In the foreword written by Martin Orne for the book Self-Hypnosis: The Chicago Paradigm by Fromm and Kahn (1990) he states,

“Perhaps the greatest single advancement made in the scientific stufy of hypnosis has been the realization that the ability to enter hypnosis is largely a skill of the patient, combining elements of focused attention, fantasy, and suspecnded belief. The role of the therapist working with the patient to use his or her hypnotic ability is to provide a context in which the patient can willingly express aspects of this cognitive skill…”

Not only can the patient benefit from hypnosis during therapy, but self-hypnosis, once learned, can be used effectively outside the therapist’s presence.”

Within my own explorations and whilst embarking upon my mission to write a truly exhaustive guide and text book on the subject of self-hypnosis (a comparably exhaustive task!) I have encountered some minor resistance to the above quoted notion, mainly from those dogmatically entrenched in a singular, seemingly non-flexible belief about what hypnosis actually is.

There still exists some disagreement over the definition of hypnosis. Which adds to the issues of explaining and studying self-hypnosis. The most comprehensive collective works on the subject of self-hypnosis happened in the 1980s and 1990s, with special recognition going to an edition of the 1981 issue of the International Journal of Clinical and Experimental Hypnosis, which was dedicated to self-hypnosis. So a while back I wrote an article to give a concise account of some historical context and theoretical notions and evidence base for self-hypnosis here on this blog.

That exploration was indeed answering less questions and leading me to more investigation, more reading and could become all-consuming!

My aim a number of weeks back, was to post a few blog entries here and with a view to adding more initial discussion to my upcoming book on the subject; that aim was to review the literature comparing hypnosis and hetero hypnosis and show that the two have a number of distinctions despite being interrelated. It would appear that some of the research about hypnosis does not always apply to self-hypnosis and it could be incorrect to assume one is a self-directed version of the other – which has been assumed by many for a lot of years.

Specific research has been conducted specifically in this regard and large chapters of credible hypnosis texts have discussed this and I thought I’d offer up a concise review here for my students to read and benefit from. However, it has not proved quite as simple as that.

To cut a long story short, in order to discuss that, a framework of other stuff needs to be set in place, and some contextualising needs to precursor those articles which will be posted here in coming weeks. To start with, I thought I’d offer up a number of key theories that clinicians, academics, researchers and other hypnosis professionals use to describe and explain self-hypnosis. That is what today’s blog entry aims to do.

Firstly, we have Clinical Self-Hypnosis:

This theory of self-hypnosis is one held by a great many hypnotherapists and it refers to a self-hypnosis experience and process that is initially taught to the client by the hypnotherapist. The client will then practice their skills, usually after an experience of heterohypnosis (i.e. induced by the therapist), which is monitored.

The client will discuss observations and experiences and the process is refined and then when practicing away from the therapist, the client may monitor their own experience with the aid of a chart or form provided by the hypnotherapist.

Secondly, we have the Theory That All Hypnosis is Self-Hypnosis:

The previous article I wrote and linked to in this article refers to this in a bit more detail and is worth reading for that purpose. In addition to many of the supporters of this notion that I mentioned there, many well known and established authors and hypnotherapists support this idea that all hypnosis is self-hypnosis (Erickson, 1948; Kroger, 1977; Spiegel & Spiegel, 1978).

Milton Erickson identified hypnosis and self-hypnosis as the same process. Maybe it was because Erickson would suggest that virtually anything could be described as hypnosis in the context of his sessions and in most areas of life. (An interesting read on and critique by Weitzenhoffer on this notion of Erickson’s was mentioned on Donald Robertsons’s blog earlier this week)

Erickson did also strongly support the idea and model of the conscious/unconscious mind and within his work maintained that it is unnecessary to know how change occurs. Erickson thereby suggested that each patient’s unconscious mind knows more that they consciously realise and as a result the unconscious can show and teach the client how to change, develop and move forward in life. This is a way I used to teach self-hypnosis and did so for a number of years – teaching self-hypnosis as a means of instructing the unconscious mind. Today, I do not subscribe to that notion at all.

In a clinical environment, it may be considered beneficial for the clients of a hypnotherapist to think of all hypnosis being self-hypnosis as it gives them more control and autonomy and dispels myths of an all-powerful hypnosis wielding hypnotist. By definition, this implies that the client creates and controls their own experience of hypnosis.

