Vermetten, E., & Kihlstrom, J.F. (2002). "Masterminds" interview [by Eric Vermetten] with John Kihlstrom, PhD. International Society of Hypnosis Newsletter, 26(1), 22-40.
John Kihlstrom is on the faculty of the Department of Psychology at the University of California, Berkeley, where he is Professor in the Department of Psychology and a member of both the Institute for Cognitive and Brain Studies and the Institute for Personality and Social Research. Fifteen years ago, he published a lead article in Science magazine on ‘The Cognitive Unconscious’ which has been widely credited with sparking renewed scientific interest in unconscious mental life, after almost a century of Freudianism (Kihlstrom, 1987)
Dr Kihlstrom received his education at Colgate University, NY, and received High Honors with his graduation in Psychology in 1970. He completed a PhD in 1975 at the University of Pennsylvania in the Program of Research Training in Personality and Experimental Psychopathology. His more than brilliant career was launched after that. He received several scholarships and fellowships, e.g. at Penn and University of Wisconsin. He taught at the Departments of Psychology at Penn, Harvard University, Stanford University, University of Wisconsin, University of Arizona, Yale University, and his current position for the last 6 years is with the University of California, Berkeley, CA.
His CV which is available on the web (http://socrates.berkeley.edu/~kihlstrm) is truly impressive. An abbreviated list of some of the committees he served: several Section Committees on Psychology, Medical Sciences, and Dentistry. He is Member of the AMA, Council on Scientific Affairs. Served at the APA, the Board of Convention Affairs, the Board of Scientific Affairs, the Board of Educational Affairs, the Science Conferences Review Committee; member of NIH, NIMH Behavioral Sciences Research Branch, Cognition, Emotion, and Personality Study Section, Perception and Cognition Study Section, Behavioral Sciences Task Force; National Research Council, and the Committee on Techniques for the Enhancement of Human Performance. He is representative to the American Association for the Advancement of Science, Section Committees on Psychology, Medical Sciences, and Dentistry.
He holds a number of editorial appointments, among which are the American Journal of Psychology, Consciousness & Cognition, and the Journal of Abnormal Psychology, and he has long served as associate editor for the International Journal of Clinical & Experimental Hypnosis
He is fellow of the American Association for the Advancement of Science, American Psychological Association, American Psychological Society, and the Society for Clinical and Experimental Hypnosis. He is member of several other organizations and societies in the field of psychological research.
After winning a graduate prize in 1973 at APA, he won two SCEH prices for (Harold B. Crasilneck Award, and Henry Guze Award for the Best "First Contribution" at the Annual Meeting "Temporal Sequencing in Posthypnotic Amnesia" for the Best Research Paper in the Field of Hypnosis "Posthypnotic Amnesia as Disrupted Retrieval". After that in 1980 the Arthur Shapiro Award for Best Book in the Field of Hypnosis, Functional Disorders of Memory; the Morton Prince Award, for distinguished contributions to the development of hypnosis in the science and profession of psychology by the American Board of Examiners in Psychological Hypnosis; Award for Best Theoretical Paper in the Field of Hypnosis, 1985 "Conscious, Subconscious, Unconscious: A Cognitive Perspective" by SCEH, and again an Award for Best Theoretical Paper in the Field of Hypnosis, 1988 "The Cognitive Unconscious", in 1991 the Bernard B. Raginsky Award, for leadership and achievement in the field of hypnosis by SCEH; the Ernest R. Hilgard and Josephine R. Hilgard Award in 1994 for the best theoretical paper in hypnosis "The Self-Regulation of Memory: For Better and for Worse, With and Without Hypnosis" by SCEH. And a Distinguished Scientific Award for an Early Career Contribution to Psychology, 1979 in the area of personality from the American Psychological Association. The National Institute of Mental Health gave him a MERIT Award in 1990 on a grant "Personality and Cognition in Hypnotic Phenomena". Yale gave him the Yale College-Lex Hixson '63 Award in 1997 for Distinguished Teaching in the Social Sciences. In 1999, at the annual meeting of the American Psychological Association, he gave the F.J. McGuigan Lecture on Understanding the Human Mind. This lecture, entitled "The Rediscovery of the Unconscious", was essentially a precis of a book, The Unconscious Mind, which he is completing this year while on sabbatical (http://socrates.berkeley.edu/~kihlstrm/ampa99.htm). A the conclusion of his service as Editor of Psychological Science, 1995-1999, the American Psychological Society presented him with its Editorial Service Award. Kihlstrom’s hypnosis research has been continuously supported by NIMH since 1977.
I am not meeting with Dr Kihlstrom. We decide to build an interview through email correspondence. Dr Kihlstrom is one of the people I perceive as almost glued to his computer, and more than eager to respond to incoming emails. The speed and detail of his responses made me believe so. His contribution to the field of hypnosis is extremely valuable, especially in the theoretical framework and in experimental studies, His hypnosis-pedigree includes scholarly clinicians and researchers that have passed away, but he captures the wisdom and insight these people have taught.
I met Dr Kihlstrom on a few occasions. One was when I was a postdoc at Yale, and my mentor Dr Bremner was interested to perform a study using word pairs, to study hippocampal function, and wanted to differentiate explicit and implicit memory functions, and wanted to use the Deese paradigm. We met in his office. I remember this entourage, the volume of the impressive library that was adjacent to his office and the dog that was running in and out. It was too bad that he had left for Berkeley soon afterwards, for we could have elaborated on brain functions and memory in more depth. In asking to help with an obituary for Jack Hilgard I had an opportunity to become reacquainted. I am most happy to have had the opportunity to have him talk about hypnotic themes for this newsletter.
