Hypnotizability in the Clinic, Viewed from the Laboratory.

A recent international survey discovered that clinicians who use hypnosis in their practice rarely assess the hypnotizability of their patients or clients. This contrasts sharply with the practice in laboratory research. One reason offered for this discrepancy is that hypnotizability does not strongly predict clinical outcome. But a comparison of this relationship with similar correlations in other domains shows that this criticism is misleading-especially when the treatment capitalizes on the alterations in perception, memory, and voluntary control that characterize the domain of hypnosis. Routine assessment of hypnotizability improves clinical practice by enabling clinicians to select patients for whom hypnosis is appropriate; and it improves clinical research by providing important information about the mechanisms underlying hypnotic effects.

Une enquête internationale récente a découvert que les cliniciens qui utilisent l'hypnose dans leur pratique évaluent rarement l'hypnotisabilité de leurs patients ou clients. Cela contraste fortement avec la pratique de la recherche en laboratoire. L'une des raisons avancées pour cette divergence est que l'hypnotisabilité ne prédit pas fortement le résultat clinique. Mais une comparaison de cette relation avec des corrélations similaires dans d'autres domaines montre que cette critique est trompeuse, surtout lorsque le traitement s'appuie sur les altérations de la perception, de la mémoire et du contrôle volontaire qui caractérisent le domaine de l'hypnose. L'évaluation de routine de l'hypnotisabilité améliore la pratique clinique en permettant aux cliniciens de sélectionner les patients pour lesquels l'hypnose est appropriée ; et il améliore la recherche clinique en fournissant des informations importantes sur les mécanismes sous-jacents aux effets hypnotiques.Gérard Fitoussi, M.D.President-elect of the European Society of Hypnosis.

Una encuesta internacional reciente descubrió que los médicos que utilizan la hipnosis en sus prácticas, rara vez evalúan la hipnotizabilidad de sus pacientes o clientes. Esto contrasta marcadamente con la práctica en la investigación de laboratorio. Una de las razones ofrecidas para esta discrepancia es que la hipnotizabilidad no predice fuertemente el resultado clínico. Pero una comparación de esta relación con correlaciones similares en otros dominios muestran que esta crítica es engañosa, especialmente cuando el tratamiento capitaliza las alteraciones en la percepción, la memoria y el control voluntario que caracterizan el dominio de la hipnosis. La evaluación rutinaria de la hipnotizabilidad mejora la práctica clínica al permitir que los médicos seleccionen pacientes para quienes la hipnosis es apropiada, y mejora la investigación clínica al proporcionar información importante sobre el mecanismo subyacente a los efectos de la hipnosis.Vanessa MuñizBaylor University, Waco, Texas, USA.

Recognition in Posthypnotic Amnesia, Revisited.

Three experiments studied recognition during posthypnotic amnesia (PHA) employing confidence ratings rather than the traditional yes/no format. As the criterion for recognition was loosened, an increase in hits was accompanied by an increase in false alarms, especially to distractor items that were conceptually related to, or semantically associated with, targets. Nevertheless, hits exceeded false alarms at every level of confidence. In addition, amnesic subjects had difficulty identifying the particular list on which recognized items were presented for study or the correct order in which targets appeared on the study list. Taken together, these findings support the conclusion that successful recognition during PHA is more likely to be mediated by a priming-based feeling familiarity than conscious recollection.

Ecological Validity and "Ecological Validity".

Egon Brunswik coined the term ecological validity to refer to the correlation between perceptual cues and the states and traits of a stimulus. Martin Orne adapted the term to refer to the generalization of experimental findings to the real world outside the laboratory. Both are legitimate uses of the term because the ecological validity of the cues in an experiment determines the ecological validity of the experiment itself.

There is more to memory than recollection and familiarity.

Theoretical models of memory retrieval have focused on processes of recollection and familiarity. Research suggests that there are still other processes involved in memory reconstruction, leading to experiences of knowing and inferring the past. Understanding these experiences, and the cognitive processes that give rise to them, seems likely to further expand our understanding of the neural substrates of memory.

Varieties of recollective experience.

