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Thursday, October 27, 2011
HYPNOTHERAPY & MEMORY RECALL
Hypnosis And The Validity Of Memories Retrieved In The ‘State’.
When a client in hypnosis is encouraged to recall a past event which he does not recall completely in the waking state, he is likely to produce a considerably more vivid form of recall, and if the incident involved emotional trauma, he is likely to relive the event displaying intense affect. It is quite common for the individual in hypnosis to describe what is occurring with extensive details, many of which would be known only to an individual who was , in fact, there.In a therapeutic setting and even in some other contexts, the individual may feel considerably relieved after the hypnotic session, and not uncommonly, psychopathological symptoms related to the matters recalled may be ameliorated or totally alleviated.
Because of the dramatic display of affect, the myriad of additional details brought forth, and the psychological improvement, there is a tendency for a therapist as well as lay observers to assume that these hypnotic memories are in fact historically accurate. This assumption is not justified. Typically, memories from different periods in the client’s life are combined; further, fantasies, beliefs, and fears may be mixed with actual recollections. While the ‘memories’ represent a psychologically meaningful truth useful in treatment, they should not be confused with historically accurate fact. There is no way by which either the hypnotist or the subject can determine which aspects of these recollections are accurate and which aspects represent anachronistic memories dating from other times or from fantasies which never occurred at all. Neither the plausibility, nor the nature of the affect, nor the subjective conviction of the patient can be accepted as meaningful evidence for the historical accuracy of the collection.Furthermore, a client may show a dramatic improvement from working through pseudomemories which have no historical basis. It should be emphasised that reliving past events in hypnosis may seem so vivid and so convincing that not only hypnotherapists but also highly trained psychiatrists may be deceived.
In the U.S.A., because of these difficulties, the American Medical Association has taken an official position on December 5th, 1984, which states that hypnosis does not result in increased reliable recall, that under some circumstances additional details may be remembered, some of which may be accurate and others inaccurate, and that recognition memory is not aided. For these reasons, the AMA has indicated that previously hypnotised witnesses should not give testimony in court concerning the matters about which they have been hypnotised. If hypnosis is used at all, it should be strictly limited to the investigational use of the technique and a number of guidelines must be followed to minimise the likelihood of a miscarriage of justice.
Throughout the world there are hundreds of different hypnotherapy associations and schools all with their own theories specialising in a particular field of therapy. The analytical hypnotherapist with Freudian approach is unique in the family of hypnotherapists mainly because all other schools adopt a suggestive approach.
The motto of the International Association of Hypno‑Analysts is "Cessante Causa Cessat et Effectus" meaning Cause and Effect. Every symptom must have a cause which in turn creates a symptom. Once the cause of the problem is found the symptoms evaporate, at least that is the theory.
An old friend of Freud's and respected physician, Joseph Brene (1842‑1925) discovered from his hypnotic work with Bertha Pappenheim (The Case of Anna 0) that:
Each symptom disappeared when traced back to its first occasion.
Symptoms were removed by recalling forgotten unpleasant events.
A symptom emerged with greater force when it was being taken away.
Repression is pushing something into the unconscious, or keeping something from becoming conscious. Repression keeps the individual from being in a continual state of confusion by preventing him from becoming aware of many things, through what is forgotten or unknown still remains an active force in the unconscious part of the mind.
A more technical definition:
Repression: A key concept of psychoanalysis is a defence mechanism that ensures that what is unacceptable to the conscious mind, and would if recalled arouse anxiety, is prevented from entering into it. Akin to denial, which tends to refer to current events, it was invoked to account for a patient's failure to recall, in the course of free association, events of significance in the past. Painful memories, being kept out of consciousness by repression, achieve psychic autonomy and become fixed. Derivatives of what has been repressed may evade the censorship and enter into consciousness in a disguised form as strange or seemingly irrational thoughts. Or they may be recalled in dreams or in other states, e.g., those due to alcohol or drugs, or hypnosis, with what Freud described as "the undiminished vividness of recent events".
The method of psychoanalysis creates conditions for the undoing of repression, i.e., the making conscious of what has been repressed. Painful experiences when so recalled are ranged alongside other related experiences which perhaps contradict it, they then undergo correction by means of other ideas.
Usually at about the age of 6, ideas and impulses associated with early sexual development are pushed into the unconscious (i.e., repressed) and denied expression. But the impulses are still there ‑ in latent form. The sexually organised memories of the three stages of infantile sexuality will influence future associations.
If you like infantile amnesia takes place so that people can later deny their early sexual experiences:
"I did this" says my memory.
"I cannot have done this" says my pride... and remains inexorable.
In the end ‑ memory yields (Nietzsche).
As the analytical course progresses case examples will demonstrate in more clarity the effects of repression. The acceptance and understanding of the concept of repression are essential to the working of hypno‑analytical therapy.
Bowers, Kenneth S. (1995, November). Revisiting a Century-Old Freudian Slip -- from Suggestion Disavowed to the Truth Repressed. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.
Cites J. Herman, Mason, and Miller who accused Freud of retreating from trauma theory to save his theory. Feminists view the Oedipal theory as a coverup for the denial of child sexual abuse. This moral position fuels trauma theory and practice. It is the moral dimension of this debate that gives so many problems for the investigation of traumatic memory.
The intellectual origins of repressed trauma are examined here. Freud's early trauma theory, his later conflict theory.
Etiology of Hysteria (1896) presents Freud's argument, based on 18 patients: child is passive victim of experience imposed on them; memory is repressed and hysterical symptoms are derivatives of these repressed memories; when memories return as pictures the task of therapy is easier than if returning as thoughts. Bartlett's memory research showed visual image is followed by sense of confidence that surpasses what should be there.
The fact that patients had to be compelled to remember was offered by Freud as evidence against the idea that the memories were suggested. The patients initially would deny the reality of their memories, which Freud used in saying that we should not think that patients would falsely accuse themselves. In letter to Fleiss, he presented the conflict theory, which he presented in 1905 in Three Essays on Sexuality and later in My Views...on Etiology of Neurosis.
