Tuesday, July 5, 2011

On Hypnosis (5/20)

Variations in Depth and Type of Trance

Both Hilgard and Erickson believe that there are definite, varying levels of hypnotic trance. For example, there is a stuporous trance – a state in which, according to Hilgard, spontaneous thinking stops and the self becomes "meaningless." In Hypnosis in the Relief of Pain, Hilgard maintains that the notion of depth in hypnosis cannot really be measured and can only be described by the person experiencing it. Still, he gives this description of a person in an hypnotic stupor:

Relaxation of the body increased for a time, but he [the subject] eventually no longer felt identified with his body. It was as though it was a "thing" left behind, so that it no longer made sense to ask him further about body relaxation. Relaxation of the body was succeeded by a peacefulness of the self, but beyond a certain depth this concept also became meaningless, because the self was no longer present. The environment also faded progressively, until finally a state was reached in which the only part of the environment that remained present was the hypnotist's voice. Time passed more and more slowly, finally reaching a point at which it ceased to be a meaningful concept. Spontaneous mental activity declined until it finally reached zero.[1]

Another kind of trance is a somnambulistic one, in which mental and physical capacities apparently remain normal. Erickson made frequent use of the somnambulistic trance both for demonstration and for therapeutic purposes. I’ll now describe an example where Erickson had called upon one individual to demonstrate the somnambulistic state. He then pretended to conclude the demonstration and dismiss the subject. But he continued, hoping to observe genuine "hypnotic behavior" rather than behavior designed to please the hypnotist.

Knowing about the subject's fondness for sweets, Erickson told her that as a reward for her performance she could choose from a platter of homemade candy. With the subject “still in the somnambulistic state," she was asked to name her favorite candy, and "expressed a marked preference for divinity fudge, and even as she spoke she was noted to salivate freely in anticipation." The hypnotist went into another room, called back with satisfaction that there was indeed some divinity fudge, and asked her whether she wanted to help herself to it at once or later. "So far as divinity fudge is concerned, immediately is scarcely soon enough," she reportedly replied. Erickson then returned to the room bringing napkins, pretending that he had a platter of candy in his hands, and saying that the platter contained a variety of candies in case those present had different preferences. Next he approached the subject and told her to go ahead and select the largest pieces of divinity fudge.

With the juvenile directness, earnestness, and simplicity so characteristic of behavior in the somnambulistic state, she replied she would. After scrutinizing the imaginary platter carefully, she made her choice of a piece and, upon urging, a second and a third, but she explained that she was taking only a small piece for the third.

The imaginary platter was passed among the group. Each person pretended to take a piece of candy and eat it. The subject then became restless, wandered around the room, and finally sat in a chair next to the table where the imaginary platter had been placed. Subsequently, "in the manner of a small child who wishes another helping of candy," she looked furtively back and forth between the imaginary platter and the hypnotist, until:

...with a slight gesture of resolution she learned forward, scrutinized the platter carefully, and proceeded to go through a performance of selecting carefully and eating several pieces of candy, now and then glancing in a hesitant manner.

The platter was passed around again. When it was her turn, the subject again selected and ate imaginary pieces of candy. Erickson notes that, throughout the performance, two "medically-trained members unobtrusively watched the subject" and independently observed her "increased salivation and swallowing," as well as her use of the napkin to wipe her fingers. Then Erickson concluded the demonstration and awakened the subject.[2]

Thus, we have stuporous trances in which the environment, the body, and the self become meaningless concepts, and we have somnambulistic trances in which hallucinatory fudge is merrily eaten with the context of normal group interaction. How can these states be possible? Are these reports mere fantasy or actual descriptions of altered neurological functioning? And if the latter is true, which brain structures mediate hypnotic trance states?


