Conscious and Unconscious Minds
Franz Anton Mesmer (1734–1815)
Marquis de Puysegur (1751–1825)
The Parisian School of Hypnosis
Laboratory Studies of Hypnosis
The State and Non-State Model of Hypnosis
Dissociation Theories of Hypnosis
Hypnotic Phenomena: Age Regression
Hypnosis and Clinical Psychology, Efficacy Studies, and Prevention
Some believe that mind is a product of the brain and thus mind is made of matter. Others believe that although mind is located in the brain, mind is not made of matter, but rather is composed of psychological processes such as thinking, feeling, and remembering. Still others believe that in addition to the brain (body) and mind there is also the matter of soul.
Historically, philosophers, scientists, and religious authorities have debated extensively the nature of mind, body, and soul. Today, many millions, perhaps billions of people around the world believe the soul is unique to humans, and that it is immortal. Despite the prevalence of the belief in the soul, the concept of soul as defined above is absent or barely treated in most versions of psychology and is considered more appropriately the province of religion, spiritualism, and/or psychic phenomena.
The idea of mind, on the other hand, has come (e.g., associationism/cognitive neurosciences) and gone (e.g., behaviorism) in psychological systems of thought, and in general is conceptualized as a set of processes such as thinking, feeling, and remembering. These processes afford knowledge of the finite world and die with the body. Material monists believe that the body or specifically the brain gives rise to mind while mental monists believe that the physical world is the product of the human mind. In contrast, dualists believe mind and body are different yet interact with each other, or the activities of each parallel yet are independent of each other (i.e., psychophysical parallelism).
Baruch Spinoza (1632–1677) is considered by some to have had a more prominent role in the establishment of psychology as an independent science than has been attributed to René Descartes (1596–1650). Spinoza argued that the mind and body were two features of the same thing yet independent of each other like the peel and fruit of a banana, and they were on an equal footing, thus providing a conceptual pathway to examine systematically psychological interactions with bodily processes. Spinoza distinguished between emotions and passions with only emotions influenced and guided by reason.
The concepts of conscious and unconscious minds grew directly from the work of Gottfried Wilhelm von Leibniz (1646–1716). His idea influenced later developments in psychophysics, Freudian psychoanalysis, and the field of hypnosis.
Phrenology was the popular 19th-century practice that established firmly in the mind of the public the idea that the brain and mind are related to each other such that variations in the bumps of the skull represented different amounts of underlying brain tissue, and more importantly, different levels of intellectual and emotional capacities as well as personality traits. Franz Joseph Gall (1758–1832), his student Johann Gasper Spurzheim (1776–1832), and the publishing firm of Fowler and Wells spread phrenology around Europe and America to such an extent that it was almost common practice for everyone to have had a “phrenological read” at one time or another.
The work of Franz Anton Mesmer (1734–1815) further popularized in the mind of the public the foundational idea that mind matters. He believed that the world was permeated by a force that he called “animal magnetism,” which if not properly distributed and flowing throughout the body gave rise to mental and physical illnesses such as, for example, anxiety attacks, memory lapses, blindness, and paralysis. After earning the MD in 1766 from the University of Vienna, Mesmer treated Viennese patients presenting symptoms for which there appeared to be no physical basis, and achieved symptom relief for many of his patients by passing and placing specially designed magnets on different parts of their bodies. After he was castigated by the Viennese medical community, Mesmer set up an initially successful practice in Paris where he established schools to train persons in his magnetic techniques. Later, Mesmer was investigated by a scientific commission appointed by the king of France and led by Benjamin Franklin, and was ultimately discredited as a fraud by the commission and the medical-scientific community. He died in Germany in 1815, although his foundational ideas that mind can influence and even repair psychological and bodily functions live on right up to the present.
James Braid (1795–1860) provided an explanation of mesmerism which he attributed to fatigue of the elevator muscles of the eyes arising from continuous staring at an object coupled with verbal suggestions of relaxation, giving rise to a sleep-like state that he called hypnosis.
The practice of hypnosis had by then been legitimized within the medical community, and was studied in the Nancy School of hypnosis under the pioneering work of Auguste Ambroise Liébeault (1823–1904) and Hippolyte Bernheim (1840–1919), according to whom hypnosis was a normal phenomenon representing a sleep-like state somewhere between wakefulness and natural sleep. Contrarily, the Parisian School of hypnosis led by the world-famous neurologist Jean-Martin Charcot (1825–1893) considered hypnosis to be a reflection of an underlying neurological disorder like hysteria. Charcot and Pierre Janet (1859–1947) promoted the foundational ideas that psychological dysfunctions and symptoms of physical illnesses could be treated with hypnosis based upon verbal suggestions, and that the human mind consists of at least two major components, namely, the conscious and the unconscious.
In America in the 1890s, Hugo Münsterberg (1863–1916), director of the prestigious psychological laboratory at Harvard University, initiated laboratory studies of hypnosis, which were later extended by Clark Hull (1884–1952) at Yale University in the 1920s and 1930s. Most of the results from both of these laboratories still stand as valid today, and include such findings as no difference in susceptibility to hypnosis as a function of intelligence and little evidence that hypnosis enhances memory.
The state model of hypnosis crystallized during the 1960s argued that hypnosis represented a special state of consciousness lying somewhere between wakefulness and natural sleep with the skill of the hypnotist as the primary determinant of the depth and effectiveness of the hypnotic state. The alternative or non-state model proposed that the hypnotic experience arises primarily from cognitive mechanisms under the control of the person being hypnotized. Thereafter, dissociation theories of hypnosis developed, promoting one of two different mechanisms: (1) that during hypnosis consciousness is fragmented such that a part of consciousness is sealed off from the analytical component of consciousness; or (2) that hypnotic states are the result of uncoupling of cognitive and behavioral subsystems from control by the executive or analytical component of consciousness.
Studies of hypnotic age regression indicate that there is not a return to previous age as reflected in age-appropriate perceptions, physiological responses, and cognitions, but rather a change from an analytical to pre-logical modes of information analyses and thinking. Interestingly, the study of hypnosis and other psychic phenomena (e.g., mental telepathy) by the Boston School of Abnormal Psychology during the period of 1870–1890 is considered by some historians of psychology as the driving force that led to the establishment of clinical psychology.
