6480003 - the phenomenology of deep hypnosis - quiescent and physically active

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    Journal of Clinical and Experimental Hypnosis, 53(1): 3759, 2005Copyright Taylor & Francis Inc.ISSN: 0020-7144 printDOI: 10.1080/00207140490914234

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    Journalof Clinical andExperimental Hypnosis531Taylor& FrancisTaylor and Francis 325 Chestnut StreetPhiladelphiaPA191060020-71440000-0000NHYPTaylor& Francis Inc.4917210.1080/002071404909142342005136ETZEL CARDEAPHENOMENOLOGY OF DEEP HYPNOSIS

    THE PHENOMENOLOGY OF DEEPHYPNOSIS: Quiescent andPhysically Active

    ETZEL CARDEA1,2

    University of Texas-Pan American, Edinburg

    Abstract: To study the phenomenology of hypnotic virtuosos, theauthor employed a 2 (hypnosis vs. control) 3 (quiescent, pedaling a

    stationary bike, having a motor pedal the bike) within-subjects designwith quantitative and qualitative measures. In a neutral hypnosiscontext with the only suggestion being to go as deeply into hypnosisas possible, participants reported alterations in body image, timesense, perception and meaning, sense of being in an altered state ofawareness, affect, attention, and imagery. They also mentioned lessself-awareness, rationality, voluntary control, and memory. Analysesof the 3 physical conditions showed that hypnotic experiences wereoverall similar, although quiescence was more conducive to alter-ations of body image and reports of depth. These results suggest thathypnotic virtuosos have alterations of consciousness that can be betterconceptualized as distinct states rather than being on a continuum.

    Ever since the time of Mesmer, there have been numerous reports ofunusual subjective experiences associated with animal magnetism andhypnosis (Ellenberger, 1970). More recently, it has been found thathypnotizability is related to anomalous phenomena including mysti-cal, out-of-body, and psi-related experiences, but most of these studieshave been correlational in nature (Cardea, Lynn, & Krippner, 2000).Hypnotizability is positively correlated with reports of alterations in

    consciousness (Pekala, 1991; West, 2003), and there is evidence thatthere may be different modes of experiencing hypnosis, one involvingmore imagery and fantasy, another, amnestic and other dissociativeprocesses (Barber, 1999; Barrett, 1992).

    Manuscript submitted January 25, 2003; final revision received July 27, 2004.1This study was supported in part by the American Psychological Associations MFP

    and Doctoral Dissertation fellowships. An earlier version of this paper received theCrasilneck award from SCEH after being presented at the 39th Annual Meeting of theSociety for Clinical and Experimental Hypnosis, Asheville, North Carolina. Thanks to

    Charles Tart, Ph.D., for his supervision; to Jaime Curts, Ph.D., for statistical consultation;and to Grant Benham, Ph.D., Dana Barth, and Lupita Weiner for editorial assistance.2Address correspondence to Etzel Cardea, Ph.D., Dept. of Psychology and Anthro-

    pology, University of Texas-Pan American, 1201 West University Drive, Edinburg, TX,78539 USA. E-mail: [email protected]

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    Various authors have proposed multifactorial experiential modelsof hypnosis involving increased suggestibility, lack of reflective aware-ness/dissociation, and alterations in consciousness/absorption (s &

    Ostvold, 1968; Cardea & Spiegel, 1991; Evans, 1963; Field, 1965), butscant research has focused on hypnotic phenomenology, especiallyamong ultraresponsive individuals (Weitzenhoffer, 2000, p. 227).Shor (1979) wrote that such inquiry should include multivariate mea-surement of subjective depth and other consciousness variables, buta problem has been to distinguish between the artifact of hypnosis(e.g., induction and suggestions, role playing) and the associated alter-ations in consciousness (Orne, 1959). A potential solution involves therarely used approach of neutral hypnosis (no explicit suggestionsafter an induction; Kihlstrom & Edmonston, 1971), similar in spirit toSheehan & McConkeys attempt to provide few cues on the nature ofthe hypnotic phenomena investigated (1982, p. 85). Another solutionto the artifact is to obtain reports on spontaneous, unsuggestedphenomena.

    Reported spontaneous alterations have included changes in bodyimage and sensations (e.g., Erickson, 1965; Gill & Brenman, 1959,Hilgard, 1968; Ludwig, 1965; Pekala, 1991), time sense, perception, andmeaning (Ludwig; Pekala), withdrawal from external concerns anddisinclination to speak or move spontaneously (e.g., Erickson; Gill &

    Brenman; Hilgard), decreased affect (Ludwig; Pekala), and increasedimagery (Pekala). When compared with hetero-hypnosis, self-hypnosisis characterized by greater imagery, free-floating attention, and recep-tivity to internal stimuli (Fromm et al., 1981).

    Of particular relevance to this study was the literature on unsug-gested phenomena related to experiences of deep hypnosis amonghighly hypnotizable subjects. Using the concept of depth to characterizeconsciousness is a metaphor that implies significant differences inexperience (Shor, 1979). The validity of this characterization is sup-ported by studies showing a positive correlation between greaterdepth and changes in objective and subjective indices (Kahn, Fromm,Lombard, & Sossi, 1989; Laurence & Nadon, 1986; Tart, 1970b). Erickson(1952) defined a plenary (very deep) state as the loss of contact with the

    body, retarded psychological and physiological functioning, and lackof spontaneity. He (1965) also reported on a gifted participant andconsciousness researcher, Aldous Huxley, who described hypnosis asan initial withdrawal from outer reality concerns, followed by changesin body sensation ending in synesthesia, a sense of loss of personalidentity, and lack of mental content.

