Hypnosis as Altered State of Consciousness

Published Date: 23 Mar 2015

The structure of this section begins with the explanation of concepts, followed by supporting theory and research studies. The variable examined in the present study is the subjective experience of high hypnotizable individuals. Therefore, this section begins with explaining related concepts to understand the variable studied.

2.1.1 Introduction

It is important to define Consciousness, before going to explain hypnosis as altered state of consciousness. Pekala (2009) defines Consciousness as one's awareness of one's subjective experience, including both the processes of being aware and the various contents of that awareness. This includes what Husserl (1913/72) would define as:

The noeses (the subjective intentional acts of consciousness, i.e., perceiving, willing, imaging, etc.) and noema (the objects of consciousness, i.e., thoughts, feelings, visualizations, etc.) of that experience, including whatever awareness/attention is capable of being aware of, and also encompasses states and altered state of consciousness. (Pekala,1991, p. 34)

Tart (1972) defines altered state of consciousness (ASC) as "a qualitative alteration in the overall pattern of mental functioning such that the experiencer feels his [or her] consciousness is radically different from the 'normal' way it functions" (Pekala, 1991).

As pointed out by Barber, 1969 an altered state of consciousness can be defined as 'the output resulting from a particular input' (Kihlstorm, 2008).

The hypnotized subject demonstrate positive hallucination (see things that are not there), negative hallucination (fail to see things that are there) volitional control (loss control of behaviour and experience) amnesia as a result of a hypnosis. One explanation offered by Kilhlstorm (1984) is that hypnosis results in altering of both monitoring (phenomenal awareness) and controlling (voluntary thought and action) aspects of consciousness. Although hypnotic induction procedure can be considered as input for altered state, this alone is not sufficient to produce hypnosis. Other factor such as the ability of the person to be hypnotized is also important to experience altered state. Therefore, 'introspective self-reports accounts of subjective experience is central to the definition of any altered state of consciousness' (Kihlstrom, 2008)

Hilgard (1975) Shor (1959, 1962) stated that 'the trance controversy in hypnosis concerns the extent to which trait, situational, and state variables account for more of the variance of hypnotic response' (cited in Pekala, 1991). Tellegen (1979) suggested focusing on interacting variables (trait, state and situation) to explain hypnotic response.

2.1.2 Research

Studying the pattern (that is the relationship of sub dimensions) and structures of consciousness as a function of hypnotic susceptibility, which contribute to determine a particular state of consciousness as suggested by Tart (Pekala, 1991).

Pekala investigated the structure of consciousness to determine the phenomenological effects of hypnosis as a function of individual difference. High susceptible will report different pattern of phenomenological subsystems of consciousness to hypnosis as against baseline condition, low susceptible.

Pekala presented a methodology to statistically assess states of consciousness. He proposed that if high susceptible reported significant pattern difference in phenomenological experience and a subjective sense of altered state (SSAS) compared to other state then they can be determined as experiencing ASC. Results supported this hypothesis, revealing that for hypnotic condition, all reported altered state of awareness against eye closed sitting quietly period. Although, high susceptible reported increase SSAS they showed less variation in structure (pattern of subsystem) during hypnotic condition. Suggesting that hypnotic induction has less effect on subsystem of pattern structure during hypnosis, which is different of medium and low susceptible. Pattern analysis was done using Jennrich chisquare test and graphically represented through Psygrams. The same study was conducted by Pekala and Kumar (1989) with different subject pool and results supported the previous study. This proves the replicability of the methodology in assessing pattern structures across stimulus condition and subject groups. Sample for these studies were participants of introductory psychology course. Sample size ranged from 6 to 400 plus in the above mentioned studies conducted by Pekala.

In the present study since the focus is on examining the structures and pattern of subjective experience of only one group (high susceptible) in one stimulus condition (hypnosis), within group analysis will be carried out. To find out if all high susceptible experience altered self awareness and various other dimensions. Pattern of their experience will be studied by examining their intensity score on dimensions of PCI through Phenomenological Intensity Score (PIPS). Since the sample size is 10 psygram cannot be computed, as it requires minimum of 50- 60 samples.

2.2 Subjective experience:

Hilgard (1975) stated that 'hypnotic responsiveness is more a matter of the characteristics of the subject than of the state produced by the hypnotic induction'. Studying dimensions of subjective experience in relation to trait aspect will help in determining why some individuals easily enter altered state of consciousness (Pekala,1991). Therefore, it is important to distinguish trait and state aspects.

According to Orne, the 'essence' of hypnosis lies in the subjective experience of the hypnotized individual. The internal, private experiences of a hypnotized individual are also crucial along with examining their behavioural responses to hypnotic suggestions for developing a comprehensive understanding of hypnotic abilities (McConkey, 2008; Sutchiff, 1958, 1960, 1961; Hilgard, 1969, 1971, 1973; Shor, 197, 1979; Orne, 1972; Spanos and Barber, 1974).