In 1905 Freud indicated he was unable to distinguish fantasy from true reports (and did not deny the existence of the latter). Freud often reconstructed the "memories" from dreams, transference, signs, symptoms, fantasies, etc. They were not produced as conscious memories, and it was Freud who inferred the sexual abuse. From signs of distress he took evidence of proof.
Freud presented his theory to his patients and then sought confirmation.
Freud asks us to abandon historical for narrative truth. The problems with Freud's first theory became worse with his second theory. In Introductory Lectures Freud states that opponents say his treatment talks patients into confirming his theories. He relies on the patient's inner reality confirming the theoretical ideas given to him. Success depends on overcoming internal resistance, however. The danger in leading a patient astray by suggestion has been exaggerated, because the analyst would have had to not allow the patient to "have his say." Freud denied strongly ever having done this.
Incorrect interpretations would not be accepted by the patients, and if believed would be suggestion. Brunbaum, another writer, said that this doesn't mean acceptance of a faulty idea won't occur. Both Milton Erickson and especially Pierre Janet reported cases in which suggestions were used to give benign memories to replace malignant ones.
Freud also viewed patient resistance to his interpretations as evidence that the interpretations were correct. Thus both resistance and acquiescence were thought to be validating. Popper's critiques using philosophy of science note that this makes his theory untestable.
Freud could not distinguish between the patient's reluctant acceptance of the truth and reluctant acceptance of a suggestion.
Contemporary theorists struggle less than Freud did with the problem of suggestion and suggestibility (and Freud did not have available the research on those areas!) Emotional upheaval that accompanies "insight" is readily taken to be validating. It may be true that bad memories are repressed, but that doesn't mean that all bad memories are true.
Treatment groups focus on recalling memories and sharing memories with others in the group, not on current relationships. Hermann states that the group provides powerful stimulus for remembering. The group, of course, is reinforced by others remembering. Repeatedly considering the possibility of abuse can increase the sense of familiarity.
Current views expressed by some clinicians that certain symptoms and syndromes (eating disorders, etc.) indicate early sexual trauma are similar to Freud's theory of hysteria. In these proposals, the inability to recall abuse becomes evidence that it occurred; and it tallies with the patient not having a sense of remembering.
Because some believe it is necessary to bring memory to light for cure to occur, there is a tendency to believe the reports of early childhood abuse.
Recognizing that some "memories" may have been a product of a therapist's suggestion helps prevent untoward effects. Modern therapists recapitulate Freud's "slip" when they do not acknowledge the role of suggestion.
Endorsing repression does not commit us to a belief that recovered memories must be accurate in all particulars. A memory that is repressed does not escape the usual kinds of degradation of memory.
And just because the material comes from unconscious sources, or has emotional accompaniments, it doesn't mean it is true. (Bowers gave an example of his dream that Israel and Venezuela shared a common border, which was rectified by his waking awareness of the Atlantic Ocean and the Mediterranean. He noted that nothing like the Atlantic can be called upon if the dream is that one's parent molested oneself at the age of six.)
Ian Hacking, in Rewriting the Soul, labels a more fundamental indeterminacy (for the historical past itself). Bathing rituals in childhood can be redescribed as abuse, which determines the historical past rather than describing it. It is thus easier to justify abuse if the event is something that can be reinterpreted. For example, the conflicts of adolescents with their parents, may be reinterpreted later if personality problems continue. If in adulthood one concludes that abuse occurred, then bathing rituals can be reinterpreted as if it were earlier abuse, as if the abuse has continued for years.
Levitt, Eugene E.; Pinnell, Cornelia Mare (1995). Some additional light on the childhood sexual abuse-psychopathology axis. International Journal of Clinical and Experimental Hypnosis, 43 (2), 145-162.
This exposition is an attempt to unravel the complexities of the relationship between childhood sexual abuse and adult psychopathology. Four facets of the relationship are examined in some detail: (a) the extent of childhood sexual abuse; (b) the probability that sexual abuse in childhood will result in psychopathology in the adult; (c) the reliability of early life memories in later life; and (d) the role of recovered memory of trauma in the healing process. The conclusions of this logico-empirical analysis are that first, government statistics tend to underestimate the extent of childhood sexual abuse, whereas independent surveys tend to overestimate it. Estimating prevalence is further complicated by variations in the definitions of key terms. Possibly the only safe conclusion is that true prevalence cannot be reliably determined. Second, empirical investigations of childhood sexual abuse conclude that not all victims are emotionally injured. A substantial number of these investigations find that a majority of victims suffer no extensive harm. Other variables such as family dynamics are involved; there may be only a few cases in which emotional harm results from sexual abuse as a single factor. Third, memory research suggests that memory in general is a dynamic, reconstructive process and that recall of childhood events is particularly vulnerable to distortion. Memory cannot dependably produce historical truth. Last, there is some clinical evidence that abreaction of a traumatic event in adulthood may have a remediative effect. Similar evidence for childhood trauma is lacking. The belief in the healing effect of recalling and reliving a childhood trauma depends on the therapist's orientation.
Nagy, Thomas F. (1995). Incest memories recalled in hypnosis -- a case study: A brief communication. International Journal of Clinical and Experimental Hypnosis, 43 (2), 118-126.
Accuracy of repressed memories recovered in hypnosis cannot be reliably determined with any greater certainty than non-hypnotically recalled events. Therefore, the practice of therapists' accepting hypnotically enhanced memories as veridical, absent corroborating evidence, is not advocated. A 52-year-old woman with a 27-year history of panic attacks and sleep disorder inadvertently recovered incest memories in hypnosis. Photographs and remembered events by other family members were thought by the patient to provide general support although they did not constitute actual proof of abuse. Implications are discussed.
Bloom, Peter B. (1994). Clinical guidelines in using hypnosis in uncovering memories of sexual abuse: A master class commentary. International Journal of Clinical and Experimental Hypnosis, 42 (3), 173-178.
