This example is taken from a case where no hypnosis was involved. But most of Erickson's stories were told to hypnotized patients, because Erickson believed that in a trance state we instinctively understand the point of the story, without consciously realizing that we do. As the Ericksonian therapist Lee Wallas puts it, they are stories for ‘the third ear’. The point of the story is absorbed and acted on unconsciously. Moreover, being in a receptive state, the point is seeded deep within our psyches. But the point of the story is only half its therapeutic purpose; a good story leaves a good feeling – the kind of good feeling you have on leaving the cinema after a great movie. Creating that good feeling is also part of the therapy of Ericksonian story-telling, and so his stories were invariably life-enhancing, positive, supportive of growth and of taking charge of one's own life. They talk of achievements, of breaking barriers, of new horizons.
From a theoretical perspective, Erickson is most interesting as marking a clear break with the Freudian assumption that regression is the way to get at most problems, which have been caused in the past. Erickson worked, Zen-like, with patients here and now, believing that we each have within us the resources for complete health, and that we should focus on improving ourselves rather than correcting past mistakes. Moreover, since he thought that ‘Your conscious mind is very intelligent, but your unconscious is a lot smarter’, the therapeutic process did not necessarily require ‘insight’ – the bringing into consciousness of whatever was required. He believed that we have the resources from our past to overcome any obstacle. If you have solved a problem in the past, you can do so again. So he would talk his patient through how she solved some problem in the past, and then recreate those conditions in the hypnotized patient's mind for the present.
Milton Erickson died over twenty years ago, but it is safe to say that almost any hypnotherapist you might visit today has been influenced by his work, and will be practising several of his techniques. I would describe Erickson as a kind of poet. There is a difference between hypnotic or ‘trance-inductive’ poetry and the kind of poetry that appeals mainly to the intellect. The main features of hypnotic poetry are that it has a regular, soothing rhythm; it is repetitive; it uses vague imagery; and it contains obscurities which tire the mind. All of these features are present in Erickson's methods. He was an artist.
The Professional Doubters
The question is: is there such a thing as hypnosis? Are people who are said to be hypnotized in a special state, distinct from other states of consciousness, or not? Can all the feats attributed to hypnotized subjects be performed equally well by people who have not undergone any kind of hypnotic induction? The literature on the debate is enormous, and the best that can be said for the controversy is that it has generated a huge volume of significant research. In what follows I have stuck to the heart of the issues. Although it is arguable that in hypnosis a number of different altered states of consciousness are involved, depending on the depth of the trance, it makes life simpler if I use the singular and just talk in terms of a single state.
In brief, state theorists argue that: (1) there is a special state of awareness called the hypnotic trance; (2) this state is marked by increased suggestibility, and enhancement of imagery and imagination, including past visual memories; (3) the state involves a decrease in the planning function, a reduction in reality testing and a number of reality distortions such as false memories, amnesias and hallucinations; (4) the state involves involuntary behaviour – the subject has temporarily lost conscious control of his behaviour. They also predict, while admitting that there is as yet no conclusive proof in this regard, (5) that EEG results will one day demonstrate a unique physiology for this supposed hypnotic state.
Non-state theorists deny all these points: (1) concepts such as ‘trance’ or ‘dissociation’, taken from abnormal psychology, are misleading, in the sense that responsiveness to suggestion is a normal psychological reaction; (2) differences in response to hypnotic suggestions are not due to any special state of consciousness, but rather to the individual's attitudes, motivations and expectancies, or to his imaginative involvement in the task; (3) all the phenomena associated with hypnotic suggestions are within normal human abilities; (4) the apparent involuntary behaviours of subjects can be explained otherwise, without bringing in a special hypnotic trance; (5) they predict that no such physiological proof will ever be found, because there is no such state. In short, looking for the hypnotic state is like looking for the emperor's new clothes.
