Definitions

Hypnosis (AAHEA, 2017) A tentative intensional definition

Task force members for hypnosis definition:

Antonio Capafons, Ph.D. (University of Valencia, Spain)*
Guy Montgomery, Ph.D. (The Mount Sinai Hospital, New York, USA)***
Irene Pérez (Private practice, Spain)*
Irving Kirsch, Ph.D. (Harvard Medical School, USA)***
Jorge Balaguer (Private practice, Spain)**
José A. Molina-del-Peral, Ph.D. (Complutense University of Madrid, Spain)*
José Fernández (Private practice, Spain)*
Joseph P. Green, Ph.D. (Ohio State University at Lima, USA)***
Juan Lamas, Ph.D. (University of A Coruña, Spain)*
M. Elena Mendoza, Ph.D. (University of Washington, USA)*
Mª José Serrano, Ph.D. (Open University of Catalonia, Spain)*
Michael Heap, Ph.D. (University of Sheffield, UK)***
Pedro Velasco (Private practice, Spain)*
Pilar Domínguez (University of Valencia, Spain)
Sara Calzado (Private practice, Spain)*

* Member of AAHEA; ** Honorary Member of AAHEA; *** Honor Member of AAHEA.

A tentative intensional¹ definition of hypnosis (AAHEA, 2017)

This definition is based on definitions and ideas of The British Psychological Society (2001), Kihlstrom (1985), Kirsch (1994), Montgomery, Hallquist, Schnur, David, Silverstein, & Bovbjerg (2010), and the theoretical approaches to hypnosis proposed by Gorassini (1989), Hilgard (1965) and Sarbin & Coe (1972), among others.

“Hypnosis” is a social construction. As such, it has various connotations that have evolved over time. The term hypnosis is commonly used to denote a range of social interactions in which the participants enact roles based on various forms of social influence. Therefore, hypnosis implies a process in which there is an explicit or implicit agreement among different people who believe that the situation is hypnotic and that an induction and de-induction (ritual or ceremony) will be used. The induction sets the stage for hypnosis and is often an expected component of the hypnosis procedure. Hypnotized people, then, will enact the roles associated with their conceptions of hypnosis. Currently, the hypnosis social construction denotes an interaction between one person (sometimes more than one), the hypnotist (or hypnotists), and another person (or people). In this interaction, the hypnotist/s attempt/s to influence the other people’s perceptions, feelings, thinking and behavior by asking them to concentrate on ideas and images that may evoke the intended effects. The verbal communications that the hypnotist uses to achieve these effects are termed hypnotic suggestions. Suggestions differ from everyday instructions in that hypnotic suggestions imply that a “successful” response is experienced with a quality of non-volitionality, automaticity, or effortlessness. People may learn to go through hypnotic procedures on their own, and this is termed “self or auto-hypnosis”.

Hypnosis is not only a pool of procedures and ways of managing suggestions, it is also a basic and applied field of research, which will continue to evolve as science advances in obtaining a greater understanding of this social construction known as hypnosis.

Variations in the social construction of hypnosis based on this framework may coexist resulting in different theoretical understandings and concepts for explaining hypnosis, as well as different procedures in its practical applications.

Addendum to the definition of hypnosis

According to scientific research:

