Discrete response patterns in the upper range of hypnotic suggestibility: A latent profile analysis

How hypnotic suggestions work - A systematic review of prominent theories of hypnosis

In recent decades, hypnosis has increasingly moved into the mainstream of scientific inquiry. Hypnotic suggestions are frequently implemented in behavioral, neurocognitive, and clinical investigations and interventions. Despite abundant reports about the effectiveness of suggestions in altering behavior, perception, cognition, and agency, no consensus exists regarding the mechanisms driving these changes. This article reviews competing theoretical accounts that address the genesis of subjective, behavioral, and neurophysiological responses to hypnotic suggestions. We systematically analyze the broad landscape of hypnosis theories that best represent our estimation of the current status and future avenues of scientific thinking. We start with procedural descriptions of hypnosis, suggestions, and hypnotizability, followed by a comparative analysis of systematically selected theories. Considering that prominent theoretical perspectives emphasize different aspects of hypnosis, our review reveals that each perspective possesses salient strengths, limitations, and heuristic values. We highlight the necessity of revisiting extant theories and formulating novel evidence-based accounts of hypnosis.

Cognitive simulation along with neural adaptation explain effects of suggestions: a novel theoretical framework

Hypnosis is an effective intervention with proven efficacy that is employed in clinical settings and for investigating various cognitive processes. Despite their practical success, no consensus exists regarding the mechanisms underlying well-established hypnotic phenomena. Here, we suggest a new framework called the Simulation-Adaptation Theory of Hypnosis (SATH). SATH expands the predictive coding framework by focusing on (a) redundancy elimination in generative models using intrinsically generated prediction errors, (b) adaptation due to amplified or prolonged neural activity, and (c) using internally generated predictions as a venue for learning new associations. The core of our treatise is that simulating proprioceptive, interoceptive, and exteroceptive signals, along with the top-down attenuation of the precision of sensory prediction errors due to neural adaptation, can explain objective and subjective hypnotic phenomena. Based on these postulations, we offer mechanistic explanations for critical categories of direct verbal suggestions, including (1) direct-ideomotor, (2) challenge-ideomotor, (3) perceptual, and (4) cognitive suggestions. Notably, we argue that besides explaining objective responses, SATH accounts for the subjective effects of suggestions, i.e., the change in the sense of agency and reality. Finally, we discuss individual differences in hypnotizability and how SATH accommodates them. We believe that SATH is exhaustive and parsimonious in its scope, can explain a wide range of hypnotic phenomena without contradiction, and provides a host of testable predictions for future research.

Post-hypnotic suggestion improves confidence and speed of memory access with long-lasting effects

In our study, we use the post-hypnotic suggestion of easy remembering to improve memory with long-lasting effects. We tested 24 highly suggestible participants in an online study. Participants learned word lists and recalled them later in a recognition memory task. At the beginning of the study, participants were hypnotized and the post-hypnotic suggestion to remember easily was associated with a cue that participants used during the recognition memory task. In a control condition, the same participants used a neutral cue. One week later, participants repeated both conditions with new word lists. Participants were significantly faster and more confident in their recognition ratings in the easy-remembering condition compared to the control condition, and this effect persisted over one week. Crucially, the increased speed and confidence in the easy-remembering condition did not affect memory accuracy. That makes our hypnosis intervention promising for patients experiencing subjective memory impairments. APA PSYCINFO CODES: 2343 (Learning and Memory), 2380 (Consciousness States), 3351 (Clinical Hypnosis).

The relationship between transliminality, hypnotic and imaginative suggestibility, and other personality traits

