PsycCRITIQUES - Contemporary Psychology: APA Review of Books
The Social Psychology of Hypnosis, Warts and All
A review of
Hypnosis: The Cognitive–Behavioral Perspective
Nicholas P. Spanos and John F. Chaves (Eds.)
Buffalo, NY: Prometheus Books, 1989. 511 pp. ISBN 0-87975-469-9. $34.95

Reviewed by
John F. Kihlstrom

Hypnosis is a social interaction in which one person experiences alterations in mental functioning—perception, memory, and so forth—in accordance with suggestions offered by another. In making sense of this phenomenon, observers have been divided into two camps almost from the beginning (Shor, 1979; see also Laurence & Perry, 1988; Sheehan & Perry, 1976). On the one side are those investigators ("special-process theorists" in the parlance of the book at hand) who focus on alterations in conscious awareness and other cognitive shifts that appear to occur during hypnosis; on the other side are those (dubbed "cognitive–behavioral theorists" in this book) who focus on the sociocultural context in which the hypnotic encounter occurs. A kind of battle royal has ensued with several different parties in the ring, and the last one on his or her feet is to be declared the winner.

The stage for this dispute was set in 18th-century France, before hypnosis ever received its name, when the Franklin Commission doubted Mesmer's claims that he cured illness through his ability to control the flow of a cosmic fluid in his patients' bodies; instead, they attributed his success to his patients' imagination. A century later, Charcot and Bernheim debated the roles played by suggestion and neurophysiological changes in both hypnosis and hysteria. In our own time, Sutcliffe distinguished between a credulous view of hypnosis, which assumes that hypnotic effects (blindness, amnesia, etc.) are identical with actual stimulus conditions, and a skeptical view, which assumes that the subject is simply acting as if the world were as suggested by the hypnotist. Theodore Sarbin, drawing on both sociology and moral philosophy, produced a social-psychological analysis of hypnosis in terms of role enactment. And T. X. Barber, heavily influenced by a Skinnerian functional behaviorism that eschewed all reference to internal, mental states, focused on the external stimulus conditions in which hypnotic behavior occurred.

In this book, Nicholas Spanos and John Chaves, both longtime associates of Barber, offer a wide variety of analyses of hypnosis from the cognitive–behavioral view. There are chapters on the assessment (Bertrand) and correlates (deGroh) of hypnotizability (Bertrand), subjects' reports of hypnotic depth (Radtke), and the experience of involuntariness in response to hypnotic suggestions (Lynn, Rhue, and Weekes). There are detailed treatments of posthypnotic amnesia (Coe), perceptual effects (Jones and Flynn), time perception (St. Jean), and the phenomena of "trance logic" and the "hidden observer" (de Groot and Gwynn). Three chapters (by Spanos, Chaves, and D'Eon, respectively) cover experimental studies and clinical applications of hypnotic analgesia for the relief of pain. A pair of chapters provides a critical examination of the psychosomatic consequences of the effects of hypnotic suggestion: the production of and remission of blisters and warts (Johnson) and the treatment of cancer (Stam). Yet another takes up a number of psycholegal issues surrounding the coercion of antisocial or self-injurious behavior and the enhancement of eyewitness memory (Wagstaff). All of these chapters are strongly critical of the view of these problems that is attributed to special-process theorists. The book wraps up with a series of broader theoretical and historical essays (by Kirsch and Council and by Diamond, Sarbin, and Coe, respectively), and the volume is framed by introductory and summary chapters written by the editors.

In these last contributions, especially, it becomes clear that the cognitive–behavioral approach is far from monolithic: There are, in fact, many different social-psychological approaches to hypnosis. There is, first of all, a consistent dubunking attitude, as reflected in experiments designed to show that ostensibly painful stimuli don't really hurt, the hypnotically deaf can really hear, and the hypnotically amnesic can really remember. A second tack accepts hypnotic behavior as genuine but goes on to show that appropriately motivated or appropriately instructed subjects can achieve the same effects without benefit of hypnosis—thus preserving the phenomena while consigning the concept of hypnosis to the dustbin of history. Sarbin and Coe, coming from sociological social psychology, construe hypnotic subjects as conforming their behavior to a prescriptive social role, but they have little that is coherent to say about subjects' private experiences. Spanos, more closely tied to traditional experimental social psychology and attribution theory, seems to agree that hypnotic behavior is the product of strategic self-presentation—a position that is coherent with his debunking activities. At other times, he attributes hypnotic effects to deliberate, strategic activities on the part of hypnotic subjects, rather than to any autonomous special state instigated by a hypnotic induction procedure. Finally, Kirsch and Council, working within the framework of social learning theory, argue that hypnotic subjects are motivated more to experience the suggested effects than to convince the hypnotist that they are doing so. Although they believe that these effects are produced by the subject's expectations that they will occur, the role played by strategic, goal-directed behavior is unclear. In any event, their position assumes, explicitly and at the outset, that the effects themselves are genuine, in the sense of being subjectively convincing and not merely social artifacts.

