On Hypnosis (Part 13/20)

My Interpretation of Suggestion and Suggestibility

Statements such as, "You feel drowsy," "Your eyes are getting heavy," and "You are going into a deep sleep" have no inherent power to cause or induce drowsiness. So why do they have this power in the hypnotic setting? It seems that a number of conditions have to be operating for this to occur.

First, the subject has to trust the person offering the suggestions. Second, the subject has to want it to work (Erickson's willingness factor, Yapko's "investment" of time, money, and hope). And third, he has to believe that the hypnotist's pronouncement of the words will produce the expected result. It appears that hypnotic suggestions are accepted only when there is a predisposition to accept them.

But why would a person wish to put himself at the disposal of another's suggestion? Most neurotics are simply bone weary. The chance to relax in the safety of another's care is just too enticing to bypass. Indeed it might take more effort not to succumb to hypnotic suggestion than to do so. When presented with an authority figure whose very demeanor speaks to unmet need (it is simple, soothing, reassuring, direct and directing), the critical brain may have a very hard time staying out "in front" or "on top." Having someone else do the thinking and the suggesting are pleasures for which most neurotics have waited a lifetime.

Moreover, accepting suggestion may be all that many people have ever done. Hypnosis simply provides another situation in which to re-enact and perpetuate their suggestibility (which is really their dependency). Surrendering to a parental figure who you feel has some quasi-magical ability to do things for you without your having to think for yourself may represent the chance to finally have something which was denied when it was more appropriately needed – as a child. In fact the actions and suggestions of the hypnotist conjure up in my mind the picture of an attentive, caring, loving parent sitting on the child's bed at the end of a day and encouraging him to "Go to sleep...sleep well...sweet dreams."

As a child is the key because the hypnotized person is childlike. As Erickson noted earlier, the hypnotic subject is naive, pliant, open to direction, literal-minded, non-analytic, and uncritical. The crucial question is, does hypnotic suggestion actually create childlike behavior, or does it simply elicit the child still inherent in the adult neurotic? I take the latter position because, as I have argued, you have to be psychologically still a child to be hypnotizable in the first place.

Still being a child means still being run by the needs of childhood which were neglected, denied, or abused. It doesn't matter how seemingly adult the person may be in everyday life. Indeed, seemingly adult behavior may only be a way of defending against the pressing childish need. Even though two people react differently to deprivation in childhood and have radically different personalities, they may both be susceptible to hypnosis because of the deprivation.

The neurotic is "not all there" in his everyday life. To be fully present would mean feeling his repressed Pain. To avoid this he becomes heavily engaged in living out the post-hypnotic (post-dissociation) suggestions of his childhood. These suggestions were usually given indirectly, sometimes as much by what was not said as by what was. They stick in the mind, prodding away at us from the inside: "You're worthless, " "You'll never be good enough," "Lie because if you tell the truth you'll be punished," "Take care of Mommy," "Touching is for sissies," "Big boys don't cry," and on and on. These "post-neurotic" suggestions run our lives; they continue to guide us long after they were uttered or otherwise communicated to us. Susceptibility to suggestion is based on a lifetime of experiences with the subsequent dissociation needed to defend against Pain. I do not believe it is possible to hypnotize a person who is in full possession of himself, who enjoys a state of inner connection, whose thoughts are not dissociated from his feelings, and who is not engaged in battling Primal Pain and need with repression. Such a person is not in the neurotic's trance and cannot therefore be susceptible to hypnotic suggestions.


Levels of Consciousness and Hypnosis

The third level of consciousness is the most "plastic" area of the brain. Because of this plasticity, it can be easily "deceived." It can accept as true an idea from the outside – that "Mommy loves you," or that "God is watching over you" – even when that idea is false. The first level of consciousness is not so plastic or malleable; it deals with survival functions and therefore is not as susceptible to change imposed by fluctuations in external circumstances. For example, if it were possible (which it is not) to program someone to have a continuing pulse rate of 250 through hypnotic suggestion, that person would soon die. This imperviousness of the first level is clearly a survival mechanism. As one moves up the levels of consciousness, however, the functions become more alterable, more susceptible to outer influences, and more adaptable. This, too, is in the service of survival.

It is the function of third-level processes to provide us with external orientation. This means that the third level must be able to perceive as well as adapt to new conditions, events, and ideas. This adaptability can work against us as easily as it works for us, depending on what we must adapt to. The neurotic has been forced to adapt to an unreal world, a world at odds with his deepest needs and feelings. He has had to adopt false concepts about himself and the world in order to survive. For instance, for a child who does not feel loved by his mother, due to the way she treats him, it may be necessary to believe her when she says she loves him, because the full realization that his mother does not love him would be emotionally shattering. Many of us appear to have adapted well to false ideas and sick values, but there are always telltale signs that this is not really true: symptoms and illnesses, nervous habits and compulsions, depressions, anxieties, and unhappiness. Indeed we can adapt, we can continue to function – but at what price?

