psychology

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Understanding the subjective experience of individuals under hypnosis

Hypnosis researchers continuing struggle for scientific recognition have always been concerned about methodological techniques. Sutcliffe (1958, 1960) argued that the fundamental difficulty in convincing people about the genuineness of hypnotic effects is that hypnosis is essentially a private experience. Thus, ‘hypnosis has always been faced with challenge of scientifically quantifying internal, subjective experiences’ (Nash and Barnier, 2008).

Assessing the experience of hypnosis has been of theoretical and practical interest throughout the history of the phenomenon (Hull, 1933; Hilgard, 1987). Three major theoretical frameworks used for hypnosis research are: Social Cognitive Theories, Neo dissociation theory and Interactive-Phenomenological theories- ‘focus on the interaction of numerous variables under hypnosis, and this depends upon the perception of the subjects and what the subjects make of their experiences’. The literature on phenomenology and hypnosis is rather recent given its origins in the 1940s with Snygg’s perceptual psychology (1941). Thus, phenomenological approach to research in hypnosis is more recent than its beginnings with Mesmer in 1766 and the history of phenomenology that dates back to Husserl and Hiedegger.

Hypnotic Experience:

According to Orne, the ‘essence’ of hypnosis lies in the subjective experience of the hypnotized individual. Participants vary greatly in their experiences during hypnosis (Hilgard 1965, Freundlich 1974).

The internal, private experiences of a hypnotized individual are also crucial along with examining their behavioural responses to hypnotic suggestions for developing a comprehensive understanding of hypnosis (Sutchiff, 1958, 1960, 1961; Hilgard, 1969, 1971, 1973; Shor, 197, 1979; Orne, 1972; Spanos and Barber, 1974). ‘Two individuals who have the same scores on a hypnotizability scale and display similar behavioural responses to hypnotic suggestions may have markedly different phenomenological experiences’ (Nash and Barnier, 2008).

Hypnotizability Scale:

The existing hypnotizability scale allows us to categorize people into high, medium and low hypnotizability based on the behavioural response, it does not provide information about the nature of subjective experience, which has lead to development of various ways of measuring and tracking the experience of hypnosis (Sheehan and McConkey, 1982; McConkey, 1991).

Many early measures of hypnotizability scale investigated the depth of hypnotic experience of individuals (for example: Harvard Continuous Scale, Cheek, 1959; Orne and Evans, 1966; Field inventory of Hypnotic depth, field, 1965; Hilgard and Tart, 1966) although majority of the scales measure behavioural response. The effects of hypnosis can be analyzed not just by measuring behavioural response but also by examining the subjective experience of the individuals. ‘Typically there is a strong concordance between behavioural and experiential measures, but experiential measures provide additional information that cannot be obtained through behavioural measures alone.

Sheehan and McConkey’s Experiential Analysis Technique:

Recognizing the significance of phenomenological features of hypnosis and the fundamental role of cognitive strategies in responding to hypnotic suggestions, Sheehan and McConkey (1982) developed the Experiential Analysis Technique (EAT). The EAT was motivated by an inter actionist perspective of hypnosis, where the hypnotic subject is considered to be a dynamic individual who brings certain skills, abilities and expectancies into hypnotic context. In the EAT, the hypnosis session is videotaped and, afterwards, the participant and a second, independent experimenter watch the videotape. The EAT is a useful technique for exploring participants’ interpretation of suggestions, any strategies that they employed and their experience of the suggested effects. Additionally, the EAT provides information on affect, imagery, intensity and levels of control associated with hypnotic responding (Barnier and McConkey, 2004). As the researcher cannot question the participant during hypnosis session. The cues afforded in the videotape of the hypnosis session remind participants about their responses and their associated subjective experiences.

One of the first studies using the EAT illustrates the different subjective experiences of a number of hypnotic participants whose behaviour responding was similar (Laurence and Perry, 1981). The findings of the EAT in general, suggested that there is diversity in how highly hypnotizable individuals approach, experience and response to hypnotic suggestions. These differences, revealed by EAT; suggest that in-depth analysis of subjective experience can help to reveal component processes in hypnotic responding. The EAT has been evaluated and extended by many researchers to explore several hypnotic phenomena, for example Sheehan et al., 1978; Laurence and Perry, 1981; Bryant and McConkey, 1989; Banyai, 1991; West and Fellows, 1996; Barnier and McConkey, 1999, 2004; Bryant and Mallard, 2002.