To our knowledge, no study has directly examined the link between hypnotic response and the personality trait of transliminality (which is underpinned, for example, by magical ideation, mystical experience, fantasy proneness, absorption, hyperaesthesia). In order to further understand the correlates of suggestibility, the aim of the current project was to investigate whether transliminality is associated with hypnotic and imaginative suggestibility (considering: objective response, subjective response and involuntariness). Another aim was to assess the contribution of transliminality as a predictor of suggestibility when a range of previously studied personality trait measures were considered. Participants completed: the Revised Transliminality Scale, Tellegen Absorption Scale, Creative Experiences Questionnaire, and the Dissociative Experiences Scale II. To avoid context effects, where knowledge or measurement of one trait or ability might influence measurement of another, a separate standalone study was conducted where hypnotic and imaginative (without hypnosis) suggestibility screenings were carried out in-person in small groups using the modified Carleton University Responsiveness to Suggestion Scale. The merging of these two datasets enabled the analyses. Transliminality was weakly correlated with the imaginative suggestibility subjective response measure (r = 0.19). Likewise, weak correlations were found between transliminality and the hypnotic suggestibility response measures (objective, r = 0.21, subjective, r = 0.23, involuntariness, r = 0.24). The multiple regressions (forward selection) reflected the pattern of correlations, with no model for any of the variables, retaining more than a single significant predictor. In summary, this study combination, avoiding context effects, shows transliminality to be a weak predictor of response to suggestion.

Redefining hypnosis: A narrative review of theories to move towards an integrative model

Hypnosis is an ancient mind-body intervention that has regained interest with the surge of research in the last decade documenting its clinical validity. Yet, theoretical controversies and misconceptions prevail among theorists, clinicians, and the general public, impeding the understanding, acceptance, replication, and use of hypnosis. Providing adequate information, which dispels misconceptions and promotes more balanced views, is warranted to facilitate the implementation and adoption of hypnosis in clinical and research settings. This review re-examines the conceptualisation of hypnosis throughout history and the theoretical controversies surrounding it while highlighting their meeting points and clinical implications. Despite dichotomies, a broad agreement appears across theoretical approaches regarding hypnotic analgesia effects, key components, and vocabulary. Further, theories highlight key factors of hypnotic responding. For instance, social theories highlight social and contextual variables, whereas state theories highlight biopsychosocial mechanisms and individual factors. Based on theories, the terms hypnotherapy or clinical hypnosis are recommended to refer to the therapeutic use of hypnosis in psychotherapeutic and medical contexts, respectively. This review concludes with a model that integrates various theories and evidence and presents hypnosis as a complex multifaceted intervention encompassing multiple procedures, phenomena, and influencing factors. This review intends to deepen our understanding of hypnosis, and promote its more rapid adoption and adequate implementation in research and clinical contexts, in addition to steering research towards evidence-based hypnotic practice. The review can have important research and clinical implications by contributing to advancing knowledge regarding hypnotic procedures, phenomena, and influencing factors.

Brain Functional Correlates of Resting Hypnosis and Hypnotizability: A Review

This comprehensive review delves into the cognitive neuroscience of hypnosis and variations in hypnotizability by examining research employing functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and electroencephalography (EEG) methods. Key focus areas include functional brain imaging correlations in hypnosis, EEG band oscillations as indicators of hypnotic states, alterations in EEG functional connectivity during hypnosis and wakefulness, drawing critical conclusions, and suggesting future research directions. The reviewed functional connectivity findings support the notion that disruptions in the available integration between different components of the executive control network during hypnosis may correspond to altered subjective appraisals of the agency during the hypnotic response, as per dissociated and cold control theories of hypnosis. A promising exploration avenue involves investigating how frontal lobes' neurochemical and aperiodic components of the EEG activity at waking-rest are linked to individual differences in hypnotizability. Future studies investigating the effects of hypnosis on brain function should prioritize examining distinctive activation patterns across various neural networks.

Hypnotizability in the Clinic, Viewed from the Laboratory

A recent international survey discovered that clinicians who use hypnosis in their practice rarely assess the hypnotizability of their patients or clients. This contrasts sharply with the practice in laboratory research. One reason offered for this discrepancy is that hypnotizability does not strongly predict clinical outcome. But a comparison of this relationship with similar correlations in other domains shows that this criticism is misleading-especially when the treatment capitalizes on the alterations in perception, memory, and voluntary control that characterize the domain of hypnosis. Routine assessment of hypnotizability improves clinical practice by enabling clinicians to select patients for whom hypnosis is appropriate; and it improves clinical research by providing important information about the mechanisms underlying hypnotic effects.