Despite these differences, the contributors to this book share a Kuhnian agenda, constantly attempting to distinguish between the traditional point of view and their revolutionary one—if not simultaneously trying to determine which version of revolutionary ideology is correct. Sarbin, in his cry against mentalism and mechanism in hypnosis research, makes it clear that the paradigm clash in hypnosis is emblematic of a core controversy in the social and behavioral sciences at large. Unfortunately, the paradigmatic distinction has never been as clear as all that. For example, debunking is not the exclusive property of the social psychologists. Even Sutcliffe was hard-pressed to name more than one exponent of the credulous point of view. Martin Orne, commonly cited as an example of a special-process theorist, made his career in hypnosis by showing that the claims for the phenomenon were often exaggerated. And E. R. Hilgard, another oft-named example, has consistently argued for the continuity between hypnosis and other personality and cognitive processes (e.g., Hilgard, 1977). Moreover, the distinctions between the alternative paradigms quickly blur. What is the difference, really, between a role-enactment in which the subject forgets that he or she is enacting a role and a special state of consciousness with dissociative qualities? Don't both theories ultimately demand an investigation of the cognitive processes that underlie such effects? There are also areas of agreement between the two paradigms—for example, that hypnosis is largely ineffective in enhancing eyewitness memory or in treating tumors. And there are shared mysteries as well: Neither paradigm has any cogent account of the mechanism whereby hypnotic suggestion leads to the remission of warts.

The fact of the matter is that there need not be any conflict between a focus on the mental (and even biological) mechanisms involved in hypnosis and on the sociocultural context in which hypnosis occurs. The two approaches can complement each other nicely. After all, the unique role of psychology in the disciplines is to link together the three different levels at which behavior can be analyzed—the biophysical, the psychological, and the social. Once the levels have been distinguished, the next step is not to deny the validity of two in favor of the remaining one, but rather to produce a synthesis of the three into a comprehensive view of some phenomenon. This task seems daunting, but some have tried to accomplish it. R. W. White, whom Spanos and Chaves acknowledge as the forerunner of the cognitive–behavioral perspective, conceptualized hypnosis as both social behavior and altered consciousness. Sutcliffe, for his part, rejected both credulity and skepticism, as he defined them, and preferred to think of hypnotic subjects as essentially deluded about the stimulus environment (Kihlstrom & Hoyt, 1988). Still, Spanos and Chaves have done the field an important service by focusing their attention and ours on an aspect of hypnosis that has long been neglected: the interpersonal relationship between subject and hypnotist and the influence of the social context in which hypnosis occurs. Both the prospects and the problems with the approach are now clearer.

Given the importance of the recent developments in the social-psychological viewpoint summarized here and given the book's cover billing as "a reference guide to contemporary research," it is unfortunate that the interests of further scholarship have been so inadequately served by the book's publisher. Because there are no subject or author indexes, it is almost impossible to find where a particular investigator's work or an individual experiment might be discussed. There is a large reference list, but there are several instances where an important paper is cited in a chapter but not listed in the bibliography or where the bibliographic information is insufficient to permit readers to obtain the paper for themselves. Nevertheless, this is a valuable compendium that belongs on the shelf, and on the mind, of everyone interested in hypnosis.


References

Nicholas P. Spanos, professor of psychology at Carleton University (Ottawa, Ontario, Canada), is author of the chapter "Hypnosis, Nonvolitional Responding, and Multiple Personality: A Social Psychological Perspective" in B. Maher and W. Maher (Eds.) Progress in Experimental Personality Research, Vol. 14.

John F. Chaves, professor and head of the Behavioral Sciences Section in the Department of Community Dentistry and Human Behavior at Southern Illinois University (Alton), and past president of APA's Division 30 (Psychological Hypnosis), is author of the chapter "Using Spontaneous Trances" in B. Zilbergeld, M. G. Edelstein, and D. L. Araoz (Eds.) Hypnosis: Questions and Answers.

John F. Kihlstrom, professor of psychology at the University of Arizona (Tucson), is coauthor, with N. Cantor, of Personality and Social Intelligence.


PsycCRITIQUES
0010-7549
Previously published in Contemporary Psychology: A Journal of Reviews, January 1991, Vol. 36, No. 1, 11–13
© 1991, American Psychological Association