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MODERN TRENDS
IN HYPNOSIS
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DAVID WAXMAN Chairman of the Scientific Program International
Society of Hypnosis
London, England
and
M . ANTHONY BASKER British Society of Medical and Dental Hypnosis
Westcliff-on-Sea, England
PLENUM PRESS • NEW YORK AND LONDON
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Main entry under title: Modern trends in hypnosis.
"Proceedings of the Ninth International Congress of Hypnosis and
Psychosomatic Medicine, held August 22-27, 1982, in Glasgow,
Scotland" - T.p. verso.
Includes bibliographies and index. 1. Hypnotism- Therapeutic
use-Congresses. 2. Hypnotism-Congresses. I. Wax
man, David. II. International Congress of Hypnosis and
Psychosomatic Medicine (9th: 1982: Glasgow, Strathclyde) [DNLM: 1.
Hypnosis-congresses. W3 IN415 9th 19821 WM 4151612 1982n]
RC490.5.M6 1985 616.89'162 84-26432
ISBN-13: 978-1-4684-4915-0 DOl: 10.1007/978-1-4684-4913-6
Proceedings of the Ninth International Congress of Hypnosis and
Psychosomatic Medicine, held August 22-27, 1982, in Glasgow,
Scotland
(C) 1985 Plenum Press. New York Softcover reprint of the hardcover
1st edition 1985 A Division of Plenum Publishing Corporation 233
Spring Street, New York, N.Y. 10013
All rights reserved
No part of this book may be reproduced, stored in a retrieval
system, or transmitted in any form or by any means, electronic,
mechanical, photocopying, microfilming, recording, or otherwise,
without written permission from the Publisher
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To Eric Wookey, MC, LDS, Honorary Consultant Dental Surgeon of the
Royal Free Hospital , Fi r s t President of the London Dental and
Medical Society for the Study of Hypnosis. He imparted his
enthusiasm and knowledge of hypnosis widely, and thus played a
prominent par t in securing the acceptance of hypnosis by profess
ional colleagues throughout the United Kingdom.
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FOREWORD
The 9th In te rna t iona l Congress of Hypnosis and Psychosomatic
Medicine expresses the cont inui ty in the e ffo r t to gain s c i
e n t i f i c knowledge of hypnosis and sc i en t i f i c s ta tus
for i t , ever s ince the 1s t In te rna t iona l Congress for
Experimental and Therapeutic Hypnotism was held in Par i s in 1889,
attended by many of the best-remembered psychia t r i s t s and
psychologists of the day - men such as Babinski, Bernheim, Binet,
Delboeuf, Freud, James, Lombroso, F.W.H. Myers, Ribot, and many
others . The cont inui ty was broken by the per iod of reduced i n
t e r e s t in hypnosis between the time of the 2nd In t e r
na t iona l Congress for Hypnotism in Paris in 1900, and the rev
iva l ofi n t e r e s t shown by the 3rd In te rna t iona l
Congress for Hypnosis and Psychosomatic Medicine in Paris in 1965.
Since then, the Congresses have met more regular ly, making the one
of which t h i s i s the repor t , the 9th.
The programs of these Congresses have become increasingly r i ch
through the years , with many of the older problems s t i l l with
us but now s tudied more dispassionately in the l i gh t of new
knowledge and new sc i en t i f i c methods in the design of inves
t iga t ions and the v a l i dat ion of sc i en t i f i c
findings.
An examination of the t i t l e s of the papers and the places from
which t he i r authors come shows how diverse and widespread the i
n t e r e s t s in hypnosis have become, both in the e ffo r t to
define the nature of hypnosis and i t s boundaries in r e l a t i
on to other categories of behavior and experience, and to explore i
t s poten t ia l service in psychotherapy and other soc ia l app l
ica t ions , as in forensic medicine.
On the s ide of understanding hypnosis i t s e l f , there are the
papers on the nature of hypnotic responsiveness and i t s
physiological
v i i
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v i i i FOREWORD
co r r e l a t e s , on the subject ive experiences within whatever
the hyp not ic condi t ion may be found to be , the nature and
consequences of self -hypnosis , and the cha rac t e r i s t i c s
of the dissoc ia t ive phenomena manifested i n hypnosis. On the c
l i n i c a l s ide there are cases and discussions r e f l ec t i
ng the use of hypnotic methods in the t reatment of disorders of se
l f - con t ro l , i n obs t e t r ic s , in pain and anxiety
reduct ion, i n psychosomatic disorders , in symptoms met i n den t
i s t r y, and with problems met in chi ldren and adolescents .
Comparative s tud ies r e l a t e hypnosis to meditation and
behavior therapy. Hypnosis and the law receives a t t en t i on in
several con t r ibu t ions .
One cannot help but be impressed by the ser iousness with which the
di rec t ion has been taken to move away from " i t has been my
experience ••• " as the way of va l ida t ing hypnotic prac t ices
to the i n t e r e s t in comparative and con t ro l l ed s tudies
which place hypnosis on the same s t a tu s as o the r medical or
psych ia t r i c prac t ices as they are taught and s tudied in our
medical schools and univers i ty depar t ments.
The b a t t l e to es t ab l i sh hypnosis on a sound s c i e n t i
f i c bas i s has not yet been won; even where i t i s accepted as
permiss ible , there are s t i l l too few s c i e n t i s t s
among those outs ide i t s ac t ive prac t i t ioners who show any
enthusiasm for i t . The gains tha t are being made, however, as
these Proceedings show, augur well for i t s fu tu re .
Ernest R. Hilgard
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PREFACE
Prac t i t ioners whose i n t e r e s t s extend over the en t i r
e spectrum of the healing disc ip l ines assembled in Glasgow from
August 22nd to the 27th 1982 to at tend the 9th In te rna t iona l
Congress of Hypnosis and Psychosomatic Medicine. They came to l i s
t e n to learned addresses , to present papers, of ten the
culmination of many years of research and c l in i ca l experience,
to pa r t i c ipa t e in workshops and general ly to mark, l ea rn
and teach a subject as old as mankind and yet amongst the most
recent and sophis t icated of psychotherapies in the mul t i d i sc
ip l inary f i e ld of the treatment of psychological i l l nes s
.
The exce l len t of the ambiance, the impressive array of speakers
and the high qua l i ty of the l ec tures culminated in a meeting
which was without doubt a considerable academic success. As a r e
su l t the 9th Congress proved an outstanding event, and i t i s
hoped, made a r ea l contr ibut ion to the prac t ice of
hypnotherapy. The s ign i f i cance of the occasion was addi t iona
l ly marked by the j o i n t sponsorship of the University of
Glasgow and the Royal Society of Medicine, as well as the warm
support of the City of Glasgow.
In these proceedings appear some of the papers which were pre
sented a t t h i s meeting. Although there were over 100 speakers,
i t
i s regre t t ed tha t in view of the r e s t r i c t i ons of
space, only a verycareful ly selected number of these papers could
ul t imately be included in the publ icat ion.
Each paper was ra ted independently by a panel of referees and the
f i na l se lec t ion represents a wide cross-sect ion of the
subject matter out l ined in the program.
ix
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x PREFACE
In view of the high qua l i ty of a l l the t a l k s given the
referees were faced with a formidable task and i t i s hoped t ha t
those speakers whose papers do not appear in t h i s volume wil l
in no way f ee l t ha t t he i r e ffo r t s were in vain.
Abstracts of a l l papers were published in the issue of The In te
rna t iona l Journal of Clin ica l and Experimen t a l Hypnosis of
April 1982 and the Edi tor has given h i s kind per mission for t h
i s to be used as a c i t ab l e reference.
The pr inc ipa l aim of the Sc ien t i f i c Program was the
encourage ment of learning and research in hypnosis both in c l i n
i c a l prac t ice and experimental s tudy, wi th the ac tua l par
t ic ipa t ion of as many as possible in the wide range of subjects
which were offered.
The general s c i e n t i f i c papers consis ted of c l in i ca l
reports and experimental f indings covering as extensive an area as
time per mitted. The subjects included the neuroses, pathological
anxiety and the many incapaci ta t ing symptoms resu l t ing
therefrom. Other papers covered the considerable f i e ld of
personal i ty problems, the addic t ions and sexual dysfunctions.
Hypnosis for the modification of pain and i t s use in obs t e t r
i c s and in pedia t r ics was discussed and a f u l l sess ion was
devoted to hypnosis in dent i s t ry. Dynamic and behavioral
techniques were included and the many l ec tures deal ing with s e
l f hypnosis proved very popular. Of par t icu lar in te res t were
the ' case h i s to r i e s which provided evidence of the prac t
ica l r e su l t s of hypno therapy. One f ac t t ha t has emerged
c lear ly over the past few years i s t ha t c l in i ca l
hypnosis, however good the r e su l t s , w i l l never be fu l l y
accepted unless val idated by experimental studies and sc ien
t i f i c evidence. I t i s es sen t i a l t ha t the c l in ic ian
works closelywith the experimental psychologist and the research
neurophysiol ogis t . With t h i s in mind, theories explaining
hypnotizabi l i ty and sugges t i b i l i t y as well as the
neurophysiology of hypnosis were explored and numerous experimental
studies were described. The use of hypnosis in criminology occupied
several hours of t a l k s as well as the f ina l Plenary
Session.
In addi t ion to the sc i en t i f i c papers Special Invi ted
Addresses were given by recognized au tho r i t i e s and National
Presidents ta lked on t he i r individual spec ia l i t i e s .
Other Invi ted Addresses and Spec ia l i ty Seminars were designed
to complement the workshops.
In the concluding paper, the President Elect of the In t e r na t
iona l Society of Hypnosis, Professor Germain Lavoie combining
learned experimental s tud ies with c l i n i c a l f indings,
chose as his subject The Clin ica l Relevance of Hypnot izabi l i
ty in Psychosis. This presentat ion wi l l undoubtedly prove a
valuable contr ibut ion to future research.
