Hypnotic Responsiveness Research Articles

The role of hearing and listening in hypnotic responsiveness

ABSTRACT The hypnosis literature emphasizes features of suggestion, induction, and communication that are described as evoking heightened responsiveness on the part of the subject or client. This article explores what is often overlooked: to have an effect, the subject must not only hear the suggestion but listen to it. The process of listening is described across multiple levels ranging from the acoustic signal to its transduction into a meaning-filled and motivationally enriched message that spurs action. That journey traverses challenging terrain, with numerous obstacles that serve to maintain past habits and response patterns, despite a client’s stated desire for adaptive change. The article highlights those obstacles and then provides descriptions of five language structures that can reach the client consciously or non-consciously, but always in ways that increase the odds that the therapeutic messaging is packaged in a manner that optimizes it being “heard,” absorbed, and enacted. Applications of each language structure are provided using relevant clinical case examples.

French Norms for a Shortened Online Adaptation of the Harvard Group Scale of Hypnotic Susceptibility, Form A

ABSTRACT This study presents the norms and psychometric properties for a shortened online adaptation of a French version of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A). Assessment of involuntariness and subjective intensity was added to the traditional scoring. A total of 373 individuals completed an online hypnotizability screening test on their own computer. Participants received the HGSHS:A script through an audio recording lasting about 30 minutes. The results showed that the item difficulty and reliability of the short online HGSHS:A were consistent with the offline version of the scale and with the reference samples. Involuntariness and subjective intensity corrections improved significantly the accuracy in the measurement of the scale and helped to dissociate between different phenomenologies in hypnotic responding. These findings indicate that the short online HGSHS:A is a reliable tool for measuring hypnotizability. Moreover, we suggest that using complementary measures of involuntariness and subjective intensity helps to shed more light on hypnotizability as part of a multi-componential approach to hypnotic response.

Intimate relationships and hypnosis: insecure adult attachment affects emotions and absorption during hypnosis.

Hypnosis research indicates that subjects are not equally hypnotizable. Most studies on hypnotizability focused on the relationships with personality or cognitive variables. At the same time, only a few proposed the contribution of the attachment style, defined as the result of the childhood relationship with the caregivers and influencing the adult relations. In the present investigation, two studies were carried out to test the possible association between adult attachment and hypnotic responsivity. The adult attachment was assessed using the Experiences in Close Relationships-Revised (ECR-R) questionnaire, while hypnosis was assessed through the Harvard Group Scale of Hypnotic Susceptibility (HGSHS:A; Study 1) and the Phenomenology of Consciousness Inventory: Hypnotic Assessment Procedure (PCI-HAP; Study 2) in order to adopt a behavioral and a phenomenological approach, respectively. Analyses showed that attachment factors (anxiety and avoidance) were not associated with the level of hypnotizability, whereas it was associated with variations of consciousness during hypnosis, mainly internal dialogue, absorption and negative emotions. Overall, the insecure attachment styles yielded increased mind wandering and restlessness during hypnosis when compared to the secure style. The reason probably lies in the feeling of anxiety or danger of insecurely attached individuals when involved in intimate or confidential relationships. These findings clarify a still poorly investigated aspect concerning the influence of attachment style on hypnotic experience and further highlight the need to consider inter-individual differences and the phenomenological perspective when assessing hypnosis and hypnotizability.

Neuroscience of Hypnosis: A Neurophysiological View of Hypnotherapy

Objective: This narrative literature review is intended to briefly clarify the history and concepts of hypnosis, history, scientific advancement in the field and therapeutic applications. The theme will have greater contextualization regarding the neurophysiology of hypnosis. Methods: In this bibliographic review (databases, websites and specialized journals) studies were selected seeking as keywords "Hypnosis", "Neurobiology", "Hypnotic Response", "Historical", "Research", to approach these concepts in the clinical area and research in the health area, in order to seek greater grounding on the concepts and neurobiological mechanisms involved in hypnotherapy. The databases evaluated were MEDLINE, GOOGLE ACADEMIC, PUBMED, SCIENCE DIRECT, SciELO and LILACS. Results: In the selected studies on the theme, the concepts on hypnotherapy and history are addressed. Hypnosis, recognized as a psychobiological process, modifies brain activity, affecting areas such as sensory cortexes, the dorsal anterior cingulate gyrus, and the prefrontal cortex. This neurocognitive alteration influences perception, making hypnosis an effective tool in the modulation of various clinical conditions in a way that complements conventional therapy. Conclusion: The neurophysiology of hypnosis is a field in constant evolution. Although the exact understanding of the neurophysiological processes underlying hypnosis is not yet fully understood, advances in neuroscience reveal insights into the hypnotic response. The progress in new neuroimaging technologies and methodologies may provide clearer answers about the mechanisms involved in hypnotherapy, as well as proving the effectiveness of its application.