"Joan," a clinical psychologist, requested a psychiatric consultation to determine whether hypnosis could recover accurate memories of suspected child abuse by her still living father. Are there clinical guidelines in using hypnosis in uncovering such possible memories of sexual abuse? We asked Dr. Peter B. Bloom to share his views with us.
NOTES: Gives case example and clinical guidelines for using hypnosis in uncovering memories of sexual abuse. 1. In medical practice, "Primum non nocere," i.e. "First do no harm." 2. "No therapist should ever, either directly or indirectly, suggest abuse outside of a specific therapeutic context--certainly not to a client who is on the phone making a first appointment!" 3. "A therapist must not jump quickly to the conclusion that abuse occurred simply because it is plausible." 4. "A therapist should never simply assume that a client who cannot remember much from childhood is repressing traumatic memories or is in denial." 5. "Remember 'a client is most vulnerable to suggestion and the untoward influence of leading questions when therapy begins to delve into painful life situations from the past, particularly from childhood.'" 6. "Therapists ... should be cautious about suggesting that clients cut off communication with their families." 7. "Therapists should reconsider the 'no pain, no gain' philosophy of treatment." 8. "The context of therapy is as important as the content." 9. "Tolerate ambiguity." (Sincerity and conviction on the part of the patient reporting abuse are not in and of themselves reason to believe the material.) 10. "Respect the current science of memory." 11. "Maintain responsibility for making the diagnosis and choosing the treatment." 12. "Pursue alternative diagnoses to account for the symptoms." 13. "Historical and narrative truth: Understand the difference."
Freyd, Jennifer J. (1994). Betrayal-trauma: Traumatic amnesia as an adaptive response to childhood abuse. Ethics and Behavior, 4.
Betrayal-trauma theory suggests that psychogenic amnesia is an adaptive response to childhood abuse. When a parent or other powerful figure violates a fundamental ethic of human relationships, victims may need to remain unaware of the trauma not to reduce suffering but rather to promote survival. Amnesia enables the child to maintain an attachment with a figure vital to survival, development, and thriving. Analysis of evolutionary pressures, mental modules, social cognitions, and developmental needs suggests that the degree to which the most fundamental human ethics are violated can influence the nature, form, processes, and responses to trauma.
NOTES: "A logical extension of this research direction, based on a strategy that has been very effective in cognitive neuroscience, would be to look for neuroanatomical underpinnings of the cognitive mechanisms implicated in dissociation. ... For instance, the ability to dissociate current experience may depend partly on representational structures that support spontaneous perceptual transformations of incoming events. One possible perceptual transformation that is amenable to scientific investigation, would be the creation of spatial representations in which the mental 'observer' is spatially distinct from the real body of that observer. Such a representation would fit patient descriptions of 'leaving their body' during a traumatic episode and viewing the scene as if from afar. Additionally one could investigate the role of mental recoding and restructuring during memory 'recovery' and psychotherapy" (pp. 19-20).
Loftus, Elizabeth; Polonsky, Sara; Fullilove, Mindy Thompson (1994). Memories of childhood sexual abuse: Remembering and repressing. Psychology of Women Quarterly, 18, 67-84.
Women involved in out-patient treatment for substance abuse were interviewed to examine their recollections of childhood sexual abuse. Overall, 54% of the 105 women reported a history of childhood sexual abuse. Of these, the majority (81%) remembered all or part of the abuse their whole lives; 19% reported they forgot the abuse for a period of time, and later the memory returned. Women who remembered the abuse their whole lives reported a clearer memory, with a more detailed picture. They also reported greater intensity of feelings at the time the abuse happened. Women who remembered the abuse their whole lives did not differ from others in terms of the violence of the abuse or whether the violence was incestuous. These data bear on current discussions concerning the extent to which repression is a common way of coping with childhood sexual abuse trauma, and also bear on some widely held beliefs about the correlates of repression.
NOTES: In previous research, it was reported that violent or incestuous abuse is particularly susceptible to repression. This study differs from previous investigations in the definition of violence. In the present study, 'violence' is defined as any act involving vaginal, oral, or anal sex. Earlier research defined 'violence' as involving sexual assault with physical injury or fear of death.
Depending on the definition of repression, a sizeable minority (31% or almost 1/5) of this sample forgot their earlier abuse for a period of time. The authors state that this suggests there is little 'robust repression' in this sample. They cannot rule out the possibility that some women who were abused still, to this day, do not recall the experience; or that some who continue to have memory loss based on organic causes, including blackouts.
The authors suggest that future research in this area use more specific questions, including assessing whether Subjects respond to statements like: "There was a time when I would not have been able to remember the abuse, even if I had been directly asked about it," or "There was a time when I would not have been able to report the abuse because I had no idea that it had even happened to me." Also, when Subjects report that a memory had emerged after a period in which they had no recall, the Experimenter should enquire about how and when the recovered memory occurred.
The authors conclude that remembering abuse is more common than forgetting it.
Malinoski, Peter; Aronoff, Jodi; Lynn, Steven J.; Moretsky, Michael (1994, August). Hypnosis and early memories. [Paper] Presented at the annual meeting of the American Psychological Association, Los Angeles.
We studied autobiographical memory in the college population, as manifested in the therapy situation, as a way of investigating an individual difference variable. Most people do not have recall before age 3 or 4 (and probably infantile amnesia begins before age 2).
Administered Autobiographical Memory Scale (AMS), and later in context of a hypnosis scale. 247 students were in phase 1, conducted as two separate experiments so that Ss wouldn't link the AMS to measures used in the second study.
First study was presented as a study of personal memories. Asked Ss to distinguish first five birthdays, circumstances around loss of first tooth, first day of high school. Also, they were asked about their earliest memory events, rated according to 3 scales (detail, vividness, accuracy of recall). Authors summed Ss' responses on these 3 ratings for the 8 item scale.
