This article was downloaded by: [Australian National University] On: 26 January 2015, At: 14:43 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
American Journal of Clinical Hypnosis Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/ujhy20
Neutral Hypnosis as Relaxation William E. Edmonston Jr. Ph.D.
a
a
Colgate University , USA Published online: 20 Sep 2011.
To cite this article: William E. Edmonston Jr. Ph.D. (1977) Neutral Hypnosis as Relaxation, American Journal of Clinical Hypnosis, 20:1, 69-75, DOI: 10.1080/00029157.1977.10403902 To link to this article: http://dx.doi.org/10.1080/00029157.1977.10403902
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/ page/terms-and-conditions
WE AMERICAN JOURNAL OF CLINICAL HYPNOSIS Volume 20, Number 1 , July 1977 Printed in U S A .
Neutral Hypnosis As Relaxation
Downloaded by [Australian National University] at 14:43 26 January 2015
WILLIAM E. EDMONSTON, Jr., Ph.D. Colgate University The thesis is advanced that neutral hypnosis is relaxation. Data from a survey of 99 patients indicate that relaxation is the primary descriptive term used to account for the subjective parameters of hypnosis. Data from recent physiological studies are reviewed in relation to Benson’s “relaxation response.” Both sets of data support the notation: Neutral hypnosis = relaxation.
Neutral hypnosis is relaxation. Throughout the history of modern hypnosis, the one central, compelling force in the induction of hypnosis has been the theme of sleep and relaxation. DePuysegur noted it; Bernheim (1888) observed it; and Hull commented upon it: “. . . subjects in deep hypnosis normally present a picture of rather complete relaxation [Hull, 1933, p. 3101.” Modem investigators and practitioners rely, almost exclusively, on induction procedures involving the concept of relaxation; not of sleep, but of relaxation. “The use of relaxation inductions in the past and present is not fortuitous, but is based on the recognized clinical similarities between hypnosis and relaxation, and the interpretation of hypnosis as a state of enhanced relaxation [Edmonston, 1972a, p. 2281.” Clinical hypnosis has long recognized the similarities between hypnosis and relaxation, but few practitioners have sought to clarify the relationship, choosing, rather, to attend to the therapeutic potentials of hypnosis. Experimental investigators, on the other hand, seldom have contact with patients who seek hypnotic experiences for therapy rather than course credit. Rather than develop a mobile laboratory (see Edmonston, 1970) to bring roving experimental investigators together with thera-
peutically oriented patients, the following survey was undertaken to bring at least one investigator together with therapeutically generated subjective data regarding the fundamental nature of hypnosis.
METHOD Four item, open-ended questionnaires were sent to 191 Fellows of the American Society of Clinical Hypnosis and the Society for Clinical and Experimental Hypnosis, with a request that they have their “three best hypnotic patients” respond to the questions and return the completed questionnaires directly to this investigator in the return envelopes provided. Each questionnaire was numbered for record keeping purposes, but only the practitioners who distributed the forms to their patients knew the identity of the individual patients. The items on the form were: (a) 1. In your own words, describe what being in a hypnotic state (trance) is like for you. Please be as detailed as possible; (b) 2. What, for you as a hypnotized individual, is unique about hypnosis?; (c) 3. How do you determine when you are hypnotized? For example, is there some feeling, some sensation, some change you perceive? Please describe in detail; and, (d) 4. Please describe anything
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else about hypnosis which seems important to you. In all, 573 surveys were distributed. Three months following the initial mailing, a follow-up letter was sent to those practitioners from whose patients no survey had been received. Three months later a second follow-up letter was sent according to the same criterion - no response from the patients.
RESULTS Seventeen percent (99) of the questionnaires were returned. A classical content analysis (see Kerlinger, 1964) of all of the responses to each item was made independently by three experimenters l . Only the data from the first three items will be reported here, because the additional comments on Item Four centered primarily on specific therapeutic benefits rather than Doreen M . Hess, Jonathan D. Saperia and the author.