The second or feeling level of consciousness ideally acts as a safeguard against the plasticity of the intellect. Through our feeling responses we can evaluate and discriminate which ideas, values, courses of action, etc., we want to accept and which we want to reject. But the second level doesn't "know" in the same way that the third level knows. The second level is intuitive rather than cognitive; it is global rather than specific; and it is immediate rather than mediated. When we allow the second level its proper function, our feelings occur first and then our minds come along afterwards to articulate the feelings. In many ways, the third level of consciousness is meant to serve the second, for it is the second level that provides us with a personal sense of self. For example, it provides us with a kind of global "gut response" to such questions as, "Is this person right for me?"; "Do I want to follow this career?"; "Do I agree with this idea and want to act on it?"; "Do I want to live the way I've been living?", and so on. The third level can then articulate the gut response via specific ideas and concepts.

When we are cut off from our gut responses – when there is a split between second and third levels – we no longer have an inner, personal source of evaluation. We are at the mercy of ideas (suggestions) with little or no way to screen them. This is why the intellect can believe it is well-adapted even when it is not, and it can believe its owner's needs are fulfilled even when they are not. This pattern of deceptive adaptation is usually well established in childhood. As children we are fed ideas that we are happy when we are not; that the family is ideal when it clearly is not; that Daddy loves us even though he is never home; that Mommy wants us even though she doesn't act like it. Out of necessity we accept these ideas, which are really commands, and we continue to function despite great Pain. Eventually we may come to believe our parents' ideas about our reality rather than believing our own experience of it. This happens because it is simply too threatening for the child to challenge the parents' views (on these matters most parents are usually quite defensive); and then it becomes too conflicting for the child to suspend himself between his own felt reality and the false reality "suggested" by his parents. At this point he gives up personal feeling for so-called parental love. He responds not to gut feelings, which have been repressed, but to what his parents tell him he should think and feel and do.

Without a solidified third level – that is, without the reality concepts adults have – children are easily able to accept someone else's version of reality. That is precisely why fairy tales are so effective for children: they love entering fantasized worlds in which reality changes with each word. Whether it is harmless fantasy or harmful parental attitudes, the child is wide open to believing it. The fact that children are more hypnotizable than adults also suggests that for the adult hypnosis depends upon third-level disengagement.

In the adult a false reality can be imposed over actual reality via the same mechanism that allows parents to impose false family realities on their children: third level disengagement.[1] Indeed, the adult becomes more childlike when hypnotized precisely because the hypnotist is addressing the intact child-brain without the interference of the reality-oriented adult brain. What this really means is that the hypnotic relationship re-enacts the neurotic paradigm: the hypnotist speaks to the subject and asks him to follow his instructions and suggestions, just as the neurotic parents did when the person was a child. This is similar to what occurs in any dominant-subordinate, leader-follower relationship in which the authority figure is able to appeal to the follower's unfulfilled childhood need. With his critical thinking abilities suspended, driven by the need to be accepted and loved and felt worthy, the follower parrots the leader's ideas, no matter how bizarre, and becomes an instrument of the leader's will. In extreme cases – Jonestown, Waco, the Taliban, and so on – followers have been known to enact their leader's hypnotic suggestions, to the point of giving away their spouses and even killing at the leader's behest. Thus the Taliban are willing to behead a poor, helpless woman who may have unwittingly shown too much ankle or leg. In one sense, the military in reproducing monotonous behavior, marching back and forth, turning on a dime together, shouting out certain phrases over and over, are hypnotizing soldiers to behave and not ask why. It is a good parallel to hypnosis. “Yours is to do and not ask why.”

There is one point to clarify. Although our childhood brain is contained within our later-developing adult brain, it is not this fact alone which makes us hypnotizable. It is the fact that, through neurosis, the child brain retains the functional quality of childishness. Hypnosis addresses the child brain of a person who in many ways is still a child – which is precisely what makes it possible to link up with or uncover the child brain in the first place. In an adult whose history was one of healthy integration, addressing the child brain would have little or no effect. A fully-integrated self could not be delineated along the lines of child self and adult self. Every aspect of the developing selfhood would have been incorporated to form a seamless, whole self which functioned as such. Thus although the child brain would retain its neurological identity, it would not manifest as separate or differentiated at the psychological and behavioral levels.

What is suggested by the hypnotist to the child-psyche of a neurotic person will have an unconscious effect later on precisely because the neurotic paradigm of imposing a false reality over the truth is so well established. This explains why post-hypnotic suggestions can work: the new parent-authority (the hypnotist) has put information into the second level or child-brain, which it obediently receives and later acts upon out of habit.