The results of efficacy and effectiveness studies of hypnosis in particular and other modalities of psychotherapy in general (e.g., cognitive and/or behavior therapies) have yielded the unequivocal findings that these types of psychological interventions work for a variety of specific disorders.
When you finish studying this chapter, you will be prepared to:
All humans appear to have a brain and a mind. Brain is made of matter such as neural tissue (e.g., neurons and glial cells) and fluids while mind is made of nonmaterial expressed as functions such as sensing, feeling, thinking, and remembering. It is unequivocally clear today that different mind functions are associated with different brain sites. As a result, many psychologists and scientists from related disciplines have concluded that “matter makes mind.” However, it would be likewise mindless to conclude that mind or cognitive strategies or interventions (e.g., relaxation techniques, cognitive-behavior therapies, visualization, self-affirmations, self-fulfilling prophecies, and hypnosis) do not influence brain and bodily functions so that we must keep in mind that “mind matters.”
As you may recall from Chapter 4, “The Philosophical Foundations of Psychology,” there has been and continues to be a fundamental debate over the meaning and nature of the human mind and soul. This debate is global with mind considered by scholars from many cultures to be the province of primarily moral philosophy, a portion of which has evolved into the psychological and social sciences. The concept of soul has also been treated initially by moral philosophers, and is now the primary province of religion- and faith-based approaches to knowledge. In general, the mind affords us contact and awareness of the finite mortal world. The mind came to be understood as psychological functions, such as, for example, sensing, feeling, thinking, and remembering. Most philosophers, scientists, and thinkers believe the mind dies with the body. The concept of soul or spirit refers primarily to that feature of a human being that many millions of people believe provides access to universal knowledge, and is immortal in comparison to the body and the mind (i.e., the brain).
There are some historians of psychology who believe Baruch Spinoza had more of an influence upon the founding of psychology as an independent science than René Descartes because of Spinoza’s views on the mind–body relationship and the denial of free will (Bernard, 1972). Spinoza was born in the Christian city of Amsterdam, of Jewish parents. After graduating from a Jewish high school in Amsterdam, Spinoza went to a Dutch teacher to learn Latin and the “new science” including the works of Copernicus, Galileo, Harvey, and Descartes. Spinoza also read the works of Arab and Jewish philosophers, especially Maimonides, but the most important of all of these scholars for the development of his own philosophical system was Descartes.
In accord with Jewish custom, which required all men to learn a trade, he became highly skilled in the art of grinding and polishing lenses. Although Spinoza first embraced Descartes’ philosophy that there was a material body and a nonmaterial mind, he later rejected the Cartesian view that God, Nature, and Mind were all separate phenomena. For Spinoza, all three were inseparable, meaning that God was everywhere and in everything, which put him in opposition to the Judaic and Christian teachings that humans are made in the image of God. Accordingly, Spinoza was criticized severely and avoided at all costs by members of both religious communities (Alexander & Selesnick, 1966). For Spinoza, the mind and body were inseparable so that whatever happened to the body was reflected in the mind as emotions and thoughts while emotions and thoughts influenced the body. The mind and body were on an equal footing providing a clear conceptual pathway to examine systematically the impact of psychological interventions upon bodily processes.
The second important aspect of Spinoza’s philosophy for the development of psychology as an independent science was his view that nature is lawful and, as “humans are a part of (Spinoza) rather than apart from (Descartes) nature,” it follows that human thoughts and behaviors are determined. According to Spinoza, free will is an illusion even though humans think of themselves as free because they may be conscious of their thoughts, intentions, and emotions at a given moment, yet all of them are caused by prior thoughts, intentions, and emotions that are unconscious because the person is not now aware of them in the present moment (Spinoza, 1677/1955).
Lastly, Spinoza assisted the launching of psychology as a separate science by distinguishing between emotions and passions. Passions, unlike emotions, are not linked to any specific thought or behavior, and therefore they are maladaptive as, for example, when a person is in a state of rage or heightened excitability. An emotion, on the other hand, is related to a specific thought or behavior such as love of a spouse or partner, which can be moderated or influenced by reason. Behavior and thoughts that are guided by reason permit adaptation and survival of the person, which is not the case under the influence of the passions.
Most people would agree that there are times when each of us may have done something automatically while not aware of what we were doing. Such experiences suggest that our mind is not unitary and consists of a conscious and unconscious component. Another way of expressing this sense of duality is that some of our experiences and actions become dissociated from our sense of conscious awareness. Our current understanding of the conscious and unconscious components of the human mind began with the ideas of Gottfried Wilhelm von Leibniz (1646–1716). Leibniz was born in Leipzig, Germany. His father died when Leibniz was six, and young Gottfried was sent off to school to continue his education that had begun as home schooling under his father’s tutelage. He entered the University of Leipzig at the age of 14 and completed his doctoral dissertation for his law degree at 19 years of age. In as much as the university awarded only 12 law doctorates per year with priority determined by age of the candidate, Leibniz did not make the top 12 slots, due to his youthful age. As a result, he left the University of Leipzig in a rage, signed up at the smaller University of Altdorf, and earned his doctorate within the following six months.
Leibniz secured his first position with a Nuremberg alchemical society, and then became a legal advisor to Baron Johann Christian von Boineburg, which afforded him the opportunity to work on projects of interest to his patron as well as on many personal projects (e.g., a cataloging system for libraries and a study of doctrinal differences and similarities between Catholics and Protestants). Leibniz was dispatched on a diplomatic mission to Paris by his patron in 1672 where he remained until 1676, and while there he invented a new kind of watch that functioned more accurately than others in use at the time as well as a mathematical calculating machine that was so advanced that it won him membership of the prestigious Royal Society as one of the first non-British members. Also, while in Paris he developed binary arithmetic in which all numbers are represented with just ones and zeroes, the system used for representation and calculation in present-day electronic computers. He also invented, independent of a similar discovery by Isaac Newton (1642–1727), the calculus that is still in use today.
