming, report imaginary companions as a child, and grew up with parents who encouraged imaginary play. Dissociaters often have a history of childhood abuse or other trauma, learned to escape into numbness, and to forget unpleasant events. Their association to "daydreaming" was often going blank rather than creating vividly recalled fantasies. Both score equally high on formal scales of hypnotic susceptibility.[46][47][48]
Individuals with dissociative identity disorderhave the highest hypnotisability of any clinicalgroup, followed by those with posttraumatic stress disorder.[49]
History
Precursors
Hypnosis is not exactly a new concept. 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. Modern day hypnosis however started in the late 18th century and was made popular by Franz Mesmer, an Austrian physician who became known as the father of ‘modern hypnotism’. In fact, hypnosis used to be known as ‘Mesmerism’ as it was named after Mesmer.
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 was no magical element to hypnotism.
Before long, hypnotism started finding its way into the world of modern medicine. The use of hypnotism in the medical field was made popular by surgeons and physicians likeElliotson and James Esdaille and researchers like James Braid who helped to reveal the biological and physical benefits of hypnotism.[50] According to his writings, Braid began to hear reports concerning various Orientalmeditative practices soon after the release of his first publication on hypnotism,Neurypnology (1843). He first discussed some of these oriental practices in a series of articles entitled Magic, Mesmerism, Hypnotism, etc., Historically & Physiologically Considered. He drew analogies between his own practice of hypnotism and various forms of Hindu yoga meditation and other ancient spiritual practices, especially those involvingvoluntary burial and apparent human hibernation. Braid's interest in these practices stems from his studies of the Dabistān-i Mazāhib, the "School of Religions", an ancient Persian text describing a wide variety of Oriental religious rituals, beliefs, and practices.
Although he rejected the transcendental/metaphysical interpretation given to these phenomena outright, Braid accepted that these accounts of Oriental practices supported his view that the effects of hypnotism could be produced in solitude, without the presence of any other person (as he had already proved to his own satisfaction with the experiments he had conducted in November 1841); and he saw correlations between many of the "metaphysical" Oriental practices and his own "rational" neuro-hypnotism, and totally rejected all of the fluid theories and magnetic practices of the mesmerists. As he later wrote:
Avicenna
Avicenna (980–1037), a Persian physician, documented the characteristics of the "trance" (Hypnotic Trance) state in 1027. At that time, hypnosis as a medical treatment was seldom used until the German doctor Franz Mesmer, reintroduced it in the 18th century.[53]
Franz Mesmer
Franz Mesmer (1734–1815) believed that there is a magnetic force or "fluid" called "animal magnetism" within the universe that influences the health of the human body. He experimented with magnets to impact this field in order to produce healing. By around 1774, he had concluded that the same effect could be created by passing the hands in front of the subject's body, later referred to as making "Mesmeric passes". The word "mesmerize", formed from the last name of Franz Mesmer, was intentionally used to separate practitioners of mesmerism from the various "fluid" and "magnetic" theories included within the label "magnetism".
In 1784, at the request of King Louis XVI, a Board of Inquiry started to investigate whether animal magnetism existed. Among the board members were founding father of modern chemistry Antoine Lavoisier,Benjamin Franklin, and an expert in pain control, Joseph-Ignace Guillotin. They investigated the practices of a disaffected student of Mesmer, one Charles d'Eslon (1750–1786), and though they concluded that Mesmer's results were valid, their placebo-controlled experiments using d'Eslon's methods convinced them that mesmerism was most likely due to belief and imagination rather than to an invisible energy ("animal magnetism") transmitted from the body of the mesmerist.
In writing the majority opinion, Franklin said: "This fellow Mesmer is not flowing anything from his hands that I can see. Therefore, this mesmerism must be a fraud." Mesmer left Paris and went back to Vienna to practise mesmerism.
James Braid
Following the French committee's findings,Dugald Stewart, an influential academic philosopher of the "Scottish School of Common Sense", encouraged physicians in his Elements of the Philosophy of the Human Mind (1818)[54] to salvage elements of Mesmerism by replacing the supernatural theory of "animal magnetism" with a new interpretation based upon "common sense" laws of physiology and psychology. Braid quotes the following passage from Stewart:[55]
In Braid's day, the Scottish School of Common Sense provided the dominant theories of academic psychology, and Braid refers to other philosophers within this tradition throughout his writings. Braid therefore revised the theory and practice of Mesmerism and developed his own method of hypnotism as a more rational and common sense alternative.
