HYPNOSIS

a special psychological state with certain physiological attributes, resembling sleep only superficially and marked by a functioning of the individual at a level of awareness other than the ordinary conscious state. This state is characterized by a degree of increased receptiveness and responsiveness in which inner experiential perceptions are given as much significance as is generally given only to external reality. The hypnotized individual appears to heed only the communications of the hypnotist. He seems to respond in an uncritical, automatic fashion, ignoring all aspects of the environment other than those pointed out to him by the hypnotist. He sees, feels, smells, and otherwise perceives in accordance with the hypnotist's suggestions, even though these suggestions may be in apparent contradiction to the stimuli that impinge upon him. Even the subject's memory and awareness of self may be altered by suggestion, and the effects of the suggestions may be extended (posthypnotically) into the subject's subsequent waking activity. The history of hypnosis is as ancient as that of sorcery, magic, and medicine, to whose methods it belonged. Its scientific history began in the latter part of the 18th century with Franz Mesmer (q.v.), a Viennese physician who used it in the treatment of patients. Because of his mistaken belief that it was an occult force, which he termed animal magnetism, that flowed through the hypnotist into the subject, he was soon discredited; but hypnotismor mesmerism, as it was named after himcontinued to interest medical practitioners. A number of clinicians made use of it without adequate recognition of its nature until the middle of the 19th century, when the English physician James Braid (q.v.) studied its phenomena and coined the terms hypnotism and hypnosis. Hypnosis attracted widespread scientific interest in the 1880s. Ambroise-Auguste Libeault, an obscure French country physician who used mesmeric techniques, drew the support of Hippolyte Bernheim, professor of medicine at Strasbourg. Independently they wrote that hypnosis involved no physical forces and no physiological processes but was a combination of psychologically mediated responses to suggestions. At about the same time, the Austrian physician Sigmund Freud visited France and was impressed by the therapeutic potential of hypnosis for neurotic disorders. On his return to Vienna he used hypnosis to help neurotics recall disturbing events that they had apparently forgotten. As he began to develop his system of psychoanalysis, theoretical considerations, as well as the difficulty he encountered in hypnotizing some patients, led Freud to discard hypnosis in favour of free association. (Generally psychoanalysts have now come to view hypnosis as merely an adjunct to the free-associative techniques used in psychoanalytic practice.) Despite Freud's influential adoption and then rejection of hypnosis, some use was made of the technique in the psychoanalytic treatment of soldiers with combat neuroses during World Wars I and II. Hypnosis subsequently acquired various other limited uses in medicine. Various researchers have put forth differing theories of what hypnosis is and how it could be understood, but there is currently still no generally accepted explanatory theory for the phenomenon. The techniques used to induce hypnosis share common features. The most important consideration is that the person to be hypnotized (the subject) be willing and cooperative and that he trust in the hypnotist. The subject is invited to relax in comfort and to fix his gaze on some object. The hypnotist continues to suggest, usually in a low, quiet voice, that the subject's relaxation will increase and that his eyes will grow tired. Soon the subject's eyes do show signs of fatigue, and the hypnotist suggests that they will close. The subject allows his eyes to close and then begins to show signs of profound relaxation, such as limpness and deep breathing. He has entered the state of hypnotic trance. A person's responsiveness to being hypnotized is greatest when he believes that he can be hypnotized, that the hypnotist is competent and trustworthy, and that the undertaking is safe, appropriate, and congruent with his wishes. Therefore induction is generally preceded by the establishment of suitable rapport between subject and hypnotist. Ordinary inductions of hypnosis begin with simple suggestions made by the hypnotist that will almost inevitably be accepted by all subjects. At this stage neither subject nor hypnotist can readily tell whether the subject's behaviour constitutes a hypnotic response or mere cooperation. Then, gradually, suggestions are given that demand increasing distortion of perception or memory (e.g., that it is difficult or impossible for the subject to open his eyes). Other methods of induction may be used. The process may take considerable time or only a few seconds. The resulting hypnotic phenomena differ from one subject to another and from one trance to another, depending upon the purposes to be served and the depth of the trance. Hypnosis is a phenomenon