general statements regarding the nature of hypnosis p e r se . Inter-judge reliabilities ranged from .93 to .99. Tables 1, 2 and 3 present the tabulations for these items. Each figure represents the number of individuals whose responses fit the category noted. For example, 84 individuals (85%) mentioned relaxation in response to the first item, and virtually everyone in the sample mentioned either relaxation or carefree, at peace, calm, loss of fear and well-being. Across all three items the preponderance of individuals offered responses categorized by terms of relaxation, calm and peacefulness. The increased number of responses in other categories (e.g., increased body control in Item Two; and numbness, floating and changes in physiology or perception in Item Three) appear due more to the nature of those items than of hypnosis. The increase in the therapy aid category of Item Two tells us what is important to patients regarding hypnosis -
TABLE 1 NUMBER OF WITH T H E
RESPONDING TO ITEM 1 DESIGNATED CONTENT CATEGORIES
INDIVIDUALS
Content Category Relaxation Carefree, at peace, calm, loss of fear, well-being Concentration, focused attention Floating Spinning sensation Numbness Heaviness Breathing changes Awareness of heart beat Feeling of warmth Individualized physiological or sensory phenomena Reduced sensory perception Increased sensory perception Inability to move Increased body control Dissociation, transcendental experience Increased anxiety Time distortion Automation Therapy aid, pain reduction Other No response
Male (28) Female (71) Total (99) 20 19 10
5 I 3 I I 0 0 4 3
0 0 2 5 0 3 0 0
5 0
64 45 22 10 0 6 I 0
84 64 32 15 I 9 2
1
1 1
5 4 5 0 I 0 9 4 3 0 0 3 2
5 8 8 0 I 2 14 4 6 0 0 8 2
NEUTRAL HYPNOSIS AS RELAXATION
71 TABLE 2
NUMBER OF WITH THE
INDIVIDUALS RESPONDING TO ITEM 2 DESIGNATED CONTENT CATEGORIES
Downloaded by [Australian National University] at 14:43 26 January 2015
Content Category
Male (28) Female (71) Total (99)
Relaxation Carefree, at peace, calm, loss of fear, well-being Concentration, focused attention Floating Spining sensation Numbness Heaviness Breathing changes Awareness of heart beat Feeling of warmth Individualized physiological or sensory phenomena Reduced sensory perception Increased sensory perception Inability to move Increased body control Dissociation, transcendental experience Increased anxiety Time distortion Automation Therapy aid, pain reduction Other No response
12 2 4 0 0 1 0 0 0 0 2 4 0 0 4
5 0 0
0 3 2 0
23 10
6 1 0
35 12 10 1 0
0
I
0 0 0
0 0 0 0 4 4 7 0 14
0 2 0 7 0 10 0
0 2 0 17 9 7
5 0
2 0 20 11
7
TABLE 3 NUMBER OF WITH THE
I N D I V I D U A L S RESPONDING TO ITEM 3 DESIGNATED CONIENTCATEGORIES
Content Category Relaxation Carefree, at peace, calm, loss of fear, well-being Concentration, focused attention Floating Spinning sensation Numbness Heaviness Breathing changes Awareness of heart beat Feeling of warmth Individualized physiological or sensory phenomena Reduced sensory perception Increased sensory perception Inability to move Increased body control Dissociation, transcendental experience Increased anxiety Time distortion Automation Therapy aid, pain reduction Other No response
Male (28) Female (71)Total (99) 12
40
52
0 2 3
14
14
4 12 4
6 15 7 20 12 8 4 4
3 4 3 0 0 0 8 9 1 3 0 3 0 1
3 I 4 1
16 9
8 4 4 6
5 4 6 0
14 14
5 9 0
0
3
0 0 0 0
0
6 6
I 3 1 10
7
Downloaded by [Australian National University] at 14:43 26 January 2015
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EDMONSTON
its utilitarian value - but does not assist us panied by physiological changes associated in understanding its basic nature or basic with the response: decreased O2 consumption (Dudley et a l , , 1963; Whitthorn, Lundmechanisms. holm, Fox & Benedict, 1932), respiratory DISCUSSION rate (Barber, 1970), and heart rate (Barber, 1970; increased EEG intensity of slow It is quite clear that hypnosis, in the per- alpha waves and theta waves, and skin receptions of patients, involves primarily re- sistance (Davis & Kantor, 1935; Estalaxation and its attendant feelings and sen- brooks, 1930); and no change in blood sations. From the subjective standpoint of pressure (Crasilneck & Hall, 1959) and recpatients being treated in the context of hyp- tal temperature. Our own data showed a decrease in heart nosis, the primary component in hypnosis is relaxation. One of the most obvious rea- rate in both hypnosis and relaxation (Edsons for patients to note this equation is, as monston, 1972b) and an increase in skin indicated above and elsewhere (Ed- resistance (Edmonston & Pessin, 1966; monston, 1972a), that induction techniques Stern, Edmonston, Ulett & Levitsky, involve both verbal and physical sugges- 1963). In the former studies, however, the tions of relaxation. The stimuli presented to skin resistance changes in the hypnotized patients are suggestions of relaxation and, group did not differ from that of the control not too surprisingly, patients respond with group (Edmonston, 1968a). However, in relaxation responses and appropriate per- both of the latter cases (Edmonston & Pessin, 1966; Stern et a l . , 1963) the compariceptions of the