Thus a f t e r f ive days of intensive work and study, o f s c i e
n t i f i c l ec tures and learned discussion, the 9th Congress was
bought to a close. Perhaps i t was because of the considerable
amount of well-
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PREFACE x i
constructed laboratory invest igat ion, coupled with the c l in i
ca l experiences so ably reported by so many devoted therap is t s
, tha t the meeting was such a success. Perhaps i t was the Scotch
mist, the warmth and generosity of the hosting society or some
magnetic in f lu ence, but somehow the purple cloak of Mesmer which
had hung over the c i ty of Glasgow tha t August week seemed to
have been l i f t e d to allow bright sunshine to penetrate a
subject tha t had been shrouded in myth, mystery and
misunderstanding for so many years .
As a resu l t i t i s hoped tha t Modern Trends in Hypnosis wi l l
influence many to explore fur ther the psychological and neuro
physiological understanding of the hypnotic s t a t e and t ha t i
t w i l l advance the therapeutic s k i l l s of a l l who read i t
for the ul t imate benefi t of the suffer ing.
D.W. P.C.M. M.G. M.A.B.
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ACKNOWLEDGMENTS
The ed i to rs wish to express t he i r thanks to the Principal and
Court of the University of Glasgow and to the President and Council
of the Royal Society of Medicine for t he i r sponsorship of t h i
s Congress. Also to the President . Council and Members of the Bri
t i sh Society of Medical and Dental Hypnosis and the Bri t i sh
Society of Experimental and Clinical Hypnosis. to Professor M.R.
Bond. 9th Congress Chairman. to Professor F.H. Frankel. President
of the Internat ional Society of Hypnosis. to Professor M.T. Orne
and Mrs Emily Carota Orne for the i r invaluable help in assembling
the program
as well as to a l l Members of the Committee of the 9th
Congress.Thanks are par t icu la r ly due to those hundreds of par
t ic ipan ts who made t h i s meeting such a success.
x i i i
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Visual Memory Processing During Hypnosis: Does i t Differ From
Waking?
H. J . Crawford and S. N. Allen
A Study on the Hypnotic Suscept ib i l i ty of Persons Attempting
Suicide: Some Therapeutic Considerations
I . Boncz, L. P. Pal lag and J . Fodor
I I I ELECTROPHYSIOLOGICAL STUDIES
EEG Evoked Poten t ia l , Hypnotic Anosmia, and Transient Olfactory
Stimulation in High and Low Susceptible
SubjectsA. P. Barabasz and C. Lonsdale
Depth EEG Recordings in Epilept ic Pat ients During Hypnotic and
Non-Hypnotic States
G. De Benedi t t is and V. Sironi
Evoked Poten t ia l Correla tes of Verbal Versus Imagery Coding in
Hypnosis
I . Meszaros, E. I . Banyai and A. C. Greguss
Hemispheric Speci f ic i ty and Hypnot izabi l i ty : An
Overview of Ongoing EEG Research in SouthAustral ia C.
MacLeod-Morgan
Some Neuromuscular Phenomena in Hypnosis M. Pajn ta r, E. Roskar
and L. Vodovnik
IV SELF HYPNOSIS
Representations of Self-Hypnosis in Personal Narrat ives
E. Fromm, A. M. Boxer and D. P. Brown
An Inves t iga t ion in to Audiotaped Self-Hypnosis Training in
Pregnancy and Labor
G. P. Davidson, N. D. Garbett and S. G. Tozer
Change in Subjective Experiences During Therapeutic
Self-Hypnosis
R. Van Dyck, P. Spinhoven and J . Commandeur
CONTENTS
119
131
139
149
161
169
181
209
215
223
235
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V HYPNOSIS AND THE ALLEVIATION OF PAIN
Why i s Hypnosis Effect ive in Pain Control? P. Sacerdote
Hypnosis and Plasmatic Beta-Endorphins G. Guerra, G. Guant ier i
and F. Tagl iaro
VI HYPNOSIS AND ADDICTIVE BEHAVIOR
Hypnosis in the Alleviat ion of the Smoking Habit M. A.
Basker
The Treatment of Alcohol and Drug Addiction: An
249
259
269
Hypnosis and Sexual Disorders P. C. Misra
Hypnotherapy in Male Impotence K. Fuchs, I . Zaidise , B. A. Peretz
and E. Paldi
VIII THE USE OF HYPNOSIS IN CRIMINOLOGY
Hypnosis, Coercive Persuasion and the Law: A His tor ica l Perspect
ive
J . -R. Laurence and C. Perry
Hypnosis in Criminal Inves t iga t ion - Ethical and Prac t ica l
Impl icat ions
M. Kleinhauz and B. Beran
An Examination of the Effects of Forensic Hypnosis H. W. Timm
Hypnosis and the Law: The Role of Induction in Witness Recall
G. F. Wagstaff
IX HYPNOSIS AND ANXIETY
Effects of Hypnosis on State Anxiety and St ress in Male and Female
In te rco l leg ia te Athletes
E. W. Krenz, R. Gordin and S. W. Edwards
291
297
309
317
327
345
359
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x v i i i
Resul ts of Anxiety Control Training in the Treatment of Compulsive
Disorders
R. P. Snaith
X CASE HISTORIES
On a Case of Urinary Retention Treated by Means of Hypnosis
A. Bot to l i , G. Guantieri and V. Azzini
Hypnosis in the Treatment of a Case of Guil la in-Barre 's
Disease
A. Gambacciani and G. Guant ier i
Hypnoanalytic Treatment of Severe Borderline ,Neurosis by Means of
Spontaneous Multiple Persona l i t i es : A Case Report
R. Kampman, R. Hirvenoja and H. Karlsson
XI SOME USES OF HYPNOSIS IN DENTISTRY
The Treatment of Dental Phobia with a Meditational and Behavioral
Reorientation Self-Hypnosis
G. W. F. Smith
The Diff icu l t Dental Pat ien t J . Gall
Index
CONTENTS
371
379
385
391
401
409
421
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SPECIAL ADDRESSES
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HYPNOSIS AND PSYCHOSOMATIC MEDICINE
Univers i ty of Glasgow 6 Whittinghame Gardens Glasgow.
Scotland
Scots have made very s ign i f i c an t contr ibut ions to both the
understanding and prac t ice of hypnosis and psychosomatic
medicine.
Most bel ieve tha t the development of animal magnetism by the
Austr ian . Franz Mesmer in the 18th century. represented the
beginning of i n t e r e s t in t rance s t a t e s . but h i s
work was influenced by e a r l i e r thoughts of a Scot . William
Maxwell. author of 'De Medicina Magnetica ' .
Perhaps the most well known of a l l Scots involved in the devel
opment of hypnosis was James Braid. a Scot t ish Surgeon working in
Manchester. Though a grea t scep t ic of Mesmerism a t f i r s t .
he changed h i s a t t i t ude completely in 1841 a f t e r at
tending a demonstration by ' a magnetiser ' Monsieur Lafontaine. I
t was Braid who concluded t h a t the t rance s t a t e was not due
to magnetic f lu ids but to heightened sugges t i b i l i t y on
the pa r t of the subject and introduced the term ' neuro
hypnotism' to descr ibe the s t a t e or condition of nervous s
leep t ha t t h i s represented. A year l a t e r he shortened t h
i s term to 'hypnot
i sm' . Scots. espec ia l ly James Esdai le . were involved in the
development of c l in i ca l uses of hypnosis. especial ly in
surgery. throughout the remainder of the 19th century.
The place of hypnosis in medicine in the 20th century has been no l
e s s ambiguous than in the previous one. but during the 1914-18
war another Scot. McDougall. demonstrated tha t i t could make a
pos i t i v e con t r ibu t ion in the treatment of ' she l l -
shock ' and began a fu r ther rev iva l of the medical use of
hypnosis which has pers i s ted s ince tha t time.
3
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4 M. R. BOND
Scots have been no l ess involved in the development of psycho
somatic medicine than of hypnosis and perhaps the most well known
contr ibut ion of a l l was tha t made by Dr. John Halliday s t i l
l l iv ing in Glasgow, who, as a Public Health Officer in the c i
ty, threw new l i gh t on psychosomatic medicine when he published
a book en t i t l ed 'Psychosocial Medicine' in 1943. In i t he
drew a t ten t ion to the ro le of soc ia l factors in the
development and maintenance of i l l nes s . His work and t ha t of
other Scots in par t icu lar, Kissen and Aitken, wi l l be
discussed in the f i na l sect ion of t h i s paper.*
INTRODUCTION - AN HISTORICAL PERSPECTIVE
Scots played a major par t in the b i r th of the prac t ice of
hypno s i s and i t s therapeut ic uses, and also in the
development of the
modern concept of psychosomatic medicine. In order to understand
whyt h i s prominence was achieved, pa r t i cu l a r l y with
regard to hypnosis, i t i s necessary to understand something of
the growth of medical education in Scotland up to the ear ly years
of the 19th century pr ior to discussing a number of the main
characters involved.
In h i s book, 'The Healers , a History of Medicine in Scot land '
, David Hamilton (1981), a surgeon in Glasgow, commented, "Scotland
offers almost unique opportuni t ies for medical his tor ians •••
there i s a r ich stock of famous doctors and t he i r discover ies
, there are also the contr ibut ions of the ancient Universi t ies
and of three equal ly old Colleges of Physicians and Surgeons". I t
might be imagined tha t
having four very ancient Universi t ies - St. Andrews,
Glasgow,Edinburgh and Aberdeen, they would have long been involved
in the education of Scot t i sh doctors , but t ha t i s not the
case. A post of 'mediciner ' was establ ished a t King's College,
Aberdeen, in 1497 and for a br i e f per iod between 1637 and 1642
there was a Chair of Medi cine in Glasgow but t h i s was
suppressed by the Church which, a t tha t t ime, held the re igns
of power in the Univers i ty.
