Hypnosis

Hypnosis is understood to be a psychological condition in which an individual may be induced to exhibit apparent changes in behavior and thought. Although some individuals experience an increase in suggestibility and subjective feelings of an 'altered state of consciousness', this is not true for everyone. In fact, supposed hypnotic indicators and subjective changes can be achieved without relaxation or a lengthy induction, a fact which increases the controversy around hypnosis.

Intense debate surrounds the topic of hypnosis. Some scientists dispute its very existence, while many therapists insist upon its value. One potential source of controversy is the wide variety of theories of hypnosis which have traditionally been split into 'state' and 'non-state' camps. This controversy may be decreasing as the value of both perspectives is increasingly recognized. Modern brain-imaging techniques offer hope for an increased understanding of the nature of hypnosis.

The applications of hypnosis vary widely. Currently, two distinct applications of hypnosis include its use in entertainment and health applications. The popular perception of the hypnotic experience is that of the entertainment version. The stage hypnotist uses a variety of methods to relax and focus the subjects eventually making it appear to the audience that the subject is asleep or, popularly termed, in trance. During the performance, the subjects seem to obey the commands of the hypnotist to engage in behaviors they might not normally choose to perform.

On the other hand, hypnosis applications in the medical and health-related fields are often experienced very differently. Evidence supports the clinical use of hypnosis for pain control, for weight control, in the treatment of irritable bowel syndrome, and as an adjunct to cognitive behavioral and other therapies. Hypnosis is not a therapy in-and-of-itself but is effectively used as an adjunct to other therapies; hence "hypnotherapy" is less preferable than the use of hypnosis-related techniques as part of an integrated psychological package.

History

 * Main article: History of hypnosis

Definitions
It is often said that there are as many definitions of hypnosis as there are hypnotists. Researchers and clinicians have different requirements from explanations of hypnosis and consequently the focus of theories from these respective fields can vary dramatically.

One fundamental distinction in hypnosis theory is between 'state' and 'non-state' approaches to hypnosis. State theorists believe that hypnosis is an altered state of consciousness, whereas non-state theorists believe that hypnotic effects are the product of more mundane psychological processes such as absorption and expectancy. Note how the APA definition (below), essentially a consensus statement from a broad range of researchers and clinicians, remains neutral with respect to this argument.

American Psychological Association
Hypnosis typically involves an introduction to the procedure during which the subject 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 contain 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.

Details of hypnotic procedures and suggestions will differ depending 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 comparing 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.

(see Complete definition and description.)

John Kihlstrom
Professor Kihlstrom of the University of California, Berkeley, defines hypnosis: "Hypnosis is a social interaction in which one person, the hypnotist, gives suggestions to another person, the subject, for imaginative experiences involving alterations in perception, memory, and the voluntary control of action. In the classic instance, these suggested experiences are accompanied by a degree of subjective conviction bordering on delusion, and an experience of involuntariness bordering on compulsion."

(see .)

Michael Yapko
Michael Yapko defines hypnosis: "...hypnosis is a process of influential communication in which the clinician elicits and guides the inner associations of the client in order to establish or strengthen therapeutic associations in the context of a collaborative and mutually responsive goal-oriented relationship. (Yapko, M.. Hypnosis and the Treatment of Depressions. Brunner/Mazel Inc., New York, New York, ISBN 0-87630-682-2, p. 37)

Dave Elman
Dave Elman defines hypnosis as "a state of mind in which the critical faculty of the human mind is bypassed, and selective thinking established." The critical faculty of your mind is that part which passes judgment. It distinguishes between concepts of hot and cold, sweet and sour, large and small, dark and light. If we can bypass this critical faculty in such a way that you no longer distinguish between hot and cold, sweet and sour, we can substitute selective thinking for conventional judgment making.

Theta State-based Some physiological definitions of hypnosis assert that a predominantly alpha state is required for successful therapeutic change, others assert that predominantly theta activity is the marker of hypnosis. Many lay definitions of hypnosis stem from a misunderstanding of what the EEG data means, and trying to define hypnosis as either an alpha or theta state is likely to be a gross oversimplification. It is important to note that non-hypnotized subjects can be found in any of these states of cortical arousal without also displaying any of the behavior, traits or the enhanced suggestibility associated with being hypnotized. Some sophisticated, and scientifically testable, models of brain activity in hypnosis have been developed (see Gruzelier's Neuropsychological Model below).