Brain Functional Correlates of Resting Hypnosis and Hypnotizability: A Review.

This comprehensive review delves into the cognitive neuroscience of hypnosis and variations in hypnotizability by examining research employing functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and electroencephalography (EEG) methods. Key focus areas include functional brain imaging correlations in hypnosis, EEG band oscillations as indicators of hypnotic states, alterations in EEG functional connectivity during hypnosis and wakefulness, drawing critical conclusions, and suggesting future research directions. The reviewed functional connectivity findings support the notion that disruptions in the available integration between different components of the executive control network during hypnosis may correspond to altered subjective appraisals of the agency during the hypnotic response, as per dissociated and cold control theories of hypnosis. A promising exploration avenue involves investigating how frontal lobes' neurochemical and aperiodic components of the EEG activity at waking-rest are linked to individual differences in hypnotizability. Future studies investigating the effects of hypnosis on brain function should prioritize examining distinctive activation patterns across various neural networks.

Redefining hypnosis: A narrative review of theories to move towards an integrative model

Hypnosis is an ancient mind-body intervention that has regained interest with the surge of research in the last decade documenting its clinical validity. Yet, theoretical controversies and misconceptions prevail among theorists, clinicians, and the general public, impeding the understanding, acceptance, replication, and use of hypnosis. Providing adequate information, which dispels misconceptions and promotes more balanced views, is warranted to facilitate the implementation and adoption of hypnosis in clinical and research settings. This review re-examines the conceptualisation of hypnosis throughout history and the theoretical controversies surrounding it while highlighting their meeting points and clinical implications. Despite dichotomies, a broad agreement appears across theoretical approaches regarding hypnotic analgesia effects, key components, and vocabulary. Further, theories highlight key factors of hypnotic responding. For instance, social theories highlight social and contextual variables, whereas state theories highlight biopsychosocial mechanisms and individual factors. Based on theories, the terms hypnotherapy or clinical hypnosis are recommended to refer to the therapeutic use of hypnosis in psychotherapeutic and medical contexts, respectively. This review concludes with a model that integrates various theories and evidence and presents hypnosis as a complex multifaceted intervention encompassing multiple procedures, phenomena, and influencing factors. This review intends to deepen our understanding of hypnosis, and promote its more rapid adoption and adequate implementation in research and clinical contexts, in addition to steering research towards evidence-based hypnotic practice. The review can have important research and clinical implications by contributing to advancing knowledge regarding hypnotic procedures, phenomena, and influencing factors.

Orexin 2 receptor antagonism sex-dependently improves sleep/wakefulness and cognitive performance in tau transgenic mice.

Tau pathology contributes to a bidirectional relationship between sleep disruption and neurodegenerative disease. Tau transgenic rTg4510 mice model tauopathy symptoms, including sleep/wake disturbances, which manifest as marked hyperarousal. This phenotype can be prevented by early transgene suppression; however, whether hyperarousal can be rescued after onset is unknown. Three 8-week experiments were conducted with wild-type and rTg4510 mice after age of onset of hyperarousal (4.5 months): (1) Tau transgene suppression with doxycycline (200 ppm); (2) inactive phase rapid eye movement (REM) sleep enhancement with the dual orexin receptor antagonist suvorexant (50 mg·kg-1 ·day-1 ); or (3) Active phase non-NREM (NREM) and REM sleep enhancement using the selective orexin 2 (OX2 ) receptor antagonist MK-1064 (40 mg·kg-1 ·day-1 ). Sleep was assessed using polysomnography, cognition using the Barnes maze, and tau pathology using immunoblotting and/or immunohistochemistry. Tau transgene suppression improved tauopathy and hippocampal-dependent spatial memory, but did not modify hyperarousal. Pharmacological rescue of REM sleep deficits did not improve spatial memory or tau pathology. In contrast, normalising hyperarousal by increasing both NREM and REM sleep via OX2 receptor antagonism restored spatial memory, independently of tauopathy, but only in male rTg4510 mice. OX2 receptor antagonism induced only short-lived hypnotic responses in female rTg4510 mice and did not improve spatial memory, indicating a tau- and sex-dependent disruption of OX2 receptor signalling. Pharmacologically reducing hyperarousal corrects tau-induced sleep/wake and cognitive deficits. Tauopathy causes sex-dependent disruptions of OX2 receptor signalling/function, which may have implications for choice of hypnotic therapeutics in tauopathies.

