Self Hypnosis: Beyond the Chicago Paradigm
The study of self-hypnosis by Fromm and Khan gives some interesting insight into self- hypnosis and how it differs from hetero-hypnosis. Although the first study of its kind, it does indicate that we need to know much more. Self-hypnosis is a learned skill that can be improved over time. However, being taught self-hypnosis in therapy is not enough. The individual also needs guidance in utilizing the trance state, self-therapy and utilizing imagery.
Self-hypnosis: Beyond the Chicago Paradigm
I recently read with great interest Self-hypnosis: the Chicago Paradigm by Erika Fromm and Stephen Kahn (Fromm & Kahn, 1990) - which contains a number of chapters reprinting articles published elsewhere, plus some new material. It was more remarkable from my point of view because it was the first in-depth study of the subject I had come across. There is virtually nothing on self-hypnosis in the more learned journals, and as the authors point out, many consider the topic more or less the same as hetero-hypnosis. But as their book testifies, this is not so. In presenting their studies they draw on the diaries of the subjects they used - although much of their formal analysis is derived from the analysis of questionnaires.
What I present here is a comment on, a critique of, and a condensed longitudinal study of the topic based on my own experience. The longitudinal studies used in their analysis were based on a mere four weeks of using self-hypnosis. My own experience comes from utilizing self-hypnosis intensively over a 25-year period. It is also based on my study of hypnosis and my training as a hypnotherapist. I am aware that one can always dispense with a single study on the grounds that it is not possible to generalize from the particular. My reply to that is that a longitudinal study over a 25-year period can, and does, give additional insight into the subject that adds to our understanding of self-hypnosis in particular, and the phenomenon of hypnosis in general. It has the added advantage that it not only draws on the experience of the person engaging in self-hypnosis, but draws on a knowledge of the subject matter which most subjects would not possess.
hetero-hypnosis versus self-hypnosis
Prior to 1970 the general belief was that self-hypnosis and hetero-hypnosis were basically the same, the only difference was who was inducing the trance state. Based on this belief, teaching self-hypnosis is to teach the individual trance induction and deepening. Fromm and her team came to question this.
The first consideration was the degree to which consciousness was split in the two types of trance. In hetero-hypnosis there is, besides the hypnotist, the subject and the part that is the observer. In other words, the individual's consciousness splits into two. In the case of self-hypnosis, however, the individual must be the director (the hypnotist) the one being directed (the subject) and the observer. In other words, in self-hypnosis the individual's consciousness splits into at least three. In their investigations, all subjects reported more splits in consciousness (what Fromm and Khan call "ego splits") in self-hypnosis than in hetero-hypnosis. My own experience confirms this too. However, the same ability can be utilized in hetero-hypnosis, e.g. when utilizing double dissociation. It appears to me that the split occurs 'more naturally' in self-hypnosis but has to be suggested in hetero-hypnosis.
My own view is that self-hypnosis is easier to achieve once hetero-hypnosis has been achieved. The reasons for this are: (a) knowing what to expect; (b) knowing/learning the body responses; (c) becoming comfortable with the experience; (d) taking advantage of post-hypnotic suggestion, and (e) removing doubts and uncertainties. My own experience, however, of teaching self-hypnosis is that individuals can induce and deepen a trance fairly readily, but then get stumped - often asking "what do I do now?" This is important. The next step is no longer self-hypnosis but more correctly self-therapy. The individual moves from being a hypnotist to being a therapist. But not all individuals know how to be a therapist, or even if they do, it does not mean that they will be a good therapist.
Therapists go through long periods of training. Why should a clinician assume, then, that an individual they train in self-hypnosis will also be a good therapist? Clearly, guidance is required in the use of suggestions, imagery, metaphors, etc., depending on the problem or the use to which the self-hypnosis is to be put. Take the following example. Suppose self-hypnosis is to be used for improving concentration and examination performance. A knowledge of learning skills is called for - unless one believes simple direct suggestions like: "I am going to perform magnificently" will work! Where self-hypnosis is for a specific purpose, like pain, then the guidance can be specific, short and reasonably comprehensive. But it should not be forgotten that what the clinician is now instructing the client in is not self-hypnosis but self-therapy. These are quite different things.