Theories
A scientific theory attempts to describe and explain the behaviour of a natural or social phenomenon, following the principles of the scientific method. Good theories produce testable hypotheses which can be supported or refuted by experimental data. There are unfortunately many vague and untestable theories of hypnosis which continue to circulate, but high quality research is still published in peer-reviewed scientific journals.

One fundamental distinction is between 'state' and 'non-state' theories of hypnosis. State theorists believe that an altered state of consciousness is a core part of hypnosis, whereas non-state theoriests believe that more mundane psychological processess such as focussed attention and expectation are sufficient to explain hypnotic phenomenon. The precise definition of what constitutes an altered state of consciousness is a matter of some debate. Although many people who are hypnotised describe their experience as 'altered' it is difficult to use these terms in the absence of a prior definition.

One final thing to say about theories is that they can work at different levels of description. Some theories of hypnosis attempt to describe hypnotic phenomenon in terms of brain activity while others concentrate more on the phenomenological experience. Both are valuable and a unified theory is a laudable goal.

Dissociation and neodissociation theories
Pierre Janet originally developed the idea of dissociation, literally a splitting-off of some components of consciousness, as a result of his work with hysterical patients. He believed that hypnosis was an example of dissociation: areas of an individual's behavioral control are split off from ordinary awareness. In this case, hypnosis would remove some control from the conscious mind and the individual will respond with autonomic, reflexive behavior. Weitzenhoffer describes hypnosis via this theory as "dissociation of awareness from the majority of sensory and even strictly neural events taking place."

Ernest Hilgard developed Janet's ideas and published his neodissociation theory in 1977. His theory, a classic 'state' theory, postulated an excutive ego (essentially a central executive system in today's cognitive psychological terms) which became dissociated from sub-components via an 'amnesic barrier'. Suggestions from a hypnotist could produce alterations in perception and behaviour, which were explainable in terms of these dissociated sub-systems. Hilgard's ideas were influenced by his discovery of the 'hidden observer' phenomenon, a process by which different components of consciousness were investigated (other researchers, notably Spanos, believed the hidden observer to be an experimental artifact).

Social constructionism / Role-playing theory
Generally, under hypnosis people become more receptive to suggestion, causing changes in the way they feel, think, and behave. Some psychologists (such as Sarbin and Spanos) have suggested that hypnosis is a social construct, so well-known that strong social expectations are played out by subjects, who believe they are in a state of hypnosis, behaving in a way that they imagine a hypnotized person would behave. Much experimental work has demonstrated that the experiences of hypnotized subjects can be dramatically shaped by expectations and social nuances. This view is often misunderstood: it does not discount the claim that hypnotized individuals are truly experiencing suggested effects, just that the mechanism by which this has taken place has in part been socially constructed and is not necessarily reliant on the idea of an altered state of consciousness

Barber theorizes that hypnosis is not a state or a trance and is not produced as the result of suggestions. He suggests that hypnosis is based on a number of overlapping variables, but, primarily, that interpersonal relationships allow the operator to restructure perceptions and conceptions of the subject. He theorizes that this occurs because the subject is relatively inattentive to the environment and, because of this misdirection of attention, the subject is willing to think as the hypnotist wants them to think.

Neuropsychological theory of hypnosis
Neuropsychological theories of hypnosis attempt to explain hypnotic phenomenon in terms of alterations in brain activity. Gruzelier, based on large amounts of EEG research, proposed that hypnosis is characterised by a shift in brain activity from anterior (front) to posterior (back).

Hypnosis as a state of hysteria
Charcot postulated that hypnosis was a symptom of hysteria and that only those people experiencing hysteria were believed to be hypnotizable. Although those exhibiting hysteria seem to be more suggestible, normal individuals are, indeed, hypnotizable which calls this theory into question.

Hypnosis as a conditioned process leading to sleep
Ivan Pavlov believed that hypnosis was a "partial sleep". He observed that the various degrees of hypnosis didn't significantly differ physiologically from the waking state and hypnosis depended on insignificant changes of environmental stimuli. Pavlov also suggested that lower brain stem mechanisms were involved in hypnotic conditioning.

