Friday 25 June 2010

Hypnosis

"Hypnotized" redirects here. For other uses, see Hypnotized (disambiguation).
Hypnosis is a mental state (state theory) or imaginative role-enactment (non-state theory) usually induced by a procedure known as a hypnotic induction, which is commonly composed of a long series of preliminary instructions and suggestions.[1] Hypnotic suggestions may be delivered by a hypnotist in the presence of the subject, or may be self-administered ("self-suggestion" or "autosuggestion"). The use of hypnotism for therapeutic purposes is referred to as "hypnotherapy."
The words 'hypnosis' and 'hypnotism' both derive from the term "neuro-hypnotism" (nervous sleep) coined by the Scottish surgeon James Braid around 1841. Braid based his practice on that developed by Franz Mesmer and his followers ("Mesmerism" or "animal magnetism"), but differed in his theory as to how the procedure worked.
Contrary to a popular misconception - that hypnosis is a form of unconsciousness resembling sleep - contemporary research suggests that it is actually a wakeful state of focused attention[2] and heightened suggestibility,[3] with diminished peripheral awareness.[4] In the first book on the subject, Neurypnology (1843), Braid described "hypnotism" as a state of physical relaxation accompanied and induced by mental concentration ("abstraction")
Skeptics point out the difficulty distinguishing between hypnosis and the placebo effect, proposing that hypnosis is so heavily reliant upon the effects of suggestion and belief that it would be hard to imagine how a credible placebo control could ever be devised for a hypnotism study.
It could be said that hypnotic suggestion is explicitly intended to make use of the placebo effect. For example, in 1994, Irving Kirsch proposed a definition of hypnosis as a "nondeceptive mega-placebo," i. e., a method which openly makes use of suggestion and employs methods to amplify its effects.
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 opposed to normal 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.

Braid elaborated upon this brief definition in a later work:
[...] the real origin and essence of the hypnotic condition, is the induction of a habit of abstraction or mental concentration, in which, as in reverie or spontaneous abstraction, the powers of the mind are so much engrossed with a single idea or train of thought, as, for the nonce, to render the individual unconscious of, or indifferently conscious to, all other ideas, impressions, or trains of thought. The hypnotic sleep, therefore, is the very antithesis or opposite mental and physical condition to that which precedes and accompanies common sleep [...]
Braid therefore defined hypnotism as a state of mental concentration which often led 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 exhibited amnesia, substituting the term "monoideism", meaning concentration upon a single idea, as a description for the more alert state experienced by the others.
Since it can not (or has not) been defined in scientific terms. It can not be subjected to the scientific method for confirming its existence as more than a theory.
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:

New Definition: Hypnosis

The Division 30 Definition and Description of Hypnosis
Hypnosis typically involves an introduction to the procedure during which the subject is told that suggestions for imaginative experiences will be presented. The hypnotic induction is an extended initial suggestion for using one's imagination, and may contain further elaborations of the introduction. A hypnotic procedure is used to encourage and evaluate responses to suggestions. When using hypnosis, one person (the subject) is guided by another (the hypnotist) to respond to suggestions for changes in subjective experience, alterations in perception, sensation, emotion, thought or behavior. Persons can also learn self-hypnosis, which is the act of administering hypnotic procedures on one's own. If the subject responds to hypnotic suggestions, it is generally inferred that hypnosis has been induced. Many believe that hypnotic responses and experiences are characteristic of a hypnotic state. While some think that it is not necessary to use the word "hypnosis" as part of the hypnotic induction, others view it as essential.
Details of hypnotic procedures and suggestions will differ depending on the goals of the practitioner and the purposes of the clinical or research endeavor. Procedures traditionally involve suggestions to relax, though relaxation is not necessary for hypnosis and a wide variety of suggestions can be used including those to become more alert. Suggestions that permit the extent of hypnosis to be assessed by comparing responses to standardized scales can be used in both clinical and research settings. While the majority of individuals are responsive to at least some suggestions, scores on standardized scales range from high to negligible. Traditionally, scores are grouped into low, medium, and high categories. As is the case with other positively-scaled measures of psychological constructs such as attention and awareness, the salience of evidence for having achieved hypnosis increases with the individual's score.
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, as a means of heightening client expectation, defining their role, focusing attention, etc. There are an enormous variety of different induction techniques used in hypnotism. However, by far the most influential method was the original "eye-fixation" technique of Braid, 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:
James Braid's Original Eye-Fixation Hypnotic Induction Method
Take any bright object (I generally use my 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 towards 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. It will generally be found, that the eyelids close with a vibratory motion, or become spasmodically closed.
Braid himself 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 (q.v., Barber, Spanos & Chaves, 1974). Many variations and alternatives to the original hypnotic induction techniques were subsequently developed. However, exactly 100 years after Braid introduced the method, another expert could still state: "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
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. (Hypnosis & Suggestion, 1884: 15)
Bernheim's conception of the primacy of verbal suggestion in hypnotism dominated the subject throughout the twentieth century, leading some authorities to declare him the father of modern hypnotism (Weitzenhoffer, 2000). Contemporary hypnotism makes use of a wide variety of different forms of suggestion 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" or in a more "authoritarian" manner. Some hypnotic suggestions are intended to bring about immediate responses, whereas others (post-hypnotic suggestions) are intended to trigger responses after a delay ranging from a few minutes to many years in some reported cases.
Some hypnotists conceive of suggestions as being a form of communication directed primarily to the subject's conscious mind, whereas others view suggestion as a means of communicating with the "unconscious" or "subconscious" mind. These concepts were introduced into hypnotism at the end of 19th century by Sigmund Freud and Pierre Janet. The original Victorian pioneers of hypnotism, including Braid and Bernheim, did not employ these concepts but considered hypnotic suggestions to be 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 believed that responses are mediated primarily by an "unconscious mind", like Milton Erickson, made more 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 also depends upon this view of the mind. By contrast, hypnotists who believed that responses to suggestion are primarily mediated by the conscious mind, such as Theodore Barber and Nicholas Spanos tended to make more use of direct verbal suggestions and instructions.
The first neuro-psychological theory of hypnotic suggestion was introduced early on 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, other than muscular movement, can be thus affected, e.g., 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 hold considerable influence over subsequent theories of hypnosis, including those of Clark L. Hull, Hans Eysenck, and Ernest Rossi. It should be noted that in Victorian psychology, the word "idea" encompasses any mental representation, e.g., including mental imagery, or memories, etc.
It has been alleged post-hypnotic suggestion can be used to change people's behaviour after emerging from hypnosis. One author wrote that "a person can act, some time later, on a suggestion seeded during the hypnotic session". A hypnotherapist told one of his patients, who was also a friend: 'When I touch you on the finger you will immediately be hypnotised.' Fourteen years later, at a dinner party, he touched him deliberately on the finger and his head fell back against the chair
Braid made a rough distinction between different stages of hypnosis which he termed the first and second conscious stage of hypnotism;[citation needed] he later replaced this with a distinction between "sub-hypnotic", "full hypnotic", and "hypnotic coma" stages.[citation needed] Jean-Martin Charcot made a similar distinction between stages named somnambulism, lethargy, and catalepsy. However, Ambroise-Auguste Liébeault and 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. Andre 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" based upon supposed observable signs, such as spontaneous amnesia, most subsequent scales measure 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.[15] 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 vividly recalled fantasies. Both score equally high on formal scales of hypnotic susceptibility.