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International Journal of Clinical and Experimental Hypnosis Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/nhyp20
Cognitive Strategies in Hypnosis: Toward Resolving the Hypnotic Conflict a
Scott P. Bartis & Harold S. Zamansky
a
a
Northeasten University , Boston, Massachusetts Published online: 31 Jan 2008.
To cite this article: Scott P. Bartis & Harold S. Zamansky (1990) Cognitive Strategies in Hypnosis: Toward Resolving the Hypnotic Conflict, International Journal of Clinical and Experimental Hypnosis, 38:3, 168-182, DOI: 10.1080/00207149008414516 To link to this article: http://dx.doi.org/10.1080/00207149008414516
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COGNITIVE STRATEGIES IN HYPNOSIS: TOWARD RESOLVING THE HYPNOTIC CONFLICT’
scon P. BARTIS
AND HAROLD
s. WMANSKY~
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Northeasten Univcnity. Barton, Masaachuvtts
Abstract: 2 experiments were carried out to assess the relative contributions of dissociation and absorption as cognitive strategies employed by high and low hypnotizable Ss in responding successfully to hypnotic suggestions. Of special interest was the manner in which Ss deal with conflicting information typically inherent in hypnotic suggestions. In the first experiment, Ss rated their attention4 focus and the involuntariness of their experience after responding to a number of hypnotic suggestions administered in the usual manner. In the second experiment, the level of conflict was varied by instructing some Ss to imagine a circumstance that was congruent and other Ss to imagine a circumstance that was incongruent with the suggested behavioral response. The results of the 2 experiments were consistent in suggesting that, depending upon the nature of the hypnotic suggestion, high hypnotizable Ss are able to employ dissociation or absorption in order to respond successfully. Low hypnotizable Ss, on the other hand, seem to be relatively ineffective dissociators. When the structure of the hypnotic suggestion precludes the use of absorption, the performance of low hypnotizables deteriorates.
An adequate theory of hypnosis must account for the way Ss resolve the conflict that is typically inherent in hypnotic suggestions. Almost all hypnotic suggestions require S to respond with an experience that contradicts the actual or true state of &airs. Thus, for example, S who knows that hidher arm is healthy and unrestrained is told that he/she cannot bend that arm. There is, then, an “incongruence” (cf. Tellegen, 1978/1979)between the suggested experience and the realistic cognition. A successful response requires that S exhibit the suggested behavior along with a report that this response was experienced as involuntary or nonvolitiond. The present authors suggest that the familiar notions of dissociation (E. R. Hilgard, 1977) and absorption (Tellegen & Atkinson, 1974) may be conceptualized as two theoretically distinct processes that offer different accounts of how the conflict intrinsic to hypnosis is resolved. Absorption is generally regarded as an important cognitive process in the successful response to hypnotic suggestions (K. S. Bowers, 1976; J. R. Hilgard, 1974; Shor, 1979; Spanos & Barber, 1972, 1974; Tellegen & Atkinson, 1974). According to this view, absorption involves an exclusive Manuscript submitted April 25, 1988; find revision received September 26, 1989. was supported in part bv Grant No. RR 071K3, Biomedical Research Support Grant Program, National institutes of Health. ‘Reprint requests should be addressed to Harold S. Zarnmsky. Ph.D., Department of Psychology. 1 8 NI. Northeastern University. Boston. M A 02115.
‘Thisresearch
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focusing on the information contained in the hypnotic suggestion, imaging events consistent with this information, and ignoring contradictory information. Thus, for example, Tellegen and Atkinson (1974)speak of absorption as a “state of ‘total attention’ during which the available representational apparatus seems to be entirely dedicated to experiencing and modeling the attentional object [p. 2741.” In other words, Ss resolve the hypnotic conflict by attending only to one side of the issue. Numerous studies, using a variety of measurement devices, have demonstrated a positive relationship between absorption in activities outside of hypnosis and individual differences in hypnotizability (As, 1963;J. R. Hilgard, 1974, 1979;Karlin, 1979;Van Nuys, 1974). Despite its acceptance as an important correlate of hypnotizability, there is little consistent evidence that, during hypnosis proper, Ss’ positive responses to suggestions are mediated by absorption (Coe, Allen, Krug, & Wurzman, 1974;Spanos & McPeake, 1977). Dissociation (E. R. Hilgard, 1977)represents another cognitive strategy that may be employed in dealing with the conflict inherent in hypnotic suggestions. Dissociation may be conceptualized as involving the simultaneous maintenance of conflicting but functionally isolated perspectives on the same experience (Zamansky & Bartis, 1985).Within this view, S given a suggestion for arm immobilizatibn may be aware of the reality-based aspects of the situation (“my arm is normal and unrestrained”), while simultaneously finding that hidher arm does not bend. Because of the functional isolation of perspectives inherent in the process of dissociation, the conflictingcognitive information does not inhibit the overt response. Indeed, Ss appear to accept both aspects as genuine accounts of their experience, des ite the logical inconsistency of this position (cf. Zamansky & Clark, 1986). Much of the experimental work on the role of dissociation in hypnosis has been limited in terms of both the procedures and Ss used. Most studies have typically examined hypnotized Ss’ experience of pain, using an experimental paradigm that involves two stages: first, analgesia is suggested; then, an attempt is made to obtain hidden (i.e., dissociated) reports of pain from those Ss who initially report some analgesia. This is the familiar hidden observer procedure (E. R. Hilgard, 1973,1977).The inability of low hypnotizable Ss to meet the first requirement (analgesia) has precluded the study of dissociation in these Ss (E. R. Hilgard, 1977). IfE.R. HiIgard is correct in proposing that hypnosis involves dissociation, then it follows that high hypnotizable Ss should be more capable of dissociation than low hypnotizables. This hypothesis, however, has yet to be fully tested. The present study describes two experiments that investigated the independent contributions of dissociation and absorption to the hypnotic
P
31n those cases where S does not explicitly report an awareness of the second perspective, it must be possible clearly to infer its functional presence from S’s behavior.
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experience in terms of the conceptualization outlined above. The present authors were especially interested in distinguishing the role played by ea& of the two processes in mediating the hypnotic behavior of high versus low hypnotizable Ss. Although the present authors have conceptualized dissociation and absorption as cognitive strategies, it is not necessarily the case that either one is utilized consciously or voluntarily by Ss in responding to a hypnotic suggestion.
EXPERIMENT 1 In the first experiment. subjective measures of attentional focus and involuntariness of experience were utilized in a preliminary attempt to distinguish the role of absorption and dissociation in the hypnotic responses of high and low hypnotizable Ss. Absorption and dissociation were operationally defined in terms of SS’ reported awareness of information that conflicted with their positive .behavioral response to hypnotic suggestions. Absorption was operationally defined as S’s report that during the suggestion hefshe thought only about what was suggested and not about what was objectively true. Dissociation was defined as the awareness of both suggested and reality-based information, while still responding positively to the suggestion. The crucial difference here between absorption and dissociation is that, for instances labelled as dissociation, S maintains cognitions that conflict with hidher behavioral response, whereas there is no such conflict, consciously, for instances labelled as absorption. METHOD Subjects
Forty-six male and female students enrolled in Introductory Psychology courses served as Ss and received course credit for their participation. The Ss were tested in groups of two to seven. Measurement of Hypnotizability
Hypnotizability was assessed with a Witem modified version of
the Stanford Hypnotic Susceptibility Scale, Form B (SHSS:B) of Weitzenhoffer and E. R. Hilgard (1959).Although originally designed for use with individuals, SHSS:B is easily adapted for group administration. The postural w a y and verbaI inhibition items were dropped. There were three other changes: An arm levitation suggestion was substituted for one of arm immobilization; the positive hallucination suggested was of thirst, not a mosquito; and the posthypnotic response was coughing (instead of standing up). Of Ss who volunteered to participate in the experiment, 16 Ss scored between 8 and 10 on the modified SHSS:B and were classified as high hypnotizable; 30 Ss scored between 1 and 3 and were considered low hypnotizable.
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Measurement of Attentwnd Focus
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For each item on the modified SHSS:B measuring hypnotizability, SS rated their attentiond focus on a 5-point Likert scale. The ss indicated which of the following alternatives best completed the sentence, “My best explanation for my experience on this item is 1. I thought only about what the hypnotist suggested and never about what was really true. 2. I thought mostly about what the hypnotist said and hardly ever about what was really true. 3. I didn’t think about what the hypnotist suggested. 4. I thought about what the hypnotist suggested as well as occasionally about what was really true. 5. I thought about what the hypnotist suggested as well as often about what was really true.