Rainville and Price (2003) described a model of conscious phenomenology that demonstrates the experiential characteristics of hypnosis. 'Consistent with Barabasz et al. (1999) who showed that ERPs markers '… reflect alterations in consciousness that correspond to participants' subjective experiences of perceptual alteration', Rainville and Price's model of consciousness shows that the experiential dimensions of relaxation, absorption (focused attention), orientation and self-monitoring reflect basic phenomenal properties of consciousness' (Barabasz & Barabasz). In other words, the study points out that these changes in experiential dimensions of individuals are associated with changes in their brain activity produced by hypnosis. 'There is currently an agreement that, in addition to the changes in external behaviour, suggestions presented in a hypnotic context may give rise to changes in subjective experience. Yet, there is no general agreement about the theoretical framework within which these changes in experience should be explained' (Kallio and Revonsuo 2003).

Woody and McConkey (2003, 2005) argued for a need of componential approach to assess 'emergent properties of hypnosis and that there may be changes in consciousness during hypnosis' (McConkey, 2008). Through factor analysis they yielded four subscales of direct motor, motor challenge, perceptual-cognitive and post-hypnotic amnesia responding. This was drawn based on factor analysis of Harvard Group Scale of Hypnotic Susceptibility: Form A and Stanford Hypnotic Susceptibility Scale, Form C. These subscales form the building block of hypnotic response. They underlie different subjective experience triggering specific property that is required to respond to different subscales. For example a motor challenge suggestion involves experience of involuntariness; prototype of trying to do something but failing, whereas for Perceptual-cognitive subscales involve feeling of external reality in the face an inconsistent actual reality, prototype of hallucination for this kind of experience. They analyzed data from four experiments to examine different building blocks of hypnotic response. 'These were experiments on (a) suggested color blindness (Mallard & Bryant, 2001), (b) posthypnotic amnesia for autobiographical memory (Barnier et al., 2004), (c) verbal posthypnotic suggestion (Barnier & McConkey, 1996, Experiment 2), and (d) motor posthypnotic suggestions (Barnier & McConkey, 1999b)'. Woody and Szechtman (2000) advanced the idea that hypnosis modifies underlying "feelings of knowing," or subjective convictions, and this view is consistent with a long tradition that has emphasized the subjective underpinnings of hypnotic responses (e.g., Sutcliffe, 1960, 1961).

Woody and McConkey (2008) suggested that future research may focus on examining subjective experience and state changes of individuals during hypnosis to predict hypnotic response. In this study PCI-HAP records the dimensions of subjective experiences for perceptual-cognitive suggestion (2 minute sitting quite period, to continue the experience of vacation that is hypnotic dream suggestion), in post assessment quantitatively and qualitatively record subjective experience to direct motor (finger raising) and motor challenge (eye catalepsy). The purpose is not to predict hypnotic response using PCI but to assess subjective experience underlying highly hypnotizable individual's hypnotic response.

In summary, although hypnotic suggestions can produce measurable changes in overt behaviour these alone do not define the essence of hypnosis. Instead, certain subjective experiences are the crux of hypnosis. Therefore, tracking experience of hypnosis is as important as measuring behavioural response for understanding the hypnotic phenomena.

2.3 Hypnotizability

2.3.1 Introduction

Hypnotizability, hypnotic suggestibility, hypnotic susceptibility, hypnotic responsiveness these terms is used interchangeably in this paper. Kirsch and Braffman (1999) defined "non-hypnotic suggestibility "to denote responsiveness to suggestions administered without the prior induction of hypnosis" and "hypnotic suggestibility is responsiveness to suggestions given after hypnosis has been induced" (Pekala, 2009). Hypnotizability is "the capacity to produce those effects generally considered to be 'hypnotic'" (Weitzenhoffer, 1997). Holroyd (2003) suggests that classically, "suggestion is defined as a communication that is accepted uncritically, in a process that is non-rational" (p. 121). In hull's (1933) studies it was found that hypnotic suggestibility and non-hypnotic suggestibility is very highly correlated emphasizing the role of individual's ability than on the altered state of consciousness (Lynn, Krisch and Hallquist, 2008).

Since 'Hypnotic susceptibility relates specifically to the subject's ability to respond to various hypnotic phenomena of which suggestibility is but one' (Raz, Fan, & Posner, 2005), ability of the subject to respond to suggestion in hypnotic and non hypnotic context may also be important. Therefore, 'this ability infuses many aspects of life, ranging from a tendency toward absorption defined as total engagement in self-altering experiences, to having hypnotic-like interactions with others irrationally or experience interactions with others as occasions for uncritical response in advertent suggestions.' (Spiegel, 2008, p. 183).

Hypnotic suggestibility holds different meaning to different theorist, it is important to note that hypnotizability here is defined from traditional view that is defined operationally as 'the number of suggestions that an individual responds to on standard scales' (McConkey and Barnier, 2004). Thus, a 'hypnotizability measure' typically involves administering a standard induction procedure, suggesting a number of hypnotic experiences, and scoring responses according to predetermined pass/fail criteria. Hilgard (1981) used "hypnotic susceptibility" and "hypnotizability" interchangeably.

Hilgard largely agreed with Hull that hypnosis was a plane of heightened suggestibility. Although in the present study no assessment was done in regard to suggestibility and non-hypnotic suggestibility, since the focus is on studying the phenomenological experience among highly hypnotizable.