A major goal of Kihlstrom’s research is to use the methods of cognitive psychology to understand the phenomena of hypnosis, a special state of consciousness in which subjects may see things that aren’t there, fail to see things that are there, and respond to posthypnotic suggestions without knowing what they are doing or why. Afterwards, they may be unable to remember the things that they did while they were hypnotized -- the phenomenon of posthypnotic amnesia, which has been a major focus of Kihlstrom’s research.
First, however, they have to find the right subjects. There are big individual differences in hypnotizability, or the ability to experience hypnosis. Screening subjects for hypnotizability is a very labor-intensive processes, and Kihlstrom and his colleagues spend at least as much time in this phase of their research as in formal experiments.
From this point on, however, Kihlstrom’s experiments look just like anyone else’s -- except that his subjects are hypnotized. In one study using a familiar verbal-learning paradigm (Kihlstrom, 1980), the subjects memorized a list 15 of familiar words, such as girl and chair, and then received a suggestion for posthypnotic amnesia. As part of this suggestion, the experimenter set up a "reversibility cue" to cancel the amnesia suggestion. After coming out of hypnosis, highly hypnotizable subjects remembered virtually none of the list, while insusceptible subjects, who had gone through the same procedures, remembered the list almost perfectly. This shows that the occurrence of posthypnotic amnesia is highly correlated with hypnotizability.
Then all subjects were given a word-association test, in which they were presented with cues and asked to report the first word that came to mind. Some of these cues were words like boy and table, which were known to have a high probability of producing the "critical targets" on the study list. Others were control cues, like lamp and dogs, which had an equally high probability of producing "neutral targets" like light and cats, which had not been studied. Despite their inability to remember the words they had just studied, the hypnotizable, amnesic subjects were no less likely to produce critical targets than were the insusceptible, nonamnesic subjects. This shows that posthypnotic amnesia is a disruption of episodic, but not semantic memory. And in fact, Endel Tulving (1983) cited this experiment as one of the few convincing studies of the difference between these two memory systems.
Even more important, the subjects were more likely to generate critical than neutral targets on the free association test. This is a phenomenon of semantic priming, in which a previous experience, like studying a list of words, facilitates performance on a subsequent task, like generating words on a free-association test (e.g., Meyer & Schvnaveldt, 1971). The magnitude of the priming effect was the same in the hypnotizable, amnesic subjects as it was in the insusceptible, nonamnesic subjects. In other words, posthypnotic amnesia entails a dissociation between explicit and implicit memory (Schacter, 1987). Kihlstrom’s experiment is now recognized as one of the first studies to demonstrate this dissociation.
The generation of so many study items as free associates gave the amnesic subjects an opportunity to be reminded of the words they had forgotten. Accordingly, Kihlstrom administered another free recall test immediately after the free-association procedure. However, the amnesic subjects still recalled less than 1 of the 15 items, on average. So, a reminder of this sort was not sufficient to breach posthypnotic amnesia. The amnesia was abolished only after administration of the pre-arranged reversibility cue, at which point the free recall of the hypnotizable subjects was indistinguishable from that of the insusceptible subjects. The reversibility of posthypnotic amnesia distinguishes it from other amnesias, such as the amnesic syndrome suffered by the famous patient H.M. and others with damage to the hippocampus. Reversibility shows that the memories in question were successfully encoded and remained available in storage. Posthypnotic amnesia is a phenomenon of retrieval -- a failure to gain access to memories available in storage. But this was already known. The most important finding of the study was the dissociation between explicit and implicit memory.
Although Kihlstrom’s 1980 experiment is now recognized as one of the earliest demonstrations of the distinction between explicit and implicit memory it was not completely convincing on that account, because of a procedural confound. The test of explicit memory was one of free recall, while the test of implicit memory, priming on the free-association test, more closely corresponds to a test of cued recall. It is well known that, all things being equal, cued recall is typically a more sensitive test of memory than free recall. Accordingly, it is possible that the difference in performance between free recall and the free-association test was simply a matter of differences in cues, rather than a qualitative difference between conscious and unconscious expressions of memory. For that reason, Jennifer Dorfman, a NIMH postdoctoral fellow working in Kihlstrom’s laboratory performed a more tightly controlled experiment, in which amnesic subjects were presented with the same cues on both explicit and implicit tests (Dorfman & Kihlstrom, 1994). On the explicit test, they were given a word (such as boy) and asked to remember an associated word (i.e., girl) from the study list. On the implicit test, they were given a word such as table, and asked to report the first word that came to mind. As expected, the hypnotizable, amnesic subjects showed a priming effect, generating critical targets more frequently than neutral targets. But they performed still very poorly on the matched explicit test of free recall. Dorfman’s findings confirmed that posthypnotic amnesia dissociates explicit and implicit memory, impairing conscious recollection but sparing the unconscious influence of memory on the subject’s experience, thought, and action.
John Kihlstrom was born and raised in upstate New York, near Ithaca and Cornell University. His mother was a school secretary and his father the minister of one of the local churches. He has an older sister, a nurse and medical administrator, and a brother, a retired public-school teacher who now deals in antiques. He is married to Lucy Canter Kihlstrom, a health-services researcher at Berkeley and Research Scientist at the Institute for the Study of Healthcare Organizations and Transactions (www.institute-shot.com), where he is also a Fellow.