Thus, scores of “1” and “2”were considered to represent a focus on the hypnotic suggestion and a relative neglect of reality-based information, while scores of “4” and “5” were considered to represent an awareness of both suggested and reality-based information. Choice “3” was included as an option for Ss who paid no attention to the hypnotic suggestion and was, in fact, rarely used. Measurement of Involuntariness of Response The Ss rated the extent to which they experienced their behavior to each hypnotic suggestion as involuntary on a 5-point scale, developed by K. S. Bowers (1981).with higher scores indicating a greater experience of involuntariness. All Ss were required to assign a rating on this measure, regardless of their response to the hypnotic suggestions. Procedure The Ss were given a brief introduction to hypnosis, followed by the modified group form of SHSS:B. After responding to all the hypnotic suggestions, Ss completed a scoring booklet modeled after that used with the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) of Shor and E. Orne (1962). For each suggestion, Ss rated their behavioral response, attentiond focus, and experienced involuntariness. The relevant responses to the posthypnotic suggestion and the amnesia suggestion are to occur while S is amnesic for the suggestion itself. Thus, for these items, the relationship between attentional focus and behavior may be different than for the other suggestions. Accordingly, Ss did not rate their attentional focus on these items. kVJLTS
The unit of analysis was Ss’ratings on individual hypnotic suggestions. On the first eight modified SHSS:B items, the low hypnotizable group of Ss passed a total of 74 items and Lled 166 items. The high hypnotizable group of Ss passed 110 and failed 18 items.
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EscpERIMENT
TABLE 1 1: MEAN A ~ X T I O N A Focus ~ RATINGSFOR PASSEDA
s Group Low Hypnotizable High Hypnotizable
.
FA~LED Ims
Passed Items
Failed Items
2 9 (1.5) 2.5 (1.3)
4.0 (1.1) 3.6 (0.8)
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Nm . Standard deviations appear in mentheses.
Table 1 reports the mean attentional focus ratings for the high and low hypnotizable Ss on passed and failed items. The low number of suggestions failed by the high hypnotizables precluded performing an ANOVA on the data. Instead, two t tests indicated a significantly greater focus on the hypnotic suggestion alone (as opposed to reality-based information) for both high and low hypnotizable Ss on passed than on failed items (p < .001).The significance of these findings, however, cannot be determined without taking account of the experience of involuntariness. For the analysis of experienced involuntariness, only data from passed items were considered. Responses fiom both hypnotizability groups were divided into two groups on the basis of Ss' reported attentional focus: focus on the suggestion alone (ratingsof 1and 2) or focus on both suggestion and reality (ratings of 4 and 5). The mean involuntariness rating for each group is given in Table 1. A 2 x 2 ANOVA, with involuntariness ratings as the dependent variable, revealed a significant main effect for attentional focus (F = 20.32, df = 1,180;p < .001). Regardless of hypnotizability level, a focus on the suggestion alone was associated with greater experienced involuntariness than was a focus on both the suggestion and reality. There was a significant interaction between hypnotizability level and attentional focus (F = 4.6, df = 1,180;p < .05). Posteriori comparisons (Tukey's HSD) demonstrated that low hypnotizable Ss who attended to both the suggestion and reality rated their behavior as significantly more voluntary than did both low hypnotizable Ss who focused on the suggestion alone and high hypnotizable Ss who focused on the suggestion and reality. The attentional focus of high hypnotizable Ss did not significantly affect the experienced involuntariness of their behavior.'
DISCUSSION The results of the first experiment suggest that the role of absorption and dissociation in the hypnotic situation (as operationally defined here) is amenable to experimental assessment. It was shown that the relevance of each process to Ss' hypnotic experience varies as a function of their '~ecause SS' ~ t i n g on~individual suggestions were used ps the unit of measurement, Merent numben and types d items may have been contributed by individual Ss. This procedure, however, did not d e c t the results: had df = 1,45 instead of df = 1,180 (number of Ss instead of number of responses) been UKd in the ANOVA, the significance of the results wouid have remained unchanged (p < .001 for attentional focus. and p < .05 for the interaction).
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TABLE 2 EXPERIENCEDINVOLUNTARINESS FOR PASSED SUGGEsnONS AS A FUNCTION OF ATTENTIONAL Focus
EXPERIMENT1: MEANRATINGS S Croup
OF
Attention to Suggestion Alone
Low Hypnotizable
2 8 (1.3) 3.5 (1.0)
4.0 (1.0) High Hypnotizable 4.0 (1.3) Note. Standard deviations appear in parentheses.
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Attention to Suggestionand Reality
hypnotizability. For both high and low hypnotizable Ss, a focus on the suggestion alone was associated with a positive behavioral response and a high degree of reported involuntariness the two components of a successful hypnotic response. This finding is in accord with a number of theoretical positions that share the belief that as Ss become absorbed in suggested ideas and images, they relax normal reality criteria and come to interpret their behavior as involuntary (I? Bowers, 1978; E. R. Hilgard, 1965, 1977; Shor, 1979; Spanos & Radtke, 1981-1982). When Ss reported being aware of reality-based information that conflicted with the hypnotically suggested behavioral response, a difference emerged between low and high hypnotizable Ss. When their positive behavioral response to suggestions was accompanied by an awareness of both kinds of information, low hypnotizable Ss reported a decrease in the involuntariness of their response. Despite their positive behavioral response, the rating of their behavior as relatively voluntary suggests that the criteria for hypnosis have not been met. High hypnotizable Ss, on the other hand, were able to be aware of information that conflicted with their behavioral response without this knowledge diminishing their experience that this behavior was involuntary. The present authors interpret these results to suggest that absorption, a unitary experience, can be observed among both high and low hypnotizable Ss,whereas dissociation, the maintenance of conflictingperspectives on the same experience, appears to be relatively restricted to Ss high in hypnotizability. To put it differently, the present results suggest that high hypnotizable Ss can utilize either absorption or dissociation in dealing with the conflict inherent in hypnotic suggestions (i.e., in responding successfully to hypnotic suggestions). Low hypnotizable Ss, on the other hand, appear to be less able to utilize dissociation as a cognitive process, and must therefore depend more exclusively on absorption in order to pass a hypnotic suggestion. The first experiment examined the spontaneous Occurrence of dissociation and absorption in Ss’ responses to hypnotic suggestions. While the results support the relevance of both concepts to hypnosis, the conclusions one may draw are limited by the correlational nature of the data. The second experiment manipulated features of the hypnotic suggestions in order to assess more directly the contribution made by dissociation and absorption to the hypnotic behavior of Ss differing in hypnotizability.
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EXPERIMENT 2
If absorption and cissociation are two ways of resolving the conflict involved in hypnosis, then manipulating the level of conflict contained in the suggestions should affect the utility of these strategies. As cognitions that are inconsistent with the suggested behavioral response become more salient, it should become more difficult to maintain a unified attention4 focus directed exclusively to the content of the hypnotic suggestion, and, consequently, absorption should become less effective as a cognitive strategy. %ansky (19n) heightened the conflict inherent in hypnotic suggestions by encouraging Ss to engage in thoughts and images that contradicted the content of those suggestions. Twelve highly hypnotizable Ss, who had previously passed suggestions such as arm catalepsy, finger lock, chair hold, and verbal inhibition, were asked to practice performing the opposite behaviors, and then were re-administered the suggestions while being exhorted to remember, to think about, and to imagine behaviors that codicted with those suggestions. The results indicated that of the 34 suggestions administered to the 12 Ss in this manner, 29 were passed (85%).Every S passed at least one suggestion and 9 Ss passed every suggestion. All Ss reported engaging in thoughts and images that were incompatible with their behavioral response. In a second experiment, Zamansky and Clark (1986) examined the ability of low as well as high hypnotizable Ss to respond in the presence of conflicting suggestions. High hypnotizable Ss replicated the results obtained by Zamansky (1977); all 17 Ss performed successfully, despite the countersuggestions. Low hypnotizable Ss, on the other hand, had difficulty when confronted with countersuggestions. Even though they had passed the original suggestions, only 2 of the 8 low hypnotizable Ss passed them when the countersuggestions were presented. Spanos, Weekes, and de Groh (1984) examined a slightly different type of conflict: that between the suggested behavior and the suggested imagery. Normally, these two aspects of hypnotic suggestions are congruent Pellegen, 1978/1979). For example, S is asked to imagine that magnets are attached to his/her hands and told that his/her hands will be attracted towards one another. Absorption in the suggested imagery comes to represent reality at that moment and increases the likelihood of a positive behavioral response (Spanos dr Barber, 1974). Two groups of highly hypnotizable Ss were used. One group received a suggestion very similar to those found in HGSHS:A, in which the suggested imagery and response are congruent. The second group received incongruent suggestions in which they were asked to image one event (a heavy weight tied to the hand) yet respond oppositely (raise the arm). The results demonstrated that the high hypnotizable Ss were quite capable of such incongruent behavior. They reported a high degree of involvement in imagery opposite
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to their behavioral response, while maintaining that their behavior was nonvolitional. Indeed, there was no difference between Ss given congruent and those given incongruent imagery in the extent of arm movement. Since this experiment used only high hypnotizable Ss, it is not clear how low hypnotizable Ss would have responded to a similar conflict. In the second experiment, the present authors attempted to assess more directly the relative contributions of absorption and dissociation to the hypnotic behavior of Ss differingin hypnotizability level by heightening the conflict inherent in the situation. Suggestions similar to those used by Spanos et al. (1984)were used, which asked Ss to image an event but to respond in the opposite manner. It was hypothesized that high hypnotizable Ss would replicate the results of Zamansky and Clark (1986) and Spanos et al. (1984); that is, that they would respond positively, despite the conflict between imagery and response. If low hypnotizable Ss are less capable than high hypnotizables of maintaining conflicting perspectives on the same experience, then they shouId have difficulty passing items for which the suggested response and imagery are incongruent.