On the flip side of the coin though, some report that clients might even feel threatened by that degree of autonomy, which could impair the relationship with the hypnotherapist. They believe that the trust which is implicit when one hypnotises another is central to the therapeutic alliance.

If we look at this subject from a research point of view, all hypnosis is not self-hypnosis. I am going to demonstrate practically and theoretically how, despite much correlation between hypnosis and self-hypnosis, all hypnosis is not self-hypnosis according to research in future blog entries comparing the two.

The discussion is still open and really requires further study to take any firm stance. While a major author on the subject of self-hypnosis in the 1970s, Shor (1979) wrote that all hypnosis is self-hypnosis, Weitzenhoffer (1989), stated that all hypnosis is a variant of heterohypnosis and that self-hypnosis is a ‘pseudohypnosis’ because it is comparatively limited in its applications.

Thirdly, Self-Hypnosis as an Altered State of Consciousness Theory:

It was the comprehensive study and work of  Erika Fromm and the Chicago group (Fromm, 1975; Fromm & Shor, 1979; Fromm et al., 1981) that started to challenge the previously dominant idea that all hypnosis is self-hypnosis. Whilst heavy going in it’s reporting of their research (at least if you are not used to academic styles of writing) it is an incredibly important and seminal work.

When Fromm and colleagues compared self-hypnosis with heterohypnosis in their studies, they did show that both heterohypnosis and self-hypnosis were characterised by absorption which fell in line with previous authors (Hilgard, 1975; Tellegen & Atkinson, 1974). They also showed the similarities between the two as both involved a fading of general reality orientation  as described in previous literature also (Shor, 1959, 1962a; Shor & Orne, 1965).

That is, the experience of self-hypnosis was shown to absorb the self-hypnotist in his or her own inner experiences, and while self-hypnotised, he or she experiences a subjective fading of the general orientation to reality. I think most people that engage in self-hypnosis tend to relate to this at some point and in some way.

It is these types of phenomena that also characterise altered states of consciousness when the literature is examined. Some therefore believe that the work of Fromm indicates that self-hypnosis is actually a state of altered consciousness. From a personal and professional stance, I have a non-state perspective of hypnosis and hypnotherapy in line with a more cognitive behavioural philosophy to my work, so some of this makes for uneasy reading (and writing) for me.

There are notable distinctions made in this body of work between hypnosis and self-hypnosis too. Fromm and Kahn (1990) showed within their studies that,

“expansive, free-floating attention and ego receptivity to stimuli coming from within are state-specific for self-hypnosis, whereas concentrative attention and receptivity to stimuli coming from a single outside source are state-specific to heterohypnosis.” 

Fromm et al. (1981) also showed that imagery in self-hypnosis was found to be rich, sequenced, and/or segmented. They found imagery apparent in self-hypnosis was greater in quantity than in heterohypnosis and was deemed subjectively (by the self-hypnotists in the study) to be more personally meaningful.

Our Fourth Theory is That of Self-Hypnosis as a Self-Directed State:

Within Fromm et al’s 1981 work, they described a number of definitions for self-hypnosis. They wrote that self-hypnosis might be perceived as a self-directed state. It was discussed that in some loosely structured self-hypnosis experiments, a hypnotist may provide suggestions. These are referred to as experimenter-initiated suggestions. The subject within that experiment then responds to those suggestions subjectively, in their own self-directed way.

For most hypnotherapists that task their clients with self-hypnosis, a self-directed theory may well make more sense than the self-initiated theory coming up next. If the hypnotherapist gives protocols and structure and a number of suggestions for the client to work on, thereafter, the client responds to those learned protocols in their own self-directed fashion and makes it applicable to the personal context and situation.

If this theory of self-hypnosis is adhered to, it does make it easier to research and compare heterohypnosis with self-hypnosis. This is because when you have a number of suggestions already given, the potential responses are limited and easier to make comparisons with.

As previously mentioned, our next theory is that of Self-Hypnosis as a Self-Initiated State:

I have a bias with regards to this theory as I have been teaching students and clients effective means of delivering their own suggestions to themselves for a number of years, but I’ll do my best to be as objective as possible.

When we refer to self-initiated self-hypnosis, we mean that  the individual self-hypnotist initiates his or her own induction and subsequent suggestions.  I like this theory of self-hypnosis because it creates self-efficacy on the part of the self-hypnotist, which has been shown (in particular by Bandura in the 1970s,80s and 90s) to enhance gains. It is a theory favoured by those such as myself who teach self-hypnosis for self-improvement.