Part II. Administered various scales: Life Experiences, Fantasy Proneness, Wilson & Barber's scale, Imagery Control Scale, Global Psychopathology, 25 item scale of physical and sexual abuse, Brier's list of symptoms of abuse, and DES (Dissociative Experiences Scale). Imbedded were 12 items to test carelessness in responding (e.g. "I have never said Hello to anyone who wore eyeglasses.")
RESULTS. Phase 1. Two people indicated they had memories dating to before their first birthday; an additional 5% of Ss gave memories between 12-24 months. This would probably be impossible. Another 14.4% described events between 24-36 months; 37.4% said their earliest memory was at age 3. Mean age for earliest memory was 3.4 years (which agrees with other surveys.) Only l subject stated his earliest memory was as late as the tenth year of life.
High intercorrelation was obtained, ranging .79 to .89, between ratings on any of the memory event ratings (as detailed, vivid, or accurate). There was a negative correlation of these ratings with age of recall. Ss who report more detail, vividness, and competence, were also likely to report earlier first memories.
Authors divided Ss into three groups based on age of first memory: 12 with first memory earlier than first year; those whose first memory was between 1-7 years; and those with a later first memory. The earlier memory group were more fantasy prone; and rated their memories as more reliable, vivid. This suggests there are persons who report memories that are covered by infantile amnesia, report them with greater detail, and are more fantasy prone than those who report memory events beginning later in life. This is consistent with Wilson & Barber's finding that fantasy prone people have vivid recall of early childhood events.
None of the memory reports correlated with psychopathology or dissociation. Dissociation (DES) was correlated with abuse indicators, however. Compared top and lowest 10% and middle range on DES on their memory scores and found no relationship. There was no support for the idea that report of early life events in dissociative people is compromised. Failure to recall early memories shouldn't suggest that people are dissociative (which some therapists tend to do).
All three memory measures were associated with Harvard Scale scores. The AMS was administered at the same time as the Harvard. Objective responding on the Harvard correlated with detail, vividness, and accuracy of recall. Also, involuntariness of response correlated with all 3 measures of the AMS. Finally, subjective involvement correlated with all three measures of AMS. At least when hypnosis is measured first, and explicit connection is suggested, there is a connection. Further research is needed to see if the relationship holds when measured in independent contexts. This may explain why High Hypnotizables are more prone to pseudo memories and leading questions. They may come to confuse them with historical reality.
The results suggest caution for early memory reports. They may be vulnerable to confusing fantasy and reality, as well as to biasing effects.
Nash, Michael R. (1994). Memory distortion and sexual trauma: The problem of false negatives and false positives. International Journal of Clinical and Experimental Hypnosis, 42 (4), 346-362.
Logically, two broad types of mnemonic errors are possible when adult psychotherapy or hypnosis patients reflect on whether they were sexually abused or not as a child. They may believe that they were not abused when in fact they were (false negative error), or they may believe they were abused when in fact they were not (false positive error). The author briefly reviews the empirical evidence for the occurrence of each of these types of errors, and illustrates each with a clinical case. Further, in considering the incidence, importance, and clinical implications of these errors, the author contends that clinical efficacy in no way assures that a false negative or a false positive has been avoided. A plea is made for theorists and researchers to acknowledge that both categories of errors can occur and to conduct future clinical and laboratory research accordingly.
Spanos, Nicholas P.; Burgess, Cheryl A.; Burgess, Melissa Faith (1994). Past-life identities, UFO abductions, and satanic ritual abuse: The social construction of memories. International Journal of Clinical and Experimental Hypnosis, 42 (4), 433-446.
People sometimes fantasize entire complex scenarios and later define these experiences as memories of actual events rather than as imaginings. This article examines research associated with three such phenomena: past-life experiences, UFO alien contact and abduction, and memory reports of childhood ritual satanic abuse. In each case, elicitation of the fantasy events is frequently associated with hypnotic procedures and structured interviews which provide strong and repeated demands for the requisite experiences, and which then legitimate the experiences as "real memories." Research associated with these phenomena supports the hypothesis that recall is reconstructive and organized in terms of current expectations and beliefs.
Spiegel, David (1994, October). On patients not remembering abuse when it in fact may have occurred. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
False memories and false non-memories may be two sides of the same coin. What is the evidence for repression?
If people are abducted by extraterrestrials, why don't they just keep them? [Joke!] It seems counter-intuitive that people would forget important, arousing things that happen.
The three main components of hypnosis (suggestibility, absorption, and dissociation) are also aspects of memory: 1. Absorption relates to encoding (narrowing attention); also happens during traumatic events (Loftus' "gun memory" which is so clear, while they don't encode what gunman's face looks like). 2. Dissociation relates to memory storage (compartmentalization of information). Traumatized people have symptoms of dissociation, depersonalization. If you are in an unusual mental state, you may watch the event; the memory is stored without the usual network of associations. 3. Suggestibility relates to retrieval. The way questions are asked influences one's response. But hypnosis is not an infinite influencer; the main damage to memory contributed by hypnosis is "confident errors" (McConkey).
We did research one week after the Loma Prieta earthquake, and found significant cognitive alterations, memory alterations, etc. In our sample, 1/4 of the people felt detached from their body or from the ground right after the earthquake.
Memory alterations were compared with data from other studies after other traumas. Difficulties with memory occurred in 29% of our sample.
The disorganization of memory can follow even just witnessing trauma (e.g. the recent slaying of 8 people in the law office in San Francisco) And people who witnessed the execution of Harris. They were in no danger themselves, yet the level of dissociative symptoms were as high in the former.
The Briere & Cone and Herman & Shatzow studies are based on self report of earlier trauma, and that is a problem in research. But Williams' study does have the age of people when they were abused as children; see her article in Journal of Consulting and Clinical Psychology.
COMMENTS FROM THE AUDIENCE:
Dabney Ewin: Sex abuse trauma differs from earthquakes because the abuser says, "If you tell anybody I'll kill you." This is like a post hypnotic suggestion, which is carried out compulsively when given to the victim during fear.