Four variants on Tulving's "Remember/Know" paradigm supported a tripartite classification of recollective experience in recognition memory into Remembering (as in conscious recollection of a past episode), Knowing (similar to retrieval from semantic memory), and Feeling (a priming-based judgment of familiarity). Recognition-by-knowing and recognition-by-feeling are differentiated by level of processing at the time of encoding (Experiments 1-3), shifts in the criterion for item recognition (Experiment 2), response latencies (Experiments 1-3), and changes in the response window (Experiment 3). False recognition is often accompanied by "feeling", but rarely by "knowing"; d' is higher for knowing than for feeling (Experiments 1-4). Recognition-by-knowing increases with additional study trials, while recognition-by-feeling falls to zero (Experiment 4). In these ways, recognition-by-knowing is distinguished from recognition-by-feeling in much the same way as, in the traditional Remember/Know paradigm, recognition-by-remembering can be distinguished from recognition-without-remembering. Implications are discussed for dual-process theories of memory, and the search for the neural substrates of memory retrieval.

Realism and constructivism in social perception.

Jussim's critique of social psychology's embrace of error and bias is needed and often persuasive. In opting for perceptual realism over social constructivism, however, he seems to ignore a third choice - a cognitive constructivism which has a long and distinguished history in the study of nonsocial perception, and which enables us to understand both accuracy and error.

Hypnotic Tactile Anesthesia: Psychophysical and Signal-Detection Analyses.

Two experiments that studied the effects of hypnotic suggestions on tactile sensitivity are reported. Experiment 1 found that suggestions for anesthesia, as measured by both traditional psychophysical methods and signal-detection procedures, were linearly related to hypnotizability. Experiment 2 employed the same methodologies in an application of the real-simulator paradigm to examine the effects of suggestions for both anesthesia and hyperesthesia. Significant effects of hypnotic suggestion on both sensitivity and bias were found in the anesthesia condition but not for the hyperesthesia condition. A new bias parameter, C', indicated that much of the bias found in the initial analyses was artifactual, a function of changes in sensitivity across conditions. There were no behavioral differences between reals and simulators in any of the conditions, though analyses of postexperimental interviews suggested the 2 groups had very different phenomenal experiences.

Patterns of hypnotic response, revisited.

It has long been speculated that there are discrete patterns of responsiveness to hypnotic suggestions, perhaps paralleling the factor structure of hypnotizability. An earlier study by Brenneman and Kihlstrom (1986), employing cluster analysis, found evidence for 12 such profiles. A new study by Terhune (2015), employing latent profile analysis, found evidence for three such patterns among highly hypnotizable subjects, and a fourth comprising subjects of medium hypnotizability. Some differences between the two studies are described. Convincing identification of discrete "types" of high hypnotizability, such as dissociative and nondissociative, may require a larger dataset than is currently available, but also data pertaining directly to divisions in conscious awareness and experienced involuntariness.

Hypnosis in the right hemisphere.

Speculations about the neural substrates of hypnosis have often focused on the right hemisphere (RH), implying that RH damage should impair hypnotic responsiveness more than left-hemisphere (LH) damage. The present study examined the performance of a patient who suffered a stroke destroying most of his LH, on slightly modified versions of two hypnotizability scales. This patient was at least modestly hypnotizable, as indicated in particular by the arm rigidity and age regression items, suggesting that hypnosis can be mediated by the RH alone - provided that the language capacities normally found in the LH remain available. A further study of 16 patients with unilateral strokes of the LH or RH found no substantial differences in hypnotizability between the two groups. Future neuropsychological studies of hypnosis might explore the dorsal/ventral or anterior/posterior dichotomies, with special emphasis on the role of prefrontal cortex.

Neuro-hypnotism: prospects for hypnosis and neuroscience.

The neurophysiological substrates of hypnosis have been subject to speculation since the phenomenon got its name. Until recently, much of this research has been geared toward understanding hypnosis itself, including the biological bases of individual differences in hypnotizability, state-dependent changes in cortical activity occurring with the induction of hypnosis, and the neural correlates of response to particular hypnotic suggestions (especially the clinically useful hypnotic analgesia). More recently, hypnosis has begun to be employed as a method for manipulating subjects' mental states, both cognitive and affective, to provide information about the neural substrates of experience, thought, and action. This instrumental use of hypnosis is particularly well-suited for identifying the neural correlates of conscious and unconscious perception and memory, and of voluntary and involuntary action.

Prospects for de-automatization.