process as relaxation. Prior to 1969 experimental data of spon- son groups were uninstructed in a comforttaneous fluctuations during electrodennal able position for a time period equal to that response studies placed hypnosis on a con- of the hypnotic induction, sufficient time to tinuum with relaxation and sleep (Ed- become relaxed, although they were not monston, 1972a, b), as Pavlov had pro- specifically instructed to do so. (These posed years ago (see Edmonston, 1967). studies were conducted before the consistThe few studies between 1969 and 1972 ent use of a relaxation group as a compariwhich compared hypnosis with relaxation son group was begun in our laboratories.) provided further physiological evidence for London and McDevitt (1970) also reported a hypnosis, relaxation equation (Paul, 1969; small basal skin resistance differences beMcAmmond, Davidson & Kovitz, 1971; tween high and low susceptible subjects. With respect to EEG changes and hypStarr & Tobin, 1970; Ham & Edmonston, 1971). A summary of these studies and a nosis, most of the work has compared the call for a greater use of relaxation control alpha densities with susceptibility, rather groups in experimentation appeared in 1972 than hypnosis with no hypnosis (e.g., Galbraith, London, Leibovitz. Cooper & Hart, (Edmonston, 1972a). More recently, Benson, Beary and Carol 1970; London, Hart & Leibovitz, 1968; (1974, see also Benson, 1975) have com- Morgan, McDonald & Hilgard, 1974; pared some of the physiological parameters Nowlis & Rhead, 1968). Edmonston and of the “relaxation response” with hypnosis Grotevant (1975) did find a considerable and other “mental techniques” (e .g ., tran- rise in percentage of alpha upon induction scendental meditation, autogenic training, in one experiment and no significant difZen, yoga), and found that most of these ference between a hypnotic and a relaxation techniques, including hypnosis, are accom- group in alpha production. Both of these
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NEUTRAL HYPNOSIS AS RELAXATION
data fit well with the relaxation response EEG data, as do the data on slow eye movements (Dunwoody & Edmonston, 1974). Regarding body temperature, London and McDevitt (1968) found lower back and foot temperatures and higher hand temperatures in “tranceables” as opposed to “non-tranceables.” Reid and Curtsinger (1968), Timney and Barber (1969) and Jackson, Barkley and Pashko (1976) have all reported an unsuggested rise in oral temperature and/or skin temperature (Reid & Curtsinger, 1968) upon induction of hypnosis. Fear, excitement or anxiety, which cause an elevation in body temperature, may have confounded the results of the first two of these studies, while the activity of the hypnotic subjects may have done the same for the latter (Jackson ef a l . , 1976). Timney and Barber (1969) observed that oral temperature tended to rise to a greater degree in subjects who had not previously participated in hypnosis. Oral temperature tended to rise less when subjects participated in an additional hypnotic session. Also, when subjects were asked to take part in a second “hypnotic experiment,” they appeared less apprehensive than during the first. The Jackson et al. (1976) “neutral hypnotic condition” subjects followed a hypnotic induction which included feelings of warmth in the hand, and hand and finger movements. Movement was not required of their control groups and thus confounds the interpretation of their data. On the other hand, Doupe, Miller and Keller (1939), who tested the same subjects in a series of experiments, with the identical hypnotic induction procedure, reported no change in rectal and skin temperature with hypnosis. The same finding with respect to oral temperature was reported by Cogger and Edmonston (1971), who used a
73
relaxation control group. The only other study also directly comparing hypnosis with relaxation (Peters & Stern, 1973) produced similar results. Neither peripheral skin temperatures nor vasomotor responses distinguished between the two conditions, and the authors concluded that the changes in both measures “. . . cannot be attributed to anything other than relaxation [Peters & Stern, 1973, p. 1061.” The physiology of subjects in hypnosis tends to yield the same sort of changes as that of subjects in a relaxation condition. These changes (or lack thereof) closely parallel those seen in the relaxation response described by Benson, Beary and Carol ( 1974). “It has been evident for two centuries that relaxation is an inseparable part of what is traditionally known as hypnotic procedures, and the response to these procedures has traditionally been one of relaxation [Edmonston, 1972a, pp. 227-2281.’’ The subjective data from patients of practicing clinicians confirms this state of affairs. The comparison of the physiology of Benson’s “relaxation response” and hypnosis indicates that the subjective reading of patients of their state is not a misinterpretation. Their physiology tells them that hypnosis is, above all else, a condition of relaxation different both from waking and sleep. Thus, it is not only the content of induction procedures that lends credence to the equation, neutral hypnosis = relaxation, but the response to these procedures, whether subjectively or objectively measured. That neutral hypnosis and relaxation are equated is not an artifact of history, but a statement of a persistent finding in the data. The equation cannot be ignored, but must be a prime consideration in the interpretation of data and attempts to assign hypnosis a unique role in human experience. 30 Maple Avenue Hamilton, New York 13346
