A Human Subjects Protocol for Hypnosis

Note:  This is a recent version of the Human Subjects protocol that covers my hypnosis research at the University of California, Berkeley.  Previous versions have been used at Harvard University, the University of Wisconsin, University of Arizona, and Yale University.  It is derived from one originally developed by Martin T. Orne and his associates at the University of Pennsylvania.

This protocol is intended to serve as a model for others who wish to conduct research on hypnosis.  It is a protocol that works, in that it satisfactorily addresses almost any conceivable question that a Human Subjects committee might have about the potential risks of hypnosis.  Fortunately, those risks are few and easily managed in laboratory situations.  

However,

it is important to note that the risks of hypnosis are few and easily managed provided that the protocol is actually followed.  It is not enough just to submit the form.  Investigators who actually implement procedures such as those described below can look forward to many rewarding and productive years of hypnosis research, with minimal risk either to their subjects or to their research programs.

Personality and Cognition in Hypnotic Phenomena

(Deleted)

The proposed investigations continue a program of research on personality and cognitive processes implicated in hypnosis and related states, which has been continuously supported by the National Institute of Mental Health since 1977. Previously the research was conducted at Harvard University (1975-1980), the University of Wisconsin (1980-1987), the University of Arizona (1987-1995), and at Yale beginning in 1995 (the grant was transferred to UCB in 1997). The abstract of the current NIMH Grant Application follows:

This research project is concerned with personality and cognitive processes implicated in hypnosis and related states. The goal is to explore the application of hypnosis as laboratory model for somatoform and dissociative psychopathology, and as a paradigm for the understanding of clinically relevant nonconscious mental processes, and to lay the scientific basis for the appropriate and effective use of hypnosis as an adjunctive treatment in medicine and psychotherapy. Throughout the research, hypnosis is studied from the perspective of information-processing approaches to perception, memory, and cognition. Although the research is focused mainly on hypnosis, studies of other cognitive, social, and personality processes will be conducted, as needed, in order to develop experimental procedures or to clarify the nature of the mechanisms underlying hypnotic phenomena. A total of five major lines of research are proposed: (1) social-cognitive processes employed in the evaluation of assessment of hypnotic response in other people; (2) neuropsychological aspects of individual differences in hypnotizability; (3) memory processes disrupted during posthypnotic amnesia and related phenomena; (4) the nature of posthypnotic suggestion; and (5) perceptual-cognitive processes involved in response to suggestions for tactile anesthesia, blindness, and deafness. Although no studies of patient populations are explicitly planned, the laboratory will seek the opportunity to conduct collaborative research on such matters as the comparative hypnotizability of patients differing in diagnostic category or age, and the efficacy of hypnosis as an adjunct to traditional forms of insight-oriented and cognitive-behavioral psychotherapy. The core of the proposal is the advancement of our understanding of hypnosis itself through laboratory research employing established paradigms in cognitive and personality psychology.

The subjects in this research will be male and female students at the University of California, aged 18 or older, native speakers of English or possessing adequate self-described ability to speak and understand English.

Subjects will be recruited for this research via established procedures through the Psychology Department Subject Pool (an option through which students enrolled in various department courses can obtain first-hand exposure to psychological research) or through flyers posted on the appropriate bulletin boards in Tolman Hall. We expect that many subjects who participate in our research will be enrolled in the introductory psychology courses (Psychology 1, 2, or 101). However, no student will be required to participate in hypnosis research in order to fulfill the requirements of any course. Sometimes, subjects will receive token monetary compensation (approximately $8.00 per hour) for their participation in our research.

Revision added 05/21/02: The consent forms have been modified to include new language pertaining to the Department of Psychology Subject Pool.

In our laboratory, there is never any deception involved in recruiting subjects for hypnosis research. All subjects who participate in any condition of our research involving hypnosis will have volunteered specifically for hypnosis research. The general nature of the experiment, including the use of hypnosis, is explained to the subjects before they volunteer. Upon arrival at the experimental session the subjects receive another description of the experiment, including a nontechnical explanation of hypnosis, and are given the opportunity to ask questions concerning hypnosis in general and the experiment in particular. All questions are willingly answered, and the experiment does not proceed until the subject is satisfied. Informed consent is obtained in writing prior to the experiment, but it is clear to subjects that they can withdraw prior to the session or at any other time without prejudicing their research participation credit or cash payment.