Hypnotizability is considered as a stable trait (Piccione, Hilgard and Philip 1989) as tested over 25-year period. Others have argued that it is an ability that can be modified with increasing knowledge about hypnosis, providing training in responsiveness and simulation of contextual effects (Diamond, 1974; Sponas, 1986). Vaitl et.al ., (2005 ) in the article Psyhcobiology of Altered States of Consciousness stated that 'The effectiveness of hypnotic suggestion in producing corresponding changes in experience (i.e., hypnotic susceptibility) varies greatly from individual to individual and is a highly stable attribute of the person'.

Fassler, Lynn and Knox's (2008) conducted a test-retest study design to answer the question Is hypnotic suggestibility as a stable trait? They found that hypnotic responsiveness is stable overtime and can be shaped by variables that affect non hypnotic behaviour such as expectancies and boredom. They stated that correlation between attitude and hypnotic susceptibility in the range of .20 and .30 and that positive attitude is important but not sufficient factor in hypnotic responding. They also found that expectancies are significant predictors of hypnotic experience and their subjective experience changed from first session to second session. Therefore, they stated that 'subjective experience as an important determinant in hypnotic responsiveness has to be further researched and included in theories to explain variation in subjective experience for hypnotic suggestions'.

Since, enhancing of hypnotizability has proved to achieve a small degree of modification (Gorassini, 2004), in this study hypnotizability is considered as a stable trait. This study initially assesses trait using HGSHS: A and assesses phenomenological experience of state effects using PCI-HAP.

2.3.2 Measuring hypnotizability

Hypnotizability can be measured based on the individuals performance on a standardized scale. Among thirteen available hypnotizability scale, Harvard Group Scale of Hypnotic Susceptibility, Form A was the most widely used scale. 74 laboratory research used HGSHS: A from the period of 1992-2003 as reported in International Journal of Clinical and Experimental Hypnosis. (Barnier and Mc Conkey, 2004 p 35).

The existing hypnotizability scale (Harvard Group Scale & Standford Scale for Hypnotic Susceptibility) allows categorizing people into high, medium and low hypnotizables based on their behavioural response and provide space for response regarding one's experience. Higher the score on these scales, higher the ability to be hypnotized. Since, these scales do not score subjective experience as a measure for hypnotzability, separate experiential scales are development in the attempt to measure and track the individual's experience of hypnosis (Sheehan and McConkey, 1982; McConkey, 1991).

Many early measures of hypnotizability scale investigated the depth of hypnotic experience of individuals (for example: Harvard Continuous Scale, Cheek, 1959; Orne and Evans, 1966; Field inventory of Hypnotic depth, field, 1965; Hilgard and Tart, 1966) although majority of the scales measure behavioural response. The effects of hypnosis can be analyzed not just by measuring behavioural response but also by examining the subjective experience of the individuals.

Barneir and McConkey (2004) after reviewing a number of studies noted that high hypnotizable persons measured across scales ( HGSHS:A, SHSS:C,CURSS,HIP) time (1974 to 2004) and cultures (European, Australian, African-American, who speak Spanish, German, English or sign language) remain same.

2.3.3 Profile Differences

The study of individual difference has lead to the development of the field in terms of measuring and understanding hypnotizability (Woody and Barnier, 2008). Clinical anecdotes, theories of hypnosis, experimental findings suggest that there exist individual differences in behaviour and experience demonstrated by high hypnotizables. These differences may due to difference in latent typological accounts and dimensions (experiential), but this area of research is dormant (Terhune and Cardeña, 2010). McConkey and Barnier (2004) also suggested that hypnotizability and/or hypnotic responding may involve both dimensional and typological accounts, which need to be examined conceptually and empirically. Therefore, identifying the individual differences on phenomenological experience becomes important.

High susceptible (HS) demonstrate characteristics different from low susceptible which are typically associated with absorption, use of vivid imagery and they process information automatically, they show distinct patterns of brain activity (Barnier and McConkey, 2004)

Highly hypnotizable individuals actively process the suggestion in order to present the hypnotic behaviour. Some high suggestible individuals may place a strong belief to the phenomenal reality of their subjective experience during hypnosis. The attribution they place to their subjective experience also contributes to diversity in their phenomenological experience. Therefore, it is important to consider cognitive and social factors as both contribute in belief and attribution place by highly hypnotized persons.

To examine individual difference and obtain specific profiles for assessment with regard to hypnotic performance two scales were developed such as Standarford Profile Scale of Hypnotic Susceptibility, Form I and Form II (Weitzenhoffer and Hilgard, 1963, 1967) and Diagnoistic Rating Scale (DRS: Orne and O'Connell, 1967). This showed that high hypnotizables did not show uniform pattern in response. These scales were for assessing hypnotic performance and not for phenomenological experience assessment. Other phenomenology approach and measures developed to assess subjective experience of hypnotic phenomena is mentioned in detail under phenomenology approach of this paper.