In carrying out their investigation the authors raise doubt about the technique used in their pilot study: "Also, we wondered whether a single autohypnosis session was sufficient to enable a subject to experience and explore the really significant phenomena of self-hypnosis." (p.31). I find this astonishing! Would anyone say from one session of golf or one session of tennis that an individual fully appreciated either? No. So why should they expect it of self-hypnosis. If self-hypnosis was innate and fixed, then this makes sense. If it is a skill that must be learnt, then it makes little sense. Hypnosis is a skill that not only can be learned but can be constantly improved. This was indeed found to be the case on a further study of six volunteers.
The authors report that subjects switch back and forth between Ego Activity and Ego Receptivity, i.e., actively deciding to focus on something as against letting things float into their awareness. This terminology, however, I find very value-laden. Furthermore, the study showed that Ego Receptivity was greater in self-hypnosis than in hetero-hypnosis. The problem here is disentangling what is going on. Ego Receptivity is highly correlated with vivid imagery, and vivid imagery was reported by the subjects to be much more prevalent in self-hypnosis than in hetero-hypnosis. They go as far as saying that "Ego Receptivity and Imagery are the most important aspects of self-hypnosis." (p.25). One interpretation of this, however, is the limitation of the study. The subjects had no great purpose or focus for engaging in self-hypnosis. Quite naturally, then, subjects would concentrate on internal states, which utilized imagery and fantasy. In hetero-hypnosis part of their focus, part of their attention, would be directed at what the hypnotist was suggesting. Even so, it does indicate an important observation that in self-hypnosis imagery is crucial for achieving focused concentration, which is essential for the trance state.
Trance is a skill
Going into trance, deepening the trance, maintaining the trance and utilizing the trance state are all skills. In hetero-hypnosis the hypnotist acts like a coach. They give instruction, encouragement and facilitate the trance process. In self-hypnosis the individual also takes on board the tasks performed by the coach. I can learn tennis by reading instructions and playing with others who know the game. I can join a club and be instructed by a coach on how best to play the game. The second route is more likely to lead me to play better. In either case, I am still the one who learns to play, and the standard I reach depends on a mixture of innate ability, practice and taking advantage of what the coach instructs me to do. Over time my skill improves, usually with many ups-and-downs. Now I could go to a club and play once a day for four weeks. My skill would improve, but I very much doubt that I would be a proficient player of tennis in such a time-period. Why, then, should researches expect so much from individuals engaging in self-hypnosis for an equally short period of time?
My comments should not be construed as saying we learn nothing from the present study, far from it. What it does imply is that we need to go beyond it. The study is an important one because it is the first of its kind. What, then do we learn from it? First, and as to be expected from any learned skill, it became easier over time. Certain aspects of the induction and deepening became automatic (almost like changing a gear). Once they had become automatic, the subjects could concentrate on the utilization of the trance state itself. Furthermore, as time went on subjects found it easier to concentrate. As in meditation, this is a learned experience. Consciousness varies, and even more when in a relaxed state. In self-hypnosis the individual has to learn to keep focused. As the trance deepens this becomes more difficult. What needs to be emphasized, however, is that if concentration wavers, then don't worry. Bring the thoughts back to what was being focused on before this happened.
