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American Journal of Clinical Hypnosis
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Advancing Research and Practice: The
Revised APA Division 30 Definition of
Hypnosis
Gary R. Elkinsa, Arreed F. Barabaszb, James R. Councilc & David
Spiegeld
a Baylor University, Waco, Texas, USA
b Washington State University, Pullman, Washington, USA
c North Dakota State University, Fargo, North Dakota, USA
d Stanford University School of Medicine, Stanford, California, USA
Published online: 07 Apr 2015.
To cite this article: Gary R. Elkins, Arreed F. Barabasz, James R. Council & David Spiegel (2015)
Advancing Research and Practice: The Revised APA Division 30 Definition of Hypnosis, American
Journal of Clinical Hypnosis, 57:4, 378-385, DOI: 10.1080/00029157.2015.1011465
To link to this article: http://dx.doi.org/10.1080/00029157.2015.1011465
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American Journal of Clinical Hypnosis, 57: 378–385, 2015
Copyright © International Journal of Clinical and Experimental Hypnosis
ISSN: 0002-9157 print / 2160-0562 online
DOI: 10.1080/00029157.2015.1011465
Advancing Research and Practice:
The Revised APA Division 30 Definition of Hypnosis
Gary R. Elkins
Baylor University, Waco, Texas, USA
Arreed F. Barabasz
Washington State University, Pullman, Washington, USA
James R. Council
North Dakota State University, Fargo, North Dakota, USA
David Spiegel
Stanford University School of Medicine, Stanford, California, USA
This article describes the history, rationale, and guidelines for developing a new definition of hypnosis
by the Society of Psychological Hypnosis, Division 30 of the American Psychological Association.
The definition was developed with the aim of being concise, being heuristic, and allowing for alter-
native theories of the mechanisms (to be determined in empirical scientific study). The definition
of hypnosis is presented as well as definitions of the following related terms: hypnotic induc-
tion, hypnotizability, and hypnotherapy. The implications for advancing research and practice are
discussed. The definitions are presented within the article.
Keywords: hypnosis, hypnotizability, hypnotic induction, hypnotherapy, definition of hypnosis
Hypnosis has both historical roots and support from contemporary clinical applications
and research. While practices that may be identified as similar to hypnosis can be traced
to ancient times (Gauld, 1995), the origin of the term is attributed to James Braid
(1785–1860). In the early 1800s, Dr. Braid adapted the methods of mesmerism to his
medical practice and initially thought the process was similar to sleep, thereby coining
the term “hypnotism” from the Greek word “hypnos” for sleep (Braid, 1853). However,
This article was originally published in the International Journal of Clinical and Experimental Hypnosis, Vol. 63,
No. 1, 2015, pp. 1–9. doi:10.1080/00207144.2014.961870
Address correspondence to Gary R. Elkins, Baylor University, Mind-Body Medicine Research Laboratory,
Department of Psychology and Neuroscience, One Bear Place #97334, Waco, TX 76798, USA. E-mail: gary_elkins@
baylor.edu
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APA DIVISION 30 DEFINITION OF HYPNOSIS 379
he later realized that during hypnosis, his patients were not asleep and concluded that
concentrated attention and prolonged absorption were involved (Spiegel & Spiegel,
2004; Tellegen & Atkinson, 1974). Since that time, a number of definitions of hypnosis
have emerged; however, one that is widely agreed upon has remained elusive.
The definition of hypnosis is fundamental to scientific inquiry, but the endeavor to
define hypnosis from differing theoretical perspectives has given rise to controversy as
to the “real” meaning of hypnosis. Disagreements are to be expected for two reasons.
First, the nature and mechanisms that underlie the effects of hypnosis are as yet not
fully known. Second, definitions with theoretical bias will inevitably result in arguments
about their accuracy. For example, some have defined hypnosis as a “procedure,” and at
the same time others have defined it as a “product” of a procedure (Nash, 2005). While
the intent of these differing approaches has been to identify an operational definition, this
has led to confusion about what is meant by the word hypnosis as well as the definition
of other terms, such as hypnotic induction, hypnotizability, and hypnotherapy.