Dale: How to we account for the vigor in the attempts of each side to convince the other. The people who have been real victims of sexual abuse need to be able to talk with the people who are victims of False Memory Syndrome. The impact on a family is just as traumatic as the sexual abuse itself.
Response by D. Spiegel: I wouldn't recommend that combination, but the point you make about damage to the falsely accused is relevant. Their lives are shattered but remember the damage done throughout life by sexual abuse.
Yapko, Michael D. (1994). Suggestions of abuse: True and false memories of childhood sexual trauma. New York, NY: Simon & Schuster.
NOTES: From the section titled "A Note to Therapists:"
"I would encourage you _not_ to (1) preclude open communication at all times among family members; (2) act as your client's 'hired gun'; (3) act as if corroboration of allegations of abuse were unnecessary; (4) jump quickly to the conclusion abuse occurred simply because it is plausible; (5) suggest a history of abuse to someone who is not your client; (6) refer a client out for hypnotic confirmation or disconfirmation on the false premise that hypnosis is some kind of lie detector; (7) ask leading or suggestive questions; (8) assume repression is in force when someone does not have much memory from childhood; (9) rely on your memory of the interaction. Tape your investigative sessions and review them later for any evidence of possible unintentional contamination of your client's recollections" (p. 217).
Sivec, Harry; Lynn, Steven Jay (1993, October). Hypnosis and early memories. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.
The investigators hypnotized people and asked that they recall their earliest memories. Gorham & Hafner tested highs and lows in 2 sessions, one with a hypnotic induction. Ss in hypnosis reported more themes, whether high hypnotizables or not. Ss might have held back in non hypnosis condition however.
Hypothesized that early memories would have affect-laden materials.
20 Ss in hypnosis group, 20 Ss in relaxation condition, all highs (scored minimum of 9 of 12 on the Harvard Scale). Ss were told they were randomly selected from a pool and that it was a study of personality. Ss were administered a number of questionnaires and tests.
The two groups received either a Stanford Form C Scale induction or a relaxation procedure.
We used the procedure of Bloom [spelling?] for recall of two memories, and to probe the earliest memory. Also to recall two recent memories. Counterbalanced for order of presentation.
Positive affect, negative affect, affect intensity, and primary process were rated; 12 themes were rated. ANOVA was used.
Earliest memory at 3.8 yrs. Next earliest is 7.5 for hypnosis and 5.2 for relaxation groups. 4.3 is earliest for hypnosis group; there may be a basement effect. Negative affect varied by condition and by order of administration and recency of memory assessed. When early memories were elicited first, no differences were found in groups; when elicited second, negative affect was greater for [missed words]. Affect was more abundant and intense in the hypnosis group, but only when recent memories were elicited before early memories and only in the [missed words].
Early recollections were slightly more primary process (bizarre) than later, which should alert clinicians.
Themes didn't differ between groups. Early memories involved more trauma than later memories. Negative affect correlated with psychopathology measures for earliest memory but not later memory.
Used posthypnotic experiences scales. There is a decrease in unpleasant experiences, suggesting the benefit of catharsis when recalling early memories.
Woody, Erik Z. (1993, October). Factors, facets, and fiddle-faddle. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights, IL.
The classic suggestion effect implies involuntary behavior. A theory by Norman & Tim Shallice (published in a book on cognitive neuropsychology by Shallice) explains the classic suggestion effect in terms of underlying control processes.
There are 2 complementary systems: 1. contention scheduling (routine acts that don't require conscious control, activating schemas through environmental events and other schemas) for well learned habitual tasks. 2. supervisory attentional system - nonroutine actions in centralized processes, accessing unique information, operating only indirectly by modulating lower level control system, biasing their selection of schemas by system #1.
These two systems permit the sense of behavior being automatic or willed. The theory can be used to explain hypnotic nonvolition. For highs, hypnosis may partly disable System #2, dissociating lower levels of control and resulting in genuine changes in behavior because System #1 would be more enabled, triggered directly by co-active schemas and environmental stimuli. This increased dependence on a lower level of control would not rule out a wide range of behavior. It's mainly novel or very complex behaviors that would diminish, plus exercise of will.
The model also illuminates our understanding of behavioral rigidity and the tendency for thought/action to be triggered by [suggestions?]. Spontaneous voluntary behavior would be diminished. (See for example Orne's studies of the effect of apparent power outage during an experiment, in which high hypnotizable Ss did not move or leave the room but sat passively, whereas low hypnotizable simulating Ss simply got up and left.)
Also a weaker "supervisor" would lead to disinhibition of inappropriate or peculiar associations or behavior. In labs one sees few such triggers, although Hilgard observed drug flashbacks. The phenomena of hypnosis sequelae appear like a disinhibition of experiences.
Hypnotic analgesia follows this model too, an automatic and controlled processing of perceptual input.
Amnesia that follows hypnosis can be explained by this theory. Shallice has a model of how memory is affected: memory is a higher control system, enabling the handling of non-routine situations. Confronted by a nonroutine memory problem, the supervisory system formulates a model of what [the information] should look like, pulls out memories, and compares the model. If hypnosis interferes with the supervisor function it should interfere with memory (the description and verification phases) leading to [hypnotic amnesia?]. [With hypnosis one would predict]: 1. Poor access to memories requiring description (not overlearned material). Recall should demonstrate good cued memory but poor free recall. [It has been observed that] hypnotic amnesia selectively impairs free recall rather than recognition recall. 2. Hypnotized Ss should show poorer verification (the ability to discriminate irrelevant from correct associations). Many studies have shown this, with impoverished verification (e.g. the "discovery" of elaborate previous lives).
A dissociated control theory of hypnosis is thus possible, emphasizing a loss of control of supervisory system processes. It would implicate changes in frontal lobe processing. The essence of hypnosis, according to this approach, is the bypassing of executive control, and the frontal lobe is viewed as a center of executive control.
There are several ways that hypnosis suggests inhibition of frontal lobe functioning: 1. impoverishment of self initiated behavior 2. other-directedness 3. frontal amnesia (unable to distinguish true memories from irrelevant memories; prone to confabulation, especially when probed with false information) 4. poorer in temporal or sequential organization in memory.