I think the secret is my chameleon-like nature: I tend to reflect, and take on, and relate to, the interests of the people around me. That means I’m a good utility person, for both a department and a professional organization. I’m interested in pretty much everything anyway, but I’m always open to new perspectives and lines of inquiry. For example, my wife, who is a health-services researcher, stimulated my interest in health applications of hypnosis, in health policy, and in aspects of health cognition and behavior. I had them before I met her, by virtue of my interest in hypnotic analgesia and my association, at Wisconsin, with Howard Leventhal, one of the leading health psychologists in America. But Lucy really brought out that interest strongly, leading to my involvement in topics far beyond hypnosis and memory.
My professional society memberships largely reflect the organization of psychology in the United States. There are two big societies, the American Psychological Association, which includes researchers and clinical practitioners; the American Psychological Society, which is focused on researchers (including clinical researchers); the Psychonomic Society, which is specifically geared toward what used to be called "experimental" psychology; and then there are the regional psychological associations, each of which I joined when I lived in the region.
As for the committee memberships, I think they reflect a general appreciation of the kind of psychology I do -- I am really a general psychologist, interested in everything, and especially in the connections among the discipline’s subfields. I appreciate a lot of different kinds of work, and I have a talent for seeing the broader implications of narrow findings. So I get asked to join a lot of committees. I do a lot less of that now: it’s time for others to have a turn.
And as for the prizes, they’re mostly for hypnosis: it’s just a fact of life that if you do some good work in a small field that gives awards, and we give a lot of awards, you’re going to get your share. The Early Career Award was pretty much of an accident, and it surprised a lot of people: I was nominated for it over my objections, and I later I learned that I got it because I was the only finalist who took individual differences seriously. Still, the timing of the award was perfect, because it made it possible for me to move from Harvard, where my appointment was ending (Harvard doesn’t have a tenure track), to Wisconsin, where I was asked to lead the social-personality area group.
The name is Swedish, maybe Swedish-Finnish, and it refers to a mountain stream. My mother’s side was Scots-Irish. Both sets of grandparents emigrated to the United States before World War I, and my parents met in New York City.
My mother also did part-time work for the school psychologist in the district, a man named Frank Coyle, and that was my introduction to psychology. I was fascinated by psychological testing at an early age, and long before college determined that I wanted to be a research psychologist. Of course, I had no inkling that I would do hypnosis research. My original interest was in mental testing, whether educational or industrial/organizational. I really had no idea what it was all about, except that I was fascinated by the possibility that mental abilities, attitudes, and the like could be measured. Later, when I was doing my clinical psychology internship, I surreptitiously traded all my therapy cases for testing cases -- until I got caught, and was saddled with some real doozies to treat. I guess that, as a clinical practice, assessment is closer to my interests in research than therapy is.
Actually, I fell into hypnosis completely by accident. Colgate discouraged early specialization, you couldn’t declare a major concentration until the end of your sophomore (second) year, and you were not permitted to take the introductory psychology course as a freshman. It also had a strong core curriculum, and by the time I actually took psychology I had fallen under the sway of existentialist approaches to philosophy and theology - this was the sixties, after all! Anyway, I got interested in issues pertaining to self and identity, and the cognitive creation of the oneself and reality, and wanted to pursue those themes. Colgate’s psychology department was very small, with not too many majors, and every one of us got to apprentice ourselves to one of the faculty. So I chose Bill Edmonston, who taught the course in personality. It was only after he accepted me into his lab that I learned he did hypnosis research -- and psychophysiology to boot!
Once exposed to hypnosis, I was quickly hooked, but the old interests didn’t dissipate. When I applied for graduate school, I actually wrote that I was interested in "quantifying the concepts of existentialist approaches to personality". The joke around Penn was that they admitted me just to see what I looked like. But it turns out that the very issues that are the focus of my research: consciousness, the self, and memory as the core of identity -- are continuous with those old existentialist impulses.
Getting back to hypnosis, my roots there are wide and deep. At the time I was at Colgate, Edmonston was the Editor of the American Journal of Clinical Hypnosis. He had been a graduate student of Frank Pattie at Kentucky, who was doing experimental research in the 1930s (and who capped his career with a scholarly biography of Mesmer), and he had been a post-doc with John Stern at Washington University, St. Louis. At Colgate, Edmonston had replaced George Estabrooks, one of the grand old men of hypnosis research, who had retired after many years as chair. Estabrooks was still a fixture around campus, however, so I had some contact with him as well. Estabrooks got interested in hypnosis through William McDougall, who had been his advisor at Harvard. Interestingly, Pattie had also been a student of McDougall’s, as were W.S. Taylor, P.C. Young, and Henry Murray. I didn't know this until recently (Mel Gravitz pointed it out to me), but it is interesting in that -- like Hlgard -- I have always felt an attachment to McDougall's purposive psychology, which was quite in opposition to the passive, mechanistic view of human mind and behavior that prevailed at the time. Through Orne, of course, I can trace my lineage back to William James: James taught Prince, who (along with McDougall) taught Murray, who taught White, who taught Orne. And through Fred Evans, who served as my day-to-day research supervisor at Penn, I am related to Gordon Hammer and J.P. Sutcliffe. Most people can probably trace such a lineage, if they try, but frankly I’m pretty proud of this heritage, and you can see it reflected in my work. My approach to consciousness and dissociation, for example, is essentially Jamesian in nature.
