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Hypnosis and Beyond: Exploring the Broader Domain of Suggestion

DOI:10.1037/cns0000019
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Peter W Halligan at Cardiff University
Peter W Halligan
David A Oakley at University College London
David A Oakley
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Abstract

Despite its many influences on numerous features of human behavior and consciousness, suggestibility, the ubiquitous disposition to generate and modify experiences, thoughts, and actions remains one of the least researched aspects of human cognition. As a critical feature of hypnosis, much research on suggestion and suggestibility has understandably focused on hypnotic suggestion with comparatively little exploration of the larger rich domain of suggestibility. From a research perspective, suggestibility, can be regarded as comprising a range of bio–psycho–social processes that facilitate or enhance the probability of a suggestion being accepted and believed. Suggestion, on the other hand, can be seen as a form of communicable ideation or belief, that once accepted has the capacity, (like other strong beliefs) to exert profound changes on a person’s mood, thoughts, perceptions, and ultimately their behaviors. Although studies of hypnotic suggestion have historically provided much productive research, the comparative neglect of the broader domain of suggestion seems surprising, given its demonstrable potential as a causal explanatory framework for many aspects of human behavior from the placebo effect to advertising. In addition to discerning the potential adaptive value(s) of suggestibility, it is now timely, given the growing interest from neuroscience in hypnotic suggestion, to revisit previous attempts to elucidate potential shared underlying psychological properties.
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Hypnosis and Beyond: Exploring the Broader Domain of Suggestion
Peter W. Halligan
Cardiff University
David A. Oakley
University College London
Despite its many influence on numerous features of human behavior and conscious-
ness, suggestibility, the ubiquitous disposition to generate and modify experiences,
thoughts, and actions remains one of the least researched aspects of human
cognition. As a critical feature of hypnosis, much research on suggestion and
suggestibility has understandably focused on hypnotic suggestion with compara-
tively little exploration of the larger rich domain of suggestibility. From a research
perspective, suggestibility, can be regarded as comprising a range of bio–psycho–
social processes that facilitate or enhance the probability of a suggestion being
accepted and believed. Suggestion, on the other hand, can be seen as a form of
communicable ideation or belief, that once accepted has the capacity, (like other
strong beliefs) to exert profound changes on a person’s mood, thoughts, percep-
tions, and ultimately their behaviors. Although studies of hypnotic suggestion have
historically provided much productive research, the comparative neglect of the
broader domain of suggestion seems surprising, given its demonstrable potential as
a causal explanatory framework for many aspects of human behavior from the
placebo effect to advertising. In addition to discerning the potential adaptive
value(s) of suggestibility, it is now timely, given the growing interest from
neuroscience in hypnotic suggestion, to revisit previous attempts to elucidate
potential shared underlying psychological properties.
Keywords:
hypnosis, suggestion, suggestibility, placebo, expectation
Hypnosis has successfully harnessed the
powerful effects of attention, expectation, and
suggestion to produce, modify, and enhance a
broad range of subjectively compelling experi-
ences and behaviors (Oakley & Halligan, 2013).
It has also captivated scientific interest for as
long as there has been a scientific psychology
(Kihlstrom, 2013). Recent reviews confirm
that hypnotic suggestion has made a signifi-
cant contribution to many areas of cognitive
and social psychological research including
cognitive neuropsychology (Barabasz &
Barabasz, 2008; Halligan & Oakley, 2013;
Kihlstrom, 2013, 2014; Oakley & Halligan,
2009, 2013). Nevertheless, despite being a
common and significant feature in many
forms of human behavior, (Schumaker, 1991)
as well as a key element responsible for gen-
erating the broad range of subjective experi-
ences and behaviors produced in hypnosis
(Kihlstrom, 2008), suggestibility has received
comparatively little attention (Gheorghiu et
al., 1989; Lundh, L., 1998; Kirsch et al.,
2011; Michael, Garry, & Kirsch, 2012; Schu-
maker, 1991) and still does not feature in the
Oxford Companion to the Mind.
Accordingly “suggestion has not yet become
a truly independent domain of psychological
research”(Gheorghiu & Kruse, 1991) and most
current research comprises the “juxtaposition of
suggestion and hypnosis” (Gheorghiu, 1989,p.