Because the hypnotic subject is unaware of what is going on outside of him, we have the notion of a magically altered state of consciousness. From the Primal viewpoint, however, it is neither magical, special, nor altered; it is simply different. The hypnotized person is operating from a lower (different) level of consciousness than is usual in the waking state. The same situation occurs in the dream state. While we are dreaming we are unaware of what is happening in the room we are in; we are unaware of the whirring of a fan or the noises emanating from the television. We are also unaware of what is happening in our own body; we do not feel the headache we had when we went to bed. Within a few minutes upon awakening, however, we again perceive the room, we again feel the pain. This is because the third level is disengaged during sleep in order to block out external, waking realities. When it re-engages upon awakening, it immediately resumes its job of attending, perceiving, sorting, and responding to waking realities – and hence, we experience a renewal of sensory inputs and pain. To go to sleep is to become unconscious which is the same in hypnosis. As I said, we cannot get well unconsciously.

In neurosis, the innate adaptability of the third level is taken advantage of as a means of repressing and dissociating from pain. Third-level disconnection helps to keep the pain from being felt because, as I have pointed out, one needs all levels of consciousness for true feeling. Instead of mediating adult realities, as it should be, the neurotic adult brain is still heavily involved in mediating a child' s reality. A third level working for a child will be drawn to external situations which serve a child's needs, such as psychotherapies or religions which are reassuring and quell a child's Pain. False ideas – such as that you can relive and resolve a past trauma in hypnosis, or that God will save and protect you – will be accepted because they suit these defensive purposes, and because falsification is already firmly established.

Hypnotic suggestion, then, takes advantage of an innate third-level plasticity and an established state of disconnection which it both reveals and amplifies.

[1]In very young children it would be more accurate to say that the third level is undeveloped rather than disengaged.

On Hypnosis (Part 12/20)

Views of Suggestibility

The degree to which a person responds to suggestions is variously termed suggestibility, hypnotizability, hypnotic responsiveness, and hypnotic susceptibility. Research in this area has gone in two particular directions: attempts to develop scales that reliably "measure" hypnotizability, and attempts to correlate degree of hypnotizability with specific personality traits and characteristics (such as intelligence, mental status, and imagination). Interestingly enough, there has been some success in developing reliable measurement scales but almost no success in correlating personality characteristics with hypnotizability.

Measurements on the scales that have been developed to measure “hypnotizability” – The Stanford Hypnotic Susceptibility Scale, and the Barber Suggestibility Scale – seem to indicate that most people are susceptible to minor hypnotic phenomena, while about 1 out of every 4 persons is capable of a profound hypnotic response. Gender makes no difference in responsiveness, but age does. Apparently we are most hypnotizable when children, so surely characteristics particular to childhood (such as an active fantasy life and a willingness to follow directions) must play a role in hypnotizability. According to Hilgard, this is true. Although the evidence is sketchy and contradictory, it seems that the factor of imagination can be correlated with hypnotizability: people who were highly imaginative as children are more easily hypnotized as adults.[1] Hilgard explains:

The hypnotizable person is one who has rich subjective experiences in which he can become deeply involved...He is interested in the life of the mind...He is willing to accept impulses from within and is not afraid to relinquish reality testing for a time. He does not appear to be a weak or dependent person; evidence indicates that more troubled, withdrawn, or neurotic individuals do not generally make as good subjects as normal outgoing individuals.

...Interviews with hundreds of subjects, before and after induction of hypnosis, have pointed to the importance of early childhood experiences. Experiences of a particular kind appear to either generate or maintain the abilities that enter into hypnotizability. A capacity to become deeply involved in imaginative experiences derives from parents who are themselves deeply involved in such areas as reading, music, religion, or the aesthetic appreciation of nature.[2]

But that's not all. Hilgard goes on to mention (and "mention" is all) that adults who were abused as children are also more hypnotizable:

A history of punishment may produce hypnotizability in either (or both) of two ways: first, through instilling a habit of automatic and unquestioned obedience; second, through a tendency to escape the harassment by moving off into a realm of imagination, thus practicing the dissociations that are later to be used in hypnosis.[3] [Italics added]

Hilgard's point of view here provides a very interesting polarity regarding hypnotizability. On one hand there is the very healthy individual who "has rich subjective experiences in which he can become deeply involved." On the other hand is the severely abused individual who allows hypnosis out of the habit of "unquestioned obedience" and dissociative responses still lingering from childhood.