Well, the field of hypnosis has suffered these three great losses, so close together in time, and I hope we can recover from them. Hilgard had a great long life, of course, he was almost present at the creation of modern psychology, but Bowers died young, and Orne went before he could really give us a comprehensive statement of his views on hypnosis. I was associated in some ways with all three: I was Martin Orne's graduate student from 1970-1975, and I took a sabbatical from Harvard at Hilgard's lab at Stanford 1977-1978, where I cemented my relationship with Ken and Pat Bowers. I had met them both earlier, as visitors to Orne's lab and at SCEH meetings, but at Stanford we became much closer. Plus, I have some historical interests, plus an ability to see people’s work in a broader context, so it was probably natural to ask me to do these obituaries.
In retrospect, it's interesting that I never even considered graduate study
at Stanford with Hilgard. Of course, he had formally retired from Stanford
in 1969, while I was still an undergraduate, so it might not have been possible
in any event. I focused on Penn because I was interested in personality
and experimental psychopathology, the basic-research arm of clinical psychology,
and Penn had one of the few such programs in existence. It was the
director of that program, Julius Wishner, who showed me the historical link
between hypnosis and hysteria. When I became involved with posthypnotic
amnesia, two other Penn professors, Burt Rosner and Paul Rozin, introduced me to
the work of Endel Tulving and to the emerging cognitive neuropsychology of
memory. Richard Solomon and Henry Gleitman ran a joint seminar on learning
that was also very important to my development as a cognitive
psychologist. Those influences, followed by my exposure to neodissociation
theory during my sabbatical at Stanford, pretty much set the course for my
career.
Hilgard published his "Divided Consciousness" book while I was there,
and Bowers was working through the ideas contained in his paper with Brenneman
on automaticity. So there was a lot of neodissociation theory in the
air. Orne, however, was always skeptical. He saw the same divisions
of consciousness that Hilgard did -- that's what "trance logic" was
all about, for example. And he understood clearly that posthypnotic
amnesia was a temporary disruption of retrieval processes, hence essentially
dissociative in nature. In the final analysis, however, I think that
Martin was more focused on the matrix of social-psychological processes
implicated in hypnosis -- hence his emphasis on demand characteristics and
ecological validity, and the "debunking" character of his studies of
age regression, antisocial behavior, and the disappearing hypnotist. But
Orne was not so much of a social psychologist that he embraced the views of Ted
Sarbin or Ted Barber. Orne was a student of the late Robert W. White, and
his position was essentially the same as White's: hypnosis is an alteration in
consciousness that takes place in a particular sociocultural context, and you
have to understand both consciousness and context if you are going to understand
hypnosis.
Orne and Hilgard were allies in the study of hypnosis, but with respect to
neodissociation theory, Orne thought that Hilgard's approach, were being
essentially cognitive in nature, ignored the social-psychological dimension of
both hypnosis and hysteria and dissociation. I think Orne was right about
this, as we very quickly when those who promoted the multiple personality
"epidemic" of the 1980s and 1990s fastened onto Hilgard's work for
scientific justification. Hilgard believed that there were valid cases of
multiple personality disorder, as do I, as did Orne. But while Hilgard
recognized the possibility of simulation or iatrogenesis, those issues weren't
salient enough in the 1970s, when he was writing the book, to make their way in
as qualifiers to his theory.
The hidden observer was in some respects an unfortunate metaphor, but it has mostly been criticized by people who didn’t have any sympathy with the process of dissociation to which it referred. All Hilgard meant was that, in phenomena like analgesia, what Sutcliffe called the "actual stimulus state of affairs" is still processed by the individual’s mental structures -- just subconsciously. And because that subconscious processing has taken place, that "stream of consciousness" can be contacted -- at least in principle. The "hidden observer" was both a metaphor for this dissociated state of affairs, and a convenient name for a technique for recovering this subconscious material. It’s not all that different from the reversibility of posthypnotic amnesia -- at one moment, the subject doesn’t remember; at another moment, he does. It’s not all that unusual.
And it’s no mark against the hidden observer that, as Spanos showed, the phenomenon is affected by the precise wording of the suggestion. Everything in hypnosis is affected by the precise wording of the suggestion.
There’s an analogous situation with respect to Orne’s concept of trance logic. Anyone who’s had any experience of hypnosis has seen trance logic, and I think that the phenomenon is essentially dissociative in nature. Orne might have been wrong to propose that it was uniquely characteristic of hypnosis, but he wasn’t wrong to draw attention to the phenomenon. I only regret that he didn’t really follow up his initial observations, which if you read the 1959 paper were rather informal, and give us a definitive study. I think that Hilgard learned a lesson from Orne’s experience, which is why he did those follow-up papers in which he really nailed the phenomenon down.
Orne was a methodological genius, very quick on the uptake, very quick to see
both the relevance of a piece of work as well as any methodological problems
with it. And he was the finest editor I think I'll ever see. He was
absolutely committed to using the International Journal to building the field of
hypnosis.
Hilgard was one of the great men of 20th century psychology, who knew everyone,
and, for a while, everything there was to know in the field. Without
Hilgard's interest and involvement, I don't think the post-war revival of
hypnosis would have occurred at all. It would have remained more of an
esoteric topic, held at arm's length by most people.
Bowers was the nicest person in psychology, extremely generous with his time and
his talents. And he was a brilliant experimentalist. I have a little
"Faustian" list of studies that I'd have killed to have done myself,
and there are more studies by Ken Bowers on that list than by anyone else.