Despite briefly toying with the name "rational Mesmerism", Braid ultimately chose to emphasise the unique aspects of his approach, carrying out informal experiments throughout his career in order to refute practices that invoked supernatural forces and demonstrating instead the role of ordinary physiological and psychological processes such as suggestion and focused attention in producing the observed effects.
Braid worked very closely with his friend and ally the eminent physiologist ProfessorWilliam Benjamin Carpenter, an early neuro-psychologist who introduced the "ideo-motor reflex" theory of suggestion. Carpenter had observed instances of expectation and imagination apparently influencing involuntary muscle movement. A classic example of the ideo-motor principle in action is the so-called "Chevreul pendulum" (named after Michel Eugène Chevreul). Chevreul claimed that divinatory pendulae were made to swing by unconscious muscle movements brought about by focused concentration alone.
Braid soon assimilated Carpenter's observations into his own theory, realising that the effect of focusing attention was to enhance the ideo-motor reflex response. Braid extended Carpenter's theory to encompass the influence of the mind upon the body more generally, beyond the muscular system, and therefore referred to the "ideo-dynamic" response and coined the term "psycho-physiology" to refer to the study of general mind/body interaction.
In his later works, Braid reserved the term "hypnotism" for cases in which subjects entered a state of amnesia resembling sleep. For other cases, he spoke of a "mono-ideodynamic" principle to emphasise that the eye-fixation induction technique worked by narrowing the subject's attention to a single idea or train of thought ("monoideism"), which amplified the effect of the consequent "dominant idea" upon the subject's body by means of the ideo-dynamic principle.[57]
Hysteria vs. suggestion
For several decades Braid's work became more influential abroad than in his own country, except for a handful of followers, most notably Dr. John Milne Bramwell. The eminent neurologist Dr. George Miller Beardtook Braid's theories to America. Meanwhile, his works were translated into German byWilliam Thierry Preyer, Professor of Physiology at Jena University. The psychiatrist Albert Moll subsequently continued German research, publishingHypnotism in 1889. France became the focal point for the study of Braid's ideas after the eminent neurologist Dr. Étienne Eugène Azamtranslated 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.[58]
Azam's enthusiasm for hypnotism influencedAmbroise-Auguste Liébeault, a country doctor. Hippolyte Bernheim discovered Liébeault's enormously popular group hypnotherapy clinic and subsequently became an influential hypnotist. The study of hypnotism subsequently revolved around the fierce debate between Bernheim and Jean-Martin Charcot, the two most influential figures in late 19th-century hypnotism.
Charcot operated a clinic at the Pitié-Salpêtrière Hospital (thus, known as the "Paris School" or the "Salpêtrière School"), while Bernheim had a clinic in Nancy (known as the "Nancy School"). Charcot, who was influenced more by the Mesmerists, argued that hypnotism was an abnormal state of nervous functioning found only in certain hystericalwomen. He claimed that it manifested in a series of physical reactions that could be divided into distinct stages. Bernheim argued that anyone could be hypnotised, that it was an extension of normal psychological functioning, and that its effects were due to suggestion. After decades of debate, Bernheim's view dominated. Charcot's theory is now just a historical curiosity.[59]
Pierre Janet
Pierre Janet (1859–1947) reported studies on a hypnotic subject in 1882. Charcot subsequently appointed him director of the psychological laboratory at the Salpêtrière in 1889, after Janet had completed his PhD, which dealt with psychological automatism. In 1898, Janet was appointed psychology lecturer at the Sorbonne, and in 1902 he became chair of experimental and comparative psychology at the Collège de France.[60] Janet reconciled elements of his views with those of Bernheim and his followers, developing his own sophisticated hypnotic psychotherapy based upon the concept of psychological dissociation, which, at the turn of the century, rivalled Freud's attempt to provide a more comprehensive theory of psychotherapy.
Sigmund Freud
Sigmund Freud (1856–1939), the founder ofpsychoanalysis, 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",[61]and he soon began to emphasise hypnotic regression and ab reaction (catharsis) as therapeutic methods. He wrote a favorable encyclopedia article on hypnotism, translated one of Bernheim's works into German, and published an influential series of case studies with his colleague Joseph Breuer entitledStudies on Hysteria (1895). This became the founding text of the subsequent tradition known as "hypno-analysis" or "regression hypnotherapy".
However, Freud gradually abandoned hypnotism in favour 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."[62]
Only a handful of Freud's followers, however, were sufficiently qualified in hypnosis to attempt the synthesis. Their work had a limited influence on the hypno-therapeutic approaches now known variously as "hypnotic regression", "hypnotic progression", and "hypnoanalysis".