Point-of-Care Testing of Enzyme Polymorphisms for Predicting Hypnotizability and Postoperative Pain

Hypnotizability is a stable trait that moderates the benefit of hypnosis for treating pain, but limited availability of hypnotizability testing deters widespread use of hypnosis. Inexpensive genotyping of four single-nucleotide polymorphisms in the catechol-o-methyltransferase (COMT) gene was performed using giant magnetoresistive biosensors to determine if hypnotizable individuals can be identified for targeted hypnosis referrals. For individuals with the proposed optimal COMT diplotypes, 89.5% score highly on the Hypnotic Induction Profile (odds ratio, 6.12; 95% CI, 1.26-28.75), which identified 40.5% of the treatable population. Mean hypnotizability scores of the optimal group were significantly higher than the total population (P = 0.015; effect size = 0.60), an effect that was present in women (P = 0.0015; effect size = 0.83), but not in men (P = 0.28). In an exploratory cohort, optimal individuals also reported significantly higher postoperative pain scores (P = 0.00030; effect size = 1.93), indicating a greater need for treatment.

Modulation of attentional bias by hypnotic suggestion: experimental evidence from an emotional Stroop task

Hypnosis is considered a unique tool capable of modulating cognitive processes. The extent to which hypnotic suggestions intervenes is still under debate. This study was designed to provide a new insight into this issue, by focusing on an unintentional emotional process: attentional bias. In Experiment 1, highly suggestible participants performed three sessions of an emotional Stroop task where hypnotic suggestions aiming to increase and decrease emotional reactivity towards emotional stimuli were administered within an intra-individual design. Compared to a baseline condition (without hypnotic suggestion), a significant increase in attentional bias was found when a hypnotic suggestion to increase emotional reactivity was administered. In contrast, the bias was eliminated when a suggestion to decrease emotional reactivity was administered. Experiment 2 investigated the effect of session repetition on attentional bias across three successive experimental sessions without hypnosis, and showed that the emotional Stroop effect did not vary across sessions. Hence, session repetition could not account for part of the modulation of attentional bias in Experiment 1. Taken together, the results suggest that specific hypnotic suggestions can influence elicitation of unintentional emotional processing. The implications are discussed regarding the locus of intervention of hypnotic suggestion in cognitive and emotional processes.

Direct Verbal Suggestibility as a Predictor of Placebo Hypoalgesia Responsiveness

OBJECTIVE

Reliably identifying good placebo responders has pronounced implications for basic research on, and clinical applications of, the placebo response. Multiple studies point to direct verbal suggestibility as a potentially valuable predictor of individual differences in placebo responsiveness, but previous research has produced conflicting results on this association.

METHODS

In two double-blind studies, we examined whether behavioral direct verbal suggestibility measures involving a correction for compliance would be associated with individual differences in responsiveness to conditioned and unconditioned placebo hypoalgesia using an established placebo analgesia paradigm. In study 1 (n = 57; mean [standard deviation] age = 23.7 [8.1] years; 77% women), we used behavioral hypnotic suggestibility as a predictor of placebo hypoalgesia induced through conditioning and verbal suggestion, whereas in study 2 (n = 78; mean [standard deviation] = 26.1 [7.4] years; 65% women), we measured nonhypnotic suggestibility and placebo hypoalgesia induced through verbal suggestion without conditioning.

RESULTS

In study 1, the placebo hypoalgesia procedure yielded a moderate placebo response (g = 0.63 [95% confidence interval = 0.32 to 0.97]), but the response magnitude did not significantly correlate with hypnotic suggestibility (rs = 0.11 [-0.17 to 0.37]). In study 2, the placebo procedure did not yield a significant placebo response across the full sample (g = 0.11 [-0.11 to 0.33]), but the magnitude of individual placebo responsiveness significantly correlated with nonhypnotic suggestibility (rs = 0.27 [0.03 to 0.48]).

CONCLUSIONS

These results suggest that the extent to which direct verbal suggestibility captures variability in placebo responsiveness depends on the use of conditioning and highlights the utility of suggestibility as a potential contributing factor to placebo responding when placebo hypoalgesia is induced through verbal suggestions.

No evidence for theta power as a marker of hypnotic state in highly hypnotizable subjects

EEG spectral-power density was analyzed in a group of nine highly hypnotizable subjects via ten frontal, central, parietal, and occipital electrodes under four conditions: 1) wake state, 2) neutral hypnosis, 3) hypnotic suggestion for altering perception of tones, and 4) post-hypnosis. Results indicate no theta-power changes between conditions, challenging previous findings that increased theta power is a marker of hypnosis. A decrease in gamma power under hypnotic suggestion and an almost significant decrease under neutral hypnosis were observed, compared to post-hypnosis. Anteroposterior power distribution remained stable over all conditions. The results are discussed and compared to earlier studies, which report heterogenous findings.

