In person, this looks strange enough. “There are a lot of ways to go into this state, but one way is to count to three,” Spiegel explains. “On one, you do one thing — look up. Two, two things — slowly close your eyes and take a deep breath. And three, three things — let the breath out, keep your eyes relaxed, and keep them closed. Let your body float. And then let one hand or the other float up in the air like a balloon.” When in this state, the hypnotized person’s hand will rise up into the air, as if on its own accord; Spiegel can reach over and gently pull the hand down, but it will float right back up again, as if it’s filled with helium.
Hypnosis is the induction of a deeply relaxed state, with increased suggestibility and suspension of critical faculties. Once in this state, sometimes called a hypnotic trance, patients are given therapeutic suggestions to encourage changes in behavior or relief of symptoms. For example, in a treatment to stop smoking, a hypnosis practitioner might suggest that the patient will no longer find smoking pleasurable or necessary. Hypnosis for a patient with arthritis might include a suggestion that the pain can be turned down like the volume of a radio.
Finally, the neural underpinnings of PHA will be even clearer when we incorporate its most important aspect in imaging studies—the dissociation between implicit and explicit memory. In PHA (and in functional amnesia) the person is unable to explicitly recall certain information, yet we see evidence of this material on implicit measures. For instance, a participant given PHA may fail to recall the word “doctor,” learned earlier, but will have no trouble completing the word fragment “d _ _ t _ r”. Mendelsohn et al. did not assess implicit memory. Rather, they tested recognition, which in a sense confounds explicit and implicit memory. We’d like to compare brain scans of a PHA group trying to explicitly recall the movie (they should show reduced activation, as above) with brain scans of the same group completing an implicit memory measure of the movie (they should show normal activation). This would be tricky to do—implicit measures of complex material such as movies and autobiographical memories are hard to find or construct. But it would contribute to a more complete neural picture of the processes involved in these fascinating forms of forgetting.
State theorists interpret the effects of hypnotism as due primarily to a specific, abnormal, and uniform psychological or physiological state of some description, often referred to as "hypnotic trance" or an "altered state of consciousness". Nonstate theorists rejected the idea of hypnotic trance and interpret the effects of hypnotism as due to a combination of multiple task-specific factors derived from normal cognitive, behavioural, and social psychology, such as social role-perception and favorable motivation (Sarbin), active imagination and positive cognitive set (Barber), response expectancy (Kirsch), and the active use of task-specific subjective strategies (Spanos). The personality psychologist Robert White is often cited as providing one of the first nonstate definitions of hypnosis in a 1941 article:
But psychiatrists do understand the general characteristics of hypnosis, and they have some model of how it works. It is a trance state characterized by extreme suggestibility, relaxation and heightened imagination. It's not really like sleep, because the subject is alert the whole time. It is most often compared to daydreaming, or the feeling of "losing yourself" in a book or movie. You are fully conscious, but you tune out most of the stimuli around you. You focus intently on the subject at hand, to the near exclusion of any other thought.
Hypnotic music became an important part in the development of a ‘physiological psychology’ that regarded the hypnotic state as an ‘automatic’ phenomenon that links to physical reflex. In their experiments with sound hypnosis, Jean-Martin Charcot used gongs and tuning forks, and Ivan Pavlov used bells. The intention behind their experiments was to prove that physiological response to sound could be automatic, bypassing the conscious mind.
Research into hypnosis in military applications is further verified by the Project MKULTRA experiments, also conducted by the CIA. According to Congressional testimony, the CIA experimented with utilizing LSD and hypnosis for mind control. Many of these programs were done domestically and on participants who were not informed of the study's purposes or that they would be given drugs.
