Hypnotic enhancement of cognitive-behavioral interventions for pain: An analogue treatment study.

Recent meta-analyses have shown that adding hypnosis enhances the effectiveness of cognitive behavioral psychotherapy. This hypnotic enhancement effect was evaluated in the analogue treatment of pain. Individuals scoring in the high (n=135) and low (n=150) ranges of hypnotic suggestibility were randomly assigned to 1 of 6 conditions: Stress Inoculation Training, the same treatment provided hypnotically, nonhypnotic analgesia suggestions, hypnotic analgesia suggestions, a hypnotic induction treatment, or a control condition. The 5 analogue treatments reduced experimental pain more than the control condition, but were not different from one another. Under circumstances optimized to detect an enhancement effect, neither Stress Inoculation Training nor analgesia suggestions produced more relief when delivered in a hypnotic context than identical treatments provided nonhypnotically. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Imaginative suggestibility and hypnotizability: An empirical analysis.

Hypnotic and nonhypnotic suggestibility were investigated in 2 experiments. In Experiment 1, nonhypnotic suggestibility was suppressed when measured after hypnotic suggestibility, whereas hypnotic suggestibility was not affected by the order of assessment. Experiment 2 confirmed a small but significant effect of hypnosis on suggestibility when nonhypnotic suggestibility was measured first. Nonhypnotic suggestibility was correlated with absorption, fantasy proneness, motivation, and response expectancy, but only expectancy predicted suggestibility when the other variables were controlled. Behavioral response to hypnosis was predicted by nonhypnotic suggestibility, motivation, and expectancy in a model accounting for 53% of the variance. Experiential response to hypnotic suggestion was predicted only by nonhypnotic suggestibility. Unexpectedly, hypnosis was found to decrease suggestibility for a substantial minority of participants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of hypnotic susceptibility.

An attempt was made to relate hypnotic susceptibility to the following: an inventory of subjective nonhypnotic personal experiences, attitudes and opinions toward and interest in hypnosis, environmental and social perceptions, 5 Guilford-Martin personality scales, and measures of response styles. The Harvard Group Scale of Hypnotic Susceptibility was administered to 80 male and 97 female college students who had previously taken the questionnaires. The results and conclusions were generally negative. Judging from the present results and those in previous studies, hypnotic susceptibility is not closely related to available personality inventories or measures of "social and environmental perceptions" and probably not to measures of subjective nonhypnotic personal experiences. An S's previous hypnotic experience, attitude toward hypnosis, and expectations regarding his own hypnotizability do appear to influence his susceptibility. (40 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral compliance with direct and indirect body movement suggestions.

Investigated the effectiveness of the 2 types in eliciting body movement behaviors by presenting 96 high-, medium-, and low-susceptible undergraduates, in hypnotic or nonhypnotic conditions, with either of 2 series of body movement suggestions. The indirect suggestions were designed to represent the approach of M. H. Erickson (see PA, Vol 60:11116 and 12262) and resulted in greater compliance in the hypnotic condition. Direct suggestions resulted in greater compliance in the nonhypnotic condition. Susceptibility to hypnosis was related to compliance in the hypnosis condition, but no interactions were found between susceptibility and type of suggestion. Sense of volition in responding was unrelated to the major findings. Discussion of the results includes a call for the accurate reporting of the wording of hypnotic suggestions in future research. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hypnotic involuntariness: A social cognitive analysis.

The experience of involuntariness is a hallmark of hypnosis. A framework for understanding involuntary experiences that draws from social psychological and cognitive perspectives on hypnotic responding is presented. There are at least 5 reasons to reject the hypothesis that hypnotic responding is automatic and involuntary: (a) Hypnotic responses have all of the properties of behavior that are typically defined as voluntary. That is, they are purposeful, directed toward goals, regulated in terms of subjects' intentions, and can be progressively changed to better achieve subjects' goals. (b) Hypnotizable subjects can resist suggestions when resistance is defined as consistent with the role of a good hypnotized subject. (c) Hypnotic behaviors are neither reflexes nor manifestations of innate stimulus–response connections. (d) Hypnotic performances consume attentional resources in a manner comparable with nonhypnotic performances. (e) Hypnotic subjects' cognitive activities clearly demonstrate their active attempts to fulfill the requirements of hypnotic suggestions, which include experiencing suggestion-related effects as involuntary. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hypnotic analgesia and stress inoculation in the reduction of pain.