METHOD Subjects Forty-one male and female students enrolled in introductory Psychology courses served as Ss. The Ss were tested in groups of one to four and received course credit for participation. No S had participated in the first experiment. Measurement of Hgpnotidility Hypnotizability was measured by a 10-item modification of HCSHS:A. The suggestions for head lowering and eye catdepsy were omitted. Of Ss who volunteered to, participate in the experiment, 23 scored between 8 and 10 on the modified HGSHS:A and were classified as high hypnotizable; 18 scored between 1and 3 and were considered low hypnotizable. Experimental Conditions Two test suggestions (modifiedafter Spanos et al., 1984)were developed that differed in their level of conflict or congruence. The suggestion with congruent imagery asked Ss to hold out their right arm, and to imagine a heavy weight tied to their hand. It was suggested that the hand would lower, The suggestion with incongruent imagery asked Ss to hold out their right arm and to imagine a large helium balloon tied to it. They were told that, despite this image, the hand would lower. Thus, for both suggestions the behavioral response was hand lowering. A S was considered to have passed the test suggestion if hidher arm lowered by at least 6 inches.
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Ten of the high hypnotizable Ss received the test suggestion with congruent imagery and 13 with incongruent imagery. Eight of the low hypnotizable Ss received the test suggestion with congruent imagery and 10 with incongruent imagery. Within each hypnotizability level, Ss were randomly assigned to the congruent and incongruent imagery conditions and did not differ in mean hypnotizability score.
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Procedure
Following a brief introduction to hypnosis, Ss were administered the first eight items of the modified HGSHS:A. During the arm lowering suggestion, E judged whether or not each S’s arm had lowered at least 6 inches. After the eighth item, Ss were administered the test suggestion with either incongruent or congruent imagery. Once again, E rated whether or not there was at least 6 inches of arm movement. Scores on the test suggestion were not included in the calculation of hypnotizability scores. Following the administration of the test suggestion, Ss were asked to open their eyes while remaining hypnotized and to rate the degree of their attention to the suggested imagery (either the balloon or the weight), the direction and extent of their arm movement, and the experienced involuntariness of their arm movement on 10-point Likert scales. They then closed their eyes, were awakened horn hypnosis, and posthypnotic response and amnesia were assessed in the usual manner. The Ss completed the modified HGSHS:A scoring booklet and were dismissed. RESULTS
All Ss demonstrated at least 6 inches of arm lowering when the relevant suggestion was gwen initially during the administration of the first 8 items of the modified HGSHS:A. Overt Response to Test Suggestwn
Six of the 8 low hypnotizable Ss who were administered the test suggestion with congruent imagery passed it, while only 2 of the 10 Ss passed the suggestion with inconpent imagery. For high hypnotizables, all 10 Ss passed the test suggestion with congruent imagery, while 11of the 13 Ss passed the suggestion with incongruent imagery. The data are presented in Table 3. Chi squares were calculated separately for high and low hypnotizable Ss. This andysis demonstrated that low hypnotizable Ss responded successfully s i p k a n t l y less often with incongruent than with congruent imagery (x = 5.7. p C .OZ). There was no significant difference in responsiveness for high hypnotizable Ss as a function of imagery type. Furthermore, the performance of the Iow hypnotizable Ss was significantly more impaired with incongruent imagery than was that of the high hypnotizable Ss (Fisher’s Exact Test, p < .005).
in
COGNITIVE STRATEGIES IN HYPNOSIS
TABLE 3
EXPERIMENT 2: NUMBER OF ss RESPONDINGTO TESTSUGGESTION AS A FUNCTIONOF IMAGERY CONGRUENCE
S Group and Imagery
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Congruence Low HypnotiPbk Congruent Imagery Incongruent Imagery High Hypnotizable Congruent Imagery Incongruent Imagery
Passed Suggestion
Failed Suggestion
6 2
8
10 11
0 2
2
TABLE 4 EXPERIMENT 2: MEAN b T I N G S OF ATTENTION TO ~ U G C E s T E D~MACEIIY AS A FUNCTIONOF IMAGERY CONGRUENCE
s Group Low Hypnotizable High Hypnotizable
Congruent Imagery
Incongruent Imagery
7.0 (1.5) 8.7 (1.6)
6.1 (2.0) 7.4 (1.5)
Note. Standard deviations appear in parentheses. TABLE 5 EXPERIMJSNT 2: MEAN hTINCS OF EXPERIENCED INVOLUNTARINESS AS A FUNCTIONOF ~MAGERYCONGRUEVCE
S Group Low Hypnotizable High Hypnotizable
Congruent Imagery
Incongruent Imagery
6.9(1.4)
5.6 (2.4)
8.8 (1.3)
8.5 (1.4)
Note. Standad deviations appear in parentheses.
Attention to Suggested Imagery The mean scores for attention to the suggested imagery are given in Table 4 for each group. A 2 x 2 ANOVA with hypnotizability level (high versus low) and imagery type (congruent versus incongruent) as between Ss variables and attention to suggested imagery as the dependent variable revealed a marginally sigdcant effect for imagery type (F = 3.33, df = 1,s;p < .lo) and a sigdcant effect for hypnotizability level (F = 9.02, df = 1,sp;< .01).Both high and low hypnotizable Ss reported more attention to congruent than to incongruent imagery. Furthermore, high hypnotizable Ss reported greater attention than did low hypnotizable Ss, even when this attention was to an event opposite to their observed behavior.
Experienced Inuoluntariness The mean ratings for Ss’report of experienced involuntarinessare given in Table 5. A 2 x 2 ANOVA indicated a significant effect for hypnotizability (F = 19.51, df = 1 , s ; p < .001). Regardless of imagery congruence,
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high hypnotizable Ss experienced their behavior as more involuntary than did low hypnotizable Ss. No other effects were significant.’