    Along similar lines, Tart (1970a) studied the phenomenology of ahypnotic virtuoso who reported that the deepest state was character-ized by: 1) non awareness of the body and breathing, 2) absolute black-ness, 3) waning of sense of identity and ego-awareness, 4) increased

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    PHENOMENOLOGY OF DEEP HYPNOSIS 39

    sense of potential, 5) alterations in time sense, 6) loss of spontaneousmental activity, and 7) a feeling of oneness with the universe. With agroup of hypnotic virtuosos, Sherman (1971) corroborated Tarts

    description of deep hypnosis, adding that medium hypnosis involvedemotional experiences, simple images, and body sensation, whereas alighter state was characterized by ideas, worries, and normal verbalthinking. These results were replicated and extended by Feldman(1976). His participants reported difficulty talking, changes in bodyimage and bodily sensations at the beginning of hypnosis, and phe-nomena such as feeling one with the surroundings, being immersed in

    blackness, and a sense of awe and wonder in deep hypnosis. He alsofound that expectations did not predict deep hypnotic phenomena andmood did not seem to change significantly during hypnosis. Hilgard(1986) did informal research in the area and concluded that deep hyp-nosis is related to loss of contact with the body, altered sense of time,pleasant mood, and mystical type phenomena such as a sense of unity.The findings of these studies have been very consistent but have hadvarious methodological limitations that include: no control for relax-ation effects (all studies reviewed), no quantitative analysis publishedand reliance on case studies (Erickson; Tart), no comparison conditions(Sherman; Tart; Feldman used a baseline condition as control), andlack of a previously validated instrument to evaluate alterations in

    consciousness (although Feldman administered the rarely used Linton-Langs questionnaire).An underresearched area concerns the effect of physical activity on

    hypnotic phenomenology, probably because in recent decades hypnoticprocedures have followed almost exclusively suggestions for relax-ation, with the person either lying down or sitting motionless. This isa different technique than that used by Mesmer, who typicallyemployed an emotionally and socially charged situation with music,physical movement, and frequent manifestation of seizure and fainting-like behaviors, akin to the exorcisms that his secular model sought toreplace (Laurence & Perry, 1988). Not surprisingly, physically activeritual contexts such as revivalist meetings, tribal, Shaker and vodouceremonies have been described as hypnotic in nature (e.g., McClennon,2001; Ravenscroft, 1965). In addition, there are findings of self-conceptchanges during hypnosis (Markwell, 1965) and that, in men, more pen-etrable body image boundaries correlate with hypnotizability (Fisher,1970).

    Nonetheless, little effort has been spent studying unsuggested alter-ations in body image and sensations manifested in hypnosis, physical

    exertion, and ritual contexts (Gill & Brenman, 1959; W. P. Morgan,1993; Cardea, 1996, respectively). An early exception is the study byLudwig and Lyle (1964), who compared a relaxation procedure withone using various physical (e.g., spinning, knee-bends) and verbal

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    (e.g., be on edge) suggestions designed to increase tension, alertness,and hostility and to diminish comfort. This hyperalert trance induc-tion procedure, in contrast with the relaxation one, resulted in partici-

    pants being more suggestible and evidencing more spontaneity,tension, agitation, and affect, which the researchers interpreted as anartifact of the suggestions.

    Other authors have developed specific inductions with suggestionsfor mental alertness but without physical activity (Liebert, Rubin, &Hilgard, 1965; Vingoe, 1968). Relaxation and active-alert suggestionshave produced similar results to traditional inductions with regard tohypnotic responsiveness (Vingoe) and pain analgesia (Miller, Barabasz,& Barabasz, 1991). An exception is the data by Gibbons (1976) ofgreater hypnotizability after a hyperempiric (great richness of expe-rience) induction.

    A method that includes both physical activity (i.e., pedaling of anergometer gauged for high effort) and comfortable verbalizations ofactivity and alertness was devised by Bnyai and Hilgard (1976). Theyfound that suggestibility did not differ between this procedure and arelaxation one, as did Mallot (1984), nor was there a difference using atouch technique to evaluate hemispheric inhibition (Cikurel & Gruzelier,1990). A technique that simplifies the physical requirements of pedal-ing and may be preferred over it (Alarcn, Capafons, Bayot, &

    Cardea, 1999) produced similar responses as a relaxation procedure(Cardea, Alarcn, Capafons, & Bayot, 1998). In the applied arena, alertor active-alert techniques have been used for various psychologicalproblems (Bnyai, Zseni, & Try, 1993).

    The phenomenology of physically passive and active hypnosis hasreceived almost no attention, despite its historical, theoretical, and cross-cultural importance. Bnyai and Hilgard (1976) reported that almost allparticipants mentioned experiencing an altered state in the active-alertprocedure, with a greater sense of alertness, in some cases close toecstasy, during and following the procedure. In a more systematicinquiry, Fellows and Richardson (1993) used physical passivity/activitycombined with suggestions for relaxation or alertness, in a counterbal-anced order. Using the Hypnotic Experiences Questionnaire, they foundthat all conditions produced moderate hypnotic experience, higherscores for the passive-relaxation condition (mostly because of greaterrelaxation), and reduced self-awareness in the passive-alertness versusthe passive-relaxation and the active-alertness conditions. However,their study has limitations, including the confound of using inductionsthat specifically suggested relaxation or alertness, thus, it is not surpris-

    ing to find that the relaxation induction produced greater relaxation.Other limitations are the use of a nonselected, small sample (in which itwould be expected that at least some people would be unaffected by theprocedure) and a questionnaire with relatively few dimensions.

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    PHENOMENOLOGY OF DEEP HYPNOSIS 41

    This study extends previous findings by using a procedure in whichhypnotic virtuosos were given only the suggestion of going deeplyinto hypnosis in three different conditions of physical activity, while

    being thoroughly evaluated before, during, and after the sessions. Thethree main hypotheses are:

    1. Reports of different levels of neutral hypnosis experience will be asso-ciated with qualitative changes in the state of consciousness.

    2. Qualitative changes in consciousness will be present in all three differentconditions of physical activity.

    3. Lack of movement or repetitive activity that is not self-generated will bemore conducive to alterations of consciousness than self-generatedmovement.

    The rationale for the first hypothesis is the consistent set of findingsof the historical and experimental literature on this area. The secondhypothesis is supported by reports of alterations of consciousnessrelated to ritually induced physical activity. Finally, the third hypothesisis based on the notion that a lack of or repetitive movement is less likelyto maintain the sense of body image and ecological self (Neisser,1988), and thus more likely to destabilize the ordinary state of con-sciousness (Tart, 1975). This study extends the literature on hypnoticphenomenology by controlling for the effects of relaxation on subjective

    experience through the use of physical activity, evaluating the effectsof different types of physical activity on subjective experience, andintegrating valid quantitative techniques with qualitative methodssuch as experience sampling and interviews.