'Theory and research on intelligence is serve as interesting parallel to theory and research of hypnotisability' (Woody & McConkey, 2005). Gardner's (1983) concept of multiple intelligences considered intelligence as something that is varied among individuals, therefore, there is not one kind of intelligence but there exist multiple intelligences. (Woody & McConkey, 2005). Similarly hypnotizability also exists in variation among individuals, resulting in multiple hypnotizabilities. In this study pre-selection of hypnotizability based on HGSHS (trait assessment) is carried out and variation in state experience is assessed using PCI. Therefore, it is a study focusing on trait-state effects.

McConkey (2008) suggested that it is essential to integrate individual differences with general psychological principles for comprehensive understanding of hypnosis. Woody and McConkey proposed a componential approach claiming that specific abilities are required for performance of suggestions during hypnosis. It is quite clear that individuals differ in their ability to respond to suggestions under hypnosis and hypnotic response is an influence of specific skills plus general hypnotizability of the individual. Therefore, it is important to find out specific ability of the individual along with general hypnotizability to examine their hypnotic response for different suggestions. This cannot be found when assessing individuals based on their behavioural response alone. Hypnotic response is defined as 'the act of positing something imagined as real that characterizes a response as hypnotic rather than the content of the imagined event' (Tellegen, 1979). Examining individuals subjective experience in reference to their response to particular suggestions can prove beneficial to identify abilities that an individual demonstrate to perform the suggestions. (McConkey, 2008).

By studying the similarities and dissimilarities of phenomenological experience of hypnosis, assist in establishing the pattern abilities that exist among highly hypnotizable individual (McConkey and Barnier 2004).

2.3.4 Correlates of Hypnotizability

2.3.4.1 Attitude and Aptitude

Attitude and aptitude are the two elements that ensure hypnosis has or will occur (Barnier and Nash 2008). The correlation between hypnotizability and attitude range from 0.20 to 0.30 and attitude refers to motivation, expectations and willingness of the individuals, which plays an important role for individuals to experience hypnosis. Socio-cognitive theorist (Spanos,1991) claim that these variables can be modified hence, hypnotizability can be enhanced.

Aptitude refers to the ability of the individual and in the absence of hypnotizability, hypnosis as a product cannot be achieved. "Aptitude-centered theories posit that the highly consistent individual differences in hypnotic performance reflect the direct and substantial operation of a latent cognitive ability" (Benham et al., cited by Pekala, 2009)

Sheehan and McConkey (1982; McConkey 1991; Sheehan, 1991) focused on the interaction between cognitions and attributions that hypnotized individuals make about their experiences during hypnosis. They identified different cognitive styles that emerged among highly hypnotizable, which varied within individuals depending on the complexity of the hypnotic experience suggested. These cognitive styles are concentrative (listen to suggestion and wait for it to happen), constructive (actively working on the suggestions received) and independent (change the suggestion to suit their preference) styles. (McConkey and Barnier, 2004)

2.3.4.2 Absorption

Hypnosis is an altered state is naturally experienced by many individuals while engaged in certain activities such as driving a car, reading a book, watching a movie, daydreaming etc. The factor that is responsible for this experience is the so called trait 'absorption' mentioned by Tellegan and Atkinson (1974) as 'almost total immersion in the (imaginal) activity, with indifference to distracting stimuli in the environment'. This trait absorption was found as the correlate to hypnotic susceptibility. (Kirsch, Lynn, Hallquist, 2008)

Tellegen and Atkinson, 1974 defined Absorption as "the openness to absorbing and self-altering experiences". This personality trait has correlated (r= .38) with hypnotic susceptibility (Pekala, 1991). This was supported by Pekala and colleagues (1988,1989) suggesting that absportion is not necessarily a characteristic of all individuals, because low susceptible reported less absorption during hypnosis against baseline condition such as eyes open/closed.

2.3.4.3 Imagination

Hypnosis Susceptibility scales involve two parts, hypnotic induction and testing of suggestions. Hypnotic inductions are often procedures instruction for mental and muscular relaxation. Suggestions are imaginative in nature (e.g., "imagine a force acting on your hands to push them apart," Weitzenhoffer & Hilgard, 1962, p. 18) imagine your arms getting heavier and heavier and lowering), that can be given in or out of hypnosis. Kirsch and Braffman (2010) emphasized on the role of imaginative suggestions defined as requests to experience an imaginary state of affairs as if it were real. Imaginative suggestibility is the degree to which the person succeeds in having the suggested experiences. Hypnotizability is defined as the effect of hypnosis on response to suggestion.

Braffman and Kirsch (1999) studied the important correlate of imaginative suggestibility as determinants of hypnotic and nonhypnotic suggestibility. Through regression analysis they found that hypnotic suggestibility and nonhypnotic suggestibility was correlated with variables such as response expectancy, attitude towards hypnosis, fantasy proneness and absportion. Hypnotic suggestibility correlated with non hypnotic imaginative suggestibility on variables response expectancy, motivation and fantasy proneness, except absorption. Hypnotizability was significantly associated only with individual differences in expectancy and motivation to respond to suggestion. They stated that 'Imaginative suggestibility is the ability or trait underlying the automatic movements, partial paralyses, selective amnesias, pain reduction, and hallucinations that are most commonly observed in the context of hypnosis' and 'highly suggestible hypnotized subjects display and report these experiences (Krisch and Braffman, 2010).