Previous APA Division 30 Definitions of Hypnosis
Division 30 of the American Psychological Association (APA) has addressed this con-
troversy in two previous definitions of hypnosis (1993 and 2003). However, neither of
these previous definitions resulted in a clear and concise definition of the terms, thus
giving rise to the need for a revised definition. This article reviews the previous APA
Division 30 definitions of hypnosis, the key critiques of these prior definitions, and the
process and guidelines for developing a new definition. The implications for advancing
research and practice are discussed. The definitions for hypnosis, hypnotic induction,
hypnotizability, and hypnotherapy are presented.
1993 Definition of Hypnosis
In 1993, a definition of hypnosis was approved by the executive committee of Division
30 of the APA (Society of Psychological Hypnosis). This definition (Kirsch, 1994)was
developed with the goal of producing “a statement on which people holding divergent
views of hypnosis could agree and which the members of Division 30 would find useful
as something that could be given to lay persons (e.g., clients) interested in hypnosis”
(p. 160). The 1993 definition reflected the positions of a number of researchers advo-
cating differing theoretical perspectives but largely identified hypnosis as a procedure
“during which a health professional or researcher suggests that a client, patient, or
subject experience changes in sensations, perceptions, thoughts, or behavior” (Kirsch,
1994, p. 143). The definition also included a list of several uses of hypnosis, stating
that “[h]ypnosis has been used in the treatment of pain, depression, anxiety, stress, habit
disorders, and many other psychological and medical problems” (Kirsch, 1994, p. 143).
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380 ELKINS ET AL.
After publication of the official definition in 1994, it became apparent that there were
a number of concerns and that the definition was unsatisfactory. The definition was
criticized as being excessively long and having significant theoretical limitations. For
example, the “state” concept was not mentioned at all, and the definition was therefore
perceived as having a theoretical bias toward preconceived social-cognitive mechanisms.
Also, the list of applications described was not exhaustive, and there was a concern that
this could be used by hospital or clinic administrators as evidence that hypnosis was
appropriate only for conditions listed. There were recommendations that the list of appli-
cations be expanded or eliminated altogether from the definition. Also, the definition did
not appear to account for such concepts as self-hypnosis or clearly distinguish between
hypnotic induction and hypnosis. There were opinions expressed that the intermingling
of definition and description contributed to the limitations (Green, Barabasz, Barrett, &
Montgomery, 2005; Kirsch, 1994).
2003 Definition of Hypnosis
Almost immediately after publication of the definition in 1994, the executive commit-
tee of APA Division 30 began to address these concerns; however, the revision proved
to be a very challenging task, and the 1994 definition served for more than a decade.
Initially, several subcommittees were formed with the goal of examining the language
and developing a more clearly stated definition. However, none of these committees suc-
ceeded in achieving a consensus, and in 2002, the previous committees were dissolved,
and a new definition committee was formed with the goals of a shorter definition of
hypnosis, eliminating the list of uses of hypnosis and considering the input and pre-
vious criticisms. The committee consisted of: Arreed Barabasz, Deidre Barrett, James
Council, Joseph Green Steve Kahn, John Kihlstrom, Michael Nash, Roger Page, and
David Spiegel. Concurrently, the University of Tennessee Conference on Brain Imaging
and Hypnosis (UTCBIH) convened and brought together 13 scholars with an interest
in neurological correlates of hypnosis. The attendees included Amanda Barnier, Grant
Benham, Vilfredo De Pascalis, Peter Killen, Kevin McConkey, Michael Nash, Pierre
Rainville, William Ray, David Spiegel, Henry Szechtman, Eric Vermietten, and Erik
Woody. The UTCBIH arrived at a working definition of hypnosis (Killeen & Nash,
2003) that anticipated neurological changes in the brain associated with hypnosis. The
UTCBIH definition was influential in generating additional considerations by the APA
Division 30 definition committee; however, while there was agreement that hypnosis
involves changes in the brain, the UTCBIH definition alone was also perceived as overly
focusing on neurological factors as mediators with hypnosis.
The 2003 APA Division 30 executive committee then set out to forge a definition
of hypnosis that was “empirically based, theoretically neutral, and relatively concise
and user friendly to promote widespread acceptance among clinicians, researchers, and
the lay public alike” (Green et al., 2005, p. 261). A formal definition was formulated
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APA DIVISION 30 DEFINITION OF HYPNOSIS 381
and disseminated for additional input. Another committee developed final wording of
the definition, and it was unanimously approved by the APA Division 30 executive
committee consisting of Arreed Barabasz, Frank DePiano, Deirdre Barrett, James
Council, Melvin Gravitz, Joseph Green, Brenda King, Guy Montgomery, and Chris Silva
(Green et al., 2005).