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REFERENCES BARBER,T. X . Physiological effects of Hypnosis and suggestion. In LSD, Marijuana, Yoga and Hypnosis. Chicago: Aldine, 1970, Pp. 135-203. BENSON,H. The relu.xation response. New York: William Morrow & Co., 1975. BENSON,H.. BEARY, J. F. & CAROL,M. P. The relaxation response. Psychiutr,v, 1974,37, 3 7 4 6 . B E R N H E I MH, . Hypnosis and suggestions in psychotherapy, (Suggestive therapeutics). New York: NYU Books, 1964 (1888). COGGER, W. G. Jr. & EDMONSTON, W. E., Jr. Hypnosis and oral temperatur A re-evaluation of experimental techniques. B I sh Journul of Clinicul Hypnosis. 1971, 2, 76-80. CRASILNECK, H. B. & HALL,J. A. Physiological changes associated with hypnosis: A review of the literature since 1948. Internutionul Jourri~ilof Clinical and Experimental Hypnosis, 1959, 7, 9-50. DAVIS,R. C. & KANTOR, J . R. Skin resistance during hypnotic states. Journal of Generul Psychology, 1935, 13, 62-81. DOUPE,J., MILLER, W. R. & KELLER.W. K . Vasomotor reactions in the hypnotic state. Journal cf Neurology, Neurosurgery and Psychiatry, 1939, 2, 97-106. DUDLEY, D. L. et a / . Changes in respiration associated with hypnotically induced emotion, pain, and exercise. Psychosomatic Medicine, 1963, 26, 46-57. DUNWOODY, R. C . & EDMONSTON, W. E. JR. Hypnosis and slow eye movements. American Journal of Clinicul Hypriosis, 1974, 16, 270-274. EDMONSTON, W. E., J R . Stimulus-response theory of hypnosis. In Gordon, J. E. (Ed.) Handbook of clinical and experimental hypnosis, New York: MacMillan, 1967, Pp. 345-387. EDMONSTON, W. E., JR. Hypnosis and electrodermal responses. American Journal of Clinical Hypnosis, 1968, 1 1 , 16-25. EDMONSTON, W. E., JR. Clinical and experimental trance: Unity through methodology. American Journal of Clinical Hypnosis, 1970, 13, 5-16. EDMONSTON, W. E., JR. Relaxation as an appropriate experimental control in hypnosis studies. American Journal of Clinical HJpnosis, 1972, 14, 281229. (a) W . E., JR. The effects of neutral hypEDMONSTON, nosis on conditioned responses. In Fromm, E. and Shor, R. E. (Eds.) Hypnosis: Research Development and Perspectives. New York: Aldine, 1972, Pp. 323-356. (b) EDMONSTON, W. E., JR. & GROTEVANT, W. R. Hypnosis and alpha density. American Journal of Clinical H.vpnosis, 1975, 17, 221-232.
EDMONSTON, W. E., JR. & PESSIN, M. Hypnosis as related to learning and electrodermal measures. Americcin Journul of Clinical Hypnosis, 1966, 9, 31-51. ESTABROOKS, G. H. The psychogalvanic reflex in hypnosis. Journul of Generul Psychology, 1930, 3, 150-157. G A L B R A I TG H .,, LONDON,P., LEIBOVITZ, M., L. M., & HART,J . T. EEG and hypnotic COOPER, susceptibility. Journal of Comparcitive and Physiological Psychology, 1970, 72, 125-131. HAM,M. W. & EDMONSTON, W. E., JR. Hypnosis, relaxation and motor retardation. Journnl of Abnormul Psychology, 1971, 77, 329-33 1. HULL,C . L. Hypnosis and suggestibility, an experimental approach. New York: Appleton-CenturyCrofts, 1933. JACKSON, T. L., J R . ,BARKLEY, R. A. & PASHKO, S. M. The effects of hypnotic induction versus high motivation on oral temperature. International Journal of Clinicul und Experimental Hypnosis, 1976, 24, 22-28. KERLINGER, F. N. Foundations of behavioral research. New York: Holt, Rinehart and Winston, 1964, Pp. 539-553. LONDON,P., HART,J. T. & LEIBOVITZ, M. P. EEG alpha rhythms and susceptibility to hypnosis. N a ture, 1968, 219, 71-72. LONDON, P. & MCDEVITT, R. A. Effects of hypnotic susceptibility and training on responses to stress. Journal of Abnormal Psvchology, 1970, 76, 336348. MCAMMOND, D. M., DAVIDSON, P. 0. & KOVITZ, D. M. A comparison of the effects of hypnosis and relaxation training on stress reactions in a dental situation. American Journal of Clinical Hypnosis, 1971, 13, 233-242. MORGAN, A. M., MACDONALD, H. & HILGARD, E. R. EEG alpha: Lateral asymmetry related to task and hypnotizability. Psychophysiology, 1974, 11, 275-282. NOWLIS,D. P. & RHEAD,J. C . Relation of eyesclosed resting EEG alpha activity to hypnotic susceptibility. Perceptual and Motor Skills, 1968,27, 1047-1050. PAUL,G. L. Physiological effects of relaxation training and hypnotic suggestion. Journal of Abnormal Psvchology, 1969, 74, 425437. PETERS,J . E. & STERN,R. M . Peripheral skin temperature and vasomotor responses during hypnotic induction. International Journal of Clinical and Experimental Hypnosis, 1973, 21, 102-108. R E I D , A . F . & CURTSINGER, G. Physiological changes associated with hypnosis: The effect of hypnosis on temperature. International Journal of Clinical and Experimental Hypnosis, 1968, 16, 11 1-1 19.