1. Hypnotized people remain in control of their behavior, responses, ideas, decisions, etc. In fact, hypnotized people can resist and ignore hypnotic suggestions. They can even give to themselves counter-suggestions. A counter-suggestion is a suggestion given to reduce or eliminate the effects of another suggestion previously received. It can be given by the person who is hypnotizing or by the hypnotized person to him/herself.
2. People who hypnotize others do not have any special powers to override the hypnotized person’s personal control.
3. Hypnosis itself is not dangerous but some misbeliefs about hypnosis can be iatrogenic. For example, the belief that hypnosis enhances memory, which may lead to hypermnesia; the beliefs that hypnosis allows access to the unconscious mind where memories are kept perfectly intact, that hypnosis can help recover past lives and their possible role as causes of current problems, and that hypnosis has the ability of helping the person develop exceptional aptitudes, like telepathy or telekinesis. Moreover, the belief that using hypnosis can cure any kind of problem may lead to additional problems when the client quits other efficacious medical-psychological interventions or does seeks the help by people who do not have the proper qualifications and training to treat the problems, pathologies, etc.
4. There are important differences in people’s ability to respond to hypnotic suggestions. Some people do not respond to almost any of them, while others respond to very difficult suggestions, such as forgetting what happened during the hypnosis session, experiencing source amnesia or cryptomnesia, and, in particular, having positive and negative hallucinations.
5. There are applications of hypnosis in the experimental field, where it can be used as a technique to study other psychological phenomena not related to hypnosis itself (i.e., Stroop effects, synesthesia, etc.).
6. There are different theories of hypnosis, some of them consider hypnosis as a state (whether a trance, an altered state of consciousness or of attention focalization with restriction of peripheral awareness), and others consider it as the result of motivational variables, expectancies, context and social pressure, social control, etc. There are integrative models that take concepts of both approaches as well.
7. There has not been found yet any empirical index of a hypnotic state, whether it be cognitive, behavioral, subjective or physiological. Therefore, this concept is still more a belief than a scientifically proven fact. It is inferred that a person is hypnotized or in a hypnotic state when they respond to hypnotic suggestions and they report that have felt hypnotized. It is always the person who is hypnotized who determines which is what makes them feel hypnotized or not.
8. There are many ways of inducing hypnosis: some of them suggest sleepiness and drowsiness; others suggest relaxation and restriction of the peripheral attention and awareness, but not sleepiness; others use suggestions for alertness, i.e., active-alert inductions (in which the person is asked to do some physical exercise and receives suggestions that their mind is becoming increasingly active, and waking hypnosis in which the person is physically active with their eyes opened and receives suggestions of an expansion of their peripheral field of attention. There are even conversational inductions without a clear ritual of induction.
9. As a procedure, hypnosis works especially well in clinical settings when it is used as an adjuvant treatment, except for some cases of pain for which can be useful used alone.
10. Hypnosis involves many ways of clinical procedures and practical applications in general, as it is indicated in its definition, either when applied as hetero-hypnosis or as self-hypnosis.

Clarification on auto/self-hypnosis: auto-hypnosis can be understood from two perspectives derived from English language: self-hypnosis and auto-hypnosis. The term “self” means one’s own self (http://www.dictionary.com/browse/self), and, according to Coue (1922), all suggestions are a form of auto-suggestion (that is, a suggestion given to a person by him-or herself). Therefore, it has been stated that all hypnosis is a way of auto-hypnosis, because what determines whether a person is hypnotized is the person’s variables, rather than any special power or abilities of the hypnotist. On the other hand, it is also used to describe the process by which a person auto-hypnotizes, that is, s/he applies an induction and de-induction ritual and gives him/herself hypnotic suggestions. In this respect, auto-hypnosis should be understood as auto-hypnosis in English (from auto -“αυτο” in Greek where the word comes from-, that can be translated as “by itself” (see the second meaning of the term: http://dictionary.cambridge.org/dictionary/english/auto), and not as self-hypnosis. In this way, the topography of auto-hypnosis is different than the topography of hetero-hypnosis, but both involve self-hypnosis, since it is the person him/herself who is hypnotized, whether by him/herself (auto) or by another person (hetero).

Clarification on Social Construction: When considering hypnosis as a social construction, it is essential to understand the contribution of the Social Constructionism. One of its most relevant authors, Gergen (1996), posed one of the fundamental assumptions: Reality is socially constructed, and, therefore, what we observe in the world does not define what we know, because the knowledge is determined by the statements socially and historically constructed in a particular cultural setting (Ibáñez, 2003). In this way, the Social constructionism considers that the statements we make about the World are not a reflection or map of the World, but a mechanism of social exchange. They create and give sense to those social phenomena that cannot be defined as absolute and static truths (Henríquez, 2010).