There is an interesting and fundamental difficulty in researching hypnosis, which goes some way towards undermining the work of both schools. It has been known since the time of Mesmer that in order to be successful a hypnotist must exude a certain confidence and assurance in the outcome of a given suggestion. A scientific researcher, however, is supposed to maintain a sceptical distance from both his subject and the hoped-for outcome. It is hardly surprising, then, that those researchers who have erred on the side of distance and aloof objectivity have often failed to find that hypnosis produces any results, while those who have gone too far in the other direction have suggested that there is no such thing as hypnosis, only rapport and suggestibility.
The chief proponent of the anti-state view since the 1950s has been Theodore Barber. I cannot resist telling an anecdote about Barber. There is a rumour, apparently started by Ernest Hilgard, that the reason Barber was so convinced of the non-existence of hypnosis as a separate state was that he was very highly hypnotizable himself – so much so that he could never see what all the fuss was about, and so he denied the existence of hypnosis. Anyway, Barber argues (repeatedly) that the concept of hypnotism is meaningless. Hypnotism is defined as an induced state of increased suggestibility, and yet it is the fact that a person is hypnotized that is supposed to produce the phenomenon of increased suggestibility. Thus the argument is circular, or so Barber claims (and he has been echoed by many others). But this argument is not as strong as it seems. We can reject his premiss by not defining hypnotism merely in terms of suggestibility, and by claiming instead that suggestibility is just one of the phenomena of the hypnotic state.
But in any case, Barber adds, the supposed phenomena of hypnosis can be explained more simply by reference to the subject's attitudes, motivations and expectancies. In an enormous number of papers, Barber has tried to show that certain hypnotic phenomena (especially amnesia, enhanced muscular performance and arm levitation) can equally well be obtained with unhypnotized subjects who have been led by the researchers (i.e. himself and his colleagues) to have a positive attitude towards the outcome of the task they have been set, to be motivated to perform well, and to expect that they will be able to perform the task. As for the more extreme or exotic phenomena, such as hallucinations, age-regression, hypermnesia and hypnotic blistering, Barber has tried either to dismiss them or to claim that in reality they do not occur in dramatic ways and that therefore unhypnotized subjects have little difficulty in displaying them too.
Once, at a meeting of the American Psychological Association in the early 1970s, Barber was banging on as usual about how it was easy to bring about analgesia in people without hypnotic induction. Among other eminent psychologists on the stage with Barber was Martin Orne. Orne flicked open his cigarette lighter and held his palm over the flame. Fine: this seemed to confirm Barber's point. But those who knew Orne chuckled because they knew that he was also making a further point – that Barber's views did not advance our understanding of hypnosis at all.
There are further serious difficulties with Barber's view. Suppose he finds that both hypnotized and task-motivated people are equally capable of task X. He then infers that the hypnotized people are actually task-motivated rather than hypnotized, and that there is no such thing as hypnosis. This is a blatant fallacy. If A produces X and B produces X, it does not follow that A and B are identical; they may simply have the same effect. What is true in Barber's position is nothing new, but has been known since the time of Bernheim
– that suggestions given to susceptible or fantasy-prone individuals in the waking state (and especially when relaxed) can often produce the same effect as suggestions given to hypnotized subjects. Barber's list of suggested responses includes: colour blindness, deafness, various emotions, improvement of short sight, hallucinations of taste and sight, and allergic reactions. But, again, this does not disprove the existence of a special state which we can call the hypnotic trance.
In his later work Barber began to move towards the view that so-called hypnosis, as well as being a product of task-motivation, is also an act of the imagination. This is called the ‘cognitivebehavioural’ approach, and its main proponents, apart from Barber, are psychologists Nicholas Spanos and John Chaves. They claim that being ‘hypnotized’ is like reading a book or watching a film: ‘The responsive hypnotic subject … has intense and vivid experiences that are produced by the words or communications he is receiving.’ Elsewhere, Spanos claims that so-called ‘hypnosis’ is just ‘goaldirected fantasy’: the subject imagines a situation which, if it actually occurred, would produce the results which the suggestions imply. Thus, as with Barber's early views, hypnosis is reduced to behaviour rather than a state.