Leibniz’s third professional position, in which he remained for the rest of his 43 years of life, was as court librarian and political and technical advisor to the House of Hanover in Germany. However, before starting this position in 1673 he visited London and Amsterdam, met Baruch Spinoza, and observed the dynamic movement of microorganisms through the first microscope invented by Anton von Leeuwenhoek (1632–1723). This observation of the smallest particles of matter convinced Leibniz that the entire world is made up of infinitesimally small entities, all of which are alive and have varying capacities to perceive—to register impressions of the rest of the world. Leibniz considered these tiny entities not to be made of matter but rather as units of energy, which he called monads after the Greek monos which means unit. He conceived of four levels of monads, which differed primarily in terms of their clarity, distinctness, and completeness of their perceptions of the world. There was a supreme monad or God, rational monads equivalent to the conscious human mind, sentient monads found in nonhuman living organisms, and, lastly, simple monads that made up the remainder of matter whether organic or inorganic. The level of awareness for the last type of monads was indistinct and unconscious.
According to Leibniz’s monadology, consciousness varies from the clear, distinct, and rational apperceptions through indistinct perceptions terminating in minute or petit perceptions which never enter our consciousness (Aiton, 1985). However, as petit perceptions accumulate their combined force eventually leads to consciousness, much like hearing the sound of rain without being able to hear the sound of a single raindrop as it falls upon a surface. Accordingly, a continuum exists between the unconscious and conscious mind. Most likely Leibniz was the first major philosopher to propose an unconscious as well as conscious mind as well as the concept of limen or threshold.
We turn now to developments in phrenology which provided the platform for the systematic study of the mind, popularized the idea of brain localization of specific mind functions, and represented a simple, straightforward, and seductive although grossly fallacious system of psychological assessment of a person.
The term phrenology was coined by Thomas Foster in 1815 and began in association with the scientific studies of the anatomy of the nervous system by Franz Joseph Gall (1758–1828). Phrenology was built upon the foundational ideas that humans could be studied scientifically and that mind could be studied objectively and explained in terms of natural causes. During a phrenology exam, the client would talk about herself or himself while the phrenologist was examining the client’s skull and then the phrenologist would find bumps on the client’s head that fit the description. Phrenology popularized the idea of brain localization of specific psychological functions. In addition, phrenology made plain the practical value of the newly emerging science of psychology to pragmatic Americans and others from the 1830s to the beginning of the 20th century.
Gall earned his medical degree at the University of Vienna in 1785, and as a skilled anato-mist demonstrated that each hemisphere of the brain controls the opposite side of the body (i.e., contra-lateral representation of function) and that mental abilities of different species correlated with the size and complexity of the cortex of the brain. He argued soundly that the anatomical convolutions of the brain were stable within a given species, meaning that the surface of the brain or cortex was not a chaotic mix of ridges (gyri) and valleys (sulci) but had a lawful structure and arrangement (Temkin, 1947). Gall’s anatomical findings were well received by the medical and scientific communities. Gall became convinced that just as the anatomy or structure of the brain is lawful, so too must the functions of the mind (i.e., psychological functions such as thinking and remembering) be lawful as well. Gall, along, with his student and colleague Johann Gasper Spurzheim (1776–1832), by the method of cranioscopy (measurement of the physical shape and bumps and dents of the skull), mapped out the location on the skull and, therefore, by deduction, the brain localization of the 37 faculties that were subsumed under the two overarching domains of the affective or emotional and intellectual faculties (Sizer & Drayton, 1892).
Gall died in Paris in 1828 and was denied burial in consecrated ground because his work was judged to be deterministic and materialistic and therefore smacked of atheism. As a consequence, his books were placed on the Catholic Church’s Index of Prohibited Books. Spurzheim carried on and visited America in August 1832, where he lectured to the faculty of Yale and Harvard, and was dead by September of that same year (Bakan, 1966). In 1838, George Combe (1788–1858), a Scottish phrenologist, lectured widely to the general public from Boston to Washington, DC, resulting in phrenological societies popping up all over the United States so that by the 1840s it appeared as if the majority of Americans believed in phrenology (Davies, 1955). Interestingly, as a harbinger of things to come, the faculty and president of Brown University declared that mesmerism was more important than phrenology (Pickard & Bailey, 1945), while in the late 1880s the Psychology Department of Cornell University was founded to accumulate evidence regarding the value of phrenology (Dallenbach, 1955).
Orson, Lorenzo, and Charlotte Fowler and Samuel Wells formed the phrenological firm of Fowler and Wells in 1844, which dominated the phrenology business from its inception to the beginning of the 20th century. Thousands of phrenological examinations, including those of celebrities such as Walt Whitman, were conducted in Fowler and Wells parlors in Boston, New York, and Philadelphia, as well as many other franchises they established throughout the country (Davies, 1955). Interestingly, Ray Kroc (1902–1984) had a phrenological examination when he was four years of age predicting that he would work in the food industry. He went on in 1955 in Des Plaines, Illinois, to establish McDonald’s restaurants, which in 2001 numbered 28,000 restaurants in 121 countries and served 29 million people per day (Gross, 1997; McDonald’s, 2001). Although riddled with shabby science, phrenology popularized the foundational ideas that the brain is the organ of the mind, mental functions can be localized in the brain, and individual characteristics can be measured, while also stressing the importance of individual differences and models of personality.
Many businesses at the beginning of the 20th century required a phrenological reading of applicants, especially for leadership or sensitive financial positions in their organizations, and thus they were sent off to phrenological parlors for an assessment of their capabilities and personalities (Davies, 1955). Although phrenological assessments are no longer used today, organizations still need to predict the performance of applicants for high-level executive positions, and they now send such applicants to Executive Assessment Centers for a battery of interviews, personality inventories, and participation in simulated decision-making exercises. In fact, personality inventories are a major component of contemporary assessment processes, due, in part, to the Five Factor Model of personality (FFM) and the robust predictive power of some of the five personality dimensions for a wide range of organizational functions (McCrae & Costa, 1997; Hogan, Hogan, & Roberts, 1996; Mount, Barrick, & Strauss, 1994; Salgado, 1997). The five personality factors can be represented by the acronym of OCEAN which stands for Openness to Experience, Conscientiousness, Extroversion, Agreeableness, and Neuroticism (or emotional stability). The evidence indicates clearly that conscientiousness (i.e., a responsible, dependable, persistent, organized, and achievement-oriented person) is the most valid predictor of a wide variety of job performances in many countries around the globe (Hogan et al., 1996; Hurtz & Donovan, 2000; Mount et al., 1994; Salgado, 1997). It has also been clearly demonstrated that emotional stability (i.e., a calm, secure, at-ease person) is also a valid predictor of a wide variety of job performances (Salgado, 1997). Thus, the bottom line when hiring someone is to select a person who is conscientious and calm.