As a corollary to this, the authors make an interesting observation on p.36. When engaging in self-hypnosis you can always give yourself enough time to carry out some suggestion. In hetero-hypnosis the client has often created an image while the therapist is trying to describe it. Furthermore, the image can often be at variance to what the therapist is describing, especially if it is quite explicit. In self-hypnosis this simply does not happen. The individual knows exactly what is wanted and creates it and knows when he or she has created it. For this reason I have found it necessary in hetero-hypnosis to utilize ideomotor responses - "Nod your head when you have done such-and-such". On one occasion when utilizing a computer re-programming metaphor (basically achieving reframing), the subject took 10 minutes! He was, however, very actively engaged in debugging his program throughout it all, as he informed me later.
Another feature discovered in the study was the loss of motivation to continue with self-hypnosis. But this is a common feature in all learning experiences. Sustaining motivation requires a high input of energy and a desire to achieve some goal. The only real goals of the volunteers were a curiosity and a desire for self-exploration. The lesson to be learned from this is that the individual must have a good reason for pursuing self-hypnosis. Pain is one of the greatest motivators. What individuals seem to want were new skills and knew areas to explore. Without these, boredom sets in. There needs to be a reason to utilize self-hypnosis, even if it is only for relaxation or the control of tension. The difficulty is that we often do not know the value of a new skill, nor do we know the many uses to which it can be put - neither of which can be achieved in four weeks. Only be acquiring this additional knowledge can a person engaging in self-hypnosis gain fully from it.
Over the many years of engaging in self-hypnosis I have found that my skills have changed and developed as I have become more knowledgeable about the subject. In the early period I tried, like the subjects in this study, simple exercises and simple explorations. Like them, I used it for problem solving and for self-exploration. Like them I became bored. What I discovered very early on was my limited acquaintance with imagery and image formation. Correcting this led to my book on Creative Visualization (Shone, 1984). In the study it was reported that individuals had greater and more vivid imagery. But as a hypnotherapist I have found individuals need some guidance on image formation and the utilization of imagery. As an example see my earlier paper on Hypnosis and ME, (Shone, 1997). I will have more to say on imagery later.
The journal reports of the subjects indicate that they explored the trance phenomena by giving themselves tasks to do and establishing which were easy and which not. But the trance state is a dynamic process. On some occasions a task may be easy while on other occasions the same task may be difficult or simply not done. The longitudinal studies do not indicate sufficiently that even entering trance can vary across states; and that the quality of the trance state can vary. The authors do speculate that the depth of trance fluctuated much more during self-hypnosis than hetero-hypnosis and that this could be because of changes in arousal levels throughout the day. My experience is just so.
Ultradian rhythms and self-hypnosis
In this study subjects were not instructed to enter self-hypnosis at the same time of the day or to take note of the time. Consequently, nothing could be gleaned from these studies concerning changes in arousal levels and its impact on the trance state. Over many years I have frequently entered self-hypnosis in the morning and again after returning from work. The morning session immediately on awakening was not found to be effective. However, after breakfast and before going to work it was very effective. In fact, this would be around the first ultradium rhythm of the day (see Rossi, 1991; Rossi, Lippincott & Bessette, 1994 and 1995). The one on returning home after work often overlapped another. But interestingly, the two differed in quality and purpose. In terms of the authors' distinctions, the morning session was Ego Active while the afternoon session was Ego Receptive. Very rarely was it the other way round.
It is now becoming documented that hemispherical dominance switches throughout the day. One manifestation of this is the dominant nostril in breathing! The 90-to 120-minute of the rest-active cycle, the ultradian rhythm, leads to much more vivid imagery during the rest phase of the cycle when self-hypnosis or hetero-hypnosis is engaged in. It is also possible that during the rest phase individuals are likely to loose consciousness more readily during hetero-hypnosis. If, as Rossi maintains, it is possible to tune oneself into the rest phase of the ultradium rhythm, then entering self-hypnosis during these periods, even for short periods of time, could be more beneficial than at other times, in which longer periods of self-hypnosis are undertaken. Or it may be that during the rest phase of the cycle Ego Receptivity is more prevalent and during the active phase more Ego Activity is prevalent. Far more research needs to be undertaken on hemispherical dominance and the ultradian rhythm and its relationship to the trance state
Imagery and self-hypnosis
A constantly reported feature of the subjects' experiences was the greater use of imagery in self-hypnosis - the imagery being idiosyncratic, very rich and very vivid. Quantitatively, about three-quarters of the subjects reported a greater and more vivid imagery in self-hypnosis than in hetero-hypnosis. It also appeared that geometric shapes were more frequent in self-hypnosis. The report also indicated that levels of imagery production remained virtually the same over the four-week period. With regard to this last point, four weeks is simply not long enough to learn the skill of utilizing imagery.