Although some modern researchers still subscribe to this theory, Kroger states "during deep sleep, conditioned reflexes and physiological responses to a repeatedly given stimulus cannot be established, whereas in hypnosis the learning of conditioned reflexes is enhanced over and above that of the nonhypnotic state."

In hypnosis, the subject typically appears to be asleep because of eye closure that is typically part of the induction procedure, but there is quite a bit of literature on blood pressure, reflexes, physiochemical and EEG studies which indicates that hypnosis more closely resembles complete wakefulness.

Role-playing theory
This theory suggests that individuals are playing a role and allowing the hypnotist to create a reality for them. This relationship depends on how much rapport has been established between the hypnotist and the subject (see Hawthorne effect, Pygmalion effect, and the Placebo effect).

Hyper–suggestibility theory
Currently a more popular theory, it states the subject's attention is narrowed by certain techniques used by the hypnotist. As attention is narrowed, the hypnotist's words eventually take over the inner voice of the subject. From this theory comes the implication that only gullible or weak-minded people are suggestible. Some people, however, find the narrowing of attention to be desirable. Milton H. Erickson was said to have told his subjects, "... and my voice will go with you," meaning that Erickson's voice would be a comforting presence in the face of adversity and trouble.

Informational theory
This theory applies the concept of the brain-as-computer model. In electronic systems, a system adjusts its feedback networks to increase the signal-to-noise ratio for optimum functioning, called a "steady state". Increasing the receptability of a receptor enables messages to be more clearly received from a transmitter primarily by trying to reduce the interference (noise) as much as possible. Thus, the object of the hypnotist is to use techniques to reduce the interference and increase the receptability of specific messages (suggestions).

Research on Hypnosis
Much research has been conducted into the nature and effects of hypnosis and suggestion, and hypnosis continues to be a popular (if somewhat peripheral) tool in contemporary psychological research. A number of different strands of hypnosis research are apparent: that which examines the 'state' of hypnosis itself, that which examines the effects and properties of suggestions in and out of hypnosis, and that which uses hypnotic suggestion as a tool to research other areas of psychological functioning.

With the advent of recent brain imaging techniques (MRI, although also EEG and PET) there has been a resurgence of interest in the relationship between hypnosis and brain function. Any human experience is reflected in some way in the brain - seeing colors or motion is underscored by activity in the visual cortex, feeling fear is mediated by activity in the amygdala - and so hypnosis and suggestion are expected to have observable effects upon brain function. An important issue for researchers conducting brain imaging is to separate the effects of hypnosis and suggestion - knowing that a suggestion given during hypnosis affects brain area X does not just tell us about hypnosis, it tells us about the effects of the suggestion too. To account for this, experiments need to include a non-hypnotic-response-to-suggestion condition - only this way can the specific effects of hypnosis be examined.

A number of brain-imaging studies have been conducted which have used hypnosis, a selection are given below:

For example, one controlled scientific experiment postulates that hypnosis may change conscious experience in a way not possible when people are not "hypnotized", at least in "highly hypnotizable" people. In this experiment, color perception was changed by hypnosis in "highly hypnotizable" people as determined by positron emission tomography (PET) scans (Kosslyn et al., 2000). (This research does not compare the effects of hypnosis on less hypnotizable people and could therefore show little causal effect due to the lack of a control group.)

Another research example, employing event-related fMRI and EEG coherence measures, compared certain specific neural activity "during Stroop task performance between participants of low and high hypnotic susceptibility, at baseline and after hypnotic induction". According to its authors, "the fMRI data revealed that conflict-related ACC activity interacted with hypnosis and hypnotic susceptibility, in that highly susceptible participants displayed increased conflict-related neural activity in the hypnosis condition compared to baseline, as well as with respect to subjects with low susceptibility." (Egner et al., 2005). Skeptics dispute the significance of such findings, claiming that such changes cannot be shown to be particular to the hypnotized state, and that any other action such as daydreaming is also likely to alter brain activity in some manner. The subject is still a matter of current research and scientific debate.