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DISCUSSION The results of the second experiment supported the prediction that when the conflict inherent in the hypnotic situation is heightened by requiring Ss to experience imagery that directly contradicts the suggested behavior, low hypnotizable Ss will be less successful in passing the hypnotic suggestion than will high hypnotizable Ss. High hypnotizable Ss responded positively, regardless of whether the test suggestion contained congruent or incongruent imagery. This result replicates the findings of previous research in which Ss were asked to engage in incompatible cognitive activity while responding to hypnotic suggestions (Spanos et al., 1984; &ansky, 1N”; Zaman~kyh Clark, 1986). A different pattern of results, however, emerged when the low hypnotizable Ss were considered. Only 2 of the 10 low hypnotizable Ss who were administered the test suggestion along with incongruent images were able to pass this suggestion. This degraded performance cannot be attributed simply to the lability of these Ss’ response to suggestions, since 6 of the 8 low hypnotizable Ss in the congruent imagery group responded successfully to the test suggestion. Significantly fewer Ss passed the suggestion with incongruent imagery. Low hypnotizable Ss appear to have dficulty with hypnotic suggestions that ask them to imagine one event and to respond behaviorally in an opposite manner. Because congruent suggestions are consistent with the test suggestions, there is no salient conflict. and it should be relatively easy to maintain a unified attentional focus on (i.e., to remain absorbed in) the content of the test suggestions. In this condition. both high and low hypnotizable Ss responded successfully to the test suggestion. The introduction of incongruent imagery, however, considerably heightened the conflict inherent in the situation, and absorption ceased to be a viable strategy for passing the test suggestion. The successful response to suggestions with incongruent imagery appears to require the ability to maintain conflicting perspectives (the cognitive perspective of the balloon image conflicts with the behavioral perspective of arm lowering) while experiencing the response as involuntary (i.e., dissociation). In this situation, most of the high hypnotizable Ss responded positively, while only 2 of tht 10 low hypnotizable Ss were able to do so. Indeed, the high hypnotizable Ss reported attending more than did the low hypnotizable Ss to the balloon ’Our interest here is in the results summed across pnssed and &iId items; it should be pointed out, however (aswa5 reported in Experiment 1). that there is a lack of independence between ratings of absorption and involuntariness and whether a suggestion was passed or
Wed.
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image, even though more of them responded successfully to the arm lowering suggestion - a movement directly opposite to their imagined experience. When absorption was a viable strategy, low and high hypnotizable Ss were about equally able to pass the test suggestion. When, however, a unified representation of the hypnotic suggestion was not possible (i.e., when it became necessary to depend upon dissociation), low hypnotizable Ss were no longer able to respond successfully, while high hypnotizable Ss responded almost as well as they had with congruent imagery. Viewed in this manner, the results of the second experiment lead to the same interpretation as did those of the first experiment. Although the methodologies of the two experiments differed considerably, their results converge in pointing to the differential availability of dissociation and absorption to high and low hypnotizable Ss in dealing with the conflict inherent in hypnotic suggestions. It seems likely that high hypnotizable Ss are able to employ both absorption and dissociation as cognitive strategies; the prevailing strategy in any one circumstance may depend, at least in part, on the degree of inherent conflict. Low hypnotizable Ss, on the other hand, appear also to be relatively effective in using absorption, but seem to be inept dissociators. They, apparently, can deal succes&lly with hypnotic suggestions only when it is possible to become fully caught up in them. When the form or content of a suggestion makes it diEcult to maintain an undivided focus of attention, their performance deteriorates. Certainly, the results of the present experiments do not provide a definitive demonstration of the roles of dissociation and absorption in mediating the hypnotic experience. Despite the Fact that the results of the two experiments -which differed considerably in their methodologies appear to be consistent with and converge upon the interpretation offered by the present authors, it may be that other theorists will be able to find an alternative explanation(s)more compatible with their own preferred orientation. J. R. Hilgard (1965) has proposed that there are multiple paths to hypnosis. The present experiments provide additional evidence that absorption and dissociation are two such paths that are differentially travelled, depending upon the individual's cognitive capabilities and hypnotizability.
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Rm..1973,80,395-411. HILCNW, E. R. Dioidcd b: Multiph controls in human thought and action. New York: Wdey. 1977. HLGARD, J. R. Personality and hypnotizability; Inferences from case studies. In E. R. Hilgud, Hypnotic swccptibdity. New York: H m u r t , Brace & World, 1965. Pp.
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343-374. HILCARD,J. R. Imginative involvement Some characteristics of the highly hypnotizable and the non-hypnotizable. Int. J . din.cxp. H y p n o s i s . 1974.22,138-156. HILGUKI, J. R. P c m m d i t y and hypnoau: A study of imagiMtiiw inuohmmt (Rev. 2nd ed.). Chcago: Univer. of Chicago &ss, 1979. KARLIN, R. A. Hypnotizability and attention. /. abnorm. Psychol.. 1979,88.92-95. SHOR.R. E. A phenomenological method for the measurement of variables important to an understanding of the nature of hypnosis. In E. Fromm & R. E. Shor (Eds.), Hypnosis: Deuelopmcnts in research and new perspectiou. (Rev. 2nd ed.) New York: Aldine, 1979.Pp. 10.5135. SHOR. R. E.. t OWE, E. C. Hanurrd Group Scale of H y p n o t i c Surceptibility. Form A . Palo Alto, CA: Consulting Psychologists Pms, 1962. SPANOS,N. P., & BARBER,T. X. Cognitive activity during "hypnotic" suggestibility: Coaldirected-fantasy and the experience o f nonvolition. ]. Penonolity, 1972,4,510524. SPANOS. N. P.. & BARI~ER,T. X. Toward a convergence in hypnosis research. Amer. Psychdogist. 1974.29.m 1 1 . SPANOS, N. P..h MCPEAKE,J. D.Involvement in suggestion-related imagings, experienced involuntariness, and credibility assigned to imagings in hypnotic subjects. 1.abnom. Psycho1 1977.83,6?37-6!3. SPANOS, N. P.,& m, H. L Hypnotic visual hallucinations as imagings: A cognitive social psychohgcd perspective. Itnag. C o p . P e n . . 1981-1982 1. 147-lfo. SPANOS,N. P., WXKES, J, R.. & DE CROH.M. The involuntary countering of suggested requests: A test of the ideomotor hypothesis of hypnotic responsiveness. B r i t . ] . erp. clin. Hypnosis, 1984, 1. 3-11, ' ~ L L E C E N , A. On measures and conceptions of hypnosis. A m . /. clin. Hypnosir, 197N 1979, 21,219-236. LEGE EN, A., & ATKINSON. C. Openness to absorbing and self-altering exprieom ("& sorption7, a hait related to hypnotic susceptibility. 1.abnorm. Pqchol., 1974, 83, 268-277. VAN Nws. D. Meditation,attention and hypnotic susceptibility: A correhond study. Int. J . clin. exp. Hypnosis. 1974,21,5%6!3. WRZENHOFFFX, A. M.,& H n w . E. R. StanfordHypnoticSwcsptibility Scales. Fonnt A and B . Palo Alto, CA:Consulting Psychologirts &u. 1959. ZAMANSKY, H. S. Suggestion and countersuggestion in hypnotic behavior. 1.&norm. p q chol., 1977,86,346351. ZAMANSKY. H. S . . & BARTIS, S. P. i k m i a t i o n in hypnosis: The hidden observer observed. J . abnonn. Psychd, 1985,92,243-248. Z.U,HANSKY. H. S., & CWU. L. E. Cognitive competition and hypnotic behavior: Whither absorption? Znt.]. din. cxp. Hypnosis. 1986.34.205-214.
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Strategies cognitives et hypnose: Vers une resolution du c o d i t hypnotique Scott P. Bartis et Harold
S. Zamansky
Resume: Deux etudes ont t t C men& nfin d'evaluer la contribution relative de la dissociation et de l'absorption, comme strategies cognitives employits par les sujets fortement et faiblement hypootisables qui dpondent avee s u d s aux suggestions hypnotiques. La f+mn dont l a sujets rtogissent P I'iiformation co-elle inhtrmte aux suggestions h y p w tiqws a t d'un inter& particulier. Dam la pnmibre etude, les sujets Cvduent la f&ation de leur attention h i que l'automatisme de leur expCrience a p d s avoir rbpondu h un certain nombre de suggestions hypwtiqua administrbs d e f v standard. Dms la seconde etude, l'inteusite du codit a C t t manipultx en donuant des instrwtiom A eertains sujets pour qu'ils imaginent une situation coherente avec la rcpOnse behaviode suggtde, et h d'autres, pour qu'ils imaginent une situation inaxrgrue par rapport 1 la dponse suggbrk. h rkultats soat cobtrenb dans les dew: etudes: selon la nature de la suggestion hypotique, les sujets fortement hypnotisabla wnt capables dutiliKr soit la dissociatioo ou l'absorption pour &pondre avec s u c c k . D'autre part, l a s u j e b faiblement hypwtisabks semblent peu efficam dans la dissociation. Lorsque In ~ t u r de e la suggestion hypmtique ernl'wge de l'absorption, la performance d a sujets faiblement hypnotkabks se dttCriore.
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International Journal of Clinical and Experimental Hypnosis Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/nhyp20
Cognitive Strategies in Hypnosis: Toward Resolving the Hypnotic Conflict a
Scott P. Bartis & Harold S. Zamansky
a
a
Northeasten University , Boston, Massachusetts Published online: 31 Jan 2008.