Investigated the influence of hypnotic ability on 3 methods of reducing cold-pressor pain. Following a baseline immersion, 30 high- and 30 low-hypnotizable undergraduates were randomly assigned to 1 of 3 treatment groups: stress inoculation training, stress inoculation training defined as hypnosis, or hypnotic analgesia. Analysis of pain reports indicated a significant hypnotic ability?×?treatment interaction. Among Ss receiving hypnotic analgesia, high-hypnotizables reported significantly less intense pain than lows. There was no differential response for high- and low-hypnotizable Ss receiving stress inoculation training, whether or not it was defined as hypnotic. Moreover, Ss in the stress inoculation condition (whether or not defined as hypnosis) reported using cognitive strategies to reduce pain, whereas this was not the case for Ss in the hypnotic analgesia condition. The present findings seem inconsistent with the social psychological account of hypnosis and are discussed from a dissociation perspective, which views hypnosis as involving changes in the way information is processed. (56 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Couple therapy as a treatment for depression: II. The effects of relationship quality and therapy on depressive relapse.

Investigated the effects of behavioral couple therapy, cognitive–behavioral therapy, and their combination on female depression 6 and 12 mo after therapy ended. It was predicted that couples receiving a behavioral couple treatment would be less likely to relapse than those receiving a cognitive–behavioral treatment for the depressed spouse alone. Relapse rates, however, did not discriminate between treatments at any follow-up point. Reductions in husband and wife dysphoria and increases in wife facilitative behavior during therapy predicted recovery. Moreover, high rates of husbands' facilitative behavior at posttest were associated with wife recovery and predicted low levels of depression at the 1-yr follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Component analysis of cognitive skill training for the enhancement of hypnotic susceptibility.

Compared 4 treatments to enhance the hypnotic responsiveness of 60 undergraduates (aged 18–34 yrs) who pretested as low in hypnotic suceptibility on the Carleton University Responsiveness to Suggestion Scale. Complete skill training included information aimed at encouraging (1) positive attitudes, (2) the use of imagery strategies, and (3) an interpretation of hypnotic behavior as active responding. Partial training included only Components 1 and 2. Both training packages enhanced attitudes toward hypnosis to an equivalent degree. However, complete training was much more effective than either partial training or no treatment at enhancing behavioral and subjective responding on 2 different posttest scales of hypnotic susceptibility. More than half of the Ss who received complete training, but none of the partial training or control Ss, scored in the high-susceptibility range on both posttests. Ss explicitly instructed to fake hypnosis and those in the complete skill-training treatment exhibited significantly different patterns of posttest responding. Findings support social-psychological perspectives that emphasize the importance of contextual factors in hypnotic responding. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The clinical use of hypnosis.

Reviews recent experimental evidence on the hypnotic treatment of obesity, cigarette smoking, alcoholism, clinical pain, warts, and asthma. It is concluded that although hypnosis may be effective with addictive behavior, the therapeutic success is attributable to nonhypnotic factors. In contrast, hypnosis appears to be of unique value in the treatment of clinical pain, warts, and asthma. Differential effectiveness may be attributable to the nature of the disorders or to the manner in which hypnosis is used in treating them. The relevance of hypnotizability to treatment is discussed, as is the need to distinguish between genuine and placebo-based hypnotic effects. It is concluded that future research must be more attentive to the (a) nature of the disorders and patient populations, (b) adequate implementation of therapeutic techniques, (c) context in which treatment is delivered, and (d) influence of hypnotic susceptibility and other S factors on outcome. (4? p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

OCMAP-PLUS: a program for the comprehensive analysis of occupational cohort data

Previous research indicated that high-hypnotizable participants reported more primary-process mentation in hypnotic dreams than low-hypnotizable participants instructed to simulate hypnosis. Differences in primary process were not evidenced in response to instructions for a "hidden part" of the participant to report on the hypnotic dream. This research replicated and extended these findings by showing that high-hypnotizable participants (n = 20) passing the dream suggestion reported more primary process in their dreams than high-hypnotizable participants instructed to remain alert and think and imagine along with suggestions (n = 20). Differences in primary process were not evidenced in response to hidden-observer suggestions, and the frequency of dream (87% hypnosis vs. 96% imagining) and hidden-observer responses (100% in both groups) was equivalent across hypnotic and nonhypnotic groups. The results provided qualified support for a psychoanalytic model of hypnosis: Differences in primary process were apparent in response to the dream but not the hidden-observer suggestion.     

