Edward J. Frischholz

The relation between the Hypnotic Induction Profile and the Stanford Hypnotic Susceptibility Scales, forms A and C.

Abstract Measures from the clinically derived Hypnotic Induction Profile (HIP) of Spiegel (1974a) were correlated with those from the laboratory derived Stanford Hypnotic Susceptibility Scales, Forms A and C (SHSS:A, SHSS:C) of Weitzenhoffer and Hilgard (1959, 1962), and with some scores from the related Harvard Group Scale of Hypnotic Susceptibility, Form A (Shor & E. Orne, 1962). Ss were paid volunteers from student populations at the University of Pennsylvania (N = 87) and from Stanford University (N = 58). Some differences in sampling procedures and orders of testing are discussed, but only minimal differences between the 2 samples resulted. Positive but nonsignificant correlations were found between the Eye-Roll sign alone and SHSS in the 2 samples. Both the Induction (IND) and Profile scoring methods of HIP were compared with SHSS. The IND, an actuarial scale, was positively correlated with SHSS. A representative value is the significant correlation of .34 between IND and SHSS:(A + C)/2 scores when ...

The Relationship between the Hypnotic Induction Profile and the Stanford Hypnotic Susceptibility Scale, Form C: Revisited

Hilgard’s comment raises some important issues, although many of these have little to do with the primary purpose of the study under discussion. This purpose was to objectively examine the relationship between three conceptually and operationally different procedures for measuring hypnotic responsivity. Hilgard’s concern over the magnitude of the correlation between the HIP and SHSS:C is unfounded. A cross-validated correlation of .66 was found between the HIP and SHSS:C in a new sample of 44 student volunteers. This demonstrates that the HIP correlates about the same with SHSS:C as the Harvard Group Scale of Hypnotic Susceptibility. Hilgard’s conception of the Eye-Roll (ER) hypothesis is clarified. Evidence which utilizes all cases in the correlational analysis is presented in support of the ER hypothesis. Happily, we all agree on a new methodology which will be definitive in testing the validity of the ER hypothesis.

The hypnotic induction profile and absorption.

This study examined the relationship between scores on the Hypnotic Induction Profile (HIP) and the trait of absorption in three different clinical groups: Smokers (n = 226), Phobics (n = 95), and patients with Chronic Pain (n = 65). Two hypotheses were investigated. The first predicted that both the Eye-Roll sign (ERS) and Induction Score (IND) of the HIP would correlate similarly (r = .30) with scores on the Tellegen Absorption Scale (TAS), as has been previously reported with other measures of hypnotic responsivity in student samples. The second was that using a combination of both ERS and IND scores to predict TAS scores would result in a significant increase in forecasting accuracy over using either HIP measure alone. Both hypotheses were supported in all three clinical groups. Correlations between HIP and Absorption scores ranged from .33 to .53. Clinical and theoretical implications of the findings are discussed.

Iatrogenic dissociative identity disorder—An evaluation of the scientific evidence.

In recent years there has been a remarkable increase in malpractice suits in which a retractor-plaintiff alleges that a defendant therapist has suggestively implanted a false dissociative identity disorder (DID) diagnosis. A critical examination of the arguments used by plaintiff expert witnesses demonstrates that the scientific evidence is insufficient, consisting largely of anecdotal case reports, non-data-based pro-false-memory opinion papers, and several methodologically questionable laboratory studies. These sparse data fail to meet a minimal standard of scientific evidence justifying the claim that a major psychiatric diagnosis like dissociative identity disorder per se can be produced through suggestive influences in therapy. However, some scientific evidence exists to show that behavioral reinforcement can affect the frequency and type of alter behavior manifesting in patients who already have DID. Plaintiff expert witnesses have confused alter creation with alter shaping. Based on the available scientific evidence, it is doubtful whether such plaintiff complaints could meet a Frye-Daubert standard in a test of admissibility of such testimony. Furthermore, current malpractice claims based in iatrogenic DID fail to consider other plausible alternative explanations for plaintiffs retraction beliefs, such as the manufacture of retraction beliefs through systematic exposure to post-treatment pro-false-memory suggestive influences and/or deceptive, factitious behavior on the part of plaintiff.