NEUTRAL HYPNOSIS AS RELAXATION
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STARR,F. H. & TOBIN,J . P. The effects of expectancy and hypnotic induction procedure on suggestibility. Atner-ictrn Jourriril of Clitiicrrl Hypnosis, 1970, 12, 261-267. STERN,J . A , , EDMONSTON, W. E., JR., ULETT,G. A. & LEVITSKY, A. Electrodermal measures in experimental amnesia. J o u n i d ofAbtzonnti1 trnd Sociril Psychology, 1963, 67, 397401.
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TIMNEY, B. N. & BARBER, T. X . Hypnotic induction and oral temperature. Interricrtiontil Jounicil of Clinictil trnd E.xperitnentti1 Hypnosis, 1969, 17, 121-132. WHITEHORN, J . C., LUNDHOLM, H., Fox, E. L. & BENEDICT, F. G . Metabolic rate in “hypnotic sleep.” New Englrrtid Jouninl of Medicine, 1932, 206, 777-78 I .
American Journal of Clinical Hypnosis Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/ujhy20
Neutral Hypnosis as Relaxation William E. Edmonston Jr. Ph.D.
a
a
Colgate University , USA Published online: 20 Sep 2011.
To cite this article: William E. Edmonston Jr. Ph.D. (1977) Neutral Hypnosis as Relaxation, American Journal of Clinical Hypnosis, 20:1, 69-75, DOI: 10.1080/00029157.1977.10403902 To link to this article: http://dx.doi.org/10.1080/00029157.1977.10403902
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/ page/terms-and-conditions
WE AMERICAN JOURNAL OF CLINICAL HYPNOSIS Volume 20, Number 1 , July 1977 Printed in U S A .
Neutral Hypnosis As Relaxation
Downloaded by [Australian National University] at 14:43 26 January 2015
WILLIAM E. EDMONSTON, Jr., Ph.D. Colgate University The thesis is advanced that neutral hypnosis is relaxation. Data from a survey of 99 patients indicate that relaxation is the primary descriptive term used to account for the subjective parameters of hypnosis. Data from recent physiological studies are reviewed in relation to Benson’s “relaxation response.” Both sets of data support the notation: Neutral hypnosis = relaxation.
Neutral hypnosis is relaxation. Throughout the history of modern hypnosis, the one central, compelling force in the induction of hypnosis has been the theme of sleep and relaxation. DePuysegur noted it; Bernheim (1888) observed it; and Hull commented upon it: “. . . subjects in deep hypnosis normally present a picture of rather complete relaxation [Hull, 1933, p. 3101.” Modem investigators and practitioners rely, almost exclusively, on induction procedures involving the concept of relaxation; not of sleep, but of relaxation. “The use of relaxation inductions in the past and present is not fortuitous, but is based on the recognized clinical similarities between hypnosis and relaxation, and the interpretation of hypnosis as a state of enhanced relaxation [Edmonston, 1972a, p. 2281.” Clinical hypnosis has long recognized the similarities between hypnosis and relaxation, but few practitioners have sought to clarify the relationship, choosing, rather, to attend to the therapeutic potentials of hypnosis. Experimental investigators, on the other hand, seldom have contact with patients who seek hypnotic experiences for therapy rather than course credit. Rather than develop a mobile laboratory (see Edmonston, 1970) to bring roving experimental investigators together with thera-
peutically oriented patients, the following survey was undertaken to bring at least one investigator together with therapeutically generated subjective data regarding the fundamental nature of hypnosis.
METHOD Four item, open-ended questionnaires were sent to 191 Fellows of the American Society of Clinical Hypnosis and the Society for Clinical and Experimental Hypnosis, with a request that they have their “three best hypnotic patients” respond to the questions and return the completed questionnaires directly to this investigator in the return envelopes provided. Each questionnaire was numbered for record keeping purposes, but only the practitioners who distributed the forms to their patients knew the identity of the individual patients. The items on the form were: (a) 1. In your own words, describe what being in a hypnotic state (trance) is like for you. Please be as detailed as possible; (b) 2. What, for you as a hypnotized individual, is unique about hypnosis?; (c) 3. How do you determine when you are hypnotized? For example, is there some feeling, some sensation, some change you perceive? Please describe in detail; and, (d) 4. Please describe anything
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EDMONSTON
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else about hypnosis which seems important to you. In all, 573 surveys were distributed. Three months following the initial mailing, a follow-up letter was sent to those practitioners from whose patients no survey had been received. Three months later a second follow-up letter was sent according to the same criterion - no response from the patients.
