"Man often becomes what he believes himself to be. If I keep on saying to myself that I cannot do a certain thing, it is possible that I may end by really becoming incapable of doing it. On the contrary, if I have the belief that I can do it, I shall surely acquire the capacity to do it even if I may not have it at the beginning."
- Mahatma Gandhi
- Mahatma Gandhi
“Hypnosis is the most effective way of giving up smoking, according to the largest ever scientific comparison of ways of breaking the habit.”
-New Scientist, 10/92
“There's entrancing news about hypnosis; it's gaining credibility as a treatment for a multitude of troubles, from nicotine addiction to post-traumatic stress disorder.”
-Business Week, Feb 2/04
According to the largest ever scientific comparison of ways of breaking the habit, Hypnosis is the most effective way of giving up smoking. In 1992, Frank Schmidt and research student Chockalingham Viswesvaran of the University of Iowa U.S. Scandinavia and elsewhere in Europe .
By combining the results from so many separate studies, the meta-analysis enables the real effectiveness of each technique to be picked out from the statistical noise that often blights studies involving smaller numbers of subjects.
The results, published in the Journal of Applied Psychology, Vol. 77 1992, show that out of 6000 smokers, 30% were smoke-free after only one session, the highest success rate among all treatments covered in the study (e.g. combination techniques such as exercise and breathing therapy had a success rate of 29% and acupuncture had a success rate of 24% to name but a few).
The Chairman of the British Society of Medical & Dental Hypnosis said of the research that current hypnosis techniques are a far cry from their popular image of music-hall tricks involving swinging fob watches. The latest relaxation techniques, he said, achieve success rates of up to 60 per cent from a single session.
Hypnotherapy, through the use of the medium of Suggestion Therapy, is the most effective treatment for smoking cessation. There are various states of mind and your mind is working on two levels. The Conscious and Subconscious. The conscious mind is your waking, reasoning mind where as the subconscious mind is much larger and controls tasks such as breathing, driving and habits. When the subconscious mind accepts a habit such as smoking it is unlikely to change that habit easily. How many times have you heard someone say “I won’t smoke”, and the first thing that person does is reach for a cigarette. This is because it is a subconscious habit. With Hypnosis we communicate directly with the subconscious mind and we can change these unwanted habits very easily using suggestion therapy.
New research from Aviva Insurance reveals that approximately a quarter of those completing an online health check admit to being smokers and that a higher proportion of females (24%) than males (22%) smoke. The research also revealed that Irish smokers smoke an average of 13 cigarettes every day costing the smoker approximately €163.80 each month and approximately €2000 a year.
The risk of developing lung cancer for Irish men will increase by 59% and by 136% for Irish woman by 2020 according to the National Cancer Registry2 and with lung cancer accounting for 20% of all deaths from cancer each year, there is a real need to stub out smoking and protect the health ofIreland
AshIreland Ireland Ireland
The risk of developing lung cancer for Irish men will increase by 59% and by 136% for Irish woman by 2020 according to the National Cancer Registry2 and with lung cancer accounting for 20% of all deaths from cancer each year, there is a real need to stub out smoking and protect the health of
Ash
The statistics about smoking in Ireland
· 25% of the population of Ireland
· In the late 1960's one half of the population smoked
· 33% of married women smoke
· 46% of smokers do not enjoy all cigarettes
· 46% were in favour of the doubling of cigarette prices
· 63% of the public supported price increase for cigarettes
· 11% of 8 to 17 years olds smoke
· Half of all smokers tried to give up in the past two years
· 61% of people attempted to quit in 2002 compared with 73% in 1997
The research which follows is divided into two sections, Smoking and Suggestion.
The former outlines research undertaken in the treatment of smokers with Hypnotherapy and the outcomes of various trials. The latter is research into the therapy used in the treatment of smoking, as well as weight-loss, nail-biting, etc. This gives a further insight into the therapy being used and the techniques and approaches being applied.
Suggestion is an idea that one accepts uncritically, and favourably, resulting in the initiation of appropriate behaviour. Suggestibility or susceptibility is the degree of patient receptivity.
Suggestion is used every time- a treatment plan is described by a doctor to a patient or a prescription is given. Any instruction, made in a kind, confident, assuring manner, will be of potential aid in bringing about desired results.
Bernheim, in about 1882, said "There is no such thing as hypnosis, there is only suggestion", and Bernheim listed rules governing suggestion which are irrefutable.
When an idea takes root in the subconscious, it must be discharged in the motor action or in thought. "The idea gives birth to an idea". Please bear in mind that the subconscious will just as well discharge a bad idea as a good one.
Bernheim's definition is that "suggestion is an idea which releases itself through the subconscious mind", and that there are certain conditions which are necessary to create auto-suggestion (the passing of a suggestion to the subconscious by oneself):
1. There must be intensity of attention to the idea itself.
2. The intensity of attention and the importance of the idea must be magnified by emotion (although it matters not which emotion is involved).
3. There must be absence of any counter suggestion from the psyche.
The following research findings on Smoking Cessation with Hypnotherapy indicate a success rate ranging from 88% to 25%.
The most successful candidates were those who were reviewed quarterly every 3, 6, 9, and 12 mounts with as many as 90% abstaining from Smoking permanently.
On reviewing the forty eight years of research listed below I have found the average success rate for Stopping Smoking with Hypnotherapy is over 50%.
Those subjects who participated in a number (averaging 4) of Stop Smoking Sessions seem to have shown the highest percentage of success.
Subjects who participated in only one Stop Smoking Cassation also experienced various levels of success at first, but this was to decrease over time with percentages dropping as low as between 18.5% and 25%.
The research listed below will give a brief outline of the progress and advances that have been made in the area of Smoking Cessation by various Hypnotherapy Organizations and Therapists down through the years.
Starting from the most recent date, this data contains in most cases a listing of the amount of subjects that were involved in each research, the procedure used and a follow up to check the long term effectiveness of Hypnotherapy for Smoking Cessation.
The following compilation of Research into Hypnotherapeutic Interventions for Smoking Cessation with specific examples of working with patients at each level of illness, and gives statistical analysis of Hypno-psychotherapeutic interventions which were used in the treatment of these clients. If you have comments on the following research, or simply ideas, approaches, techniques or opinions, please feel free to post below, or on our discussions page on Facebook at http://www.facebook.com/group.php?gid=142527652458782
The Institute of Clinical Hypnotherapy & Psychotherapy Training and Accreditation is running a Smoking Cessation and Addictions Masterclass for Hypnotherapists and like-minded health professionals at the Marino Institute of Education, Griffith Avenue, Dublin 9 on Saturday 4th December, 2010. Please visit our website www.hypnosiseire.com for details or email ichphq@gmail.com
SMOKING
2001
Barber, Joseph (2001). Freedom from smoking: Integrating hypnotic methods and rapid smoking to facilitate smoking cessation. International Journal of Clinical and Experimental Hypnosis, 49 (3), 257-266.
Hypnotic intervention can be integrated with a Rapid Smoking treatment protocol for smoking cessation. Reported here is a demonstration of such an integrated approach, including a detailed description of treatment rationale and procedures for such a short-term intervention. Of 43 consecutive patients undergoing this treatment protocol, 39 reported remaining abstinent at follow-up (6 months to 3 years post treatment).
Gibbons, Don E. (2001). Experience as an art form: Hypnosis, hyperempiria, and the Best Me technique. San Jose CA
NOTES
The Best Me Technique is a procedure for constructing suggestions which incorporates many different dimensions of experience -- beliefs, emotions, sensations, thoughts, motives, and expectations -- for maximum involvement and effectiveness. Best Me suggestions may be used with either hyperempiria, an alert induction based on suggestions of mind expansion and increased alertness and sensitivity, or with more traditional forms of hypnotic induction.
The Best Me Technique is a procedure for constructing suggestions which incorporates many different dimensions of experience -- beliefs, emotions, sensations, thoughts, motives, and expectations -- for maximum involvement and effectiveness. Best Me suggestions may be used with either hyperempiria, an alert induction based on suggestions of mind expansion and increased alertness and sensitivity, or with more traditional forms of hypnotic induction.
2000
Green, Joseph P.; Lynn, Steven Jay (2000, August). Hypnosis and suggestion-based approaches to smoking cessation: An examination of the evidence. [Paper] Presented at the annual meeting of the American Psychological Association, Washington, D. C..
This article reviews 59 studies of hypnosis and smoking cessation from the point of view of whether the research provides support for hypnosis as an empirically supported treatment (Chambless and Hollon, 1998). Whereas hypnotic procedures generally yield higher rates of abstinence relative to wait list and no treatment conditions, hypnotic interventions are generally comparable to a variety of non-hypnotic treatments. The evidence for whether hypnosis yields outcomes superior to placebos is mixed. In short, hypnosis can not be considered to be a specific and efficacious treatment for smoking cessation. Furthermore, in many cases, it is impossible to rule out cognitive/behavioral and educational interventions as the source of positive treatment gains associated with hypnotic treatments. Hypnosis can not, as yet, be regarded as a well-established treatment for smoking cessation. Nevertheless, it seems justified to classify hypnosis as a "possibly efficacious" treatment for smoking cessation. - Abstract taken from Psychological Hypnosis: A Bulletin of [Amer Psychol Assn] Division 30. Fall, 2000.
1999
Capafons, A. (1999). Applications of emotional self-regulation therapy. In Kirsch, I. ; Capafons, A.; Cardeqa, E.; Amigs, S. (Ed.), Clinical hypnosis and self-regulation: Cognitive-behavioral perspectives (pp. 331-349). Washington , D.C.
This chapter reviews the main applications of emotional self-regulation therapy, which have received empirical support: smoking reduction, obesity, fear of flying, drug addictions, and premenstrual distress and dysmenorrhea. The logic of each treatment and main empirical results are summarized.
1997
Bayot, A.; Capafons, A.; Cardeqa, E. (1997). Emotional self-regulation therapy: A new and efficacious treatment for smoking.. American Journal of Clinical Hypnosis, 40 (2), 146-156.
We described emotional self-regulation therapy, a recently-developed suggestion technique for the treatment of smoking, and present data attesting to its efficacy. Of the 38 individuals who completed treatment, 82% (47% of the initial sample)stopped smoking altogether and 13% (8% of the initial sample) reduced their smoking. A follow-up at 6 months showed that 66% (38% of the initial sample) of those who had completed the treatment remained abstinent and reported minimal withdrawal symptoms or weight gain. In a no-treatment comparison group, only 8% reduced their smoking or became abstinent.
Johnson, David L. (1997). Weight loss for women: Studies of smokers and nonsmokers using hypnosis and multicomponent treatments with and without overt aversion. Psychological Reports, 80 (3, Pt 1), 931-933.
Study 1 compared 50 overweight adult female smokers (mean age 37.7 yrs) and 50 nonsmokers (mean age 41.2 yrs) in an hypnosis-based, weight-loss program. Smokers and nonsmokers achieved significant weight losses and decreases in Body Mass Index. Study 2 treated 100 women either in an hypnosis only (n = 50) or an overt aversion and hypnosis (n = 50) program. This multicomponent follow-up study replicated significant weight losses and declines in Body Mass Index. The overt aversion and hypnosis program yielded significantly lower posttreatment weights and a greater average number of pounds lost. (PsycINFO Database Record (c) 2003 APA, all rights reserved)
1995
Capafons, A.; Amigs, S. (1995). Emotional self-regulation therapy for smoking reduction: Description and initial empirical data.. International Journal of Clinical and Experimental Hypnosis, 43 (1), 7-19.
Self-regulation therapy (Amigs, 1992)is a set of procedures derived from cognitive skill training programs for increasing hypnotizability. First, experiences are generated by actual stimuli. Clients are then asked to associate those experiences with various cues. They are then requested to generate the experiences in response to the cues, but without the actual stimuli. When they are able to do so quickly and easily, therapeutic suggestions are given. Studies of self-regulation therapy indicate that it can be used sucessfully to treat smoking.
Holroyd, Jean (1995). Handbook of clinical hypnosis, by Judith W. Rhue, Steven Jay Lynn, & Irving Kirsch (Eds.) [Review]. International Journal of Clinical and Experimental Hypnosis, 43 (4), 401-403.