    METHOD

    Sample

    From an initial sample of 147 students (99 females, mean age =20.51, SD = 5.15), 23 individuals who scored at least nine on the Har-vard Group Scale of Hypnotic Susceptibility and 19 on Fields Inven-tory were evaluated with individual hypnotic tests, and generalpersonality (Myers-Briggs Type Indicator) and psychological status(MMPI) inventories. Only individuals (n = 12) who continued to per-form very well in individualized hypnotic tests and seemed to havesound physical and psychological health were invited to continue inthe study. The mean age of these participants was 20.42 (SD = 2.54),two thirds of them women. The hypnotizability of the participants

    exceeded criteria for hypnotic virtuosity (see Register & Kihlstrom,1986) as evidenced by the Harvard Group Scale (M = 10.58, SD = 0.90),the Fields Inventory Scale (M = 26.75, SD = 5.01), the Stanford Scale C (M =10.58, SD = 0.99), and the Stanford Profile Scales I (M = 19.5, SD = 3.28)

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    and II (M = 20.91, SD = 3.72). They also had very high scores in theAbsorption Scale (M = 25.5, SD = 7.39), but their scores on the Percep-tual Alterations Scale were overall low (M = 8.08, SD = 5.43). Two

    respondents had previous experience with hypnosis (for relaxation,study habits, and sports), and none reported being in a meditationgroup or ingesting psychoactive drugs or psychedelics shortly beforeor during the time of the experiment, although two or three peoplementioned having ingested psychedelics sometime in the past. Partici-pants did not know each other and were asked not to try to contacteach other until after the experiment ended.

    Instruments

    All of the instruments used except for the ad hoc checklist have beenemployed previously and have adequate validity and reliability.

    Instruments related to hypnosis. (1) The Fields Inventory Scale ofHypnotic Depth (Field, 1965) lists 38 experiences associated with threetypes of hypnotic phenomena: absorption and internal and externalunawareness, feelings of automaticity and compulsion, and disconti-nuity from normal experience. (2) The Harvard Group Scale of HypnoticSusceptibility, Form A (HGSHS:A; Shor & Orne, 1962) is widely usedas a screening measure of hypnotic ability, with a score range of 0 to

    12. (3) The Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C;Weitzenhoffer & Hilgard, 1962), with a maximum score of 12, is typi-cally considered the gold standard of hypnotic susceptibility mea-surement. (4) The Revised Stanford Profile Scales of HypnoticSusceptibility, Forms I and II (Weitzenhoffer & Hilgard, 1967) providegreater flexibility in scoring than the HGSHS:A or the SHSS:C (i.e., it isscored from 0 to 3, rather than dichotomously) and include difficultitems such as analgesia to a mild electric shock that only true hypnoticvirtuosos are likely to pass. Score range is 0 to 27. (5) The self-reportscale of hypnotic depth used in this study was modeled after the North

    Carolina Scale (Tart, 1970b), in which the participant is told that anumber will appear automatically in his or her mind whenever theexperimenter says state. As compared to the original North Carolinascale, no phenomena were provided as examples of what might consti-tute hypnosis. The scale used here was: 0 = wide awake, 110 = feelingslightly different than normal, 1120 = light hypnosis, 2130 = mediumhypnosis, 3140= deep hypnosis, 41 and up = very deep hypnosis.

    Other instruments. (1) Absorption was measured through the widelyused scale of the Differential Personality Questionnaire (Tellegen &

    Atkinson, 1974), with a maximum score of 34. (2) Experience samplingmethodology (Csikszentmihalyi & Larson, 1987; Easterlin & Cardea,19981999) with the open-ended question, what are you experiencing?was employed throughout the sessions, at approximately 5-minute

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    PHENOMENOLOGY OF DEEP HYPNOSIS 43

    intervals. (3) The Phenomenology of Consciousness Inventory (PCI;Pekala, 1991) is a set of two parallel 71-item questionnaires scored on a07 Likert-type scale that evaluates retrospective account of subjective

    experience. It has been used for many types of alterations of conscious-ness (Pekala & Cardea, 2000). (4) An ad hoc checklist of 189 phenomenatapping various subjective/ behavioral phenomena (body sensations,

    body image, feelings, sense of time, identity, memory, perceptualexperiences, thought, concentration, altered state of consciousness,control, behavior, interpersonal phenomena, and transpersonal experi-ences), including an option for no change from ordinary experience.The list inquired whether participants had experienced any of thephenomena and at what level of hypnotic depth. (5) The MinnesotaMultiphasic Personality Inventory (MMPI) was used to screen outemotionally distressed individuals (Buros, 1972). Besides the generalscales, the ego-strength subscale (Barron, 1953) was scored to measurepersonal flexibility and resourcefulness. (6) The Perceptual AlterationScale (Sanders, 1986) was administered to evaluate dissociative type ofexperiences. (7) Last, the Myers-Briggs Type Indicator (Briggs Myers &McCaulley, 1985), a personality inventory, was used to provide a dis-crete classification across four dimensions of personality and cognitivestyles (introversion-extraversion, sensation-intuition, thinking-feeling,and judgment-perception).

    Procedure

    The design was repeated-measures factorial, with 2 (hypnosisversus no hypnosis) 3 factors (types of physical stimulation: motion-less on a bed, pedaling a stationary bicycle at a comfortable rate, andhaving a motor do the pedaling at a comfortable rate). After the initialselection of participants, three hypnosis-training sessions were con-ducted to familiarize participants with the laboratory and three physicalconditions. During these sessions, participants were asked whatinductions and experiences they preferred from their previous hyp-nosis testing and were asked to find out what they needed to do to gointo hypnosis, deepen the experience, and come out of hypnosis,independently of the hypnotist. They were also introduced to andpracticed the self-report scale of hypnotic depth. To measure expect-ancies, they were asked what they expected to happen during deephypnosis. Participants were told that they should consider them-selves coresearchers and feel free to mention any suggestions orcriticisms. They were also told that the researcher was more interestedin finding out what they experienced than in proving any particular

    point, and that they should let me know if they felt pressure from meto bias their reports in any way. This approach sought to treat participantsin a participatory, humanistic way (Tart, 1977), while maintaininginternal validity.