A Critical Review of Standardized Measures of Hypnotic Suggestibility

The most well-established finding gleaned from decades of experimental hypnosis research is that individuals display marked variability in responsiveness to hypnotic suggestions. Insofar as this variability impacts both treatment outcome in therapeutic applications of hypnosis as well as responsiveness to suggestions in experimental contexts, it is imperative that clinicians and researchers use robust measures of hypnotic suggestibility. The current paper critically evaluates contemporary measures of hypnotic suggestibility. After reviewing the most widely used measures, we identify multiple properties of these instruments that result in the loss of valuable information, including binary scoring and single-trial sampling, and hinder their utility, such as the inclusion of suboptimal suggestion content. The scales are not well-suited for contemporary research questions and have outlived their usefulness. We conclude by outlining ways in which the measurement of hypnotic suggestibility can be advanced.

Hypnosis-induced modulation of corticospinal excitability during motor imagery

Hypnosis can be considered an altered state of consciousness in which individuals produce movements under suggestion without apparent voluntary control. Despite its application in contexts implying motor control, evidence for the neurophysiological mechanisms underlying hypnosis is scarce. Inter-individual differences in hypnotic susceptibility suggest that sensorimotor strategies may manifest in a hypnotic state. We tested by means of transcranial magnetic stimulation applied over the primary motor cortex whether motor system activation during a motor imagery task differs in the awake and in the hypnotic state. To capture individual differences, 30 healthy volunteers were classified as high or low hypnotizable (Highs and Lows) according to ad-hoc validated scales measuring hypnotic susceptibility and personality questionnaires. Corticospinal activation during motor imagery in the hypnotic state was greater in the Highs than the Lows. Intrinsic motivation in task performance and level of persuasion modulated corticospinal activation in the Highs. Corticospinal system activation under hypnosis may have practical implications that merit research in areas where hypnosis can be applied to improve motor performance, such as loss of motor abilities and sports.

Styles of Experiencing Hypnosis: A Replication and Extension Study

Beyond hypnotizability, there may be different styles of experiencing hypnosis relevant to both basic research and clinical practice. Previous research has demonstrated the presence of inward attentive and dissociative subtypes among more highly hypnotizable individuals during a group protocol. With a sample of undergraduate students, we successfully replicated the presence of these 2 subtypes among those who were relatively more hypnotizable. Inward attentive and dissociative subtypes did not differ in their overall experience of the depth of the relationship with the hypnotist, though the dissociative subjects reported elevated everyday dissociative experiences. We then explored features of each subtype, noting possible altered memory experience in the dissociative style and reduced experience of rationality in both the inward attentive and dissociative styles. We discuss the scientific and clinical implications of this line of research.

Effects of Prehypnotic Instructions on Hypnotizability and Relationships Between Hypnotizability, Absorption, and Empathy

Although hypnotizability exhibits high across-time and across-test consistencies, it is not clear (a) how different preambles to a hypnotic procedure (metasuggestions) influence responsiveness to suggestions and the strength of the association between two hypnotizability scales and (b) how hypnotizability relates to absorption and empathy. In Experiment 1, nonclinical participants (N = 152 women) were administered the Modified Tellegen Absorption Scale (MODTAS), Interpersonal Reactivity Index (IRI), Hypnotic Induction Profile (HIP), and Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C). In Experiment 2, nonclinical participants (N = 188; 105 women and 83 men) were administered the MODTAS, IRI, and Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A). The induction scores of the HIP (HIP-IND) and the SHSS:C scores showed a significantly stronger correlation when the HIP was introduced to the participants after hypnosis metasuggestion (HIP-H-IND) than after imagination metasuggestion (HIP-I-IND). Metasuggestion was a moderator of the association between HIP-IND and SHSS:C scores. Participants with low and medium, but not with high, hypnotizability levels on the SHSS:C showed significantly higher scores on the HIP-I-IND than on the HIP-H-IND. The strong correlations between the SHSS:C, HIP-H-IND, and HIP eye-roll (HIP-ER) scores indicate that both the HIP-H-IND and HIP-ER are robust measures of hypnotizability. Absorption and empathy were not significantly associated with hypnotizability. Women were more hypnotizable than men, as assessed by the HGSHS:A. The clinical relevance of metasuggestions, intended to increase responsiveness to suggestions, is discussed as a strategy to improve treatment outcomes.