Field (1965) developed a finger signaling method and asked subjects to move their hand when hypnotic depth increased. Evans and Orne (1965) asked subjects to move the hands of the clock with the numbers 1 (normal and alert) to 10 (‘as deeply hypnotized as any person to become’). Both these studies focused on assessing the subjective experience through depth ratings and examine the concordance of experience with behaviour.

In 1999 McConkey used a’ dial’ method to track the strength of the ongoing hypnotic experience across types of items (direct motor, motor challenge, perceptual-cognitive) and the time course of items (i.e. suggestions or onset phase, test phase and offset or cancellation phase). Subjects (high, medium, and low hypnotizable) were asked to turn a dial to indicate a change in the strength of their subjective experience. The dial was connected to a computer that recorded the position of the pointer (i.e. rating of experience) every second across the three phases of each item. This study revealed that highly hypnotizable individuals showed enhanced positive experience during test phase and encouraged the intensity of their subjective involvement.

Mc Conkey and Barnier (2004) presented a brief summary of the performance patterns of highly hypnotizable individuals in responses to diverse suggestions during hypnosis. Pattern of their ratings suggested that subjects who passed according to the behavioral criteria experienced the suggested effects to a greater degree. Ratings of highs and mediums did not differ, whereas they differed from lows on all three items (Mc Conkey, Wende and Barnier 1999). In other words, the findings indicated that the experience of subjects changed across the phases which were different for different type of subjects and for different types of item.

‘There is currently an agreement that, in addition to the changes in external behaviour, suggestions presented in a hypnotic context may give rise to changes in subjective experience. Yet, there is no general agreement about the theoretical framework within which these changes in experience should be explained’ (Kallio and Revonsuo 2003).

The EAT and dial method highlight the value of supplementing the behavioural indicators of hypnotizability scales with subjective indicators. However, the EAT is best suited for a detailed investigation of selected subjects as it would require more time and personnel. On the other hand, the dial method is simple and can be used with any subject; however it requires subjects to assign a single number to their complex subjective experience of hypnosis.

Hypnosis phenomenology:

Rainville and Price (2003) described a model of conscious phenomenology that demonstrates the experiential characteristics of hypnosis. ‘Consistent with Barabasz et al. (1999) who showed that ERPs markers ‘… reflect alterations in consciousness that correspond to participants’ subjective experiences of perceptual alteration’ (p.18), Rainville and Price’s model of consciousness shows that the experiential dimensions of relaxation, absorption (focused attention), orientation and self-monitoring reflect basic phenomenal properties of consciousness’ (Barabasz & Barabasz, p.341). In other words, the study points out that these changes in experiential dimensions of individuals are associated with changes in their brain activity produced by hypnosis. The present study focuses on identifying the commonalities and differences of subjective experience of individuals in relation to hypnotizability.

Perceptual Psychology:

Perceptual Psychology is a phenomenological-humanistic orientation first conceptualized by Snygg and Combs in 1949. Perceptual Psychology was described as an approach to human science that postulated satisfying needs and focusing on behaviour or being essentially created by perceptual awareness and personal meanings. A number of perceptual psychological principles necessary to gain an understanding of the essence of the hypnotic experience are discussed by Combs, et al. (1976/1988) Perception was defined by them as “… any differentiation a person is capable of making in his phenomenal field whether or not an objectively observable stimulus is present”. Perceptual Psychology utilizes theoretical assumptions such as the need to maintain and maximize one’s potential from a perceptual frame of reference to examine human experience. This perceptual theory was the first step and foundation in moving toward a phenomenological research approach to hypnosis. Criticism to this approach is that there is limited research that suggests this theoretical approach’s contribution to understanding hypnotic experience. Therefore, investigations using this approach to explore the hypnotic subjective experience of hypnotizable will contribute towards theory developed.

Woodard’s theory of perceptual hypnosis (1996, 2003) depicted hypnotic phenomena as dependent on one’s personal meanings. In 2004 gave a new qualitative approach to researching hypnotic experiencing by combining aspects of phenomenological research as in work of Giorgi, Moustakas, and Wertz, familiarity with Husserl’s philosophy, and a perceptual psychological research method to formulate the theory of Perceptually Oriented Hypnosis. The author suggests that this methodology enables therapist, clients to share benefits from the effects of their hypnotic experiencing in it’s inter subjective sense.

