Strange New World of Hypnosis Part II: Hypnotic Susceptibility and Suggestion

hypnotic eyeNineteenth-century clinical practice was the first framework within which hypnotic susceptibility was measured (Pearson, 2003). The dimension experienced during hypnosis is appropriately termed “openness to experience” in McCrae and Costa’s “big five” factor analytic model of personality (McCrae, 1993), or “creativity/psychoticism” in Eysenck’s (1995) earlier identified “big three.”

Questions arose whether every person was hypnotizable, or only a select few (Hilgard, 1965). Hilgard standardized the measurement process toward what is now termed “hypnotic susceptibility” or “hypnotizability.”

The scales in use today focus on changes in “subjective experience associated with hypnosis per se or related to different suggestions” (Kallio & Revonsuo, 2005, p. 117). Hypnosis begins by applying “a standard induction and then a series of standardized suggestions” (p. 117).

The introductory hypnotic suggestion often begins with an induction that includes a series of test suggestions administered to determine the hypnotizability of the subject. Benham et al (2006) demonstrated expectation of hypnotic ability alone is not the sole determinant of a subject’s hypnotizability. Rather, the results were compatible with the idea that “there is a latent trait or cognitive ability that underlies hypnotic response and that, along with prior attitudes, strongly codetermines the nature and extent of an individual’s response to hypnotic suggestion” (p. 348). Overall, the residual variability in hypnotic performance is yet unexplained by the influence of expectation. If the trigger is ineffective, it may be the case–with the exception of drug use–that the ASC (altered state of consciousness) is not experienced.

Charles Tart (1972) conducted a study testing the ability of individuals to increase hypnotizability. Tart first attempted to induce hypnosis with the subjects to ensure they were not easily hypnotized. After determining their inability to fall into trance, he entered the same individuals into a nine-month training program to enhance hypnotizability. At the end of training, Tart noticed a substantial increase in hypnotizability in the participants. It is pertinent to note that Tart attributed much of the increased susceptibility to hypnosis to the deconstruction of previously held societal stigmas toward altered states (1972).

Tart (1970) proposed that hypnotizability, and susceptibility, could be modified with specialized training. Human beings have an “innate ability to experience a variety of altered states of consciousness, with concurrent experiential and behavioral alterations” (p. 264). Because of societal stigma attached to altered consciousness experiences, along with the immediate behavioral conditioning processes Westerners undergo to ensure normative alignment, “many individuals lose or inhibit this innate ability to function in a variety of states of consciousness in the course of becoming acculturated” (p. 264).

Tart’s hypnotic training study demonstrated an increase in hypnotic ability among individuals. This change was largely due to assisting individuals in overcoming many social inhibitions about experiencing, reporting, and acting within other states of consciousness. While the study identified a social barrier toward experiencing altered consciousness, it is unclear how organic or even how valuable the experience of altered consciousness states may be for the individual once that barrier is lifted.

Gruzelier (2005) suggests an integrated multilevel approach for hypnotic ASC studies tracing the hypnotic induction process in order to understand hypnosis from a neurocognitive perspective. Hypnotic ASCs require biological and physiological states different from ordinary consciousness states (Gruzelier, 2004, 2005; Kallio & Revonsuo, 2005).

Phenomenological and physiological data indicate pure consciousness is completely different from waking experiences (Travis & Pearson, 2000). Skin conductance, apneustic breathing, and increases in the peak power of the electroencephalograph (EEG) suggest a significantly different state from waking, sleeping and dreaming consciousness (Travis & Pearson, 2000).

Whereas consciousness is contingent upon first-person experience (Gruzelier, 2005), altered states may be categorized into four different areas: occurring spontaneously; evoked by physical/physiological stimuli; induced by psychological means; or caused by diseases (Vaitl, Birbaumer, Gruzelier, Jamieson, Kotchoubey, et al., 2005). Hypnosis falls into the third category.

Attempts have been made to “map brain states evoked by specific challenges involving discrete phenomena that contribute to the domain of hypnosis, and unambiguously reside within ASC” (Gruzelier, 2005, p. 3). For neural hypnosis, options were proposed (Gruzelier, 1998, 1993) to elucidate the state of altered brain functional organization representing neural hypnosis when created by classical hypnotic procedures (Ray & DePascalis, 2003).

Another interesting testament to the power of suggestion can be examined in studies performed by Rainville, Duncan, Price, Carrier, & Bushnell. Rainville et al (1997) questioned hypnotic suggestions designed to influence pain affect without altering pain sensation. Studies supported that when hypnotic suggestions were specifically aimed at “pain sensation rather than at the emotions associated with pain, not only were there changes in both unpleasantness and intensity ratings, but also there were changes in the primary somatosensory cortex and the cingulated cortex” (Damasio, 1999, p. 75). The Rainville et al (1997) study suggests that by virtue of the hypnotic suggestion, varying degrees of pain experience and suppression might be achieved.