Transcranial electrical stimulation of the prefrontal cortex to boost the hypnosis experience: who benefits most?

Many attempts have been made to enhance hypnotizability. The most recent studies adopted the non-invasive brain stimulation to deactivate the dorsolateral prefrontal cortex (DLPFC) during hypnosis, indicating this as a promising approach. However, it is still no clear whether individual factors can predict the effects of stimulation on hypnotizability. In the present study we adopted the phenomenological consciousness inventory (PCI) to retrospectively assess the mental processes during hypnosis and to predict hypnotizability, here defined as "hypnoidal state." The aim was to investigate the possible role of the hypnotic susceptibility on the efficacy of a validated approach of hypnosis enhancement through cathodal transcranial electrical stimulation (tDCS) of the left DLPFC. Results indicated that the lower hypnoidal state at baseline predicted the greater enhancement after the active tDCS. These findings suggest the subjects with lower hypnotic responsiveness as the best candidates for the tDCS interventions of hypnosis enhancement, at least for the montage targeting the left DLPFC. Neurocognitive underpinnings and clinical implications of the results are discussed.

Reliability and Validity of the Elkins Hypnotizability Scale within a Clinical Sample

ABSTRACT Hypnotherapy is used in clinical settings to treat mental and physical health-related conditions. Hypnotic response can be measured through hypnotizability scales to help interventionists personalize treatment plans to suit the patients’ individualized hypnotic abilities. Examples of these scales are the Elkins Hypnotizability Scale (EHS) and the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C). According to the previous literature, these scales have good discriminating ability and internal consistency (α = 0.85) in collegiate samples, but the psychometric properties of the EHS for a targeted clinical population have not been determined yet. This study assessed said properties, and results showed adequate reliability of the EHS in a targeted clinical sample and strong convergent validity of the EHS to the SHSS:C. The authors conclude that the EHS is a strong and useful measure of hypnotizability that is pleasant, safe, brief, and sensible to individualities in hypnotic ability found in diverse clinical samples.

Adaptive Experiential Theory of Hypnosis

ABSTRACT State and nonstate theories of hypnosis have dominated the field for decades and helped advance hypnosis clinically and scientifically. However, they fall short in various ways including insufficient consideration of unconscious/experiential processes. The authors’ new theory is predicated on Epstein’s cognitive-experiential self-theory, a dual-process model that provides a comprehensive understanding of the rational system and the experiential system and highlights that, although they interact synergistically, their features and modes of operation differ greatly. The rational system, influenced by logic and reason, is demanding of cognitive resources and operates effortfully with minimal affect. In contrast, the experiential system is emotionally driven, associative, and encodes reality in images and feelings without conscious effort. Our theory, the adaptive experiential theory, posits that complex hypnotic responding is attributable to an individual’s ability to adapt and deliberately shift from processing primarily within the rational system to the experiential system. Greater association with the experiential system yields alterations in processing reality, which allows hypnotic suggestions to be internalized and enacted without excessive interference from the rational system.

HIPNOSE: definição, importância, limitações e possibilidades baseadas em evidências

The primary objective of this review is to analyze the main theoretical perspectives that define hypnosis, the value of considering it as a unique phenomenon, the evidence that sustains that view, and its effect on research. For more than a century in which the subject has been studied, the results are still hampered by a methodological flaw since the beginning of the research, the definition of the phenomenon. This review used the Medline via Pubmed as database for bibliographic search, including a total of 41 studies, where it could be found that 72,7% of the surveyed studies, adopt the approach in which there's an alternate state of consciousness to explain the phenomenon and to guide its interpretations, even though there isn't enough evidence to sustain the existence of an alternate state of consciousness exclusively hypnotic and it's relation to the capability of hypnotic response. In conclusion, it's suggested the performance of more studies that bring a merger between sociocognitive and state of mind perspectives, so that the findings can come to help with the evolution of hypnosis, which already presents strong results when applied in different medical and psychotherapeutic treatments, predominantly in the Cognitive-Behavioral Therapy.

Advancing hypnotic inductions: An Ericksonian perspective

ABSTRACT Hypnotic induction is a requisite step before starting hypnotherapy, but its role is often underappreciated. In traditional hypnosis, the induction is the means to get the person into trance; it is frequently scripted and does not have direct relationship to the hypnotherapy to follow. In contradistinction, Milton Erickson strategically coordinated induction with hypnotherapy. We first review the functions of informative and evocative communication. We define hypnosis as an interpersonal state. During induction, the hypnotherapist encourages responsiveness to implied meaning which paves the way for therapeutic utilization. Induction is a context for offering therapeutic suggestions. Components of induction are reviewed – focusing attention, altering intensity, dissociation, and building responsiveness. The hypnotherapist’s “palette” of evocative tools to elicit hypnotic responsiveness include gestures, posture, proximity, tone and tempo of voice, and unusual forms of grammar. Additional ways to increase therapeutic impact include precision and modulation of tension and the density of communication.