4) with the result that “the manifestation and
nature of suggestion have been discussed in the
literature primarily in connection with hypnotic
events”(Gheorghiu et al., 1989, p. 4). Conse-
quently, fundamental aspects of suggestion and
suggestibility have been relatively unexplored,
and “the importance of treating suggestion as an
important domain in its own right has been
largely ignored” (Kirsch et al., 2011).
Peter W. Halligan, Cardiff University; David A. Oakley,
University College London.
Correspondence concerning this article should be ad-
dressed to Peter W. Halligan, School of Psychology, Cardiff
University, Cardiff CF10 3AT. E-mail: Halliganpw@
cardiff.ac.uk
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
Psychology of Consciousness: Theory, Research, and Practice © 2014 American Psychological Association
2014, Vol. 1, No. 2, 105–122 2326-5523/14/$12.00 http://dx.doi.org/10.1037/cns0000019
105
... Suggestion, a concept not related to hypnosis alone, is also necessary to define. Halligan and Oakley (2014), as a starting point, referred to American psychologist Boris Sidis' (1867-1923) first definitions of suggestion. They pointed out that for Sidis, a suggestion was a communicable ideaa form of beliefthat under certain levels of suggestibility could be communicated directly or indirectly, and resulting in automatic and rapid, temporary or permanent alterations in the subject's experience or behavior. ...
... They pointed out that for Sidis, a suggestion was a communicable ideaa form of beliefthat under certain levels of suggestibility could be communicated directly or indirectly, and resulting in automatic and rapid, temporary or permanent alterations in the subject's experience or behavior. Halligan & Oakley (2014, p. 111) Suggestions can be hypnotic or non-hypnotic depending on whether they are administered with or without hypnosis, that is, with or without a hypnotic induction (Halligan & Oakley, 2014). When suggestions are given in a hypnotic context, they can be administered by a person designated or perceived to be in the role of a "hypnotist" or the suggestions can be self-administered, in which case the situation is construed as "self-hypnosis" . ...
... Posthypnotic suggestions are suggestions that are administered during hypnosis but intended to take their effects following the termination of the hypnotic experience, that is, after the formal hypnosis session has ceased (e.g., Barnier & McConkey, 1999;Halligan & Oakley, 2014). Thus, the suggestions can be (partially) separated from the hypnotic context . ...
HYPNOSIS, ATTENTION AND ATTENTION DEFICITS - PERSPECTIVES FROM BRAIN FUNCTIONS, BEHAVIORAL PERFORMANCE AND CLINICAL APPLICATIONS
Thesis
Full-text available
  • Jan 2022
Background. The present thesis combines studies on hypnosis, attention, and attention deficits from various perspectives to extend our understanding of hypnosis and its applications. This thesis includes experimental and clinical research of hypnosis from the perspectives of brain functions, behavioral performance, and clinical interventions. This thesis investigated whether brain oscillations, pre-attentive auditory information processing, auditory attentional performance, and deficits of attention can be influenced by hypnosis and hypnotic suggestions. Two studies focused on highly hypnotizable healthy participants, one study compared adults with attention deficit hyperactivity disorder (ADHD) to control participants, and one investigated solely adults with ADHD. Aims. The present thesis examined: 1) whether hypnosis differs from the wake state as measured with the spectral power density of electroencephalography (EEG); 2) whether hypnosis and hypnotic suggestions can be used to influence bottom-up and/or top-down auditory attention. The former was indexed by the pre-attentive mismatch negativity (MMN) component of the auditory event-related potential (ERP). The latter was measured as the performance on a Continuous Performance Test (CPT); 3) whether hypnotherapy and hypnotic suggestions can be applied to adults with ADHD to relieve their symptoms in a long-lasting way, and to improve their attentional performance in an auditory reaction time task requiring sustained voluntary attention. Methods. The present thesis applied various methods for investigating the research aims: EEG (Studies I–II), behavioral reaction time task (Study III) and self-report measures for evaluating the follow-up results of two individual psychological treatments, hypnotherapy and cognitive behavioral therapy (CBT) in ADHD adults (Study IV). The first three studies had a similar procedural structure including four experimental conditions: 1) pre-hypnosis, 2) after a hypnotic induction (i.e., neutral hypnosis), 3) hypnotic-suggestion condition with study-specific suggestions and 4) post-hypnosis. The first and second studies included a common EEG experiment with nine highly hypnotizable participants. In the first study, EEG spectral power was measured and analyzed at ten frontal, central, and posterior/occipital electrodes. In