RESULTS Seventeen percent (99) of the questionnaires were returned. A classical content analysis (see Kerlinger, 1964) of all of the responses to each item was made independently by three experimenters l . Only the data from the first three items will be reported here, because the additional comments on Item Four centered primarily on specific therapeutic benefits rather than Doreen M . Hess, Jonathan D. Saperia and the author.
general statements regarding the nature of hypnosis p e r se . Inter-judge reliabilities ranged from .93 to .99. Tables 1, 2 and 3 present the tabulations for these items. Each figure represents the number of individuals whose responses fit the category noted. For example, 84 individuals (85%) mentioned relaxation in response to the first item, and virtually everyone in the sample mentioned either relaxation or carefree, at peace, calm, loss of fear and well-being. Across all three items the preponderance of individuals offered responses categorized by terms of relaxation, calm and peacefulness. The increased number of responses in other categories (e.g., increased body control in Item Two; and numbness, floating and changes in physiology or perception in Item Three) appear due more to the nature of those items than of hypnosis. The increase in the therapy aid category of Item Two tells us what is important to patients regarding hypnosis -
TABLE 1 NUMBER OF WITH T H E
RESPONDING TO ITEM 1 DESIGNATED CONTENT CATEGORIES
INDIVIDUALS
Content Category Relaxation Carefree, at peace, calm, loss of fear, well-being Concentration, focused attention Floating Spinning sensation Numbness Heaviness Breathing changes Awareness of heart beat Feeling of warmth Individualized physiological or sensory phenomena Reduced sensory perception Increased sensory perception Inability to move Increased body control Dissociation, transcendental experience Increased anxiety Time distortion Automation Therapy aid, pain reduction Other No response
Male (28) Female (71) Total (99) 20 19 10
5 I 3 I I 0 0 4 3
0 0 2 5 0 3 0 0
5 0
64 45 22 10 0 6 I 0
84 64 32 15 I 9 2
1
1 1
5 4 5 0 I 0 9 4 3 0 0 3 2
5 8 8 0 I 2 14 4 6 0 0 8 2
NEUTRAL HYPNOSIS AS RELAXATION
71 TABLE 2
NUMBER OF WITH THE
INDIVIDUALS RESPONDING TO ITEM 2 DESIGNATED CONTENT CATEGORIES
Downloaded by [Australian National University] at 14:43 26 January 2015
Content Category
Male (28) Female (71) Total (99)
Relaxation Carefree, at peace, calm, loss of fear, well-being Concentration, focused attention Floating Spining sensation Numbness Heaviness Breathing changes Awareness of heart beat Feeling of warmth Individualized physiological or sensory phenomena Reduced sensory perception Increased sensory perception Inability to move Increased body control Dissociation, transcendental experience Increased anxiety Time distortion Automation Therapy aid, pain reduction Other No response
12 2 4 0 0 1 0 0 0 0 2 4 0 0 4
5 0 0
0 3 2 0
23 10
6 1 0
35 12 10 1 0
0
I
0 0 0
0 0 0 0 4 4 7 0 14
0 2 0 7 0 10 0
0 2 0 17 9 7
5 0
2 0 20 11
7
TABLE 3 NUMBER OF WITH THE
I N D I V I D U A L S RESPONDING TO ITEM 3 DESIGNATED CONIENTCATEGORIES
Content Category Relaxation Carefree, at peace, calm, loss of fear, well-being Concentration, focused attention Floating Spinning sensation Numbness Heaviness Breathing changes Awareness of heart beat Feeling of warmth Individualized physiological or sensory phenomena Reduced sensory perception Increased sensory perception Inability to move Increased body control Dissociation, transcendental experience Increased anxiety Time distortion Automation Therapy aid, pain reduction Other No response
Male (28) Female (71)Total (99) 12
40
52
0 2 3
14
14
4 12 4
6 15 7 20 12 8 4 4
3 4 3 0 0 0 8 9 1 3 0 3 0 1
3 I 4 1
16 9
8 4 4 6
5 4 6 0
14 14
5 9 0
0
3
0 0 0 0
0
6 6
I 3 1 10
7
Downloaded by [Australian National University] at 14:43 26 January 2015
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EDMONSTON
its utilitarian value - but does not assist us panied by physiological changes associated in understanding its basic nature or basic with the response: decreased O2 consumption (Dudley et a l , , 1963; Whitthorn, Lundmechanisms. holm, Fox & Benedict, 1932), respiratory DISCUSSION rate (Barber, 1970), and heart rate (Barber, 1970; increased EEG intensity of slow It is quite clear that hypnosis, in the per- alpha waves and theta waves, and skin receptions of patients, involves primarily re- sistance (Davis & Kantor, 1935; Estalaxation and its attendant feelings and sen- brooks, 1930); and no change in blood sations. From the subjective standpoint of pressure (Crasilneck & Hall, 1959) and recpatients being treated in the context