The present study is based on McConkey et al., (1999) and Woodard’s Phenomenological and Perceptual research methodology for understanding hypnotic experiencing. In this study participants experience is qualitatively analyzed using phenomenological approach on three different hypnotic items; arm levitation (ideomotor item), arm rigidity (challenge item) and anosmia (Loss of sense of smell to specific odor -a perceptual-cognitive item) across three different phases that is suggestion phase, test phase and cancellation of test phase. The experiential similarities and dissimilarities between high, medium and low hypnotizable individuals on arm levitation, arm rigidity and anosmia items will be analyzed through phenomenological approach.

This proposal for a qualitative study of the subjective experience of individuals under hypnosis is an attempt to understand hypnotizable individuals (highs, mediums and lows) to know how individuals experience the given suggestion and influence them to behave or respond in a certain way. The proposed study emerges from the noticeable lack of detail in the literature with regard to the experience of the person under hypnosis.

As Nash and Barnier (2008) suggest that more qualitative research on the experience of hypnosis is necessary ‘to expect and explicate subjective experiencing and enhance exploration of individual difference that cannot be captured in artificially controlled environment’. Main aim of this study is to understand the structure of hypnotic experience of high, medium and low hypnotizable and to examine if the subtle difference in their subjective experience results in difference in their hypnotic response. This will facilitate development of subjective indicators to scales that measure hypnotizability.

Research design and Methods:

Needing a suitable explorative research design to explore the pattern of subjective experience of hypnotizable individuals under hypnosis, I chose phenomenology. Vandenberg (1997) considers Husserl (1859-1938) as “the fountainhead of phenomenology in the twentieth century, although the phenomenology origins can be traced back to Kant and Hegel.

Groenewald (2004) points out that ‘to arrive at certainty, anything outside immediate experience must be ignored, and in this way the external world is reduced to the contents of personal consciousness. Realities are thus treated as pure ‘phenomena’ and the only absolute data from where to begin’. The aim of phenomenology is the return to the concrete, captured by the slogan ‘Back to the things themselves!’ (Eagleton, 1983, p56; Kruger, 1988, p.28; Moustakas, 1994, p.26). However only in the 1970s phenomenological psychologist established a praxis, which is a methodological realization of the phenomenological philosophical attitude (Stones, 1988) which was not developed earlier.

Smith defines the discipline of phenomenology initially as the study of structures of experience, or consciousness. ‘Literally, phenomenology is the study of “phenomena”: appearances of things, or things as they appear in our experience, or the ways we experience things, thus the meanings things have in our experience’ (Smith, 2008).

The purpose of the present study is to gather data regarding the perspectives of research participants about the phenomenon of their experience under hypnosis to suggestions, test and cancellation of test phases. I chose phenomenological approach as it is best suitable to explore the pattern of subjective experience of hypnotizable individuals.

Participants:

A large group of college students will be administered the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS: A). Ten highly hypnotizable (highs), ten medium hypnotizable (mediums) and ten low hypnotizable (lows) college students will be selected from this large group. Longitudinal studies indicate that hypnotizability assessed in college students remains about as stable as IQ over a period of 25 years (Piccione et al., 1989). Because Boyd (2001) regards two to 10 participants or research subjects as sufficient to reach saturation and Creswell (1998, pp.65 113) recommends “long interviews with up to 10 people” for a phenomenological study.

Procedure:

30 participants selected based on hypnotizability after administering Harvard Group Scale of Hypnotic Susceptibility will be individually presented with a taped standardized hypnotic induction procedure followed by suggestion, test and cancellation of test on three hypnotic items: arm levitation (direct motor), arm rigidity (motor challenge) and anosmia (perceptual-cognitive).

After the hypnotic session, participants will be asked to write in an essay form their experiences. Then, participants will be subjected to in-depth interview within 2 weeks of their written description of hypnotic experience with the researcher.

Hypnotic Scale:

Hypnotizability scale adapted for this study is Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS: A) by Ronald E. Shore and Emily Carota Orne (1962). This scale is an adaptation for group administration with self report scoring of the original, individually administered and objectively scored Stanford Hypnotic Susceptibility Scale, Form A (Weitzenhoffer & Hilgard, 1959). This revised version can be administered to groups of unlimited size.

Data gathering methods

Acoording to Giorgi, the operative word in phenomenological research is ‘describe’. One of the methods practiced by classical phenomenologist is to describe a type of experience just as we find it in our own (past) experience. Thus, Husserl and Merleau-Ponty spoke of pure description of lived experience. Subsequent to this, the participants of the present study will be first requested to describe their experience of hypnotic session in their own words in a written essay form (they will be told not to worry about the grammar, writing style).