[1]Ernest R. Hilgard and Josephine R. Hilgard, Hypnosis in the Relief of Pain (Los Altos, CA: William Kaufmann, 1975), p. 21.
[2]Milton H. Erickson, "Experimentally Elicited Salivary and Related Responses to Hypnotic Visual Hallucinations Confirmed by Personality Reactions," Collected Papers of Milton H. Erickson on Hypnosis, Vol. 2, Edited by Ernest L. Rossi (New York: Irvington, 1980), pp. 176-177. Originally published in Psychosomatic Medicine, April, 1943,5, 185-187.
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On Hypnosis (4/20)



Non-State Theories

Theodore Barber, a leading hypnosis researcher is a strong proponent of the non-state theory. For him hypnosis is nothing extraordinary; it is a normal, everyday behavior mistakenly given a special name. So-called hypnotic behavior, according to Barber, can be understood as being the result of interpersonal factors, such as the subject's desire to please the hypnotist by successfully carrying out what is requested of him, much like what often happens between client and therapist in any kind of psychotherapy.

Barber points out that all attempts to define hypnosis to date have involved a semantic merry-go-round: a person is said to behave a certain way because she is hypnotized. But how do we know she is hypnotized? Because she behaves a certain way. Or worse yet: A person is in a trance because she is hypnotized. How do we know she is hypnotized? Because she is in a trance! While the concepts of trance and hypnosis are used to define one another, they are also used interchangeably. According to Barber, proof that hypnosis is a special state of consciousness requires the discovery of behavior other than that used to describe it.

Furthermore, if hypnosis is a special state, shouldn't instruments clearly indicate its difference from a waking or a sleeping state? "For nearly one hundred years," writes Barber, "researchers have been trying to delineate an objective physiological index that differentiates the hypnotic state from non-hypnotic states...The attempt to find a physiological index of 'hypnotic trance per se' has not succeeded."[1] Specifically, physiological measures such as EEG, blood pressure, pulse rates, and body temperature do not demonstrate any variation between a "hypnotic" and "non-hypnotic" state.

Peter Brown, who has studied what underlies the phenomenon of hypnotic communication, modifies Barber's thesis as follows: "Though there are changes in brain functioning during hypnosis, they are not unique to hypnosis nor are they uniform across all subjects...The changes in brain function that occur in hypnosis are similar to the normal ultradian variations in activity and do not appear to differ from changes found in other types of absorbed concentration."[2] Brown adds that "It is easy to speak of an 'altered state of consciousness' or of 'dissociation,' as if we know precisely what these terms mean. The evidence suggests that the trance state involved substantial changes in cognition, emotion, perception, and physiologic regulation. But these changes do not exist in a vacuum. Intermingled with them will be the surrounding context for the individual: their previous history, current concerns, and the quality of the interaction and degree of rapport they experience with the hypnotherapist."[3]

According to the non-state theory, the vital functions and behavior of someone in a hypnotic trance are not dissimilar to those of someone who is not in a trance. People role-play, act, distort, conceal, fantasize, and imagine themselves as others while awake, and they also do these things while hypnotized. While either in a hypnotic trance or an everyday trance, they are able to consciously or unconsciously focus on a particular stimulus and tune out all others. Moreover, Barber and other non-state theorists say that what happens to people in hypnosis can be explained largely in terms of the relationship between the subject and the hypnotist, based on the subject's psychology, motivations, and drives. As children, they try to please their parents; as students, they seek approval from teachers; and as hypnotic subjects, they do the same.