the second study, the MMN was recorded at three frontal electrodes using a passive oddball paradigm with sinusoidal standard (500 Hz) and deviant (520 Hz) tone stimuli. Both studies included in the hypnotic-suggestion condition suggestions aimed at altering the tone perception (“all tones sound similar in pitch”). The third study examined, in adults with ADHD and in healthy control participants, whether hypnotic suggestions can influence performance in a three-minute version of the auditory CPT. The suggestions aimed at improving speed and accuracy. The fourth study used a controlled, randomized design in investigating the effectiveness of hypnotherapy in treating adults with ADHD. It compared the six-month follow-up outcome of the hypnotherapy with the outcome of a short CBT in various self-report symptom scales. Repeated-measures analysis of variance and t-tests were used in the statistical analysis of the studies. Results. The results of Study I revealed no EEG power changes between pre-hypnosis and hypnosis conditions, challenging the current understanding that the increase of theta power is a marker of the hypnosis state. Contrary to the results of a few earlier studies, no statistically significant differences in the MMN amplitudes between the conditions were found in Study II, indicating that the auditory pre-attentive processing may not be influenced by hypnosis or hypnotic suggestions. Study III indicated that hypnotic suggestions have an effect on the reaction times in the CPT both in ADHD adults and healthy control participants. Study IV revealed that the treatment benefits remained during the six-month follow-up with both hypnotherapy and CBT groups when measured with self-report ADHD symptom scales. The benefits of hypnotherapy and CBT, however, differed in general psychological well-being, anxiety and depression, and approached significance in the ADHD symptoms scale, indicating a better long-term outcome for hypnotherapy. Conclusion. Results of the present thesis indicate that: 1) the spectral power of EEG in the theta band cannot be used as a reliable marker of the hypnotic state in highly hypnotizable participants; 2) hypnotic suggestions can be used to influence performance in a sustained attention reaction time task, but they do not modulate the early pre-attentive auditory information processing, reflected by MMN; 3) hypnosis, hypnotic suggestions, and short hypnotherapy treatments can be successfully applied to adults with ADHD to improve their performance in a sustained attention reaction time task, and to reduce their ADHD and other symptoms in a long-lasting (at least half a year) way. Thus, hypnosis/hypnotherapy seems to be a usable treatment method for the ADHD adult population.
... Prior expectations and suggestion are also proposed to impact on perceptual experiences. Halligan and Oakley highlight the effects of priming, such that prior knowledge or belief can influence individuals' thoughts, behaviour, and emotions, and exposure to paranormal suggestion can result in the reporting of paranormal phenomena [10]. As an example, Wiseman and colleagues [11] created a series of fake seances, and suggested to participants that an object was moving, although no movement occurred. ...
Paranormal experiences, sensory-processing sensitivity, and the priming of pareidolia
Article
Full-text available
This investigation tested the effect of priming on pareidolia (the hearing of illusory words in ambiguous stimuli). Participants (41 women, 20 men, mean age 29.95 years) were assigned to primed (n = 30) or unprimed (n = 31) groups: the former were told the study was of ‘purported ghosts voices’, the latter ‘voices in noisy environments.’ Participants were assessed for perception of human voices within recordings of purported electronic voice phenomena (EVP), degraded human speech, normal human speech, and white noise. The primed group had significantly higher perception of voices within EVPs than in degraded speech, this difference was not found for unprimed participants. In contrast to the previous use of this design, the primed group did not have higher perception of voices in EVPs and degraded speech than did the unprimed group. The Aesthetic Sensitivity dimension of the Highly Sensitive Person Scale (HSPS) was associated with detection of degraded stimuli, but not with accuracy of stimulus identification. HSPS score was related to lifetime reporting of anomalous and paranormal experiences. This study partially replicates a paranormal priming effect and shows relationships between HSPS and detection of ambiguous stimuli and anomalous and paranormal experiences.
... Phenomenological control is not restricted to direct, verbal imaginative suggestion, but rather can occur in a variety of contexts (Halligan & Oakley, 2014) and in response to implicit suggestion (e.g., repeatedly passing iron rods at a short distance from the subject's body in the 18 th century progenitor of hypnosis, mesmerism; Hammond, 2013;Pintar & Lynn, 2008). It is goal-directed but experienced as unintentional. ...