There is a long tradition (over a century) of hypnosis research (the majority of which not using brain imaging techniques) which has allowed scientists to test key ideas in the debate. Hypnosis has been shown to be an effective tool for pain relief, and when combined adjunctively with other therapeutic techniques it has been demonstrated to be a powerful tool (it is effective for weight loss, IBS, anxiety conditions and many more - the data for smoking cessation are more dubious).

General methods
The act of inducing a hypnotic state is referred to as an induction procedure. There is no current consensus on what the requirements are for an induction procedure to be effective; while some practitioners use simple calming verbal techniques, others use complex triggers, including mechanical devices (see Michael Robinson's Self-Hypnosis Learning or Licensed Online Counseling, page 45).

Many experienced hypnotists claim that they can hypnotize almost anyone. They also claim it is a myth that people with strong will power cannot be hypnotized, as they claim these generally make the best participants. This is based on the idea that those who are most intelligent are also the most creative and as such they will make strong associations with the structure of language used by the hypnotist and by the visual or auditory representations inside of their mind. On the other hand, there is a common claim that no one can really be hypnotized against his or her will (Liébault, Le sommeil provoqué (Paris, 1889)). The counter-claim given by many hypnotists is that while you cannot make someone do anything against their will, you can change what it is that they wish to do.

Many religious and cultural rituals contain many similarities with techniques used for hypnotic induction and induce similar states in their participants.

Focused attention
This school of thought holds that hypnosis as a state is very similar to other states of extreme concentration, where a person becomes oblivious to his or her surroundings while lost in thought. Often suggested as an example is when a driver suddenly finds himself much further down the road without any memory of driving the intervening distance (highway hypnosis), or when a person is watching television and focuses so intently on the program that he or she ceases to be aware of the sides of the screen.

The act of hypnotizing, is, in effect, the act of manually inducing a similar state (''See, for example, general information on the ASCH website).

Suggestibility
Psychologists have produced controversial studies that seem to show a strong correlation between the ease of putting someone in a state of hypnosis and their level of suggestibility. Some of these studies have produced the Harvard scale, Stanford scale, and eye-roll test; all of which are supposed to predict how easily a person can be put in a hypnotized state.

Hypnosis has further been described as "The suspension of the critical factor" which expands on the idea of "increased suggestibility". A person who claims to be hypnotized may accept statements as true that he or she would normally reject.

For example, when told "you have forgotten your name," the subject in a normal state would react with disbelief, but under hypnosis people have claimed that they have, indeed, forgotten their own names.

It often appears as if the hypnotized participant accepts the authority of the hypnotist over his or her own experience. When asked after the conclusion of such a session, some participants appear to be genuinely unable to recall the incident, while others say that they had known the hypnotist was wrong but at the time it had seemed easier just to go along with his instructions. (Richard Feynman describes this in his memoir Surely You're Joking, Mr. Feynman! as his own experience under hypnosis.) The mechanism of this effect is however disputed: Some hypnotists would claim that this showed the difference between a deep and a shallow hypnotic trance, while skeptics would question the validity of this conclusion, citing that such effects can be duplicated in other circumstances where an agent holds authority, such as the Milgram experiment, and suggest that unreliability in results discredits a scientific theory of hypnosis.

Judgment
Some believe that hypnosis can affect the subject's judgment and therefore could potentially cause them harm. In the hand of a "professional" seeking to promote the subject's welfare, those of this opinion believe, hypnosis can produce profound effects and be a complement to treatment. Some of those who believe in hypnosis believe that in most cases one can resist hypnosis if one is aware of it. However, some of those who hold this belief also believe in brainwashing and/or mind control and believe that when hypnotism takes place in the context of these, resisting hypnosis is far more difficult. These beliefs are not generally based on scientific evidence, as there is no scientific consensus on whether mind control even exists, let alone whether it is more difficult to resist hypnotism in the context of this unverified theoretical construct.

Abreaction
Some psychologists and other mental health professionals are concerned that practitioners of hypnosis might evoke intense emotions in their clients that they are untrained to handle. These abreactions might occur when spontaneously or purposefully recalling traumatic events or, some believe, spontaneous mental breakdowns.