How do we proceed to make this theoretical approach useful? We should do more neuropsychological studies, as Helen Crawford does. They emphasize the inhibition of frontal lobe functions.
Testable hypotheses arise: 1. Hypnotizable Ss should show the same kind of problem solving problems as frontal lobe patients. 2. Memory of hypnotized Ss should be like patients with frontal amnesia.
Claridge, Karen (1992). Reconstructing memories of abuse: A theory-based approach. Psychotherapy, 29, 243-252.
The recovery of traumatic memories is an important part of therapy with survivors of abuse. This article describes a conceptual framework for memory reconstruction based on Horowitz' (1986) theory of stress response syndromes. The client's history of intrusive symptoms provides a way to anticipate the nature of the trauma, even when no memory of it exists. Ongoing intrusive symptoms are used to retrieve memory fragments, and their emotional impact is used to build the client's emotional tolerance. Emphasis is placed on preparing for memories by identifying what the client will need when the memories return, building coping skills, and beginning to restructure cognitions at the "what if" stage of remembering. Case material is used to illustrate.
Lynn, Steven Jay; Rhue, Judith W. (1992, October). Memory. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington, VA.
NOTES: [Author presented a dramatic case report of patient who recalled specific events that subsequently he and the patient investigated and disproved. What the patient thought they saw could not possibly have been seen.]
The experimental literature on memory gives us some things to think about. Therapy relies highly on memory, and the therapist shapes the contours of the memory by validating the memories, which are rarely doubted. Tacit acceptance of memories as historical facts is part of the contract of therapy.
Memory studies challenge the idea of accurate storage. Some people are unduly confident of their memory. Bartlett's research demonstrated distortion according to schema, interpretations, embellishments, etc. Jacobi et al indicate people's theories about what happened shape memory.
One theory is that trauma leads to amnesia, repression, dissociation. But research does not show inability to recall early life events indicates presence of a traumatic history. Repression is not prima facia evidence of abuse. The Courage to Heal book states that merely thinking you were abused is evidence that you probably were.
How do vague ideas crystallize? Loftus finds if inability to remember isn't attributed to ordinary forgetting, the person may look for memories, thereby creating them.
Studies of persons who confess to crimes, unsure whether they did or didn't do them, indicate that these people are easily coerced. Doubt in a memory's accuracy can be reframed by a therapist.
Hypothesis: Therapists who confidently state a view risk implanting pseudomemories. Therapists must be cautious.
Clients can confuse sources of information that they receive. Different sources of information can be integrated into a single memory (e.g. what occurred to them and what occurred to siblings can be integrated into a pseudomemory). Some limited evidence that early life experience memories could be implanted has been presented by Loftus.
Certain client characteristics contribute to false memories: 1. Present mood state (mood congruent memory). This effect is reliable when people are clinically depressed. Though clinicians may say it indicates early childhood abuse, the memory might be selective or biased. 2. History of fantasy-proneness. In childhood this type of person might have had problems distinguishing fantasy from reality. LaBelle et al found absorption made it difficult to distinguish sounds in hypnosis from what really occurred, creating pseudo- memories. With this population it is essential to avoid suggesting abuse.
Lynn was successful in implanting an idea of abuse in an alter called Person. He used the Orne technique (from the BBC film "Hypnosis on Trial") to ask a patient what she had told him about her dog during the hypnosis; he did this to convince her of the importance of exploring her amnestic episodes.
Does hypnosis foster a literal re-experiencing of childhood events? NO. Nash, in an exhaustive review, failed to find correspondence between information from hypnotic age regression and childhood events. He notes that literal reliving is not possible. It is possibly an expression of primary process thinking. Hypnosis doesn't ameliorate memory problems; and it may exacerbate memory problems.
Lynn views primary process thinking observed in hypnosis as due to the demand of hypnosis to fantasize and relinquish critical thinking or objectivity. This plus Therapist and Patient expectancies may foster tenacious beliefs that events occurred.
Many hypnotic suggestions may interfere with memory. The AMA 1985 report suggests that hypnosis can influence confidence in a 'memory' with no actual improvement in accuracy.
The effects aren't limited to hypnosis however. Simulators and controls also generate pseudomemories. Repeated questioning of Ss who are led to believe that questioning helps distinguish memories from fantasies, actually diminishes the accuracy of memories.
Hypnotizability is correlated with pseudomemory occurrence. We should evaluate a client's hypnotizability when evaluating for pseudomemories.
Perceived verifiability rate is important, as pseudomemories are higher where you can't verify the reported memory, it is thought. Therefore, approach with caution. Make every effort to corroborate memories.
Subjective reports may tell narrative truths even though inconsistent with the historical record, and could be useful independent of historical accuracy. I agree that those 'memories' could be important, just as age progression or past life regression material could be useful in therapy. But should we base our interpretations or conclusions on events that are not confirmed? A patient's belief in abuse by their parent has enormous implications for a family.
Therapists should understand the dynamics of a request for using hypnosis to recall forgotten memories before using uncovering techniques. Ask yourself, "Why is this being requested?" Also ask other questions: 1. Is the person fantasy prone, dissociative, suggestible, a high hypnotizable? 2. Is the person stabilized enough to focus on an abreaction? 3. Is there conscious or unconscious motivation to avoid responsibility for one's own behavior? 4. Is there a wish to arrive at a facile solution, a magic cure, the royal road to the unconscious; or is there an attempt to control the treatment hour, to avoid issues, to test the therapist? 5. Is therapy stalled, not moving forward? 6. Am I angry with the client because they expect to uncover more?
Instead of using hypnosis to retrieve memories, I may focus on the issues to which I answer 'Yes' in the forgoing list.