One attitude I got from both Orne and Hilgard, and from Ken Bowers too, for that matter, is that while hypnosis is intrinsically interesting, for most people hypnosis is chiefly of interest for what it can tell us about other things. You never see academic departments listing a job for a professor of hypnosis. They want cognitive psychologists, or social psychologists, or whatever. Introductory textbooks might have a chapter on consciousness, but they don't have chapters on hypnosis. And so you have to make those connections. Hypnosis will thrive, and hypnosis researchers will thrive, to the extent that hypnosis is connected up to other things. Memory has served this purpose for me. Beginning with my work on posthypnotic amnesia, I've been able to branch out to work on other aspects of memory, and explicit-implicit dissociations in other domains, such as sleep or general anesthesia, and even to personality, through the role that memory plays in identity, and the idea that the self is a knowledge structure stored in memory.
Hilgard used analgesia to much the same purpose: at the same time as he was working on hypnotic analgesia, he was making fundamental contributions to the psychophysics of pain, and using analgesia to promote hypnosis within the medical community. And his book on divided consciousness was full of things besides hypnosis: hypnosis was only one phenomenon that illustrated his fundamental point. No matter how many papers you publish on hypnosis, if you don't give people outside the small circle of hypnotists reason to be interested,
Well, you have to work on something. Edmonston was interested in the
concept of "neutral" hypnosis, what happens after hypnosis is induced
but before suggestions are given. He was essentially a Pavlovian, as
evidenced by his later book on hypnosis and relaxation. I wasn't a
Pavlovian. As a student in the late 1960s, I was interested in altered
consciousness, and at the same time as I was working on hypnosis I was trying to
get the Colgate electronics shop to build an alpha-wave feedback device so I
could replicate the studies Kamiya had recently reported in Psychology Today,
and I was trying to get a visiting Zen master, Shibayama Roshi, into Edmonston's
psychophysiology lab so I could record his brain waves while he meditated.
As a result, my undergraduate honors thesis was entitled "Alterations in
Consciousness in Neutral Hypnosis" (it was published in the American
Journal in 1971). I just took highly hypnotizable subjects and gave
them a semantic differential test in and out of hypnosis. I gave Martin
Orne a copy of my thesis to read, and his immediate response was to persuade me
that nothing occurs in hypnosis except in response to suggestion. So that
while my results were "interesting", in his view they didn't have much
to do with hypnosis. So from then on, my interests turned in toward
figuring out how specific hypnotic suggestions worked.
I fell into posthypnotic amnesia completely by accident. Fred Evans had
this idea that hypnotic subjects recalled hypnotic suggestions out of their
correct temporal sequence, but he didn't have the proof. There was a lot
of archival data in the Orne lab, so we took a couple of large samples and did a
systematic study, and we found out he was right. Organization theory was
very hot in the study of memory at that time, and my contribution was to link
this observation to basic memory theory -- hence my first experimental work on
posthypnotic amnesia as disorganized recall. Organization theory faded in
the study of memory, as new approaches came to the fore, but I still think that
was good work, and the essential ideas are sound. More recently, my
interests have focused on the dissociation between explicit and implicit memory
in posthypnotic amnesia, but my view is that explicit memory refers to temporal
context in a way that implicit memory does not. So there's a continuity
there.
To be honest, I haven’t given this much thought. To my mind, it only makes sense to look at neurobiology once the psychology has been thoroughly worked out. Now, we have a pretty good grasp of posthypnotic amnesia from the psychological end, features such as reversibility and explicit-implicit dissociation, and with these new brain-imaging techniques available -- here at Berkeley we have a 4T MRI dedicated to research -- we can look at what’s going on in the brain. Posthypnotic amnesia is fundamentally a disruption in explicit episodic memory, so the hippocampus might well be involved at some level. But it’s also a disorder of memory retrieval, so the frontal-lobe structures that strategically organize the retrieval process -- remember that early work on temporal disorganization? -- might also be implicated. The problem is getting people to stay hypnotized in an MRI machine, which is damn noisy. PET would be quieter, but it’s also more invasive, and besides we don’t have one at Berkeley. But we know how to do the experiment. There are just some practical details to be worked out.
Well, that’s true so far as it goes, but I think there’s more to it than that. The self is the center of consciousness. Every conscious state involves a mental representation of the self as the agent or patient of some action, or the stimulus or experiencer of some state. James understood this, as did Janet and Claparede. In all instances of unconscious influence, the mental representation of the self is somehow missing. In explicit memory, we say "I remember this or that". In implicit memory, we say "This or that is so". If you’re conscious, you’re conscious of what you’re doing and experiencing, and you can’t be consicous of what you’re doing or experiencing without connecting that action or experience up to some mental representation of the self. Without a self, you’re one of Dennett’s zombies, operating completely on automatic pilot. I don’t know whether consciousness causes self or self causes consciousness, but the two are intimately related.
The scales are the most important thing about hypnosis research, and that's
why Hilgard is such a central figure. He gave us the scales, and the
scales put hypnosis research on a firm quantitative basis. Hypnosis can be
studied only in the hypnotizable. By selecting subjects on their scale
scores, we can predict with some confidence who is going to respond to
suggestions for amnesia, or whatever.
