Truth in memory: ramifications for psychotherapy and hypnotherapy

Why Ineffective Psychotherapies Appear to Work: A Taxonomy of Causes of Spurious Therapeutic Effectiveness

The past 40 years have generated numerous insights regarding errors in human reasoning. Arguably, clinical practice is the domain of applied psychology in which acknowledging and mitigating these errors is most crucial. We address one such set of errors here, namely, the tendency of some psychologists and other mental health professionals to assume that they can rely on informal clinical observations to infer whether treatments are effective. We delineate four broad, underlying cognitive impediments to accurately evaluating improvement in psychotherapy-naive realism, confirmation bias, illusory causation, and the illusion of control. We then describe 26 causes of spurious therapeutic effectiveness (CSTEs), organized into a taxonomy of three overarching categories: (a) the perception of client change in its actual absence, (b) misinterpretations of actual client change stemming from extratherapeutic factors, and (c) misinterpretations of actual client change stemming from nonspecific treatment factors. These inferential errors can lead clinicians, clients, and researchers to misperceive useless or even harmful psychotherapies as effective. We (a) examine how methodological safeguards help to control for different CSTEs, (b) delineate fruitful directions for research on CSTEs, and (c) consider the implications of CSTEs for everyday clinical practice. An enhanced appreciation of the inferential problems posed by CSTEs may narrow the science-practice gap and foster a heightened appreciation of the need for the methodological safeguards afforded by evidence-based practice.

Are high hypnotizables especially vulnerable to false memory effects? A sociocognitive perspective

This article examines issues raised by a recent UK legal case in which the defense argued that the accusations made by the highly hypnotizable plaintiff were likely based on false memories. The authors argue that the evidence related to hypnotizability and false memory production is inconsistent but may be illuminated by a sociocognitive perspective. They present 2 preliminary studies that indicate that when the instructions imply that accurate reporting is a feature of hypnosis, higher hypnotizables may actually be more resistant than low or medium hypnotizables to false memories arising from misleading information given during hypnosis. They conclude that, when memory accuracy is emphasized rather than productivity, there is little evidence to link high hypnotizability with a propensity to produce false memories.

Enhancing witness memory with techniques derived from hypnotic investigative interviewing: focused meditation, eye-closure, and context reinstatement

Due to several well-documented problems, hypnosis as a forensic interviewing tool has been largely replaced by the cognitive interview; however, the latter is problematic in time and complexity. This article builds on previous research showing that some procedures used in traditional hypnotic forensic interviewing might still be useful in developing alternative procedures for use in investigative interviewing. Two experiments are described that include a focused meditation with eye-closure technique with similarities to conventional hypnotic induction but without the label of hypnosis. In the first, focused meditation was comparable to a context reinstatement, or revivification, technique in facilitating memory in children aged 6 to 7 without increasing errors or inflating confidence. In the second, when used in combination with context reinstatement, focused meditation was resistant to the effects of misleading information in adults. Implications are discussed.

Hypnosis and upper digestive function and disease

Hypnosis is a therapeutic technique that primarily involves attentive receptive concentration. Even though a small number of health professionals are trained in hypnosis and lingering myths and misconceptions associated with this method have hampered its widespread use to treat medical conditions, hypnotherapy has gained relevance as an effective treatment for irritable bowel syndrome not responsive to standard care. More recently, a few studies have addressed the potential influence of hypnosis on upper digestive function and disease. This paper reviews the efficacy of hypnosis in the modulation of upper digestive motor and secretory function. The present evidence of the effectiveness of hypnotherapy as a treatment for functional and organic diseases of the upper bowel is also summarized, coupled with a discussion of potential mechanisms of its therapeutic action.

Naturally Occurring and Suggestion- Dependent Memory Distortions: The Convergence of Disparate Research Traditions

Two lines of research that have revealed the existence of memory distortions are reviewed. Both began at the beginning of this century and continue through today. One is a coherent research tradition aimed at investigating suggestion-dependent memory distortions produced by clinical and social psychological manipulations; the other consists of a series of unrelated studies on naturally occurring memory distortions. These latter studies are aimed at establishing some of the basic processes underlying the functioning of normal human memory and have not previously been considered together as part of the literature on memory errors.