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    The experiment took place in a silent and very low-light room. Inthe hypnosis sessions, participants were exposed to the physical condi-tions in counterbalanced order, while a 130 induction count was used.

    The only suggestion used was that as the count progressed participantswould go into an increasingly deeper state of hypnosis and continue inthat state until they decided to come out of hypnosis. At the end ofthe induction and at 5-minute intervals throughout the session theexperimenter repeated the word state, to elicit a numerical depthreport, and asked what are you experiencing? Participants were freeto report their experience at any point if they so desired. Betweenreports, participants remained quiescent or pedaled in silence, and theexperimenter just sat silently. The length of the hypnosis sessions wasnot predetermined, but experiencers often started coming out of hyp-nosis (i.e., giving numerical reports of decreasing depth) after anaverage of 51.6 minutes (SD = 13.2).

    After the hypnosis session, control sessions were conducted withthe physical condition order counterbalanced. These sessions alsoincluded a 130 count but without a suggestion to go into deep hypno-sis. They lasted about 17 minutes, with three reports for each session;this length was predetermined because pilot testing established thatparticipants became bored or fell asleep after about 15 minutes.Respondents were asked not to do what they had done to attain a deep

    hypnotic state, while remaining open to whatever happened. Thecontrol sessions were designed to evaluate the initial experience ofparticipants exposed to the physical conditions but without the inten-tion to go into hypnosis.

    After every session, participants were interviewed about their expe-rience and filled out the PCI for their deepest state and the checklistfor all levels; all sessions were recorded and transcribed. Respondentswere asked at the end of the project and 8 months later if they attributedany positive or negative changes to their participation and if theycontinued to use (self-) hypnotic techniques. The study was approved

    by the IRB of the University of California, Davis, and participantssigned informed consent forms.

    ANALYSES

    Differences in frequencies were analyzed by nonparametric tests,binomial for two categories, chi squares for the number of correlationsand the checklist variables. For the latter, the data were arrangedaccording to three categories: no hypnosis/feeling slightly different

    than normal, light/medium hypnosis, and deep/very deep hypnosis.The observed frequencies were compared with the expected (1/3rd,1/3rd, and 1/3rd) frequency. Correlations for hypnotizability measuresand the PCI were assessed through Pearsons product-moment statistic.

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    Scores on the PCI, depth reports, and session lengths were analyzedthrough ANOVAs for repeated measures. Scheff tests for differences

    between two conditions were conducted if the original ANOVA was

    significant. Effect sizes were evaluated through Cohens d. Multivariateanalyses for the PCI could not be carried out because of the small n, sothe Wilcoxon signed-rank test was used for the pattern of results. Forall analyses, significance level was established a priori atp < .05.

    RESULTS

    Personality and Hypnotizability Measures

    As mentioned previously, scores on hypnotizability and relatedtests showed that this was a group of extreme hypnotic virtuosos. Thecorrelation matrix among the various hypnotizability and related mea-sures shows that the only significant correlations were between FieldsInventory Scale and the Stanford Profile Scales, and between the twoProfile Scales.

    The Myers-Briggs Inventory showed that 10 out of 12 individualshad an intuition (N) rather than a sensing (S) type, which would

    be significant in a population with 50% distribution of the intuitiontype, as Briggs Myers and McCaulley (1985) found for a sample of medi-cal students. The comparison between this sample and that of medical

    students is, however, speculative. This result could be explained by theproposed high preponderance in a hypnosis volunteer sample (Hilgard,1968) of N types, or by a relationship between intuitive cognitivestyle and hypnotizability (Crawford, 1981). The two individuals whowere not N types had the lowest scores on the Ego Strength scale, thehighest scores in the PAS, and reported more distressing imagery

    Table 1Correlation Matrix for Hypnotizability and Related Measures

    hg fi shc sp1 sp2 ab pas

    hg 1fi .32 1shc -.21 .01 1sp1 -.23 .6* .32 1sp2 .12 .63* .21 .77* 1ab .1 -.2 -.06 -.38 -.2 1pas -.23 .19 .26 .02 .03 .38 1

    Note. hg = Harvard group scale; fi= Fields inventory; shc= Stanford C; sp1 = Stanfordprofile 1; sp2 = Stanford Profile 2; ab = Absorption scale; pas = Perceptual alterationscale.

    *p < .05.

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    (e.g., being buried alive, being chased by a man carrying a knife) thananybody else.

    Hypnotic PhenomenaDepth reports. Control sessions lasted only about 17 minutes and

    produced three reports per session, so they were compared with thefirst three reports during hypnosis. Depth ratings for the control condi-tions were considerably lower than those for the reports during hyp-nosis, means and SD of 8.32 (11.39) and 38.31 (12.78), respectively,F(11,1) = 166.19, p < .0001. The former typically referred to relaxationor thinking about everyday matters (e.g., playing the guitar, coming tothe experiment), whereas reports for hypnosis typically involved more

    intense physical sensations and imagery (e.g., floating, falling down atunnel, prisms).

    PCI. The number of differences in PCI scores between the hypnosisand control conditions cannot be attributed to chance (Z = 2.93, p .8). As compared with the control condi-tion, deep hypnosis was associated with alterations in body image,time sense, perception and meaning, and the sense of being in an

    altered state of awareness. Affect was more intense; there was greaterattentional focus and amount as well as vividness of imagery, but therewas less self-awareness, rationality, voluntary control, and memory.Other variables that do not seem relevant to hypnosis per se such assexual excitement and arousal showed no differences. Hypnosishad considerably fewer significant correlations among the PCI scalesand subcales than the control one (40 vs. 89, 2 = 18.61,p < .0001).