NOTES
"This is a book for the thinking clinician" (p. 401). "The editors are to be congratulated for making this volume much more coherent than most edited books" (p. 402). "My impression is that the book is best suited for an intermediate or advanced course on hypnotherapy, or for people who are already using hypnosis in treatment. Although there is some material on the basics of hypnotic inductions and a few introductory sample scripts for inductions, a beginners'' course should probably use a different book, or this book could be accompanied by an inductions manual. ... I recommend it very highly" (p. 403).
"This is a book for the thinking clinician" (p. 401). "The editors are to be congratulated for making this volume much more coherent than most edited books" (p. 402). "My impression is that the book is best suited for an intermediate or advanced course on hypnotherapy, or for people who are already using hypnosis in treatment. Although there is some material on the basics of hypnotic inductions and a few introductory sample scripts for inductions, a beginners'' course should probably use a different book, or this book could be accompanied by an inductions manual. ... I recommend it very highly" (p. 403).
1993
Page, Roger A.; Handley, George W. (1993). The use of hypnosis in cocaine addiction. American Journal of Clinical Hypnosis, 36, 120-123.
An unusual case is presented in which hypnosis was successfully used to overcome a $50-0 (five grams) per day cocaine addiction. The subject was a female in her twenties. Six months into her addiction, she acquired a commercial weight-control tape that she used successfully to stop smoking cigarettes (mentally substituting the word "smoking"), as well as to bring her down from her cocaine high and allow her to fall asleep. After approximately 8 months of addiction, she decided to use the tape in an attempt to overcome the addiction itself. Over the next 4 months, she listened to the tape three times a day, mentally substituting the word "coke." At the end of this period, her addiction was broken, and she has been drug free for the past 9 years. Her withdrawal and recovery were extraordinary because hypnosis was the only intervention, and no support network of any kind was available.
Spiegel, David; Frischholz, Edward J.; Fleiss, Joseph L.; Spiegel, Herbert (1993). Predictors of smoking abstinence following a single-session restructuring intervention with self hypnosis. American Journal of Psychiatry, 150, 1090-1097.
Examined the relation of smoking and medical history, social support, and hypnotizability to outcome with Spiegel's smoking-cessation program. A consecutive series of 226 smokers were treated with the single-session approach and followed up for 2 years. With a total abstinence criterion, 52% success was found after 1 week, and 23% abstinence at 2 years. Hypnotizability and having been previously able to quit smoking for at least a month significantly predicted the initiation of abstinence. Hypnotizability and living with a significant other person predicted 2-year maintenance. The results are superior to those of spontaneous efforts to stop smoking and suggest it is possible to predict which patients are most likely to respond and which patients are least likely to respond to such a brief intervention.
1992
Spanos, Nicholas P.; Simulates, Ann; de Faye, Barbara; Mondoux, Thomas J.; Gabora, Natalie J. (1992-93). A comparison of hypnotic and nonhypnotic treatments for smoking. Imagination, Cognition and Personality, 12, 23-43.
Three experiments administered variants of Spiegel's (1970) smoking cessation procedure to smokers in hypnotic and nonhypnotic treatments. Follow-up periods were from twelve to twenty-four weeks depending on the experiment. Complete abstinence was an infrequent outcome in all three experiments. Greater-than-control reductions in smoking for treated subjects were obtained in two of the experiments but, in both cases treatment and control subjects failed to differ significantly before the end of the follow-up period. Hypnotic and nonhypnotic treatments produced equivalent smoking reductions in all studies, and neither hypnotizability nor questionnaire assessments of motivation to quit correlated significantly with treatment outcome. Implications are discussed. NOTES 1:
NOTES
When the experimenters compared number of treatments they simply compared two sessions of Spiegel's one-session treatment with four sessions of it. The authors make the point that perhaps they should vary the four sessions.
"In all three of the present experiments the abstinence rates associated with the Spiegel treatment were very low. Our abstinence rates were similar to those reported in one earlier study [4 - Perry et al.], but substantially lower than those reported in three other studies [2, 22, 25]. The reasons for these discrepancies between studies remains unclear, but experiment 3 suggests that these discrepancies cannot be accounted for simply in terms of whether the subjects were drawn from a university or nonuniversity population, and experiment 2 suggests that the discrepancies are unrelated to the number of treatment sessions administered to subjects.
"The finding that hypnotic and nonhypnotic subjects in all three experiments attained equivalent reductions in smoking is consistent with other comparison studies in this area which indicate that hypnotic treatments are no more effective than various nonhypnotic procedures at inducing reductions in smoking [22, 25, 30]. More generally, these findings are consistent with comparison studies on a wide variety of clinical disorders (headache pain, warts, phobias, obesity) which indicate that hypnotic treatments are no more effective than nonhypnotic ones at producing therapeutic change (see [3] for a review).
"The failure to find significant correlations between smoking reduction and hypnotizability among treated subjects is also consistent with the findings of most studies in this area [3], but the reasons why significant correlations between these variables are found in some studies and not others remains unclear. Spanos [3] suggested that significant correlations between these variables are particularly likely when hypnotizability testing is integrated into the treatment protocol. Under these circumstances subjects are likely to form strong expectations about treatment success on the basis of their self- observed responses to the hypnotizability scale. Such expectations may, in turn, influence subjects' motivations to comply with the treatment regimen, the self-statements they make concerning their likelihood of quitting, etc. In all of the present experiments hypnotizability was assessed at the end of the follow-up period and, therefore, could not influence subjects' expectations of treatment success" (pp. 40-41).
Spiegel, David (1992, October). Hypnotizability. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington , VA.
NOTES
Dr. Spiegel announced that this was a last minute substitution for Fred Frankel's presentation on Hypnotizability.
We have ongoing a major replication of the study that we published on group therapy with terminally ill breast cancer patients. The matched control patients get educational materials but not psychotherapy. We are looking at NKC cytotoxicity and delayed hypersensitivity.
Tasks: spend 15 minutes discussing list of problems; 15 minutes discussing things like, "What is your spouse doing that doesn't help; what can we do to help it?" We get drop in NKC cytotoxicity immediately afterward, returning after 24 hrs to usual levels. Controls don't drop in NKC cytotoxicity. This measure of stress may be a predictor of survival time.
In Fawzy's study of group therapy with melanoma patients, they noted a significant difference at 6 months in interferon augmented activity of NK, which didn't hold up at a year. But at 6 years there were 10 of 40 deaths in control group vs 3 of 40 deaths in treated group. This is a vigorous effect.
Cohen's study of colds in New England J. of Med is another good clinical study.
There are two broad areas of relevance of hypnotizability to healing: 1. Hypnotizability as a trait: do highs differ in way they regulate body or mind? 2. Is there something you do when in hypnotized state that is different? Studies of treatment of warts with hypnosis are important 3. Transition between states, e.g. circadian rhythms; is there a shift in wakefulness between trance and nontrance states that affects health?
Psychiatric Diagnosis and self regulation. High hypnotizability is associated with certain psychiatric disorders (dissociative reaction, PTSD, MPD, etc.). Schizophrenics score much lower than normals (av. = 4 vs 7; replicated with the Hypnotic Induction Profile (HIP). Stanford Hypnotizability Scales show no difference in means, but do show a difference in range). I don't know what this means. But schizophrenics can falsely pass some Stanford Scale items, e.g. amnesia which they don't however reverse; so schizophrenics' hypnotizability scores may be inflated on Stanford scales. We don't see extremely high scores in schizophrenics.
Psychoactive medication doesn't affect scores of schizophrenics, but improves scores of anxiety neurotics (by reducing anxiety). Frischholz has an article coming out in a psychiatry journal that confirms this.
There is a lot of evidence that patients with dissociative disorders are more hypnotizable than other groups. Frischholz et al couldn't replicate Frankel's finding of higher scores in phobics. Pettinati et al found higher scores in bulimia and I haven't seen anything to counter that. Another idea is that high hypnotizables are very good at internal regulation
Spiegel & Ken Kline selected Ss who could regulate gastric activity. They got an 80% increase in gastric acid output while imagining eating; got 40% decrease in output when imagining something pleasant that wasn't imagining eating. Injected with pentagastrin, which induces gastric output, they still got a decrease in gastric acid output in the relaxation condition.
This suggests that hypnotizability should be a selection criterion for some research. See also Katz et al. 1974 (?) with acupuncture; and McGlashan, Evans & Orne on the placebo response.
Herbert Spiegel found that 2/3 of highs but 1/3 of lows were cured of phobia. Eye roll sign on the HIP, living with spouse/lover, rating self as hypnotizable, and giving a postcard follow-up response at one week post treatment were associated with 89% rate abstinence at 2 years follow-up, when only 23% overall of 223 were abstinent. Absence of those positive predictors was associated with only a 4% rate of abstinence.
1991
Court, John (1991). Lord of the trance. Journal of Psychology and Christianity, 10(3), 261-265.
A verbatim account of hypnotically-based therapy utilizing Christian imagery serves as the basis for illustrating some of the benefits of this appraoch where therapist and client share the same value system. The interactions challenge some of the familiar objections to Christian involvement with hypnosis.
Holroyd, Jean (1991). The uncertain relationship between hypnotizability and smoking treatment outcome. International Journal of Clinical and Experimental Hypnosis, 39, 93-102.
Literature on the relationship between hypnotizability and smoking treatment outcome was reviewed. 91 private patients treated for smoking with hypnotherapy participated in an investigation designed to correct problems in some of the earlier research. 43% quit smoking by the end of treatment but only 16% abstained at least 6 months. Neither immediate quitting nor continued abstinence correlated with hypnotizability. Other variables hypothesized to predict smoking cessation also were not correlated with outcome: number of treatment sessions, need to smoke, motivation to quit, and gender. The low abstention rate may have impeded verification of a relationship between hypnotizability and treatment outcome.
NOTES
In the Discussion, the author notes that the low overall abstention rate works against finding the predicted relationships, as did restricted range on the hypnotizability measure. "Secondly, the present research design in effect tested the potency of hypnosis (hypnotizable patients) against nonhypnotic treatment (nonhypnotizable control patients) in a research design recommended by Orne (1977). Intensive nonhypnotic involvement with the nonhypnotizable individuals over several sessions may have worked against finding differences between low and high hypnotizables" (p. 99).
"Patients generally did not complete the recommended four sessions ... and they generally were non-adherent to recommended follow-up telephone contact. The observed relationship between initial quitting and number of treatment sessions may exist because people who are responding to treatment stay in treatment longer, or because more treatment sessions provide a more potent intervention, or both" (p. 99). "Treatment contracts between patients and therapist increased the number of sessions that patients completed but did not increase their abstinence rate" (p. 100).
1990
Suedfeld, Peter (1990). Restricted environmental stimulation and smoking cessation: A 15-year progress report. International Journal of the Addictions, 25, 861-888.
The first successful use of restricted environmental stimulation therapy (REST) as a method of smoking cessation was reported in this journal in 1972. Since then, close to 20 papers and articles have further investigated this application. The results have been consistently positive and have further shown that--unlike most techniques--REST combines synergistically with other effective treatment modalities. The effect of REST seems to target primarily the major problem with other known treatments in this area: It substantially reduces the relapse rate among clients who quit smoking at the end of treatment. Furthermore, REST is safe, has no known adverse side effects, and is easily tolerated by most participants. Nevertheless, the method has not found wide acceptance among practitioners. This paper explores and answers some of the concerns that may be involved in its relative lack of popularity. NOTES 1:
NOTES
Provides a thorough review of REST (restricted environmental stimulation technique) and smoking cessation, with analysis of why the technique has not been widely adopted, how to set up a lab (including costs and equipment), and the political considerations surrounding REST research (many of which would apply to hypnosis). The author describes how sensory restriction got a bad reputation in Hebb's lab. But both "brainwashing" and intensive interrogation rely primarily on overstimulation and intense stimulus bombardment; these are occasionally interrupted for brief periods to arouse fear and uncertainty about their resumption.
The optimal approach in treatment of smokers seems to be to combine an approach that maximizes immediate cessation rates, with REST which maximizes continuing maintenance rates. Tikalsky (1984) reported that combining REST with self- management training and the establishment of a social support group, there was a 6-month abstinence rate of 88%. (This was a clinical treatment study rather than a controlled experiment.)