Univers i ty medical degrees were not establ ished u n t i l the
18th century and even then most of them were awarded without formal
teach ing or examination to medical men of good repute who could
find others to sponsor them. The degrees were sought to increase
the s ta tus of doctors and a l so to give weight to those who
wished to prac t ice medicine i n England where the e a r l i e s t
degrees obtained by Scots were ca l led 'Scotch Degrees' in a r a
the r derogatory fashion because of the ease with which they could
be obtained. In fac t , a ra ther amusing scandal arose in London
in which an i l l i t e r a t e London brushmaker obtained an M. D.
from Edinburgh and, armed with i t , applied for a post a t the
London Hospital .
*Inaugural address by the Chairman of the 9th In te rna t iona l
Congress.
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SCOTTISH CONTRIBUTIONS 5
Returning to the 17th century, the re were four groups of men
involved in the care of the s ick. F i r s t , and most pres t ig
ious of a l l , were the physic ians . Although the smal les t
group they were dis t ingu i shed by t h e i r wealthy backgrounds,
con t inen ta l Univers i ty t r a in ing , and the large fees they
demanded. Astrology, which had been cen t ra l to the p r a c t i c
e of t h e i r work for a long t ime, faded from use a t t h i s
per iod, but in i t s place they subs t i tu ted uroscopy -
diagnosis by examination of the urine. This method of diagnosis
eased t h e i r profess iona l l i f e considerably as they did not
need to examine the pa t i en t . In f ac t , they were prepared to
t r e a t by post Their remedies were complex, often involving the
use of animal and plan t ex t rac t s and some chemicals. However,
they did not adminis ter or de l iver these personal ly but l e f t
matters to more lowly beings - the apothecar ies and surgeons. One
point of i n t e r e s t and s i g n i f i c ance to those in te
res ted in hypnosis and psychosomatic medicine was
t he i r i n t e r e s t i n , and search fo r, a s ingle powder or
agent to curedisease , wherein l i e s the germ of the l a t e r
development of mesmerism and then hypnosis.
The second group of healers were the apothecar ies and i t only
remains to say t h a t they made considerable incomes but , when
they began to challenge physicians for pa t ien t s they were, with
some d i f f i c u l t y, excluded from the t r a in ing of doctors
and the f u l l prac t i c e of medicine by laws which were
promoted by the physic ians .
Surgeons were regarded as l e s s e r men than physic ians , though
not to such a great extent in Scotland as in England. They were
seen as
craftsmen and learned t h e i r t rade by apprent iceship , a
method of education which l as ted u n t i l the f i r s t ha l f
of the 19th century when Univers i ty degrees and the Medical Act
of 1858 regu la r i sed a l l med i c a l t r a in ing .
Barbers were a l so involved in surgery, but regarded as i n f e r
i o r to surgeons. Never theless , a t the incept ion of ce r t a i
n Colleges they were admitted and t h e i r a c t i v i t i e s
were con t ro l l ed . For example, Robert Haries was admitted to
the Facul ty, l a t e r the Royal College of Physicians and
Surgeons of Glasgow, in 1645 with the s t r i c t ru l ing tha t he
should be allowed "only to meddle with simple wounds and not to
meddle with physic , tumors, ulcers , dis loca t ions and f rac
tures" , (Hamilton 1981). Eventually the barbers were forbidden to
en te r the Colleges and to take up any form of medical or surg ica
l prac t ice . This bar took place in Edinburgh in 1648, but not u
n t i l 1722 in Glasgow.
The dreadful s tandards of care given to the s ick in the 16th
century by a l l manner of people, including physic ians , led
eventual ly to the formation of bodies or corporat ions which were
es tab l i shed to maintain s tandards of s k i l l and pa t ien t
care and, of course , the f inanc ia l i n t e r e s t of those who
had medical t r a i n ing . Three Colleges were formed and, i n
order of foundation, they were the Royal College
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6 M. R. BOND
of Surgeons of Edinburgh in 1505, the Royal College of Physicians
and Surgeons of Glasgow i n 1599, and the Royal College of
Physicians of Edinburgh in 1681. This order i s ra ther curious
bearing in mind tha t physic ians had the highest s t a tu s , and
tha t Glasgow in the 16th century was a much smal ler town than
Edinburgh. The or ig ins of the corporat ions were very di ffe ren
t and worth mentioning.
The incorporat ion of surgeons and barbers in Edinburgh took place
in 1505 and the terms under which the c ra f t was founded was s
imi la r to tha t of others , in other words a body for the protect
ion of i t s members and regulat ion of t he i r t r a in ing and
conduct. Hamilton t e l l s us t ha t a f t e r apprent iceship the
po t en t i a l surgeon was examined in anatomy, had to prove he
was able to read and wri te , and t ha t he understood the s igns
of the zodiac necessary for the progno s i s of disease by as t ro
logy. Entry was l imi ted to the sons and
sons- in- law of craftsmen, sons of the nob i l i t y, or those
marrying thedaughter of a surgeon - provided she was a clean virgin
The Edinburgh surgeons were given a monopoly to s e l l aqua v i t
ae , an ear ly form of whisky, a drink which had not become popular
and which was only considered to be a medicine a t t h a t t
ime.
In 1599 Glasgow was not a major town. Nevertheless an important
medical corporat ion was establ ished a t tha t date , even though
the re was only one physic ian, s ix surgeons, one apothecary, and
two mid wives, i n Glasgow. The corporat ion 's j u r i sd i c t i
on , unl ike tha t of the Surgeons' College in Edinburgh, covered a
wide geographical area , including much of West and Central
Scotland. In addi t ion to powers
to regu la te medical t r a in ing and prac t ice i t was also
empowered toinspect the s e l l e r s of drugs.
The reason for the establishment of the College in Glasgow a t a l
l l i e s in the s t a tu r e of the person who was the driving
force behind i t s b i r t h . He was Master Pete r Lowe, a Scot,
medically t r a ined in France and almost cer ta in ly connected
with the p o l i t i c a l a c t i v i t i e s of James I in tha t
country. Why he chose to l i ve in Glasgow i s not known but his
ear ly awareness of the medical problems of the area , and h i s
close re la t ionsh ip with the king, led to h i s gaining a char
te r for the establishment of the College. The king was i n t e r e
s t ed in medical matters , apar t from his well known d i s l i ke
of smoking, which be banned a t Court.
I t i s i n t e r e s t i ng to note t h a t the College was
prepared to admit physic ians without examination, but not
surgeons
The College of Physicians in Edinburgh was the l a s t corporat ion
to be es tab l i shed , and then only with considerable d i ff i cu
l ty. Undoubtedly the physic ians sought to control t he i r own
numbers, which were increasing qui te rap id ly, an d . i f
possible to gain power over the surgeons and apothecaries. , as had
happened in London. The surgeons were outraged, the Faculty in
Glasgow f e l t threatened, and King's
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SCOTTISH CONTRIBUTIONS 7
College in Aberdeen s ta ted tha t the r e s t r i c t i ons
proposed would apply to t he i r t ra inees who wished to prac t
ice in Edinburgh and thus con t ravened t he i r char te r. Even
the Town COuncil of Edinburgh were opposed, no doubt because of the
number of surgeons who were members of i t , but perhaps t he i r r
ea l fea r was tha t the t r a in ing of physic ians would move
away from Edinburgh Univers i ty, which they cont ro l l ed .
Eventually, having made several attempts to found the College from
1621 onwards, a charter was granted in 1681, probably because one
of the backers had close connections with the Royal Court and also
because the apothecar ies were engaged in a dispute with the
surgeons and thus supported the proposals for the f i r s t time.
Hamilton makes the in te res t ing and ra ther amusing point tha t
, a t the time of the f i r s t appl ica t ion of the physic ians ,
which was to Oliver Cromwell, there was a cer ta in lack of subt le
ty on t he i r par t in the framing of t he i r request . Thus, a
College was needed because of "the
frequent murders committed universa l ly, and in a l l pa r t s ,
by quacks,women, gardeners, and others grossly ignorant ••• and the
unlimited and unaccountable prac t ice of surgeons, apothecaries
and empirics pretending to medicine • • • • a l l these undertaking
the cure of a l l diseases without the advice and ass i s tance of
physic ians" .
By the 18th century Scotland had a wide reputat ion for the t r a
in ing of doctors and was espec ia l ly famous for surgery. The
influence of Scot t i sh Colleges and Univers i t ies was such tha
t a t the beginning of the 19th century 95% of doctors in Br i ta
in with a med i c a l degree t r a ined in Scotland, which had a v
i r t u a l monopoly in medical education. For example, in 1815
there were more than a thousand doctors in t r a in ing in
Scotland. I t i s not surpr i s ing therefore tha t much of English
medical prac t ice was in the hands of Scotsmen or men t r a ined
in Scotland and, the re fore , t ha t these men were a t the center
of events surrounding the b i r t h of hypnosis. However, the
general publ ic was not over impressed with medical care and a t
the end of the 18th century doctors were, with good reason,
regarded with fear and suspicion. They were s t i l l making grea t
use of the pract ices of bleeding and purging and surgery was
barbar ic . In addi t ion there was evidence of the prac t ice of
the new mysterious cul t s of phrenology (Mill ingen 1837)
mesmerism and homeopathy. L i t t l e wonder tha t home remedies
abounded and tha t a se l f -he lp move ment centered on the use of
' spa ' therapy developed. Thus, a t the turn of the 19th century
the prac t ice of medicine l e f t much to be desired and, apar t
from ex te rna l cr i t i c i sms , there were many in te rna l
controvers ies and r iva l s , not l e a s t in r e l a t i on to
mesmerism, and i t was here tha t Scots were a t the center of the
debate and the v i t r i o l i c exchanges tha t abounded.