2.3.4.4 Involuntariness / Automaticity

In so far as there is consensus that involuntariness is the core phenomenological feature of hypnotic responses (Kihlstrom, 2008; Kirsch & Lynn, 1998; Weitzenhoffer, 1980). They indicate that the relationship between involuntariness and hypnotic suggestibility is modulated by (typological) experiential response to a hypnotic induction (Nash and Barnier, 2008). According to Barnier, Dienes and Mitchell (2008) the experience of involuntariness, a characteristic feature of hypnotic response was explained by Weitzenhoffer (1974) as classic suggestion effect, 'the transformation of the essential, manifest ideational content of a communication' into behaviour that is experienced as involuntary.

The above mentioned variables are only few of the correlates of hypnotic susceptibility form the socio-cognitive theorist's perspective.

2.3.5 Theories

Vaitl et al., (2005) 'Current theories of hypnosis emphasize the enactment of self-directed cognitive strategies (Spanos, 1986), response expectancies (Kirsch, 2000), or alterations in central executive control (Bowers, 1992; Farvolden & Woody, 2004) as

processes mediating response to hypnotic suggestion'.

2.3.5.1 Disassociated Control Theory

Based on Norman and Shallice (1986) model of action control, this theory states that involuntariness is the result of hypnotic induction which leads to inhibition of high-level executive or Supervisory attentional systems (SAS) or central processing resources responsible for control of volition (will). The suggested phenomena are the result of activation of low-level cognitive control structures or schemata, triggered by hypnotist words and not attention. (Woody and Sadler, 2008; Brown and Oakley, 2004)

This theory contrasts neodissociation and sociocognitive approaches which explain hypnotic behaviour of involuntariness as attribution of involuntariness, but executed voluntarily. One limitation of this theory is that hypnotic phenomena can be suggested without hypnotic induction; therefore the explanatory power of dissociated control theory is reduced. (Brown and Oakley, 2004)

2.3.5.2 Response set theory

Kirsch and Lynn 1997 mainly emphasize on subjective experiences under hypnosis. They propose that subjects enter hypnosis with generalized response expectancy, engaging in experiencing the suggestion given by hypnotist leading to alteration in their experience, which depends on the response sets (relationship between individual action and events in environment) placed before execution of behaviour. Therefore, subjects experience involuntariness of hypnotic behaviour by attributing it to external cause. The role of expectancies and intentions do not require much attention, therefore response is automatic or quasi-automatic operation and this interferes in 'initiating, interrupting, continuing and terminating action'. Motor movements may require less or no attention, but motor challenge entail 'intentionality and attentional resources to produce and maintain suggested response'(Lynn, Kirsch and Hallquist, 2008) . Therefore, it is suggestions and altered experience that triggers response sets operating in a mindless, automatic manner.

Empirical evidence supports response set theory demonstrated in Dual-task methodology showed that interference in challenging tasks increased for high susceptible under hypnosis. Response set theory assumes that 'generating the subjective experience is necessary for activation of expected response resulting in increased interference' (Brown and Oakley, 2004).

2.3.5.3 Barber (1999) Three dimensional theory of high hypnotic suggestibility

Barber (1999) argued that there exist three types of highly responsive participants and proposed a three dimensional theory of high hypnotic suggestibility. They are the fantasy prone, the amnesia prone and the positively set participants. The fantasy prone were identified initially with in-depth interview, revealing that these participants engaged in pretend play as children, enjoying life like sexual fantasies highly , experienced vivid and realistic fantasy based experience. Only one percent of college students are amnesia-prone and fantasy prone, majority of the HS are positively set participants. They present positive attitudes towards the idea of hypnosis, positive motivation to perform and experience as suggested, positive expectation to experience suggested effects, positive set to visualize suggestions. (Lynn, Meyer and Shindler, 2004)

Phenomenology Approach and hypnotic experience

2.4.1 Introduction

Hypnosis researchers continuing struggle for scientific recognition have always been concerned about methodological techniques. Sutcliffe (1958, 1960) argued that the fundamental difficulty in convincing people about the genuineness of hypnotic effects is that hypnosis is essentially a private experience. Thus, 'hypnosis has always been faced with challenge of scientifically quantifying internal, subjective experiences' (Nash and Barnier, 2008).

It important to understand what is phenomenology, before looking into various phenomenological approach suggested by various researchers. Smith defines the discipline of phenomenology initially as the study of structures of experience, or consciousness. 'Literally, phenomenology is the study of "phenomena": appearances of things, or things as they appear in our experience, or the ways we experience things, thus the meaning things have in our experience' (Smith, 2008). A phenomenon is "any object perceived by the senses or consciousness" (Flew, 1979, p. 248).

Woodard (2003) has given a comprehensive historical overview of the development of theory and research on hypnotic experience, which is presented as follows. Research approaches to study hypnotic experience can be broadly classified into two categories. Firstly, Quasi-Phenomenological approaches to research labeled as phenomenology but maintain quantitative emphasis. This approach includes Shor's Method, Sheehan and McConkey's Experiential Analysis Technique and Pekala's Phenomenology of Consciousness Inventory (PCI). Secondly, Pure-Phenomenological approach includes Arrigo's Hermeneutical-Phenomenological Research, Beshai's Phenomenology of Hypnosis, Cowles Existential-Phenomenological Model, Woodard's phenomenological and perceptual methodology and Sundararajan's Heideggerian Approach.