"The estimated maintenance rates after REST converge at about 50%, about twice as high as those commonly accepted as characterizing the literature (see, e.g., Hunt and Bespalec, 1974; Shumaker & Grunberg, 1986). The unusually high maintenance rates (percentage of subjects who were abstinent at every follow-up throughout 12 months, using as the baseline those who had quit at end of treatment) are in most--although not all- -cases combined with only average quit rates (using total number of followed-up subjects as the baseline), indicating that the initial impact of REST is less impressive than its effect on long-term maintenance" (p. 872).
Why is REST underutilized? Some say it is a placebo. But there is evidence that "expectancy has but little effect on objectively quantifiable (as opposed to subjective) measures in REST (Barabasz & Barabasz, 1990; Suedfeld, 1969b; Suedfeld, Landon, Epstein, & Pargament, 1971)" (p. 873). See also Suedfeld & Baker-Brown (1986).
How does REST work? "In REST, the normal flow of exogenous stimuli is suddenly and very drastically reduced. As a result, attention can be (in fact, must be, if the processing of information is a basic human need) refocused to the ongoing internal generation of physiological, cognitive, affective, memorial, imaginal, and other stimulation. This enables REST participants to concentrate on working out personal problems, including (if so desired) those related to the continuation or termination of their smoking habit" (p. 874).
Second, the removal of specific smoking-related cues interrupts automatic, overlearned response sequences so most clients report that they no longer smoke mechanically, and conditioned cravings for a cigarette are extinguished in many Ss.
It appears from the literature that low-arousal treatments such as hypnosis and meditation are reinforced by REST. REST should improve conditioning or cognitive change therapies because it improves learning and memory, and research supports this assumption. REST also should facilitate the acceptance of information ('messages') because it decreases defenses against novel or dissonant information, but that has not proven true in research to date.
1988
Jeffrey, L. K.; Jeffrey, T. B. (1988). Exclusion therapy in smoking cessation: A brief communication. International Journal of Clinical and Experimental Hypnosis, 36(2), 70-74.
This study investigated the effect of exclusion therapy on the outcome of a 5-session treatment protocol for smoking cessation. A total of 120 Ss were randomly assigned to a group hypnotic and behavioral program which required 48 hours of pretreatment abstinence from use of tobacco products, or to an identical treatment which encouraged, but did notinclude, this pretreatment stipulation. Results indicated there were no significant differences between groups in dropout rates or number of Ss abstinent from smoking. For all Ss, including dropouts, the abstinence rate was 59.2% upon completion of treatment. It was 45.5% and 36.7% at 1- and 3-month follow-up, respectively.
Neufeld, V.; Lynn, Steven Jay (1988). A single-session group self-hypnosis smoking cessation treatment: A brief communication. International Journal of Clinical and Experimental Hypnosis, 36 (2), 75-79.
This study was designed to assess the efficacy of a manual-based, single-session group of self-hypnosis intervention. At 3 months follow-up, 25.92% of the total number of participants (14 male, 13 females) reported continuous abstinence, and at 6 months, 18.52% of the participants reported continuous abstinence. Reported social support and motivation to quit were both associated with successful outcome. Comparison of the current data with other findings reported by the American Lung Association (Davis, Faust, & Ordentlich, 1984) suggests that treatment effects may not be solely attributable to the use of a maintenance manual, education, and attention. Limitations of the research associated with issues of experimental control, generalizability of the findings, and outcome measures are discussed.
Williams, J. M.; Hall, D. W. (1988). Use of single session hypnosis for smoking cessation. Addictive Behaviors, 13, 205-208.
Twenty volunteers for smoking cessation were assigned to single-session hypnosis, 20 to a placebo control condition, and 20 to a no-treatment control condition. The single-session hypnosis group smoked significantly less cigarettes and were significantly more abstinent than a placebo control group and a no-treatment control group at posttest, and 4-week, 12-week, 24-week, and 48-week follow-ups.
1987
Gmur, M.; Tschopp, A. (1987). Factors determining the success of nicotine withdrawal: 12-year follow-up of 532 smokers after suggestion therapy (by a faith healer). International Journal of Addictions, 22, 1189-1200.
In 1973, 532 heavy smokers were questioned prior to treatment by the faith healer Hermano and requestioned 4 months, 1 year, 5 years, and 12 years after the therapeutic ritual. From the moment of treatment, 40% of the subjects remained nonsmokers (with no relapse) after 4 months, 32.5% after one year, 20% after 5 years, and 15.9% after 12 years. At the time of the follow-up, 37.5% of the Ss were nonsmokers, the majority of them having stopped smoking again after suffering a relapse. To investigate factors determining success, Ss who for 12 years had uninterrupted abstinence were compared with those who for 12 years had continued to smoke almost without interruption. Personality factors, sociodemographic features, and characteristics of smoking behavior showed no demonstrable connection with the tendency to relapse. On the other hand, it did prove possible to explain 16% of the variance in the responses to treatment: in particular, high alcohol consumption, markedly addictive smoking, rare attendance at church, and the attitude that 'you have to believe in the treatment' were found to be conducive to relapse and addiction.
1986
Barabasz, Arreed F.; Baer, Lee; Sheehan, David V.; Barabasz, Marianne (1986). A three-year follow-up of hypnosis and restricted environmental stimulation therapy for smoking. International Journal of Clinical and Experimental Hypnosis, 34, 169-181.
Clinical follow-up data were obtained from 307 clients. Clinicians' experience level, contact time, and procedural thoroughness varied in 6 interventions for smoking cessation. An additional intervention combined hypnosis with restricted environmental stimulation therapy (REST). The major results suggest positive treatment outcomes to be related to greater hypnotizability, absorption, hypnotist experience level, procedural thoroughness, and client-therapist contact time. The least effective intervention (4% abstinence at 4-month follow-up) involved intern trainees using a short, single-session approach. The most effective procedure (47% abstinence at 19-month follow-up) involved the combination of hypnosis and
REST. Data interpretation limitations are discussed.
Lambe, R.; Osier, C.; Franks, P. (1986). A randomized controlled trial of hypnotherapy for smoking cessation. Journal of Family Practice, 22, 61-65.
NOTES
242 patients who were smokers (49% of all patients in this group family practice) were contacted, and 180 (74%) who were interested in hypnosis as a method of helping them quit were included in the study. These 180 were randomly assigned to control and hypnosis groups. Of the 90 assigned to hypnosis: 50% 45 had at least 1 hypnosis session
7% 6 quit smoking before hypnosis 20% 18 declined hypnosis 23% 21 were lost to follow-up [This gives some idea about volunteer participation in research.]
1985
Jeffrey, Timothy B.; Jeffrey, Louise K.; Greuling, Jacquelin W.; Gentry, William R. (1985). Evaluation of a brief group treatment package including hypnotic induction for maintenance of smoking cessation: A brief communication. International Journal of Clinical and Experimental Hypnosis, 33 (2), 95-98.
Hypnotic, cognitive, and behavioral interventions were used in a 5-session treatment program to assist 35 Ss with maintenance of smoking cessation. 63% of the treated Ss discontinued smoking, and 31% maintained abstinence for 3 months (p <.005). These results include 13 dropouts, all of whom were smoking at 3 months follow-up. No S in the waiting-list-control group quit smoking. The results demonstrate that a brief, group treatment program, including hypnotic techniques, can be effective for smoking cessation.
1980
Holroyd, Jean (1980). Hypnosis treatment for smoking: An evaluative review.International Journal of Clinical and Experimental Hypnosis, 28 (4), 341-357.
17 studies of hypnosis for treatment of smoking published since 1970 were reviewed. Abstinence after 6 months posttreatment ranged from 4% to 88%. Effectiveness of treatment outcome was examined in terms of: S population, individual versus group treatment, standardized versus individualized suggestions, use of self-hypnosis, number of treatment sessions and time span covered by the treatment, and use of adjunctive treatment. At 6 months follow-up, more than 50% of smokers remained abstinent in programs in which there were several hours of treatment, intense interpersonal interaction (e.g., individual sessions, marathon hypnosis, mutual group hypnosis), suggestions capitalizing on specific motivations of individual patients, and adjunctive or follow-up contact. The 17 studies are presented in sufficient detail to permit clinicians to follow the published procedures, and recommendations are made for future research.
Powell, Douglas H. (1980). Helping habitual smokers using flooding and hypnotic desensitization techniques: A brief communication. International Journal of Clinical and Experimental Hypnosis, 28 (3), 192-196.
A subgroup of individuals who were helped to stop smoking by hypnosis or other means returned to consuming a few cigarettes a day. A flooding and hypnotic desensitization technique assisted 4 of 7 individuals who resumed smoking in becoming and remaining abstinent for a 6- to 9-month follow-up period.
1979
Pederson, Linda L.; Scrimgeour, William G.; Lefcoe, Neville M. (1979). Variables of hypnosis which are related to success in a smoking withdrawal program.International Journal of Clinical and Experimental Hypnosis, 27 (1), 14-20.
65 habitual smokers were randomly assigned to one of 4 groups: live-hypnosis plus counseling, videotape-hypnosis plus counseling, relaxation-hypnosis plus counseling, and counseling alone. The content and mode of presentation of the hypnosis session varied among the first 3 groups. At 6 months posttreatment, the live-hypnosis plus counseling group contained significantly more abstainers than the other 3 groups. The importance of the specific content of the hypnosis session and the presence of the hypnotherapist for the effectiveness of the procedure is discussed.
Perry, Campbell; Gelfand, Robert; Marcovitch, Phillip (1979). The relevance of hypnotic susceptibility in the clinical context. Journal of Abnormal Psychology, 88(5), 592-603.
Despite experimental evidence that hypnotic susceptibility is a relatively stable characteristic of the individual, and one that is very difficult to modify, clinical investigators tend to see susceptibility as irrelevant to therapeutic outcome. Such investigators view motivational and interpersonal variables as more essential to the therapeutic change. The evidence for the clinical relevance of hypnotizability is sparse and contradictory. Most existing studies stem from medical hypnosis and indicate that susceptibility plays an important role in the successful treatment of such conditions as clinical pain, warts, and asthma. Two studies are reported that seek to pursue a contrary finding reported by Perry and Mullen, who found that susceptibility was unrelated to the successful treatment of a socially learned behavior (cigarette smoking). Both studies confirmed the earlier finding of a lack of relation. In Study 1, however, stepwise multiple regression analysis located three inventory items concerning the motivation of cigarette smokers. The combination of items was found to predict outcome for 67.39% of 46 clients treated either by hypnosis or by rapid smoking. The finding was replicated in Study 2, which utilized a combined hypnosis - rapid smoking technique and employed a different therapist. The outcome for 9 of the 13 quitters and 37 of the 62 nonquitters across the two studies could be predicted by the three motivational questionnaire variables.
1978
Stanton, Harry E. (1978). A one-session hypnotic approach to modifying smoking behavior. International Journal of Clinical and Experimental Hypnosis, 26, 22-29.
Recent literature reviewing attempts to modify smoking behavior through the use of hypnosis is outlined, and an approach utilizing only 1 treatment is described. This single session includes: (a) the establishment of a favorable "mental set" on the part of the patient, (b) a hypnotic induction, (c) ego-enhancing suggestions, (d) specific suggestions directed toward the cessation of smoking, (e) an adaption of the "red balloon" visualization, and (f) success visualization. Of 75 patients treated by this technique, 45 ceased smoking. 6 months after the treatment session, 34, or 45%, were still nonsmokers, attesting to the efficacy of the method.
1977
Barkley, R. A.; Hastings, J. E.; Jackson, T. L., Jr. (1977). The effects of rapid smoking and hypnosis in the treatment of smoking behavior. International Journal of Clinical and Experimental Hypnosis, 25 (1), 7-17.