The role of hypnotizability assessment in treatment

Disparate opinions about the importance of the assessment of hypnotizability reflect very different ideas about what hypnosis is, the relevance of hypnotizability to psychotherapy and treatment outcome, and the importance of gathering scientific data to document treatment effectiveness and the presence of hypnotic effects. In this article, we argue that in recent years important developments have occurred in the conceptualization, assessment, and technical aspects of hypnotic intervention that imply that clinicians who eschew the use of hypnotizability assessment ought to reconsider their position. In making this argument, we will discuss reasons for assessing hypnotizability, the relation between hypnotizability and treatment outcome, and practical considerations in the assessment of hypnotizability.

DISSOCIATION, COMORBIDITY OF DISSOCIATIVE DISORDERS, AND CHILDHOOD ABUSE IN A COMMUNITY SAMPLE OF WOMEN WITH CURRENT AND PAST BULIMIA

Dissociation and childhood sexual abuse were examined in a community sample of current bulimics (N=47), past bulimics (N=29), and non-bulimic controls (N=37). All respondents completed questionnaires requesting information relating to bulimia, dissociation, and incidence and severity of childhood sexual abuse. Participants scoring high on the measure of dissociation (N=21) were further assessed with a structured clinical interview to determine the proportion who would fulfill the formal criteria for a DSM-IV dissociative disorder. Results indicated that dissociation was highest among current bulimics, and that past bulimics had lower levels of dissociation than current bulimics (although higher than non-bulimic controls). However, there was no association between level of dissociation and incidence of reported childhood sexual abuse. In addition, the incidence of childhood sexual abuse was no higher among bulimics than among the general population – although the severity of the abuse was reported to have been higher. The severity of self-reported childhood sexual abuse was also found to be higher among current bulimics than among past bulimics. Comorbidity of DSM-IV dissociative disorders among current bulimics was found to be 10%.

The plasticity of early memory reports: social pressure, hypnotizability, compliance, and interrogative suggestibility

Early autobiographical memory reports by adults were very sensitive to social influence in a leading interview. The mean age of initial earliest memory report was 3.7 years. When participants were instructed to close their eyes, visualize, and focus on their 2nd birthday, 59% reported a birthday memory. After repeated probes for earlier memories, 78% of subjects reported memories at or prior to 24 months of age, and 33% reported memories within the first 12 months of age. The mean age of the final earliest memory reported was 1.6 years. Participants rated their memory reports as accurate and did not recant them when given an opportunity. The age of earliest memory reports in the suggestive interview correlated negatively with measures of compliance, hypnotizability, and interrogative suggestibility.

Can cognitive neuroscience illuminate the nature of traumatic childhood memories?

Recent findings from cognitive neuroscience and cognitive psychology may help explain why recovered memories of trauma are sometimes illusory. In particular, the notion of defective source monitoring has been used to explain a wide range of recently established memory distortions and illusions. Conversely, the results of a number of studies may potentially be relevant to forgetting and recovery of accurate memories, including studies demonstrating reduced hippocampal volume in survivors of sexual abuse, and recovery from functional and organic retrograde amnesia. Other recent findings of interest include the possibility that state-dependent memory could be induced by stress-related hormones, new pharmacological models of dissociative states, and evidence for 'repression' in patients with right parietal brain damage.

Incest memories recalled in hypnosis--a case study: a brief communication

Accuracy of repressed memories recovered in hypnosis cannot be reliably determined with any greater certainty than non-hypnotically recalled events. Therefore, the practice of therapists' accepting hypnotically enhanced memories as veridical, absent corroborating evidence, is not advocated. A 52-year-old woman with a 27-year history of panic attacks and sleep disorder inadvertently recovered incest memories in hypnosis. Photographs and remembered events by other family members were thought by the patient to provide general support although they did not constitute actual proof of abuse. Implications are discussed.