An insula view of predictive processing in hypnotic responses.

An insula view of predictive processing in hypnotic responses.

Desformylflustrabromine (dFBr), a positive allosteric modulator of the α4β2 nicotinic receptor modulates the hypnotic response to ethanol.

Binge drinking can increase an individual's risk of developing alcohol use disorder (AUD). Ethanol targets multiple neurotransmitter systems; however, not much is known about its effects on the cholinergic system. Nicotinic acetylcholine receptors (nAChRs) are ligand-gated ion channels, the heteromeric α4β2 nAChR being a commonly expressed subtype. Desformylflustrabromine (dFBr), a positive allosteric modulator (PAM), increases the efficacy of α4β2 nAChR invitro and has previously been shown to have translational potential. In this study, we investigated whether dFBr modulates the hypnotic response to ethanol. Ethanol-induced loss of righting reflex (LORR) duration was measured in the presence and absence of dFBr. The β2 nAChR selective antagonist dihydro-β-erythroidine (DHβE) was used to study the involvement of the β2 subunit. Additionally, we used a crosslinking-based western blot assay to estimate changes in total versus intracellular α4 nAChR protein in thalamic tissue of rats treated with vehicle, dFBr, ethanol, or ethanol and dFBr. Lastly, using Xenopus oocyte two-electrode voltage clamp (TEVC) studies, we determined the effects of ethanol and dFBr on α4β2 nAChR. Pretreatment with 6mg/kg dFBr reduced ethanol-induced LORR duration as compared to rats treated with ethanol alone. LORR studies with DHβE suggest that dFBr reduced ethanol-induced LORR duration via the β2 nAChR subunit. Crosslinking-based western analyses revealed that ethanol caused early increases in total and presumably surface thalamic α4 nAChR subunit protein levels. This ethanol-induced α4 nAChR upregulation was significantly reduced in rats pretreated with 6mg/kg dFBr. In TEVC studies, ethanol potentiated ACh-induced currents in α4β2 nAChR, while it slightly reduced dFBr potentiation of maximal ACh currents. Our results suggest that thalamic nAChRs containing the α4 subunit are rapidly upregulated by a single intoxicating dose of ethanol. Furthermore, dFBr, an α4β2 nAChR-selective PAM, significantly attenuates the hypnotic response to ethanol via actions on β2 nAChR. Overall, these results indicate that dFBr represents an option to reverse ethanol intoxication.

Segregated brain state during hypnosis.

Can the brain be shifted into a different state using a simple social cue, as tests on highly hypnotizable subjects would suggest? Demonstrating an altered global brain state is difficult. Brain activation varies greatly during wakefulness and can be voluntarily influenced. We measured the complexity of electrophysiological response to transcranial magnetic stimulation in one ‘hypnotic virtuoso’. Such a measure produces a response arguably outside the subject’s voluntary control and has been proven adequate for discriminating conscious from unconscious brain states. We show that a single-word hypnotic induction robustly shifted global neural connectivity into a state where activity remained sustained but failed to ignite strong, coherent activity in frontoparietal cortices. Changes in perturbational complexity indicate a similar move towards a more segregated state. We interpret these findings to suggest a shift in the underlying state of the brain, likely moderating subsequent hypnotic responding.

Hypnotherapy for Procedural Pain and Distress in Children: A Scoping Review Protocol.

ObjectiveInadequately treated pain and distress elicited by medical procedures can put children at higher risk of acute and chronic biopsychosocial sequelae. Children can benefit from hypnotherapy, a psychologically tailored intervention, as an adjunct to pharmacological agents to address the multiple components of pain and distress. Despite providing evidence on the effectiveness and potential superiority of hypnotherapy to other psychological interventions, research on hypnotherapy for pediatric procedural pain and distress has been predominantly limited to oncology and needle procedures. Plus, there is a lack of reporting of intervention manuals, factors influencing hypnotic responding, pain unpleasantness outcomes, theoretical frameworks, adverse events, as well as barriers and facilitators to the feasibility of delivering the intervention and study procedures. The proposed review aims to map the range and nature of the evidence on hypnotherapy for procedural pain and distress in children to identify gaps in literature and areas requiring further investigation.MethodsThis review will follow the Arksey and O‘Malley (2005) methodology and incorporate additional scoping review recommendations by the Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses. Relevant studies will be identified through searching published literature databases (PubMed, Cochrane Library, PsycINFO, Embase, CINAHL, Scopus and Web of Science) and grey literature in addition to hand-searching of reference lists and key journals. Two authors will independently screen titles and abstracts of search results followed by full-texts review against eligibility criteria.ConclusionFindings are anticipated to guide future research and inform the development of tailored hypnotic interventions in children.

