Low Hypnotizables Research Articles

Treating Hot Flashes with Hypnosis: Does Hypnotizability Modulate Reductions?

Hypnosis is an effective treatment option for a variety of concerns. Past research has suggested that those who score in the high range of hypnotizability initially show greater improvement than those in the low range. A post hoc analysis was conducted to examine the extent to which hypnotizability modulates the reduction of hot flash frequency. Average number of hot flashes reported during hypnosis treatment and a 12-week follow-up were grouped according to participants' level of hypnotizability. Using baseline data, the reduction percentage of hot flash frequency was plotted and visually examined to determine when a clinically significant reduction (50%) in hot flashes was reached. Our results suggested that, regardless of hypnotizability, participants ultimately obtained a 50% reduction in hot flash frequency. Interestingly, participants who were rated as either moderately or highly hypnotizable achieved a 50% reduction by Week 3 while those of low hypnotizability did not cross the 50% reduction threshold until the 12-week follow-up. Implications from these findings include the importance of assessing hypnotizability in clinical settings to better tailor treatment dose and expectations.

Physiological Correlates of Hypnotizability: Hypnotic Behaviour and Prognostic Role in Medicine.

Studies in the field of experimental hypnosis highlighted the role of hypnotizability in the physiological variability of the general population. It is associated, in fact, with a few differences which are observable in the ordinary state of consciousness and in the absence of suggestions. The aim of the present scoping review is summarizing them and indicate their relevance to the neural mechanisms of hypnosis and to the prognosis and treatment of a few medical conditions. Individuals with high, medium and low hypnotizability scores display different cerebral functional differences-i.e., functional equivalence between imagery and perception/action, excitability of the motor cortex, interoceptive accuracy-possibly related to brain structural and functional characteristics, and different control of blood supply at peripheral and cerebral level, likely due to different availability of endothelial nitric oxide. These differences are reviewed to support the idea of their participation in hypnotic behaviour and to indicate their prognostic and therapeutic usefulness in a few medical conditions.

Immediate hypnosis effects and outcome predictors in chronic nociplastic pain

ABSTRACT This study used data from a randomized controlled trial on the efficacy of hypnosis with analgesic suggestions relative to hypnosis with nonspecific suggestions to explore two areas. The first was the immediate effects of each hypnosis session and their relevance to the treatment induced change in pain intensity. The second was the identification of variables associated with the beneficial effects of hypnosis treatment in the form of reducing pain intensity and pain quality. The predictive value of the initial treatment response, hypnotizability, and the dichotomous variable of pain medication use were examined. Both interventions resulted in similar significant reductions in pain intensity after each session, but without a cumulative effect. The initial response correlated positively and moderately with pain intensity decreases induced by the complete hypnosis treatment. There was only a weak association between hypnotizability and pain quality improvement. Only participants not taking pain medications achieved a meaningful reduction in pain outcomes. Each hypnosis session results in an immediate reduction in chronic nociplastic pain intensity, and a fruitful first session may be a positive signal to continue therapy. Even patients with low hypnotizability can obtain beneficial outcomes. Pain medication use may become a new predictor in hypnosis research, as significant decreases in pain intensity and pain quality occurred only in the absence of pharmacotherapy. However, the results of this study require confirmation in further research with longer treatment periods.

Is Hypnotic Induction Necessary to Experience Hypnosis and Responsible for Changes in Brain Activity?