The 2003 definition was “restricted to procedures that are used in research and clinical
practice” (Green et al., 2005, p. 262); however, it was fully two paragraphs long, stating:
“Hypnosis typically involves an introduction to the procedure during which the sub-
ject is told that suggestions for imaginative experiences will be presented. The hypnotic
induction is an extended initial suggestion for using one’s imagination, and may con-
tain further elaborations of the introduction. A hypnotic procedure is used to encourage
and evaluate responses to suggestions. When using hypnosis, one person (the subject)
is guided by another (the hypnotist) to respond to suggestions for changes in subjective
experience, alterations in perception, sensation, emotion, thought, or behavior. Persons
can also learn self-hypnosis, which is the act of administering hypnotic procedures on
one’s own. If the subject responds to hypnotic suggestions, it is generally inferred that
hypnosis has been induced. Many believe that hypnotic responses and experiences are
characteristic of a hypnotic state. While some think that it is not necessary to use the
word hypnosis as part of the hypnotic induction, others view it as essential” (Green
et al., 2005, p. 262). “Details of hypnotic procedures and suggestions will differ depend-
ing on the goals of the practitioner and the purposes of the clinical or research endeavor.
Procedures traditionally involve suggestions to relax, though relaxation is not necessary
for hypnosis and a wide variety of suggestions can be used including those to become
more alert. Suggestions that permit the extent of hypnosis to be assessed by compar-
ing responses to standardized scales can be used in both clinical and research settings.
While the majority of individuals are responsive to at least some suggestions, scores on
standardized scales range from high to negligible. Traditionally, scores are grouped into
low, medium, and high categories. As is the case with other positively scaled measures
of psychological constructs such as attention and awareness, the salience of evidence
for having achieved hypnosis increases with the individual’s score” (Green et al., 2005,
p. 263).
The 2003 definition was an advance, but the lack of parsimony and restriction to
procedures was perceived as significant limitations. For example, in a special issue of
the American Journal of Clinical Hypnosis, the definition was critiqued for being exces-
sively long (Heap, 2005), contradictory in places (McConkey, 2005), restrictive in regard
to allowing for alternative theories (Rossi, 2005), and having a “lack of coherence”
(Heap, 2005). Also, the definition was criticized for not including reference to states of
consciousness (Barabasz, 2005; Daniel, 2005; Spiegel & Greenleaf, 2005;Yapko,2005).
Notably, while it was acknowledged that “it is clear that shifts in consciousness can occur
with and without formal hypnotic procedures in a variety of everyday situations” (Green
et al., 2005, p. 262), this was not reflected in the definition.
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382 ELKINS ET AL.
Several recommendations emerged from critique of the 2003 definition. Nash (2005)
identified that a clearer distinction needed to be made between hypnotic procedures and
hypnosis as a product stating that: “hypnosis (the product) is not achieved just because
a hypnosis procedure has been administered” (Nash, 2005, p. 268). Consistent with
this was the recommendation that the phenomena of hypnotic experience be reflected
in future definitions of hypnosis (Araoz, 2005; Woody & Sadler, 2005). Additionally,
Nash (2005) suggested that what is needed is “an optimally heuristic definition that pre-
serves pluralism—one that recognizes the incompleteness of our concepts, generates a
level epistemological playing field, enables our theories to “reach,” [sic] and which is
relatively resistant to the teflon shield of pre-emptive definition” (p. 266).
2014 Revised Definition of Hypnosis
In 2013, Dr. Arreed Barabasz, as President of APA Division 30, appointed a new com-
mittee to revise the 2003 definition of hypnosis. The Hypnosis Definition Committee
(HDC) was comprised of the following members: Gary Elkins (Chair), David Spiegel,
James Council, and Arreed Barabasz. The HDC was tasked with considering the cri-
tiques of the previous definitions as well as the recommendations noted above. The HDC
agreed that it is necessary that the definition of hypnosis be free as possible from ortho-
doxy and allow for differing theoretical orientations about the mechanisms by which
hypnosis occurs. In this regard, the HDC followed the following guidelines:
1. The definition should be a concise description that identifies the object of interest
and its characteristics.