I do not believe current research is sufficiently persuasive to throw out hypnosis for retrieving memories. The dangers of pseudomemory are endemic to therapy. Incorporating hypnosis into a broader frame of therapy depends on the skill of the clinician. However, we must use hypnosis with great caution
COMMENTS FROM AUDIENCE. Joseph Dane: In 75% of cases that could be verified, they found corroborating evidence: what should you look for as an index that the memory recalled in hypnosis is more likely to be accurate?
Lynn: Many instances of abuse are corroborated. No one questions the veracity of all memories. To my knowledge there are no ways of corroborating genuine from false memories. We know subjective conviction is not sufficient, and clients' affective experience can be very misleading. Since my experience [in the case study reported at the beginning of this presentation] I have talked with many therapists who have had similar experiences.
David Spiegel - the problem is not the hypnosis: patients go in and out of hypnosis all the time, momentarily. The problem is, how do I explore the material in psychotherapy? There is no substitute for corroboration if you can get it. But you have to be sensitive to the vulnerability of those people.
Howard Hall: What is a genuine memory? No memory is undistorted. More importantly, can we verify significant events that might have had long term consequences, like abuse? We should try to verify memories when we base treatment programs on them. The only memories in the literature that have a reputation of being accurate are highly traumatic events that stand out, and these reports are anecdotal in nature.
Murrey, Gregory J.; Cross, Herb J.; Whipple, Jim (1992). Hypnotically created pseudomemories: Further investigation into the 'memory distortion or response bias' question. Journal of Abnormal Psychology, 101 (1), 75-77.
In order to study whether pseudomemories represent actual memory distortions or are a result of response bias, 60 highly hypnotizable subjects and subjects from the general population were divided into 4 experimental groups and were tested for pseudomemory manifestation after receiving a false suggestion. Of the 4 groups of subjects, 3 were offered a monetary reward as a motivation to distinguish false suggestion from the actual occurrence. Pseudomemory manifestation was found to be significantly higher among subjects not offered a reward than among subjects who were offered such a reward. The implications of these findings are discussed.
The article contains a review of the literature through 1989. The study tested the hypothesis that when it is important to distinguish fantasy from reality in a hypnosis experiment, subjects can do so--a position presented by Spanos and McLean (1986). They used a verifiable event to test for pseudomemory production, as in research published by McCann and Sheehan (1988). Subjects were 30 high hypnotizable and 30 unselected students.
Subjects were shown a videotape of a mock robbery scene. The next week, Groups A, B, and C heard audiotapes "to enhance memory," but in addition to motivating statements about "trying to remember" certain details, the tapes included misleading information (e.g. "Remember the color of the hat the robber was wearing" when in fact there was no hat on the robber). Subjects in these groups were 'influenced.'
"Both highly hypnotizable subject groups (Groups A and B) listened to the audiotape after being administered a 10-min hypnotic induction procedure (modified from that of Barber, 1969). Subject Group C listened to the audiotape without hypnosis. The control group, Group D, did not listen to the audiotape and was, therefore, classified as 'uninfluenced.'"
A week later subjects responded to multiple-choice and yes-no or true-false questions about the robbery scene. The yes-no question about whether the robber was wearing a hat served as the dependent variable, a measure of pseudomemory. "To motivate subjects to report the truth rather than to follow any perceived expectations of the experimental of social context, we offered subjects in Groups B, C, and D a monetary reward if they achieved the most correct answers on the quiz (according to the videotape). The reward was offered just before administration of the quiz to ensure that no collusion between the subjects could occur. Group A was not offered any such reward" (p. 76).
"The number of subjects in Group A (hypnotized, influenced, no reward) who reported the false information at posttest (12) was significantly greater then that of Group B (hypnotized, influenced, offered reward.... However, the difference in incidence of pseudomemory between Group B and the control group, Group D (not hypnotized, uninfluenced, offered reward), was nonsignificant" (p. 76).
Table 1 Incidence of Pseudomemory Per Group ------------------------------------------------------------------------------------------- False suggestion Group A Group B Group C Group D
result (n=15) (n=15) (n=15) (n=15) -------------------------------------------------------------------------------------------
Accepted 12 6 7 3
Rejected 3 9 8 12 ------------------------------------------------------------------------------------------ Note. Group A = hypnotized, influenced, not offered reward.
Group B = hypnotized, influenced, offered reward.
Group C = not hypnotized, influenced, offered reward.
Group D = not hypnotized, not influenced, offered reward.
In the Discussion, the authors wrote, "Because the only variable among these groups was the reward, a reasonable conclusion from the findings is that pseudomemories manifested by the subjects were (for the most part) not actual memory distortions. Presumably, the reward provided the subjects in Group B an incentive to 'report the truth' and a disincentive to give biased reports on the basis of the perceived expectations of the social or experimental context. Thus these data suggest that pseudomemory effects or the occurrence of the pseudomemory phenomenon among highly hypnotizable subjects can be minimized by providing a motivation to subjects to give unbiased reports.
"A major implication of these findings is that researchers should control for response bias resulting from perceived social demands or from leading test designs when they conduct pseudomemory research. Of further concern is the fact that a number of researchers contend that hypnotic interrogation of eye-witnesses can greatly facilitate the creation of pseudomemories (Levitt, 1990; Loftus, 1979; Orne, 1979; Putnam, 1979), and therefore hypnosis either should not be allowed in the courtroom or should be strictly controlled. Yet in light of our findings, response bias may be a confound in pseudomemory research, and thus researchers need to be cautious when making inferences to specific situations from data obtained in an experimental setting.
"Despite the existence of a confound of (unmeasured) differences in hypnotizability between the two groups, there was no significant difference between Group B and the control group (Group D). This suggests that if response bias is controlled for, there may not be significant differences in manifestation of pseudomemories between highly hypnotizable subjects and subjects representative of the general population. However, further research is needed in order to address this question" (pp. 76-77).
Perry, Nancy W. (1992, Summer). How children remember and why they forget. The Advisor (Published by American Professional Society on the Abuse of Children), 5 (3), 1-2; 13-16.
NOTES: "'My memory is the thing I forget with.' (a child's definition, cited in Grossberg, 1985, p. 60)" (p. 1).