The relevance of formal hypnotic induction to the experience of trance and its neural correlates is not clear, in that hypnotizability, beliefs and expectation of hypnosis may play a major role. The aim of the study was assessing the EEG brain activity of participants with high (highs) or low hypnotizability scores (lows), aware of their hypnotizability level and informed that the session will include simple relaxation, formal hypnotic induction and neutral hypnosis. A total of 16 highs and 15 lows (according to the Stanford Hypnotic Susceptibility Scale, form A) were enrolled. Their EEGs were recorded during consecutive conditions of open/closed-eyes relaxation, hypnotic induction, neutral hypnosis and post hypnosis not interrupted by interviews. The studied variables were theta, alpha and gamma power spectral density (PSD), and the Determinism (DET) and Entropy (ENT) of the EEG signal Multidimensional Recurrence Plot (mRP). Highs reported significantly greater changes in their state of consciousness than lows across the session. The theta, alpha and gamma PSD did not exhibit condition-related changes in both groups. The Alpha PSD was larger in highs than in lows on midline sites, and the different sides/regions' theta and gamma PSD were observed in the two groups independently from conditions. ENT showed no correlation with hypnotizability, while DET positively correlated with hypnotizability during hypnosis. In conclusion, the relevance of formal hypnotic induction to the experience of trance may be scarce in highs, as they are aware of their hypnotizability scores and expecting hypnosis. Cognitive processing varies throughout the session depending on the hypnotizability level.

Electrodermal Orienting Response During Active-Alert Hypnosis: Do Verbal Suggestions Influence Automatic Attentional Processes?

ABSTRACT This study explored the influence of suggestions on differences in electrodermal laterality of the skin conductance orienting response (SCR). Thirty-two participants were randomly assigned to either permitting or excluding suggestions. During the dream task in the permitting condition the suggestion was: “You are aware of your surroundings and any distractions that might disturb your dream,” while in the excluding condition the wording was: “No outside stimulus will disturb your sleep.” Participants were presented with 12 standards and 2 deviant computer-generated tones during active-alert hypnosis and musical control conditions in a mixed within-between design. High hypnotizables produced higher SCRs after permissive compared to excluding suggestions during hypnosis, while low hypnotizables did the same in the control condition. Study limitations include some loss of data due to equipment failure and relative homogeneity of sample, therefore results cannot be considered definitive.

Hypnotizability and psychopathology of patients with personality disorders

ABSTRACT Assessment of hypnotizability is useful in research and predicting the effects of hypnosis in clinical practice. There are few contemporary scientific reports examining the relationship between hypnotizability and psychopathological personality dimensions. The current study explores the connections between abnormal personality in psychiatric patients and the hypnotizability level. Fifty-five patients with anxiety and personality disorders who previously completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were invited to undergo the Elkins Hypnotizability Scale – Clinical Form (EHS-CF). The hypnotizability scores comprise a normal distribution but shifted toward low scores. Twenty-seven patients were included in the low hypnotizability (LOW) group, and 28 patients in the medium to high (MID-HIGH) group. The number of participants with high scores on the Psychopathic Deviate and Paranoia MMPI-2 clinical scales was significantly higher in the LOW than in the MID-HIGH group. Patterns of associations between hypnotizability and psychopathology differed in the two groups. The results indicate that moderate hypnotizability should be considered a normal trait that has no meaningful relationship with psychopathology, but certain dysfunctional symptoms of personality disorders may entail resistance and a defensive attitude toward the hypnotherapy, resulting in a tendency to obtain lower hypnotizability.

Cerebral Blood Flow in Healthy Subjects with Different Hypnotizability Scores.

Hypnotizability is a cognitive trait associated with differences in the brachial artery flow-mediated dilatation of individuals with high hypnotizability (highs) and low hypnotizability scores (lows). The study investigated possible hypnotizability-related cerebrovascular differences. Among 24 healthy volunteers, the Stanford Hypnotic Susceptibility Scale Form A identified 13 medium-to-lows (med-lows), 11 medium-to-highs (med-highs), and 1 medium hypnotizable. Hypnotizability did not influence the significant changes produced by the trail making task (TMT), mental arithmetic task (MAT), hyperventilation (HVT), and rebreathing (RBT) on heart rate (HR), arterial blood pressure (ABP), and partial pressure of end-tidal CO2 (PETCO2), but moderated the correlations between the changes occurring during tasks with respect to basal conditions (Δ) in ABP and PETCO2 with middle cerebral artery flow velocity (MCAv). In HVT, med-lows exhibited a significant correlation between ΔMCAv and ΔPETCO2, and med-highs showed a significant correlation between ΔABP and ΔMCAv. Cerebrovascular reactivity (CVR) and conductance (ΔCVCi) were significantly correlated with ΔMCAv only in med-lows during HVT and RBT. For the first time, cerebrovascular reactivity related to hypnotizability was investigated, evidencing different correlations among hemodynamic variables in med-highs and med-lows.