Émile Coué
Émile Coué (1857–1926) assisted Ambroise-Auguste Liébeault for around two years at Nancy. After practising for several months employing the "hypnosis" of Liébeault and Bernheim's Nancy School, he abandoned their approach altogether. Later, Coué developed a new approach (c.1901) based on Braid-style "hypnotism", direct hypnotic suggestion, and ego-strengthening which eventually became known as La méthode Coué.[63] According toCharles Baudouin Coué founded what became known as the New Nancy School, a loose collaboration of practitioners who taught and promoted his views.[64][65] Coué's method did not emphasise "sleep" or deep relaxation, but instead focused uponautosuggestion involving a specific series of suggestion tests. Although Coué argued that he was no longer using hypnosis, followers such as Charles Baudouin viewed his approach as a form of light self-hypnosis. Coué's method became a renowned self-helpand psychotherapy technique, which contrasted with psychoanalysis and prefigured self-hypnosis and cognitive therapy.
Clark L. Hull
The next major development came frombehavioural 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 behavioural psychology interpretation of hypnosis, emphasising conditioned reflexes, rivalled the Freudian psycho-dynamic interpretation which emphasised unconscious transference.
Dave Elman
Although Dave Elman (1900–1967) was a noted radio host, comedian, and songwriter, he also made a name 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
Milton Erickson (1901–1980) 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, characterised 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 practising "hypnosis" at all, and his approach remains in question.
Cognitive-behavioural
In the latter half of the 20th century, two factors contributed to the development of the cognitive-behavioural approach to hypnosis:
- Cognitive and behavioural theories of the nature of hypnosis (influenced by the theories of Sarbin[67] and Barber[35]) became increasingly influential.
- The therapeutic practices of hypnotherapy and various forms of cognitive behavioural therapy overlapped and influenced each other.[68][69]
Although cognitive-behavioural theories of hypnosis must be distinguished from cognitive-behavioural approaches to hypnotherapy, they share similar concepts, terminology, and assumptions and have been integrated by influential researchers and clinicians such as Irving Kirsch, Steven Jay Lynn, and others.[70]
At the outset of cognitive behavioural therapyduring the 1950s, hypnosis was used by early behaviour therapists such as Joseph Wolpe[71] and also by early cognitive therapists such as Albert Ellis.[72] Barber, Spanos, and Chaves introduced the term "cognitive-behavioural" to describe their "nonstate" theory of hypnosis in Hypnosis, imagination, and human potentialities.[35]However, Clark L. Hull had introduced a behavioural psychology as far back as 1933, which in turn was preceded by Ivan Pavlov.[73]Indeed, the earliest theories and practices of hypnotism, even those of Braid, resemble the cognitive-behavioural orientation in some respects.[69][74]
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. However, a study published in 1958 by the Council on Mental Health of the American Medical Association documented the efficacy of hypnosis in clinical settings.[75]
Hypnosis has been used as a supplemental approach to cognitive behavioral therapysince 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 stimuli. One way of inducing the relaxed state was through hypnosis.[76]
Hypnotism has also been used in forensics,sports, education, physical therapy, andrehabilitation.[77] 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[78] and mystical experiences.[79][80] 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.[81]
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.[82]
Hypnotherapy
Hypnotherapy is a use of hypnosis in psychotherapy.[83][84][85] 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, and posttraumatic stress,[86][87][88]while certified hypnotherapists who are not physicians or psychologists often treat smoking and weight management.
Hypnotherapy is a helpful adjunct having additive effects when treating psychological disorders, such as these, along with scientifically proven cognitive therapies. Hypnotherapy should not be used for repairing or refreshing memory because hypnosis results in memory hardening, which increases the confidence in false memories.[89]
Preliminary research has expressed brief hypnosis interventions as possibly being a useful tool for managing painful HIV-DSP because of its history of usefulness in pain management, its long-term effectiveness of brief interventions, the ability to teach self-hypnosis to patients, the cost-effectiveness of the intervention, and the advantage of using such an intervention as opposed to the use of pharmaceutical drugs.[90]
Modern hypnotherapy has been used, with varying success, in a variety of forms, such as:
Charcot demonstrating hypnosis on a "hysterical"Salpêtrière patient, "Blanche" (Marie Wittmann), who is supported by Joseph Babiński.[91]
- Cognitive-behavioural hypnotherapy, or clinical hypnosis combined with elements of cognitive behavioural therapy[69]
- Age regression hypnotherapy (or "hypnoanalysis")
- Ericksonian hypnotherapy
- Fears and phobias[92][93][94][95][96][97]
- Addictions[98][99]
- Habit control[100][101][102]
- Pain management[103][104][105][106]
- Psychotherapy[107]
- Relaxation[108]
- Reduce patient behavior (e.g., scratching) that hinders the treatment of skin disease[109]
- Soothing anxious surgical patients
- Sports performance[110][111]
- Weight loss[112][113][114]
Barrett described specific ways this is operationalized for habit change and amelioration of phobias. In her 1998 book of hypnotherapy case studies,[87] she reviews the clinical research on hypnosis with dissociative disorders, smoking cessation, and insomnia, and describes successful treatments of these complaints.