Hypnotherapy
Hypnotherapy is a term to describe the use of hypnosis in a therapeutic context. Many hypnotherapists refer to their practice as "clinical work." Hypnotherapy can either be used as an addition to the work of licensed physicians or psychologists, or it can be used in a stand-alone environment where the hypnotherapist in question usually owns his or her own business. The majority of certified hypnotherapists (C.Hts in the US, Diploma. Hyp in the UK) today earn a large portion of their money through the cessation of smoking (often in a single session) and the aid of weight loss (body sculpting). Some of the so called 'incurable' diseases have shown to be treatable with the mind-body (such as cancer, diabetes, and arthritis). Some of the treatments practiced by hypnotherapists, in particular so-called regression, have been viewed with skepticism.

The American Medical Association and the American Psychological Association have both cautioned against the use of repressed memory therapy in dealing with cases of alleged childhood trauma, stating that "it is impossible, without other corroborative evidence, to distinguish a true memory from a false one", and so the procedure is "fraught with problems of potential misapplication". This is why Forensic Hypnosis is not widely used in many countries' legal systems.

Clinical Hypnosis
The American Society of Clinical Hypnosis is an organization that "promotes greater acceptance of hypnosis as a clinical tool with broad applications". Hypnosis is applied to a great range of both physical and psychological ailments, rather than being restricted to purely psychological phenomena. The society was founded by Milton Erickson, a doctor who attempted to put hypnosis on a firm therapeutic backing in the 1950s.

Milton H. Erickson was opposed to non-board-licensed healthcare professionals performing therapeutic hypnotism, which has since caused difficulty for certified laymen willing to practice. In the United States, certified lay hypnotists are now said to perform "non-therapeutic issue-resolution hypnotism", rather than "hypnotherapy". 

Recently, efforts to reduce obesity with hypnosis (when used in combination with cognitive behavioral therapy, exercise, and a low-fat diet) have been effective in most cases.

Self-hypnosis
Self-hypnosis&mdash; (or autosuggestion) hypnosis in which a person hypnotizes himself without the assistance of another person to serve as the hypnotist&mdash;is a staple of hypnotherapy-related self-help programs. It is most often used to help the self-hypnotist stay on a diet, overcome smoking or some other addiction, or to generally boost the hypnotized person's self-esteem. It is rarely used for the more complex or controversial uses of hypnotism, which require the hypnotist to monitor the hypnotized person's reactions and responses and respond accordingly. Most people who practice self-hypnosis require a focus for their attention in order to become fully hypnotized; there are many computer programs on the market that can ostensibly help in this area, though few, if any, have been scientifically proven to aid self-hypnosis.

Some people use devices known as mind machines to help them go into self-hypnosis more readily. A mind machine consists of glasses with different colored flashing LEDs on the inside, and headphones. The LEDs stimulate the visual channel while the headphones stimulate the audio channel with similar or slightly different frequencies designed to produce a certain mental state. A common occurrence is the use of binaural beats in the audio which is said to produce hypnosis more readily.

Dental Application
The use of hypnosis in dentistry has a long history. Dealing with hypnodontia -- the use of hypnosis in dentistry -- has attested to the increasing sophistication of hypnotic procedures to deal with the special problems of the dental patient. Besides smoothing out dental procedures by way of its generalized anti-anxiety effects, it can increase overall patient comfort, make the dental experience acceptable and bearable, decrease resistance to future intervention, and through posthypnotic suggestions, encourage more rapid recovery.

Obstetric Application (Painless Childbirth)
The practice of hypnotically assisted deliveries has a history of over a century. Falling into disfavor due to competition from chemical anesthesia, hypnosis has seen a revival in the last two decades. One important reason for this comeback is the realization that hypnosis may find usefulness not only in obstetric analgesia or anesthesia, but also in all phases of giving birth from pregnancy to postpartum recovery.

Forensic Application
Scientific knowledge of hypnosis applied to Legal problems is called forensic hypnosis. Courts prior to 1968 consistently excluded post-hypnotic testimony on the grounds that it was unreliable and apt to influence a jury unduly. Now hypnosis practice is growing stronger and still admissible in courtroom testimonies as long as the stringent criteria and guidelines are met. American Law Institute’s Model Penal Code specifies Crime done by hypnotic Suggestion & Witness evidence in court after Hypnotic suggestion are not valued. In the U.S., Oregon, Texas, Indiana,Nevada, and California states have separate hypnotic investigation acts. Nevada courts accept hypnotically refreshed statements as evidence for judgment. Russia generally uses hypnosis in criminal investigations.