The assessment of intelligence has been a central and at times an extremely controversial issue in psychology and related disciplines throughout the 20th century (Herrnstein & Murray, 1994; Neisser et al., 1996). In a comprehensive report from the American Psychological Association, Neisser et al. (1996) concluded that there are many ways to be intelligent and thus there are many conceptualizations of intelligence. In general, intelligence test scores predict individual differences in academic achievement fairly well, yielding correlations of about 0.50 with grade point average and 0.55 with number of completed years of education. Also, a significant correlation between occupational status and intelligence has been demonstrated even when measures of education and family background have been statistically controlled. They also report one of the most striking findings regarding intelligence test scores, namely, the Flynn Effect, or the fact that mean IQ test scores in many countries around the world have increased more than 15 points, a full standard deviation, in the last 50 years and the rate of increase may be accelerating (Flynn, 1999). It may be that these increases in IQ test scores are driven by improved nutrition, cultural changes, experiences in testing, or some other factors. Although a fair amount is known about the nature and assessment of intelligence, there are many questions that remain unanswered to date such as the pathways of genetic and environmental influences on intelligence and what accounts fully for the differences in IQ scores between blacks and whites (Neisser et al., 1996).
Franz Anton Mesmer was born in Iznang on the German shore of Lake Constance. He attended the University of Vienna and earned an MD in 1766, based on his dissertation titled “On the Influence of the Planets,” in which he argued that the planets influenced human health and well-being through a celestial force in much the same way the waxing and waning of the moon influences the tides of the oceans. He called this planetary force “animal gravitation or magnetism,” which he believed was like Isaac Newton’s (1642–1727) conception of universal gravity, that is, a powerful and ubiquitous force that could operate at distance upon biological processes much like metal filings drawn to a magnet. According to Mesmer, physical and/or mental illnesses were due to the congestion of the animal magnetism in different parts of the body and the appropriate treatment consisted of redistributing and thus balancing the flow of “animal gravitation or animal magnetism” by placing magnets on different parts of the body.
Mesmer married a wealthy widow ten years his senior and of noble descent, Maria Anna von Posch, thus affording him access to the wealthy and influential members of Viennese society. He established a respected medical practice in Vienna, and became a patron of the arts and friend of Wolfgang Amadeus Mozart (1756–1791). Mesmer practiced medicine sporadically and his interest in animal magnetism was reawakened when he met a Jesuit priest and professor at the University of Vienna, Maximillian Hell (1720–1779), who told Mesmer of healings he had accomplished by placing magnets on the body of his patients. Thereafter, Mesmer saw as a patient a 27-year-old woman, Fraulein Oesterlin, who presented with a large number of physical symptoms for which there was no observable bodily cause. Mesmer decided to treat her with magnets as he had learned that some English physicians were also treating certain diseases with magnets and he had been very impressed by Father Hell’s experiences with magnets as well. Mesmer directed the patient to swallow some preparation containing iron, and then shortly thereafter attached three magnets specially designed by Father Hell to her stomach and legs. Fraulein Oesterlin began to feel streams of a mysterious fluid running downward through her body with many of her presenting symptoms (e.g., dizziness, feelings of weakness, and anxiety) receding for a number of hours. Mesmer concluded that these results were due not to the magnets alone but rather to a magnetic fluid accumulated in the patient with the magnets enhancing the animal magnetism and giving it direction and expressing its influence at a distance (Ellenberger, 1970).
Mesmer focused the rest of his life on the elaboration and use of animal magnetism as a powerful cure for a wide variety of illnesses. He used magnets in the early stages of his medical practice, eventually abandoning the placement of magnets on the body of the patient as he became convinced that he could manipulate the animal magnetism by waving a special wand, laying his hands over the patient’s body, and finally realizing his words alone drove the above manipulations. Lastly, Mesmer developed a group technique for manipulating the flow of animal magnetism in his patients by having them sit around a “baquet,” a tub filled with magnetized water, with each patient holding onto a metal rod attached to the baquet. He would then encourage by his words and domineering presence one of his patients to have a crisis consisting of emotional outbursts, screaming and sobbing, and eventually convulsing. He observed that, in general, after one patient went into a crisis others around the baquet followed suit. Almost all of the patients experienced some temporary relief of their symptoms, and some even claimed they were cured.
Mesmer’s fame spread by word of mouth from his patients as well as by the publicity surrounding two particular incidents. In 1775, he challenged the miraculous healings of a priest named Johann Joseph Gassner (1727–1779) explaining that the healings were a result of the redistribution of animal magnetism rather than, as Gassner claimed, a result of the driving out of demons through his practice of exorcism (Ellenberger, 1970). Mesmer’s attribution of theses cures to animal magnetism won the debate since his theory fit more with the Zeitgeist or spirit of the times and emphasized the power of naturalistic rather than supernatural forces as suggested by Gassner. The second incident that further rocketed Mesmer to notoriety in Vienna occurred in 1777 when he agreed to treat Fraulein Paradies, a 17-year-old pianist, blind since the age of three and a favorite friend of then Austrian Empress Maria Theresa (Fancher, 1996). Both Fraulein Paradies and Mesmer claimed that her sight was restored as result of Mesmer’s magnetic treatments but the cure was limited as she could see only when alone with Mesmer. This incident caused the Viennese medical community to claim that Mesmer was a fraud and as a consequence his standing in the community toppled, which in turn caused Mesmer to leave Vienna for Paris in 1778.
Once in Paris, Mesmer set up his practice in a private mansion and magnetized patients from the highest social levels for large fees while also having a sliding fee schedule for less well-off Parisians. His practice grew and he switched to group treatments using the “baquet” mentioned earlier. However, resentment grew within the Parisian medical community as word spread of Mesmer’s success, the exorbitant fees collected from his wealth-ier clients, and his unconventional treatments. In 1784, the king of France appointed a commission consisting of Benjamin Franklin, then U.S. ambassador to France, as presiding officer; Antoine Lasoivier, the great chemist; and Joseph Guillotin, the creator of the guillotine, to study objectively the effects of animal magnetism. The commission reported in August 1784 that Mesmer did affect the well-being of some of his clients not by a physical force, but rather by suggestion and there was no evidence found for the existence of animal magnetism, which the commission concluded was a figment of Mesmer’s imagination.