To cite this article: Scott P. Bartis & Harold S. Zamansky (1990) Cognitive Strategies in Hypnosis: Toward Resolving the Hypnotic Conflict, International Journal of Clinical and Experimental Hypnosis, 38:3, 168-182, DOI: 10.1080/00207149008414516 To link to this article: http://dx.doi.org/10.1080/00207149008414516
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COGNITIVE STRATEGIES IN HYPNOSIS: TOWARD RESOLVING THE HYPNOTIC CONFLICT’
scon P. BARTIS
AND HAROLD
s. WMANSKY~
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Northeasten Univcnity. Barton, Masaachuvtts
Abstract: 2 experiments were carried out to assess the relative contributions of dissociation and absorption as cognitive strategies employed by high and low hypnotizable Ss in responding successfully to hypnotic suggestions. Of special interest was the manner in which Ss deal with conflicting information typically inherent in hypnotic suggestions. In the first experiment, Ss rated their attention4 focus and the involuntariness of their experience after responding to a number of hypnotic suggestions administered in the usual manner. In the second experiment, the level of conflict was varied by instructing some Ss to imagine a circumstance that was congruent and other Ss to imagine a circumstance that was incongruent with the suggested behavioral response. The results of the 2 experiments were consistent in suggesting that, depending upon the nature of the hypnotic suggestion, high hypnotizable Ss are able to employ dissociation or absorption in order to respond successfully. Low hypnotizable Ss, on the other hand, seem to be relatively ineffective dissociators. When the structure of the hypnotic suggestion precludes the use of absorption, the performance of low hypnotizables deteriorates.
An adequate theory of hypnosis must account for the way Ss resolve the conflict that is typically inherent in hypnotic suggestions. Almost all hypnotic suggestions require S to respond with an experience that contradicts the actual or true state of &airs. Thus, for example, S who knows that hidher arm is healthy and unrestrained is told that he/she cannot bend that arm. There is, then, an “incongruence” (cf. Tellegen, 1978/1979)between the suggested experience and the realistic cognition. A successful response requires that S exhibit the suggested behavior along with a report that this response was experienced as involuntary or nonvolitiond. The present authors suggest that the familiar notions of dissociation (E. R. Hilgard, 1977) and absorption (Tellegen & Atkinson, 1974) may be conceptualized as two theoretically distinct processes that offer different accounts of how the conflict intrinsic to hypnosis is resolved. Absorption is generally regarded as an important cognitive process in the successful response to hypnotic suggestions (K. S. Bowers, 1976; J. R. Hilgard, 1974; Shor, 1979; Spanos & Barber, 1972, 1974; Tellegen & Atkinson, 1974). According to this view, absorption involves an exclusive Manuscript submitted April 25, 1988; find revision received September 26, 1989. was supported in part bv Grant No. RR 071K3, Biomedical Research Support Grant Program, National institutes of Health. ‘Reprint requests should be addressed to Harold S. Zarnmsky. Ph.D., Department of Psychology. 1 8 NI. Northeastern University. Boston. M A 02115.
‘Thisresearch
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focusing on the information contained in the hypnotic suggestion, imaging events consistent with this information, and ignoring contradictory information. Thus, for example, Tellegen and Atkinson (1974)speak of absorption as a “state of ‘total attention’ during which the available representational apparatus seems to be entirely dedicated to experiencing and modeling the attentional object [p. 2741.” In other words, Ss resolve the hypnotic conflict by attending only to one side of the issue. Numerous studies, using a variety of measurement devices, have demonstrated a positive relationship between absorption in activities outside of hypnosis and individual differences in hypnotizability (As, 1963;J. R. Hilgard, 1974, 1979;Karlin, 1979;Van Nuys, 1974). Despite its acceptance as an important correlate of hypnotizability, there is little consistent evidence that, during hypnosis proper, Ss’ positive responses to suggestions are mediated by absorption (Coe, Allen, Krug, & Wurzman, 1974;Spanos & McPeake, 1977). Dissociation (E. R. Hilgard, 1977)represents another cognitive strategy that may be employed in dealing with the conflict inherent in hypnotic suggestions. Dissociation may be conceptualized as involving the simultaneous maintenance of conflicting but functionally isolated perspectives on the same experience (Zamansky & Bartis, 1985).Within this view, S given a suggestion for arm immobilizatibn may be aware of the reality-based aspects of the situation (“my arm is normal and unrestrained”), while simultaneously finding that hidher arm does not bend. Because of the functional isolation of perspectives inherent in the process of dissociation, the conflictingcognitive information does not inhibit the overt response. Indeed, Ss appear to accept both aspects as genuine accounts of their experience, des ite the logical inconsistency of this position (cf. Zamansky & Clark, 1986). Much of the experimental work on the role of dissociation in hypnosis has been limited in terms of both the procedures and Ss used. Most studies have typically examined hypnotized Ss’ experience of pain, using an experimental paradigm that involves two stages: first, analgesia is suggested; then, an attempt is made to obtain hidden (i.e., dissociated) reports of pain from those Ss who initially report some analgesia. This is the familiar hidden observer procedure (E. R. Hilgard, 1973,1977).The inability of low hypnotizable Ss to meet the first requirement (analgesia) has precluded the study of dissociation in these Ss (E. R. Hilgard, 1977). IfE.R. HiIgard is correct in proposing that hypnosis involves dissociation, then it follows that high hypnotizable Ss should be more capable of dissociation than low hypnotizables. This hypothesis, however, has yet to be fully tested. The present study describes two experiments that investigated the independent contributions of dissociation and absorption to the hypnotic
P
31n those cases where S does not explicitly report an awareness of the second perspective, it must be possible clearly to infer its functional presence from S’s behavior.
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experience in terms of the conceptualization outlined above. The present authors were especially interested in distinguishing the role played by ea& of the two processes in mediating the hypnotic behavior of high versus low hypnotizable Ss. Although the present authors have conceptualized dissociation and absorption as cognitive strategies, it is not necessarily the case that either one is utilized consciously or voluntarily by Ss in responding to a hypnotic suggestion.
EXPERIMENT 1 In the first experiment. subjective measures of attentional focus and involuntariness of experience were utilized in a preliminary attempt to distinguish the role of absorption and dissociation in the hypnotic responses of high and low hypnotizable Ss. Absorption and dissociation were operationally defined in terms of SS’ reported awareness of information that conflicted with their positive .behavioral response to hypnotic suggestions. Absorption was operationally defined as S’s report that during the suggestion hefshe thought only about what was suggested and not about what was objectively true. Dissociation was defined as the awareness of both suggested and reality-based information, while still responding positively to the suggestion. The crucial difference here between absorption and dissociation is that, for instances labelled as dissociation, S maintains cognitions that conflict with hidher behavioral response, whereas there is no such conflict, consciously, for instances labelled as absorption. METHOD Subjects
Forty-six male and female students enrolled in Introductory Psychology courses served as Ss and received course credit for their participation. The Ss were tested in groups of two to seven. Measurement of Hypnotizability
Hypnotizability was assessed with a Witem modified version of
the Stanford Hypnotic Susceptibility Scale, Form B (SHSS:B) of Weitzenhoffer and E. R. Hilgard (1959).Although originally designed for use with individuals, SHSS:B is easily adapted for group administration. The postural w a y and verbaI inhibition items were dropped. There were three other changes: An arm levitation suggestion was substituted for one of arm immobilization; the positive hallucination suggested was of thirst, not a mosquito; and the posthypnotic response was coughing (instead of standing up). Of Ss who volunteered to participate in the experiment, 16 Ss scored between 8 and 10 on the modified SHSS:B and were classified as high hypnotizable; 30 Ss scored between 1 and 3 and were considered low hypnotizable.
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Measurement of Attentwnd Focus
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For each item on the modified SHSS:B measuring hypnotizability, SS rated their attentiond focus on a 5-point Likert scale. The ss indicated which of the following alternatives best completed the sentence, “My best explanation for my experience on this item is 1. I thought only about what the hypnotist suggested and never about what was really true. 2. I thought mostly about what the hypnotist said and hardly ever about what was really true. 3. I didn’t think about what the hypnotist suggested. 4. I thought about what the hypnotist suggested as well as occasionally about what was really true. 5. I thought about what the hypnotist suggested as well as often about what was really true.