The Additive Benefit of Hypnosis and Cognitive-Behavioral Therapy in Treating Acute Stress Disorder.

This research represents the first controlled treatment study of hypnosis and cognitive- behavioral therapy (CBT) of acute stress disorder (ASD). Civilian trauma survivors (N = 87) who met criteria for ASD were randomly allocated to 6 sessions of CBT, CBT combined with hypnosis (CBT-hypnosis), or supportive counseling (SC). CBT comprised exposure, cognitive restructuring, and anxiety management. CBT-hypnosis comprised the CBT components with each imaginal exposure preceded by a hypnotic induction and suggestions to engage fully in the exposure. In terms of treatment completers (n = 69), fewer participants in the CBT and CBT-hypnosis groups met criteria for posttraumatic stress disorder at posttreatment and 6-month follow-up than those in the SC group. CBT-hypnosis resulted in greater reduction in reexperiencing symptoms at posttreatment than CBT. These findings suggest that hypnosis may have use in facilitating the treatment effects of CBT for posttraumatic stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hypnosis, suggestion, and placebo in the reduction of experimental pain.

Two experiments compared placebo and hypnotic analgesia in high and low hypnotizable subjects. Experiment 1 demonstrated that hypnotic and placebo analgesia were equally ineffective in low hypnotizables, but that hypnotic analgesia was much more effective than placebo analgesia in high hypnotizables. Experiment 2 replicated these results, but also included low and high hypnotizables who were given a nonhypnotic suggestion for analgesia. Both the low and high hypnotizables in this group reported greater suggested than placebo analgesia and as much suggested analgesia as high hypnotizable hypnotic subjects. Both experiments found substantial discrepancies between the amount of pain reduction subjects expected from the various treatments and the amount of pain reduction they actually reported following exposure to those treatments. In Experiment 2, subjects in all treatments who reduced reported pain engaged in more cognitive coping and less catastrophizing than those who did not reduce pain. Theoretical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Modification of hypnotizability: A review.

Discusses the domain of hypnotic behavior and presents the controversy between clinical and experimental hypnotists concerning the modification of the ability to be hypnotized. 4 sections deal with the evidence demonstrating that responsiveness to hypnosis can be meaningfully altered. Modification studies are discussed in relation to sensory alterations, hypnotic set and environmental setting situational variations, training experiences in nonhypnotic behavior, and training in hypnotic behavior. Persistent hypnotic performance alterations are differentiated from transitory changes. An attempt is made to synthesize the findings, and possible approaches in future investigation are discussed. (51/2 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of instructional set on attributions of nonvolition during hypnotic and nonhypnotic analgesia.

Fifty highly hypnotizable subjects were assigned to four treatment groups or a no-treatment control group and then underwent two pain stimulation trials. Half the treated subjects were administered hypnotic analgesia, half waking analgesia. Within hypnotic and nonhypnotic treatments, half the subjects were given actively worded analgesia instructions, half passively worded instructions. Subjects in the four treated groups reported equivalent pain reduction and equivalent use of coping imagery, although hypnotic subjects rated themselves as more deeply hypnotized than did nonhypnotized subjects. Both hypnotic and nonhypnotic subjects given passive instructions rated their pain reduction as occurring involuntarily, whereas those given active instructions reported that their pain was reduced through their active use of coping strategies. These findings support sociocognitive formulations of hypnotic responding that view ratings of involuntariness as reflecting contextually guided interpretations of behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expert judgments of hypnosis from subjective state reports.

Suggestibility was assessed in 60 college students after a traditional hypnotic induction, an alert induction, progressive relaxation training, or instruction in goal-directed imagery. Responsiveness to suggestion did not differ between groups. Ss also generated open-ended reports of their states of awareness and of their experience of 3 hypnotic suggestions. A sample of these reports from 24 moderately to highly suggestible Ss were evaluated by 18 experts in the field of hypnosis. Expert ratings of Ss' open-ended reports indicated that (1) traditional hypnotic inductions produce a state of consciousness that is indistinguishable from nonhypnotic relaxation training, (2) the subjective experience of hypnotic suggestions after imagination training is indistinguishable from that after hypnotic inductions, and (3) suggestibility is unrelated to state of consciousness as assessed by experts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Instructional set and the relative efficacy of hypnotic and waking analgesia.