    The PCI results give a general sense of the differences but no infor-mation about the actual content of the experiences; the checklist andintra- and postsession interviews provide that information. Significantitems from the checklist are presented below, arranged by the level ofhypnosis in which they were most prevalent. Only phenomena thatwere reported in more than one third of the sessions (i.e., at least12 times out of 33 valid reports) were included in the analyses; that left120 variables, of which 68 were significant, most of them related todeep hypnosis experiences. The checklist analyses are supplemented

    by quotations obtained from experience sampling and postsessioninterviews.

    The stage ofno hypnosis and feeling slightly different than normalwas

    characterized as involving relaxation and no changes in ordinarysensations, body image, feelings, time sense, identity, memory, percep-tion, thought, concentration, state of consciousness, control, behavior,interpersonal phenomena, or transpersonal experiences.

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    Light/medium hypnosis was characterized by a focus on body sensa-tions such as feeling light and spinning. Experience sampling atthe beginning of the session often included this type of phenomena,along with changes in body image (e.g., Participant 2: my hands have

    been growing). Respondents also mentioned loss of touch with theenvironment, both at this stage and during deep hypnosis.

    By and large, most of the significant differences were found duringdeep and very deep hypnosis. Many phenomena describing a sense of the

    body floating and being disembodied were endorsed on the checklistand often mentioned at the beginning of deep hypnosis reports (float-

    ing, flying, mind leaving the body, etc.). Participants reportedno sense of time, or time becoming still or slowing down.Emotions at this level of hypnosis were positive overall (e.g., love,

    wonder, and freedom). There was, however, one dysphoric emotion,

    Table 2Mean scores and SDs in the Phenomenology of Consciousness Inventory

    Dimension HYPNOSIS CONTROL F d

    ALTERED EXPERIENCE 3.70 (.86) 0.61 (.99) 56.0*** 3.49Body image 3.89 (1.10) 0.95 (1.36) 29.9 *** 2.49Time sense 4.13 (1.45) 0.59 (1.25) 57.5 *** 2.74Perception 4.06 (1.52) 0.51 (.89) 70.0 *** 2.99Meaning 3.07 (1.52) 0.46 (.97) 25.5 *** 2.15

    POSITIVE AFFECT 2.27 (1.06) 1.18 (1.44) 9.8 * 0.9Joy 3.39 (1.56) 1.47 (1.83) 10.8** 1.18Sexual Excitement 0.8 (1.03) 0.91 (1.92) 0.0 -0.07Love 2.62 (1.63) 1.17 (1.52) 14.0 ** 0.96

    NEGATIVE AFFECT 1.1 (1.02) 0.29 (.53) 20.6 ** 1.05Anger 0.79 (1.32) 0.29 (.70) 4.1 0.5Sadness 1.29 (1.30) 0.27 (.59) 10.5 ** 1.06Fear 1.29 (1.43) 0.31 (.67) 24.7 ** 0.92

    ATTENTION 4.68 (.81) 3.83 (1.28) 3.5 0.83Direction 4.76 (.79) 3.47 (1.60) 7.0 * 1.07Absorption 4.57 (1.36) 4.36 (1.42) 0.1 0.16

    VISUAL IMAGERY 4.87 (1.06) 2.26 (1.64) 29.98 *** 1.98Amount 5.33 (.83) 2.03 (1.53) 80.89 *** 2.81Vividness 4.5 (1.50) 2.47 (1.93) 15.95 ** 1.23

    SELF-AWARENESS 2.87 (1.06) 4.83 (1.20) 24.18 *** -1.82A.S. OF AWARENESS 4.97 (.94) 1.05 (1.22) 50.47 *** 3.78AROUSAL 1.53 (1.40) 1.52 (1.41) 0.0 0.01RATIONALITY 3.76 (1.42) 5.04 (1.24) 9.1 ** -1.01VOLUNTARY CONTROL 1.83 (1.08) 3.89 (1.66) 16.8 ** -1.54MEMORY 4.81 (.89) 5.42 (.71) 19.3 *** -0.79INTERNAL DIALOGUE 2.62 (1.77) 3.46 (2.05) 1.3 -0.46

    *** =p < .001; ** =p .01; * =p < .05.

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    fear, most prevalent at this stage. Reports during and after the ses-sion made it clear that when experiencers reported this fear, it wasabout the unusualness of the experiences encountered. With respect to

    cognition, participants endorsed difficulties remembering everydayactivities at the same time as suddenly remembering forgottenevents. They expressed greater control over their mental states whilemaintaining a free-floating attention.

    Participants reported a change of modality from concepts toimages and having no thoughts. Various items referring to imagerywere endorsed at this level, including increased quality, sustainedsequences, spontaneous imagery, greater realness, and imagerynot referable to a sensory modality. The change to imagistic thoughtmay explain the endorsement of dreaming as a descriptor for thisstate. Special mention should be made of the almost universal reportsof both flashes of light, brightness, and great obscurity.

    Various items associated with transpersonal experiences includingbeing one with everything, greater relatedness, loss of identity,

    but being in touch with ones inner self were common at this level.There was a sense of being in a different reality that entailed pro-found personal insight, increased sense of potentiality, andincreased meaningfulness. In sum, deep hypnosis was characterized

    by disconnection with the body and the environment, mostly positive

    emotions, a switch from thoughts to images, and a sense of connected-ness with everything and other transpersonal phenomena.This enumeration of frequent and significant checklist variables

    does not provide the sense of the sequence of events, whereas tran-scripts from the experiential sampling reports do. At the beginningstage, people did not experience any notable change other than feelingmore relaxed. During medium hypnosis, these slight body sensationsgave rise to experiences of floating and flying (and sometime sinking),and an increasing disconnection from the body and the environment.Gradually, these somatic sensations were increasingly incorporatedinto ongoing, imaginal events (e.g., Participant 8: walking down a spiralstaircase). There was a shift from conceptual thinking to spontaneousimagery (e.g., geometric designs like prisms, grids, and tunnels), which

    became more elaborate and vivid (e.g., Participant 10: [pictures] likenothing else in this world: geometric).