Mesmer left Paris in 1792 for London and then Germany where he died in 1815. Right up until his death, he attributed his cures (in most cases the removal of psychological symptoms of anxiety and related bodily responses) to the flow of vital energy (i.e., animal magnetism), while in retrospect it seems more reasonable to identify suggestion, social contagion or influences of others, and self-fulfilling prophecies for generating the crisis that he thought was essential for a cure (Eden, 1984; Merton, 1948).
Amand-Marie-Jacques de Chastenet, Marquis de Puysegur was a student of Mesmer. The Marquis de Puysegur, and a member of one of the most prominent families of 18th-century French nobility, used magnets and reported that his patients did not have to experience a crisis, which Mesmer thought was essential for symptom relief, but instead benefited as well from putting the patient in a peaceful and sleep-like trance that Puysegur referred to as artificial somnambulism.
The transition from mesmerism to hypnosis makes plain the powerful influences of prevailing scientific paradigms and how they serve to dampen innovation while providing some degree of explanation of interesting, although not yet fully understood, phenomena. For example, John Elliotson (1791–1868) was a successful and creative physician at the prestigious London University College Hospital who was the first to use the then newly invented stethoscope to listen to the sounds of the heart (around 1837) and was the first to use suggestions encouraging relaxation or mesmerism as a surgical anesthetic to diminish pain. Elliotson was ridiculed by his medical superiors and colleagues for using mesmerism as well as the stethoscope, neither of which they thought would be of any value in the practice of medicine. Elliotson resigned from the hospital in protest when the university council passed a resolution prohibiting the practice of mesmerism in the hospital, thus precluding him or others from studying further the effects of systematic and focused suggestions as well as an anesthetic agent upon a variety of illnesses. In addition, Elliotson was dismissed from his duties as president of the Royal Medical and Chirurgical Society (Alexander & Selesnick, 1966). Clearly, scientific paradigms can in some cases cause a great deal of professional and personal pain.
James Esdaile (1808–1859), a physician with the British army in Calcutta, performed in the late 1840s more than 250 painless operations using mesmerism or suggestions encouraging relaxation to anesthetize his Indian patients. Esdaile kept meticulous clinical notes and reported that the anesthetic effect was substantial and that for some serious operations the mortality rate was reduced by almost 50% with anesthetized patients. Back in Britain, Esdaile’s results were dismissed on racist grounds that his patients really liked to be operated on, his Indian assistants probably colluded in some way with the patients, and what worked for Indians would not work for Europeans (Ellenberger, 1970). Around 1850, ether and chloroform were starting to be used widely for anesthesia and as a consequence interest in mesmerism as an anthesthetic agent waned quickly.
James Braid (1795–1860), a prominent Manchester surgeon concluded in his book, The Rationale of Nervous Sleep (published in 1843) that the mesmeric trance states were simply the result of excess muscle fatigue due to prolonged concentration giving rise to physical exhaustion. As such mesmerism came to be understood as a sleep-like state and was renamed first neuro-hypnology, which Braid shortened to hypnosis (Alexander & Selesnick, 1966). Thus, hypnosis was made acceptable by using an explanation that fit within the medical paradigm, namely, hypnosis was the result of muscular fatigue of the elevator muscles of the eyes, which relax causing the eyes to close after prolonged fixation on an object, coupled with relaxing verbal suggestions from the hypnotist. Braid advanced the systematic study of hypnosis by conceptualizing it as a biological phenomenon that could be studied scientifically.
From 1860 to 1880, hypnosis fell to the margins of medical and surgical practice, due, in part, to the development of chemical anesthetic agents. However, a modest French physician, Auguste Ambroise Liébeault (1823–1904), after having established a solid medical practice in the small rural village of Pont-Saint-Vincent not far from the city of Nancy, France, started to experiment with hypnosis. He recruited patients, mostly poor people and peasants, by allowing them to choose between standard medical treatments for a fee or treatment by hypnosis for free. He considered hypnosis the same as natural sleep, which differed only because it was induced by suggestion and concentration on the idea of sleep. Liébeault treated a wide range of illnesses, such as arthritis and ulcers. He attracted the attention of Hippolyte Bernheim (1840–1919) from Nancy, a physician renowned because of his research on typhoid fever, who started using hypnosis in 1882 and published his findings in 1886 (Ellenberger, 1970). Bernheim became the leader of the Nancy School of hypnosis, according to which hypnosis was not a pathological condition but rather a natural state of heightened suggestibility, that is, the ability to transform an idea into an act induced by the suggestions of the hypnotist. Bernheim used hypnosis less and less as he came to observe that he could obtain the same effects by suggestion alone during the awake state as he could with hypnosis. He called this new treatment strategy “psychotherapeutics” (Ellenberger, 1970). The Nancy School of hypnosis promoted the foundational ideas that hypnosis was a state of heightened suggestibility, a state somewhere on a continuum between wakefulness and natural sleep, and that susceptibility to hypnosis was a trait that varied from person to person.
The Parisian School of hypnosis, led by the great 19th-century neurologist Jean-Martin Charcot (1825–1893), argued that only people suffering from hysteria (presenting bodily symptoms like paralysis, convulsions, anesthesia, and memory loss without any signs of organic or physical illness) could be hypnotized (Ellenberger, 1970; Fancher, 1996). According to Charcot, susceptibility to hypnosis, like susceptibility to hysteria, was a reflection of some underlying neurological disorder.
Charcot earned his MD in 1853, and then became the private physician and traveling companion for a wealthy banker. He married a wealthy widow and returned as a financially secure man to the famous Salpêtrière Hospital in 1862 where he had done his clinical residency as a medical student. Initially, the large Salpêtrière Hospital in Paris housed about 4,500 indigent patients, most of whom were women suffering from a variety of neurological and psychosomatic disorders. Charcot focused his attention upon those female patients who exhibited difficulty remembering events and persons, temporary paralysis of a limb that the patient could not move while awake yet moved freely when the patient was asleep, and anesthesia or insensitivity to noxious and painful stimuli, all of which are the cardinal symptoms of hysteria. Charcot concluded that hysteria was due to the progressive deterioration of the nervous system. In as much as both hysteria and hypnosis shared the same cardinal symptoms of selective memory loss, paralysis, and anesthesia, Charcot believed that hypnotizability indicated the presence of hysteria. As Charcot’s reputation as a premier neurologist grew throughout Europe many came, including Sigmund Freud (1856–1939), to see his spectacular demonstrations of hypnosis, especially when he hypnotized Blanche Wittman, who was one of his most demonstrative patients, exhibiting a wide variety of imaginary sensations and physical states during the hypnotic state.