29 Ss were assigned to one of 3 treatment conditions and treated for their cigarette smoking over a 2-week period. These conditions were: group rapid smoking, group hypnosis, and an attention-placebo control group. All treatments produced significant reductions in average daily smoking rates during the treatment phase but all Ss returned to near baseline levels of smoking by the 6-week follow-up. The rapid smoking and hypnosis groups did not differ from the control group in smoking rates at treatment termination or at the 6-week follow-up. They also did not differ from the control group in the number of Ss abstaining from smoking by treatment termination but did differ at follow-up. Eventually, at the 9-month follow-up, only Ss from the group rapid smoking condition had significantly more abstainers than the control group. The results suggested that rapid smoking can work as effectively in group procedures as previous individualized approaches had demonstrated. Group hypnosis, while less effective than some previous individualized approaches had indicated, was nevertheless only marginally less effective than the group rapid smoking procedure. The use of abstinence rates as opposed to average rates of smoking was strongly recommended as the best measure of treatment effectiveness for future research in this area.
1976
Watkins, Helen H. (1976). Hypnosis and smoking: A five session approach.International Journal of Clinical and Experimental Hypnosis, 24, 381-390.
An individualized method of treatment aimed at the reduction of smoking is described which is based on a study of the motivations of each client. Specialized suggestions and specifically-tailored fantasies are then initiated to undermine rationalizations and reinforce the person's commitment to stop smoking. A number of different techniques are mobilized within a hypnotic, "concentation-relaxaton" approach and are combined with behavior therapy procedures to achieve strong counter-motivations to smoking. 78% of those who finished the program stopped smoking, and 67% were still not smoking at the end of 6 months. The individuals who were most resistant to the treatment appeared to be those who were using smoking as a way of controlling anger.
1975
Mullen, G.; Perry, C. (1975). The effects of hypnotic susceptibility on reducing smoking behavior treated by a hypnotic technique. Journal of Clinical Psychology, 31, 498-505.
In order to examine the relationship between hypnotizability and treatment outcome in which hypnosis is used, 54 people ages 19-47 who undertook to stop smoking were studied. Although it is logical that there should be a relationship, clinical anecdotal material published by people who used hypnosis (Freud, Weitzenhoffer, Lazarus, Sheehan, Orne) suggests that may not be the case. Hypnotic susceptibility was evaluated with a clinical procedure developed by Orne and O'Connell (the DRP). Patients were taught self hypnosis using a brief procedure developed by Herbert Spiegel. Baseline smoking rate and three-month follow-up with postcards mailed every week were employed as measures. Success in the treatment program was defined as a 50% reduction in smoking behavior. After 3 months, 7 people were abstinent, 10 had reduced smoking to criterion level (50%), 16 people had discontinued the investigation, and 21 did not change. Considering only the 15 most and 15 least hypnotizable, 12 of the 15 high susceptibles had reduced smoking by at least 50%, as compared to 5 of the 15 of the low susceptibles. (chi square = 4.88, df = 1, p<.05).
1972
Suedfeld, Peter; Landon, P. Bruce; Pargament, Richard; Epstein, Yakov M. (1972). An experimental attack on smoking (attitude manipulation in restricted environments, III). International Journal of the Addictions, 7 (4), 721-733.
Forty male cigarette smokers were Ss in a study which involved 24 hr of sensory deprivation (SD) and a brief anti-smoking message. On a measure of belief instability (errors in scaling the extremeness of statements about smoking), SD Ss showed more instability than controls; but the scores of Ss who heard the message were about equal, regardless of SD. Agreement with antismoking statements was highest in the SD-no message and message-no SD groups. While the message induced belief instability and attitude change under normal circumstances, it had the opposite effect in SD. This may have been due to the stimulus value of the message and/or to the overt nature of the manipulation attempt. In spite of this, three months later SD Ss (regardless of message) reported smoking significantly less than controls. The results relate the known cognitive effects of SD to its effects on persuasibility, further explore the cognitive uncertainty model of attitude change, and indicate the potential usefulness of SD as a technique for bringing about significant attitudinal and behavioral change.
1970
Dengrove, Edward; Nuland, William; Wright, M. Erik (1970). A single-treatment method to stop smoking using ancillary self-hypnosis: Discussion. [Comment/Discussion] .
NOTES
Discusses H. Spiegel''s (see PA, Vol. 45:Issue 1) smoking treatment method comparing it to behavior therapy and suggesting modifications to treat smokers not responding to the method as described. It is suggested that certain psychological conditions must become active for nonsmoking status to be achieved or maintained including: (a) recognizing the consequences of smoking to be imminent, (b) identifying oneself as a nonsmoker, (c) expecting and wanting to participate in a satisfying future, and (d) adopting a way by which the individual can gain control over smoking. The technique outlined deals with these 4 dynamic aspects and makes a significant contribution to the treatment of the smoker''s problem. (German & Spanish summaries) (PsycINFO Database Record (c) 2003 APA, all rights reserved)
Discusses H. Spiegel''s (see PA, Vol. 45:Issue 1) smoking treatment method comparing it to behavior therapy and suggesting modifications to treat smokers not responding to the method as described. It is suggested that certain psychological conditions must become active for nonsmoking status to be achieved or maintained including: (a) recognizing the consequences of smoking to be imminent, (b) identifying oneself as a nonsmoker, (c) expecting and wanting to participate in a satisfying future, and (d) adopting a way by which the individual can gain control over smoking. The technique outlined deals with these 4 dynamic aspects and makes a significant contribution to the treatment of the smoker''s problem. (German & Spanish summaries) (PsycINFO Database Record (c) 2003 APA, all rights reserved)
Hall, J. A.; Crasilneck, H. B. (1970). Development of a hypnotic technique for treating chronic cigarette smoking. International Journal of Clinical and Experimental Hypnosis, 18, 283-289.
4 hypnotic sessions were found successful, in the majority of cases, in eliminating cigarette smoking without undersirable substitution symptoms. Patients were strongly motivated by the referring physicians and by various nonhypnotic techniques incorporated into the treatment program. Examples are given of the specific nature of both the hypnotic and the nonhypnotic suggestions employed. (German & Spanish summaries) (PsycINFO Database Record (c) 2002 APA, all rights reserved)
Kline, Milton
Results of the present experimental approach to the treatment of smoking habituation tend to be consistent with the view of smoking habituation as a dependence reaction, parallel to drug addiction, and with the concept that habituation must be examined as a psychosomatic entity. Therapeutic approaches must take into account the psychophysiological characteristics of deprivation behavior. Hypnosis, and particularly extended periods of hypnotherapy involving the reduction and control of deprivation behavior, seems to offer a promising approach to the therapeutic treatment of smoking habituation. (German & Spanish summaries) (17 ref.) (PsycINFO Database Record (c) 2003 APA, all rights reserved)
Nuland, William; Field, Peter B. (1970). Smoking and hypnosis: A systematic approach. International Journal of Clinical and Experimental Hypnosis, 18, 290-306.
Compared 2 methods of helping cigarette smokers stop smoking using 181 patients. After 6 mo., 60% of those treated with an active, personalized approach were not smoking. This approach emphasized: (a) the feedback, under hypnosis, of the S''''s own reasons for quitting, (b) maintaining contact with the S by telephone, (c) use of meditation during hypnosis to obtain individualized motives, and (d) self-hypnosis. Only 25% of Ss were successfully treated by an earlier hypnotic procedure that did not systematically employ these features. (German & Spanish summaries) (PsycINFO Database Record (c) 2003 APA, all rights reserved)
Spiegel, Herbert (1970). A single-treatment method to stop smoking using ancillary self-hypnosis. International Journal of Clinical and Experimental Hypnosis, 18 (4), 235-250.
Discusses the 1st 615 patient-smokers who were treated with a single 45-min session of psychotherapy reinforced by hypnosis. Technique of treatment, including rationale of approach, induction procedure, assessment of hypnotizability, and training instructions to stop smoking are presented in detail. 6-mo follow-up study results are discussed. Of 44% who returned a questionnaire, hard-core smokers stopped for at least 6 mo. Another 20% reduced their smoking to varying degrees. Results of a 1-session treatment compare favorably with, and often are significantly better than, other longer-term methods reported in the literature. It is suggested that every habitual smoker who is motivated to stop be exposed to the impact of this procedure, or its equivalent, so that at least 1 of 5 smokers can be salvaged. (French & Spanish summaries). (PsycINFO Database Record (c) 2003 APA, all rights reserved)
Spiegel, Herbert (1970). A single-treatment method to stop smoking using ancillary self-hypnosis: Final remarks in response to the discussants. International Journal of Clinical and Experimental Hypnosis, 18 (4), 268.
Reexamines the major points of the author''s papers (see PA, Vol. 45:Issue 1) on smoking modification. Data inclusion, therapy length, Ss'' ability to change, and use of multiple therapists and tape recordings as reinforcement are discussed. It is concluded that the method should be used to "sharpen our techniques that we can relatively quickly learn who has the capacity to change for given goals, and then to help evoke the desired change as efficiently as possible." (PsycINFO Database Record (c) 2003 APA, all rights reserved)
1964
Stein, C. (1964). A displacement and reconditioning technique for compulsive smokers. International Journal of Clinical and Experimental Hypnosis, 12 (4), 230-238.
A procedure for reducing total anxiety in chronic smokers while ostensibly directed toward permissive alteration of the smoking pattern is presented. In light trance the motivated patient is taught: (a) elementary respiratory relaxation (natural sigh), (b) displacement of emphasis from inhaling smoke to _exhaling_ clean fresh air, (c) enhancement of satisfaction from other pleasurable factors -- touch, shape, color, aroma, flame, smoke clouds, and taste, (d) to puff, hold smoke in mouth, inhale fresh air through nose and exhale through mouth. In most cases practice in stressing positive qualitative smoking pleasure soon results in automatic quantitative reduction of cigarette consumption. 5 brief case reports are presented.
1956
Hershman, Seymour
NOTES
"Conclusion: Several methods are described wherein psycho-biologic techniques can be used with hypnotic procedures to treat excessive cigarette smoking with relatively permanent results. These techniques include symptom substitution, reeducation, reconditioning, reassurance and persuasion. The use of fantasy evocation, visual imagery, etc. by means of the hypnotic state produces an increase in the patient's responsiveness to therapy.
"Conclusion: Several methods are described wherein psycho-biologic techniques can be used with hypnotic procedures to treat excessive cigarette smoking with relatively permanent results. These techniques include symptom substitution, reeducation, reconditioning, reassurance and persuasion. The use of fantasy evocation, visual imagery, etc. by means of the hypnotic state produces an increase in the patient's responsiveness to therapy.
"Several case histories have been presented to illustrate some of the various techniques and their reactions. These procedures can readily be made available to a vast number of people with gratifying results. It is felt that all professional people in the therapeutic fields should be aware of the excellent use which can be made of hypnosis, and should acquaint themselves with hypnotic techniques in order to utilize them to the best interests of their patients. It is important to note that psychodynamic orientation is essential to the proper utilization of hypnosis and that the training received by the stage entertainer lacks this important element" (p. 29).
SUGGESTION
1995
Lee DY. Barak A. Uhlemann MR. Patsula P. Effects of preinterview suggestion on counselor memory, clinical impression, and confidence in judgments. Journal of Clinical Psychology 1995;51(5):666-75 This study examined the effects of schematic preinterview suggestion on counselors' (a) recognition memory of the information presented by the client; (b) clinical impression rating of the client; and (c) confidence in rating clinical impression. Fifty-two Master's-level counselor-trainees were assigned randomly to two conditions of preinterview suggestion about the status of the client (i.e., depression and no depression). After subjects had received appropriate preinterview information (i.e., depression or no-depression content) and had viewed a videotaped counseling interview, information was gathered from them. The results indicated that the preinterview suggestion (a) did not affect counselor-trainees' clinical impression rating of the client; (b) did not affect confidence of rating; and (c) yielded a weak, but significant, confirmatory memory. Implications for the interview setting are discussed.
Barnier, Amanda J.; McConkey, Kevin M. (1995, November). Posthypnotic suggestion: Knowing when to stop helps to keep it going. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio , TX
NOTES
Posthypnotic suggestion sometimes leads to compulsive and involuntary responding, but we have little information about the parameters of such a response. In some research in our laboratory, we found that subjects who were given a posthypnotic suggestion that encouraged them to experience a desire to respond, showed a different pattern of response from those simply told to make a specific behavioral response. In another study, we gave subjects a posthypnotic suggestion to mail a postcard every day to the experimenter; some subjects were told to respond until they saw the hypnotist again (termination), others were given no specific information about how long they should respond (no termination). Those expecting a termination to the suggestion showed a different pattern of response across 16 weeks of testing. Thus, the information included in the suggestion about how or when to respond influences posthypnotic responding.