    Some imagery seemed to be cross-modal or synesthetic (e.g., Patient 4:lines of different colors that stretch infinitely . . . making music that Ihave never heard before), and the mostly imaginal activity sometimesgave way to great darkness and a sense of void (e.g., Participant 9:

    for a while I was just total nothing). Paradoxically, these occurrencesalternated with those of great light and brightness, along with reportsof merging with pure light or energy and finding ones innermostcore (e.g., Participant 5: I am not matter anymore. . . . Im just energy).

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    Positive emotions such as love and freedom were characteristic of deephypnosis, although there was some fear about the unusual eventsexperienced. The euphoria was accompanied by a sense of potentiality,

    meaningfulness, insight, and connectedness (e.g., Patient 5: the bestplace to be), and time seemed to slow down until it became meaning-less. Respondents felt as thought they were in another plane of reality.Reports also included some specific common features (e.g., frequentmention of bodies of water, tunnels, and viscous substances).

    Physical Activity

    The hypnosis sessions lasted significantly more minutes during thequiescent than the pedaling and motor conditions, means and SDs of58.75 (12.23), 48.17 (12.76), and 47.83 (12.46); F(11, 1) = 5.53 and 5.89,

    p < .05, for those two comparisons. Quiescence was more conducive togreater depth reports than self-pedaling, (means and SDs of 26.55(22.70) and 20.94 (17.00), respectively; F(11, 1) = 7.13,p < .05). The ped-aling and motor conditions did not differ from each other. Figure 1shows that the difference for self-reports was already present at thethird report and that difference remained constant throughout thesessions. There was also a significant interaction effect, F(22, 2) = 3.64,

    Figure 1.

    43210

    30

    40

    50

    60

    First three reportsAll reports

    Da a f m "H s d h r

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    50 ETZEL CARDEA

    p < .05. Whereas physical conditions did not make a difference fordepth reports in the control conditions, F(11, 2) = 0.88,p > .1, they didso for hypnosis, F(11, 2) = 7.14,p < .005.

    The PCI showed differences for three scales: body image, F(20, 2) =3.69,p < .05, sadness, F(20, 2) = 3.53,p < .05, and arousal, F(20, 2) =5.19,p .01). Contrast analyses showed that quiescence was related togreater body image changes than self-pedaling, F(10, 1) = 5.98,p < .05,and greater sadness and arousal were reported for pedaling than forquiescence and the motor conditions (p .05 for all analyses). Therewere also significant interactions for joy, F(20, 2) = 3.91,p < .05; andself-awareness, F(20, 2) = 5.07,p .01. During the control conditions,ratings of joy were higher for quiescence than for the other two con-ditions, but this relationship reversed during hypnosis, showing a rela-tive shift in which both pedaling conditions became more pleasantduring hypnosis in comparison with lying down, which did notchange. For self-awareness, contrast analyses showed that partici-pants were less self-aware during the motor than during the quiescentcondition but only during hypnosis, F(20, 2)=4.34,p < .05.

    Spontaneous within-session comments and postsession interviewsrevealed that participants experienced quiescence to be the most con-ducive condition to go into hypnosis because it was associated withlosing a sense of the physical body, having body image changes, and

    greater imagery. Participants found the motor condition to be difficultat the beginning but later it facilitated the maintenance of a deep hyp-notic state. Self-pedaling was typically mentioned as the most difficultcondition to go under hypnosis because of greater effort and awarenessof the physical body.

    Related Information

    Respondents were able to maintain contact with the experimenterthroughout the session and could reincorporate themselves to theirusual activities after the sessions. Concerning the expectations about

    deep hypnosis, some were inaccurate (e.g., three participants statingthat whatever happened would be due to the hypnotists control),while some mentioned expectations of no body sensations, unawarenessof surroundings, and being in a void. Queried as to how they got into adeep state, participants mentioned reducing internal dialogue andmaintaining a focus of attention, whether on breathing, pedaling, oranything else, to go into hypnosis. At deeper levels, they felt theirtask was to let things happen and maintain a free-floating focus. Theyalso reported being able to maintain or terminate, but not produce,

    their experiences.Aftereffects of participation were universally positive. Neither atthe end of the session nor 8 months later was there any mention ofa negative effect. On the other hand, experiencers mentioned that, as

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    PHENOMENOLOGY OF DEEP HYPNOSIS 51

    a consequence of their participation, they had gained greater percep-tual vividness and dream recall, increased personal insight, decreasedanxiety and nightmares, validated spirituality, and enhanced inner

    peace. In an unexpected follow-up, a participant wrote about usingself-hypnosis successfully many years later for anesthesia-free child-birth (Cummings, 1998).

    CONCLUSION

    All three hypotheses were supported. This study replicates andextends previous findings that hypnotic virtuosos experience consistentand significant unsuggested alterations of consciousness, even after con-trolling for the effects of relaxation. The effects of specific forms of phys-ical activity on experience were also elucidated. The results of this andrelated studies suggest that different levels of hypnotic experience (e.g.,light vs. very deep) are better seen as distinct modes of experiencing(Tart, 1975), than as variations in intensity (Singer, 1977). For instance,the initial greater awareness of the physical body seems to disappear atsome point, whereas other phenomena (e.g., a bright light, absence ofthought) emerge all of a sudden during deep hypnosis. The results donot support the notion of a single hypnotic state or trance but of var-ious commonly experienced modalities of experiencing. Contrary to

    Feldmans study (1976), there were significant changes in emotion.The experiences during deep hypnosis can be compared with thosedescribed in other contexts. Some reports were identical to those in aqualitative study of deep states of meditation (e.g., there was nosense of my physical body . . . no thought, youve fallen into a holethats so deep, is utterly serene; Gifford-May & Thompson, 1994).Another study with meditators using the PCI found significant changesin meaning, time sense, love, and state of awareness (Venkatesh, Raju,Shivani, Tompkins, & Meti, 1997). It is of interest that the sequence ofmedium to deep hypnotic phenomena is consistent with phenomenaof increasing absorption mentioned in the classic meditation literature(Holroyd, 2003). Also, specific phenomena reported in this study (e.g.,floating out of the body, merging with a light, being one witheverything) have been mentioned in the literature on mystical, near-death, OBE, and shamanic experiences (Cardea, 1996; Cardea et al.,2000; McClennon, 2001). The content and sequence of going fromsimple images (e.g., geometric) to more complex narratives partlyusing those images is also found in studies of psychedelic-induced(Siegel, 1977) and other altered states of consciousness (Hunt, 1985).