Tested the hypothesis that hypnotic analgesia is intrinsically more effective than waking analgesia by administering both treatments while varying expectations concerning treatment efficacy. 23 male and 37 female undergraduates were assigned to hypnosis/hypnosis, hypnosis/explicit instruction, hypnosis/ambiguous instruction, and control groups. Ss given equivocal information about the efficacy of the 2 treatments exhibited larger pain tolerance in hypnotic analgesia. Ss explicitly informed that waking analgesia was more effective exhibited equivalent pain tolerance in the 2 treatments. Although these Ss rated themselves as deeply hypnotized on their hypnotic analgesia trial, they rated themselves as much less hypnotized on their waking analgesia trial. Findings did not support the hypothesis. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hypnotizability, preference for an imagic cognitive style, and memory creation in hypnosis.

We sought to extend the finding (J.-R. Laurence and C. Perry, 1983) that it is possible through hypnosis to create a pseudomemory of a specific event. Subjects were compared on their responses to a hypnotic suggestion. We also examined the relation between nonhypnotic measures (Preference for an Imagic Cognitive Style [PICS] test and the Tellegen Absorption Scale [TAS]) and response to the suggestion. Highly (45.45%) and moderately-highly (46.15%) susceptible subjects believed that the pseudomemory was veridical, but none of the low susceptible subjects did so. Together, hypnotic susceptibility, the PICS, and their interaction more strongly predicted pseudomemory creation than any of these main effects alone. Performance on the TAS was also related to the occurrence of pseudomemory, but this relation was redundant with performance on other measures. These results point to the complexity of the variables involved in pseudomemory creation during hypnosis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivated involvement in hypnosis: The illustration of clinical rapport through hypnotic dreams.

Examined the dream reports of 27 hypnotic, 23 task-motivated, and 16 control imagination Ss to analyze the nature of the relation between the S and hypnotist. Dreams were judged by independent raters in response to a request for dreaming about hypnosis. Categories of analysis pertained to rapport-involvement, self, and the hypnotist. Data show that hypnotic Ss' dreams were distinguished from nonhypnotic Ss' dreams by being characteristically more positive. Hypnotic Ss also perceived the hypnotist in an authoritative manner more than waking Ss, the rapport present indicating protection-care or guidance. This pattern of data was especially evident for Ss whose objective performance, as indexed by their expectancy behavior, independently classified them as the most highly motivated in the sample. Data index the transference-like involvement of some hypnotic Ss. With respect to dreaming, however, that involvement is more appropriately viewed in terms of Ss' motivated cognitive commitment to the task of dreaming rather than as the regressive display of infantile wish fulfillment implied by orthodox psychoanalysis. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of videotape playback of hypnotic events on posthypnotic amnesia.

Examined the breakdown of amnesia by showing 48 hypnotic and nonhypnotic undergraduates (Harvard Group Scale of Hypnotic Susceptibility) a videotape of the hypnotic events they had experienced. The extent of the amnesia for these events was defined precisely, and simulating procedures were employed to analyze the cues in the overall test situation. Videotape display of the hypnotic events was presented via the Experiential Analysis Technique and served to optimize conditions for breakdown. Some hypnotic Ss' amnesia could not be broken down even though they were exposed via videotape playback to the events to be recalled and when suggestions for the period of amnesia were quite explicit. Simulators showed breaching of amnesia but attributed their recall to the videotape rather than to the hypnotic session. Hypnotic Ss were distinctive in their inability to recall experiential aspects of their performance even though they could recall behavioral aspects. The data are discussed in relation to the hypothesis that dissociative cognitive mechanisms underlie posthypnotic amnesia. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Memory distortion following exposure to false information in hypnosis.

92 Ss preselected for hypnotic responsiveness on the Harvard Group Scale of Hypnotic Susceptibility—Form A were tested in strict application of the real–simulating model of hypnosis to examine the hypothesis that hypnotic Ss distinctively incorporate false material into their memories when that material is introduced after, rather than before, hypnotic induction. Both real (n?=?46) and simulating (n?=?46) Ss were either exposed or not exposed to misleading information after receiving induction instruction. Procedures for testing were otherwise identical to those adopted in an earlier study by the 1st author and J. Tilden (see record 1984-14147-001) in which false information was presented prior to hypnosis. Results confirm the hypothesis and show that hypnotic Ss differed appreciably from simulating Ss by incorporating more misleading material into their memory. Findings highlight the possibility of distinctive processing in hypnosis and implicate lowered critical assessment by hypnotic Ss of information they confidently accepted in the hypnotic context. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)