Interoceptive Accuracy as a Function of Hypnotizability

ABSTRACT This study aimed to measure the interoceptive accuracy (IA) of individuals with high (highs), medium (mediums), and low hypnotizability (lows) through the heartbeat-counting task during 3 relaxation trials. Participants completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), ECG and skin conductance (SC) were monitored, and the experienced difficulty in counting was reported. Results showed similar counting difficulty and number of actual heartbeats in highs, mediums, and lows. SC decreased in highs during all trials, in mediums and lows only in the third trial. IA measured as [1 – (ǀrecorded heartbeats–counted heartbeatsǀ)/recorded heartbeats] was negatively correlated with hypnotizability and not correlated with interoceptive sensitivity (IS) measured by MAIA scales. Among mediums, IA was higher in males than in females.

Linear and non linear measures of pupil size as a function of hypnotizability

Higher arousal and cortical excitability have been observed in high hypnotizable individuals (highs) with respect to low hypnotizables (lows), which may be due to differences in the activation of ascending activating systems. The present study investigated the possible hypnotizability-related difference in the cortical noradrenergic tone sustained by the activity of the Locus Coeruleus which is strongly related to pupil size. This was measured during relaxation in three groups of participants—highs (N = 15), lows (N = 15) and medium hypnotizable individuals (mediums, N = 11)—in the time and frequency domains and through the Recurrence Quantification Analysis. ECG and Skin Conductace (SC) were monitored to extract autonomic indices of relaxation (heart interbeats intervals, parasympathetic component of heart rate variability (RMSSD) and tonic SC (MeanTonicSC). Most variables indicated that participants relaxed throughout the session. Pupil features did not show significant differences between highs, mediums and lows, except for the spectral Band Median Frequency which was higher in mediums than in lows and highs at the beginning, but not at the end of the session.Thus, the present findings of pupil size cannot account for the differences in arousal and motor cortex excitability observed between highs and lows in resting conditions.

Postural effects of interoceptive imagery as a function of hypnotizability

The aim of the study was to investigate the effects of pleasant and unpleasant interoceptive imagery on postural control in participants with different hypnotizability, interoceptive sensibility and ability of imagery. Forty-one healthy individuals classified as high (highs), medium (mediums) and low hypnotizables (lows) according to the Stanford Hypnotic Susceptibility Scale, form A (SHSS, A) were characterized for Interoceptive Sensitivity (IS) through the Multisensory Assessment of Interoceptive Awareness (MAIA) and for organic mental imagery (ORG) through Betts’ questionnaire. The experimental session included baseline closed eyes conditions preceding tasks of pleasant (P) and unpleasant imagery (U) and a neutral cognitive task (NT) while standing on a stabilometric platform. Subjective reports of vividness and pleasantness/unpleasantness of mental images were collected. Postural variables, ECG and pneumogram were acquired. Highs exhibited greater vividness of imagery than mediums/lows and larger Area of the Centre of Pressure (CoP), while mediums and lows decreased it during all tasks with respect to baseline conditions. Significant differences moderated by IS and ORG were found between highs and lows in the CoP Area. In all groups significant task related differences in the CoP Area were moderated only by IS. Cardiovascular variables were similar in the three groups, but differed among tasks and were influenced by IS and ORG. Our findings extend earlier observations on the role of hypnotisability in the postural correlates of sensorimotor imagery to interoceptive imagery, support the hypothesis that interoceptive sensibility moderates postural control and cardiorespiratory variables during interoceptive imagery, and confirm earlier reports of the absence of hypnotisability-related modulation of cardiorespiratory variables during emotional tasks.