    The phenomena reported probably are not exclusive to a hypnosiscontext but rather support the notion that hypnotic virtuosos have apropensity to experience various anomalous experiences (Pekala &Cardea, 2000).

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    Although most of the effects can be attributed to the hypnotic context,thus refuting Edmonstons equation of relaxation with hypnosis(1991), physical activity also had some impact. Consistent with Fellows

    and Richardsons study (1993), quiescence was associated with reportsof a deeper state, which could be explained by the initial greater bodyimage changes, especially feelings of floating and being disembodied.There were also some accounts of more imagery in this condition. Thispattern is similar to the one shown in the cluster analyses of Winkelman(1992) on cross-cultural data on altered states of consciousness, whichshowed an association between immobility, a sense of floating out ofones body, and imagery. These somatic alterations represent alterna-tive body representations, associated with continued attention to sub-

    jective experience and reduction of somatic feedback (Alvarado, 2000;Tart, 1975). The increase in visual imagery cannot be explained by thegreater visual stimulation encountered when physically active, as Pope(1978) has proposed, since participants kept their eyes closed duringthe sessions. Greater imagery could be explained either by stimulusgeneralization between lying down and dreaming (R. F. Morgan &Bakan, 1965), or by a limited resources explanation that the resourcesnot spent on movement could be deployed in greater imagery whenquiescent. Although posture alone has not been seen to affect hypnoticresponsiveness (Ruch & Morgan, 1971), lying down and inactivity

    were not separated in the present study, so further research is neededto elucidate this matter.The diminished self-awareness in the motor activity condition sug-

    gests that repetitive activity does not have to be attended to (perhapsbecause of neural habituation) once the whole organism becomesattuned to a specific rhythm and then maintains residual, unreflectiveawareness. This result is also consistent with Winkelmans (1992) findingof an association between rhythmic drumming/dancing and amnesiain cross-cultural data. Finally, self-pedaling was deemed to be morearousing and dysphoric and less conducive to hypnosis deepening. Thisfinding is consistent with a previous study (Alarcn et al., 1999) inwhich people who do not habitually ride a bicycle preferred a simplerform of physical activity to a self-generated pedaling in a hypnoticcontext. Differences were obtained even with a relatively mild form ofphysical exertion, thus it may be that subjective experience in contextsof greater physical arousal and exertion will differ more from reportsobtained from quiescence, as Winkelmans analysis suggests. Also, inritually induced altered states, social facilitation may shape the inter-pretation of the phenomena and enhance the experience.

    As for the effect that hypnotizability testing may have had, it isworth pointing out that most of the phenomena reported in deep hyp-nosis bore no resemblance to the hypnotic tasks that participants had

    been exposed to previously. It is of interest that whereas the Stanford

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    C only had a .01 correlation with the Field scale of hypnotic experi-ences, the Profile Scales correlated strongly with it. This may be partlyexplained because the scoring system for the Profile Scales offers

    greater variance than that for the Stanford C. The little variance on theStanford C (participants were chosen based on scoring 912) did notallow for a valid measurement of its correlation with other measures.Although the Stanford C is considered the gold standard of hypno-tizability, the Profile Scales may offer a more varied sampling of hyp-notic behaviors and experiences attainable by hypnotic virtuosos(Weitzenhoffer, 2000). It would be important to address this hypothesiswith a larger sample, including various levels of hypnotic ability.

    Participants did not show elevated dissociation, in a trait, pathologicalsense, as measured by the PAS. On the other hand, they exhibited dis-sociation, or uncoupling of psychological processes, in the descriptivesense (Cardea, 1994), as indicated by comparing the PCI correlationsfor the hypnosis and control conditions. Pekala (1991) has presentedevidence that during hypnosis psychological processes tend to becomeuncoupled. There were two individuals with high dissociation scoresand the lowest scores in the ego strength scale; they were also the onlynonintuitive types and reported very distressing imagery. This patternis consistent with the formulation of different types of high hypnotizables(Barber, 1999; Barrett, 1992; Cardea, 1996), where the dissociative

    type may be more likely to evidence psychological distress than thefantasy-prone type.There was remarkable consistency in the phenomena reported, but

    their manifestation showed individual variations. For instance,although episodes of darkness were common, they might have beenexperienced as an imaginal adventure in a dark cave or as being sub-merged in a black substance. The reports of free-floating attention toinner experiences and, at times, increased imagery are consistent withresearch by Fromm et al. (1981) on self-hypnosis (and indeed partici-pants in this study were mostly responsible for the hypnotic process).

    This study includes methodological improvements over previousones but has some limitations. First, the findings are generalizable onlyto hypnotic virtuosos in the context of neutral-deep hypnosisdescribed. Although some phenomena (e.g., radical changes in bodysensations and image) have been reported in more typical contexts ofhypnosis, others (e.g., experiencing the void or merging with the light)have only been described in deep hypnosis procedures or nonhypnoticcontexts. Second, some readers may object to the choice of a within-subjects design. Barabasz and Barabasz (1992) have argued that this

    design may be optimal to detect differences resulting from a hypnoticintervention, but it can also be argued that highs may hold back theirreports during the control sessions, especially considering that the hyp-nosis sessions preceded the control ones (see Braffman & Kirsch, 1999).

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    A related criticism is that demand characteristics might have stronglyinfluenced the results. I sought to reduce these characteristics byrequesting honest reports and employing a simple count induction

    and a neutral query. Furthermore, meta-analyses of various researchareas show that a similar context to this (i.e., laboratory interviews ofsensory restriction) had a very small interpersonal expectancy effect (r =.07; Rosenthal & Rubin, 1978). The request that participants not useself-hypnosis in the control sessions took into consideration the find-ing that highs may engage in self-hypnosis during control sessions,thus invalidating them (Tart & Hilgard, 1966). Nonetheless, this issuedeserves further scrutiny.