Sixty Years After Orne’s American Psychologist Article: A Conceptual Framework for Subjective Experiences Elicited by Demand Characteristics
Article
Full-text available
  • Jul 2022
Study participants form beliefs based on cues present in a testing situation (demand characteristics). These beliefs can alter study outcomes (demand effects). Neglecting demand effects can threaten the internal and external validity of studies (including their replication). While demand characteristics garnered much attention following Orne’s introduction of this notion, consideration of their effects has become sparse in experimental reports. Moreover, the concept remains confusing. Here, we introduce a conceptual framework for subjective experiences elicited by demand characteristics. The model distinguishes between participants’ awareness of the hypothesis, their motivation to comply with it, and the strategy they use to meet situational requirements. We stress that demand characteristics can give rise to genuine experiences. To illustrate, we apply the model to Evaluative Conditioning and the Rubber Hand Illusion. In the General Discussion, we discuss risks and opportunities associated with demand characteristics, and we explain that they remain highly relevant to current research.
... A perennial question is where hypnosis falls within the broader domain of suggestion and suggestibility, and whether the various phenomena linked under this term can be encapsulated within a broader category such as direct verbal suggestibility (Halligan & Oakley, 2014;Oakley & Halligan, 2017). Although it is conceptually appealing to consider hypnosis as a member of a broader class, the evidence that these different phenomena form a single homogeneous category is mixed. ...
Hypnosis and imagination
Chapter
  • Jul 2022
Hypnosis involves the use of verbal suggestion to modulate behaviour and experience. Hypnosis and imagination have long been associated and the view that hypnotic suggestion effects changes in experience through imagination is a persistent one. In this review, we first present a brief overview of hypnosis and then turn to its potential relationship to imagery and imagination. We consider whether individual differences in imagination may relate to hypnotic suggestibility and the extent to which imagery is recruited during response to hypnotic suggestions in psychological and neuroimaging studies. Finally, we briefly consider the roles of imagery and suggestion in clinical applications of hypnosis. We conclude that whilst hypnotic suggestibility may relate to variability in imagination, hypnotic suggestion and voluntary forms of imagery are subserved by dissimilar neurocognitive mechanisms.
... Phenomenological control is not restricted to direct, verbal imaginative suggestion, but rather can occur in a variety of contexts (Halligan & Oakley, 2014) and in response to implicit suggestion (e.g., repeatedly passing iron rods at a short distance from the subject's body in the 18 th century progenitor of hypnosis, mesmerism; Hammond, 2013;Pintar & Lynn, 2008). It is goal-directed but experienced as unintentional. ...
Sixty years after Orne’s American Psychologist article: A Conceptual Framework for Subjective Experiences Elicited by Demand Characteristics.
Preprint
Full-text available
  • Jun 2021
Unlike objects, study participants form beliefs from cues present in a testing situation (demand characteristics). These beliefs can alter study outcomes (demand effects). Neglecting demand effects can threaten the internal and external validity of studies (including their replication). While demand characteristics garnered much attention following Orne's introduction of this notion, consideration of their effects has become sparse in experimental reports. Moreover, the concept remains confusing. Here, we introduce a conceptual framework for subjective experiences elicited by demand characteristics. The model distinguishes between participants' awareness of the hypothesis, their motivation to comply with it, and the strategy they use to meet situational requirements. We stress that demand effects may elicit genuine experiences. To illustrate the heuristic value of the model, we apply it to Evaluative Conditioning and the Rubber Hand Illusion. The General Discussion summarizes the main insights of our current analysis and discusses risk and opportunities associated with demand characteristics.
... Based on experience from a range of psychological (Oakley, 1985) and neuropsychological phenomena including striking dissociations between what patients report verbally and what they can respond to behaviourally (e.g., visual neglect, anosognosia) (LeDoux et al., 2020), hypnosis Halligan, 2009, 2013), suggestion (Halligan and Oakley, 2014), placebo (Kirsh, 2019), and conditions such as amnesia (Milner, 1967), blindsight, (Weiskrantz, 1997), visual neglect (Marshall and Halligan, 1988;Halligan and Marshall, 1991), hysteria (Halligan, 2011), and phantom limbs (Halligan, 2002), we concluded that psychological content experienced in subjective awareness is generated by and within non-conscious brain systems in the form of a continuous self-referential "personal narrative." Wegner (2002) presents a compelling series of cases where people feel they are willing an act when they are not, such as in phantom limbs and ear wiggling, or when they feel they are not willing an act or experience when they are in fact initiating, such as auditory hallucinations, automatic writing, the Chevreul pendulum effect, dowsing, ideomotor actions -particularily in the context of hypnosis, which can produce the feeling that "your actions are happening to you rather than that you are doing them" (Lynn et al., 1990). ...