Spanos, DeGroot, & Gwynn (1987) conducted a study wherein they identified participants both with high susceptibility to hypnosis and without. The participants were given repeated age regression suggestions taken from Laurence (1979) that they were becoming younger. A series of questions were posed to determine whether the subject was successfully regressed, and were scored afterward as passing if they reported they were 5 years old when the experimenter asked their age. Chi-square tests showed that both the highly susceptible hypnotics and the nonhypnotic susceptible participants “failed to differ significantly in their frequency of passing suggestions for age regression” (p. 917).

Of particular interest in the Spanos et al (1987) study, and others conducted with the intent of exploring susceptibility (Stanley, Lynn, & Nash, 1986), is the power of suggestion in initiating a hypnotic altered state. Despite selecting nonhypnotics and hypnotics to participate in the study, Spanos et al (1987) demonstrated a remarkable parallel in the power of suggestion for both groups, despite their predisposition to hypnotic susceptibility.

Braffman & Kirsch (1999) concluded through similar studies on hypnotic suggestion that the way people respond can be strongly influenced by a variety of situation factors. Such variables include the provision of information about hypnotic behavior and the careful wording of suggestions (Kirsch, 1991). The extent to which someone responds to a suggestion can be modified by training (Gorassini & Spanos, 1999), but without such training the hypnotic suggestibility is reported to be stable (Piccione, Hilgard, & Zimbardo, 1989).

Despite questions surrounding the theoretical bases of hypnotic suggestion, most researchers agree that suggestions, in and of themselves, are integral in initiating hypnosis (Kallio & Revonsuo, 2005). Hypnotic suggestions may serve as a vital step in triggering the participant to engage in the altered state experience, in many cases guiding the participant to explore a specific concept while engaged in the hypnotic state (Bartocci, 2004; Gruzelier, 2005).

Transpersonal Hypnotherapy

Transpersonal hypnotherapy differs from other types of hypnotherapy not specifically in method or technique, but in scope and orientation (Tart, 2008). Entering into the transpersonal realm involves specified worldviews that offer largely positive and hopeful directions (Boorstein, 2000) for its participants. Such a pursuit of the spiritual aspect of life poses problems for researchers.

Essentially, such ephemeral pursuits rest outside the space-time dimension and may be intermingled in ways that escape articulation and understanding on a simplistic and logical level (Boorstein, 2000). Proponents of transpersonal psychology proclaim that meditation, holotropic breathing, and psychedelics are a few methods whereby otherworldly experiences can be achieved.

Transpersonal psychotherapy, as a practice, is concerned with “the psychological processes related to the realization, or making real, of states such as “illumination,” “mystical union,” “transcendence,” and “cosmic unity” (Sutich, 1980, p. 9). Altered states of consciousness are of great interest to transpersonalists due to their indicative contact with the spirit world, encounters with the divine, and insights into the “wider, broader, higher, and/or deeper aspects of existence” (Krippner, 2000, p. 141).

Views of the transcendent aspect of human nature were first proposed by psychologists such as James, Jung, Maslow, and Assagioli (Marquis & Wilber, 2008). The distinct patterns of EEG and fMRI recordings found in advanced meditators document suprarational ego development from an objective viewpoint (Goleman, 2003).

The transpersonal stance is that psychologists and psychotherapists act more fully when they acknowledge and explore the transpersonal and transcendental potentials of human development (Marquis & Wilbur, 2008). Because process and outcome research of transpersonal psychology is considered methodologically unapproachable (Marquis & Wilber, 2008), and on some counts impossible, the justification comes from the necessity to draw from numerous therapeutic methods with the intent of fully considering both transpersonal and traditional scopes.

Meditation, holotropic breathing, and psychedelics may be more appropriately identified as the triggers used to initiate the resulting altered states for specified transpersonal practices. It is only by virtue of engaging in some type of precursor, or trigger activity, that many clients of transpersonal hypnotherapy seem able to suspend normal consciousness and enter into an altered hypnotic state.

Stanislav Grof (2008) describes the transpersonal experience as “losing the connection with the present,” and “becoming All There Was” (p. 158). The holotropic states as described by Grof and his contemporaries are strikingly similar to the collective unconscious elucidated by Carl Jung. Some transpersonal hypnotherapists (Grof, 2006) claim to elicit experiences from past ancestral lives, and establishing a bridge between the real and the spiritual.

Read Part I: Strange New World: History, Hypnosis & Trance


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 Photo courtesy of Look Into My Eyes on Flickr.

Strange New World of Hypnosis Part II: Hypnotic Susceptibility and Suggestion