Thus, scores of “1” and “2”were considered to represent a focus on the hypnotic suggestion and a relative neglect of reality-based information, while scores of “4” and “5” were considered to represent an awareness of both suggested and reality-based information. Choice “3” was included as an option for Ss who paid no attention to the hypnotic suggestion and was, in fact, rarely used. Measurement of Involuntariness of Response The Ss rated the extent to which they experienced their behavior to each hypnotic suggestion as involuntary on a 5-point scale, developed by K. S. Bowers (1981).with higher scores indicating a greater experience of involuntariness. All Ss were required to assign a rating on this measure, regardless of their response to the hypnotic suggestions. Procedure The Ss were given a brief introduction to hypnosis, followed by the modified group form of SHSS:B. After responding to all the hypnotic suggestions, Ss completed a scoring booklet modeled after that used with the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) of Shor and E. Orne (1962). For each suggestion, Ss rated their behavioral response, attentiond focus, and experienced involuntariness. The relevant responses to the posthypnotic suggestion and the amnesia suggestion are to occur while S is amnesic for the suggestion itself. Thus, for these items, the relationship between attentional focus and behavior may be different than for the other suggestions. Accordingly, Ss did not rate their attentional focus on these items. kVJLTS
The unit of analysis was Ss’ratings on individual hypnotic suggestions. On the first eight modified SHSS:B items, the low hypnotizable group of Ss passed a total of 74 items and Lled 166 items. The high hypnotizable group of Ss passed 110 and failed 18 items.
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EscpERIMENT
TABLE 1 1: MEAN A ~ X T I O N A Focus ~ RATINGSFOR PASSEDA
s Group Low Hypnotizable High Hypnotizable
.
FA~LED Ims
Passed Items
Failed Items
2 9 (1.5) 2.5 (1.3)
4.0 (1.1) 3.6 (0.8)
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Nm . Standard deviations appear in mentheses.
Table 1 reports the mean attentional focus ratings for the high and low hypnotizable Ss on passed and failed items. The low number of suggestions failed by the high hypnotizables precluded performing an ANOVA on the data. Instead, two t tests indicated a significantly greater focus on the hypnotic suggestion alone (as opposed to reality-based information) for both high and low hypnotizable Ss on passed than on failed items (p < .001).The significance of these findings, however, cannot be determined without taking account of the experience of involuntariness. For the analysis of experienced involuntariness, only data from passed items were considered. Responses fiom both hypnotizability groups were divided into two groups on the basis of Ss' reported attentional focus: focus on the suggestion alone (ratingsof 1and 2) or focus on both suggestion and reality (ratings of 4 and 5). The mean involuntariness rating for each group is given in Table 1. A 2 x 2 ANOVA, with involuntariness ratings as the dependent variable, revealed a significant main effect for attentional focus (F = 20.32, df = 1,180;p < .001). Regardless of hypnotizability level, a focus on the suggestion alone was associated with greater experienced involuntariness than was a focus on both the suggestion and reality. There was a significant interaction between hypnotizability level and attentional focus (F = 4.6, df = 1,180;p < .05). Posteriori comparisons (Tukey's HSD) demonstrated that low hypnotizable Ss who attended to both the suggestion and reality rated their behavior as significantly more voluntary than did both low hypnotizable Ss who focused on the suggestion alone and high hypnotizable Ss who focused on the suggestion and reality. The attentional focus of high hypnotizable Ss did not significantly affect the experienced involuntariness of their behavior.'
DISCUSSION The results of the first experiment suggest that the role of absorption and dissociation in the hypnotic situation (as operationally defined here) is amenable to experimental assessment. It was shown that the relevance of each process to Ss' hypnotic experience varies as a function of their '~ecause SS' ~ t i n g on~individual suggestions were used ps the unit of measurement, Merent numben and types d items may have been contributed by individual Ss. This procedure, however, did not d e c t the results: had df = 1,45 instead of df = 1,180 (number of Ss instead of number of responses) been UKd in the ANOVA, the significance of the results wouid have remained unchanged (p < .001 for attentional focus. and p < .05 for the interaction).
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TABLE 2 EXPERIENCEDINVOLUNTARINESS FOR PASSED SUGGEsnONS AS A FUNCTION OF ATTENTIONAL Focus
EXPERIMENT1: MEANRATINGS S Croup
OF
Attention to Suggestion Alone
Low Hypnotizable
2 8 (1.3) 3.5 (1.0)
4.0 (1.0) High Hypnotizable 4.0 (1.3) Note. Standard deviations appear in parentheses.
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Attention to Suggestionand Reality
hypnotizability. For both high and low hypnotizable Ss, a focus on the suggestion alone was associated with a positive behavioral response and a high degree of reported involuntariness the two components of a successful hypnotic response. This finding is in accord with a number of theoretical positions that share the belief that as Ss become absorbed in suggested ideas and images, they relax normal reality criteria and come to interpret their behavior as involuntary (I? Bowers, 1978; E. R. Hilgard, 1965, 1977; Shor, 1979; Spanos & Radtke, 1981-1982). When Ss reported being aware of reality-based information that conflicted with the hypnotically suggested behavioral response, a difference emerged between low and high hypnotizable Ss. When their positive behavioral response to suggestions was accompanied by an awareness of both kinds of information, low hypnotizable Ss reported a decrease in the involuntariness of their response. Despite their positive behavioral response, the rating of their behavior as relatively voluntary suggests that the criteria for hypnosis have not been met. High hypnotizable Ss, on the other hand, were able to be aware of information that conflicted with their behavioral response without this knowledge diminishing their experience that this behavior was involuntary. The present authors interpret these results to suggest that absorption, a unitary experience, can be observed among both high and low hypnotizable Ss,whereas dissociation, the maintenance of conflictingperspectives on the same experience, appears to be relatively restricted to Ss high in hypnotizability. To put it differently, the present results suggest that high hypnotizable Ss can utilize either absorption or dissociation in dealing with the conflict inherent in hypnotic suggestions (i.e., in responding successfully to hypnotic suggestions). Low hypnotizable Ss, on the other hand, appear to be less able to utilize dissociation as a cognitive process, and must therefore depend more exclusively on absorption in order to pass a hypnotic suggestion. The first experiment examined the spontaneous Occurrence of dissociation and absorption in Ss’ responses to hypnotic suggestions. While the results support the relevance of both concepts to hypnosis, the conclusions one may draw are limited by the correlational nature of the data. The second experiment manipulated features of the hypnotic suggestions in order to assess more directly the contribution made by dissociation and absorption to the hypnotic behavior of Ss differing in hypnotizability.
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EXPERIMENT 2
If absorption and cissociation are two ways of resolving the conflict involved in hypnosis, then manipulating the level of conflict contained in the suggestions should affect the utility of these strategies. As cognitions that are inconsistent with the suggested behavioral response become more salient, it should become more difficult to maintain a unified attention4 focus directed exclusively to the content of the hypnotic suggestion, and, consequently, absorption should become less effective as a cognitive strategy. %ansky (19n) heightened the conflict inherent in hypnotic suggestions by encouraging Ss to engage in thoughts and images that contradicted the content of those suggestions. Twelve highly hypnotizable Ss, who had previously passed suggestions such as arm catalepsy, finger lock, chair hold, and verbal inhibition, were asked to practice performing the opposite behaviors, and then were re-administered the suggestions while being exhorted to remember, to think about, and to imagine behaviors that codicted with those suggestions. The results indicated that of the 34 suggestions administered to the 12 Ss in this manner, 29 were passed (85%).Every S passed at least one suggestion and 9 Ss passed every suggestion. All Ss reported engaging in thoughts and images that were incompatible with their behavioral response. In a second experiment, Zamansky and Clark (1986) examined the ability of low as well as high hypnotizable Ss to respond in the presence of conflicting suggestions. High hypnotizable Ss replicated the results obtained by Zamansky (1977); all 17 Ss performed successfully, despite the countersuggestions. Low hypnotizable Ss, on the other hand, had difficulty when confronted with countersuggestions. Even though they had passed the original suggestions, only 2 of the 8 low hypnotizable Ss passed them when the countersuggestions were presented. Spanos, Weekes, and de Groh (1984) examined a slightly different type of conflict: that between the suggested behavior and the suggested imagery. Normally, these two aspects of hypnotic suggestions are congruent Pellegen, 1978/1979). For example, S is asked to imagine that magnets are attached to his/her hands and told that his/her hands will be attracted towards one another. Absorption in the suggested imagery comes to represent reality at that moment and increases the likelihood of a positive behavioral response (Spanos dr Barber, 1974). Two groups of highly hypnotizable Ss were used. One group received a suggestion very similar to those found in HGSHS:A, in which the suggested imagery and response are congruent. The second group received incongruent suggestions in which they were asked to image one event (a heavy weight tied to the hand) yet respond oppositely (raise the arm). The results demonstrated that the high hypnotizable Ss were quite capable of such incongruent behavior. They reported a high degree of involvement in imagery opposite
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to their behavioral response, while maintaining that their behavior was nonvolitional. Indeed, there was no difference between Ss given congruent and those given incongruent imagery in the extent of arm movement. Since this experiment used only high hypnotizable Ss, it is not clear how low hypnotizable Ss would have responded to a similar conflict. In the second experiment, the present authors attempted to assess more directly the relative contributions of absorption and dissociation to the hypnotic behavior of Ss differingin hypnotizability level by heightening the conflict inherent in the situation. Suggestions similar to those used by Spanos et al. (1984)were used, which asked Ss to image an event but to respond in the opposite manner. It was hypothesized that high hypnotizable Ss would replicate the results of Zamansky and Clark (1986) and Spanos et al. (1984); that is, that they would respond positively, despite the conflict between imagery and response. If low hypnotizable Ss are less capable than high hypnotizables of maintaining conflicting perspectives on the same experience, then they shouId have difficulty passing items for which the suggested response and imagery are incongruent.