Mass Application
Influencing the crowds of common longings and yearnings by a demagogue is called mass hypnosis. Generally mass hypnosis is applied to religious sessions. The pious mob will easily respond to, monotonously repeating suggestive words. Many forms of music and dance can be used to create religious trance.

Stage Application
In stage hypnosis, a hypnotist carefully chooses volunteers from the audience, puts them into a trance using hypnosis and then plants suggestions for them to perform. The critical factor in all stage hypnosis shows is the choice of enthusiastic and credulous individuals. Various techniques exist for discerning whether an individual is a likely candidate for a hypnosis stage act. Often, the sheer willingness of audience members to volunteer is a sign that they will "go along with" the hypnotist's suggestions during the show, whether or not they ever really become hypnotised in the first place. For example, the volunteers may be made to believe they are drunk, aliens speaking a strange alien language, naked or seeing others naked, 6-year-old children, ballet dancers etc. Such suggestions are designed to be temporary, lasting the duration of the show. Stage hypnosis is a unique performance in that it involves "real" people from the audience responding in a variety of ways, making no two shows the same. There has been debate over the years as to whether some degree of fraud or collusion may be involved in some stage hypnosis acts.

Regarding the phenomenon of stage hypnotism, Jon Connelly, Ph.D., a therapeutic hypnotist, writes:

''How does the stage hypnotist create the illusion of "taking over" his subject's minds? It appears they are helpless to refuse whatever he directs them to do under his power and control.''

''How is this accomplished? It begins with the hypnotist asking for volunteers from an audience already entranced enough with the idea of stage hypnosis that they chose to make attending the show their priority. Naturally, they all have expectations about what they will witness.''

''The audience is made up of three categories of attendees. The first is prepared, and actually hoping to come up on stage to be subjects despite knowing they will be doing silly things in front of everyone else. The second category is comprised of those who want to prove they can't be hypnotized. These folks are likely to volunteer but only to prove the hypnotist wrong. Finally, the third group is simply interested in watching the show.''

''The first thing the hypnotist does is to ask for volunteers. On the crowded stage, he "tests" their willingness to cooperate by directing them to do something and he observes their reactions. Anyone not cooperating is eliminated. Seeing others dismissed, enhances the willingness of the remaining volunteers to cooperate even more fully.''

''The task of finding the most cooperative and dramatic volunteers is accomplished as the hypnotist asks those on stage to do even stranger things and eliminates those whose performance isn't up to par. Soon a small number of volunteers remain. These people are willing to dramatically engage in almost anything the hypnotist suggests. The audience has enjoyed the screening process on another level, believing the hypnotist has caused the subjects to become more and more entranced with hypnosis.''

''The hypnotist tells the small group of remaining subjects to relax even more into the role of "hypnotized person" he created for them. There is little difference between a good hypnotic subject and a good actor. The context and the understanding each has of why they are doing what they are doing, is the main difference. They both voluntarily throw themselves into the role created for them since both are stage performers.''

''The stage hypnotist is like a casting director for a movie. The casting director selects people who can vividly imagine and act on what is written in the script as if it was real. These are the same qualities that would make someone a good hypnotic subject. Both the hypnotist and the film director create the scene and encourage the subject or actor into imagining their role to the extent that it can become real to them. They are often described as "absorbed" in the role. Actors know their job is to fool the audience into experiencing the role as real also. The hypnosis subject imagines her role so vividly, it is experienced as real. On some level, both the actor and the hypnotized subject know what is happening. Neither is being "controlled."''

''In stage hypnosis, audience members confuse what is really cooperation with control over the subject's mind. But it is an illusion.''

Indirect Application
In addition to direct application of hypnosis (that is, treatment of conditions by means of hypnosis), there is also indirect application, wherein hypnosis is used to facilitate another procedure. Some people seem more able to display 'enhanced functioning', such as the suppression of pain, under hypnosis.

One of the major initial applications of hypnotism was the suppression of pain during medical procedures; this was supplanted (in the late 19th century) by the development of more reliable chemical anesthetics.

Some studies suggest that while hypnosis may possess these qualities, they are not exclusive to hypnosis, that it is often the drama and fantasizing that produces the behavior.