One reason there are so many scales is that the purpose of the scales differ
from one to the other. The Stanford Forms A and B have been supplanted by
the Harvard Form A, which is useful for preliminary subject screening. The
Stanford Form C is essential for confirming a person's level of
hypnotizability. Assessment can stop there, in my view. Nobody uses
the Profile Scales, and their essential purpose, for subject selection, is met
by the tailored Form C that was developed as a group exercise during that year
at Stanford with the Hilgards, and the Bowerses, Crawford, I, and others were
together. I think that Barber introduced the BSS scale because he didn't
want to use someone else's procedure, and I suspect that Spanos introduced the
Carleton scale for the same purpose. But these scales have fallen into
disuse now, and I think it's a mistake for there to be a proliferation of
hypnotizability scales. We can all do our work with the Harvard A and
Stanford C.
Well, to be perfectly honest, I’m not a fan of HIP. I’m a big fan of Herb Spiegel, who gave me more useful psychotherapy training in one three-day SCEH workshop than I got in a year of formal internship, and I admire Herb’s eagerness to study things like his smoking treatment empirically. Herb understood clearly that it only made sense to use hypnosis to treat patients who were hypnotizable, and I appreciate the impulse behind the HIP, which is to permit rapid clinical measurement of hypnotizability. But it’s pretty clear that the eye-roll sign is unrelated to hypnotizability, and if you take out the eye-roll sign the HIP is essentially a short scale of hypnotizability just like the others. I think that Stanford Hypnotic Clinical Scales, which take a little longer to administer, do a better job of assessing hypnotic talent. Sure, the HIP gives you a first approximation more quickly, perhaps, but if assessment is really important to treatment then you ought to take the time to do it thoroughly. Given how long we take to give patients the MMPI or a WAIS, not to mention a Rorschach or TAT, 20 minutes doesn’t seem too long for assessing something that might actually be clinically useful, like hypnotizability.
I should say, though, that I have concerns about the proliferation of scales outside of the Stanford-Harvard series. As I indicated earlier, the Stanford Scales put hypnosis research on a firm quantitative basis: for the first time, we could compare results across laboratories, and all select subjects the same way. And, of course, they made it possible to study hypnotizability itself, as a cognitive ability or personality trait. But when people started introducing their own scales, this uniformity disappeared. Some of the scales, such as the Barber Suggestibility Scale and the Carleton University Responsiveness to Suggestion Scale, were really in-house instruments that never caught on. But while Barber and Spanos were active, their use of these idiosyncratic scales made it just that much harder to replicate and extend each others’ studies. This is not to say that after 40 years, there isn’t a need to do some tinkering with the scales. In our own lab, we have added assessments of subjective success and experienced involuntariness, for example, and fiddled with the wording a teeny bit to reflect contemporary American English usage, but the fact is that they are pretty good as they were originally published.
The dissociative phenomena that interest me most are the lapses in
consciousness, as with functional amnesia, blindness or deafness, or
paralysis. The negative symptoms, you might say. These are the
phenomena for which some kind of neodissociation theory applies most
easily. The positive symptoms, as in hysterical automatisms, are more
puzzling. But I don't think they're truly automatic, in the sense that has
evolved in information-processing theory. I think they just appear
to be automatic, because the person is not aware of initiating them.
No, I don’t think so. State-dependent memory is in some sense dissociative, in that memories that are not accessible in one state become accessible in another state. But posthypnotic amnesia is not a phenomenon of state-dependent memory. The memories come back when you give the reversibility cue, and the patient doesn’t become rehypnotized. And when I was at Harvard, Ron Shor, Donna Pistole, Heather Brenneman, and I did a little study that showed pretty convincingly that the reinduction of hypnosis, per se, doesn’t reverse amnesia. Neither is posthypnotic suggestion state-dependent: a clever study by Joe Reyher and Larry Smyth some years ago showed that people don’t re-enter hypnosis when they execute a posthypnotic suggestion.
I think that Jack Watkins’ affect bridge was a brilliant clinical insight, and obviously there’s a connection to state-dependency. Anybody who’s ever been in a close, long-term relationship knows that when one party’s angry over something, all sorts of stuff can come out, that’s unrelated to the topic of the argument but is united by its association with previous anger states. Depression can work the same way, creating a vicious cycle in which depression makes someone more likely to remember sad events, which makes him more depressed, and so on. I’m sure that the technique is very helpful clinically, but there’s a catch. If, for example, you’re using the affect bridge to recover memories, then you incur some sort of obligation to check on the accuracy of those memories. Affect can bridge to imagination, and delusion, as well as to reality, and the clinician really has to work out which is which. That’s how we got into such trouble with the recovered-memory movement: they accepted the memories at face value, because they made clinical sense, like Freud’s old "tally" argument, without bothering to check whether, or to what extent, they were true.
I reject the distinction between interpersonal and intrapersonal.
Hypnosis is both a special state of consciousness and a social interaction, and
hypnotic alterations in consciousness are embedded in a particular sociocultural
definition of what hypnosis is. Some people prefer to study the social
context, others prefer to focus on the altered consciousness. I'm
interested in consciousness, so I'm in the latter crowd. But I acknowledge
the importance of sociocultural factors -- I just don't think they're the whole
thing. And, OK, I'm a dissociation theorist, if you held a gun to my head,
but only because I think that dissociations are the most interesting aspects of
hypnosis. So did Jack Hilgard. So did William James. But to
say one is a dissociation theorist doesn't mean anything more than that.