THE RISE OF MESMERISM
For centur ies there was a be l i e f t ha t cer ta in substances
and man-made objects l i ke amulets possessed curat ive powers,
espec ia l ly
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8 M. R. BOND
when made under the influence of magic. The mysterious a t t r ac t
ive powers of magnets led to the bel ie f t ha t they could a ff ec
t the body by v i r tue of imperceptible emanations and. in fac t .
a Scot. William
Maxwell. author of De Medicina Magnetica. was hounded by
academic.re l ig ious and medical men fo r h i s theor ies in t h i
s area. In a s imi l a r way e l e c t r i c i t y. which could ac
tua l ly be seen passing from a generator to the human body. was
also held to have curat ive proper t i e s . However. in the l a t
e 18th century these matters were of r e l a t i ve ly l i t t l e
i n t e re s t u n t i l the dramatic appearance on the medical
scene of Franz Anton Mesmer.
I t was Mesmer who was a t the center of heated disputes tha t
raged over h i s theory of animal magnetism which s t imulated
James Braid. a Scot. to examine i t s various aspects . to def ine
hypnotism and to es tab l i sh the prac t ice of medical hypnosis
on an acceptable
bas i s .
Mesmer was a Swiss, born in 1734. He took a medical t r a in ing in
Vienna and in 1766 wrote a t r ea t i s e based on his i n t e re s
t i n a s t ro logy en t i t l ed 'The Influence of The Planets on
the Human Body'. This was f a r from being a new topic and the work
was greeted with amuse ment. Mesmer was hea r t i l y r idiculed
and. as a r e su l t . became much more secre t ive and myst ical
in his i n t e re s t s and works thereaf te r - a f ac t which
probably contributed fu r ther to his condemnation. His theory was
founded upon the assumption of the existence of a subt le element
or essence prevading a l l nature . o r what Newton ca l led ' t he
e t h e r ' . At f i r s t Mesmer thought t h i s might be e lec t
r i c i ty but l a t e r
re jec ted the idea in favor of magnetic emanations. This idea he
may have taken from the Je su i t Professor of Astronomy in Vienna.
Maximilian Hell.
Using magnetised rods Mesmer put theory in to prac t ice . t r ave
l l ing widely in Europe and effect ing a number of miraculous
cures. Later he gave up the use of rods bel ieving t ha t the f l u
id they con ducted from h i s body to the pa t ien t could be t r
ans fe r red equal ly wel l by repeatedly passing h i s hands from
the p a t i e n t ' s head to his legs j u s t in f ron t of the
body. Believing h i s power to be due to t r ans mission of a
magnetic f lu id he coined the term 'animal magnetism' to d i ff e
ren t i a t e i t from mineral magnetism. In medical c i r c l e s
Mesmer was regarded as an imposter and continued c r i t i c i sm
was heaped upon him. At l a s t he reached Par i s where he
generated great emotions. l a rge numbers of pat ien ts . a great
deal of money. and the wrath of the sc i en t i f i c and medical
establishment. The l a t t e r eventual ly se t up a commission.
the f i r s t of three. to invest igate Mesmer's work. I t was
headed by Benjamin Franklin and included Lavois ier and Dr. Gui l
lo t in . I t s report of 1784 made two important poin ts . Fi r s
t . tha t imagination played an important par t in the cures
achieved. and second tha t evidence for a magnetic f l u id was
lacking. I t did not damn Mesmer's work out of hand but the
comments were loudly acclaimed as a r e j ec t i on of a l l t ha t
Mesmer stood for. Although increasing
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SCOTTISH CONTRIBUTIONS 9
pressure forced Mesmer to leave Par i s h i s work was car r ied on
by numerous pupi l s , including D'Eslon, who was the f i r s t of
many mes meris ts to v i s i t Br i t a in i n the l a t e 18th,
and ear ly 19th century. However, mesmerism was overshadowed for
several years a t the begin ning of the 19th century by i n t e r e
s t i n phrenology - them method of r e l a t i ng mental and moral
a t t r i bu t e s to the shape and contours of the heat and
proposed by the German, Franz Gall , and his pupi l and d i s c ip
l e , Johann Spurzheim (Cri tchley 1979). Apparently Dr. Gall was a
b r i l l i a n t anatomist and dissec tor who, despi te the fa i
lure of h i s system of phrenology, contr ibuted very s ign i f
ican t ly to understanding of the anatomy of the bra in and cran ia
l nerves and who was a fo re runner of those who have s ince sought
to l oca l i s e bra in functions in what might be termed, a new
sor t of phrenology. In i t s heyday the cul t of phrenology was
represented by no fewer than 29 soc i e t i e s in Bri ta in . One
of those who was an avowed phrenologis t was the Scot,
Dr. John El l io t son of University College, London. He was edi
tor ofthe Zoist , a per iod ica l which commented upon phrenology
and which wil l be mentioned l a t e r . He was also f i r s t
President of the London Phrenological Society and a number of other
famous people were a l so supporters of the cu l t , including
Thomas Wakely, Editor of the Lancet.
El l io t son , a l so in te res ted in mesmerism, was regarded as
an overact ive eccen t r ic . In fac t , one of h i s eccen t r i c
i t i e s was the use of the stethoscope which he introduced in to
Br i t i sh medical prac t ice Nevertheless, he held the Chair of
Prac t i ca l Medicine a t University College, London, and was
President of the Royal Medical and
Chirurgical Socie ty the re . In 1837 h i s i n t e r e s t in
mesmerism wasra i sed to fever p i t ch by the v i s i t of a
famous French mesmerist, Baron du Potete , and, as in everything e
lse he did, El l io t son plunged i n to experiments and treatments
with a cer ta in lack of caut ion, cha rac t e r i s t i c of him.
Wakely, Editor of the Lancet, was vio len t ly opposed to mesmerism
and in an e f f o r t to convince him of i t s worth El l io t son
made the f a t a l mistake of attempting ear ly experiments a t
Wakely's house using two g i r l s , the Okey s i s t e r s , who
were unstable , highly suggest ible young women, prone to pe t ty
fraud and considerably exhibi t ionism. The experiments fa i led
miserably and the f u l l venom of Wakely f e l l upon El l io t
son who l a t e r , because of h i s many unortho doxies, became
disc red i ted and was removed from h i s professor ia l post .
However, he remained in pr iva te prac t ice , continued h i s i n
t e r es t in mesmerism and remained an ac t ive ed i to r of the
quarter ly magazine, The Zoist , from i t s f i r s t publ icat ion
in 1843 u n t i l he died in 1856. This journal served to co l l ec
t and di ffuse an enormous volume of information about mesmerism
and cerebra l physiology and was very i n f luen t i a l , espec ia
l ly amongst lay people.
A second Scot, not a doctor but a lawyer, J . C. Colquhoun (1836).
made a more reasoned approach to the nature of mesmerism in his two
volume work ' I s i s Revelata - An Inquiry in to the Origins ,
Progress and Present Sta te of Animal Magnetism.' With a c l a r i
t y of
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10 M. R. BOND
mind possessed by the bes t l ega l brains he constructed a pos i t
ive case for the r e a l i t y of the phenomena associated with
animal magnet ism. He c r i t i c i s e d scept ics for ignoring
the huge mass of fac t s ava i lab le to them and commended the
subject for s c i e n t i f i c inves t iga t ion . He was
unconvinced by the arguments for a magnetic process or f lu id but
much impressed by the powerful effec ts the mind could have on the
body and vice versa .
The prac t i ca l value of mesmerism was c lear ly demonstrated by
a pragmatic Scot in the Indian par t of the Colonial Service. Dr.
James Esdai le (1846) appalled by the pain and suffer ing of his pa
t ien ts and impressed by the powers of mesmerism to induce t
rance, used i t in many successful surg ica l operations, mostly of
a minor nature . I t should be borne in mind t ha t the sentiments
of the day regarding pain di ffe red from our own. They were summed
up in Esda i le ' s quote from a
Dr. Copland who s ta ted t ha t , "pain i s a wise provis ion of
nature , andpa t i en t s ought to suffe r pain while t he i r
surgeon i s operat ing; they are a l l the be t t e r for i t and
recover be t t e r " . In one per iod of eight months Esdaile
operated upon 73 pat ien ts and in the same period t rea ted 18
medical cases , most having neurological or what we would c a l l
psychia t r ic disorders . Pragmatism, a strong feature of the Scot
t i sh persona l ity even today, led him to several basic
conclusions which were, f i r s t , the operator should not put too
much emphasis on carefu l se lec t ion of subjects ; second, fa i
lure to respond to mes merism in heal thy people did not mean t ha
t when possessed by the des i re to overcome an i l l n e s s they
would remain r e s i s t an t to i t and, l a s t , t ha t the e ff
ec t s of mesmerism were similar to ce r t a in nat ive
myst ical treatments for i l l nes s , an effec t commented upon by
others , notably Colquhoun and Braid.
The Scot who made the grea tes t and most l a s t i ng contr ibut
ion to the debate on mesmerism was James Braid (Dingwall 1968). He
was born in 1795, son of a landowner in Fife , and was educated a t
Edinburgh University. He reconci led many of the conf l ic t s
surrounding mes merism by care fu l experimentation and thoughtful
l i t e r a ry contr ibu t ions , of which the bes t known i s
'Neurypnology or the Rationale of Nervous Sleep considered in re la
t ion with Animal Magnetism' (Waite 1899). The work, hypnotism, i s
h i s own shortened form of the term, neurophypnotism which he
derived from neurypnology.