In a July 2001 article for Scientific Americantitled "The Truth and the Hype of Hypnosis", Michael Nash wrote that, "using hypnosis, scientists have temporarily created hallucinations, compulsions, certain types of memory loss, false memories, and delusions in the laboratory so that these phenomena can be studied in a controlled environment."[116]
Irritable bowel syndrome
Hypnotherapy has been studied for the treatment of irritable bowel syndrome.[117][118]Hypnosis for IBS has received moderate support in the National Institute for Health and Clinical Excellence guidance published for UK health services.[119] It has been used as an aid or alternative to chemicalanesthesia,[120][121][122] and it has been studied as a way to soothe skin ailments.[123]
Pain management
A number of studies show that hypnosis can reduce the pain experienced during burn-wound debridement,[124] bone marrow aspirations, and childbirth.[125][126] TheInternational Journal of Clinical and Experimental Hypnosis found that hypnosis relieved the pain of 75% of 933 subjects participating in 27 different experiments.[116]
Hypnosis is effective in reducing pain from[127] and coping with cancer[128] and other chronic conditions.[116] Nausea and other symptoms related to incurable diseases may also be managed with hypnosis.[129][130][131][132] 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."[133]
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.[134] Additionally, Meyerson and Uziel have suggested that hypnotic methods have been found to be highly fruitful for alleviating anxiety in patients suffering from severe dental phobia.[135]
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.[136]
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.[137]
Other medical and psychotherapeutic uses
Treating skin diseases with hypnosis (hypnodermatology) has performed well in treating warts, psoriasis, and atopic dermatitis.[138]
The success rate for habit control is varied. A meta-study researching hypnosis as a quit-smoking tool found it had a 20 to 30 percent success rate,[139] while a 2007 study of patients hospitalised for cardiac and pulmonary ailments found that smokers who used hypnosis to quit smoking doubled their chances of success.[140]
Hypnosis may be useful as an adjunct therapy for weight loss. A 1996 meta-analysis studying hypnosis combined with cognitive behavioural therapy found that people using both treatments lost more weight than people using cognitive behavioural therapy alone.[141]The virtual gastric band procedure mixes hypnosis with hypnopedia. The hypnosis instructs the stomach that it is smaller than it really is, and hypnopedia reinforces alimentary habits. A 2016 pilot study found that there was no significant difference in effectiveness between VGB hypnotherapy and relaxation hypnotherapy.[142]
Controversy surrounds the use of hypnotherapy to retrieve memories, especially those from early childhood or (supposed) past-lives. The American Medical Association and the American Psychological Association caution against recovered-memory therapy in cases of alleged childhood trauma, stating that "it is impossible, without corroborative evidence, to distinguish a true memory from a false one."[143] Past life regression, meanwhile, is often viewed with skepticism.[144][145]
Psychiatric nurses in most medical facilities are allowed to administer hypnosis to patients in order to relieve symptoms such as anxiety, arousal, negative behaviours, uncontrollable behaviour, and to improve self-esteem and confidence. This is permitted only when they have been completely trained about their clinical side effects and while under supervision when administering it.[146]
Military
A 2006 declassified 1966 document obtained by the US Freedom of Information Act archive shows that hypnosis was investigated for military applications.[147] The full paper explores the potentials of operational uses.[147] The overall conclusion of the study was that there was no evidence that hypnosis could be used for military applications, and no clear evidence whether "hypnosis" is a definable phenomenon outside ordinary suggestion, motivation, and subject expectancy. According to the document:
Furthermore, the document states that:
The study concludes:
Research into hypnosis in military applications is further verified by the Project MKULTRA experiments, also conducted by theCIA.[148] According to Congressional testimony,[149] the CIA experimented with utilizing LSD and hypnosis for mind control. Many of these programs were done domestically and on participants who were not informed of the study's purposes or that they would be given drugs.[149]
Self-hypnosis
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.[150]
Stage hypnosis
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.[151] 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".[152] 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.