After which, unstructured in-depth individual interviews will be conducted with all 30 participants’. The individual description of the internal experience of the participants being hypnotized during hypnotic experiencing is the phenomenon for investigation through letting the participant guide the interview and further clarification on any vague or incomplete statements made by the participant’s initial description of the hypnotic experience will be explored. Non leading questions of unstructured in-depth interview will focus on subjective experience of participants’ with respect to thoughts, feelings, images, sensory experience and any others experiences of the participants at all three phases- suggestion, test and cancellation of test for three different task of arm levitation, arm rigidity and anosmia. All interviews will be audio recorded with the permission of the interviewee. This will further be transcribed and analyzed. Then try to make sense of the meaning of their experience by coding it, then categorizing according to major themes. However at the core of phenomenology, “the intent is to understand the phenomena in their own terms- to provide a description of human experience as it is experienced by the person herself” (Bentz & Shapiro, 1998, p.96) and allowing the essence to emerge (Cameron, Schaffer & Hyeon-Ae, 2001).

Memoing (Miles & Huberman, 1984, p.69) is another important source of data in the present qualitative research. It is a reflective process based on what the researcher sees, hears, experiences, and thinks in the course of collecting the data. ‘Miles and Huberman (1984) emphasize that memos (or filed Notes) must be dated so that the researcher can later correlate them with the data’ (Groenewald, 2004). It is essentially important in a qualitative research for the researchers to be reflexive as one may easily be absorbed in the data collection process and fail to reflect on what is happening.

Three data gathering methods adopted for the current study are audio recordings of unstructured in-depth phenomenological interview, documentation of written essay from participants and memoing. Interviews will be audio recorded and transcribed verbatim, which are analyzed in detail to elicit key themes, with the focus shifting back and forth from the key claims of the participant (both in interview and their written essay), to the researcher’s interpretation of the meaning (memoing) of those claims.

Explication of the data:

According to Hycner (1999) “The term analysis means ‘breaking into parts’ and therefore often means a loss of the whole phenomenon… [whereas ‘explicitation’ implies an]…investigating of the constituents of a phenomenon while keeping the context of the whole”, p.161). Hycner’s explicitation process will be followed here. The five step process is:

Bracketing and phenomenological reduction:

Giorgi (1989) elucidated the meaning of phenomenological reduction as “It means to describe what is present without making the existential claim [that] that is the way it is present. The phenomenological reduction primarily refers to the withholding of the existential claim” (as cited by Groenewald, 2004) Therefore, not reducing the phenomena to cause and effect but to develop a holistic sense of the phenomena. ‘Bracketing out’ means not letting the researcher’s presuppositions, their own meaning and interpretation or theoretical concepts interfere with the participant’s experience of the phenomena (Creswell, 1998; Moustakas, 1994; Sadala & Adorno, 2001). In other words, it refers to bracketing out the researchers preconceptions or personal views from influencing the participant’s description of the hypnotic situation.

Delineating units of meaning:

This is a crucial stage of explicitation of data. The researcher rereads the transcript through several times to get a sense of each participant’s experience as a whole. ‘A meaning unit is a unit of expression that creates meaning’ (Woodard, 2004). Units of meanings are carefully extracted from the written description and interview, and then look at the meaning units separately and as a whole. This will be based on the literal content and number of times a meaning was mentioned and how it was used.

Clustering of units of meaning to form themes:

The meaning units are looked at in relationship to how the participants experienced each of the meaning units. Units of meanings of the same themes are placed together to form and determine central themes. In this manner, the researcher moves toward the psychological meaning of each participant’s experience of hypnosis (to the scientific discourse supporting the research).

Summarizing each interview, validate and modify:

To obtain a holistic understanding, it is necessary to summarize each interview incorporating the themes elicited. At this phase, the participants will be requested to validate the essence of the interview captured and accordingly necessary modification will be done (Hycner, 1999). This is a form of validity check.

Extracting general and unique themes from all the interviews and making a composite summary:

Following the above four steps, commonalities and differences of themes as experienced by participants (high, medium, low hypnotizable) will be outlined. The explicitation process will be concluded by writing a composite summary, which will reflect the context from which the themes emerged (Hyncer, 1999; Moustakas, 1994).