    Another limitation is that the length of the hypnosis and control ses-sions varied. Comparisons at parallel points showed that hypnosisproduced reports of greater depth and changes in experience, butequalizing the length for both types of sessions would eliminate thispotential artifact. Furthermore, a design that counterbalances hypnosis-no hypnosis, or measures them in different contexts and also includes lowsimulators, could evaluate the context and demand characteristics pre-cisely. Finally, although Feldman (1976) did not find that expectationswere good predictors of the actual phenomena encountered, the find-ings in this study are mixed and recommend a systematic evaluation ofexpectancies in future research.

    Even considering its limitations, this study extends previous find-ings and indicates that highs may experience striking alterations ofconsciousness, even in the absence of specific suggestions in thatregard. The consistency of reports across participants and with those ofother studies on deep hypnosis and anomalous experiences is strikingand demands further scrutiny. It suggests that these experiences reflectcommon patterns of alterations of consciousness and, probably, commonneurological underpinnings (cf. Newberg & DAquilli, 2000). Thesecommonalities need to be integrated into our view of human experi-ence and may have evolutionary implications (McClennon, 2001). Thepositive aftereffects of participation also suggest that, in addition to itstheoretical and research import, the type of procedure described heremay be of benefit in therapeutic and self-growth contexts.

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    Weitzenhoffer, A. M. (2000). The practice of hypnotism (2nd ed.). New York: Wiley.Weitzenhoffer, A. M., & Hilgard, E. R. (1962). Stanford Hypnotic Susceptibility. Scale. Form

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    Unpublished manuscript.

    Winkelman, M. (1992). Shamans, priests and witches: A cross-cultural study of magico-religiouspractitioners.Anthropological Research Papers No. 44. Tempe, AZ: Arizona: Arizona StateUniversity.

    Die Phnomenologie tiefer Hypnose: Ruhig und krperlich aktiv

    Etzel Cardea

    Zusammenfassung: Zur Untersuchung der Phnomenologie hypnotischerVirtuosen wurde ein 2 (Hypnose, Kontrolle) *3 (ruhig, auf einem stationrenFahrrad tretend, auf dem durch einen Motor angetriebenen stationrenFahrrad sitzend)-within-subjects-Design mit quantitativen und qualitativenMaen eingesetzt. In einem Kontext neutraler Hypnose, wobei lediglichdie Suggestion bestand, so tief wie mglich in Hypnose zu gehen,berichteten die Versuchspersonen Vernderungen im Krperschema, derZeitwahrnehmung, der Wahrnehmung und Bedeutung, dem Erleben einesvernderten Bewusstseinszustands, des Affekts, der Aufmerksamkeit undder Vorstellungsttigkeit. Weiter erwhnten die Teilnehmer verminderteSelbstaufmerksamkeit, Rationalitt, willentliche Kontrolle und Erinnerung.Die Auswertung der drei krperlichen Bedingungen zeigte, dass diehypnotischen Erfahrungen insgesamt hnlich abliefen, obgleich dieRuhebedingung zu strkeren Vernderungen des Krperschemas undBerichten grerer Hypnosetiefe fhrte. Diese Befunde legen nahe, dasshypnotische Virtuosen Vernderungen im Bewusstsein erleben, welche sichbesser als distinkte Zustnde im Gegensatz zu anderen Positionen aufeinem Kontinuum charakterisieren lassen.

    RALF SCHMAELZLEUniversity of Konstanz, Konstanz, Germany

    La phnomnologie de lhypnose profonde : passif et pendantune action physique

    Etzel Cardea

    Rsum : afin dtudier la phnomnologie des virtuoses de lhypnose,lauteur a employ des mesures quantitatives et qualitatives pour une tude2 (hypnose vs. contrle) x 3 (passif, pdaler un vlo immobilis, pdaler unvlo motoris). Dans un contexte dhypnose neutre avec pour seulesuggestion dtre en transe aussi profonde que possible, les participants

    relatent des altrations de limage corporelle, de la notion de temps, de laperception et signification, de la notion dtre en tat de conscience altre,de laffecte, de lattention et de limagerie. Ils font aussi part dune baisse dela conscience de soi, du niveau de rationalit, du contrle volontaire et de la

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    PHENOMENOLOGY OF DEEP HYPNOSIS 59

    mmoire. Lanalyse des 3 conditions physiques montre que les exprienceshypnotiques sont globalement similaires bien que le fait dtre passifamenait plus daltrations de limage corporelle et une transe plusprofonde. Ces rsultats suggrent que les virtuoses de lhypnose ont desaltrations de la conscience qui pourraient tre mieux conceptualises entant qutats distincts plutt que places sur un continuum.

    VICTOR SIMONPsychosomatic Medicine & Clinical HypnosisInstitute, Lille, France

    La fenomenologa de la hipnosis profunda: Fsicamente activa y yacente

    Etzel Cardea

    Resumen: Para estudiar la fenomenologa de los virtuosos hipnticos, elautor emple un diseo intragrupal de 2 (hipnosis vs. control) x 3 (inmvil,pedaleando una bicicleta inmvil, o con un motor moviendo los pedales),con medidas cuantitativas y cualitativas. En un contexto de hipnosisneutral con la nica sugestin de entrar tan profundamente en hipnosiscomo fuera posible, los participantes mencionaron modificaciones en laimagen corporal, sentido de tiempo, percepcin y significado, sensacin deestar en un estado alterado de consciencia, emocin, atencin, y capacidadpara imaginar. Tambin mencionaron menos auto-consciencia, racionalidad,control voluntario, y memoria. Anlisis de las tres condiciones fsicas

    mostraron que las experiencias hipnticas fueron semejantes en general,aunque la inmovilidad fue ms conducente a modificaciones de la imagencorporal e informes de profundidad hipntica. Los resultados tambinsugieren que los virtuosos hipntico muestran alteraciones de conscienciaque se pueden conceptualizar ms como estados discretos que en uncontinuo.

    ETZEL CARDEAUniversity of Texas, Pan American,Edinburg, Texas, USA