Barber's views on hypnotizability are quite different from Hilgard's. He points out that of the 60 or more studies that have investigated personality characteristics in relation to hypnotizability, the results are either negative (no relationship between personality and hypnotizability) or conflicting (one study finds a relationship, another does not). For example, one study found a positive correlation between "neuroticism" and hypnotizability (i.e., the more neurotic, the more hypnotizable), while another study found a negative correlation (i.e., the more neurotic, the less hypnotizable). Several other studies found no relationship whatsoever (i.e., neurosis does not affect hypnotizability in either direction).[4] Moreover, Barber does not agree with Hilgard that imagination or any other personality characteristic contributes to hypnotizability. For Barber, the research indicates only that (1) two people with very different personalities may be equally hypnotizable, and (2) two people with very similar personalities may vary drastically in their susceptibility to hypnosis. To explain this dilemma Barber suggests that either we don't yet have the tools to tap the aspects of personality related to hypnosis, or personality plays only a very minor role in it. Perhaps, he suggests, it is the situation rather than the personality that ultimately determines degree of hypnotic responsiveness.

It seems that Hilgard and Barber are presenting opposite viewpoints. Hilgard's view of hypnotizability is an intradynamic, static one: the person's internal imaginative capacities largely determine a degree of hypnotic responsiveness that remains fairly constant over time. Barber's view, on the other hand, is an interdynamic, fluctuational one: the hypnotic situation, together with what the person wants, feels, and expects in that situation, determines a responsiveness that varies from one situation and time to the next.

Erickson's view of hypnotizability combined some of both. Although he stated that "anyone who can be socialized can be hypnotized," he also believed that external factors such as the skill of the hypnotist and the amount of time taken for hypnotic "training" were important considerations. More important, however, was the subject's own willingness to experience hypnosis. This willingness constituted the single most important factor in the acceptance of suggestion. In fact, willingness was more important than trance in the matter of suggestibility. "Trance," wrote Erickson, "does not ensure the acceptance of suggestion"[5] – but willingness does.

Yapko discusses a related factor: the relationship between self-esteem and hypnotizability. In his view a person with low self-esteem is more likely than someone with high self-esteem to give another person power to influence him, such as through the use of suggestion. Lacking a strong sense of self, this individual's high suggestibility makes it easy for him to be strongly influenced by someone else's values or dictates.[6] Yapko also mentions the "need for acceptance," which may be particularly strong among those with low self-esteem and which may predispose them to be good (suggestible) hypnosis subjects. The subject has sought the hypnotist's help and implicitly believes that hypnosis can be helpful. Since he views the hypnotist as an authoritative individual who can offer perspective, advice, and possibly solutions for what ails him or her, he is predisposed to accept the hypnotist's suggestions.

Also to be taken into account is the hypnotist's reputation, which can contribute to suggestibility. People would come from all over the world to be hypnotized by Milton Erickson, for instance. According to Yapko, "Many of them came thousands of miles to be put in a trance by him, and into a trance they went!" Furthermore, there is an emotional component to an individual's expectations regarding hypnosis. "The more emotional investment the person has in that expectation," writes Yapko, "the less likely he is to experience anything that contradicts it...When people invest money, hope, and time in something, they desperately want it to work, even if 'only a little.'"[7]



[1]Lynn and Nash (Jan. 1994) maintain that "increased fantasy and decreased objectivity" underlie suggestibility. ("Truth in memory: ramifications for psychotherapy and hypnotherapy." American Journal of Clinical Hypnosis, 36(3), 194-208.) In a study by Segal and Lynn (1992-93), it was asserted that a link exists between imagination, fantasy, and dissociation. ("Predicting dissociative experiences: imagination, hypnotizability, psychopathology, and alcohol use." Imagination, Cognition, and Personality, 12, 287-300.) According to Lynn and Rhue (1988), the majority of fantasy-prone persons are highly hypnotizable." ("Fantasy proneness: hypnosis, developmental antecedents, and psychopathology." American Psychologist, 43, 35-44.
[2]Hilgard, et al., Introduction to Psychology, pp. 175-176.
[3]Ibid., p. 176.
[4]Barber, Hypnosis, p. 93.
[5]Erickson, et al., Hypnotic Realities, p. 228.
[6]In some instances, responding to suggestions (while hypnotized or awake), people have even confessed to crimes they did not commit. "When persons are uncertain about what they did or did not do and come to distrust their memories," write Lynn and Nash, "they are particularly vulnerable to suggestive and coercive influences." ("Truth in memory: ramifications for psychotherapy and hypnotherapy." American Journal of Clinical Hypnosis, 36(3), Jan. 1994, 194-208. Edwin adds: "It is well known that people are suggestible in the waking state and more so in hypnosis, and alert or in trance they can produce a "memory" that is called for or suggested by an authority figure. This is suggestion, not therapy." ("Many memories retrieved with hypnosis are accurate." American Journal of Clinical Hypnosis, 36(3), Jan. 1994, 174-176.)
[7]Trancework, pp. 127-128, pp. 91-98.