The interoception and imagination loop in hypnotic phenomena

We tested a working hypothesis that the ideomotor and motor-control suggestions measured by current hypnotizability scales depend on the activation of an interoception-imagination processing loop. In three experiments, participants were exposed to an induction phase, Items 3 (mosquito hallucination) and 8 (arm immobilization) of the Stanford Hypnotic Susceptibility Scale, Form C, and a new version of Item 8 involving the additional activation of imaginative and interoception processes. We found that this modified version of Item 8 elicited greater responsiveness to suggestion, irrespective of its position in the sequence of hypnotic items. We argue that this interoception-imagination loop hypothesis provides a useful information processing analysis for understanding several hypnotic phenomena.

Polymorphism of Opioid Receptors μ1 in Highly Hypnotizable Subjects

The possible cooperation between hypnotizability-related and placebo mechanisms in pain modulation has not been consistently assessed. Here, we investigate possible genetic bases for such cooperation. The OPRM1 gene, which encodes the μ1 opioid receptor-the primary site of action for endogenous and exogenous opioids-is polymorphic in the general population for the missense mutation Asn40Asp (A118G, rs1799971). The minor allele 118G results in decreased levels of OPRM1 mRNA and protein. As a consequence, G carriers are less responsive to opioids. The aim of the study was to investigate whether hypnotizability is associated with the presence of the OPRM1 polymorphism. Forty-three high and 60 low hypnotizable individuals, as well as 162 controls, were genotyped for the A118G polymorphism of OPRM1. The frequency of the G allele was significantly higher in highs compared to both lows and controls. Findings suggest that an inefficient opioid system may be a distinctive characteristic of highs and that hypnotic assessment may predict lower responsiveness to opioids.

Hypnotizability and the Peripersonal Space

High hypnotizability is associated with left-sided cerebral asymmetry, which could influence measurement of the Peripersonal Space (PPS). Right-handed participants with high (highs, n = 20), medium (mediums, n = 9), and low hypnotizability scores (lows, n = 20) performed the line bisection test on a computer screen automatically displaced at distances of 30, 60, and 90 cm from the subjects' eyes. Highs' results showed rightward bias of the bisection (Relative Error, RE) for all presentation distances. In contrast, in lows RE was displaced leftward at 30 cm and exhibited a progressive rightward shift at 60 and 90 cm, as occurs in the general population. Mediums' RE values were intermediate between highs' and lows' values. Bisection Times (BT) were significantly longer in highs/mediums than in lows. Findings indicate that the highs' bisection identifies PPS as if it was extrapersonal, but further studies should assess its functional characteristics. The highs/mediums longer BT suggest less efficient sensorimotor performance.

A Pragmatic Guide to the Setting up of Integrated Hypnotherapy Services in Primary Care and Clinical Settings

Despite the continued debate and lack of a clear consensus about the true nature of the hypnotic phenomenon, hypnosis is increasingly being utilized successfully in many medical, health, and psychological spheres as a research method, motivational tool, and therapeutic modality. Significantly, however, although hypnotherapy is widely advertised, advocated, and employed in the private medical arena for the management and treatment of many physical and emotional disorders, too little appears to be being done to integrate hypnosis into primary care and national health medical services. This article discusses some of the reasons for the apparent reluctance of medical and scientific health professionals to consider incorporating hypnosis into their medical practice, including the practical problems inherent in using hypnosis in a medical context and some possible solutions.

