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Zahedi A, Jay Lynn S, Sommer W. How hypnotic suggestions work - A systematic review of prominent theories of hypnosis. Conscious Cogn 2024; 123:103730. [PMID: 39032268 DOI: 10.1016/j.concog.2024.103730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/10/2024] [Accepted: 07/13/2024] [Indexed: 07/23/2024]
Abstract
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.
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Affiliation(s)
- Anoushiravan Zahedi
- Department of Psychology, University of Muenster, Germany; Department of Psychology, Humboldt-Universitat zu Berlin, Germany; Neuroscience Research Center, Charité-Universitätsmedizin Berlin, Germany.
| | - Steven Jay Lynn
- Psychology Department, Binghamton University, Binghamton, NY, USA
| | - Werner Sommer
- Department of Psychology, Humboldt-Universitat zu Berlin, Germany; Department of Psychology, Zhejiang Normal University, Jin Hua, China
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Zahedi A, Lynn SJ, Sommer W. Cognitive simulation along with neural adaptation explain effects of suggestions: a novel theoretical framework. Front Psychol 2024; 15:1388347. [PMID: 38966744 PMCID: PMC11223671 DOI: 10.3389/fpsyg.2024.1388347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/30/2024] [Indexed: 07/06/2024] Open
Abstract
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.
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Affiliation(s)
- Anoushiravan Zahedi
- Department of Psychology, University of Münster, Münster, Germany
- Department of Psychology, Humboldt-Universitaet zu Berlin, Berlin, Germany
- Neuroscience Research Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Steven Jay Lynn
- Department of Psychology, Binghamton University, Binghamton, NY, United States
| | - Werner Sommer
- Department of Psychology, Humboldt-Universitaet zu Berlin, Berlin, Germany
- Department of Psychology, Zhejiang Normal University, Jinhua, China
- Department of Physics and Life Science Imaging Center, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
- Faculty of Education, National University of Malaysia, Kuala Lumpur, Malaysia
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Geagea D, Ogez D, Kimble R, Tyack Z. Redefining hypnosis: A narrative review of theories to move towards an integrative model. Complement Ther Clin Pract 2024; 54:101826. [PMID: 38199053 DOI: 10.1016/j.ctcp.2023.101826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/14/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024]
Abstract
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.
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Affiliation(s)
- Dali Geagea
- Child Health Research Centre, Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia.
| | - David Ogez
- Department of Anaesthesiology and Pain Medicine, University of Montreal, Montreal, Canada
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, Queensland Children's Hospital, The University of Queensland, Brisbane, Australia
| | - Zephanie Tyack
- Child Health Research Centre, Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia; Australian Centre for Health Service Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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Kaczmarska AD, Mielimąka M, Rutkowski K. Hypnotizability and psychopathology of patients with personality disorders. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2022; 65:160-168. [PMID: 35793675 DOI: 10.1080/00029157.2022.2081125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Assessment of hypnotizability is useful in research and predicting the effects of hypnosis in clinical practice. There are few contemporary scientific reports examining the relationship between hypnotizability and psychopathological personality dimensions. The current study explores the connections between abnormal personality in psychiatric patients and the hypnotizability level. Fifty-five patients with anxiety and personality disorders who previously completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were invited to undergo the Elkins Hypnotizability Scale - Clinical Form (EHS-CF). The hypnotizability scores comprise a normal distribution but shifted toward low scores. Twenty-seven patients were included in the low hypnotizability (LOW) group, and 28 patients in the medium to high (MID-HIGH) group. The number of participants with high scores on the Psychopathic Deviate and Paranoia MMPI-2 clinical scales was significantly higher in the LOW than in the MID-HIGH group. Patterns of associations between hypnotizability and psychopathology differed in the two groups. The results indicate that moderate hypnotizability should be considered a normal trait that has no meaningful relationship with psychopathology, but certain dysfunctional symptoms of personality disorders may entail resistance and a defensive attitude toward the hypnotherapy, resulting in a tendency to obtain lower hypnotizability.