Present Experiment: Laboratory test of including specific information in the posthypnotic suggestion about how long to respond - cancellation cue vs. no cancellation cue. Responding indexed on four different tests: formal, embedded, informal, postexperimental. Also used real/simulating methodology. We expected that responding would decline across the four tests, but that the decline would be slowest for those expecting a cancellation cue.
Methodology: High hypnotizable subjects scored 8-10 on SHSS:C, lows scored 0- 3 on SHSS:C. Given real/simulating instructions (Orne, 1959). Formal test was given immediately after deinduction; embedded test was given during an inquiry question; informal test was given as the hypnotist appeared to terminate the experiment and leave the room; postexperimental test was given by another experimenter during a postexperimental inquiry. The suggestion was to cough when Ss heard a particular response cue.
Results: On the forma test, there was no difference between reals or simulators in either the cue or no cue condition, although simulators in the cue condition tended to overplay their response. Across the tests, responding declined. In particular, the majority of reals and simulators in the no cue condition stopped responding after the formal test. In the cue condition, reals and simulators responded similarly on the embedded test, but differently on the informal test; more reals than simulators continued to respond across the tests. Few subjects responded on the postexperimental test. Subjects' postexperimental comments indicated that reals and simulators in the no cue condition believed that one response was sufficient; simulators in the cue condition were confused about whether to keep responding, and reals in the cue condition responded compulsively across the test.
Conclusions: The inclusion of a cancellation cue in a posthypnotic suggestions maintains responding for a longer period. Responding posthypnotically is not explained solely by demand characteristics. Rather, individuals respond on the basis of their interpretation of the implied intent of the hypnotist's message (c.f., Sheehan, 1971). Responding changes across test types. These findings contribute to a model of posthypnotic responding. They point to the active responding of hypnotized individuals (c.f., Kihlstrom: experimental subjects try to make sense of the message of the suggestions and instructions they receive).
1994
Barber, Joseph (1994, October). How to use and abuse boundaries with hypnosis. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco
NOTES
(for only part of the presentation) I would like to focus on how we can productively use boundaries. Hypnosis experience reactivates archaic experiences with parents; if therapist can evoke trust, the patient can feel increasingly that they can relax into the experience.
Bejenke, Christel J. (1993, October). A clinician's perspective. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis,Arlington Heights , IL
NOTES
Presents point of view of a private practice anesthesiologist in Santa Barbara , California
Use of hypnosis as hypnoanesthesia is rare since Esdaile, with brief resurgence in 50's, because surgery techniques advanced before anesthesias did in areas that were very risky. Now it is a matter of choice, and may be undertaken because of a patient's extreme fear of anesthesia, previous bad experience with anesthesia, fervent belief in holistic method, allergy, or previous experience with hypnosis. Still advised to use hypnosis for MRIs, radiation procedures, former drug addicts (who may have problems with drugs), burn patients, release of neck contractions, and medical procedures--especially with children--like lumbar puncture.
She disagrees with Kroger's estimate of only 10% of patients being able to use hypnoanesthesia; she does not believe it requires a lot of training, or profound muscle relaxation.
There is no indication of how many cases are actually done with hypnosis. Also, published cases are not representative of the quantity or complexity of cases; most published cases have a few extraordinary characteristics. The Irish surgeon Jack Gibson has done more than 4000 cases, some very complicated.
I have used it for D & Cs, and complex cases that were not published. Most of my patients elected to be alert during the hypnosis and conversed with their surgeons. The most common benefit is that recovery from anesthesia is not necessary; but these days with newer anesthesias recovery from anesthesia is rapid anyway. However, if as we suspect anesthesia affects immune function, that would be another reason to use hypnosis.
Preparation for surgery may be of three types: 1. formal hypnosis techniques 2. "hypnoidal" techniques that aren't formal 3. unprepared patients in whom hypnosis is used at last moment.
Examples. 1. Formal hypnosis: This symposium deals with this type of approach. Three groups derive particular benefit -- those requiring prolonged artificial ventilation postoperatively (because otherwise sedation must be used, which leads to complications), where prepared patients tolerate interventions calmly and comfortably -- cancer patients, for whom this can be first experience of patient to see self as active participant in care rather than a victim of the illness and of complicated technology -- pediatric patients. 2. Hypnoidal (hypnosis like) techniques: This is the most important application. Time doesn't permit much discussion here. Patients are in an altered state when they come for surgery, highly suggestible, and suggestions appear to be as effective as during formal trance state. The doctor can elicit positive responses during "casual conversation" while seemingly giving information to the patient. (The reverse is true also, with inadvertent negative suggestions, to the detriment of the patient.) Scrupulous adherence to medical facts is important during this type of conversation.
Operating room fixtures are useful for focus of attention, and I have published this information in an article.
Recovery room also is place where case specific information and appropriate suggestions can be given. Patient can experience his ability to alter sensations, for the first time, following suggestions.
Remainder of the hospitalization offers opportunity for reinforcing case specific positive suggestions.
Bennett, Henry L. (1993, October). Hypnosis and suggestion in anesthesiology and surgery. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights , IL
NOTES
He began by saying that he is opposed to using hypnosis for surgery, though he favors a theory of how hypnosis effects physiological change, and cites T. X. Barber's classic "Changing Unchanging Bodily Processes."
Relaxation puts patient in a "psychological strait jacket" because surgery is so highly stressful. He gives information "about how to go through the surgery more comfortably," gets across the idea about coping style, tells them surgery is exertional and that they are tired afterward, that he can help them "using things you already know how to do," and specifies exactly what they can do--using model of himself as a trainer.
In some recent research he used pairs of pictures, some of which lead to pupillary constriction (blood pressure goes down) or dilation (blood pressure goes up). Instructing them to look, patients looked twice as long at the pictures than they did during free gaze. When not instructed to look, heart rate went down; when told to look, heart rate went up. So the researchers went back to free gaze. He uses this as a metaphor for many of the pre- surgery preparation activities that encourage relaxation "inappropriately."
He cites Cohen & Lazarus re vigilant copers, Price et al (1957), and some other studies on epinephrine effects. He uses examples of work patients may have done (e.g. planting a garden) when talking with patients prior to surgery, that gives them a sense of accomplishment later.
You have to give specific instructions or suggestion, not general relaxation suggestions.
Question from the audience: Can preoperative instructions (not hypnosis) diminish blood loss.
In Bennett's answer he seems to be reporting the earlier study: they found 150- 4000 cc blood loss, high variability. Extent of blood loss was determined by extent of surgery, by instructions to patients vs no instructions.
This study was replicated by Enqvist, Bystedt, & von Konow in the Anesthesia conference atEmory University
May 1993 Western Journal of Medicine article, Disbrow, Bennett, & Owinos, with 40 lower abdominal surgery patients who got specific instructions or not. The SHCS was used to measure hypnotizability: highs resolved quicker than low hypnotizable patients. They also found that instructed patients did better than those who did not get specific instructions.
There are now 3 replications of McClintock's study: people use less medications after surgery, when tapes about rapid recovery are played *during* surgery.
Bennett is now using tapes with suggestions for recovery during surgery.
Blankfield, Robert P. (1993, October). Suggestion, hypnosis, and relaxation as adjuncts for surgery patients: Lessons from studies involving cardiac surgery patients. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington Heights , IL
NOTES
The author stated that his research and the few other studies of cardiac surgery patients do not support idea that cardiac surgery patients benefit from hypnosis and suggestion.
Types of intervention have varied: hypnosis, suggestion, relaxation; pre-op, during, or post-op; with many different outcome variables.
Aiken & Henrichs (1971) study was nonrandomized, nonblinded, for 30 patients getting open heart surgery. Treated patients had benefits.
Surman, Hackett, Silverberg, & Behrendt (1974) had a randomized, single-blind design for 40 patients taught Self Hypnosis (S-H), for elective mitral valve surgery. No difference in benefits. But 45% of patients taught S-H reported a subjective sense of benefit (though objective indicators didn't support that). [He says the difference between subjective/objective outcome ratings is important.]
Hart (1980) used randomized, single-blind design for 40 patients who had open heart surgery. No differences found except initial 3 days post surgery.
Greenleaf et al (1992) - see her paper presentation of this date.
Blankfield et al (presented at Society of Clinical and Experimental Hypnosis meeting in 1992) used a randomized, single-blind design for 95 patients, who were randomly assigned to taped suggestions, music, or controls. No differences were found in benefits.
Our data were re-analyzed: patients who felt tape was helpful were compared to the remaining 62 patients, but there again were no differences in amount of narcotics used for pain, though there was a trend in the right direction; nursing assessments failed to identify less anxiety.
The point is, whereas the bulk of publications suggest benefits, there is little evidence with this population. Could these patients be different in personality, ability to respond to intervention, amount of external stimuli? They should be studied because there are a lot of these patients with only a few surgeons and you don't have to gain the cooperation of a lot of different surgeons to do this kind of research. Also, there is uniformity in cardiac surgery whereas standard operating surgery is in a state of flux in other areas (e.g. movement from generous incisions to micro procedures, and patients receiving this type of surgery remain in hospital for a week whereas this opportunity to study them during inpatient post-surgical period is disappearing in other areas). It is my opinion that cardiac patients may not be highly receptive to suggestion.
Curiously, according to Surman and my research, 1/2 the subjects report benefits. Either some benefits are subtle, or they are reporting a placebo effect.
Future studies need more patients, and the investigators must stratify on personality inventory variables such as Type A personality, hypnotizability, motivation, anxiety, depression, family support, social support systems. This is labor intensive, to determine which characteristics determine differing outcomes. The patients used in this type of research require more presurgery evaluation than previously has occurred.
The MMPI can be self administered and is widely acceptable, but is cumbersome, not well suited to people who are acutely ill. Assessment of Type A personality is important because Type A's might be less receptive to suggestion. Structured interview is time consuming, but a 52-item questionnaire can be self administered. Other factors listed above are important.
Bruehl, Stephen; Carlson, Charles R.; McCubbin, James A. (1993). Two brief interventions for acute pain. Pain, 54, 29-36.
This study evaluated two brief (3-5 min) interventions for controlling responses to acute pain. Eighty male subjects were randomly assigned to 1 of 2 intervention groups (Positive Emotion Induction (PEI PEI PEI PEI
De Pascalis, Vilfredo (1993). EEG spectral analysis during hypnotic induction, hypnotic dream and age regression. International Journal of Psychophysiology, 15, 153-166.
EEG was recorded monopolarly at frontal (F3, F4), central (C3, C4) and posterior (in the middle of O1-P3-T5 and O2-P4-T6 triangles) derivations during the hypnotic induction of the Stanford Hypnotic Clinical Scale (SHCS) and during performance following suggestions of hypnotic dream and age-regression as expressed in the before-mentioned scale. 10 low-hypnotizable and 9 highly-hypnotizable and right- handed female students participated in one experimental session. Evaluations were Fast- Fourier spectral analyses during the following conditions: waking-rest in eyes-open and eyes-closed condition; early, middle, and late phases of hypnotic induction; rest-hypnosis in eyes closed condition; hypnotic dream and age regression. After spectral analysis of 0 to 44 Hz, the mean spectral amplitude estimates across seven Hz bands (theta 1, 4-6 Hz, theta 2, 6-8 Hz; alpha 1, 8-10 Hz; alpha 2, 10-13 Hz; beta 1, 13-16 Hz; beta 2, 16-20 Hz; beta 3, 20-36 Hz) and the 40-Hz EEG band (36-44 Hz) for each experimental condition were extracted. In eyes-open and -closed conditions in waking and hypnosis highly-hypnotizable subjects produced a greater 40-Hz EEG amplitude than did low hypnotizable subjects at all frontal, central and posterior locations. In the early and middle hypnotic induction highly-hypnotizables displayed a greater amount of beta 3 than did low hypnotizables and this difference was even more pronounced in the left hemisphere. With posterior scalp recordings, during hypnotic dream and age regression, high hypnotizables displayed, as compared with the rest-hypnosis condition, a decrease in alpha 1 and alpha 2 amplitudes. This effect was absent for low hypnotizables. Beta 1, beta 2 and beta 3 amplitudes increased in the left hemisphere during age regression for high hypnotizable; low hypnotizables, in contrast, displayed hemispheric balance across imaginative tasks. High hypnotizables during the hypnotic dream also displayed in the right hemisphere a greater 40-Hz EEG amplitude as compared with the left hemisphere. This difference was even more evident for posterior recording sites. This hemispheric trend was not evidenced for low hypnotizable subjects. Theta power was never a predictor of hypnotic susceptibility, 40-Hz EEG amplitude displayed a very high main effect (p<0.004) for hypnotizability in hypnotic conditions by displaying a greater 40-Hz EEG amplitude in high hypnotizables with respect to lows. NOTES 1:
NOTES
In the Discussion section, the authors indicate that they have no idea why they didn't replicate results of other theta studies, including their own, except maybe due to complex interaction among personality, subject selection, situation-specific factors, and hypnotizability.