New directions in hypnosis research: strategies for advancing the cognitive and clinical neuroscience of hypnosis

This article summarizes key advances in hypnosis research during the past two decades, including (i) clinical research supporting the efficacy of hypnosis for managing a number of clinical symptoms and conditions, (ii) research supporting the role of various divisions in the anterior cingulate and prefrontal cortices in hypnotic responding, and (iii) an emerging finding that high hypnotic suggestibility is associated with atypical brain connectivity profiles. Key recommendations for a research agenda for the next decade include the recommendations that (i) laboratory hypnosis researchers should strongly consider how they assess hypnotic suggestibility in their studies, (ii) inclusion of study participants who score in the middle range of hypnotic suggestibility, and (iii) use of expanding research designs that more clearly delineate the roles of inductions and specific suggestions. Finally, we make two specific suggestions for helping to move the field forward including (i) the use of data sharing and (ii) redirecting resources away from contrasting state and nonstate positions toward studying (a) the efficacy of hypnotic treatments for clinical conditions influenced by central nervous system processes and (b) the neurophysiological underpinnings of hypnotic phenomena. As we learn more about the neurophysiological mechanisms underlying hypnosis and suggestion, we will strengthen our knowledge of both basic brain functions and a host of different psychological functions.

Pain modulation as a function of hypnotizability: Diffuse noxious inhibitory control induced by cold pressor test vs explicit suggestions of analgesia

The aim of the present study was to compare the effects of explicit suggestions of analgesia and of the activation of the Diffuse Noxious Inhibitory Control (DNIC) by cold pressor test on pain perception and heart rate in healthy participants with high (highs, N=18), low (lows, N=18) and intermediate scores of hypnotizability (mediums, N=15) out of hypnosis. Pain reports and the stimulus-locked heart rate changes induced by electrical nociceptive stimulation of the left hand were studied in the absence of concomitant stimuli (Control), during suggestions of analgesia (SUGG, glove analgesia) and during cold pressor test used as a conditioning stimulus to the right hand (DNIC, water temperature=10-12°C) in the REAL session. Participants were submitted also to a SHAM session in which the DNIC water temperature was 30°C and the suggestions for analgesia were substituted with weather forecast information. Both suggestions and DNIC reduced pain significantly in all subjects; however, the percentage of reduction was significantly larger in highs (pain intensity=55% of the control condition) than in mediums (70%) and lows (80%) independently of the REAL/SHAM session and of the specific pain manipulation. Heart rate was not modulated consistently with pain experience. Findings indicate that both suggestions and DNIC influence pain experience as a function of hypnotizability and suggest that both sensory and cognitive mechanisms co-operate in DNIC induced analgesia.

Nuances and Uncertainties Regarding Hypnotic Inductions: Toward a Theoretically Informed Praxis

Although most definitions of hypnosis consider inductions as the initial stage in a hypnosis protocol, knowledge of inductions remains poor and uninformed by recent developments in theory and research. It is frequently argued that inductions play a critical role in hypnotic responding or, by contrast, are largely interchangeable and unimportant. Drawing on the literature on suggestibility, spontaneous phenomenology, neurophysiology, and cognition, this article argues that the value of inductions, as well as the potential value of inductions, is more nuanced and uncertain. Certain components of standard inductions appear to be efficacious in enhancing suggestibility, whereas others do not have any clear benefits. The impact of inductions on suggestibility seems to vary across suggestions and modes of assessment with the sources of this variability being unknown. Considering these effects, and the broader impact of inductions on spontaneous conscious states and cognition, through the lens of heterogeneity in high hypnotic suggestibility and componential models of hypnotic suggestibility may offer novel research avenues in this area. The article concludes by arguing for the practical and theory-driven optimization of inductions.

Complementing the Latest APA Definition of Hypnosis: Sensory-Motor and Vascular Peculiarities Involved in Hypnotizability

The aim of this article is to complement the recently revised American Psychological Association (APA) definition of hypnotizability. It (a) lists a few differences in sensorimotor integration between subjects with high (highs) and low (lows) hypnotizability scores in the ordinary state of consciousness and in the absence of suggestions, (b) proposes that hypnotizability-related cerebellar peculiarities may account for them,

Patterns of hypnotic response, revisited

It has long been speculated that there are discrete patterns of responsiveness to hypnotic suggestions, perhaps paralleling the factor structure of hypnotizability. An earlier study by Brenneman and Kihlstrom (1986), employing cluster analysis, found evidence for 12 such profiles. A new study by Terhune (2015), employing latent profile analysis, found evidence for three such patterns among highly hypnotizable subjects, and a fourth comprising subjects of medium hypnotizability. Some differences between the two studies are described. Convincing identification of discrete "types" of high hypnotizability, such as dissociative and nondissociative, may require a larger dataset than is currently available, but also data pertaining directly to divisions in conscious awareness and experienced involuntariness.