METHOD Subjects Forty-one male and female students enrolled in introductory Psychology courses served as Ss. The Ss were tested in groups of one to four and received course credit for participation. No S had participated in the first experiment. Measurement of Hgpnotidility Hypnotizability was measured by a 10-item modification of HCSHS:A. The suggestions for head lowering and eye catdepsy were omitted. Of Ss who volunteered to, participate in the experiment, 23 scored between 8 and 10 on the modified HGSHS:A and were classified as high hypnotizable; 18 scored between 1and 3 and were considered low hypnotizable. Experimental Conditions Two test suggestions (modifiedafter Spanos et al., 1984)were developed that differed in their level of conflict or congruence. The suggestion with congruent imagery asked Ss to hold out their right arm, and to imagine a heavy weight tied to their hand. It was suggested that the hand would lower, The suggestion with incongruent imagery asked Ss to hold out their right arm and to imagine a large helium balloon tied to it. They were told that, despite this image, the hand would lower. Thus, for both suggestions the behavioral response was hand lowering. A S was considered to have passed the test suggestion if hidher arm lowered by at least 6 inches.
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Ten of the high hypnotizable Ss received the test suggestion with congruent imagery and 13 with incongruent imagery. Eight of the low hypnotizable Ss received the test suggestion with congruent imagery and 10 with incongruent imagery. Within each hypnotizability level, Ss were randomly assigned to the congruent and incongruent imagery conditions and did not differ in mean hypnotizability score.
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Procedure
Following a brief introduction to hypnosis, Ss were administered the first eight items of the modified HGSHS:A. During the arm lowering suggestion, E judged whether or not each S’s arm had lowered at least 6 inches. After the eighth item, Ss were administered the test suggestion with either incongruent or congruent imagery. Once again, E rated whether or not there was at least 6 inches of arm movement. Scores on the test suggestion were not included in the calculation of hypnotizability scores. Following the administration of the test suggestion, Ss were asked to open their eyes while remaining hypnotized and to rate the degree of their attention to the suggested imagery (either the balloon or the weight), the direction and extent of their arm movement, and the experienced involuntariness of their arm movement on 10-point Likert scales. They then closed their eyes, were awakened horn hypnosis, and posthypnotic response and amnesia were assessed in the usual manner. The Ss completed the modified HGSHS:A scoring booklet and were dismissed. RESULTS
All Ss demonstrated at least 6 inches of arm lowering when the relevant suggestion was gwen initially during the administration of the first 8 items of the modified HGSHS:A. Overt Response to Test Suggestwn
Six of the 8 low hypnotizable Ss who were administered the test suggestion with congruent imagery passed it, while only 2 of the 10 Ss passed the suggestion with inconpent imagery. For high hypnotizables, all 10 Ss passed the test suggestion with congruent imagery, while 11of the 13 Ss passed the suggestion with incongruent imagery. The data are presented in Table 3. Chi squares were calculated separately for high and low hypnotizable Ss. This andysis demonstrated that low hypnotizable Ss responded successfully s i p k a n t l y less often with incongruent than with congruent imagery (x = 5.7. p C .OZ). There was no significant difference in responsiveness for high hypnotizable Ss as a function of imagery type. Furthermore, the performance of the Iow hypnotizable Ss was significantly more impaired with incongruent imagery than was that of the high hypnotizable Ss (Fisher’s Exact Test, p < .005).
in
COGNITIVE STRATEGIES IN HYPNOSIS
TABLE 3
EXPERIMENT 2: NUMBER OF ss RESPONDINGTO TESTSUGGESTION AS A FUNCTIONOF IMAGERY CONGRUENCE
S Group and Imagery
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Congruence Low HypnotiPbk Congruent Imagery Incongruent Imagery High Hypnotizable Congruent Imagery Incongruent Imagery
Passed Suggestion
Failed Suggestion
6 2
8
10 11
0 2
2
TABLE 4 EXPERIMENT 2: MEAN b T I N G S OF ATTENTION TO ~ U G C E s T E D~MACEIIY AS A FUNCTIONOF IMAGERY CONGRUENCE
s Group Low Hypnotizable High Hypnotizable
Congruent Imagery
Incongruent Imagery
7.0 (1.5) 8.7 (1.6)
6.1 (2.0) 7.4 (1.5)
Note. Standard deviations appear in parentheses. TABLE 5 EXPERIMJSNT 2: MEAN hTINCS OF EXPERIENCED INVOLUNTARINESS AS A FUNCTIONOF ~MAGERYCONGRUEVCE
S Group Low Hypnotizable High Hypnotizable
Congruent Imagery
Incongruent Imagery
6.9(1.4)
5.6 (2.4)
8.8 (1.3)
8.5 (1.4)
Note. Standad deviations appear in parentheses.
Attention to Suggested Imagery The mean scores for attention to the suggested imagery are given in Table 4 for each group. A 2 x 2 ANOVA with hypnotizability level (high versus low) and imagery type (congruent versus incongruent) as between Ss variables and attention to suggested imagery as the dependent variable revealed a marginally sigdcant effect for imagery type (F = 3.33, df = 1,s;p < .lo) and a sigdcant effect for hypnotizability level (F = 9.02, df = 1,sp;< .01).Both high and low hypnotizable Ss reported more attention to congruent than to incongruent imagery. Furthermore, high hypnotizable Ss reported greater attention than did low hypnotizable Ss, even when this attention was to an event opposite to their observed behavior.
Experienced Inuoluntariness The mean ratings for Ss’report of experienced involuntarinessare given in Table 5. A 2 x 2 ANOVA indicated a significant effect for hypnotizability (F = 19.51, df = 1 , s ; p < .001). Regardless of imagery congruence,
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high hypnotizable Ss experienced their behavior as more involuntary than did low hypnotizable Ss. No other effects were significant.’
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DISCUSSION The results of the second experiment supported the prediction that when the conflict inherent in the hypnotic situation is heightened by requiring Ss to experience imagery that directly contradicts the suggested behavior, low hypnotizable Ss will be less successful in passing the hypnotic suggestion than will high hypnotizable Ss. High hypnotizable Ss responded positively, regardless of whether the test suggestion contained congruent or incongruent imagery. This result replicates the findings of previous research in which Ss were asked to engage in incompatible cognitive activity while responding to hypnotic suggestions (Spanos et al., 1984; &ansky, 1N”; Zaman~kyh Clark, 1986). A different pattern of results, however, emerged when the low hypnotizable Ss were considered. Only 2 of the 10 low hypnotizable Ss who were administered the test suggestion along with incongruent images were able to pass this suggestion. This degraded performance cannot be attributed simply to the lability of these Ss’ response to suggestions, since 6 of the 8 low hypnotizable Ss in the congruent imagery group responded successfully to the test suggestion. Significantly fewer Ss passed the suggestion with incongruent imagery. Low hypnotizable Ss appear to have dficulty with hypnotic suggestions that ask them to imagine one event and to respond behaviorally in an opposite manner. Because congruent suggestions are consistent with the test suggestions, there is no salient conflict. and it should be relatively easy to maintain a unified attentional focus on (i.e., to remain absorbed in) the content of the test suggestions. In this condition. both high and low hypnotizable Ss responded successfully to the test suggestion. The introduction of incongruent imagery, however, considerably heightened the conflict inherent in the situation, and absorption ceased to be a viable strategy for passing the test suggestion. The successful response to suggestions with incongruent imagery appears to require the ability to maintain conflicting perspectives (the cognitive perspective of the balloon image conflicts with the behavioral perspective of arm lowering) while experiencing the response as involuntary (i.e., dissociation). In this situation, most of the high hypnotizable Ss responded positively, while only 2 of tht 10 low hypnotizable Ss were able to do so. Indeed, the high hypnotizable Ss reported attending more than did the low hypnotizable Ss to the balloon ’Our interest here is in the results summed across pnssed and &iId items; it should be pointed out, however (aswa5 reported in Experiment 1). that there is a lack of independence between ratings of absorption and involuntariness and whether a suggestion was passed or
Wed.