Electrodermal Correlates of Hypnosis: Current Developments

Hypnosis has proven to be an effective treatment in disorders that affect the autonomic nervous system (ANS). However, the studies investigating the nature of its effect on the ANS have reported contradictory results. Measurement of electrodermal activity (EDA) is an objective way to assess the activity of the sympathetic branch of the ANS. We aim to elucidate the effects of hypnosis on EDA. Here, we report the results of two studies, both investigating the psychophysiological effects of hypnosis.In the first experiment, subjects engaged in an HGSHS:A group hypnosis session to measure their hypnotizability. EDA was measured bilaterally from their wrists. We found a significant reduction in EDA levels and the number of nonspecific responses during the hypnotic induction phase. This effect was observed in all three hypnotizability groups—high, medium, and low hypnotizables. A three-way interaction confirmed that EDA patterns on the left and right sides were characteristically different in these three groups. Left-side dominance was typical in high hypnotizables, whereas low hypnotizables were characteristically right-sided. EDA levels of the two sides remained synchronous in medium hypnotizables. During the suggestion phase, we found significant differences in EDA levels depending on the test suggestions, modulated by hypnotizability. A suggestion, harder to respond to, elicited higher arousal in high hypnotizables as compared to low hypnotizables. In the second experiment, we performed five consecutive hypnosis sessions to confirm the reproducibility of the most prominent effect found in Study 1—a gradual decrease in the level of skin conductance during hypnotic induction. We also confirmed that this effect is independent of the hypnotizability level. We conclude that arousal is bilaterally reduced during hypnosis induction, which is persistent across different levels of hypnotizability. At the same time, lateral differences define unique EDA patterns in the induction phase, characterizing high, medium, and low hypnotizables.

HYPNOTIC SUGGESTIONS GIVEN BEFORE NIGHTTIME SLEEP EXTEND SLOW-WAVE SLEEP AS COMPARED TO A CONTROL TEXT IN HIGHLY HYPNOTIZABLE SUBJECTS

ABSTRACT While slow-wave sleep (SWS) is fundamental for maintaining health and well-being, it is typically reduced with stress or age. The authors have previously reported that hypnotic suggestions before sleep increased SWS duration and slow-wave activity (SWA) during a midday nap in hypnotizable younger and older women. To test generalizability, they investigated this effect across 8 hours nighttime sleep in 43 healthy young French-speaking subjects (19 males) of high and low hypnotizability. In accordance with their previous results, listening to hypnotic suggestions before sleep was followed by higher amounts of SWS in highly hypnotizable subjects and higher SWA power compared to a control condition. The effects were most pronounced at the beginning of the night. Further studies are needed to examine whether hypnotic suggestions can deepen sleep also above non-intervention nights. The findings provide a basis for the examination and potential application of hypnosis to improve sleep in clinical populations.

Imagined and Actual Movements with and without Suggestions for anesthesia in Subjects with Different Hypnotizability

Background: Hypnotizability is a psychophysiological trait associated with several differences including the level of functional equivalence (FE) between imagery and perception - that is similarity of the cortical activations and network configurations associated with each of them. FE is stronger in the individuals with high hypnotisability (highs) with respect to low hypnotizable participants (lows). In this frame, the study investigates the EEG correlates of imagined arm/hand movements (MI) and of actual movements performed in the absence (M) and in the presence of suggestions of arm/hand anesthesia (MA) in highs and lows. Methods: The EEG alpha (8-12 Hz) and beta (13-25 Hz) absolute power, classically associated with movement preparation and execution were studied in 18 highs and 17 lows classified according to the Stanford Hypnotic Susceptibility Scale, form A. EEG was recorded during M, MI, MA. The subjective reports of imagery and the duration of movements were also studied. Results: The movements duration did not differ between highs and lows. Highs reported better imagery during MI, greater perceived influence of the suggestion of anaesthesia during MA, lower cognitive effort than lows for both tasks. In line with earlier studies, spectral analysis did not reveal significant restructuring of the cortical activity during tasks in highs, whereas lows showed cortical changes during MI and MA indicating that they were able to mentally simulate movements and to accept suggestions for anaesthesia during voluntary movement, despite their low hypnotizability scores. Conclusions: Findings suggest that peculiar psychophysiological characteristics could enable different individuals to respond to suggestions.

