Hidden Depths: The Story of Hypnosis (46 page)

The guideline I use is this: I don't want anyone that I do hypnosis with ever to fail at anything. If I'm making a suggestion about something that can be verified easily, I will probably use words such as ‘could' or ‘might' – what we call ‘modal operators of possibility'. ‘Your arm
may
begin to rise…' That way, if what I've asked for doesn't occur, the person won't have ‘failed'. If I'm making a suggestion about something that is completely unverifiable, I'm more likely to use words that imply causation: ‘This
makes
you sink deeper into trance' or ‘That
causes
you to become more relaxed.' Since the
suggestion is unverifiable, he won't be able to conclude that he's failed.

Emotional words – sometimes called ‘anchors' – are important. Having found out enough about his client to tell which words were likely to trigger emotional responses, either positive or negative, Erickson would pepper his talk with these words in order to harness the emotional energy for therapeutic purposes.

But the technique for which Erickson is most famous is his use of analogies and metaphorical stories, for which he apparently had an astonishing gift. I'm sure some of the stories were prepared and polished, but others were spontaneous: Erickson could think in this metaphorical mode as swiftly and clearly as he could in normal associative mode. The tales are very often personal, details of Erickson's own life which he tailors to suit the moment, with the purpose of reframing the patient's problems. Most of the stories are too long to quote, but here's a short one designed to communicate the point that the unconscious mind can be trusted to do the right thing at the right time:

A lot of people were worried because I was four years old and didn't talk, and I had a sister two years younger than me who talked, and she is still talking but she hasn't said anything. And many people got distressed because I was a 4-year-old boy who couldn't talk. My mother said, comfortably, ‘When the time arrives, then he will talk.'

Simple and to the point. And the point of the stories was always the same: ‘First you model the patient's world, then you role-model the patient's world.' Stories and metaphors engage the imagination and pleasant emotions of the client; Erickson also used jokes, puns and riddles to the same effect. They relax the client and make him open to their metaphorical content, for they are in fact parables for his own problem and the way out of it. They can contain hidden action commands. One famous example involved a case of chronic bed-wetting in a twelve-year-old boy. The parents had tried everything, from patience to bribery and punishment. Erickson found out that the boy loved baseball, so he talked to the child about the muscle control needed to play expert baseball. In order to catch
the ball, he said, the muscles have to all clamp down at just the right moment; in order to release the ball, the muscles have to let go at just the right time, or the ball doesn't go where you want it to go. If you get it right, Erickson concluded, it's great – a real achievement. The boy stopped wetting his bed.

Or again, and perhaps with rather less subtlety, in dealing with a married couple who had sexual difficulties, he might get them to talk instead about food, a common metaphor for sex. He would get the woman to agree that she enjoyed lingering over the starters, while the husband liked to plunge straight into the main course. If the clients began to see what Erickson was driving at, he would change the subject, but re-introduce it from time to time. And he would end by suggesting, apparently just as a general piece of advice, that they find an evening when they could have a pleasant dinner together – hoping that a fulfilling dinner would lead to fulfilling sex.

This example is taken from a case where no hypnosis was involved. But most of Erickson's stories were told to hypnotized patients, because Erickson believed that in a trance state we instinctively understand the point of the story, without consciously realizing that we do. As the Ericksonian therapist Lee Wallas puts it, they are stories for ‘the third ear'. The point of the story is absorbed and acted on unconsciously. Moreover, being in a receptive state, the point is seeded deep within our psyches. But the point of the story is only half its therapeutic purpose; a good story leaves a good feeling – the kind of good feeling you have on leaving the cinema after a great movie. Creating that good feeling is also part of the therapy of Ericksonian story-telling, and so his stories were invariably life-enhancing, positive, supportive of growth and of taking charge of one's own life. They talk of achievements, of breaking barriers, of new horizons.