Woodard (2003) states that ‘the general structure is a cumulating of common meaning shared by many individuals’ descriptions of a phenomenon as we are all fundamentally the same in essence, when we tap our core being”. In this study a general structure of the hypnotic experience of hypnotizable individuals (high, medium and low) will be drawn to identify the commonalities and differences in their experience to suggestion, test and cancellation of test on arm levitation, arm rigidity and anosmia.

The use of software packages such as ATLAS, NUD*IST, The ethnographer do not help with phenomenology as the understanding of the meaning of phenomena “cannot be computerized because it is not an algorithmic process” (Kelle, 1995, p.3)

Validation technique

Internal coherence and presentation of evidence are two important criteria to assess the reliability and validity of qualitative research (Smith, 1996). Therefore, in order to satisfy these conditions each theme will be supported by original discourse from participants.

Validity is assessed through other researchers seeing what the researcher sees, in reflecting on the meaning and process that led to the general psychological structures, by allowing the scientific community to scrutinize the research study.

Analyzing qualitative data uncovers new meaning from the interview data by taking a different view of the same data by others. However, validity means, if they were to take the same stance as the researcher, then they could see what he perceived. As pointed out by Woodard (2004) ‘phenomenological research methodology seeks to understand knowledge of the lived experience or person-in-situation and does not seek to control beahviour or situations nor judge or label unique aspects of one’s experience’.

Significance of the study

‘When investigating non hypnotic patterns of response in highly hypnotizable subjects, it is necessary to identify patterns of hypnotic performances among highs which may help us investigate non hypnotic ones’ (Nash and Barnier, 2008). Thus, underlying the pattern of experience and performance of hypnotizable individuals under hypnosis will help us in comparing and understanding their response to suggestion in a non hypnotic context.

‘Individuals differ in the degree to which they respond to hypnotic suggestions because of this the measurement of individual differences in hypnotic responsivity is central to the field’ (Heap, Brown and Oakley, 2004). This study will contribute towards developing measures to assess the specific response profiles of individuals (Highs, medium and lows) to particular hypnotic suggestions, one such measure is the Stanford Profile Scale of hypnotic suggestibility, Form I and Form II. By understanding the subjective experience of hypnotizable individuals it will add to theoretical understanding of hypnotic response and hypnotizability.

Therefore, analyzing the subjective experiences of hypnotizable participants from the present study can serve as subjective indicators of hypnotizable individuals (high, medium and low) along with beahvioural response criteria on hypnotizability scale.

Ethical issues:

Informed consent agreement will be given to all participants of the research. (Holloway,1997; Kavle, 1996). Based on Bailey’s (1996.p.11) recommended items, the present study will take in a specific informed consent’ agreement’, which includes:

‘That they are participating in research,

The purpose of the research

The procedures of the research

The voluntary nature of research participation

The subject’s (informant’s) right to stop the research at any time

The procedures used to protect confidentiality (Arksey & Knight, 1999; Bless & Higson Smith, 2000; Kvale , 1996, Street, 1998)’ (Groenewald, 2004)

Participants will be given written information about the study and asked to sign a consent form before the study begins.

Queries regarding the hypnotic phenomenon will be clarified. Misconception such as the hypnotist is in control or any other fears will be clearly addressed.

Normally in practice, post hypnotic suggestion is given for therapeutic purpose. This is intentionally removed or in other words no post hypnotic suggestions will be given for participants of this study.

Confidentially of participants’ identity will be maintained by assuring the participants that personal information will not be released.

Timeline:

Tabular Research Activity Timeline (RAT) for 3 years

Year 1

Year 2

Year 3

Aim

0-6 months

6-12 months

0-6 months

6-12 months

0-6 months

6-12 months

Research Proposal

*

Literature Review

*

Draft

Review

Review

Rewrite

Methods Chapter

Draft

Rewrite

Collection of Data

*

*

Analysis of Data

*

*

Writing up Analysis

*

*

*

Conclusion

*

Introduction

*

Editing

*

Budget:

Consumable:

Stationary items such as cds, writing note pads, pens, print outs- Rs.10, 000

Books, Journals, Travel, phone calls, internet charges – Rs 30, 000

Non Consumable:

Reclining chair for the purposes of hypnosis – Rs 20,000

Renting out a room with table, chair, cupboard – Rs 50,000

Equipment (computer, and audio recorder) as well as transcription - Rs 50,000 – 70,000

Total: Approximately Rs 1,50,000 – Rs 2,00,000


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