CHANGES IN OXYTOCIN AND CORTISOL IN ACTIVE-ALERT HYPNOSIS: Hormonal Changes Benefiting Low Hypnotizable Participants

It is increasingly clear that oxytocin and cortisol play an intricate role in the regulation of behavior and emotions impacting health, relationships, and well-being. Their long-term, cross-generational effect makes them an important focus of the present study. This exploratory research examined changes in oxytocin and cortisol levels and their correlations with different phenomenological measures in both hypnotist and subject during active-alert hypnosis. The level of oxytocin increased whereas the level of cortisol decreased in the hypnotist. When comparing the oxytocin changes of subjects with their hypnotizability, those with low hypnotizability scores experienced an increase in oxytocin, and those with medium and high hypnotizability scores showed no change or decrease. This could explain why clients’ hypnotizability is not considered an important factor during hypnotherapy.

The "hypnotic state" and eye movements: Less there than meets the eye?

Responsiveness to hypnotic procedures has been related to unusual eye behaviors for centuries. Kallio and collaborators claimed recently that they had found a reliable index for "the hypnotic state" through eye-tracking methods. Whether or not hypnotic responding involves a special state of consciousness has been part of a contentious debate in the field, so the potential validity of their claim would constitute a landmark. However, their conclusion was based on 1 highly hypnotizable individual compared with 14 controls who were not measured on hypnotizability. We sought to replicate their results with a sample screened for High (n = 16) or Low (n = 13) hypnotizability. We used a factorial 2 (high vs. low hypnotizability) x 2 (hypnosis vs. resting conditions) counterbalanced order design with these eye-tracking tasks: Fixation, Saccade, Optokinetic nystagmus (OKN), Smooth pursuit, and Antisaccade (the first three tasks has been used in Kallio et al.'s experiment). Highs reported being more deeply in hypnosis than Lows but only in the hypnotic condition, as expected. There were no significant main or interaction effects for the Fixation, OKN, or Smooth pursuit tasks. For the Saccade task both Highs and Lows had smaller saccades during hypnosis, and in the Antisaccade task both groups had slower Antisaccades during hypnosis. Although a couple of results suggest that a hypnotic condition may produce reduced eye motility, the lack of significant interactions (e.g., showing only Highs expressing a particular eye behavior during hypnosis) does not support the claim that eye behaviors (at least as measured with the techniques used) are an indicator of a "hypnotic state.” Our results do not preclude the possibility that in a more spontaneous or different setting the experience of being hypnotized might relate to specific eye behaviors.

Hypnotizability and the Peripersonal Space

High hypnotizability is associated with left-sided cerebral asymmetry, which could influence measurement of the Peripersonal Space (PPS). Right-handed participants with high (highs, n = 20), medium (mediums, n = 9), and low hypnotizability scores (lows, n = 20) performed the line bisection test on a computer screen automatically displaced at distances of 30, 60, and 90 cm from the subjects’ eyes. Highs’ results showed rightward bias of the bisection (Relative Error, RE) for all presentation distances. In contrast, in lows RE was displaced leftward at 30 cm and exhibited a progressive rightward shift at 60 and 90 cm, as occurs in the general population. Mediums’ RE values were intermediate between highs’ and lows’ values. Bisection Times (BT) were significantly longer in highs/mediums than in lows. Findings indicate that the highs’ bisection identifies PPS as if it was extrapersonal, but further studies should assess its functional characteristics. The highs/mediums longer BT suggest less efficient sensorimotor performance.

Brain Activity and Functional Connectivity Associated with Hypnosis.