2.4.2 Pure Phenomenology

Phenomenological research methods to study hypnotic experience based on philosophical phenomenology are : Arrigo's Hermeneutical-Phenomenological Research (1998) with Neurolinguistic Programming (NLP) to investigate changing belief with NLP technique called reimprinting (changing limiting belief about the self), she investigated two therapist-client interactions during hypnosis session and meaning was drawn from bridging her internal experience of an external viewpoint through observing videotapes. Beshai's Phenomenology of Hypnosis (1974), he stated "Phenomenology views hypnosis as a social, interactional phenomenon involving dialectic between perception and imagination, between the subject and the hypnotist, or between the self and other" (p.220). He investigated internal experiencing of two graduate students. Woodard presented phenomenological and perceptual methodology for understanding hypnotic experience (Woodard, 2004) by investigating internal experience of psychologist and clients' of hypnosis session. He argued for an affective theoretical approach for better understanding hypnosis, hypnotic phenomena and factors affecting the therapist-client relationship. Other theoretical approaches are Cowles Existential-Phenomenological Model. Cowles (1998) stated "I suggest that perception prefigures embodiment: our bodies will react according to what we perceive to be real and true. Ergo, the power of suggestion is created through an alteration of perception" Cowles explained that this alteration of perception through suggestion occurs as a result of the hypnotic experience with its relaxation of physical and mental activity that "… allows the prefigurement of embodiment by perception to stand out more clearly". Sundararajan's Heideggerian Approach (1993) utilized a Heideggerian interpretation of partial hypnotic inductions of Milton Erickson to demonstrate the autonomy of language as a self-referential system. She explained that the hypnotist's skill is in listening as the language or words bring "authentic appearance", i.e., "calls things into being, it brings things near, it grants presence and it is silence" in a unique way for each individual.

2.4.3 Quasi Phenomenology

In Shor's Phenomenological Method (1979), a skilled examiners other than the hypnotist and participant made interpretative judgment retrospectively to subject's descriptions of experience to hypnotic suggestions. The investigator applied diagnostic evaluations using eight dimensional variables (trance, nonconsicous involvement, archaic involvement, drowsiness, relaxation, vividness of imagery, absorption, and access to the unconscious) and a five-category rating scale (none, less than slightly, slight, intermediate and moderate, and don't know) to descriptions of the conscious hypnotic experience of the participant. (McConkey and Barnier, 2004; Woodard, 2004)

Sheehan and McConkey's Experiential Analysis Technique: Recognizing the significance of phenomenological features of hypnosis and the fundamental role of cognitive strategies in responding to hypnotic suggestions, Sheehan and McConkey (1982) developed the Experiential Analysis Technique (EAT). The EAT was motivated by an inter actionist perspective of hypnosis, where the hypnotic subject is considered to be a dynamic individual who brings certain skills, abilities and expectancies into hypnotic context. In the EAT, the hypnosis session is videotaped as the researcher could not question the participant during hypnosis session. Later on the participant and a second, independent experimenter watched the videotape. The cues afforded in the videotape of the hypnosis session reminded participants about their responses and their associated subjective experiences. The EAT is a useful technique for exploring participants' interpretation of suggestions, any strategies that they employed and their experience of the suggested effects. Additionally, the EAT provides information on affect, imagery, intensity and levels of control associated with hypnotic responding (Barnier and McConkey, 2004). .

One of the first studies using the EAT illustrates the different subjective experiences of a number of hypnotic participants whose behaviour responding was similar (Laurence and Perry, 1981). The findings of the EAT in general, suggested that there is diversity in how highly hypnotizable individuals approach, experience and respond to hypnotic suggestions. These differences, revealed by EAT; suggest that in-depth analysis of subjective experience can help to reveal component processes in hypnotic responding. The EAT has been evaluated and extended by many researchers to explore several hypnotic phenomena, for example Sheehan et al., 1978; Laurence and Perry, 1981; Bryant and McConkey, 1989; Banyai, 1991; West and Fellows, 1996; Barnier and McConkey, 1999, 2004; Bryant and Mallard, 2002.

Field (1965) developed a finger signaling method and asked subjects to move their hand when hypnotic depth increased. Evans and Orne (1965) asked subjects to move the hands of the clock with the numbers 1 (normal and alert) to 10 ('as deeply hypnotized as any person to become'). Both these studies focused on assessing the subjective experience through depth ratings and examine the concordance of experience with behaviour.

In 1999 McConkey used a 'dial' method to track the strength of the ongoing hypnotic experience across types of items (direct motor, motor challenge, perceptual-cognitive) and the time course of items (i.e. suggestions or onset phase, test phase and offset or cancellation phase). Subjects (high, medium, and low hypnotizable) were asked to turn a dial to indicate a change in the strength of their subjective experience. The dial was connected to a computer that recorded the position of the pointer (i.e. rating of experience) every second across the three phases of each item. This study revealed that highly hypnotizable individuals showed enhanced positive experience during test phase and encouraged the intensity of their subjective involvement.