Although Charcot’s theory that hypnosis and hysteria were reflections of an underlying neurological disorder is no longer considered valid, he gave hypnosis further scientific credibility and promoted the foundational idea that hysteria and other psychological ailments such as neuroses and psychoses are as real and in some cases as painful and debilitating as physical illnesses. Charcot helped immensely to put the mind and body on the same footing, and to make plain that “mind matters.”
Alfred Binet (1857–1911), who later went on to develop the first systematic test of human intelligence, worked as a laboratory assistant for Charcot at La Salpêtrière from 1883 to about 1890, during which time he assisted Charcot in experimental studies of transfer and polarization (Wolf, 1973). For example, during hypnosis the act of moving one leg could be transferred to movement of the other leg by passing a magnet near the patient while polarization yielded opposite or polar emotions or perceptions as a result of the magnet. Interestingly, neither transfer nor polarization could be demonstrated by other hypnotists including members of the Nancy School. Eventually, Binet and others had to retract their earlier claims and demonstrations of these phenomena and attribute them appropriately to suggestion and the willingness of the patient to please the hypnotist as the patients knew in advance what was expected of them (Wolf, 1973).
Pierre Janet (1859–1947) studied under Charcot at the La Salpêtrière and like Charcot believed that hysteria was due to a weakness of the nervous system. Janet reasoned further that this nervous weakness gave rise to inadequate psychological tension and a lack of psychic cohesiveness of the personality induced by excessive fatigue. Conscious experiences became split off from each other yielding hysteria and dissociative phenomena such that the individual behaved as if completely motivated by separate, dissociated personalities. Janet hypnotized many patients diagnosed with this psychological disorder, characterized by phobias, anxiety, obsessions, or compulsions, and found that their neurotic symptoms receded when they could recall the traumatic event that appeared to have been associated with the onset of their symptoms. Janet concluded that hysterical symptoms arise from the subconscious influence of dissociated aspects of the person’s personality. The dissociated parts of consciousness, once remembered, could then be integrated under hypnosis so that eventually the personality became whole again. Thus, unlike Charcot, Janet explained hypnosis and hysteria as the result of psychological rather than organic influences, and anticipated some of Sigmund Freud’s foundational ideas of unconscious memories and motives shaping conscious experiences and behaviors.
In 1892, Hugo Münsterberg (1863–1916), at the invitation of William James, became director of the Psychology Laboratory at Harvard University. Münsterberg enjoyed an excellent reputation as a careful and methodical laboratory-based experimental psychologist, and was very interested in applying psychological ideas derived from the laboratory to assist people with daily living in a wide variety of situations such as the workplace, school, and the courtroom. In effect, Münsterberg was an early example of the scientist-professional model that was adopted widely in psychology in the 1950s and was known as the Boulder Model for training clinical psychologists (Albee, 1970, 2000; Baker & Benjamin, 2000; Benjamin & Baker, 2000). Münsterberg accepted clinical patients in his laboratory only if they presented problems of scientific interest, which was determined through assessment using clinical interviews, observations of their behaviors, and responses to word-association tests. None of his patients paid a fee for his services. He tailored his treatment plan to fit the needs of the individual, although throughout most plans he relied heavily on suggestions, therapist and self-based positive expectations that the patient would get better (self-fulfilling prophecies), and in some cases he used hypnosis (Münsterberg, 1909). His endorsement of hypnosis was important for legitimizing hypnosis as sound and scientific clinical treatment strategy (Münsterberg, 1910).
Clark L. Hull (1884–1952), in his book, Hypnosis and Suggestibility: An Experimental Approach (1933), summarized approximately ten years of systematic laboratory studies employing physiological recordings during the hypnotic state as well as standardized techniques for fixation and providing direct suggestions for producing the hypnotic state. Almost all of Hull’s findings regarding hypnosis are still considered valid today, including his foundational finding that the personal capacity for hypnosis is distributed normally like other human traits, such as height, weight, and intelligence. This was an important finding because it stressed that the individual rather than “the power of the hypnotist” alone is a key variable for the induction of the hypnotic state (Hull, 1933).
Again based upon objective laboratory findings, Hull reported further that females were slightly more hypnotizable than males, children more susceptible than adults, no differences in susceptibility to hypnosis as a function of intelligence, and likewise no relationship between neurosis or psychosis and susceptibility to hypnosis.
The laboratory-based studies of hypnosis were extremely important because they made plain that hypnotic phenomena such as posthypnotic suggestions could be studied objectively and systematically, and the efficacy of hypnosis as a therapeutic strategy could be evaluated empirically. As a consequence of sustained laboratory studies coupled with systematic clinical case studies, there evolved new models and theories to explain hypnotic phenomena and the mechanism(s) responsible for hypnosis.
Hypnosis is now part of mainstream psychology (Kirsch & Lynn, 1995), used by many mental health professionals, and when used in conjunction with cognitive-behavioral and psychodynamic treatments improves substantially their efficacy (Kirsch, Montgomery, & Sapirstein, 1995; Kraft & Rudolfa, 1982). Hypnosis also remains an important research topic (Lynn & Rhue, 1991). Hypnosis is the primary focus of Division 30-Society for Psychological Hypnosis of the American Psychology Association. Division 30 has defined hypnosis as a procedure wherein changes in sensations, perceptions, thoughts, feelings, or behavior are suggested, with this definition embraced by a broad range of practitioners and researchers (Chaves, 1994; Fromm, Hilgard, & Kihlstrom, 1994). It is now well established based upon extensive laboratory and clinical research that hypnosis is not a reflection of weakness or gullibility, not related to sleep. Responsiveness to hypnosis is more dependent upon the efforts and abilities of the person hypnotized than the hypnotist; suggestions are responded to equally with or without hypnosis, hypnosis does not increase the accuracy of memory, and hypnosis does not yield literal reexperiencing of childhood events (Hilgard, 1965, 1975; Kirsch & Lynn, 1995).