Braid regarded mesmerism, or hypnotism, as a ser ious subject and
bel ieved t ha t i t s use in the treatment of i l l nes s should
be confined to doctors . He proved to h i s own sa t i s fac t ion
and tha t of others t ha t magnetic f lu id was non-exis tent and
emphasized tha t hypnotism involved the use of considerable powers
of suggestion by the hypno t i s t , together with a need for
sugges t ib i l i ty on the par t of the pat ien t . He concluded,
i n h i s own words, tha t " a l l I claim for hypnotism i s now
wil l ing ly admitted by the great major i ty of scien t i f i c
men who have invest igated the subject without previous preju dice
in favor of mesmerism". In addi t ion to h i s work on
hypnosis
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SCOTTISH CONTRIBUTIONS 11
Braid a l so dea l t f irmly with a number of o the r i s sues ,
for example he disproved the exis tence of many of the phenomena
assoc ia ted with cla i rvoyance, proved t h a t the c u l t of
elect robiology was e s sen t i a l l y the process of hypnotism
induced by the use of zinc and copper discs , and showed tha t
severa l phenomena assoc ia ted with mesmerism were sub jec t ive ,
t h a t i s of the mind's invent ion and not a r e s u l t of
magnetic forces or f l u i d . I n t e r e s t i n g l y, a t an e
a r l i e r s tage Bertrand, in France, had come to a s i m i l a r
conclusion.
Despite Bra id ' s work the prac t ice of mesmerism continued
(Townsend 1844) and indeed E l l i o t s o n , through the medium
of the Zois t attempted to d i s c r e d i t him on severa l
occasions. A Mr. William Davey (1862), ac tua l ly es tab l i shed
a Scot t i sh Curat ive Mesmeric Associa t ion in 1853 wel l a f t
e r the publ ica t ion of Bra id ' s book, and he was jo ined in t
h i s venture by Gregory, the Professor of Chemistry a t the
Univer
s i t y of Edinburgh, who became President of the Society. I t
wassupported by a number of eminent Scots in the c i t y, inc
luding the President of the Royal Socie ty of Edinburgh, S i r
Thomas Brisbane .
As far as Scotland was concerned the i n t e r e s t shown in
mesmerism and hypnotism faded and the dominant features of the
medical scene in the l a t t e r ha l f of the 19th century were re
la ted to the discovery of anaesthes ia and the con t ro l of surg
ica l seps i s , together with the rapid development of the s p e c
i a l i t i e s of surgery and pathology in both Glasgow and
Edinburgh.
The l i n e of hypnosis was not dead. Bra id ' s work was
quickly
taken up in France where the Nancy and Par i s i an Schools of
Hypnosis were es tab l i shed and i t was to Par i s tha t Sigmund
Freud went to l ea rn more of hypnosis from the French neuro log i
s t , Charcot, who bel ieved tha t hypnosis could be induced in
neuro t i c p a t i e n t s and t h a t the suscep t i b i l i t y
to hypnosis was a s ign of hys te r ia .
Freud i s the l i nk between the 19th century and between hypnosis
and psychosomatic medicine, because i t was in the ear ly years of
the 20th century tha t h i s pupi l s e s tab l i shed the formal
study of psycho somatic disorders .
HYPNOSIS AND PSYCHOSOMATICS IN THE 20TH CENTURY
I n t e r e s t i n hypnosis for the f i r s t 50 years of the
century was almost non-exis tent in Scotland and p r i o r to the
1950s i t s use was seldom mentioned except in r e l a t i on to t
reatment of she l l shock in the 1914/18 War by a Scot , Dr. John
McDougall.
In the 1950s f r e sh i n t e r e s t was genera ted in hypnosis
and was re f lec ted in the fac t tha t Professor Ferguson Rodger,
then the Pro fessor of Psychologica l Medicine in Glasgow, headed a
group which on behalf of the B r i t i s h Medical Associa t ion
inves t iga ted the claims of
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12 M. R. BOND
the prac t i t ioners of hypnosis. The Commission concluded t ha t
i t had a usefu l ro le in pain control and psychotherapy and t ha
t i t should be taught to medical and dental s tudents . At the
same time Dr. David
Fisher. both a doctor and dent i s t . establ ished several
hypnotherapyc l in i c s in Glasgow and was a lso the moving force
behind the found a t ion of the Scot t i sh Divis ion of the Br i t
i sh Medical and Dental Hypnosis Society - the parent body of which
had been founded by the fus ion of the Medical and Dental Societ
ies in 1952. Much more re cent ly the Br i t i sh Society of
Experimental and Clin ica l Hypnosis was founded and has two
branches in Scotland. Thus. in the l a s t 30 years there has been
increasing i n t e re s t in hypnosis in Scotland and. a t presen t
. i t s prac t ice i s both f lour ishing and expanding.
Psychosomatics i s a term covering i n t e re s t in the r e l a t
i on between physical and emotional aspects of disease. This has a
long
his tory and the term. psychosomatic, appears to have been used f i
r s t a t the beginning of the 19th century in Germany by Heinroth.
How ever, formal study of diseases , regarded as spec i f ica l ly
psychoso matic , d id not begin u n t i l the ear ly pa r t of the
20th century when pupi ls of Freud firmly establ ished the study of
psychosomatic d i s orders l inking cer ta in conditions of the
mind with par t icu lar physi ca l symptoms or diseases .
The most outs tanding contr ibut ion in Scotland to t h i s f i e
ld of medicine was made by Dr. John Hall iday, an epidemiologist
and Medical Off ice r of Health in Glasgow. In the 1930s and 40s
Dr. Halliday became impressed by, and studied the effec ts of , soc
ia l fac tors upon i l l nes s . In h i s book. 'Psychosocial
Medicine' , published in 1948 he ref ined the concept of a
psychosomatic disorder as follows: "A psy chosomatic affec t ion i
s a disease which complies with the psychoso matic formula and
whose prevalence r i s e s or f a l l s in accordance with the r i
s e or f a l l of communal upset t ing events , tha t i s , in
accordance with the pressure of environment in i t s psychological
aspects" . This seems to have been a forerunner of l a t e r i n t
e re s t in the subject of l i f e events and t h e i r r e l a t i
on to emotional d i s t r e s s and mental i l l nes s . Dr. Hal l
iday ' s inves t iga t ions revealed tha t disorders f i t t i n g
t h i s pat te rn . included pept ic ulcera t ion and g a s t r i t
i s . exopthalmic go i t r e , hypertensive disorders including
hypertension, coronary thrombosis. angina and cerebrovascular
disorders . and psy choneuroses. including anxiety s t a t e s and
hys te r ia . There are many others deta i led in h i s book and h
i s work was warmly received. e s pec ia l ly in the United States
where one of the founders of the psy chosomatic school in tha t
country. Dr. Flanders Dunbar (1946) acknow ledged h i s contr ibut
ion a t length in her book. 'Emotions and Bodily Change. a l i t e
r a t u r e survey of 1910-1945'. Dr. Halliday was the f i r s t
President of the Glasgow Psychosomatic Society. which remains one
of only two in Bri ta in and which was founded in 1959 a t the ins
t iga t ion of the l a t e Drs. David Kissen and Astor Sclare .
This Society continues to f lour i sh .
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SCOTTISH CONTRIBUTIONS 13
Another Scot who made a s ign i f ican t contr ibut ion to psychoso
matic medicine was the l a t e Dr. David Kissen who, pr ior to h i
s un t imely death in 1968, carr ied out a ser ies of s tud ies ,
some with Professor Hans Eysenck of London University, upon the re
la t ion of psychological and physiological aspects of personal i
ty and proneness to malignant lung disease. Professor Cairns Aitken
of the Univers i ty of Edinburgh, current ly ed i to r of the
Journal of Psychosomatic Re search and Professor of Rehabi l i ta t
ion Medicine a t Edinburgh Univer s i t y, has made s ign i f ican
t contr ibut ions to our understanding of anxiety, as an aspect of
psychosomatic medicine, and one of his close assoc ia tes , Dr.
Lorna Cay, has provided much information about emotional aspects of
heart disease and the rehabi l i ta t ion of vict ims of myocardial
in fa rc t ion .
To conclude, the psychosomatic approach to medicine f
lourishes
and continues to grow in Scotland. I t i s appropria te to
concludet h i s paper with the hope tha t the present t rend
towards a wider use of the psychosomatic approach and in tegra t
ion of hypnosis and a l l i e d techniques in to the treatment
programmes for those with a combination of psychological and
physiological symptoms wi l l continue.
REFERENCES
Colquhoun, J . C., 1836, Animal magnetism, in : I s i s Revelata -
"An Inquiry in to the Origins, Progress and Present Sta te of
Animal Magnetism," (Vol I ) , I s i s Revelata, ed. ,Maclachlan
Stewart, Edinburgh.
Cri tchley, M., 1979, "The Divine Banquet of the Brain," Raven
Press , New York.
Davey, W., 1862, "The I l l u s t r a t ed Prac t i ca l
Mesmerist," (6th ed . ) , J . Burns, London.
Dingwall, E. J . , 1968, "Abnormal Hypnotic Phenomena - a Survey of
19th Century Cases," (Vol.IV), United Sta tes of America and Great
Bri ta in , J . & A. Churchill Ltd . , London.
Dunbar, F. , 1946, "Emotions and Bodily Change," (3rd ed . ) ,
Columbia University Press , New York.
Esdai le , J . , "Mesmerism in India and i t s Prac t i ca l
Application in Surgery and Medicine," 1846, Longman, Brown, Green
& Longman, London.
Halliday, J . L. , The incidence of psychosomatic affec t ions in
Bri ta in ," 1945, Psychosom.Med., 7:135-146.
Halliday, J . L. , 1948, "Psychosocial Medicine: A Study of the
Sick Society," Heinemann Medical Books, London.
Hamilton, D., 1981, "The Healers, A History of Medicine in Scot
land," Canongate, Edinburgh.
Millingen, J . G., 1837, "Cur ios i t i es of Medical Experience,"
(Vols. 1 and 2) , Richard Bently, London.
Townsend, C. H., 1844, "Facts in Mesmerism," (2nd. ed . ) Bai l l i
e r e , London.