Music hypnosis
The discussion of music as hypnosis was a development of Franz Mesmer, a German physician who invented the theory of ‘animal magnetism’ in the 18th century, combined with the romantic aesthetics of music that portrayed mesmeric trances to the self. It is a new conception of the self and the sensual aesthetics of music that portrayed musical mesmeric trance as a treatment to symptom such as hysteria. Mesmer would often conclude his treatments by playing music on a glass armonica.[153][154]
Franz Mesmer argued that music is a matter of ‘sympathetic vibration’, just as his theory ofanimal magnetism where the sound vibration can communicate, propagated, and reinforced.[155] Mesmer believe that his theory of a universal fluid and mesmeric gaze can be manipulated and contributed to health. The use of instruments such as pianos, violins, harps, and especially glass armonica were known as the instruments that featured in his treatment and liable for Mesmer's success.[156]
The direct physical ability of hearing in human leads to the impossibility to reject the sounds entering the ears. In fact, music has contributed to external stimuli that provoked exhilaration and anxiety. This encourage the idea of ‘losing one’s self’, which is a sentimental escape from the realm of one’s psyche. However, this idea can often be disturbing and detrimental. It sometimes lead to a harmful concern within the boundary between oneself and those who manipulate it.[157]
Hypnotic music became an important part in the development of a ‘physiological psychology’ that regarded the hypnotic state as an ‘automatic’ phenomenon that links to physical reflex. Jean-Martin Charcot's use of gongs and tuning forks and Ivan Pavlov’s use of bell have shown a condition reflexes in their experiment of sound hypnosis. The idea behind this experiment was to prove the automatic responses to sound and to physiologically determined the bypassing of the conscious mind. It was clear that music can be a potential threat to oneself, in which it create susceptibility to external stimuli and therefore as a danger to self-control and the sanity of an individual.[158]
The automatic responses to sound shows the possibility of 'mental contagion' through music where anxiety is related to unrestrained fears about the impact of music to nerve. The nervous system's automatic reflexes and its connection between physical stimulation and the mind has become the main point of the discussion during the eighteen century. The impact of music on the nerve was seen as a refined context of the nerves of sensibility. However, by the early nineteenth century, music was assigned and integrated into the medical critique of modern stimulation. Some medical critics suggested that music has an ability to directly causes pathologies of the nerves, but some argued that the effect on the imagination from a musical nervous stimulation is an extension of the fear; going beyond stimulated nerves and losing the autonomy.[159]
Music as Satanic brainwashing
Between the 1980s and 1990s, a moral panic erupted in the US that conjugated a corrupted version of the science of brainwashing; the belief in a literal supernatural threat (Satanic Panic) that lies within the musical genre of heavy metal. Certain books such as The Devil's Disciples stated that some bands brainwashed American teenagers with subliminal messages to lure them into the worship of the devil, sexual immorality, murder, and especially suicide.[160] The use of satanic iconography and rhetoric in this genre provokes the parents and society, and also advocate masculine power for an audience, especially on teenagers who were ambivalent of their identity. The counteraction on heavy metal in terms of satanic brainwashing is an evidence that linked to the automatic response theories of musical hypnotism.[161]
Crime
Various people have been suspected of or convicted for hypnosis-related crimes, including robbery and sexual abuse.
In 2011, a Russian "evil hypnotist" was suspected of tricking customers in banks around Stavropol into giving away thousands of pounds worth of money. According to the local police, he would approach them and make them withdraw all of the money from their bank accounts, which they would then freely give to the man.[162] A similar incident was reported in London in 2014, where a video seemingly showed a robber hypnotizing a shopkeeper before robbing him. The victim did nothing to stop the robber from looting his pockets and taking his cash, only calling out the thief when he was already getting away.[163][164]
In 2013, the then-40-year-old amateur hypnotist Timothy Porter attempted to sexually abuse his female weight-loss client. She reported awaking from a trance and finding him behind her with his pants down, telling her to touch herself. He was subsequently called to court and included on the sex offender list.[165] In 2015, Gary Naraido, then 52, was sentenced to 10 years in prison for several hypnosis-related sexual abuse charges. Besides the primary charge by a 22-year-old woman who he sexually abused in a hotel under the guise of a free therapy session, he also admitted to having sexually assaulted a 14-year-old girl.[166]
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