2. The definition should be heuristic and allow for alternative theories of the
mechanisms.
The committee recognized that following these guidelines would be a different
approach from that taken in the past by APA Division 30; however, learning from the past
definitions was emphasized as well as undertaking the task of addressing prior critiques
and recommendations. The committee was able to successfully achieve a consensus, and
on March, 24, 2014, the revised definition was approved unanimously by the attending
members of the executive committee. The executive committee consisted of the follow-
ing individuals: Arreed Barabasz, Marianne Barabasz, Gary Elkins, Joseph Green, John
Mohl, Omar Sanchez-Armass, Donald Moss, James Council, Eric Wilmarth, Leonard
Milling, Guy Montgomery, Stephanie Schilder, and Ciara Christensen. The approved
definitions are listed below along with brief commentary for each:
Hypnosis: “A state of consciousness involving focused attention and reduced peripheral awareness
characterized by an enhanced capacity for response to suggestion.”
The HDC was deliberate in seeking to craft a concise and heuristic description to simply
identify the object of interest (hypnosis) and its characteristics. We believe the definition
allows for alternative theories of the mechanisms (to be determined in scientific study) as
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APA DIVISION 30 DEFINITION OF HYPNOSIS 383
well as inquiry as to whether the “state of consciousness” is in fact altered from waking
consciousness, similar to other states (i.e., meditative, mindfulness, yoga), or unique to
hypnosis:
Hypnotic induction: “A procedure designed to induce hypnosis.”
By intentionally defining hypnotic induction, the HDC sought to distinguish between
hypnosis (the product) and procedures that are designed to lead to hypnosis. The def-
inition is designed such that it does not specify what procedures may involve or the
context in which they may occur. This may allow for procedures that involve interaction
between a therapist and client, self-hypnosis procedures, or other procedures that may
be identified in the future in clinical practice of research (such as through advances in
technology):
Hypnotizability: “An individual’s ability to experience suggested alterations in physiology, sensa-
tions, emotions, thoughts, or behavior during hypnosis.”
The term “hypnotizabilty” as chosen over other related terms (such as suggestibility,
hypnotic suggestibility, hypnotic susceptibility, or trance) to best reflect current pref-
erences for descriptors. For example, a survey of members of the Society for Clinical
and Experimental Hypnosis revealed a strong preference for the term “hypnotizability”
(50%) and hypnosis as an identifiable state (Christensen, 2005). It is recognized that
research exists indicating there are individual differences in ability to experience sugges-
tions during hypnosis. In addition, there have accordingly been several scales developed
to measure the individual differences (Barber & Wilson, 1978; Elkins, 2013;Spiegel
&Spiegel,2004; Weitzenhoffer & Hilgard, 1959,1962; Wilson & Barber, 1978).
Definition and measurement are inter-related in scientific research, and both are essential
to furthering empirical study of hypnosis:
Hypnotherapy: “The use of hypnosis in the treatment of a medical or psychological disorder or
concern.”
The HDC recognized that hypnosis has been applied to numerous disorders and that
research is likely to continue to identify new applications and knowledge about the use
of hypnosis in treatment. However, creating a list of applications is in itself limiting.
The identification of “medical or psychological disorder or concern” is intended to be
very broad and encompass all health care disciplines and is not limited to any particular
diagnosis or concern in the absence of a specific diagnosis.
Summary
The definitions seek to provide clarity to terms that are essential to advancing research
and clinical practice in hypnosis. In critique of previous definitions, Nash commented
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384 ELKINS ET AL.
that “[s]cientific understanding is advanced by defining the domain of interest with an
optimal, definitional resolution that is neither too narrow nor too broad” (2005, p. 277).
We agree with this sentiment. In working toward this goal, we have sought to disentangle
the definition of hypnosis from discussion of the current state of knowledge, the applica-
tions, and kept commentary regarding differing theoretical perspectives to a minimum.
Future research will be needed to fully identify the clinical applications and the mech-
anisms that may underlie hypnosis, whether these be social, cognitive, neurobiological,
interpersonal, a combination of these, or some as yet undiscovered factors.
Acknowledgements
The American Journal of Clinical Hypnosis would like to thank the International
Journal of Clinical and Experimental Hypnosis for their permission to use this article
in our special issue.
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