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14 M• . R. BOND
Waite, A. E. , 1899, Braid on hypnotism, in : "Neurypnology or the
Rationale of Nervous Sleep etc . ,"Redway, London.
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Abstrac t
Fred H. Frankel
Beth I s r ae l Hospital and Harvard Medical School 330 Brookline
Avenue Boston, MA, 02215, USA
The or1g1ns of hypnosis a re indisputably c l i n i c a l , but i t
s current accep tab i l i ty and recogni t ion stem l a rge ly from
the high ca l ib re of academic investment and the findings in
experimental l abora to r ies in recent years . What we know has
been accumulated in the context of a r igorous adherence to f ine
ly developed research methods, construct ive scept ic ism, and cold
fac t s . Cl in ica l r e s u l t s , on the other hand, demand f l
e x i b i l i t y, imaginative phrases , deep
fee l ings , and even l o f t y thoughts. The poetry and the
science areboth e s se n t i a l fo r su rv iva l .
INTRODUCTION
I have wondered in common with many of you I am sure , about the
appropr ia te nature of a pres iden t ia l address . I t c e r t a
i n ly i s poorly timed for a p o l i t i c a l statement because i
t comes toward the end of the term of off i ce , and the l i n e of
succession has already been es tab l i shed for the coming s ix
years . I f I were fo r tuna te enough to be able to make some ex t
raord inar i ly valuable pronouncements today in
the hope of re turning to off ice in 1989, you wi l l sure ly a l l
have forgot ten them by then. On the other hand, the address might
be considered to be something akin to a Sta te of the Nation
Address - a review of where the Society has been, where we a re a t
, and where we a re headed.
* Pres iden t ia l Address by the Pres ident of the In te rna t
iona l Society of Hypnosis.
15
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16 F. H. FRANKEL
I f i t were to follow the theme cur ren t ly predominant in most i
n s t i t u t i ons in the United Sta tes including hospi ta l s
and academic cen te rs , i t would be l i ke an address to the
shareholders - a business report tha t would be f i l l e d with f
i s ca l ly re levant s ta tements and an eloquent bottom l ine
.
I mean no disrespect to p o l i t i c s , to the presidency of my
adopted country, or to big business. I bel ieve I recognize the
importance of a l l three. However, in the hope tha t the re a re
other prerogat ives open to the president of a socie ty such as
ours , I wi l l choose ye t another format. With your indulgence I
wil l use the occasion, unashamedly, to e laborate on a personal
perspect ive on hypnosis t ha t i s admittedly ne i ther wholly or
ig ina l nor unique. I wish a t the outse t to acknowledge the many
contr ibut ions of my col leagues, some of whom are i n t h i s
audience or on t h i s podium. I
wi l l , I fear, have to depend, in my presentat ion, on those con
t r ibut ions , and wi l l t ry to avoid shaping t he i r findings
to my own ends.
I come not as a t heo r i s t , grappling with formulae to r e l a
t e the psychological to the physiological , although I might wish
tha t I were. I come not as an exper imental is t with a keen ins
igh t in to methodology and t ha t enviable ease with s t a t i s t
i c s tha t resembles the s k i l l s of the t rapeze a r t i s t
grabbing supports out of nowhere, although I might wish t ha t I
did. I come ra ther as a c l in ic ian and c l i n i c a l teacher
who has t r ave l led the highways and byways of c l i n i ca l and
academic psychiat ry on two cont inents for more than th ree
decades. I t seemed to me t ha t i f I did not use t h i s
opportunity to
confront some of what I have gathered along the way, I probably
never would lay claim openly to my own ambivalence. Having spent
most a of my time as a c l in ic ian , and some as an inves t iga
tor, I bel ieve I am general ly regarded as a c l in i ca l inves t
iga tor. On the other hand, I might a lso qual i fy as an inves t
iga t ive c l i n i c i an , or even as a curious one. Which a l l
somewhat resembles the con f l i c t t ha t many of us seem to have
as we grow older. I n i t i a l l y having preferred to see
ourselves as l i be ra l s with a conservative leaning, we now f
ind t ha t we are r ea l l y conservatives with, perhaps, a l i be
ra l bent .
I be l ieve the essence of what I wish to address i s the unavoid
able complexity, uncer ta in ty, and ambiguity in our f ie ld as I
see i t , and the need for us to to le ra te the s i t ua t i on
while we s t i l l s t ruggle to understand what i t i s t ha t we
accomplish with the use of hypnosis. As we wel l know, close vis
ion while v i t a l to the pursui t of any d e t a i l s , tends to
bl ind us to the view of the whole. In our impatience to fo s t e r
ideas tha t we personal ly cher ish, our nemesis lurks in a
tendency to be cava l ie r about what others do.
As a c l i n i c a l psych i a t r i s t I am no s t ranger to
complexity and ambiguity. Doubts, uncer ta in meanings, and the
need to l i ve with a combination of in te rpre ta t ions are a way
of l i f e in the f i e ld t ha t has nurtured me for most of my
profess ional l i f e . How e l s e can one
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HYPNOSIS - BOTH POETRY AND SCIENCE 17
be of help, for example, to a pat ien t to rn by angry feel ings
toward an e lder ly paren t , o r a dying spouse? Moral and
psychodynamic absol u tes a re of l i t t l e value. Directed by
the moral imperat ive , I could say to him, "How can you be so
vicious or unkind toward someone who i s dying?" Or wi l l I help
him psychodynamically, do you th ink, i f I t e l l him tha t he
has every r i gh t to be angered by the fac t t ha t h i s l i f e
i s being eroded by the demands and the needs of his suffe r ing re
la t ive? Should I say then, "You go ahead, and l e t them know?"
Perhaps what I might ul t imately do t ha t might be more usefu l ,
i s to s i t sympathet ical ly, saying l i t t l e , but making i t
c lear tha t I , too, know the human condi t ion to be a tough one,
and tha t I wi l l t ry to help him cope with whatever i r reconc i
lab le and i r r a t iona l feel ings a r i s e in him.
How should I bes t respond to the needs of a pat ien t who rec i t
e s
a l i s t of physical complaints for which her physic ians can
uncover nophysiological cause. As she recounts them, I de tec t a
hin t of sad ness in her voice . On an i nv i t a t i on to her to
share her feel ings with me, she descr ibes a se r i e s of deep
personal losses , the deaths of close family members tha t
immediately preceded the onset of her symptoms. Should I t r e a t
her be encouraging her to t a lk about the hurt of her gr i e f ,
or should I prescr ibe medication t ha t i s aimed a t helping to l
i f t her depression? Will I be wiser yet to use a combi nat ion of
both methods; have her f i r s t r eca l l her feel ings and then
wait for an opportune time to introduce medication in addi t ion.
Perhaps I wi l l se lec t t ha t path. but i t should be noted tha
t the re i s a l i t e r a t u r e and a body of profess ional
opinion in favor of each
pos i t ion . p re fe r r ing e i t he r one approach or the other,
r a the r than a combination. How should I regard physical symptoms
t ha t respond to bio log ica l remedies, but t ha t never theless
or ig ina te in the emotions - in the anguish of tha t curious
mixture of physical and psychologi ca l discomforts tha t Lindemann
(1945) described as the "g r i e f r e ac t ion" .
Although on more so l id ground in some areas than we were twenty f
ive years ago. psychiat ry s t i l l has more quest ions than
answers - but we offer no apologies . We have a growing body of
knowledge derived from our c l i n i c a l experience and our
laboratory s tud ies ; some of our dearest concepts have stood the
t e s t of t ime. In moments of c r i s i s our col leagues , even
those who are c r i t i c a l , know t ha t they must c a l I o n
us because. l imited though we might be, we s t i l l know more
about the management and treatment of dis t ressed and psychot ic
behavior and su i c ida l depressions than they do. When t he i r
pa t i en t s on the medical and surg ica l f loors and in the
emergency wards behave i r r a t i ona l ly they c a l I o n us.
Both burdened and armed with knowing how ambiguous i s our t r ade
, we go fo r th . Because our data are for the most par t s o f t .
not hard. and because we cannot re ly on an impressive ba t te ry
of unequivocal laboratory t e s t s , we have to re ly on a modicum
of good sense and a demonstration of good manners. We aim to be
recept ive but not passive . caut ious but not cowered, and
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18 F. H. FRANKEL
r e a l i s t i c but not cava l ie r. We know t ha t the f i na l
so lu t ion to dis turbed behavior has ye t to be wri t ten . But
we have learned tha t we are more l ike ly to be successful i f we
remain f l ex ib l e , non judgmental, and open to suggestion as we
proceed with our interviews and our t rea tment plans . Subsequent
events are of ten open to var ious in te rpre ta t ions as we s t
ruggle to balance the demands of the psycho log ica l and the
physical , of the r a t i ona l and the emotional. We l ea rn when
to prescr ibe a p i l l , when to explore fee l ings , and when to
off e r reassurance. Sometimes we prudently wait to discover the
course of ac t ion t ha t i s bes t . I have said we go fo r th
both burdened and armed with the knowledge of the ambiguit ies
inherent in our ca l l i ng . Burdened, because i t i s bothersome
not to know many of the answers, but armed because without being
aware of the uncer ta in t ies in our work we might well do more
harm than good.
Unexpected though i t might seem, t o l e r a t i ng uncer ta inty
i s notpecu l ia r to only those of us who t o i l in the
behavioral sc iences . Closer examination of the hard sciences
impresses us with the fac t t ha t even the re , beyond a ce r t a
in poin t , a sse r t ions are l e s s f i n i t e . The Alber t
Einsteins and the Niels Bohrs provide us with notable examples.
What should be c lea rcu t i s f requent ly not so. Those i l l u s
t r i o u s individuals had the a b i l i t y to acknowledge the
value of more than one theory of l i g h t . Theirs i s a sober
reminder of how the grea t l ea rn to l i ve with ambiguity.