From this approach, reality is established as a consequence of a dialectic process among social relationships, typified habits, and social structures (Berger & Luckmann, 1968). At an individual level, we use symbolic interpretations, internalizing roles, and then our identities are created (and recreated continuously).

Indeed, in order to obtaining a more accurate understanding of this complex process of the reality construction, as well as of the subjective reality, we refer to Bourdieu (2008). This author took back Aristotle’s term habitus to account for the set of generative schemes from which people perceive the world and act on it. The concept habitus is also used by this author, along with the concept of field, to explain how the social practices are constituted by the relationship construed between two ways of existence of what is social. On one hand, “field” will refer to the external social structures: what is social becomes a thing, that is, social positions that have been construed in historical dynamics. In this way, field will be the educational system, the economic field and the political field. On the other hand, habitus will refer to the internalized social structures that have been incorporated in the individuals as schemes of perception, action, and thought (therefore, they have not been the product of thoughts).

The theoretical development of these terms facilitates the understanding and awareness of the continuously transformative nature that characterizes our reality, because, when the interpretations and meanings given to those phenomena and events are personally and socially modified, reality is coming along with those changes.

When we state that hypnosis is a social construction, we mean that it is a process that occurs in the scope of a particular society and that is accepted as natural. Although we know that it is a product of the own culture, of the perceptions, of the interpretations, and of the shared meanings, we have to define it from its constitution in the social interaction: as a product of a social and cultural historical construction that is in permanent change and resignification.

One of the implications that will derive from this conception is that its transformative character will vary according to the changes that take place at the level of institutions, beliefs, and meanings in the particular cultural settings. If we take back the terms that Bourdieu (2008) used to explain his theoretical approach (habitus and field), we can easily understand that in the social phenomenon of hypnosis, individuals have to internalize the necessary roles, schemes, and meanings, so that the process of hypnosis can take place.

Therefore, it is of great relevance the constitution of the subjective reality and the complementarity character of the roles, schemes and habitus of the individuals that make possible the process of hypnosis. In this definition of hypnosis, the concept of role is not explanatory, but descriptive. In the hypnotic process a role is activated (which may be different according to the construction of the hypnosis that both the hypnotized person and the person who hypnotizes have), but this does not indicate that the role is the determinant factor of the hypnotic behavior. It is a concept merely descriptive that is inherent to the concept of social construction.
 

References

• Berger, P., & Luckmann, T. (1968). La construcción social de la realidad [Social reality construction]. Buenos Aires, Arg: Amorrortu.
• Bourdieu, P. (2008). El sentido práctico [The practical sense]. Madrid, Esp: Siglo XXI Editores.
• British Psychological Society (2001). The nature of hypnosis. Leicester, UK): British Psychological Society. Retrieved 12-02-2017, http://ukhypnos.wpengine.netdna-cdn.com/wp-content/uploads/2015/01/The-Nature-of-Hypnosis_0.pdf
• Coué, E. (1922/1956). La maitrise de soi-même par l’autosuggestion consciente [Self mastery through conscious autosuggestion]. Paris, FR: Éditions J. Oliven.
• Gergen, K. J. (1985). The social constructionist movement in modern psychology. American Psychologist, 40(3), 266.
• Gorassini, D.R. (1999). Hypnotic responding: A cognitive-behavioral analysis of self-deception. In I. Kirsch, A. Capafons, E. Cardeña & S. Amigó (Eds.), Clinical hypnosis and self-regulation: Cognitive-behavioral perspectives (pp. 73-103). Washington, D.C.: American Psychological Association.
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• Kirsch, I. (1994). Defining hypnosis for the public. Contemporary Hypnosis, 11(3), 142-143.
• Montgomery, G. H., Hallquist, M. N., Schnur, J. B., David, D., Silverstein, J. H., & Bovbjerg, D. H. (2010). Mediators of a brief hypnosis intervention to control side effects in breast surgery patients: Response expectancies and emotional distress. Journal of Consulting and Clinical Psychology, 78(1), 80-88. DOI 10.1037/a0017392
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