Objective Signs of the Hypnotic State: Breuer's Absent Pupillary Reflex Sign
For those who discount trance state completely, this is an objective sign, and is the opposite of the normal physiological response. When the subject/patient/client is in 'deep' hypnosis (based upon most scales)she/he is asked to stay in hypnosis and open their eyes. The pupils are usually dilated. When a penlight is shone into the eyes the pupils will usually stay dilated or poorly reactive (the normal non-hypnotic response being contraction). Some clinicians use this as a benchmark for cases being readied for hypno-anesthesia. What is meant by very 'deep hypnosis' is debatable as is the terminology used for that state (somnamulistic, Esdaile, Ultradepth, etc.). This is a brief test and will not take away from therapy. (Dr. William Breuer popularized this test in University lectures to his students after conducting a research project that involved professionals in multiple sites from three countries.) HISTORY: The early mention of this sign is in an 'archaic' and esoteric book, 'Hypnotism' by Carl Sextus, which stated that when people are asked to open their eyes while remaining in deep trance and then when a light is shone into their eyes, their pupils won't contract. Use any suggestions you wish to keep them in hypnosis, but at this point in trance do not use any suggestions relating to their eyes, visual focus, light or the pupils' dilation/contraction.

Professional associations and governmental authorities
Several types of organizations exist to further the professionalism and regulation of practicing hypnotists. For example, professional associations typically offer opportunities for collegial exchanges and professional development in general and/or specialized areas of hypnosis. They also may establish codes of conduct and standards for various certification programs. They may offer such certification programs directly or approve third-party programs. Organizations not affiliated with any professional association may offer their own certificates as well.

Governmental authorities, such as state licensing agencies, may establish minimum requirements for credentials that must be earned before one may practice hypnosis within their jurisdiction. Such credentials typically are called certificates or licenses. Some noteworthy examples of professional associations and governmental authorities that offer certification, licensure or statutes that regulate hypnosis follow.

Popular culture
The notion of hypnotism has elicited many presentations in popular culture. Intrinsically, the notion that people are susceptible to commands outside their conscious control can be an effective way of representing the notion of the fallible narrator.

Fictional treatments
The typical uses of hypnotism in fiction concentrate on one of the major abilities of hypnotism. As mentioned in the introduction, hypnotism can be used to:
 * Recollect knowledge
 * Take command of a subject
 * Implant suggestions that the subject will obey while free of the hypnotic trance.

The recollection of knowledge has inspired use in detective fiction, as a tool for witnesses to examine details (such as license plate numbers) that could not be recalled while fully conscious. This appears in many television series, such as Law & Order or Homicide: Life on the Street. In addition, it has been expanded to the notion of remembering "past lives", that is, previous reincarnations of the subject, in such movies as "DEAD AGAIN."

In real-life cases, recollection of knowledge via hypnosis has been used in many cases, but its effectiveness is disputed. Proponents claim that recovered memories have aided in the solving of many crimes, often corroborating with physical evidence which would have been impossible to obtain otherwise. Skeptics suggest that such successes are a function of simple chance, pointing to cases where its use on victims of rape or attempted murder to help them jog their memory in identifying an accused has caused sentences to be doled out to the wrong person. This is because the hypnotist might make suggestions that are more likely to be remembered as "truth". Most experts recommend that the practice be used at most like a lie detector, to glean more information, and never as the smoking gun.

The notion of implanting suggestions is probably the most thoroughly explored; ranging from comedies such as The Naked Gun trilogy to dramas such as The Manchurian Candidate and Oldboy. These films usually center around the concept of brainwashing or mind control. Several cases have been recorded where the defense argued the accused had committed the murder under hypnosis, though there is little real evidence that such control is possible.

Books

 * Hypnosis and Suggestion in the Treatment of Pain: A Clinical Guide, by Joseph Barber. NY: Norton (1996).