Einstein (1924) wrote, "We now have two theor ies of l i g h t ,
both indispensable , but , i t must be admitted, without any l og i
ca l connection between them, despi te twenty years of co lossa l e
ffo r t by theore t ica l phys ic i s t s . " Bohr (1934) in
h i s evaluat ion of the apparently contradic tory wave and pa r t
i c l etheor ies to explain the propagation of l i g h t ,
suggested more d i r ec t l y tha t opposite viewpoints under the
circumstances are not only i nd i s pensable, they are
complementary. In other words, ra ther than being mutually
exclusive , they can be mutually enhancing.
Hypnosis in Mesmer's Time
Moving now c loser to home, to our own f i e ld of endeavor, we
might ponder how Franz Anton Mesmer. the acknowledged fa ther of
hypnosis. might have f e l t had he sensed the poten t ia l and the
com plex i ty of what he bequeathed to us. To what extent could he
have apprecia ted tha t his prac t ices would. on the one hand.
contr ibute to the development of an important re l ig ious i n s t
i t u t ion (Podmore. 1963) and on the other lead to some of the
most sophis t icated methodology in the study of the behavioral
sciences? To what extent could he have been aware tha t h i s work
heralded a new perspect ive - tha t i t lay on the threshold of a
dialogue between the psyche and the soma - and t ha t i t would
pave the way to sweeping psychological theor ies (Ellenberger.
1910) tha t would i n i t i a l l y reveal more questions than
answers. Could he have even vaguely recognized t ha t among those
who showed an i n t e re s t in h i s work would be some dedicated
to the accumu-
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HYPNOSIS - BOTH POETRY AND SCIENCE 19
l a t i on of f ac t s , and yet others whose primary commitment
was to the exercise of fantasy.
I t seems tha t in whichever di rec t ion one follows hypnosis, one
encounters t h i s jux tapos i t ion of two seemingly contradic
tory perspec t ives - a kind of dualism tha t seeks to expla in the
phenomenon in the i r reduc ib le terms of one or another system.
Is i t phys ica l , or a l l psychological? I s i t r a t i o na l
, or a l l emotional? I s i t f ac t , or a l l fantasy?
There i s l i t t l e to suggest tha t e i t he r Mesmer or the s p
i r i t of h i s time could have apprecia ted the pervasiveness of
the purely psychological , the impact of the emotions, or the inf
luence of fantasy. Mesmer wrote tha t the explanation of what he
accomplished resided in h i s Fluid Theory (Mesmer, 1774) in the
physical r e a l i t y of
a magnetic f lu id t h a t could pass through the body of the
magnetizerto the pa t i e n t . As the world was being opened up a
t t h a t s tage in his to ry by the dramatic discover ies of
modern physics , i t comes as no surpr i se tha t the important
answers were assumed to l i e i n t h a t realm. I t i s i n t e r
e s t i ng to note however, tha t desp i t e Mesmer's wri t t en
commitment to a physical explanat ion tha t he hoped would be
acceptable to sc ience, he was not above performing an elaborate
and t hea t r i c a l r i t u a l in h i s c l i n i c a l prac t
ice , obviously aimed a t what we today would regard as the
psychological s e n s i b i l i t i e s of his pa t i en t s . His
method of magnetizing, we a re to ld , was choreographed with color
and sound. Looking in to the rea r mirror of his to ry we must
wonder whether he r e a l l y did s e t t l e fo r an amalgam of
poetry and
science - or whether, despi te the s c i e n t i f i c pretensions
of h i s Fluid Theory, he was not e s s en t i a l l y a poet - a
committed 18th century prototype of the modern science f i c t i on
w r i t e r, perhaps with l e s s personal ins igh t .
I t i s usefu l to note t h a t in our t ime, in the f i e ld of
hypnosis, the contes t i s l ined up in a way tha t bears the mark
of two cen tur ies of c l i n i c a l work, and a ha l f century of
modern laboratory i n v e s t i gat ion. We are confronted by the
fac t t h a t unbridled c l i n i c a l experience with hypnosis i
s now being p i t t e d against the log ica l findings of soph is t
i ca ted methodology. Perhaps the grea tes t cha l lenge to the f i
e ld of hypnosis a t t h i s time l i e s in how we resolve the
differences between a r i ch ly imaginative c l i n i c a l focus
and the fac t s tha t emanate from the laboratory, between the
poetry on the one hand and the science on the other. Are they i r r
educ ib ly d i f f e r en t , o r a re they interdependent? Are
they mutually exclusive , o r in the words of the p hys i c i s t s
, are they complemetary?
Modern Hypnosis
I t might be usefu l to take stock again of the a r t i s t r y tha
t has been an in tegra l par t of the prac t ice of c l i n i c a l
hypnosis s ince i t s
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20 F . H. FRANKEL
incept ion. Mesmer's purple cape, the music, and the general mil
ieu surrounding the event in h i s time had a d i s t i nc t ly t
hea t r i ca l qual i ty. To t h i s day. many c l in ic ians in
the induction procedures assume the s tudied pose o r the voice i n
f l ec t i on of the "hypnot izer." Their behavior i s d i s t inc
t ly manipulative. Whether over t ly con t ro l ing or permissive.
the tempo of the di rec t ions i s slow. and the speech monotonous.
quie t ing . and reassur ing. Pat ien ts are offered a "very
enjoyable" or even "momentous" experience; they are perhaps
encouraged to bel ieve they are "ent i t l ed" to the reward of a
deep sense of re laxat ion. They are persuaded to disconnect or
disengage from the workaday world, and to soar with the images tha
t are suggested d i r ec t ly. or encouraged. Existence becomes
purple prose or sheer poetry. I t i s onto t h i s subs t ra te tha
t the se lec ted the ra peut ic s t ra tegy i s graf ted - the numb
feel ing to displace the pain . the image of the blood vesse l s
expanding to allow a grea te r degree of
body heat to reach the f ingers or the toes a ff l i c t ed by a r
t e r i a lspasm, or the wondrous sense of a grea t confidence l i
ke a p i l l a r of l i gh t growing within oneself . Colorful
language. vivid imagery, and a voyage to a make-believe world are
closely woven in to the whole experience.
Some c l in i c i ans prefe r to s t r i p the event of these embel
l ish ments; however, even when the induct ion procedures are
pedestr ian. such as "close your eyes . count to ten and re lax" .
the s t ra tegy must s t i l l depend on imagination for i t s
energy. This can be fostered by allowing a spontaneous unfolding of
fantasy; i t might be brought on by asking the pat ien t to use
whatever images he chooses to c rea te the
numb fee l ings . or the warm feel ings. or the sense of increasing
se l f confidence. This l a t t e r approach i s general ly favored
by those who graduate to c l i n i c a l work through a previous
involvement in i nves t i gat ive studies in the laboratory. Many c
l in ic ians seem to show l i t t l e preference for t h i s pa le
r vers ion of hypnosis, while s t i l l o thers assume a s ty le of
pract ice t ha t l i e s somewhere in between. There are few i f
any dependable s tud ies repor t ing on the incidence of the d i f
f e r en t s ty l e s or on t he i r comparable eff icacy. My own i
n c l i nat ion has been to deemphasize the t hea t r i ca l in
hypnosis, and to come down on the somewhat conservative s ide of my
ambivalence. Both my prac t ice and my teaching r e f l ec t t h i
s . My pa t ien t s a re often inv i ted to pa r t i c ipa t e in
the event. motivated not only by the wish to get wel l . but also
by a s p i r i t of adventure and cur ios i ty.
I be l ieve I chose to follow t h i s l i ne because of my respect
and continued admiration for the inves t iga t ive s tudies tha t
have emerged in recent decades. By cas t ing hypnosis in a casual
mould. s t r ipped of i t s magic and mystique, inves t iga tors
have made i t r ea l ; t he i r work with s tandardized procedures
has led to major developments. With the refinement of the hypnot
izabi l i ty scales and an increasingly impressive methodology.
they have uncovered several parameters of hypnosis - some of which
might have been suspected while others came as a surpr i se .
Working l a rge ly with volunteers from the col lege
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HYPNOSIS - BOTH POETRY AND SCIENCE 21
s tudent popula t ion in a f r i end ly but very prosaic manner
compared with tha t in the c l i n i c a l s i t ua t i ons , inves
t iga to rs have shown tha t hypnot izab i l i ty i s not universa
l ly d i s t r i bu t e d , tha t women a re not on average more
hypnotizable than men, and t h a t the l eve l of general education
has no e ff ec t on the degree of responsiveness. They have
demonstrated these f a c t s , and many more (Hilgard, 1965).
A major consequence of t h i s i n t e l l e c t u a l and
determined pursu i t of the phenomenon of hypnosis has been the d i
s t i l l a t i o n of what i s bel ieved to be i t s essence - the
a l t e r a t i o n of percept ion. This might be associa ted with
a l te red cogni t ion and even a l t e r ed memory, but wi thin t
h i s conceptual framework the a l t e r e d s t a t e of awareness
measured primari ly in terms of the sub jec t ive experience of the
hypnotized individual i s the hallmark of hypnosis.