They observe that the alpha results conform with previous findings (p. 163). Beta bands were sensitive. Highs showed left-hemisphere prevalence in all beta bands during age regression; they also showed hemispheric balance in the hypnotic dream condition. Beta 3 amplitude was also greater among highs than lows. "among high hypnotizables, beta 3 amplitude in the early hypnotic condition was greater in the left hemisphere as compared to the right and as the hypnotic induction proceeded hemisphere balancing, with reduced beta 3 amplitude, was displayed. This result appears in agreement with the predictions of the neurophysiological model proposed by Gruzelier et al. (1984) and Gruzelier (1988) as well as with other studies in which beta rhythm was found to discriminate performances between high and low hypnotizables (e.g., Meszaros et al., 1986, 1989; Sabourin et al., 1990)" (p. 163-164).
40 Hz amplitude was higher in highs and increased in right hemisphere during the hypnotic dream, especially in posterior areas. "This pattern of hemispheric activation may be interpreted as an expression of the greater right-hemisphere activation and of the release of posterior cortical functions during the hypnotic dream and is compatible with the predictions of the Gruzelier model of hypnosis, however, the results obtained in this study for 40-Hz EEG amplitude failed to reveal an inhibition of the left-hemisphere activity with the progress of the hypnotic induction" (p. 164).
(They note that De Pascalis & Penna, 1990, agreed with the Gruzelier 1988 model: highs in early induction had increase of 40-Hz in both hemispheres, but as induction proceeded they had inhibition of left and increase in right hemisphere activity. In this current experiment, only beta 3 showed the hemispheric trend of Gruzelier's model. They cite other details of current study, p. 164, not consonant with Gruzelier.)
"The 40-Hz EEG rhythm, which according to Sheer (1976) is the physiological representation of focused arousal, appeared to discriminate between differential patterns of high and low hypnotizables. Both during hypnotic induction and during hypnotic dream and age regression highly hypnotizables exhibit greater 40-Hz EEG amplitude with respect to the lows. These findings support the validity of the assumption that hypnosis is characterized by a state of focused attention (Hilgard, 1965) and that 40-Hz EEG activity reflects differential attentional patterns among subjects high and low in hypnotizability. On the basis of these findings it would appear that 40-Hz EEG and beta 3 spectral amplitudes may prove to be useful measures of individual hypnotizability" (p. 164).
1992
Anonymous (1992, May). Studies: Learning can occur while under anesthesia.Daily Breeze (South Bay Los Angeles County
NOTES
"Surgical patients can absorb information while they're knocked out, and even learn tips that help with recovery, researchers reported Friday at a symposium on memory and anesthesia.
"Researchers at Papworth Hospital Cambridge , England
"Patients who were played the suggestion tape - which told them they were doing well, or wouldn't feel much pain - left the hospital 1 1/2 days earlier on average than other patients.
"Another study, from the University of Arizona College of Medicine, found that surgical patients who heard specific pain-relief suggestions recovered more easily than those hearing vague advice such as, 'Think of being well.'
"'These are still early days to invest in every operating suite buying a tape recorder to play for the patients,' said Dr. Sunit Ghosh, a researcher with the Papworth team. 'But this definitely does hold promise.'
"Scholars at the second annual Symposium on Memory and Awareness in Anesthesia said patients rarely wake up recalling - unprompted - something that happened during anesthesia.
"But several studies showed subconscious learning while the patients were out cold.
"Not everyone accepted the findings.
"'It shows an enormous sensitivity on the part of the brain, if it can be shown,' said Eugene Winograd, an Emory University psychologist and organizer of the Emory- sponsored conference. 'I'm not confident it has been shown yet.'
"Some researchers in other studies found no association between messages heard during anesthesia and learning.
"Dr. Alan Aitkenhead, professor of anesthesia at the University of Nottingham in England, found no significant difference between patients who heard recuperative suggestions and patients who were treated to a deliberately dull history of the hospital where they were.
"Aitkenhead said his study kept all patients quite deeply anesthetized, and that may be why they might not have learned as much as patients in other studies.
"'By far, most likely, it's a difference in levels of anesthesia,' he said.
"The Papworth researchers, in another study, found that some patients showed strong word associations after hearing tapes of groups of words during surgery; but other patients under a different anesthesia didn't.
"'There needs to be standardization of our testing,' Ghosh said. 'I think it's partly related to the anesthesia technique and partly related to the way in which material is presented to the patient.'
"Dr. Peter Sebel, an Emory anesthesiologist and conference organizer, said that if patients can retain information about a speedy recovery, they probably retain other information, too - for example, a surgeon's discouraging operating-room assessment of their prognosis."
1991
Burish, Thomas G.; Snyder, Susan L.; Jenkins, Richard A. (1991). Preparing patients for cancer chemotherapy: Effect of coping preparation and relaxation interventions. Journal of Consulting and Clinical Psychology, 59 (4), 518-525.
60 cancer chemotherapy patients were randomly assigned to 1 of 4 treatments: (a) relaxation training with guided relaxation imagery (RT), (b) general coping preparation package (PREP), (c) both RT and PREP, or (d) routine clinic treatment only. All patients were assessed on self-report, nurse observation, family observation, and physiological measures and were followed for 5 sequential chemotherapy treatments. Results indicate that the PREP intervention increased patients' knowledge of the disease and its treatment, reduced anticipatory side effects, reduced negative affect, and improved general coping. RT patients showed some decrease in negative affect and vomiting, but not as great as in past studies. The data suggest that relatively simple, 1-session coping preparation intervention can reduce many different types of distress associated with cancer chemotherapy and may be more effective than often-used behavioral relaxation procedures.
DeKoninck, J.; Brunette, R. (1991). Presleep suggestion related to a phobic object: Successful manipulation of reported dream affect. Journal of General Psychology, 118, 185-200.
When compared with subjects who received presleep suggestions for negative affect, subjects who received positive affect suggestions had significantly higher levels of positive emotions in their dreams, rated their own dreams as more pleasant, and had significantly lower levels of anxiety, sadness, and aggression. This supports the hypothesis that presleep suggestion can be an effective technique in influencing the affective dimension of the dream.
1990
Barber, Theodore Xenophon (1990, August). Some things I've learned about hypnosis after 37 years. [Audiotape] Presented at the annual meeting of the American Psychological Association, Boston
NOTES
"We are a unity of cells. Every cell is a citizen with it's own jobs, communicating all the time; cells send messages; the way we communicate with them is by suggestions. Each _cell_ is a mind-body.... When I do it now [hypnotic inductions], I say, 'We're going to go into hypnosis, we're _both_ going to go into hypnosis. I'm going to close my eyes (etc.)' - modeling hypnosis for them."
Biasutti, M. (1990). Music ability and altered states of consciousness: An experimental study. International Journal of Psychosomatics, 37, 82-85.
The relationship between music and altered states of consciousness was studied with 30 subjects divided into hypnosis and control groups. The "Test di abilita musicale" was applied. The hypnosis group did the retest after posthypnotic suggestions and the second in waking conditions. The hypnosis group had better results than the control group, especially in the rhythm test (p < 0.0001).
1989
Baker, Elgan L.; Levitt, Eugene E. (1989). The hypnotic relationship: An investigation of compliance and resistance. International Journal of Clinical and Experimental Hypnosis, 37, 145-153.
The purpose of this investigation was to assess the ability of hypnotic Ss to voluntarily resist a neutral suggestion when a monetary reward was offered for resistance. 19 of 40 Ss (47.5%) successfully resisted after money was offered by the "resistance instructor." The correlation between resistance/compliance and hypnotizability was -.44 (high hypnotizables were more likely to comply). Ss' impressions of the hypnotist tended to be positive; impressions of the resistance instructor tended to be neutral. There was a tendency for nonresistors to have a more positive view of the hypnotist but it is not as marked as was found in an earlier study (Levitt & Baker, 1983).
NOTES
Twelve (75%) of the high hypnotizables did not resist; two (16.7%) of the low hypnotizable Ss did not resist.
In their discussion, they state that "these data support the conclusion that hypnotizability or talent accounts for a significant portion of the variance in determining compliance with suggestions during trance. ... [Further], this research may be conceptualized as examining the contributions of a trait variable (hypnotizability) as compared with a variety of situational or state variables (motivation, social perception, environmental contingencies) in determining compliance and suggestibility. Inherent in this model of research is the assumption that many observed hypnotic phenomena (such as suggestibility) are interactive in nature, representing the outcome of the interplay between trait and state variables and between historically determined and contemporary forces. Such a perspective is consistent with the emerging view of trance behavior and experience and validly parallels the phenomenology of experimental and clinical hypnosis which describe both consistency and variability in hypnotic responsiveness for a specific subject or patient across varying conditions and time" (p. 151).
"This study also serves to clarify the important role of positive social perception and a positive sense of alliance with the hypnotist as a correlate of compliance with suggestion. It is clear that Ss who complied despite inducements to resist reported a more positive perception of the hypnotist and a more gratifying sense of relatedness with him than did their counterparts who resisted in response to financial inducement. These data do not indicate whether the positive perceptions contributed to compliance, as transference theories of trance involvement would predict, or whether they were consolidated after the fact due to other variables such as management of potential cognitive dissonance. It does seem reasonable to conclude, however, that the relationship is influential in the process of suggestibility and compliance" (p. 151).
1988
Azuma, Nagato; Stevenson, Ian (1988). 'Psychic surgery' in the Philippines
Psychic surgeons and their patients were observed in the Philippines
Council, James R.; Loge, D. (1988). Suggestibility and confidence in false perceptions: A pilot study. British Journal of Experimental and Clinical Hypnosis, 5, 95-98.
Subjects received audiotaped instructions implying that they would perceive increases in odor or heaviness while comparing stimuli in a sensory-judgment task. Stimuli were actually indiscriminable. Subjects pretested as higher or lower in hypnotizability performed the task in either hypnotic or non-hypnotic conditions. In both treatments, greater hypnotizability was associated with more perceived changes in the stimuli and greater confidence in the reality of those perceptions. Results support a general factor underlying suggestibility in hypnotic and nonhypnotic situations. The findings are discussed in relationship to false confidence effects reported in hypermnesia research.
1986
Discusses suggestion in psychotherapy and defines it as a body-affective process, an indissociable psychosociobiological entity that acts at an archaic unconscious level far beyond that of transference, mediates the influence of one individual on another, and is capable of producing manifest psychological and physiological changes. Present in all types of therapy, indirect (nondeliberate, nonintentional) suggestion is the element that plays an important role in change and can be observed in hypnotic experimentation. It is further argued that transference and suggestion are phenomena that do not altogether overlap. Suggestion is the condition of transference without which transference could not be established.
1985
Bennett, Henry L.; Davis, H. S.; Giannini, Jeffrey A. (1985). Non-verbal response to intraoperative conversation. British Journal of Anesthesiology, 57, 174-179.
In a double-blind study, 33 patients (herniorraphy, cholecystectomy and orthopedic) were randomly assigned to either suggestion or control groups. Under known clinical levels of nitrous oxide and enflurane or halothane anesthesia, suggestion patients were exposed to statements of the importance of touching their ear during a postoperative interview. Compared with controls, suggestion patients did touch their ear (tetrachoric correlation 0.61, P <0.02). test, U (Mann-Whitney frequently more so did they and
Bolocofsky, David N.; Spinler, Dwayne; Coulthard-Morris, Linda (1985). Effectiveness of hypnosis as an adjunct to behavioral weight management.Journal of Clinical Psychology, 41 (1), 35-41.