Before long, hypnotism started finding its way into the world of modern medicine. The use of hypnotism in the medical field was made popular by surgeons and physicians like Elliotson and James Esdaille and researchers like James Braid who helped to reveal the biological and physical benefits of hypnotism. According to his writings, Braid began to hear reports concerning various Oriental meditative practices soon after the release of his first publication on hypnotism, Neurypnology (1843). He first discussed some of these oriental practices in a series of articles entitled Magic, Mesmerism, Hypnotism, etc., Historically & Physiologically Considered. He drew analogies between his own practice of hypnotism and various forms of Hindu yoga meditation and other ancient spiritual practices, especially those involving voluntary burial and apparent human hibernation. Braid's interest in these practices stems from his studies of the Dabistān-i Mazāhib, the "School of Religions", an ancient Persian text describing a wide variety of Oriental religious rituals, beliefs, and practices.
In order for a hypnotherapist to convey positive suggestions for change, the patient must be in a receptive state. The state is called trance and the method of achieving a trance is through induction. Induction techniques are many and varied and involve the therapist offering suggestions that the patient follows. The formerly common "your eyes are getting heavy" suggestion may still exist, but other more reliable and acceptable (by the patient) forms of induction have come to the forefront. The artful hypnotherapist is always aware of the present condition of the patient and uses this information to lead him/her down the path of induction. In its lighter stages, trance can be noted by the relaxation of muscles. At this point, hands can levitate when given the suggestion, and paresthesia, a feeling of numbness, can be induced. In a medium trance, a patient can be led to experience partial or complete amnesia , or failure to recall events of the induction after the fact. A deep trance opens the patient to powerful auditory, visual, or kinesthetic experiences. The phenomenon of time distortion is experienced most profoundly at this level. Patients may believe they have been away briefly, and may react with disbelief when told they were away much longer. Although some work can be done in lighter states of trance, the best circumstance for implementing change is when the patient reaches a deep trance state. At this level, the patient is focused inwardly and is more receptive to positive suggestions for change. This is also the point at which the therapist can invoke posthypnotic suggestions, or instructions given to the patient so he/she will perform some act or experience some particular sensation following awakening from the trance. For example, these suggestions, if accepted by the patient, can be formed to make foods taste bad, cigarettes taste bad, delay impulses, curb hunger, or eliminate pain. However, it should be noted that posthypnotic suggestions given to a person, which run counter to the person's value system or are not something they are likely to do under ordinary circumstances, will not be accepted and therefore not implemented.
We have, however, come a long way from the days of Mesmer’s animal magnetism. The increasing interest in mindfulness meditation suggests that mainstream acceptance of the mind-body connection is growing. This year, two well-received books by serious science journalists, Marchant’s Cure, out in January, and Erik Vance’s Suggestible You, out this month, explore this territory — the demonstrable results of hypnosis, faith, and even magic — long dismissed as pseudoscience or explained away as the placebo effect. Just last month, NPR reported that placebo pills work even when people know they’re taking a placebo. “Those are real, biological changes underlying those differences in your symptoms,” Marchant told Science of Us earlier this year. It’s all in your mind. But that doesn’t mean it’s not real.
To investigate the effectiveness of cognitive hypnotherapy (CH), hypnosis combined with cognitive-behavioral therapy (CBT), on depression, 84 depressives were randomly assigned to 16 weeks of treatment of either CH or CBT alone. At the end of treatment, patients from both groups significantly improved compared to baseline scores. However, the CH group produced significantly larger changes in Beck Depression Inventory, Beck Anxiety Inventory, and Beck Hopelessness Scale. Effect size calculations showed that the CH group produced 6%, 5%, and 8% greater reduction in depression, anxiety, and hopelessness, respectively, over and above the CBT group. The effect size was maintained at 6-month and 12-month follow-ups. This study represents the first controlled comparison of hypnotherapy with a well-established psychotherapy for depression, meeting the APA criteria for a "probably efficacious" treatment for depression.
Hypnosis is not a psychotherapeutic treatment or a form of psychotherapy, but rather a tool or procedure that helps facilitate various types of therapies and medical or psychological treatments. Only trained health care providers certified in clinical hypnosis can decide, with their patient, if hypnosis should be used along with other treatments. As with psychotherapy, the length of hypnosis treatment varies, depending on the complexity of the problem.