From a theoretical perspective, Erickson is most interesting as marking a clear break with the Freudian assumption that regression is the way to get at most problems, which have been caused in the past. Erickson worked, Zen-like, with patients here and now, believing that we each have within us the resources for complete health, and that we should focus on improving ourselves rather than correcting past mistakes. Moreover, since he thought that ‘Your conscious mind is very intelligent, but your unconscious is a lot smarter',
the therapeutic process did not necessarily require ‘insight' – the bringing into consciousness of whatever was required. He believed that we have the resources from our past to overcome any obstacle. If you have solved a problem in the past, you can do so again. So he would talk his patient through how she solved some problem in the past, and then recreate those conditions in the hypnotized patient's mind for the present.

Milton Erickson died over twenty years ago, but it is safe to say that almost any hypnotherapist you might visit today has been influenced by his work, and will be practising several of his techniques. I would describe Erickson as a kind of poet. There is a difference between hypnotic or ‘trance-inductive' poetry and the kind of poetry that appeals mainly to the intellect. The main features of hypnotic poetry are that it has a regular, soothing rhythm; it is repetitive; it uses vague imagery; and it contains obscurities which tire the mind. All of these features are present in Erickson's methods. He was an artist.

The question is: is there such a thing as hypnosis? Are people who are said to be hypnotized in a special state, distinct from other states of consciousness, or not? Can all the feats attributed to hypnotized subjects be performed equally well by people who have not undergone any kind of hypnotic induction? The literature on the debate is enormous, and the best that can be said for the controversy is that it has generated a huge volume of significant research. In what follows I have stuck to the heart of the issues. Although it is arguable that in hypnosis a number of different altered states of consciousness are involved, depending on the depth of the trance, it makes life simpler if I use the singular and just talk in terms of a single state.

In brief, state theorists argue that: (1) there is a special state of awareness called the hypnotic trance; (2) this state is marked by increased suggestibility, and enhancement of imagery and
imagination, including past visual memories; (3) the state involves a decrease in the planning function, a reduction in reality testing and a number of reality distortions such as false memories, amnesias and hallucinations; (4) the state involves involuntary behaviour – the subject has temporarily lost conscious control of his behaviour. They also predict, while admitting that there is as yet no conclusive proof in this regard, (5) that EEG results will one day demonstrate a unique physiology for this supposed hypnotic state.

Non-state theorists deny all these points: (1) concepts such as ‘trance' or ‘dissociation', taken from abnormal psychology, are misleading, in the sense that responsiveness to suggestion is a normal psychological reaction; (2) differences in response to hypnotic suggestions are not due to any special state of consciousness, but rather to the individual's attitudes, motivations and expectancies, or to his imaginative involvement in the task; (3) all the phenomena associated with hypnotic suggestions are within normal human abilities; (4) the apparent involuntary behaviours of subjects can be explained otherwise, without bringing in a special hypnotic trance; (5) they predict that no such physiological proof will ever be found, because there is no such state. In short, looking for the hypnotic state is like looking for the emperor's new clothes.

There is an interesting and fundamental difficulty in researching hypnosis, which goes some way towards undermining the work of both schools. It has been known since the time of Mesmer that in order to be successful a hypnotist must exude a certain confidence and assurance in the outcome of a given suggestion. A scientific researcher, however, is supposed to maintain a sceptical distance from both his subject and the hoped-for outcome. It is hardly surprising, then, that those researchers who have erred on the side of distance and aloof objectivity have often failed to find that hypnosis produces any results, while those who have gone too far in the other direction have suggested that there is no such thing as hypnosis, only rapport and suggestibility.

The chief proponent of the anti-state view since the 1950s has been Theodore Barber. I cannot resist telling an anecdote about Barber. There is a rumour, apparently started by Ernest Hilgard, that the reason Barber was so convinced of the non-existence of hypnosis as a separate state was that he was very highly hypnotizable himself –
so much so that he could never see what all the fuss was about, and so he denied the existence of hypnosis. Anyway, Barber argues (repeatedly) that the concept of hypnotism is meaningless. Hypnotism is defined as an induced state of increased suggestibility, and yet it is the fact that a person is hypnotized that is supposed to produce the phenomenon of increased suggestibility. Thus the argument is circular, or so Barber claims (and he has been echoed by many others). But this argument is not as strong as it seems. We can reject his premiss by not defining hypnotism merely in terms of suggestibility, and by claiming instead that suggestibility is just one of the phenomena of the hypnotic state.

