Today’s blog title seems like a tongue twister and a half… Well, it does not just seem it, it is a tongue twister… Yet it is a brain twister of sorts too, because many people consider hypnotic susceptibility, hypnotisability or suggestibility to be the same thing… Perhaps they are. This blog entry is really for hypnotherapy students, so excuse me if you regularly tune in and today is not fun reading for you.
Before I get on todays rather dry blog topic, I thought I’d let you all know that we have just added 4 video clips to the Gold Plus members area here… They include lengthy demonstrations of hypnotherapy and also a full-on glove anaesthesia that is dramatically tested and proven… All the clips were taken from my hypnotherapy diploma in the last year so are current and present… As I am on my diploma course (intensive format) all week this week, I am unable to write my ezine… So as a one time treat for you, the glove anaesthesia video clip is going to be available to publicly view in my ezine for this single week only. Otherwise, the only place you can see that footage is in the members area. Come join us to benefit from them.
Ok, back on topic today then…
Hypnotic susceptibility scales, which have been mainly developed in experimental settings, were preceded by more primitive scales, developed within clinical practice over the years, which were intended to infer the “depth” or “level” of “hypnotic trance” on the basis of various subjective, behavioural or physiological changes.
James Braid (who introduced the term “hypnotism”), attempted to distinguish, in various ways, between different levels of the hypnotic state. Subsequently, the French neurologist Jean-Martin Charcot also made a similar distinction between what he termed the lethargic, somnambulistic, and cataleptic levels of the hypnotic state.
However, Ambroise-Auguste Liébeault and Hippolyte Bernheim introduced more complex hypnotic “depth” scales, based on a combination of behavioural, physiological and subjective responses, some of which were due to direct suggestion and some of which were not.
In the first few decades of the 20th century, these early clinical “depth” scales were superseded by more sophisticated “hypnotic susceptibility” scales based on experimental research. Numerous scales have been developed, which measure suggestions for ideomotor or cognitive effects, and either aim to inhibit or produce an effect.
The most widely used scales are those developed in the 1950s and 1960s by Andre Weizenhoffer and Ernest Hilgard- The Stanford Scales of Hypnotic Susceptibility (SSHS), (Weitzenhoffer and Hilgard, 1959, 1962).
When we evaluate tests we want to know if they are valid (measure what they are supposed to measure) and reliable (test- retest reliability).
One criticism of all these scales has been that they do not really measure susceptibility to hypnosis, only susceptibility to responsiveness. There are many aspects to hypnosis, such as suggestibility, expectation, susceptibility and induction. Many of the scales were developed to measure these individual aspects, so it can be difficult to compare them.
There are pros and cons as far as these scales are concerned…. Susceptibility scales are widely used in clinical and non-clinical research for the purposes of investigating differences between people of varying susceptibility (both in and out of hypnotic context). Of interest in clinical research is whether higher susceptibility to hypnosis is predictive of a better outcome, and if so, for what kinds of problem.
Wadden and Anderton (1982) reviewed clinical trials of hypnosis and concluded that hypnotic susceptibility was more likely to be a factor in the outcome for problems they termed as “automatic” (such as pain, asthma, skin complaints) as opposed to “self-initiated” (such as smoking and obesity). These findings suggest that susceptibility scales may be of use as a screening instrument for determining whether or not to use a hypnotic-based treatment.
Spiegel and Greenleaf (1992) propose that the Hypnotic Induction Profile is useful diagnostically in differentiating psychotic patients from those with dissociative disorders.
Administering a scale prior to treatment may give very useful indications of the types of suggestions to which a patient is more likely to respond in treatment.
Heap et al (1994) used the Creative Imagination Scale (CIS) with psychosomatic patients and found that if a patient scored low on this scale they had to spend more time customising the kinds of images used in treatment. Whereas high scorers responded well to standard images.
A scale such as the CIS may be a good way of introducing hypnosis to a patient and may be a useful practice instrument for new practitioners to become accustomed to delivering suggestions (as it is read from a script).
However, if the patient is not very responsive, then they may have less confidence in the therapy and a lowered expectation of success. Expectation plays a big part in the hypnotic process.
Susceptibility is a fairly stable characteristic but it does not correlate robustly with any major dimension of personality or cognitive style. Hence two people may obtain the same high score, but for different reasons.
People who find they can become absorbed in a book, piece of music etc to the exclusion of whatever is going on around them tend to score high on susceptibility scales.
However, absorption is not a key defining property of hypnosis.
Some scales like the Stanford Scales of Hypnotic Susceptibility (SSHS) are very time consuming to deliver and score (taking up to an hour or more).
However, for research purposes, the SSHS can be useful, and some consider it essential when measuring susceptibility on two occasions and researchers want to minimize learning and familiarity effects. (Form A and B are parallel versions- suggestions are nearly all different on both forms, but scales yield the same scores and distributions for the general population).
Form C samples a broader range of suggestions and discriminates among more highly susceptible subjects. It is regarded as the “gold standard” measure of susceptibility for the purposes of research.
A shorter measure is the Stanford Hypnotic Arm Levitation and Induction Test (SHALIT).
This is a standard arm levitation test (Hilgard et al, 1979), which takes less than ten minutes to administer and score (and correlates with the SHSS:A at 0.63). This is much more practicable for use in a busy practice, where time costs the client money.
The Hypnotic Induction Profile (HIP) developed by Spiegel and Spiegel (1987), has the advantage of being briefer than the Stanford scales and is a combined scale and induction.
There are different types of suggestibility and not all are related to hypnotic responsiveness.
Eysenck and Furneaux (1945) distinguished between primary and secondary suggestibility. Primary is typified by ideomotor responses and is related to measured hypnotic susceptibility. Secondary is more complex and concerned with direct or implied changes in sensory modalities and has been linked to ease of persuasion and gullibility.
It is unrelated to hypnotic responsiveness.
Suggestibility tests have a compounding effect, that is the more tests the person “passes” in a row, the more likely they are to pass the next one, and the more open to accepting the hypnotherapist’s suggestions. This can be beneficial to increase confidence and expectation.
Most tests are relatively quick and easy to deliver and the time spent delivering them is time enhancing the outcome of treatment.
When a person passes a test by giving the response you suggested, remember to praise them.
Success will improve if you set up each test with a good introduction and start off with little steps to test compliance.
If you search the archives of this blog, you can find my in depth description of the Chevreuls pendulum process which is a great suggestibility test and you look at Wikipedia and google other tests such as the classic book/balloon test, the finger vice, magnetic hands and so on… Many of which are used by hypnotists as full blown inductions as well as testing processes.