Giving Up on Consciousness as the Ghost in the Machine
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  • Apr 2021
Consciousness as used here, refers to the private, subjective experience of being aware of our perceptions, thoughts, feelings, actions, memories (psychological contents) including the intimate experience of a unified self with the capacity to generate and control actions and psychological contents. This compelling, intuitive consciousness-centric account has, and continues to shape folk and scientific accounts of psychology and human behavior. Over the last 30 years, research from the cognitive neurosciences has challenged this intuitive social construct account when providing a neurocognitive architecture for a human psychology. Growing evidence suggests that the executive functions typically attributed to the experience of consciousness are carried out competently, backstage and outside subjective awareness by a myriad of fast, efficient non-conscious brain systems. While it remains unclear how and where the experience of consciousness is generated in the brain, we suggested that the traditional intuitive explanation that consciousness is causally efficacious is wrong-headed when providing a cognitive neuroscientific account of human psychology. Notwithstanding the compelling 1st-person experience (inside view) that convinces us that subjective awareness is the mental curator of our actions and thoughts, we argue that the best framework for building a scientific account is to be consistent with the biophysical causal dependency of prior neural processes. From a 3rd person perspective, (outside view), we propose that subjective awareness lacking causal influence, is (no more) than our experience of being aware, our awareness of our psychological content, knowing that we are aware, and the belief that that such experiences are evidence of an agentive capacity shared by others. While the human mind can be described as comprising both conscious and nonconscious aspects, both ultimately depend on neural process in the brain. In arguing for the counter-intuitive epiphenomenal perspective, we suggest that a scientific approach considers all mental aspects of mind including consciousness in terms of their underlying, preceding (causal) biological changes, in the realization that most brain processes are not accompanied by any discernible change in subjective awareness.
Modulation of attentional bias by hypnotic suggestion: experimental evidence from an emotional Stroop task
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  • Jan 2023
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.
From Photography to fMRI
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Hysteria, a mysterious disease known since antiquity, is said to have ceased to exist. Challenging this commonly held view, this is the first cross-disciplinary study to examine the current functional neuroimaging research into hysteria and compare it to the nineteenth-century image-based research into the same disorder. Paula Muhr's central argument is that, both in the nineteenth-century and the current neurobiological research on hysteria, images have enabled researchers to generate new medical insights. Through detailed case studies, Muhr traces how different images, from photography to functional brain scans, have reshaped the historically situated medical understanding of this disorder that defies the mind-body dualism.
From Photography to fMRI: Epistemic Functions of Images in Medical Research on Hysteria
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  • Sep 2022
Hysteria, a mysterious disease known since antiquity, is said to have ceased to exist. Challenging this commonly held view, this is the first cross-disciplinary study to examine the current functional neuroimaging research into hysteria and compare it to the nineteenth-century image-based research into the same disorder. Paula Muhr's central argument is that, both in the nineteenth-century and the current neurobiological research on hysteria, images have enabled researchers to generate new medical insights. Through detailed case studies, Muhr traces how different images, from photography to functional brain scans, have reshaped the historically situated medical understanding of this disorder that defies the mind-body dualism.
Direct verbal suggestibility: Measurement and significance
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  • Mar 2021
Hypnotic suggestibility is part of the wider psychological trait of direct verbal suggestibility (DVS). Historically, DVS in hypnosis has informed theories of consciousness and of conversion disorder. More recently it has served as a research tool in cognitive science and in cognitive neuroscience in particular. Here we consider DVS as a general trait, its relation to other psychological characteristics and abilities, and to the origin and treatment of clinical conditions. We then outline the distribution of DVS in the population, its measurement, relationship to other forms of suggestibility, placebo responsiveness, personal characteristics, gender, neurological processes and other factors, such as expectancy. There is currently no scale specifically designed to measure DVS outside a hypnotic context. The most commonly used and well-researched of the hypnosis-based scales, the Harvard Group Scale, is described and identified as a basis for a more broadly based measure of DVS for use in psychological research.
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