But in any case, Barber adds, the supposed phenomena of hypnosis can be explained more simply by reference to the subject's attitudes, motivations and expectancies. In an enormous number of papers, Barber has tried to show that certain hypnotic phenomena (especially amnesia, enhanced muscular performance and arm levitation) can equally well be obtained with unhypnotized subjects who have been led by the researchers (i.e. himself and his colleagues) to have a positive attitude towards the outcome of the task they have been set, to be motivated to perform well, and to expect that they will be able to perform the task. As for the more extreme or exotic phenomena, such as hallucinations, age-regression, hypermnesia and hypnotic blistering, Barber has tried either to dismiss them or to claim that in reality they do not occur in dramatic ways and that therefore unhypnotized subjects have little difficulty in displaying them too.

Once, at a meeting of the American Psychological Association in the early 1970s, Barber was banging on as usual about how it was easy to bring about analgesia in people without hypnotic induction. Among other eminent psychologists on the stage with Barber was Martin Orne. Orne flicked open his cigarette lighter and held his palm over the flame. Fine: this seemed to confirm Barber's point. But those who knew Orne chuckled because they knew that he was also making a further point – that Barber's views did not advance our understanding of hypnosis at all.

There are further serious difficulties with Barber's view. Suppose he finds that both hypnotized and task-motivated people are equally capable of task X. He then infers that the hypnotized people are
actually task-motivated rather than hypnotized, and that there is no such thing as hypnosis. This is a blatant fallacy. If A produces X and B produces X, it does not follow that A and B are identical; they may simply have the same effect. What is true in Barber's position is nothing new, but has been known since the time of Bernheim – that suggestions given to susceptible or fantasy-prone individuals in the waking state (and especially when relaxed) can often produce the same effect as suggestions given to hypnotized subjects. Barber's list of suggested responses includes: colour blindness, deafness, various emotions, improvement of short sight, hallucinations of taste and sight, and allergic reactions. But, again, this does not disprove the existence of a special state which we can call the hypnotic trance.

In his later work Barber began to move towards the view that so-called hypnosis, as well as being a product of task-motivation, is also an act of the imagination. This is called the ‘cognitivebehavioural' approach, and its main proponents, apart from Barber, are psychologists Nicholas Spanos and John Chaves. They claim that being ‘hypnotized' is like reading a book or watching a film: ‘The responsive hypnotic subject … has intense and vivid experiences that are produced by the words or communications he is receiving.' Elsewhere, Spanos claims that so-called ‘hypnosis' is just ‘goaldirected fantasy': the subject imagines a situation which, if it actually occurred, would produce the results which the suggestions imply. Thus, as with Barber's early views, hypnosis is reduced to
behaviour
rather than a
state
.

Apart from the emphasis on imagination, the views expressed in the book Barber co-authored with Spanos and Chaves read pretty much like early Barber. The supposed hypnotic induction procedure serves only to produce positive attitudes, motivations and expectancies in the subject. Hence subjects show a high level of responsiveness to test suggestions (e.g. you cannot raise your right arm) and a ‘hypnotic' appearance (e.g. relaxed, eyes closed, drowsy, etc.), and report that they were hypnotized. Perceptual and physiological effects, age-regression, trance logic and visual hallucinations are not best explained by reference to ‘hypnotic trance' because unhypnotized control subjects are also capable of manifesting the same phenomena. Hypnotic surgery is explicable because most parts of the body are actually rather insensitive to the surgeon's scalpel. Also,
pain is reduced when patients have low levels of anxiety and fear, and positive expectations. Some cases of alleged hypnotic analgesia may actually be cases of post-'hypnotic' amnesia – the patient has simply forgotten that she suffered pain. Stage hypnotism works partly by fraud, and partly because the atmosphere makes for suggestibility and obedience.