Since the earliest demonstrations of hypnotic phenomena the fundamental question still not fully answered is the identification of the mechanism(s) for explaining how hypnotic communication gets translated into behavior. The State or Special Process Model of Hypnosis, dominant during the 1960s, attempted to answer that question by proposing that the hypnotic state is a unique form of consciousness somewhere between wakefulness and sleep (Bowers, 1966; Kirsch & Lynn, 1995, 1998). According to this model, the primary agent in the dyadic hypnotic relationship is the hypnotist who, based upon her or his clinical and persuasive skills, could induce the unique hypnotic state. The failure to find systematic and reliable clarion markers for this unique state of consciousness, such as, for example, true age regression as reflected in age-appropriate physiological or cognitive changes, caused most researchers and clinicians to reject this model.
On the contrary, the Non-State or Social Psychological Model proposes that hypnotic suggestions are translated into behavior when the person being hypnotized engages in two fundamental cognitive processes, namely, (1) sustaining and elaborating upon suggested images, and (2) disregarding other distracting internal and external stimulus intrusions (Barber, 1969; Spanos & Barber, 1974). According to the non-state or social psychological model, hypnotic behaviors are identical to other complex social behaviors arising from ability, expectancy, attribution, and belief (e.g., self-fulfilling prophecies). We turn now to the more recently developed dissociation theories of hypnosis, which have evolved out of and replaced the state and non-state models of hypnosis.
Spanos (1982) introduced the terms special process to replace the state model and social psychological to replace the non-state model of hypnosis. The special process model included dissociation theories of hypnosis according to which hypnotic behavior is qualitatively different from nonhypnotic behavior because it is produced by either a trance or dissociation. The foundational idea that hypnosis and related hypnotic phenomena arise from the dissociation of consciousness into two or more parts can be traced to the earlier work of Charcot (1887/1889) and Janet (Janet, 1889).
Hilgard’s (1986, 1994) neodissociation theory focuses upon the division of consciousness into parts not immediately available to each other, while other dissociation theories focus upon the dissociation or uncoupling of cognitive and behavioral subsystems from executive control (Bowers, 1992; Bowers & Davidson, 1991; Woody & Bowers, 1994). Thus, according to the dissociation of control theory of Bowers and his colleagues, hypnosis uncouples lower-level functions from the integration of the subsystems normally driven by consciousness.
The evidence in support of either Hilgard’s neodissociation theory of the fragmentation of consciousness or Bowers’ and colleagues’ dissociation of control theory that proposes an uncoupling between the executive control system (i.e., alert, monitoring, critical, and analytical form of consciousness) and subsystems such as movement and memory is slim (Dixon & Laurence, 1992). Accordingly, there are still many unanswered questions regarding hypnosis and the mechanism(s) responsible for it (Hilgard, 1975; Kirsch & Lynn, 1995). For example, does hypnosis potentiate other forms of psychotherapy? What are the physiological mechanisms responsible for hypnosis? What changes, if any, occur during hypnotic age regression (Kirsch & Lynn, 1995).
In hypnotic age regression, a participant is instructed to relive an experience that occurred earlier in life, usually involving an adult reliving some earlier childhood event, which in some cases yields dramatic changes in behavior and demeanor. Authentic hypnotic age regression must include three components, namely, ablation (the functional loss, similar to amnesia, of knowledge acquired after the regressed age); reinstatement (the return to prior patterns of perceptual, cognitive, or physiological performances); and revivification (recovery, like hyperamensia, of previously inaccessible memories), with reinstatement having been studied most extensively (Kihlstrom, 1985).
The effects of hypnotic age regression have been studied especially for visual illusions. In some interesting studies, Parrish, Lundy, and Leibowitz (1968, 1969) studied the effects of hypnotic age regression upon the magnitudes of the Ponzo and Poggendorff illusions, which increase and decrease, respectively, as a function of chronological age from childhood to adulthood. These investigators found that when 19-year-old participants were age regressed to nine and five years of age the Ponzo illusion decreased, while the Poggendorff illusion increased in magnitude, respectively. Interestingly, task motivated, non-hypnotized participants were not able to match these performances. Unfortunately, others have been unable to replicate these findings (Asher, Barber, & Spanos, 1972; Perry & Chisholm, 1973).
Nash (1987) reviewed 60 years of hypnotic age-regression research and found no systematic evidence for the reinstatement of psychological or physiological functions during hypnotic age regression. It appears as if a wide variety of affective, cognitive, and perceptual responses of hypnotically age-regressed persons do not resemble those of children and, when they do, waking control subjects do as well on the target measures. What does seem to occur is a shift toward more prelogical modes of thinking so that hypnotic age regression involves more a topographic rather than a temporal shift of thinking, perceiving, and feeling (Nash, 1987).
Recently, Taylor (2000) has argued that the study of hypnosis has played a pivotal role in the establishment of clinical psychology in contrast to the widely received doctrine that Lightner Witmer (1867–1956) established the field at the University of Pennsylvania in 1896. It is indeed the case that Witmer made significant contributions to the development of psychology in the schools, advocated that psychologists and physicians work together, and that he was most interested in the study of mentally defective children (Routh, 1994; Taylor, 2000). It appears as if Witmer did not embrace or practice psychotherapy, or “psychotherapeutics” as it was originally called, at the beginning of the 20th century. Taylor (2000), on the contrary, has suggested that clinical psychology in the United States began, like experimental psychology, within the tradition of the university setting when physiological psychology fused with psychical research to study the paranormal including dissociation and hypnosis. During the period from 1870 to 1890, the physiological and psychological laboratories at Harvard University studied extensively functional rather than organic disorders of the nervous system including comprehensive investigations of hypnotic phenomena. There then developed at Harvard University a graduate specialty called experimental psychopathology, with courses offered by William James, and at Clark University with courses offered by Adolf Meyer, including courses on hypnosis. This period of investigations of hypnosis and other related phenomena is known as the Boston School of Abnormal Psychology, and served as the point of departure for further study of the nature and outcomes of psychotherapy from 1880 to 1920 (Burnham, 1968; Gifford, 1978; Taylor, 2000).
Lipsey and Wilson (1993) provided a meta-analysis of the efficacy of psychological, educational, and behavioral treatments based upon thousands of investigations of reported treatment outcomes. The unequivocal results of this comprehensive study are that well-developed psychological, educational, and behavioral treatments have substantial positive effects on targeted outcome variables. There were 54 studies that used hypnosis exclusively as the treatment intervention, and there was a strong positive effect upon the study outcomes (Edwards, 1991). In short, psychotherapy in general and hypnosis in particular work!