109 17-67 year olds completed a behavioral treatment for weight management either with or without the addition of hypnosis. Results show that, at the end of the 9-week program, both interventions resulted in significant weight reduction. However, at 8-month and 2-year follow-ups, the hypnosis Ss showed significant additional weight loss, while those in the behavioral-treatment-only group exhibited little further change. More Ss who used hypnosis also achieved and maintained their personal weight goals. It is suggested that hypnosis may have been an effective motivator for Ss to continue practicing the more adaptive eating behaviors acquired during treatment. Findings support the utility of employing hypnosis as an adjunct to a behavioral weight management program. (25 ref)
1984
Bryant-Tuckett, Rose; Silverman, Lloyd H. (1984). Effects of the subliminal stimulation of symbiotic fantasies on the academic performance of emotionally handicapped students. Journal of Counseling Psychology, 31 (3), 295-305.
Divided 64 10.8 - 19.3 yr old emotionally disturbed residents of a treatment school into an experimental and control group matched for age, IQ, and reading ability. Both groups were seen 5 times/week for 6 weeks for tachistoscopic exposures of a subliminal stimulus. The stimulus for the experimental group was the phrase, "Mommy and I are one," conceived of as activating symbiotic fantasies that in a number of previous studies with varying groups of Ss had led to greater adaptive behavior. The control group was exposed to the phrase, "People are walking." Results show that experimental Ss manifested significantly greater improvement on theCalifornia
Critelli, Joseph W.; Neumann, Karl F. (1984). The placebo: Conceptual analysis of a construct in transition. American Psychologist, 39, 32-39.
The placebo in psychotherapy has unfortunately retained the negative connotation of an inert "nuisance variable," a label that it originally incurred in the field of medicine. In addition, the transition toward more cognitive models of psychotherapy, particularly Bandura's theory of self-efficacy, has led to problems in defining the placebo within psychology. This transition has resulted in an awkward interface between certain preferred cognitive metaphors and the negative connotations of a presumably cognitive placebo construct. As a result, suggestions have recently been made to dismiss the placebo construct from psychology and to do away with the use of true placebo controls in outcome research. The present analysis maintains that (a) the placebo can be adequately defined within psychology, (b) the negative connotation of the placebo label is largely undeserved, (c) the placebo retains a continuing conceptual and empirical utility for evaluating psychotherapy, and (d) the therapeutic efficacy of current therapies is well established even though they have not generally been shown to be more effective than nonspecific treatment.
1983
Borgeat, Francois; Goulet, Jean (1983). Psychophysiological changes following auditory subliminal suggestions for activation and deactivation. Perceptual and Motor Skills, 56, 759-766.
This study was to measure eventual psychophysiological changes resulting from auditory subliminal activation or deactivation suggestions. 18 subjects were alternately exposed to a control situation and to 25-dB activating and deactivating suggestions masked by a 40-dB white noise. Physiological measures (EMG, heart rate, skin-conductance levels and responses, and skin temperature) were recorded while subjects listened passively to the suggestions, during a stressing task that followed and after that task. Multi-variate analysis of variance showed a significant effect of the activation subliminal suggestions during and following the stressing task. This result is discussed as indicating effects of consciously unrecognized perceptions on psycho- physiological responses.
Classen, Wilhelm; Feingold, Ernest; Netter, Petra
In 45 headache patients the relationship between sensory suggestibility and three measures of treatment effect-ratings on (1) intensity of headaches; (2) efficacy of drugs, and (3) physician's competence - was investigated in a double-blind long-term crossover study. Subjects scoring high on sensory suggestibility clearly showed more relief of headaches upon the analgesic as well as upon the placebo. The physician's competence was rated higher by high-suggestible patients, whereas ratings on drug efficacy were low in all patients. The seemingly controversial behavior of high-suggestible patients was interpreted as a call for continuation of the physician's efforts in spite of the relief the patients already achieved.
1982
Belicki, Kathryn; Bowers, Patricia (1982, October). Dimensions of dissociative processing, absorption and dream change following a presleep instruction. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Indianapolis , IN.
NOTES
Subjects' tendency to have things pop into their mind when asked to imagine, image them, or to do a divergent thinking task is correlated with behavior change out of awareness (dissociated), change in dream content in response to indirect suggestion - the request to pay attention to a certain element in their dreams. Effortless imagining (as opposed to working at it), a particular type of dissociative phenomenon, is associated with dream change.
Bowers, Patricia G. (1982). The classic suggestion effect: Relationships with scales of hypnotizability, effortless experiencing, and imagery vividness. International Journal of Clinical and Experimental Hypnosis, 30 (3), 270-279.
How well the Stanford Hypnotic Susceptibility Scales assess what Weitzenhoffer (1978) terms the "classic suggestion effect" is addressed by developing an index of nonvolitional behavior (N-VB) for a group form of the Stanford Hypnotic Susceptibility Scale, Form C of Weitzenhoffer and Hilgard (1962) given to 43 Ss. The N- VB index, reflecting the classic suggestion effect's dual criteria of both behavioral responsiveness to suggestion and nonvolition ratings, was correlated highly with the traditional scoring of the group SHSS:C and moderately with the Harvard Group Scale of Hypnotic Susceptibility, Form A. Effortless experiencing of imagination and imagery vividness relate similarly to traditional and N-VB scores of hypnotizability. In addition, the relationship between involuntary ratings and passing and failing an item of the group SHSS:C was examined for each of the 10 items. There was a significant relationship for 7 of the items.
1980
Bauer, Herbert; Berner, Peter; Steinringer, Hermann; Stacher, Georg (1980). Effects of hypnotic suggestions of sensory change on event-related cortical slow potential shifts. Archiv fur Psychologie, 133 (3), 161-169.
"The purpose of this study was to evaluate whether cortical slow potentials related to a S1-S2 paradigm are influenced by hypnotic suggestions of sensory change. Five healthy subjects susceptible to hypnosis participated each in two identical experiments with three conditions. In condition (1) and (2) each three intensities of 800 and 4000 Hz tones were presented. Preceding condition (2) hypnosis was induced and the subjects received the suggestion to hear the 800 but not the 4000 Hz tones. In condition (3), the tones were presented as S1 and a flash as S2. The subjects received the same suggestions as in (2) and a motor response to S2 was required. EEG was recorded from Cz. In (1) 800 and 4000 Hz tones caused negativities of equal amplitude, in (2) only minute negativities developed, possibly due to hypnosis induced deactivation. In (3) the S1-S2 related negativities were significantly smaller in amplitude during 4000 Hz tones than during 800 Hz tones, while the negativities preceding S2 differed only after the most intense S1. Hypnotic suggestions attenuate S1-S2 related negative potentials, possibly by affecting cognitive functions.
1979
Barber, Joseph; Donaldson, David; Ramras, Susan; Allen, Gerald D. (1979). The relationship between nitrous oxide conscious sedation and the hypnotic state.Journal of the American Dental Association, 99, 624-626.
NOTES
Nitrous oxide-oxygen produces a state of consciousness in the patient that is reported to be similar to the hypnotic state. In this investigation, the authors test the hypothesis that nitrous oxide-oxygen heightens a patient's responsiveness.
This study apparently did not have a control group receiving nitrous oxide but no suggestions, to evaluate the amnesia and analgesic effects of the drug alone.
1978
Connors, J. R.; Sheehan, P. W. (1978). The influence of control comparison tasks and between-versus within-subjects effects in hypnotic responsivity. International Journal of Clinical and Experimental Hypnosis, 26, 104-122.
Type of experimental design (between- versus within-subjects) and type of control task were examined for their differential effects on the magnitude of objective and state report test scores associated wtih response to items on the Stanford Hypnotic Scale of Susceptibility, Form C (Weitzenhoffer & Hilgard, 1962). In an integrated program of work exploring design effects in hypnotic research, Ss in each of 7 comparison conditions that involved hypnosis and 4 separate comparison conditions that did not involve hypnosis were tested twice on successive occasions. Three of the control tasks used (waking, imagination, and imagination [alert] instruction) were counterbalanced with hypnosis to analoyze possible order effects associated with hypnotic test conditions. Data indexed the patterns of between- versus within-subjects effects associated wtih standard control tasks and also highlighted the order effects that accompanied them. Imagination instructions, in particular, pose specific difficulties that require attention when Ss are tested as their own controls.
1977
Anderson, J. W. (1977). Defensive maneuvers in two incidents involving the Chevreul pendulum: A clinical note. International Journal of Clinical and Experimental Hypnosis, 25, 4-6.
NOTES
"Hypnosis frequently facilitates increased access to the unconscious. In both of these cases, the hypnotized subject gained contact with a thought which otherwise would likely have remained out of awareness. Then the ego quickly resorted to defensive maneuvers in order to deny the thought" (p. 6).
"Hypnosis frequently facilitates increased access to the unconscious. In both of these cases, the hypnotized subject gained contact with a thought which otherwise would likely have remained out of awareness. Then the ego quickly resorted to defensive maneuvers in order to deny the thought" (p. 6).
1976
Chaves, John F.; Barber, Theodore Xenophon (1976). Hypnotic procedures and surgery: A critical analysis with applications to 'acupuncture analgesia'. American Journal of Clinical Hypnosis, 18 (4), 217-236.
Although hypnotic procedures are useful for reducing the anxiety of surgery and helping patients tolerate surgery, they do not consistently eliminate pain. Six factors that are part of or associated with hypnotic procedures help patients tolerate surgery. These factors pertain to patient selection, the patient-physician relationship, the preoperative 'education' of the patient, the adjunctive use of drugs, and the use of suggestions of analgesia and distraction. It appears that the same factors account for the apparent successes of 'acupuncture analgesia' as well. A frequently-overlooked fact, that most internal tissues and organs of the body do not hurt when they are cut by the surgeon's scalpel, is also important in understanding how surgery can be performed with either 'hypnoanesthesia' or 'acupuncture analgesia.'
1975
Barber, Theodore Xenophon (1975). Responding to 'hypnotic' suggestions: An introspective report. American Journal of Clinical Hypnosis, 18 (1), 6-22.
The author first presents an introspective report which describes some of his attitudes, motivations, and expectancies and ongoing thought processes while he is responding to 'hypnotic' suggestions. The introspective report indicates that (a) suggested effects are experienced when a person thinks with and imaginatively focuses on those things that are suggested and (b) a person imaginatively focuses on the suggestions when he sees the test situation as useful and worthwhile and when he wants to and expects to experience those things that are suggested. It is then argued that the responsive subject in a hypnotic situation differs in every important respect from the sleepwalker and closely resembles the person who is involved in reading an interesting novel or in observing an interesting motion picture. Finally, the author outlines a course, now being developed, that aims to teach individuals how to respond to suggestions.
1974
Chaves, John F.; Barber, Theodore Xenophon (1974). Acupuncture analgesia: A six-factor theory. Psychoenergetic Systems, 1, 11-21.
The dramatic successes claimed for acupuncture suggest that Western medicine has failed to identify important factors that pertain to the nature of pain and its control. This may not be the case, as there are at least six factors which are often overlooked by writers describing the absence of pain (i.e., analgesia) during acupuncture: (a) the patients accepted for surgery under acupuncture usually believe that it will work, (b) drugs are frequently used in combination with acupuncture, (c) the pain associated with surgical procedures is less than is generally assumed, (d) the patients are prepared in special ways for surgery under acupuncture, (e) the acupuncture needles distract the patient from the pain of surgery and, (f) suggestions for pain relief are present in acupuncture treatment. It is concluded that more research is needed to determine whether additional factors are needed to help explain the phenomenon of acupuncture analgesia.
1973
Brown, H. Alan (1973). Role of expectancy manipulation in systematic desensitization. Journal of Consulting and Clinical Psychology, 41 (3), 405-411.
Expectancy, relaxation, and hierarchy content were manipulated in a 2X2 factorial design with two additional control groups. It was hypothesized that a major portion of therapeutic change following desensitization could be accounted for by the subjects' responses to positive feedback inherent in the paradigm. Spider-phobic subjects saw either photographs of spiders or blank slides that they believed to be tachistoscopically presented pictures of spiders. In the factorial part of the design, half of the subjects believed their progress through the hierarchy to be contingent on autonomic responses; the others believed rate of progress to be random. Findings did not support the hypothesis that expectancy was the only factor in desensitization, but they did serve to clarify the role of expectancy vis-a-vis the counterconditioning elements typically discussed in the literature.