[1]Theodore X. Barber, Hypnosis: Scientific Approach (New York: Van Nostrand Reinhold, 1969), p. 7.
[2]Peter Brown, The Hypnotic Brain: Hypnotherapy and Social Communication. (New Haven and London: Yale University Press, 1991), p. 175.
[3]Brown, The Hypnotic Brain, p. 241.
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Review of "Beyond Belief"

This thought-provoking and important book shows how people are drawn toward dangerous beliefs.
“Belief can manifest itself in world-changing ways—and did, in some of history’s ugliest moments, from the rise of Adolf Hitler to the Jonestown mass suicide in 1979. Arthur Janov, a renowned psychologist who penned The Primal Scream, fearlessly tackles the subject of why and how strong believers willingly embrace even the most deranged leaders.
Beyond Belief begins with a lucid explanation of belief systems that, writes Janov, “are maps, something to help us navigate through life more effectively.” While belief systems are not presented as inherently bad, the author concentrates not just on why people adopt belief systems, but why “alienated individuals” in particular seek out “belief systems on the fringes.” The result is a book that is both illuminating and sobering. It explores, for example, how a strongly-held belief can lead radical Islamist jihadists to murder others in suicide acts. Janov writes, “I believe if people had more love in this life, they would not be so anxious to end it in favor of some imaginary existence.”
One of the most compelling aspects of Beyond Belief is the author’s liberal use of case studies, most of which are related in the first person by individuals whose lives were dramatically affected by their involvement in cults. These stories offer an exceptional perspective on the manner in which belief systems can take hold and shape one’s experiences. Joan’s tale, for instance, both engaging and disturbing, describes what it was like to join the Hare Krishnas. Even though she left the sect, observing that participants “are stunted in spiritual awareness,” Joan considers returning someday because “there’s a certain protection there.”
Janov’s great insight into cultish leaders is particularly interesting; he believes such people have had childhoods in which they were “rejected and unloved,” because “only unloved people want to become the wise man or woman (although it is usually male) imparting words of wisdom to others.” This is just one reason why Beyond Belief is such a thought-provoking, important book.”
Barry Silverstein, Freelance Writer

Quotes for "Life Before Birth"

“Life Before Birth is a thrilling journey of discovery, a real joy to read. Janov writes like no one else on the human mind—engaging, brilliant, passionate, and honest.
He is the best writer today on what makes us human—he shows us how the mind works, how it goes wrong, and how to put it right . . . He presents a brand-new approach to dealing with depression, emotional pain, anxiety, and addiction.”
Paul Thompson, PhD, Professor of Neurology, UCLA School of Medicine

Art Janov, one of the pioneers of fetal and early infant experiences and future mental health issues, offers a robust vision of how the earliest traumas of life can percolate through the brains, minds and lives of individuals. He focuses on both the shifting tides of brain emotional systems and the life-long consequences that can result, as well as the novel interventions, and clinical understanding, that need to be implemented in order to bring about the brain-mind changes that can restore affective equanimity. The transitions from feelings of persistent affective turmoil to psychological wholeness, requires both an understanding of the brain changes and a therapist that can work with the affective mind at primary-process levels. Life Before Birth, is a manifesto that provides a robust argument for increasing attention to the neuro-mental lives of fetuses and infants, and the widespread ramifications on mental health if we do not. Without an accurate developmental history of troubled minds, coordinated with a recognition of the primal emotional powers of the lowest ancestral regions of the human brain, therapists will be lost in their attempt to restore psychological balance.
Jaak Panksepp, Ph.D.
Bailey Endowed Chair of Animal Well Being Science
Washington State University

Dr. Janov’s essential insight—that our earliest experiences strongly influence later well being—is no longer in doubt. Thanks to advances in neuroscience, immunology, and epigenetics, we can now see some of the mechanisms of action at the heart of these developmental processes. His long-held belief that the brain, human development, and psychological well being need to studied in the context of evolution—from the brainstem up—now lies at the heart of the integration of neuroscience and psychotherapy.
Grounded in these two principles, Dr. Janov continues to explore the lifelong impact of prenatal, birth, and early experiences on our brains and minds. Simultaneously “old school” and revolutionary, he synthesizes traditional psychodynamic theories with cutting-edge science while consistently highlighting the limitations of a strict, “top-down” talking cure. Whether or not you agree with his philosophical assumptions, therapeutic practices, or theoretical conclusions, I promise you an interesting and thought-provoking journey.
Lou Cozolino, PsyD, Professor of Psychology, Pepperdine University