For some c l i n i c i ans deeply invested in the use of
hypnosis,immersed in the r i ch metaphors in frequent use, and
involved in the in tense re la t ionsh ips t h a t mark the
therapeut ic encounter, t h i s simple explanation i s somewhat dul
l and not a l toge ther re levan t . I t i s seen a t bes t as a
disappointment, and a t worst as a be t raya l . They regard i t as
leaving l i t t l e j u s t i f i c a t i o n for the imaginative
prac t ices and in tense re la t ionsh ips tha t surround t h e i r
use of hyp nos i s . Although the re la t ionsh ip between the
hypnot izer and the sub jec t , and the sub j ec t ' s consenting p
a r t i c i pa t i on are seen as necessary for the development in
the laboratory of the a l t e r ed per cept ion or a l te red
awareness, the phrase i t s e l f " a l t e r ed perception" by i t
s very nature diminishes the importance of the overtones so
dear
to the hear t s of c l i n i c i an s who prefe r more co lor fu l
prac t ice and phraseology. The crea t ive s ty l e and the
imaginative terms they use add to the psychological impact of the
procedure. Perhaps because the words are o f ten purposeful ly
obscure and the content r i ch in metaphor, the whole lends s t a t
u r e to the c l i n i c i an and enhances his procedures. He says:
" I am about to make contact with your deeply unconscious mind, to
help you communicate with a par t of you t h a t has been hidden
from you u n t i l now. Deeply unconscious pathways w i l l lead
you to the psychological forces wi thin you t h a t w i l l enable
you to r e s i s t the urge to reach for a c iga re t t e . "
Despite the rese rva t ions of these who c r i t i c i z e the
laboratory de f in i t i on , t h i s ornate phraseology leads prec
i se ly to the experience of an a l t e r e d percept ion. The
hypnot izer, with the a id of important sounding language,
encourages the pa t i e n t to experience what he, the pa t i en t
, perceives to be deeply hidden s t rengths . Even though they
might not be so deeply hidden tha t only the the rap is t can
provide access to them, they can be made to seem so inaccess ib le
in order to have them be tha t much more i n f l uen t i a l when
they emerge.
What i s not immediately conveyed by the b r i e f phrase , "a l t
e r ed percept ion" , perhaps, i s the a r t i s t r y, the poetry.
and the tendency c l i n i c a l l y to encourage the impression t
h a t th ings in hypnosis a re
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22
l a rge r than l i f e . This l a t t e r aspect hypnotic s i t ua
t i on , than to hypnosis. in the language, and in the
ambience.
proceed.
F. H. FRANKEL
seems to belong more to the I t i s car r ied in the s ty l e , Let
me t ry to explain as I
In a great s p i r i t of compromise, or possibly complementarity,
the l a t e Ronald Shor described hypnosis as possessing th ree
dimen s ions (Shor, 1962). The experience of the a l te red percept
ion or t rance i s but one. The other two include the important and
spec ia l re la t ionsh ip between the subject and the individual
carrying out the procedure, and the sub jec t ' s i n t e r e s t
in and motivation to p a r t i c i pate in hypnosis. This in
terpersonal i n t e r ac t i on , and the inner preparedness to
respond to the hypnosis exer t considerable inf luence on the way
in which the hypnosis proceeds.
In the c l i n i c a l se t t i ng these dimensions are pa r t i cu
l a r l y complex, involving many other psychodynamic forces , the
a t t i t ude of the pa t i en t to his i l l n e s s , h i s
expecta t ions of hypnosis, the environ mental fac to rs - a l l of
which inf luence the p a t i e n t ' s ul t imate response to
hypnosis and his symptomatic response to the therapy. I t should be
remembered tha t these two fac tors , namely the re la t ionsh ip
and the motivat ion, are equally re levan t to the progress of any
other form of psychotherapy. We who use hypnosis are not a lone.
All who prac t ice psychotherapy depend, for the effect iveness of
t he i r methods, on the s t reng th of the re la t ionsh ip and
the p a t i e n t ' s deep i n t e r e s t in improving.
I t i s unfor tunate tha t the t heo re t i c a l and inves t iga t
ive concept of the a l t e r e d percept ion, useful as i t i s ,
when examined out of context conveys a predominantly i n t e l l ec
tua l i n t e rp re t a t i on of the event of hypnosis. While t h
i s does an i n ju s t i c e to the idea as i t was o r ig ina l l
y formulated (Orne, 1959) the re i s no escaping the inhosp i t ab
le reac t ion to i t among many c l in ic ians . Perhaps i t i s
because the other fac tors contr ibut ing to the hypnotic s i t ua
t i on appear to receive short s h i f t in comparison. Perception
i s d i s cussed, descr ibed, and measured. Even though sub jec t
ive i t qua l i f i e s as sc ience. On the o ther hand the
importance of the in terpersonal re la t ionsh ip involved in
hypnosis, the rapport , o r the t ransference, and the sum t o t a
l of the psychodynamic forces which inf luence motiv a t i on ,
acknowledged though they be, s t i l l appear to be re legated to a
minor ro le . They are es sen t i a l l y the der iva t ives of fee
l ings , ubiqu i tous , and challenging to any would-be s c i e n t
i s t . They promote the i l l u s ions and give l i f e to the
metaphors; and as such they are the poetry.
Few c l i n i c i ans w i l l deny the importance of the therapeut
ic re la t ionsh ip , whether they regard ' i t merely as rapport ,
or whether they inves t i t with the complexit ies t h a t make up
the psycho-analytic t ransference. The psych ia t r i c l i t e r a
t u r e i s rep le te with references to the phenomenon. We know i
t has much to do with the emotional
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HYPNOSIS - BOTH POETRY AND SCIENCE 23
l ives of the two people involved. Something ine ffab le , i t i s
yet cruc ia l to, the ca l ib re of the therapy and of the hypnotic
experience. The re la t ive ly l ack lus t re outcome with s e l f
hypnosis learned from books confirms t h i s view. The phenomenon
has, however, thus f a r def ied measurement, and in the laboratory
publ icat ions i s given l i t t l e a t t en t i on .
I t wi l l come as no surpr i se to you now to hear t ha t the sc
ien t i s t in me of ten succumbs to t h i s other 've ry c l in i
ca l s ide of the ambivalence. I am, however, reassured in my
surrender by the fac t tha t the role of imagination in hypnosis
was dea l t with only cursori ly in inves t iga t ive work u n t i
l the importance of imaginative involvement emerged from c l in i
ca l observation (Hi1gard, 1970). I submit tha t the a ff ec t in
hypnosis i s also an idea whose time in the laboratory has come.
Although the l e s s fas t id ious have regarded
every aspect of the hypnotic in te rac t ion as hypnosis, others
among ushave d i f f e r en t i a t ed between the essence of
hypnosis - the a l te red perception - and the other forces in the
hypnotic s i tua t ion . I t i s time now to turn our a t ten t ion
to the l a t t e r , to examine them, to t ry to measure them i f
we dare , and to l ea rn to l i ve with them.
Even though t h i s ser ious dialogue between the poetry and the
science i s only now about to dawn, a glimmer has been seen for
some time. We might fashion discussions in the future on the format
of those current ly in vogue. Two examples immediately come to
mind: hypnot izabi l i ty in both the laboratory and c l in i ca l
contexts , and the value of memories recal led in hypnosis. Perhaps
a b r i e f review of
these two areas and of how the varying viewpoints can be and have
been thus fa r reconci led, wi l l remind us tha t contradictory
view points are not necessa r i ly mutually exclusive; they can in
fac t complement each other.
Hypnot izabi l i ty Measure
As already indicated by me, c l in ic ians have of ten been incl
ined to disregard the laboratory measurements as inappl icable to
the c l i n i c a l scene. Contrasting the populat ions , one young
and heal thy, the other suffer ing and represent ing several age
groups, they con clude tha t laboratory hypnosis and c l i n i c a
l hypnosis are not compar able e n t i t i e s . When requested to
apply to measures developed in the laboratory to pat ien ts , these
c r i t i c s demur on the grounds tha t the t e s t s are lengthy
and in t rus ive (Sacerdote, 1982), or t ha t they would in te r fe
re with the course of treatment were they to be introduced in to
the c l in i ca l s i t ua t i on . There i s evidence to the
contrary (Frankel e t a l . , 1979), indicat ing tha t the
laboratory sca les can indeed be appl ied to pat ien ts without
creat ing the havoc tha t has been prophesied by the c r i t i c s
; furthermore s tudies reveal i n t e r e s t ing cor re la t ions
between high scores and spec i f ic types of psychi a t r i c
disorders (Frankel and Orne, 1976). But t ha t i s not the focus
of
t h i s presentat ion.
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24 F. H. FRANKEL
What i s a t s take here i s the apparent contradict ion between
the ex ten t of the hypnotic response on the hypnot izabi l i ty
scales and the degree to which pa t i en t s respond
symptomatically to therapy involving hypnotic procedures. While
these individual react ions are re la ted in severa l ways, they
are not i den t i ca l . The response to a hypnotic induct ion
procedure i s not equivalent to the response to a the ra peut ic
procedure. In f ac t , pa t i en t s who are highly hypnotizable
might show no therapeut ic response to a treatment involving
hypnosis i f the secondary gain from t he i r symptoms i s such t
ha t they are loa th to give them up. Secondary gain i s a v i t a
l force in the perpetuat ion of symptoms. We know well the extent
to which a t t en t i ve and sympath e t i c r e l a t i ve s can
unwit t ingly prolong the behavior of i l l n e s s . Pain c l in i
c s have a remarkable accumulation of data to support tha t .
Furthermore, and i n cont ras t , pa t ien t s who respond poorly
to t e s t s of hypnot izab i l i ty might ye t show a pos i t ive
therapeut ic response to
procedures involving hypnosis, for the simple reason tha t
theyrespond to the se t t i ng in which hypnosis takes place even
though they might not be hypnotizable. They respond to the
therapeut ic inf luence of the ambience, the encouragement, and the
re laxa t ion tha t con t r i bute to the s i tua t ion in which
the hypnosis i s encouraged to take place , even when the hypnosis
per se f a i l s to occur.
We are here again ta lking about the hypnotic s i t ua t i on . I t
i s , i n t ru th , inescapable , and we come f u l l c i r c l e .
The poor hypnotic subjec t s gain r e l i e f from t he i r
symptoms very often from the reassur ance, the t r u s t , and the
expecta t ions t ha t are inherent in a l l acknowledged c l i n i
c a l procedures. The mystique surrounding hypnosis,
unre l iab le though i t be, might well add to the e ff ec t s .
The b