Hypnotizability in Relation to the Ability to Learn Thermal Biofeedback

Abstract We investigated previous findings that hypnotizability was unrelated to the ability to learn to control skin temperature. Twenty-six subjects were given the Hypnotic Induction Profile (HIP) and Stanford Hypnotic Susceptibility Scale (SHSS:C), Form C. Hypnotizability scores were then correlated with temperature changes recorded during two different periods in three different thermal biofeedback sessions. The two different periods consisted of a no-feedback recording period and a feedback recording period following a habituation period. HIP and SHSS:C scores were significantly correlated, r (24)= .60, p < .001. However, none of the scores on either hypnotizability measure correlated significantly with any changes in temperature during any period of any thermal biofeedback session. Clinical implications of these findings are discussed.

Medicare procedure code 90880 (medical hypnotherapy): use the code (not the word).

In my July 1995 editorial (Frischholz, 1995), I discouraged potential contributors to the American Journal of Clinical Hypnosis from using the word “hypnotherapy” for several reasons. First, I felt that hypnosis is not a form of therapy in its own right. Second, it is unclear what is meant by the word “hypnotherapy,” since various health care professionals use hypnosis as an adjunct to another primary treatment strategy in so many different ways (e.g., look at the many different ways hypnosis is used in the treatment of smoking). Finally, I believe that members of the American Society of Clinical Hypnosis are not just “hypnotherapists,” but health care professionals (medical doctors, psychologists, social workers, dentists, nurses, etc.) who utilize hypnosis to facilitate their own clinical specializations. I feel strongly about this and still discourage the use of the word “hypnotherapy” for these reasons. However, I recently learned that Medicare has a procedure code (90880) for “medical hypnotherapy.” While I am dissatisfied with the label, I believe there is some merit for using such a separate procedure code. Basically, the code is to be used by a service provider who is trained both in the clinical uses of hypnosis and in the field of psychotherapy. Consequently, service providers who use this code are reimbursed at a higher rate (e.g., in Chicago, Illinois:

Suggested Posthypnotic Amnesia in Psychiatric Patients and Normals

48.27) than those who use the G0073 procedure code for individual psychotherapy alone (e.g., in Chicago, Illinois:

Significant Dates in the History of Forensic Hypnosis

39.34). This represents a 23% higher rate for a single 45–50 minute session. The higher rate is merited by the dual expertise providers must have in order to provide this service compared to psychotherapy alone. Therefore, I would encourage members of our society to consider using the code, while downplaying the label “hypnotherapy.” There are also many restrictions associated with using Medicare procedure code 90880. These rules are specified in Table 1, which is reproduced from page 10 of the May 1997 Illinois Medicare B Bulletin. Another potential problem with using Medicare procedure code 90880 concerns whether or not Medicare considers one to be an “eligible” provider. For example,

Hypnotic and Nonhypnotic Control of Ventilation

The present study examined both quantitative and qualitative hypnotizability differences among four psychiatric patient groups (dissociative disorder (n = 17), schizophrenic (n = 13), mood disorder (n = 14), and anxiety disorder (n = 14) patients), and normals (college students (n = 63)). Dissociative disorder patients earned significantly higher corrected total scores on the Stanford Hypnotic Susceptibility Scale, Form C (mean = 7.94), than all other groups. Likewise, dissociative disorder patients initially recalled significantly fewer items when the posthypnotic amnesia suggestion was in effect (mean = .41) and reversed significantly more items when the suggestion was canceled (mean = 3.82) than all other groups. In contrast, schizophrenic patients recalled significantly fewer items when the amnesia suggestion was in effect (mean = 1.85) and reversed significantly fewer items when it was canceled (mean = .77) than the remaining groups. This qualitative difference between schizophrenic patients and the other groups on the suggested posthypnotic amnesia item was observed even though there were no significant quantitative differences between groups in overall hypnotic responsivity.

Antidepressant Medications, Placebo, and the Use of Hypnosis in the Treatment of Depression

Important dates in the history of forensic hypnosis are identified and their significance is briefly described. Trends regarding the use of forensic hypnosis are highlighted, as well as criticisms of various positions. The authors recommend that professionals who practice forensic hypnosis be thoroughly familiar with the significant precedents, problems, and pitfalls that have arisen concerning the use of hypnosis with memory in forensic settings.