Can unconscious intentions be more effective than conscious intentions? Test of the role of metacognition in hypnotic response

While several theories assume that responses to hypnotic suggestions can be implemented without executive intentions, the metacognitive class of theories postulate that the behaviors produced by hypnotic suggestions are intended and the accompanying feeling of involuntariness is only a consequence of strategically not being aware of the intention. Cold control theory asserts that the only difference between a hypnotic and non-hypnotic response is this metacognitive one, that is, whether or not one is aware of one's intention to perform the relevant act. To test the theory, we compared the performance of highly suggestible participants in reducing the Stroop interference effect in a post-hypnotic suggestion condition (word blindness: that words will appear as a meaningless foreign script) and in a volitional condition (asking the participants to imagine the words as a meaningless foreign script). We found that participants had equivalent expectations that the posthypnotic suggestion and the volitional request would help control the conflicting information. Further, participants felt they had more control over experiencing the words as meaningless with the request rather than the suggestion; and they experienced the request largely as imagination and the suggestion largely as perception. That is, we set up the interventions we required for the experiment to constitute a test of cold control theory. Both the suggestion and the request reduced Stroop interference. Crucially, there was Bayesian evidence that the reduction in Stroop interference was the same between the suggestion and the volitional request. That is, the results support the claim that responding hypnotically does not grant a person greater first order abilities than they have non-hypnotically, consistent with cold control theory.

Myths and misconceptions about hypnosis and suggestion: Separating fact and fiction

SummaryWe present 21 prominent myths and misconceptions about hypnosis in order to promulgate accurate information and to highlight questions for future research. We argue that these myths and misconceptions have (a) fostered a skewed and stereotyped view of hypnosis among the lay public, (b) discouraged participant involvement in potentially helpful hypnotic interventions, and (c) impeded the exploration and application of hypnosis in scientific and practitioner communities. Myths reviewed span the view that hypnosis produces a trance or special state of consciousness and allied myths on topics related to hypnotic interventions; hypnotic responsiveness and the modification of hypnotic suggestibility; inducing hypnosis; and hypnosis and memory, awareness, and the experience of nonvolition. By demarcating myth from mystery and fact from fiction, and by highlighting what is known as well as what remains to be discovered, the science and practice of hypnosis can be advanced and grounded on a firmer empirical footing.

Trait phenomenological control predicts experience of mirror synaesthesia and the rubber hand illusion

In hypnotic responding, expectancies arising from imaginative suggestion drive striking experiential changes (e.g., hallucinations) — which are experienced as involuntary — according to a normally distributed and stable trait ability (hypnotisability). Such experiences can be triggered by implicit suggestion and occur outside the hypnotic context. In large sample studies (of 156, 404 and 353 participants), we report substantial relationships between hypnotisability and experimental measures of experiential change in mirror-sensory synaesthesia and the rubber hand illusion comparable to relationships between hypnotisability and individual hypnosis scale items. The control of phenomenology to meet expectancies arising from perceived task requirements can account for experiential change in psychological experiments.

Hypnotic Responsiveness and Dissociation: A Multi-Variable Analysis

Since Charcot [1], researchers and theorists have associated hypnotic responsiveness with dissociation. However, contemporary researchers have typically not documented impressive or statistically significant correlations between the most commonly used measure of dissociation, the Dissociative Experiences Scale-II [2, 3] and hypnotic responsiveness. We examined the ability of two measures of non-pathological dissociation, which have received scant attention in the hypnosis literature, the Wessex Dissociation Scale (WDS; [4]) and the Dissociative Processes Scale (DPS; [5]), in the context of a broader investigation of predictors of hypnotic responsiveness including expectancies, fantasy-proneness, absorption, and an index of more serious dissociative experiences and symptoms in a sample of undergraduate students. Scales of non-pathological dissociation and most measures of pathological dissociation did not correlate significantly with hypnotic responsiveness; however, stepwise regression analyses predicting HGSHS:A behavioral and subjective scores retained the Detachment factor of the DPS in the final model, along with expectancies and absorption. We present our findings in the context of a broader discussion of dissociation and hypnosis.