of hyp- tal temperature. Our own data showed a decrease in heart nosis, the primary component in hypnosis is relaxation. One of the most obvious rea- rate in both hypnosis and relaxation (Edsons for patients to note this equation is, as monston, 1972b) and an increase in skin indicated above and elsewhere (Ed- resistance (Edmonston & Pessin, 1966; monston, 1972a), that induction techniques Stern, Edmonston, Ulett & Levitsky, involve both verbal and physical sugges- 1963). In the former studies, however, the tions of relaxation. The stimuli presented to skin resistance changes in the hypnotized patients are suggestions of relaxation and, group did not differ from that of the control not too surprisingly, patients respond with group (Edmonston, 1968a). However, in relaxation responses and appropriate per- both of the latter cases (Edmonston & Pessin, 1966; Stern et a l . , 1963) the compariceptions of the process as relaxation. Prior to 1969 experimental data of spon- son groups were uninstructed in a comforttaneous fluctuations during electrodennal able position for a time period equal to that response studies placed hypnosis on a con- of the hypnotic induction, sufficient time to tinuum with relaxation and sleep (Ed- become relaxed, although they were not monston, 1972a, b), as Pavlov had pro- specifically instructed to do so. (These posed years ago (see Edmonston, 1967). studies were conducted before the consistThe few studies between 1969 and 1972 ent use of a relaxation group as a compariwhich compared hypnosis with relaxation son group was begun in our laboratories.) provided further physiological evidence for London and McDevitt (1970) also reported a hypnosis, relaxation equation (Paul, 1969; small basal skin resistance differences beMcAmmond, Davidson & Kovitz, 1971; tween high and low susceptible subjects. With respect to EEG changes and hypStarr & Tobin, 1970; Ham & Edmonston, 1971). A summary of these studies and a nosis, most of the work has compared the call for a greater use of relaxation control alpha densities with susceptibility, rather groups in experimentation appeared in 1972 than hypnosis with no hypnosis (e.g., Galbraith, London, Leibovitz. Cooper & Hart, (Edmonston, 1972a). More recently, Benson, Beary and Carol 1970; London, Hart & Leibovitz, 1968; (1974, see also Benson, 1975) have com- Morgan, McDonald & Hilgard, 1974; pared some of the physiological parameters Nowlis & Rhead, 1968). Edmonston and of the “relaxation response” with hypnosis Grotevant (1975) did find a considerable and other “mental techniques” (e .g ., tran- rise in percentage of alpha upon induction scendental meditation, autogenic training, in one experiment and no significant difZen, yoga), and found that most of these ference between a hypnotic and a relaxation techniques, including hypnosis, are accom- group in alpha production. Both of these
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NEUTRAL HYPNOSIS AS RELAXATION
data fit well with the relaxation response EEG data, as do the data on slow eye movements (Dunwoody & Edmonston, 1974). Regarding body temperature, London and McDevitt (1968) found lower back and foot temperatures and higher hand temperatures in “tranceables” as opposed to “non-tranceables.” Reid and Curtsinger (1968), Timney and Barber (1969) and Jackson, Barkley and Pashko (1976) have all reported an unsuggested rise in oral temperature and/or skin temperature (Reid & Curtsinger, 1968) upon induction of hypnosis. Fear, excitement or anxiety, which cause an elevation in body temperature, may have confounded the results of the first two of these studies, while the activity of the hypnotic subjects may have done the same for the latter (Jackson ef a l . , 1976). Timney and Barber (1969) observed that oral temperature tended to rise to a greater degree in subjects who had not previously participated in hypnosis. Oral temperature tended to rise less when subjects participated in an additional hypnotic session. Also, when subjects were asked to take part in a second “hypnotic experiment,” they appeared less apprehensive than during the first. The Jackson et al. (1976) “neutral hypnotic condition” subjects followed a hypnotic induction which included feelings of warmth in the hand, and hand and finger movements. Movement was not required of their control groups and thus confounds the interpretation of their data. On the other hand, Doupe, Miller and Keller (1939), who tested the same subjects in a series of experiments, with the identical hypnotic induction procedure, reported no change in rectal and skin temperature with hypnosis. The same finding with respect to oral temperature was reported by Cogger and Edmonston (1971), who used a