of degrees, ranging from light to profound trance states but with no fixed constancy. Ordinarily, however, all trance behaviour is characterized by a simplicity, a directness, and a literalness of understanding, action, and emotional response that are suggestive of childhood. The surprising abilities displayed by some hypnotized persons seems to derive partly from the restriction of their attention to the task or situation at hand and their consequent freedom from the ordinary conscious tendency to orient constantly to distracting, even irrelevant, events. Suggestibility, a state of greatly enhanced receptiveness and responsiveness to suggestions and stimuli presented by the hypnotist, constitutes the central phenomenon of hypnosis. Appropriate suggestions by the hypnotist can induce a remarkably wide range of psychological, sensory, and motor responses from persons who are deeply hypnotized. By acceptance of and response to suggestions, the subject can become deaf, blind, paralyzed, hallucinated, delusional, amnesic, or impervious to pain or to uncomfortable body postures, or he can display various behavioral responses that he regards as reasonable or desirable in the given situation that has been suggested to him by the hypnotist. One fascinating manifestation that can be elicited from a subject who has been in a hypnotic trance is that of posthypnotic suggestion and behaviour. By this is meant the subject's execution, at some later time, of instructions and suggestions that were given to him while he was in a trance. With adequate amnesia induced during the trance state, the individual will not be aware of the source of his impulse to perform the instructed act. Posthypnotic suggestion, however, is not a particularly powerful means for controlling behaviour when compared to a person's conscious willingness to perform actions. Many subjects seem unable to recall what happened while they were in deep hypnosis. This posthypnotic amnesia, as it is called, can either result spontaneously from deep hypnosis or it can result from suggestion by the hypnotist during the trance state. The amnesia may include all the events of the trance state or only selected items, or it may be manifested in connection with matters unrelated to the trance. Posthypnotic amnesia may be successfully removed by appropriate hypnotic suggestions. Conversely, hypermnesia, a memory capacity that transcends the everyday ability, is another aspect of hypnotic behaviour. For example, in the trance state, the subject, by virtue of an uncritical willingness to make the effort and a freedom from inhibitions deriving from preformed judgments, can vividly remember long-forgotten, even deeply repressed experiences, recount them in extensive detail and still maintain an amnesia for them at the ordinary level of consciousness. This remarkable ability permits the recovery of memories that are otherwise unavailable to conscious awareness, and it was thus of great usefulness to Freud as he embarked on his explorations of his patients' unconsciously held memories. Hypnosis has been officially endorsed as a therapeutic method by medical, psychiatric, dental, and psychological associations throughout the world. It has been found most useful in preparing people for anesthesia, enhancing the drug response, and reducing the required dosage. In childbirth it is particularly helpful, because it is effective in alleviating the mother's discomfort while avoiding drug-induced impairment of the child's physiological function. Hypnosis is highly regarded in the management of otherwise intractable pain, including that of terminal cancer. It is valuable in reducing the widespread fear of dental procedures; the very people whom dentists find most difficult to treat frequently respond best to hypnotic suggestion. In the area of psychosomatic medicine, hypnosis has been used in a variety of ways. Patients have been trained to relax and to carry out, in the absence of the hypnotist, exercises that have had salutary effects on some forms of high blood pressure, headaches, and functional disorders. In psychotherapy, hypnosis has been used in a variety of ways. For example, the technique of revivifying traumatic events in order to produce an emotional catharsis continues to be a useful treatment in relieving neuroses with traumatic onset, such as those that develop in combat, among individuals with relatively stable prior adjustments. Though the induction of hypnosis requires little training and no particular skill, when used in the context of medical treatment, it should never be employed by individuals who do not have the competence and skill to treat such problems without the use of hypnosis. Hypnosis has been repeatedly condemned by various medical associations when it is used purely for purposes of public entertainment, owing to the danger of persons suffering adverse posthypnotic reactions to the procedure. Indeed, in this regard, several nations have banned or limited commercial or other public displays of hypnosis on such grounds. Martin T. Orne A. Gordon Hammer The Editors of the Encyclopdia Britannica