1972
Barber, Theodore Xenophon; de Moor, Wilfried (1972). A theory of hypnotic induction procedures. American Journal of Clinical Hypnosis, 15 (2), 112-135.
The first part of the paper delineates nine variables in hypnotic induction procedures that give rise to heightened responsiveness to test-suggestions: (a) defining the situation as hypnosis; (b) removing fears and misconceptions; (c) securing cooperation; (d) asking the subject to keep his eyes closed; (e) suggesting relaxation, sleep, and hypnosis; (f) maximizing the phrasing and vocal characteristics of suggestions; (g) coupling suggestions with naturally-occurring events; (h) stimulating goal-directed imagining; and (i) preventing or reinterpreting the failure of suggestions. Data are presented to support the theory that the nine variables augment responsiveness to test-suggestions by giving rise to positive attitudes, motivations, and expectancies which, in turn, tend to produce a willingness to think with and vividly imagine those things that are suggested. The second part of the paper specifies situational variables and variables involved in induction procedures that produce a trance-like appearance, changes in body feelings, and reports of having been hypnotized.
Bowers, Kenneth S.; Kelly, P. (1970). Stress, disease, psychotherapy, and hypnosis. Journal of Abnormal Psychology, 490-505.
Presents evidence for the importance of suggestion and hypnotic ability in the healing or amelioration of various somatic disorders. It is argued that even in some treatment interventions that are not explicitly hypnotic, suggestion and hypnotic ability may be hidden factors that help to promote successful healing. Consequently, hypnotic ability may be an individual difference variable that influences treatment outcome in a manner not heretofore recognized by many investigators and clinicians involved in helping the psychologically and physically ill.
Bartlett, Edmund E.; Faw, Terry T.; Liebert, Robert M. (1967). The effects of suggestions of alertness in hypnosis on pupillary response: Report on a single subject. International Journal of Clinical and Experimental Hypnosis, 15 (4), 189-192.
THE PUPIL SIZE OF A SINGLE S WAS RECORDED UNDER 2 TYPES OF HYPNOTIC SUGGESTION: ALERTNESS INSTRUCTIONS AND TRADITIONAL RELAXATION INSTRUCTIONS. IT WAS FOUND THAT THE SIZE OF THE PUPIL INCREASED SIGNIFICANTLY UNDER ALERTNESS INSTRUCTIONS. THIS RESULT WAS TAKEN AS FURTHER CORROBORATION OF THE HYPOTHESIS THAT CHANGES IN VARIOUS PARAMETERS OF AROUSAL APPARENTLY ASSOCIATED WITH HYPNOSIS MAY BE ATTRIBUTED TO SPECIFIABLE CHARACTERISTICS OF THE INSTRUCTIONS USED RATHER THAN TO STABLE CHARACTERISTICS OF THE "STATE" OF HYPNOSIS. (PsycINFO Database Record (c) 2002 APA, all rights reserved)
1965
Agosti, E.; Camerota, G. (1965). Some effects of hypnotic suggestion on respiratory function. International Journal of Clinical and Experimental Hypnosis, 13 (3), 149-157.
Several respiratory indices were measured in 10 Ss in 3 states: at rest, with hypnotic suggestion of relaxation, and with hypnotic instructions to imagine muscular work. The same suggestions were given to 10 control Ss in the waking state. The suggestion of relaxation produced a decrease in pulmonary ventilation in both groups, although it was substantial only in the hypnotic group which started from a higher baseline level. The imagined work produced an increase in ventilation, especially in the hypnotic group. However, in both instances because of compensatory changes in respiratory efficiency the actual uptake of oxygen remained almost unaffected. (PsycINFO Database Record (c) 2002 APA, all rights reserved)
Barber, Theodore Xenophon (1965). Physiological effects of 'hypnotic suggestions': A critical review of recent research (1960-64). Psychological Bulletin, 201-222.
Recent studies are reviewed which were concerned with the effectiveness of suggestions given under "hypnosis" and "waking" experimental treatments in alleviating allergies, ichthyosis, myopia, and other conditions and in eliciting deafness, blindness, hallucinations, analgesia, cardiac acceleration and deceleration, emotional responses, urine secretion to sham water ingestion, narcotic-like drug effects, and other phenomena. The review indicates that a wide variety of physiological functions can be influenced by suggestions administered under either hypnosis or waking experimental treatments, and direct and indirect suggestions to show the particular physiological manifestations are crucial variables in producing the effects.
Das, J. P. (1965). Relationship between body-sway, hand-levitation, and a questionnaire measure of hypnotic susceptibility. International Journal of Clinical and Experimental Hypnosis, 13 (1), 26-33.
67 randomly selected college students were administered the body-sway test, a questionnaire measure of tranceability, and an induction procedure utilizing hand-levitation to determine hypnotic susceptibility. The 6 Es varied in age, sex; 5 of them had little experience as hypnotists. All reference to "hypnosis" was omitted from the induction procedure. Significant phi-coefficients between body-sway and levitation (.52), levitation and tranceability frequency (.28) and intensity (.25), and body-sway and tranceability intensity (.33) were obtained. (16 ref.) (PsycINFO Database Record (c) 2002 APA, all rights reserved)
1964
Anderson, Milton L.; Sarbin, T. R. (1964). Base rate expectations and motoric alterations in hypnosis. International Journal of Clinical and Experimental Hypnosis, 12 (3), 147-158.
Degree of responsiveness to "suggestion" in an experiment which did not utilize hypnotic induction (the Berkeley Berkeley
Black, Stephen (1964). Mind and body. London
NOTES
Defines psychosomatic disease as one that responds to psychotherapy. Believes only 5% are highly hypnotizable, that hypnosis is learnable in 1/2 hour, that hypnosis is not a useful treatment for psychosomatic disorders because you can't use interpretation [of unconscious]. The 'unconscious' is "... a complex of informational systems derived from such primaeval mechanisms" (p. 133). "Primaeval mind is involved in these mechanisms of genetics and immunology" (p. 133). "There is thus a 'somatic mind' which is unconscious and presumably without any means of verbalization of experience--and a 'cerebral mind' which is conscious" (p. 133). The dividing line is not clear.
Rapport is discussed on pp. 160, 169 as one of the spontaneous characteristics of hypnosis, in the absence of suggestion. The same for posthypnotic suggestion (rapport and amnesia). Spontaneous _physiological_ changes in hypnosis relate to mind-body relationships (p. 169)
Conditioned reflex is discussed on p. 161
"...the subjective evidence indicates that a perceptual change involving any sensory modality can be produced by DSUH" [direct suggestion under hypnosis] p. 178. Suggestion can selectively affect different parts of the body p. 197.
Research: "Hypnosis is not only the most important and practical way of _proving_ the existence of the unconscious--which is still in doubt in some circles--but is in fact the only way in which unconscious mechanisms can be manipulated under repeatable experimental conditions for purposes of investigation" (p. 152).
Mind-body is "amenability to control" Catatonia, which characterizes both animal and human hypnosis, seen in hypnosis, is induced by constriction (i.e. disorientation). The Cartesian concept of mind and body tends to confuse the issue p. 157.
Rapport is discussed (p. 157).
Suggestion (p. 159) "It was this concept of 'suggestion'--which so obviously parallels 'amenability to control' in animals--that eventually established hypnosis in the French schools of psychiatry as a state of increased suggestibility. ... still the standard definition of hypnosis in most medical psychiatric textbooks and in lay dictionaries" (p. 159).
Black (1969) did some biochemical sleuthing to learn how information transmitted by words becomes information encoded somatically, as when psychosomatic allergies flare and recede or disappear. What accounts for suggestion "curing" an allergic skin reaction in one part of the body while another part not included in the suggestion remains reactive? What accounts for the instantaneous skin allergy cure which sometimes occurs with suggestion (in 24 hours)?
Skin sensitivity tests in highly hypnotizable Ss who were also very allergic were inhibited by direct suggestion under hypnosis under highly controlled experimental conditions--and in one subject the effect (inhibition) was relatively permanent--ruling out (he suggests) a neurological mechanism. He did further experiments to examine whether the result was due to an instant neurological mechanism and a long-term endocrinal mechanism.
p. 212 He ruled out peripheral blood flow as the cause of diminished skin sensitivity (there was no change in blood flow with suggestions of heat or cold). Therefore decrease in blood flow couldn't explain in neurovascular terms the 'instant' inhibition of skin sensitivity (allergy) tests. Was it due to systemic--especially adrenal-- changes? He demonstrated increases in plasma cortisol under hypnosis with suggestions of fear. On p. 230 he summarizes the facts he established by skin sensitivity tests, plasma- cortisol studies, and histology - endocrinological.
Black, Stephen; Edholm, O. G.; Fox, R. H.; Kidd, D. J. (1963). The effect of suggestion under hypnosis on the peripheral circulation in man. Clinical Science, 26, 223-230.
Summary.
1. The effects on the circulation in the forearm and hand of both direct and indirect suggestion under hypnosis of thermal stimuli have been studied. 2. The induction of hypnosis did not significantly alter the forearm blood flow, but a small reduction in hand blood flow was usually observed. Pulse rate in general slowed slightly as did respiration rate. 3. The effect of body heating on forearm and hand blood flow was not modified by hypnosis. 4. Direct suggestion under hypnosis of body heating or body cooling, with and without body heating, produced only small changes. 5. The changes associated with suggestion were not related to the thermal suggestion. Whatever the suggestion, the usual response was a reduction in hand blood flow and an increase in forearm blood flow. 6. The rise of body temperature with heating was not modified by direct suggestion, under hypnosis, of body cooling. 7. No change in body temperature could be elicited by suggestion. 8. In a few experiments marked changes in forearm blood flow occurred. These appeared to resemble the changes in the circulation produced by emotional stimuli. 9. The smaller changes more frequently observed were also similar to those produced by mild emotional stimuli" (p. 229). [N.B. The Subjects were normal, healthy adults, N = 9, between 21-45 years old; highly hypnotizable, amnesic for trance.]
1959
Observation that student subjects often go into a deeper level of hypnosis after suggestions have been given for ending the session has led the writer to explore the reactions of subjects to this phenomenon and to set up a simple experiment using ideomotor responses in ten gynecological patients who needed hypnosis for therapy. In each of the ten patients there was a deepening of the trance after the suggestion to awaken had been given. It was the opinion of the subjects that they deepened the trance in rebellion against the direction for terminating a pleasant experience" (p. 227).
1956
Barber, Theodore Xenophon (1956). 'Sleep' and 'hypnosis': A reappraisal. Journal of Clinical and Experimental Hypnosis, 4, 141-159.
NOTES
"Some recent experiments and a reevaluation of the electroencephalographic findings indicate that the term 'hypnosis' has subsumed at least two more or less distinct phenomena: (a) 'hypnosis' preceded by 'trance-inducing suggestions' which is closely related to 'light sleep' and (b) 'hypnosis' without 'trance-inducing suggestions' which is often a 'waking' state.
"From this viewpoint we can begin to reevaluate the contradictory physiological experiments comparing sleep and hypnosis, the most favorable conditions for producing hypnosis, amnesia and decreased suggestibility in very deep hypnosis, and the reports of waking and sleeping hypnosis. We can also reappraise such thorny problems in hypnotic theory as the production of hypnosis by artificial means, autohypnosis, and animal hypnosis.
"The argument presented calls for further research. We should investigate (a) suggestibility during extreme relaxation; (b) response on hypnotic tests when the subject is told, "Go to sleep and I'll be back later to give you some tests'; (c) deep trance phenomena during sleep; (d) hypnotizability of good sleepers and insomniacs; (e) beneficial suggestions during sleep; (f) physiological functions during 'light sleep' and hypnosis; (g) the response of 'sleep-walkers' to standard hypnotic tests; (h) the relationship of 'light sleep' dreams to hypnotically induced dreams; and (i) the relationship of sleep amnesia to hypnotic amnesia" (pp. 153-154).
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