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image, even though more of them responded successfully to the arm lowering suggestion - a movement directly opposite to their imagined experience. When absorption was a viable strategy, low and high hypnotizable Ss were about equally able to pass the test suggestion. When, however, a unified representation of the hypnotic suggestion was not possible (i.e., when it became necessary to depend upon dissociation), low hypnotizable Ss were no longer able to respond successfully, while high hypnotizable Ss responded almost as well as they had with congruent imagery. Viewed in this manner, the results of the second experiment lead to the same interpretation as did those of the first experiment. Although the methodologies of the two experiments differed considerably, their results converge in pointing to the differential availability of dissociation and absorption to high and low hypnotizable Ss in dealing with the conflict inherent in hypnotic suggestions. It seems likely that high hypnotizable Ss are able to employ both absorption and dissociation as cognitive strategies; the prevailing strategy in any one circumstance may depend, at least in part, on the degree of inherent conflict. Low hypnotizable Ss, on the other hand, appear also to be relatively effective in using absorption, but seem to be inept dissociators. They, apparently, can deal succes&lly with hypnotic suggestions only when it is possible to become fully caught up in them. When the form or content of a suggestion makes it diEcult to maintain an undivided focus of attention, their performance deteriorates. Certainly, the results of the present experiments do not provide a definitive demonstration of the roles of dissociation and absorption in mediating the hypnotic experience. Despite the Fact that the results of the two experiments -which differed considerably in their methodologies appear to be consistent with and converge upon the interpretation offered by the present authors, it may be that other theorists will be able to find an alternative explanation(s)more compatible with their own preferred orientation. J. R. Hilgard (1965) has proposed that there are multiple paths to hypnosis. The present experiments provide additional evidence that absorption and dissociation are two such paths that are differentially travelled, depending upon the individual's cognitive capabilities and hypnotizability.
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REFERENCES As. h Hypnotizability as a function of non-hypnotic experiences.I . obnonn. soe. Psqchol., 1963,66,142,-150.
BOWWS, K. S. Hypnaris for tht ~ri0u.94 curiouc. N m York: Norton, 1976. BOWERS. K. S. Do the Stanford scales tap the "classic suggestion effect?" Int. 1.din. exp. Hypnosis. 1981.29,4253.
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Rm..1973,80,395-411. HILCNW, E. R. Dioidcd b: Multiph controls in human thought and action. New York: Wdey. 1977. HLGARD, J. R. Personality and hypnotizability; Inferences from case studies. In E. R. Hilgud, Hypnotic swccptibdity. New York: H m u r t , Brace & World, 1965. Pp.
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343-374. HILCARD,J. R. Imginative involvement Some characteristics of the highly hypnotizable and the non-hypnotizable. Int. J . din.cxp. H y p n o s i s . 1974.22,138-156. HILGUKI, J. R. P c m m d i t y and hypnoau: A study of imagiMtiiw inuohmmt (Rev. 2nd ed.). Chcago: Univer. of Chicago &ss, 1979. KARLIN, R. A. Hypnotizability and attention. /. abnorm. Psychol.. 1979,88.92-95. SHOR.R. E. A phenomenological method for the measurement of variables important to an understanding of the nature of hypnosis. In E. Fromm & R. E. Shor (Eds.), Hypnosis: Deuelopmcnts in research and new perspectiou. (Rev. 2nd ed.) New York: Aldine, 1979.Pp. 10.5135. SHOR. R. E.. t OWE, E. C. Hanurrd Group Scale of H y p n o t i c Surceptibility. Form A . Palo Alto, CA: Consulting Psychologists Pms, 1962. SPANOS,N. P., & BARBER,T. X. Cognitive activity during "hypnotic" suggestibility: Coaldirected-fantasy and the experience o f nonvolition. ]. Penonolity, 1972,4,510524. SPANOS. N. P.. & BARI~ER,T. X. Toward a convergence in hypnosis research. Amer. Psychdogist. 1974.29.m 1 1 . SPANOS, N. P..h MCPEAKE,J. D.Involvement in suggestion-related imagings, experienced involuntariness, and credibility assigned to imagings in hypnotic subjects. 1.abnom. Psycho1 1977.83,6?37-6!3. SPANOS, N. P.,& m, H. L Hypnotic visual hallucinations as imagings: A cognitive social psychohgcd perspective. Itnag. C o p . P e n . . 1981-1982 1. 147-lfo. SPANOS,N. P., WXKES, J, R.. & DE CROH.M. The involuntary countering of suggested requests: A test of the ideomotor hypothesis of hypnotic responsiveness. B r i t . ] . erp. clin. Hypnosis, 1984, 1. 3-11, ' ~ L L E C E N , A. On measures and conceptions of hypnosis. A m . /. clin. Hypnosir, 197N 1979, 21,219-236. LEGE EN, A., & ATKINSON. C. Openness to absorbing and self-altering exprieom ("& sorption7, a hait related to hypnotic susceptibility. 1.abnorm. Pqchol., 1974, 83, 268-277. VAN Nws. D. Meditation,attention and hypnotic susceptibility: A correhond study. Int. J . clin. exp. Hypnosis. 1974,21,5%6!3. WRZENHOFFFX, A. M.,& H n w . E. R. StanfordHypnoticSwcsptibility Scales. Fonnt A and B . Palo Alto, CA:Consulting Psychologirts &u. 1959. ZAMANSKY, H. S. Suggestion and countersuggestion in hypnotic behavior. 1.&norm. p q chol., 1977,86,346351. ZAMANSKY. H. S . . & BARTIS, S. P. i k m i a t i o n in hypnosis: The hidden observer observed. J . abnonn. Psychd, 1985,92,243-248. Z.U,HANSKY. H. S., & CWU. L. E. Cognitive competition and hypnotic behavior: Whither absorption? Znt.]. din. cxp. Hypnosis. 1986.34.205-214.
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Strategies cognitives et hypnose: Vers une resolution du c o d i t hypnotique Scott P. Bartis et Harold
S. Zamansky
Resume: Deux etudes ont t t C men& nfin d'evaluer la contribution relative de la dissociation et de l'absorption, comme strategies cognitives employits par les sujets fortement et faiblement hypootisables qui dpondent avee s u d s aux suggestions hypnotiques. La f+mn dont l a sujets rtogissent P I'iiformation co-elle inhtrmte aux suggestions h y p w tiqws a t d'un inter& particulier. Dam la pnmibre etude, les sujets Cvduent la f&ation de leur attention h i que l'automatisme de leur expCrience a p d s avoir rbpondu h un certain nombre de suggestions hypwtiqua administrbs d e f v standard. Dms la seconde etude, l'inteusite du codit a C t t manipultx en donuant des instrwtiom A eertains sujets pour qu'ils imaginent une situation coherente avec la rcpOnse behaviode suggtde, et h d'autres, pour qu'ils imaginent une situation inaxrgrue par rapport 1 la dponse suggbrk. h rkultats soat cobtrenb dans les dew: etudes: selon la nature de la suggestion hypotique, les sujets fortement hypnotisabla wnt capables dutiliKr soit la dissociatioo ou l'absorption pour &pondre avec s u c c k . D'autre part, l a s u j e b faiblement hypwtisabks semblent peu efficam dans la dissociation. Lorsque In ~ t u r de e la suggestion hypmtique ernl'wge de l'absorption, la performance d a sujets faiblement hypnotkabks se dttCriore.
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