Hypnosis has proven clinical utility, yet changes in brain activity underlying the hypnotic state have not yet been fully identified. Previous research suggests that hypnosis is associated with decreased default mode network (DMN) activity and that high hypnotizability is associated with greater functional connectivity between the executive control network (ECN) and the salience network (SN). We used functional magnetic resonance imaging to investigate activity and functional connectivity among these three networks in hypnosis. We selected 57 of 545 healthy subjects with very high or low hypnotizability using two hypnotizability scales. All subjects underwent four conditions in the scanner: rest, memory retrieval, and two different hypnosis experiences guided by standard pre-recorded instructions in counterbalanced order. Seeds for the ECN, SN, and DMN were left and right dorsolateral prefrontal cortex, dorsal anterior cingulatecortex (dACC), and posterior cingulate cortex (PCC), respectively. During hypnosis there was reduced activity in the dACC, increased functional connectivity between the dorsolateral prefrontal cortex (DLPFC;ECN) and the insula in the SN, and reduced connectivity between the ECN (DLPFC) and the DMN (PCC). These changes in neural activity underlie the focused attention, enhanced somatic and emotional control, and lack of self-consciousness that characterizes hypnosis.

The relation of hypnotizability and dissociation to everyday mentation: An experience-sampling study.

Research has found that individuals varying in hypnotizability and dissociation respond differently to questionnaires and procedures geared to affect their state of consciousness, but their stream of consciousness in everyday life has not been investigated. We evaluated the everyday mentation of students (N 46) in a 2 (High vs. Low Hypnotizability) 2 (High vs. Low Dissociative) design through experience sampling with personal digital assistants (PDAs). The PDAs prompted volunteers randomly 8 times per day during 5 days and included questions about attention, type of mental activity, and mood, among others, which resulted in 5 factors: focus/absorption, daydreaming, negative affect, control/awareness, and detachment. High control/ awareness correlated with high focus/absorption, low negative affect, and low detachment. Detachment correlated also with daydreaming. As predicted, high dissociatives reported less control but more detachment and negative affect than low dissociatives. High hypnotizables (Highs) did not report more focus/absorption than low hypnotizables (Lows) but endorsed more daydreaming and negative affect. Highs reported more thoughts than Lows, and Lows reported more sensory impressions than Highs. Hypnotizability and dissociation also interacted: Low dissociatives/Lows reported less daydreaming than the others, and high dissociatives/Lows experienced less control than the other 3 groups combined. Participants reported less control/awareness during daydreaming, with high dissociatives/Highs showing a larger decrement than the others. Most mentations referred to thoughts or sensory impressions; the former were characterized by more negative affect than the latter. In general, individuals felt more dysphoric when (Less)

Chaos–chaos transition of left hemisphere EEGs during standard tasks of Waterloo-Stanford Group Scale of hypnotic susceptibility

A recent study, recurrence quantification analysis of EEG signals during standard tasks of Waterloo-Stanford Group Scale of hypnotic susceptibility investigated recurrence quantifiers (RQs) of hypnotic electroencephalograph (EEG) signals recorded after hypnotic induction while subjects were doing standard tasks of Waterloo-Stanford Group Scale (WSGS) of hypnotic susceptibility to distinguish subjects of different hypnotizability levels. Following the same analysis, the current study determines the capability of different RQs to distinguish subjects of low, medium and high hypnotizability level and studies the influence of hypnotizability level on underlying dynamic of tasks. Besides, EEG channels were sorted according to the number of their RQs, which differed significantly among subjects of different hypnotizability levels. Another valuable result was determination of major brain regions in observing significant differences in various task types (ideomotors, hallucination, challenge and memory).

Effects of Hypnotic Analgesia and Virtual Reality on the Reduction of Experimental Pain Among High and Low Hypnotizables

This research compared a no-treatment control condition and 3 experimentally induced pain treatment conditions: (a) virtual reality distraction (VRD), (b) hypnotic analgesia (HA), and (c) HA + VRD in relieving finger-pressure pain. After receiving baseline pain stimulus, each participant received hypnosis or no hypnosis, followed by VRD or no VRD during another pain stimulus. The data analysis indicated that, overall, all 3 treatments were more effective compared to the control group, irrespective of whether it involved hypnotic analgesia, virtual reality distraction, or both (hypnosis and virtual reality). Nevertheless, the participants responded differently to the pain treatment, depending on the hypnotizability level. High hypnotizables reported hypnotic analgesia, but low hypnotizables did not show hypnotic analgesia. VR distraction reduced pain regardless of hypnotizability.