"Unlike the simpler forms of memory retrieval, free recall is strongly age-related... the recall skills of preschool children develop gradually" (p. 2). "...in some cases, younger children can provide _more_ accurate information than adults (Lindberg, 1991). For example, if an event is particularly salient (as sometimes happens in cases of trauma), recall may be exceptionally good (Brainerd & Ornstein, 1991; Lindberg, 1991)" (p. 13).
"Children have limited ability to use memory strategies. For this reason, children often know more than they can freely recall" (p. 13).
"The use of _rehearsal_ as a memory strategy is almost automatic for adults. ... Ten-year-olds also commonly use rehearsal to aid memory. Young children, however, have not mastered rehearsal (Harris & Liebert, 1991).
"Another memory strategy is imagery, which involves (1) mentally picturing a person, place, or object, or (2) visually associating two or more things that are to be remembered. Children develop imagery much later than other memory strategies. Indeed, some people never learn this memory strategy (Flavell, 1977)" (p. 13).
"... stress alone may not impair memory processes. Indeed, stress can lead to arousal, heightened attention, and improved encoding (Deffenbacher, 1983). However, stress that results from intimidation may lead to either impairment in encoding or problems in recalling or reporting memories" (p. 14).
"Because the effect of suggestion on material that has been well encoded tends not to be significantly different across age groups (Cohen & Harnick, 1980), it may be that younger children's inferior performance on suggestive tasks results from inferior encoding" (p. 15).
Summit, Roland C. (1992, Summer). Opinion: Misplaced attention to delayed memory. The Advisor (Published by American Professional Society on the Abuse of Children), 5 (3), 21-25.
NOTES: "I believe this is the time to cap a century of progress with a monumental achievement in awareness. We must cherish and develop the concept that what we don't know can hurt us. We can establish, for the first time, that our lives and even the nature of our society can be shaped by experiences so terrible that they are, in the words of Josef Breuer a century ago, 'forbidden to consciousness' (1895, p. 225). We may learn that huge chunks of oppositional thought, cruelty, perversity, helplessness, self-destruction and mental illness are derived from this hidden reservoir of suffering, and we could inspire unprecedented achievements in healing, prevention and enlightened peacemaking" (p. 21).
"We have been slow to consider the implications of dissociation for protective awareness of child sexual abuse" (p. 22).
"And we should respect the painful threat that enlightenment poses for our comforting faith in a just and fair society. We would have to consider that we may be capable as a people of hiding our most grotesque activities under the cover of dissociation, so that we don't know we're doing it, our victims can't say it's happening, and as an outer society we will insist that no such thing could possibly exist" (p. 22).
"While it is urgently important to know that dissociation is real, it is doubly important not to endorse as accurate, in fact, details or encounters that may be part of a still unknown process of distortion" (p. 22).
"The most distinguished clinicians, the people who occupy the platform of authority as scientists and educators, are joining with those who, until now, have been recognized mainly for their adversarial positions. Now those two poles are coming together in aroused opposition to the phenomenon of delayed memory, especially when acquired in therapy with young women in their 30's, especially when those therapists lack an M.D. or a Ph.D. diploma. We face, once again, an ageist, sexist, elitist professional standoff around an issue that deserves to be explored in harmony" (p. 24).
"In California and several other states the statute of limitations has been suspended for individuals who can demonstrate delayed discovery of childhood trauma" (p. 24).
"The rush to judgment is not confined to civil litigation. There is no statute of limitations on murder" (p. 24).
"How many kids have hidden the memory of unspeakable assaults which can be unearthed years later to plunge them into courtroom testimony? How many free citizens could be sued or imprisoned by such remote discoveries? What should we do as scientists in support of or in opposition to those delayed memories?" (P. 24).
"We know that skepticism can quash the emergence of dissociated memories. Can we prove that therapeutic zeal cannot enhance such memories? Survivors who gain a clear picture of sexual assault in the climactic period of discovery tend to fade out the sharp edges as they achieve resolution and healing. The most seasoned survivors may discount the intermediate memories which once provided the impetus for their recovery" (p. 25).
Wielawski, Irene (1991, October 3). Unlocking the secrets of memory. Los AngelesNOTES 1:
NOTES: This is a newspaper article about Eileen Franklin-Lipsker of Palo Alto, who testified that her father, George T. Franklin, killed an 8-yr-old girl in 1979 and that she repressed the memory for nearly two decades.
Pillemer, D. B.; White, S. H. (1989). Childhood events recalled by children and adults. In Reese, H. W. (Ed.), Advances in child development and behavior. New York: Academic Press.
NOTES: Authors discuss a dual memory theory. The first memory system is prominent in early childhood, and is a system in which are organized and evoked by persons, locations, and emotions. Such memories are not easily "transportable" outside the original experience. These memories are accessed through images of face and place, actions, or feelings. The second memory system begins to develop in early childhood, is verbally mediated, and stores experiences in narrative form. Such memories are accessible through verbal interaction, and can be reviewed and shared with others verbally. For a small child, to access all of a memory one would need to tap into both memory systems. The authors suggest that the first memory system continues to be available throughout one's life, especially when strong emotion was associated so that verbal cues are not attached. [This has implications for retrieval of "lost" memories using imagery-based approaches like hypnosis.]
Terr, Lenore C. (1988). What happens to early memories of trauma? A study of twenty children under age five at the time of documented traumatic events. Journal of the AmericanAcademy of Child and Adolescent Psychiatry, 27, 96-104.
The verbal and behavioral remembrances of 20 children who suffered psychic trauma before age 5 were compared with documentations of the same events. Ages 28 to 36 months, at the time of the trauma, serves as an approximate cutoff point separating those children who can fully verbalize their past experiences from those who can do so in part or not at all. Girls appear better able than boys to verbalize parts of traumas from before ages 28 to 36 months. Short, single traumas are more likely to be remembered in words. At any age, however, behavioral memories of trauma remain quite accurate and true to the events that stimulated them.