Research by Raz and his associates has repeatedly found that suggestions for hypnotic agnosia, administered to highly hypnotizable subjects, reduce or even eliminate Stroop interference. The present paper sought unsuccessfully to extend these findings to negative priming in the Stroop task. Nevertheless, the reduction of Stroop interference has broad theoretical implications, both for our understanding of automaticity and for the prospect of de-automatizing cognition in meditation and other altered states of consciousness.

William E. Edmonston, Jr.: Editor, 1968-1976.

This article is part of an occasional series profiling editors of the American Journal of Clinical Hypnosis (AJCH). William E. Edmonston was the second editor, succeeding Milton H. Erickson. His research focused on the use of conditioning paradigms and psychophysiological measures to explore a wide variety of hypnotic phenomena, leading to a "neo-Pavlovian" theory of neutral hypnosis as physiological relaxation (anesis). A longtime professor of psychology at Colgate University, he created an interdisciplinary undergraduate major in neuroscience, and was named New York State College Professor of the Year in 1988. He gave the Journal a new look, and a greater balance of clinical and experimental papers. The article also provides background on George Barton Cutten, George H. Estabrooks, and Frank A. Pattie, pioneers of hypnosis who were linked to Edmonston.

Allocation of attentional resources in posthypnotic suggestion.

Highly hypnotizable subjects received a nonhypnotic instruction to respond to a particular digit in a display and a posthypnotic suggestion to respond to a different digit. On some test trials, these 2 responses were tested separately; on others, they were placed in conflict. Overall, subjects were no more responsive to posthypnotic cues than to nonhypnotic cues, nor did their response latencies differ. However, response to posthypnotic cues diminished when they conflicted with the nonhypnotic cues. Analysis of response latencies showed that posthypnotic responding interfered with nonhypnotic responding (and vice versa), even on those trials where there was no procedural conflict. Posthypnotic behavior is not inevitably evoked by the presentation of the prearranged cue. Furthermore, the interference between posthypnotic and nonhypnotic responses indicates that posthypnotic responding consumes attentional resources. Both findings indicate that posthypnotic behavior is not automatic in the technical sense of that term.

Placebo: feeling better, getting better, and the problems of mind and body.

Over its history, medicine has vacillated between acknowledging placebo effects as important and trying to overcome them. Placebos are controversial, in part, because they appear to challenge a biocentric view of the scientific basis of medical practice. At the very least, research should distinguish between the effects of placebos on subjective and objective endpoints. Theoretically, placebos are of interest because they underscore the other side of the mind-body problem: how mental states can affect physical conditions.

Associative and categorical relations in the associative memory illusion.

What kinds of associations underlie the associative memory illusion? In Experiment 1, lists composed of horizontal, or coordinate, free associates elicited false recognition of critical lures much more often than did lists composed of vertical, or subordinate, category instances. Experiment 2 replicated this result, and showed that the difference between free associates and category instances was not an artifact of differential levels of forward or backward associative strength. Associative structure plays an important role in the associative memory illusion: The illusion is strongest when the critical lure lies at the same level of categorization as the studied items.

Dissociative disorders.

The dissociative disorders, including "psychogenic" or "functional" amnesia, fugue, dissociative identity disorder (DID, also known as multiple personality disorder), and depersonalization disorder, were once classified, along with conversion disorder, as forms of hysteria. The 1970s witnessed an "epidemic" of dissociative disorder, particularly DID, which may have reflected enthusiasm for the diagnosis more than its actual prevalence. Traditionally, the dissociative disorders have been attributed to trauma and other psychological stress, but the existing evidence favoring this hypothesis is plagued by poor methodology. Prospective studies of traumatized individuals reveal no convincing cases of amnesia not attributable to brain insult, injury, or disease. Treatment generally involves recovering and working through ostensibly repressed or dissociated memories of trauma; at present, there are few quantitative or controlled outcome studies. Experimental studies are few in number and have focused largely on state-dependent and implicit memory. Depersonalization disorder may be in line for the next "epidemic" of dissociation.

Unity within psychology, and unity between science and practice.

The unity of psychology as a science is to be found in its definition as the science of mental life, and its explanation of individual behavior in terms of mental states. This disciplinary focus will help negotiate psychology's relations with other disciplines, such as neuroscience and cognitive science. The unity within psychology between science and practice is to be found in a focus on scientific evidence as the source of the status, autonomy, and privileges of professional practitioners. Psychology should avoid the temptations of reductionism, and assert (and enjoy) its twin status as both a biological science and a social science.