Pekala's (1995) Phenomenology of Consciousness Inventory (PCI) was "… developed to assess and quantify states of consciousness and altered states of consciousness (Tart, 1975) and it has been used extensively in the assessment of the phenomenology of the hypnotic experience". It is a 53-item self-report scale that has been used to assess subjective reports of hypnosis retrospectively. Retrospective Phenomenological assessment is used to "combine the strengths of behaviorism's overt variables with introspection's covert events: Map consciousness in reference to specific short well- defined stimulus conditions, retrospectively assess that subjective experience, across groups of randomly selected individuals and use standardized self-report questionnaires". (Pekala, 2009 in Keynote address at SCEH). The author called it psychophenomenology (Pekala, 1980; Pekala & Wenger, 1983) to distinguish it from philosophical phenomenology (Husserl, 1913/72; Kockelmans, 1967) and the phenomenological psychologists (Valle & King, 1978). Psychophenomenology was designed to not only describe 'but to empirically quantify and statistically assess the phenomena of consciousness' in a reliable and valid manner' (Pekala, 1991). This psychophenomenological approach to consciousness assumes the principle of stimulus-state specificity (principle of specificity) which states that

Across groups of randomly selected individuals the same behaviours in the same stimulus setting (the same stimulus conditions) will be associated with the same intensities and patterns of phenomenological experience (the same phenomenological state) while different stimulus conditions will be associated with different intensities and/or patterns of phenomenological experience (Pekala, 1991 p. 85-86)

The EAT and dial method highlight the value of supplementing the behavioural indicators of hypnotizability scales with subjective indicators. However, the EAT is best suited for a detailed investigation of selected subjects as it would require more time and personnel. In the present study experience of highly hypnotizable individuals is examined using Pekala's Phenomenology Consciousness Inventory.

2.4.4 Empirical study using PCI

Pekala's PCI has been used broadly in the study of states of consciousness or to study various stimulus conditions including: Hypnotism (Pekala, 1991b, 2002; Pekala & Kumar, 2000, 2007), Breathing (Pekala, Forbes, Contrisciani, 1988/89a), Trance drumming (Maurer, Kumar, Woodside, & Pekala, 1997; Woodside, Kumar, & Pekala,1997), Fire-walking (Pekala & Ersek,1992/93; partially replicated by Hillig & Holroyd, 1997/98), an OBE within an NDE (Maitz & Pekala, 1991). Other researchers have used it to look at Schizophrenia (Roussel &Bachelor, 2000/01), Meditation (Hageman, 2008; Venkatesh et al., 1997), Mediumship and shamanism (Rock & Beischel, 2008; Rock et al, 2008), Self regulation of eating behavior (Hutchinson-Phillips et al., 2006) and Agoraphobia and virtual reality (Huang et al., 2000) (Pekala, 2009, slide. 31)

2.4.5 Application of PCI

In this section some of the studies that have used PCI to investigate trait-state aspects of hypnosis and differential organisation of the structures of Consciousness during hypnosis are reviewed.

Hilgard 1975, stated that 'hypnotic responsiveness is more a matter of the characteristics of the subject than of the state produced by the hypnotic induction. Studying dimensions of subjective experience in relation to trait aspect will help in determining why some individuals easily enter altered state of consciousness. Therefore, it is important to distinguish trait and state aspects contributing to phenomenological experience of hypnosis.

Pekala and Kumar 1988 conducted a study to determine if high susceptible individuals report greater degree of phenomenological experience in comparison with low susceptible on hypnotic induction and eye closed baseline condition. HGSHS: A was used determine hypnotic susceptibility and PCI to map phenomenological experience. The results supported the hypothesis that high susceptible showed phenomenological difference in eye close baseline condition and enhanced phenomenological experience during hypnosis against low susceptible.

In the following year (1989) Pekala and Kumar replicated the previous study to examine the phenomenological effects for high and low susceptible such as the dimensions of phenomenological experience and intensity difference in experience during hypnotic induction against baseline eyes open/closed condition. It was suggested that if high susceptible reported decreased volitional control, self awareness, increased absorption, positive and negative affect, rationality and memory; and a greater alteration in state of awareness and altered experience (body image, time sense, perception and unusual meaning during baseline condition (eyes open/closed) they may have an increased experience of the same without an induction. They found that there was significant intensity differences comparing different states (eyes closed versus hypnotic induction) especially for high susceptible compared to lows. During hypnosis high susceptible compared to low susceptible, reported increased altered experiences involving altered body image, altered time sense, altered perception and altered meaning, absorption, altered state of awareness and decreased internal dialogue, rationality, volitional control, memory, self-awareness, and arousal. They also found that the interactions between stimulus conditions and susceptibility groups resulted in 10 out of 26 dimensions to be significant (p< .01 level). Hypnosis intensified the following experiences especially for high susceptibles on the dimensions of altered experiences, altered body image, altered time sense, altered perception and altered meaning, self-awareness altered state of awareness, internal dialogue, rationality, volitional control and memory. The results of this study replicated the findings of the previous study. It was interpreted by supporting Tellegen perspective that hypnotic susceptibility is the result of interacting variables, emphasizing the role of hypnotic ability along with state/situational variables contributing to phenomenological effects. (Pekala, 1991)

Pekala and colleagues have consistently studied the phenomenological effects due to hypnotic induction and found it is strongly related to hypnotizability. Three studies Pekala et al., 1986; Kumar and Pekala, 1989; Pekala et al., 1989) comparing hypnotic induction with eyes closed baseline condition was 'consistently associated with decreased positive affect (joy, love, sexual excitement), sadness, self awareness, internal dialogue, rationality, volitional control and memory and increased altered experience involving time sense, perception and state of awareness'. There were 'no particular suggestions given relevant to enhancing an individual's responsiveness to the PCI dimensions were given'.