Also, as presented earlier in Chapter 3, and important to review here again in the context of our discussion of hypnosis, there are two fundamental methods to determine if psychotherapy and other psychological interventions work, namely, efficacy and effectiveness studies (Seligman, 1995). In general, the methodology of choice that has served as the gold standard for evaluating the outcomes of psychotherapy has been efficacy studies that contrast some kind of therapy to a comparison group under well-controlled conditions, some of which are outlined in Table 6.1. For example, the results of efficacy studies indicate that cognitive therapy, interpersonal therapy, and medications all provide equally well moderate relief from unipolar depressive disorder; cognitive therapy works very well in panic disorders; and systematic desensitization relieves specific phobias. Unfortunately, efficacy studies are not very realistic because, for example, psychotherapy in the field is not of fixed duration as is the case for efficacy studies. Psychotherapy is self-correcting so if one technique does not work another technique is tried, and clients shop around for the appropriate therapist instead of, as in efficacy studies, being passively and randomly assigned to a predetermined therapy (Seligman, 1995).
Consumer Reports (1995, November) published an article that employed an effectiveness methodology based upon 2,900 returned questionnaires from subscribers who had seen a mental health professional. The findings indicated that clients benefited very substantially from long-term (one year or more) compared to short-term therapy and the combination of psychotherapy and medication was no more effective than psychotherapy alone. Interestingly, no particular modality of psychotherapy (e.g., cognitive, behavioral, and/or dynamic therapies) was better than the other for any reported disorder (Seligman, 1995).
Table 6.1 Features of Efficacy Studies of Psychotherapeutic Interventions
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Source: Adapted from Seligman, M.E.P., The effectiveness of psychotherapy: The Consumer Reports Study. pp. 965-974. Reprinted by permission of Martin E. P. Seligman, PhD.
Like the efficacy method, the effectiveness method has limitations such as relying upon retrospective reports rather than concurrent reports of the effects of therapy. However, the combined results of efficacy and effectiveness studies make unequivocally clear that psychotherapy is a valuable treatment for a variety of psychological and physical disorders.
Despite the clearly established positive benefits of psychotherapy and hypnosis, the limited availability of these treatments (due to costs, time, and health insurance limits) indicates the need to shift from a totally remedial to a prevention strategy for dealing with the many mental health problems that are attributable in large measure to poverty, lack of educational opportunities, crime, and discrimination (Albee, 1970, 1990). According to Albee (2000), the social learning stress-related model of mental disorders seeks first and foremost to reduce poverty, discrimination, exploitation, and prejudices because they are major sources of stress causing emotional problems. Furthermore, Albee (1998, 2000) acknowledges that psychotherapy is effective but too expensive to be profitable for corporate health care organizations. According to Albee (2000) clinical psychology has joined with corporate forces and proponents of the organic/brain defect medical model of stress-induced illnesses that perpetuate social injustices. The real issue is to deal directly with the root causes of stress and mental health problems of the “many” rather than focus primarily upon the “few” who can afford psychotherapy (Albee, 1990, 2000).
We started this chapter with a brief discussion of the ideas of mind, body, and soul. Psychology has focused primarily upon the nature of the relationship between the mind and body, particularly the brain. Baruch Spinoza played a prominent role in the establishment of psychology as an independent science as a result of his views that mind and body are on an equal footing, thoughts and behaviors are determined, and emotions are driven by reason. Gottfried Wilhelm von Leibniz gave us the idea of monads threshold of consciousness and that the mind consists of conscious and unconscious components. Leibniz’s ideas influenced later developments in psychophysics, Freudian psychology, and ultimately our understanding of hypnosis.
Phrenology, a popular 19th-century practice, firmly established in the public’s mind that the mind and brain are related. Although phrenology was based upon shabby science, it promoted the idea that, just as the anatomy of the brain appears lawful, so then the functions of mind may also be lawful.
We then reviewed the work of Franz Anton Mesmer, especially his construct of animal magnetism. Mesmer switched ultimately from using magnets to only his words to induce in his patients a crisis which he believed essential for a cure. The practice of mesmerism or the use of suggestions was employed successfully as an anesthetic by some prominent English physicians. James Braid explained mesmerism as a state induced by fatigue of the elevator muscles of the eye due to prolonged staring at an object coupled with suggestions to relax. He called this sleep-like state hypnosis.
Hypnosis was studied by the Nancy School of hypnosis, which advocated that hypnosis was a natural phenomenon of a sleep-like state somewhere between wakefulness and natural sleep. The Parisian School of hypnosis, led by the world-renowned neurologist Jean-Martin Charcot, believed that hypnosis, like hysteria, was a reflection of an underlying neurological disorder. Systematic laboratory investigations of hypnosis and related psychic phenomena were launched by Hugo Münsterberg at Harvard University in the mid-1890s and continued at Yale University under the direction of Clark Hull up until the 1930s. As a result of systematic laboratory and clinical case studies the state and non-state models of hypnosis were developed. The former model stressed that hypnosis represented a unique state of consciousness somewhere between wakefulness and normal sleep. The non-state model stated that hypnosis was not a unique state of consciousness, but rather arose primarily from cognitive mechanisms of sustaining and elaborating upon suggestions and ignoring intrusive internal and/or external stimuli. Thereafter, dissociation theories of hypnosis, which proposed that hypnosis was either the result of the fragmentation of consciousness or the uncoupling of cognitive and behavioral subsystems from control by the executive or analytical component of consciousness, rose to prominence. We then briefly reviewed the findings of hypnotic age regression that indicate clearly that there is not a return to the functions of a previous age but rather the appearance of pre-logical modes of information analyses and thinking.
We reviewed the contributions of the Boston School of Abnormal Psychology that studied extensively hypnosis and related phenomena from about 1870 to 1890, and is considered by some to be the primary force for the development of clinical psychology. We also presented the extensive results of efficacy and effectiveness studies, which indicate clearly that hypnosis as well as other forms of psychotherapy are sound interventions for a variety of disorders. Lastly, we indicated the importance of promoting prevention programs that focus upon dealing with the stresses and illnesses that arise out of poverty, discrimination, and lack of educational opportunities that challenge many millions of people around the globe.