Images can be realistic or they can be unrealistic, they can metaphorical or symbolic, they can be empowering or not. Creative imagery is a skill. There is a basic and natural level of imagery that everyone can utilize. But to go beyond this requires some understanding of imagery formation and imagery utilization. Hypnotherapists are well acquainted with basic imagery. I can say to a client relax or I can ask them to imagine that they are on a beach, lying in the warm sun just having had a swim. "¦ But as the subjects indicated, they can become bored. Images need to be varied, even when wanting to illicit the same response. This is as true in self-hypnosis as it is in hetero-hypnosis.
Good imagery utilizes the subject's own experiences. In hetero-hypnosis these experiences must be obtained either by direct questioning or by simply listening to the client. In self-hypnosis the individual knows what interests them, knows the type of fantasies that they like and can relate to. But even here, exploring new images can still be achieved and perfected. However, unless imagery is to be developed simply for its own sake, it needs to be directed at some purpose. There needs to be a goal or reason for the imagery in the first place. Consider the simple example of someone worried about examinations. The hypnotherapist can do a whole variety of procedures to help: direct suggestion, going through the examination in the mind's eye, being given post-hypnotic suggestions about what they should do when they first go into the examination room and sit down, etc. But suppose you know that they are a great fan of Star Trek. In the case of self-hypnosis you would know this without having to illicit it.
The point is, that with this knowledge it is possible to construct a very elaborate image that has the individual on the spaceship Enterprise, heading for a planet on which examinations are undertaken. On board, however, they go through all sorts of procedures to enhance their abilities and allow them to achieve their full potential. Such imagery can be as simple or elaborate as the individual needs. The point is that in self-hypnosis, the images can be as elaborate as the individual wants, and can be pursued for as long as the individual wants. But having said this, images of this type need to be practiced. The self-hypnotist has to become proficient at creating images easily and quickly. I do not believe that imagery is a constant innate characteristic. Once this is accepted, then the logic is that imagery can be improved and utilized far more efficiently. One simple way forward is to learn a stock of images, try them and adapt them for your own purpose (see Denning & Phillips, 1993; Epstein, 1989; Fanning, 1988; Page, J.L., 1990, Page, M, 1990; Shone, 1984; Stanton, 1985; Wells, 1990). Like fairy stories, there are good fairy stories and there are ones not so good. Equally, there are good images and there are images that are not so good. But an image that is good for one person may not be for another. The Star Trek image is good for someone who likes Star Trek and is comfortable with science fiction, but for others a different image is called for.
In hetero-hypnosis it is the therapist who has to become proficient in the use of imagery. In the case of self-hypnosis, it is the individual himself or herself. Once again, then, we return to the point that individuals require guidance in the use of imagery if they are to take full advantage of it.
When teaching self-hypnosis to a client it is important to realize that a number of skills are required:
i) entering, deepening and maintaining the trance state
ii) utilizing the trance state
iv) utilizing imagery
The first is often all that a client is given guidance in. But this is the easiest and (probably) the least important of the list - so long as the individual can enter self-hypnosis. Once the skill of entering and deepening self-hypnosis is achieved, which is not at all difficult for most people, then the real difficulty is utilizing the trance state; knowing exactly how to engage in self-therapy and how to utilize imagery to its full advantage.
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