To think of hypnosis as dissociative doesn't require one to think of hypnosis as
trauma based, because as I said there is no good evidence that trauma has
anything to do with dissociation. Hypnosis is dissociative because the
person is not aware of something -- memory, visual percept, whatever -- that he
or she would ordinarily be aware of, and which influences his or her ongoing
experience, thought, and action outside of awareness.
"Dissociation" in this sense is purely descriptive.
Yes, I regret having to bow out of the Rotterdam symposium. I had given
keynotes at the first two symposia on memory and awareness in anesthesia, in
Glasgow and Atlanta, and I still think that the problem of implicit memory in
general anesthesia is extremely interesting, if also extremely difficult to get
a handle on. Still, I follow this area with great interest, as one of
those extensions from my original work on posthypnotic amnesia.
With respect to the recovered memory debate, I have to say that it has been a
disaster for hypnosis, for psychology, and for the mental-health professions in
general, at least on this side of the Atlantic. I'm not all that familiar
with how things have gone in Europe. The idea that trauma causes amnesia,
through a mechanism like dissociation or repression, has been part of
psychiatric folklore since the time of Janet and Freud. But there never
was any good evidence for it, and there still isn't, no matter what some
enthusiasts argue. And there has never been any good evidence of the
validity of recovered memories of trauma. In more than 100 years of
clinical folklore, there is only a handful of well documented cases, and some of
those are weak. Emotional arousal makes events more memorable, not less,
and there is no theoretical reason to expect that hypnosis can recover forgotten
memories, whether in the courtroom or in the consulting room.
The recovered-memory movement made three mistakes, I think. The first was
to embrace the essentially Freudian position that mental illness is caused by
specific traumatic experiences. There's no evidence for this, and aside
from the occasional case of post-traumatic stress disorder the fact is that most
people who have experienced trauma do remarkably well. The second, related
to the first, was to believe that mental illness could only be treated by
bringing those experiences into conscious awareness and working them
through. But the most successful forms of psychotherapy, such as
cognitive-behavioral therapy, focus the patient on the here and now rather than
the there and then. The third mistake, and it follows naturally from the
first two, was to fail to gather independent corroboration of recovered memories
of trauma. If you believe that trauma causes mental illness, then you are
disposed to believe it when the mentally ill tell you they've been
traumatized. But, in my view, if you are going to attribute mental illness
to historical events, and treat mental illness accordingly, you have an
obligation to confirm that the history is true. Otherwise, patient and
therapist can slip into a folie a deux, pardon my French, and therapy can go off
in entirely the wrong direction. Which, apparently, it did, for thousands
of people. There's no controlled clinical study showing that recovered
memory therapy makes people better, and some evidence that it makes them
worse.
Here's what we have to show for recovered-memory therapy in the United States:
medical-malpractice lawsuits sometimes reaching into the millions of dollars;
third-party lawsuits for damages, the first time nonpatients have ever been able
to sue therapists for damages; and, in the United States, attempts to
legislatively forbid certain therapeutic practices. At a time when the
challenge from biological psychiatry has never been greater, the whole concept
of psychotherapy has been thrown into disrepute -- not to mention the concept of
mental illness, and especially psychogenic theories of etiology. To the
extent that hypnosis, and hypnotists, played a part in recovered-memory therapy,
we have shared in these outcomes. Just when things were starting to go
well.
Well, I don't think of PTSD as dissociative in nature. It's an anxiety
disorder, in an entirely different class of syndromes. For example, PTSD
patients remember too much -- they can't forget what happened to them, or
at least set it aside. But in the functional amnesias, patients remember too
little -- they don't remember things they ought to remember. Trauma
enhances memory -- which is one reason that I doubt the traumatic etiology of
dissociative disorder. But of course, given the base rates, some patients
will have traumatic histories and dissociative disorder just by chance.
But we shouldn't magnify that chance relationship.
As for your professor, it would be inappropriate for me to diagnose at a
distance, but maybe he was right! Maybe he didn't have PTSD. Human beings
are remarkably resilient. Not everyone who is exposed to traumatic
circumstances suffers from PTSD. I don't see any a priori reason to
label him as avoidant or in denial or somesuch.
There's clearly a relation between hypnosis and what we used to call hysteria
and now call the dissociative and conversion disorders. In fact, I have argued
that the conversion disorders are essentially dissociative in nature, and
wrongly classified as "somatoform". It may very well be, as some
have argued, that hypnotizability is a risk factor for dissociative disorder.
That would make sense. I don't think the evidence for a traumatic etiology of
the dissociative disorders is very strong. It's mostly based on
uncorroborated self-report. To find a history of trauma in a hysterical
patient makes for a nice Freudian story, but like most Freudian stories, it's
probably wrong. And, of course, there's no reason to think that trauma has
anything to do with high hypnotizability. I think of hypnotizability as a
skill or a talent. Some people have it, other's don't, like talent for
music or a sport. We don't know how those talents arise, but in this
respect hypnotic talent is no more mysterious that singing talent.