Apart from the emphasis on imagination, the views expressed in the book Barber co-authored with Spanos and Chaves read pretty much like early Barber. The supposed hypnotic induction procedure serves only to produce positive attitudes, motivations and expectancies in the subject. Hence subjects show a high level of responsiveness to test suggestions (e.g. you cannot raise your right arm) and a ‘hypnotic’ appearance (e.g. relaxed, eyes closed, drowsy, etc.), and report that they were hypnotized. Perceptual and physiological effects, age-regression, trance logic and visual hallucinations are not best explained by reference to ‘hypnotic trance’ because unhypnotized control subjects are also capable of manifesting the same phenomena. Hypnotic surgery is explicable because most parts of the body are actually rather insensitive to the surgeon's scalpel. Also, pain is reduced when patients have low levels of anxiety and fear, and positive expectations. Some cases of alleged hypnotic analgesia may actually be cases of post-’hypnotic’ amnesia – the patient has simply forgotten that she suffered pain. Stage hypnotism works partly by fraud, and partly because the atmosphere makes for suggestibility and obedience.
Where the cognitive-behavioural emphasis on imagination is involved, it should be said that this has turned out to be a double-edged sword, working against them just as effectively as it does for them. They argue that the subjects’ imaginative involvement in the task is what creates or helps to create the phenomena. State theorists have turned this on its head. They agree that imagination is an important factor – but a factor that enables a person to reach a trance state, in which the phenomena will be produced.
I don't want to get into all the experimental evidence that supports the non-state theorists, or tends to disprove their position, because it is obvious to the unbiased reader that experiments can be made to prove or disprove all sorts of things, depending on what you want to read into them. In reading accounts of the often ingenious experiments psychologists have set up in order to test one or another alleged phenomenon of hypnotism, it is clear that the results are frequently ambiguous, and that the researcher's own philosophical preconceptions invariably guide how the results are interpreted. For instance, in a classic experiment a psychologist called Seymour Fisher showed that subjects responded to post-hypnotic cues only when they thought the experiment was still ongoing; if they thought the experiment had ended, they stopped scratching their ears in response to the trigger-word ‘psychology’ (which was the post-hypnotic suggestion that had been implanted in them). This experiment was meat and drink to the non-state theorists, since it cast doubt on the validity of hypnotic phenomena. But actually it is arguable that, the way the experiment was set up, Fisher had implicitly asked his subjects to respond to the cue only as long as the experiment was in progress, in which case it is not surprising that he got the results he did. This is a subtle point, but it goes to show that experimental results are not as hard and fast as they seem to be.
In task-motivational experiments the subjects are under strong pressure to report in a way that pleases the experimenter, regardless of what they actually felt, whereas subjects in hypnotic experiments are rarely under such pressure. When an honest report is insisted upon, the results are far less striking, far less supportive of the task-motivational theory, whereas the same demand on hypnotized subjects makes little or no difference to their reports. Task-motivational instructions can alter reports but not experiences. So, to return for the moment to the vital issue of resistance to pain, and those who report in Barber's experiments that they feel no pain: ‘Common sense suggests that the subjects really did experience the pain but dared not admit it. The negative report … might well be due to Barber's telling them that they would not feel pain if they really tried, and that if they did they were making his experiment a failure, wasting time and making their professor look silly! Most of us will tell a convenient lie if we are under sufficient moral pressure.’
It also seems possible to me that for a light trance the social-psychological model might be correct – that so-called hypnosis is ‘strategic social behavior’ – while for a deep trance, the state theorists might be correct. This would explain why the cognitive behaviourists get the results they do, and others get results which tend in the opposite direction. For instance, Barber and his colleagues have frequently found in their experiments that non-hypnotized subjects display the same phenomena as supposedly hypnotized subjects; others, however, have found that hypnotized subjects can produce, for instance, a far greater variation of skin temperature than non-hypnotized subjects. Perhaps, as the Victorians found, the deeper the level of trance, the more striking the phenomena that are produced. Erickson once defined a deep trance as ‘that level of hypnosis that permits the subject to function adequately and directly at an unconscious level of awareness without interference by the conscious mind’. The social-psychological model can only deal with a quite different level of the mind, and denies any functioning on the part of a hypnotized subject at an unconscious level.