 * The Highly Hypnotizable Person, Michael Heap, Richard J. Brown &amp; David A. Oakley, (2004), Routledge
 * Better and Better Every Day, Emile Coue, (1960).
 * Uncommon Therapy, Jay Haley (about the psychotherapeutic intervention techniques of Milton Erickson)
 * Open to suggestion. The uses and abuses of hypnosis. Robert Temple, 1989, ISBN 1-85030-710-4
 * Clinical and Experimental Hypnosis William S. Kroger, M.D., 1977, ISBN 0-397-50377-6
 * Fromm,E. and Shot,R.E. (eds) Hypnosis: Research Developments and Perspectives, 2nd edn, New York Aldine
 * Hilgard, E. R. (1965). Hypnotic Susceptibility NY, Harcourt, Brace & World, Inc.
 * Hilgard, E. R. (1977) Divided Consciousness: Multiple Controls in Human Thought and Action John Wiley & Sons.
 * Hilgard, Ernest R. & Hilgard, Josephine R. (1975). Hypnosis in the Relief of Pain. Los Angeles: William Kaufmann.
 * Wagstaff, G.F. (1981) Hypnosis, Compliance and Belief, Brighton: Harvester.
 * Wagstaff, G. F. (1987) Hypnosis. In: H. Beloff and A. Coleman (eds) Psychology Survey no. 6, Leicester: British Psychological Society.
 * Wagstaff,G. Mind control,

Papers
Gibson, H.B. (1982) The use of hypnosis in police investigations, Bulletin of the British Psychological Society 35: 138-42. Nogrady, H., McConkey, K.M., Laurence, J.R. and Perry, C. (1983) Dissociation, duality and demand characteristics in hypnosis, Journal of Abnormal and Social Psychology 92: 223-35. Orne, M.T. (1979) On the simulating subject as quasi-control group in hypnosis research: what, why and how? In: E. Fromm and R.E. Shot (eds) Hypnosis: Research Developments and Perspectives, 2nd edn, New York Aldine. Orne, M. T. (1970). Hypnosis, motivation, and ecological validity. In W. Arnold and M. Page (Eds.), Nebraska symposium on motivation. Lincoln, NE: University of Nebraska Press. Sarbin, T.R. and Slagle, R.W. (1972) Hypnosis and psychophysiological outcomes. In: E. Fromm and R.E. Shot (eds) Hypnosis: Research, Developments and Perspectives, Chicago, Ill.: Aldine-Atherton. Wadden, T. and Anderton, C.H. (1982) The clinical use of hypnosis, Psychological Bulletin 91: 215-43. Wilson, S.C. and Barber, T.X. (1983) The fantasy-prone personality: implications for understanding imagery, hypnosis and parapsychological phenomena. In: A. Sheikh (ed.) Imagery: Current Theory, Research and Application, New York: John Wiley.

Self-Hypnosis Aids

 * Neuro Programmer 2 - Software that uses brainwave synchronization (entrainment) to achieve a suggestible state, and then introduces suggestions made by the user, either typed or recorded.

Professional associations

 * American Board of Medical Hypnosis
 * American Council of Hypnotist Examiners
 * American Hypnosis Board for Clinical Social Work
 * American Psychological Association, Division 30 Psychological Hypnosis: "Brings together psychologists and other professionals interested in scientific and applied hypnosis."
 * American Psychotherapy and Medical Hypnosis Association
 * American Society of Clinical Hypnosis, founded by Milton Erickson in 1957: "Promotes greater acceptance of hypnosis as a clinical tool with broad applications."
 * Australian Society of Hypnosis "The society of medical and associated professionals" http://www.ozhypnosis.com.au
 * British Association of Therapeutical Hypnotists
 * Council of Professional Hypnosis Organizations (International)
 * General Hypnotherapy Register Largest (UK) umbrella body
 * General Hypnotherapy Standards Council (UK) Overseeing the GHR.
 * National Board for Certified Clinical Hypnotherapists (USA)
 * National Guild of Hypnotists (USA)
 * Professional Board of Hypnotherapy (Canada)
 * Society of Clinical and Experimental Hypnosis (USA)
 * Institute of Clinical Hypnosis and Counseling. (India)http://www.hypnotradition.com
 * Gesellschaft für therapeutische Hypnose und Hypnoseforschung (Germany)

Governmental authorities

 * California statute (Enter Chapter "820", Year "2002")
 * Florida statute
 * Indiana Hypnotist Committee
 * http://www.hypnotherapists.org.uk

Historical sites

 * The Hypnosis Museum of Historical Equipment & Methodology