Psychologists can do without Freud because Freud was wrong in every
detail. His view of unconscious mental life is wrong. His
psychosexual theory of development was wrong. His psychosexual theories of
neurosis are wrong. Freudian psychoanalysis can't be an effective
treatment for mental illness because people don't become mentally ill because of
unresolved Oedipal crises. The whole thing is wrong-headed, and it always
was. Freud's own patient Dora knew this intuitively, which is why she got
out of Freud's office as fast as she could. Everybody else should have
followed her example. The Australian psychologist Malcolm Macmillan has
done a thorough analysis of Freudian doctrine (Freud Evaluated: The Completed
Arc, MIT Press, 1991), and nobody who reads it can ever take Freud seriously
again. I'm not even sure that Freud should be taught as part of the
history of psychology. The psychological theories we have today, and
the psychological therapies, that work, owe nothing to Freud. At the
University of Arizona I was responsible for teaching the general survey course
on personality, and on two semesters I cut Freud out entirely. I had to
cut out half the textbook, too, but otherwise it worked quite well.
Psychologists who are interested in personality should do more to link theories
of personality to theories in the rest of psychology, as Nancy Cantor and I
tried to do in our theory of social intelligence, and in our work on the
self. And those who are interested in mental illness and its treatment
should do the same, as cognitive-behavioral therapists do in their successful
treatments. We don't need Freud. We've got a perfectly good
psychology without him.
Freud's been popular because he told wonderful stories, and human beings love
wonderful stories. But they're just stories, like fairy tales. In my
view, Freud’s popularity in mainstream psychology courses reflects a real
intellectual failure on our part. Whose theory of personality is as
interesting as Freud's? Put another way, how many movies have been based
on the 'Big Five" model of personality? Freud filled a vacuum.
When most of psychology was off doing psychophysics and pigeon-pecking,
psychologists influenced by Freud were grappling with the big issues in
psychology. Think of the work of David Rappaport, for example. But
once other psychologists started grappling with those same issues, taking them
seriously, getting beyond what John Marks once called the world of "rats
and cheese", they found out that they didn't need Freud after all.
For example, we now know a lot about the psychological unconscious, but we
didn't need Freud for any of it, and none of it supports Freud in any way.
Some people may have gotten involved in some issues by way of Freud, but those
lines of research are now, as Gordon Allport would have put it,
"functionally autonomous" of Freud. We can get along without him --
more than that, Freud is a dead weight, holding us down.
There will never be a professorship in hypnosis, and the day it happens will be a disaster for the field. Just as hypnosis isn't a profession -- there are only psychotherapists and physicians and dentists who use hypnosis -- so hypnosis is not a science -- there are just cognitive and social psychologists, among others, who do hypnosis research. Hypnosis will survive to the extent that it stays connected to these disciplines. When psychoanalysis moved out of the academy, and promoted itself as an alternative science, or profession, or whatever, on that day it began to die. The same would happen to hypnosis.
I’d prefer that hypnosis be taught in the regular curriculum, as a topic for research and a potential therapeutic modality, just as other things are. But failing that, it’s really up to the societies, and I think that the societies -- I’m particularly familiar with SCEH -- do a pretty good job. The most important thing to stress, though, is not technique but rather the scientific basis of clinical hypnosis. Why would we think that hypnosis would work for such-and-such condition? Why favor this particular approach? What’s the evidence that it actually does work? If we escape from the scientific base we’re all in big trouble. So I worry a lot when, for example, we have one "research" workshop and then a bunch of "clinical" workshops, as if clinical practice is somehow separate from science. The future of medicine and psychotherapy is in evidence-based or empirically supported treatments, and I think that any clinical technique that is taught should be accompanied by scientific documentation that it really works. As an example, consider Elvira Lang’s work on hypnotic analgesia as an adjunct to conscious sedation for outpatient surgery. Her carefully controlled studies show not just that hypnosis helps, but also that it is cost-effective. That’s the kind of work we should be promoting, because that’s the kind of work that will help hypnosis retain its place in the clinician’s armamentarium, and its respect among medical authorities.
The question of lay hypnosis is a difficult one, because anyone can hypnotize -- it’s all in the subject, after all, not in the hypnotist. You can’t prevent people from hypnotizing each other at cocktail parties and night-club shows. But lay hypnotists have no business be treating patients. Martin Orne taught a good rule: if a person is not professionally qualified to treat something without hypnosis, then they’re not qualified to treat something with hypnosis, either. First you look for that professional certificate on the wall -- physician, dentist, clinical psychologist, or whatever. Then you look for the certificate of hypnosis.
It’s true that I’ve taught at a number of places, moving an average of about every six years -- sometimes I wonder why I bothered to get tenure! But of course in the American system you take your tenure with you, and at least in this country academic life has become increasingly peripatetic. Anyway, every place I’ve been has had its attractions, so each move has much more been positive, moving toward something, than negative, away from something. Harvard was a great place to begin a career, not just because it was Harvard, with all its reputation and resources and very distinguished senior faculty, but also because of the extraordinary people I had a junior colleagues. But Harvard rarely tenures from below, and so I had to leave, and I was lucky that Wisconsin came along -- a beautiful campus in a wonderful city that fostered my development as a personality and social psychologist. Wisconsin’s cognitive psychology, however, was somewhat weak, and so when the opportunity came to be part of a new program in cognitive psychology and cognitive science, and my wife told me how beautiful the southwestern desert was, I was ready to go. Arizona was great, another beautiful location, and the opportunity to build something new, but social psychology was weak. So when the opportunity arose to go to Yale, which was strong in both cognitive and social psychology, I jumped at the chance. Yale was great, but Lucy and I had always hoped we might end up in Northern California, so when Berkeley came along, we jumped. I doubt that we’ll be going Back East, as we say in America. Lucy and I have both had opportunities to move since then, but at this point I don’t think we’re going anywhere.
This page last modified 04/08/10 02:58:52 PM.