Another prominent sceptical and behaviourist position on hypnosis is that of Theodore Sarbin and William Coe. They claim that hypnosis is just role-playing (or compliance, as British psychologist Graham Wagstaff puts it). The subject wants to please the operator, and plays out the role expected of him; he may even feel under some kind of pressure to comply. Now, there is an element of truth in this. Anyone who has been hypnotized knows that there is a point (in a light trance, at any rate) where he chooses to go along with the hypnotist's suggestions, and so may be said to be playing a role; this has been a recognized aspect of hypnosis since the nineteenth century. But that is not a reason to deny that there is such a special state as the hypnotic trance: you could say that part of the definition of the hypnotic trance is precisely that it involves this mental ambiguity – the parallel-awareness feeling of ‘Shall I or shan't I go along with this?’ In any case, I go back to Esdaile's surgical operations. Speaking as a man, there is no way that I'm going to play a role while someone is probing my testicles with a scalpel. I'm going to have to be in a deep enough trance to be analgesic in the relevant area.
Nicholas Spanos has a slightly more sophisticated take on analgesia. He argues that the phenomena attributed to hypnosis are what he calls ‘social behavior’. Subjects are so motivated to respond in keeping with their expected role that they develop ‘cognitive strategies’ to do things such as overcoming pain. In this view, to say that they are playing a role is not to say that they are faking it: they make use of ‘cognitive strategies’ such as imagery, self-distraction and verbalizations that help to convince them that the pain is not so bad, and these strategies do genuinely raise pain thresholds. So-called ‘hypnotizability’, according to Spanos, is a learnable skill, as subjects learn to deploy their cognitive strategies more successfully. Graham Wagstaf
f agrees with this view, and adds that only if the cognitive strategies fail to work will a subject resort to mere behavioural compliance – that is, faking it. And Wagstaff should know, since in 1970, while a university student, he was ‘hypnotized’ on stage by the magician Kreskin, and put through some of the usual tricks of a stage hypnotist.
The pain-relieving effect of hypnosis has, however, been proved time and again to be real. In one experiment, for instance, outside assessors could not distinguish simulators from genuinely hypnotized subjects by their responses, or lack of responses, to electric shocks. After the experiment, however, the simulators said that they felt the shocks and had to suppress their response, while the hypnotized subjects said that they felt nothing. Contrary experiments which are supposed to show that task-motivated or compliant subjects gain as much relief from pain have often been poorly designed. The idea is not to hypnotize subjects, but just to persuade them by suggestion and relaxation not to feel so much pain. The problem with these experiments is that any of the subjects who are susceptible to hypnosis will drift into a hypnotic state as a result of relaxing and listening to the suggestions, and so at least some of the subjects are gaining relief from pain through hypnosis, after all. It is as hard to prove that someone is not hypnotized as it is to prove that she is.
While it has generally been my role in this book to report rather than to comment, I feel impelled to offset the vociferousness of these non-state theorists, who basically rule the roost at the moment and are in danger of carrying the day by the sheer weight of their publications. Although there are certain minor differences between their views, they are similar enough for Spanos and Barber to have spoken, prematurely, of a ‘convergence’ in academics’ opinions about hypnosis, as if the state theory had been laid to rest once and for all. So let me say that there are five kinds of phenomena which, as far as I can see, still present obstacles to their view. These are: first, state-dependent memory; second, resistance to pain; third, the ability not to blister and other remarkable effects showing control of organic processes; fourth, the phenomenon of post-hypnotic suggestion; fifth, the phenomenon of trance logic.
Hidden Depths: The Story of Hypnosis Page 39