In Life Before Birth Dr. Arthur Janov illuminates the sources of much that happens during life after birth. Lucidly, the pioneer of primal therapy provides the scientific rationale for treatments that take us through our original, non-verbal memories—to essential depths of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.
Gabor Maté MD, author of In The Realm of Hungry Ghosts: Close Encounters With Addiction

An expansive analysis! This book attempts to explain the impact of critical developmental windows in the past, implores us to improve the lives of pregnant women in the present, and has implications for understanding our children, ourselves, and our collective future. I’m not sure whether primal therapy works or not, but it certainly deserves systematic testing in well-designed, assessor-blinded, randomized controlled clinical trials.
K.J.S. Anand, MBBS, D. Phil, FAACP, FCCM, FRCPCH, Professor of Pediatrics, Anesthesiology, Anatomy & Neurobiology, Senior Scholar, Center for Excellence in Faith and Health, Methodist Le Bonheur Healthcare System


A baby's brain grows more while in the womb than at any time in a child's life. Life Before Birth: The Hidden Script That Rules Our Lives is a valuable guide to creating healthier babies and offers insight into healing our early primal wounds. Dr. Janov integrates the most recent scientific research about prenatal development with the psychobiological reality that these early experiences do cast a long shadow over our entire lifespan. With a wealth of experience and a history of successful psychotherapeutic treatment, Dr. Janov is well positioned to speak with clarity and precision on a topic that remains critically important.
Paula Thomson, PsyD, Associate Professor, California State University, Northridge & Professor Emeritus, York University

"I am enthralled.
Dr. Janov has crafted a compelling and prophetic opus that could rightly dictate
PhD thesis topics for decades to come. Devoid of any "New Age" pseudoscience,
this work never strays from scientific orthodoxy and yet is perfectly accessible and
downright fascinating to any lay person interested in the mysteries of the human psyche."
Dr. Bernard Park, MD, MPH

His new book “Life Before Birth: The Hidden Script that Rules Our Lives” shows that primal therapy, the lower-brain therapeutic method popularized in the 1970’s international bestseller “Primal Scream” and his early work with John Lennon, may help alleviate depression and anxiety disorders, normalize blood pressure and serotonin levels, and improve the functioning of the immune system.
One of the book’s most intriguing theories is that fetal imprinting, an evolutionary strategy to prepare children to cope with life, establishes a permanent set-point in a child's physiology. Baby's born to mothers highly anxious during pregnancy, whether from war, natural disasters, failed marriages, or other stressful life conditions, may thus be prone to mental illness and brain dysfunction later in life. Early traumatic events such as low oxygen at birth, painkillers and antidepressants administered to the mother during pregnancy, poor maternal nutrition, and a lack of parental affection in the first years of life may compound the effect.
In making the case for a brand-new, unified field theory of psychotherapy, Dr. Janov weaves together the evolutionary theories of Jean Baptiste Larmarck, the fetal development studies of Vivette Glover and K.J.S. Anand, and fascinating new research by the psychiatrist Elissa Epel suggesting that telomeres—a region of repetitive DNA critical in predicting life expectancy—may be significantly altered during pregnancy.
After explaining how hormonal and neurologic processes in the womb provide a blueprint for later mental illness and disease, Dr. Janov charts a revolutionary new course for psychotherapy. He provides a sharp critique of cognitive behavioral therapy, psychoanalysis, and other popular “talk therapy” models for treating addiction and mental illness, which he argues do not reach the limbic system and brainstem, where the effects of early trauma are registered in the nervous system.
“Life Before Birth: The Hidden Script that Rules Our Lives” is scheduled to be published by NTI Upstream in October 2011, and has tremendous implications for the future of modern psychology, pediatrics, pregnancy, and women’s health.
Editor