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Affiliation(s)
| | - Michał Mielimąka
- Department of Psychotherapy, Jagiellonian University Medical College, Kraków, Poland
| | - Krzysztof Rutkowski
- Department of Psychotherapy, Jagiellonian University Medical College, Kraków, Poland
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Sine H, Achbani A, Filali K. The Effect of Hypnosis on the Intensity of Pain and Anxiety in Cancer Patients: A Systematic Review of Controlled Experimental Trials. Cancer Invest 2021; 40:235-253. [PMID: 34698595 DOI: 10.1080/07357907.2021.1998520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Pain is a common symptom in cancer patients. Hypnosis is considered one of the most recognized non-pharmacological techniques in pain management. In oncology, this technique can be used as a complementary treatment to reduce the level of pain and anxiety. The objective of this study is to systematically review and evaluate controlled clinical trials (CCTs) examining the effect of hypnosis on the intensity of pain, and anxiety in cancer patients. METHODS A systematic review was conducted according to the recommendations of the "Preferred reporting items for systematic reviews and meta-analyses" (PRISMA). The Cochrane systematic review database, the abstract databases, Scopus, PubMed, Google Scholar, and Cochrane Library have been systematically reviewed from 2005 to 2018. RESULTS Eleven CCT with a total of 1182 participants met the inclusion criteria and were included in this review. The participants were mainly women (n = 968). Their average age alternates between 48 and 58 years. Perceived pain was measured primarily by visual analog scale (VAS)/numerical pain rating scale (NPRS), which showed that anxiety was measured by Hospital Anxiety and Depression scale (HADS). Hypnosis-related anxiety and pain decreased significantly with respect to usual treatment. CONCLUSIONS Evidence suggests promising results of hypnosis on the management of pain, and anxiety levels in the vast majority of cancer patients. Therefore, because of the exploratory design and high risk of bias, the effectiveness of hypnosis or hypnotherapy in reducing pain and anxiety levels remains unclear. There is a need for more rigorous randomized controlled trials (RCTs).
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Affiliation(s)
- Hayat Sine
- Clinical Epidemiology and Medico-Surgical Sciences, Faculty of Medicine and Pharmacy, Mohammed V-Rabat University, Rabat, Morocco
| | - Abderrahmane Achbani
- Department of Biology, Faculty of Sciences, Laboratory of Cell Biology and Molecular Genetics, University Ibn Zohr, Agadir, Morocco.,Higher Institute of Nursing Professions and Health Techniques, Marrakech, Morocco
| | - Karim Filali
- Clinical Epidemiology and Medico-Surgical Sciences, Faculty of Medicine and Pharmacy, Mohammed V-Rabat University, Rabat, Morocco
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Can posthypnotic suggestions boost updating in working memory? Behavioral and ERP evidence. Neuropsychologia 2020; 148:107632. [PMID: 32976853 DOI: 10.1016/j.neuropsychologia.2020.107632] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 09/05/2020] [Accepted: 09/15/2020] [Indexed: 12/24/2022]
Abstract
Updating is an essential executive function (EF), responsible for storing, retrieving, and substituting information in working memory (WM). Here we investigated whether posthypnotic suggestions (PHS) given to high-hypnotizable participants can enhance updating in WM and measured neural correlates of the observed effects by recording event-related brain potentials (ERP). In a tone-monitoring task different syllables were presented in random order, requiring a response to every fourth presentation of a given syllable. Experiment 1 (n = 19) established the relationship between performance and several ERP components across updating load (different numbers of syllables). In Experiment 2 (n = 18), a no-hypnosis (NH) and a hypnosis-plus-PHS session were administrated in counterbalanced order. Task instructions, presented at the beginning of the sessions, emphasized a cognitive strategy, demanding imagination of visual counters, a strategy that was also emphasized during PHS. PHS additionally contained suggestions stimulating cognitive simulation of the task, where participants were advised to apply the suggested strategy. Relative to the NH session, PHS enhanced WM performance with medium to large effect sizes. In ERPs, PHS increased the P2 and P3 components, indicating the proactive recruitment of control-related attention and updating-related cognitive control processes, respectively. PHS also reduced updating load effects in the posterior recognition component, suggesting diminished demands on WM buffers. These ERP findings suggest that PHS enhanced updating in WM by strengthening proactive control, which may have diminished the necessity for reactive control. Hence, the present results suggest that our PHS had worked like mental practice helping participants to develop an efficient and context-dependent trigger-action contingency. Consequentially, the present study provides a new framework for employing PHSs, which may be used as a basis for developing new training regimes for modifying WM or other EFs.
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