Kumar and Pekala, 1989 found that the hypnotic induction (Harvard Scale protocol) when compared with baseline sitting quietly period for the high susceptible showed that they experienced altered body image, altered time sense, altered perception, self-awareness, altered state of awareness, internal dialogue, rationality, volitional control and memory and less distracted during hypnotic induction. The authors compared the pattern of inter-correlations for 12 major dimensions, and found less association of dimensions for high susceptible compared to low susceptible. These results were interpreted by the authors through Hilgard's neodissociation theory to suggest that: '... hypnosis appears to maintain a very low level of association among the subsystems of consciousness for very highs (Pekala and kumar,p.18) (as mentioned by Kumar, Pekala, McCloskey, 1999)

Kumar, Pekala, McCloskey (1999) in their study on the cross validation of findings regarding the phenomenological state effects during hypnosis, found that dissociated control state (trance effects- alterations in state of awareness and altered experiences), positive affect, and attention to internal process were significantly correlated with hypnotisability. They examined the five state effects factors (Factor -based scales) which correlated with hypnotisability in two sample of participants. One sample was from the previous study (Pekala et al, 1993) consisting of 150 participants and they examined 53 participants (53/60) for their cross validity study, who were classified as high, medium and low based on Harvard scores. The other two state effects were negative affect and visual imagery. They reported that the factor based state effects scores across three different studies (their cross validation study, 1999, Kumar et al, 1996 and Pekala et al., 1993) using different assessment instruments (Harvard and Stanford) provides a 'strong support to the robust nature of state effects associated with hypnotisability'. The higher the hypnotisability the stronger the state effects of positive affect, inward absorbed attention to mental process, and dissociated control both in trance and reality orientations as traditionally described Farthing,(1993) that 'hypnosis is an altered state of consciousness characterized by both alterations of subjective experience and alterations of mental process of perception, thinking, memory and control of behaviour.'

'Dixon and Laurence (1992), the highly hypnotizable typically report experiencing a different state of awareness during a hypnotic induction. There subjective experiences are related to the notions of imaginative involvement, absorption, loss of volitional control and dissociation.' (As cited/referred by Kumar, Pekala, McCloskey (1999))

In 1989, Pekala et al., conducted a study to compare the pheonomenological effects across four stimulus condition: deep abdominal breathing, progressive relaxation hypnotic induction procedure and eyes closed baseline condition. The first three stress management condition was compared with baseline condition. Subjects were 300 nursing students divided into ten groups; their hypnotic susceptibility was assessed using HGSHS and PCI to map phenomenological experience. Two sessions were scheduled with approximately one week apart. The results showed that across conditions, differences were seen in phenomenological effects among the hypnotic susceptible individuals. Hypnosis compared against baseline condition showed that, high susceptible reported increased altered experiences and state of awareness and decreased self-awareness, rationality, volitional control and memory than lows. Comparing progressive relaxation and hypnosis, it was noticed that high susceptible reported experiences of progressive relaxation condition as increased positive affect (love, joy), altered experience and altered state of awareness, inward and absorbed attention and decreased self-awareness rationality, volitional control, memory and arousal. This was found similar even during hypnosis, except self-awareness. They stated that irrespective of the stimulus condition 'be it hypnosis or progressive relaxation, it will result in facilitating alteration in subjective experience'. Unsure of the role of context effects and expectancy in generating alteration in subjective experience during hypnosis, but when expected to be hypnotized it facilitates alteration in subjective experience for high than for lows. That absorption is not necessarily a characteristic of all subjects. Increased absorption during hypnosis is not necessarily a trait of all subjects (i.e lows experienced absorption during baseline condition than hypnosis). They interpreted the results as an interaction of trait and situational variables. (Pekala, 1991, p 279-286)

The study of individual difference has lead to the development of the field in terms of measuring and understanding hypnotizability (Woody and Barnier, 2008). Hypnotizability and/or hypnotic responding may involve both dimensional and typological accounts, which need to be, examined conceptually and empirically (McConkey and Barnier 2004). Therefore, identifying the individual differences on phenomenological experience becomes important.

The main focus of the present study is to examine the subjective experience of highly hypnotizable individuals during hypnosis. To answer the following questions:

What are the subjective experiences of high hypnotizable individuals during hypnosis?

What is the pattern of dimensions experienced highly hypnotizable individuals?

What are the dimensions that are commonly experience by highly hypnotizable individuals?

What are dimensions that are uniquely experienced by highly hypnotizable individuals?