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relaxation control group. The only other study also directly comparing hypnosis with relaxation (Peters & Stern, 1973) produced similar results. Neither peripheral skin temperatures nor vasomotor responses distinguished between the two conditions, and the authors concluded that the changes in both measures “. . . cannot be attributed to anything other than relaxation [Peters & Stern, 1973, p. 1061.” The physiology of subjects in hypnosis tends to yield the same sort of changes as that of subjects in a relaxation condition. These changes (or lack thereof) closely parallel those seen in the relaxation response described by Benson, Beary and Carol ( 1974). “It has been evident for two centuries that relaxation is an inseparable part of what is traditionally known as hypnotic procedures, and the response to these procedures has traditionally been one of relaxation [Edmonston, 1972a, pp. 227-2281.’’ The subjective data from patients of practicing clinicians confirms this state of affairs. The comparison of the physiology of Benson’s “relaxation response” and hypnosis indicates that the subjective reading of patients of their state is not a misinterpretation. Their physiology tells them that hypnosis is, above all else, a condition of relaxation different both from waking and sleep. Thus, it is not only the content of induction procedures that lends credence to the equation, neutral hypnosis = relaxation, but the response to these procedures, whether subjectively or objectively measured. That neutral hypnosis and relaxation are equated is not an artifact of history, but a statement of a persistent finding in the data. The equation cannot be ignored, but must be a prime consideration in the interpretation of data and attempts to assign hypnosis a unique role in human experience. 30 Maple Avenue Hamilton, New York 13346
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REFERENCES BARBER,T. X . Physiological effects of Hypnosis and suggestion. In LSD, Marijuana, Yoga and Hypnosis. Chicago: Aldine, 1970, Pp. 135-203. BENSON,H. The relu.xation response. New York: William Morrow & Co., 1975. BENSON,H.. BEARY, J. F. & CAROL,M. P. The relaxation response. Psychiutr,v, 1974,37, 3 7 4 6 . B E R N H E I MH, . Hypnosis and suggestions in psychotherapy, (Suggestive therapeutics). New York: NYU Books, 1964 (1888). COGGER, W. G. Jr. & EDMONSTON, W. E., Jr. Hypnosis and oral temperatur A re-evaluation of experimental techniques. B I sh Journul of Clinicul Hypnosis. 1971, 2, 76-80. CRASILNECK, H. B. & HALL,J. A. Physiological changes associated with hypnosis: A review of the literature since 1948. Internutionul Jourri~ilof Clinical and Experimental Hypnosis, 1959, 7, 9-50. DAVIS,R. C. & KANTOR, J . R. Skin resistance during hypnotic states. Journal of Generul Psychology, 1935, 13, 62-81. DOUPE,J., MILLER, W. R. & KELLER.W. K . Vasomotor reactions in the hypnotic state. Journal cf Neurology, Neurosurgery and Psychiatry, 1939, 2, 97-106. DUDLEY, D. L. et a / . Changes in respiration associated with hypnotically induced emotion, pain, and exercise. Psychosomatic Medicine, 1963, 26, 46-57. DUNWOODY, R. C . & EDMONSTON, W. E. JR. Hypnosis and slow eye movements. American Journal of Clinicul Hypriosis, 1974, 16, 270-274. EDMONSTON, W. E., J R . Stimulus-response theory of hypnosis. In Gordon, J. E. (Ed.) Handbook of clinical and experimental hypnosis, New York: MacMillan, 1967, Pp. 345-387. EDMONSTON, W. E., JR. Hypnosis and electrodermal responses. American Journal of Clinical Hypnosis, 1968, 1 1 , 16-25. EDMONSTON, W. E., JR. Clinical and experimental trance: Unity through methodology. American Journal of Clinical Hypnosis, 1970, 13, 5-16. EDMONSTON, W. E., JR. Relaxation as an appropriate experimental control in hypnosis studies. American Journal of Clinical HJpnosis, 1972, 14, 281229. (a) W . E., JR. The effects of neutral hypEDMONSTON, nosis on conditioned responses. In Fromm, E. and Shor, R. E. (Eds.) Hypnosis: Research Development and Perspectives. New York: Aldine, 1972, Pp. 323-356. (b) EDMONSTON, W. E., JR. & GROTEVANT, W. R. Hypnosis and alpha density. American Journal of Clinical H.vpnosis, 1975, 17, 221-232.
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TIMNEY, B. N. & BARBER, T. X . Hypnotic induction and oral temperature. Interricrtiontil Jounicil of Clinictil trnd E.xperitnentti1 Hypnosis, 1969, 17, 121-132. WHITEHORN, J . C., LUNDHOLM, H., Fox, E. L. & BENEDICT, F. G . Metabolic rate in “hypnotic sleep.” New Englrrtid Jouninl of Medicine, 1932, 206, 777-78 I .