The problems with this theory of self-hypnosis arise when it comes to research because it is focused upon a  number of hypnotic potentialities rather than on measuring specific changes which is necessary for solid evidence base.  Within a therapeutic context, we want to measure outcomes and gains and levels of change, and for research to mean anything, we are often required to employ the same levels of measurement.  Without such, evaluating effectiveness is just about impossible.

Next up, we have the Researcher-Definition of Hypnosis Theory:

In the 1980s, the work of Spanos et al (1986) and their Carleton Hypnotic Skills Training programme showed how hypnotisability could be developed with practice of pre-defined self-hypnosis skills. Prior to that instruction and practice, the individuals were hypnotised formally with a standardised process and prior to that, they were shown a video of how it looked to be hypnotised.

This theory then is that the individuals learn about hypnosis upon arrival to the research environment. They subsequently are given information, are interviewed, have standardised hypnosis experiences, and prescribed skills training. All of which result in a particular and ready-made experience of self-hypnosis.

The beauty of which does mean we can research effectively and monitor standardized processes as well as accurately measuring effects.

There is a problem with this though, a rather obvious one which was pointed out by Fromm et al (1981). Let’s face it, such a prescribed experience is perhaps no longer in essence self-hypnosis, is it? For some authors, this is necessary to compare, contrast and measure and make studies possible.

Finally then, we have Hypnotist-Absent Self-Hypnosis and Hypnotist-Present Self-Hypnosis theories:

These two are general theories discussed in a lot of literature, but are fairly generic and self-explanatory. Obviously, no hypnotist is present with hypnotist-absent theory of self-hypnosis.

Though in the hypnotherapy environment, the client may learn to develop self-hypnosis skills in stages with the aid of the therapist, in a very real sense, self-hypnosis can be initiated and completed alone and does not actually require the presence of the hypnotist. Our first mentioned theory; that of clinical self-hypnosis, is a prime example of hypnotist absent self-hypnosis.

Though with the hypnotist-present self-hypnosis, the hypnotist may well be there with the individual, the hypnotist may be silent or may offer words without giving direct suggestions. The hypnotist may however, offer guidance or loose suggestions to help in the initial stages of learning self-hypnosis though.

As you can perhaps begin to see and those of you with any experience of hypnosis, especially in a therapeutic environment, there are so many variable in place when it comes to self-hypnosis: What is the outcome, what is the personality of the individual, what is the nature of the issue, what is the context, what is the working definition or understanding of self-hypnosis underpinning that individual’s experience, and so much more.

These theories then are probably difficult to truly isolate and support strictly. Facets of most of these theories will be applicable dependent on the individual, so having a broad understanding of the theories can help us as we move forward and start comparing self-hypnosis with hetero hypnosis in a bit more depth in coming blog entries here.

In the meantime, have a wonderful weekend…

References:

Erickson, M. H. (1948) Hypnotic Psychotherapy. In The Medical clinics of North America (pp. 571-583). New York: W. B. Saunders.

Fromm, E., & Kahn, S. (1990) Self-hypnosis: The Chicago paradigm. New York: Guildford Press.

From above book:

The relation of self-reports of hypnotic depth in self-hypnosis to hypnotizability and imagery production (pp. 147-159)

Representations of self-hypnosis in personal narratives (pp. 115-121)

The role of imagery in self-hypnosis: Its relationship to personality characteristics and gender (pp. 135-146).

Fromm, E. (1981) Ego-psychological parameters of hypnosis and their clinical applications. In H. Wain (Ed), Theoretical and clinical aspects of hypnosis. Miami, FL: Symposia Specialists.

Johnson, L. S. (1981) Current research in self-hypnotic phenomenology: The Chicago Paradigm. International Journal of Clinical and Experimental Hypnosis, 29 (3), 247-258.

Kroger, W. S. (1977) Clinical and experimental hypnosis (2nd ed.) Philadelphia: J. B. Lippincott.

Shor, R., & Easton, R. D. (1973) Preliminary report on research comparing self and hetero-hypnosis. American Journal of Clinical Hypnosis, 16 (1), 37-44.

Spiegel, H., & Spiegel, D. (1978) Trance and treatment: Clinical uses of hypnosis. New York: Basic Books.