Note on patient subjects. One line of investigation described in the NIMH proposal is concerned with individual differences in hypnotic response among neurological patients with different types of brain damage (e.g., left vs. right, or anterior vs. posterior portions of the brain). According to our plan, these patients will be recruited through their physicians, and compensated for both their time and travel. Patient participation in our research will be strictly voluntary, and their decision to participate will in no way influence their treatment. However, I am not requesting approval for any hypnosis experiments involving patients at this time: separate approval will be sought as the opportunity to work with patients arises, and as detailed protocols can be developed.

There is no screening of prospective subjects prior to their entry into the research.

An important feature of our research program is the careful assessment of individual differences in hypnotizability by means of a group testing session followed by an individual testing session. The initial group testing session may involve up to 100 subjects seated in a large, comfortable classroom, along with the experimenter and a number of trained assistants. Following brief introductory remarks on the nature of hypnosis, and the completion of one or more standard personality scales (such as the Absorption scale of the Multidimensional Personality Questionnaire), the subjects receive a tape-recorded administration of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A), a standardized procedure in use since 1962. The HGSHS:A consists of a standard induction procedure in which subjects are instructed to relax, focus their eyes on a target of their choosing, and attend to suggestions for further relaxation and focused attention, and eye closure. After their eyes are closed, the subjects receive suggestions for a series of imaginative experiences of the sort commonly associated with hypnosis. For example, they are asked to extend their right arms and imagine them pulled down by an imaginary weight. Later, after the termination of hypnosis, the subjects rate their response to each suggestion according to standard criteria. None of the suggestions are embarrassing or threatening in any way.

The purpose of the group testing session is to familiarize subjects with hypnotic procedures, and also to provide a preliminary assessment of their ability to experience hypnosis. On the basis of their HGSHS:A scores, and depending on the requirements of other experiments, selected subjects are invited to return to the laboratory (located on the 4th floor of Tolman Hall) for an individual testing session involving the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C), a standardized procedure in use since 1962. The format of this session is the same as the group session -- except, of course, that it involves only a single experimenter and a single subject. The SHSS:C differs from the HGSHS:A in that it contains a wider variety of suggestions, including suggestions for "cognitive" alterations. In the suggestion for hypnotic age regression, for example, subjects are asked to imagine that they are in the first or second grade (their choice), sitting in school on a pleasant day. The experimenter evaluates the subject's response to each suggestion according to standard behavioral criteria. The purpose of the SHSS:C session is to obtain a more reliable estimate of hypnotizability than is available from the HGSHS:A session alone.

On the basis of their SHSS:C scores, subjects will again be invited to return to the laboratory for other experiments. For all intents and purposes, these experiments resemble standard studies in cognitive and personality psychology, except that some of the subjects are hypnotized during their participation. For example:

(1) In the studies of evaluation of hypnotic response, subjects (who are not themselves hypnotized) will read verbal descriptions of other people's responses to hypnotic suggestions, and they will be asked to evaluate how "deeply" those people are hypnotized. These descriptions will be constructed by the experimenter so that they vary systematically along one or more dimensions, following procedures commonly employed in studies of social judgment.

(2) In the studies of individual differences in hypnotizability, subjects (whose level of hypnotizability will be known from the HGSHS:A and SHSS:C sessions) will be asked to complete personality questionnaires or engage in perceptual-cognitive tasks. For example, the subjects will be asked to search for specific letters or words embedded in a larger array of items. The speed and accuracy with which subjects perform this task will be correlated with their level of hypnotizability.

(3) In a typical study of posthypnotic amnesia, hypnotized and unhypnotized subjects study a list of words, and then receive a suggestion to forget these words. After termination of hypnosis, the subjects are engaged in various tests of memory. The suggestion for amnesia is canceled at the termination of the experiment, so that all subjects leave the laboratory with complete memory of what has gone on.

(4) In a typical study of posthypnotic suggestion, hypnotized subjects and controls will receive a suggestion to press a particular key in response to a pre-arranged cue (posthypnotic suggestions are often covered with suggestions for amnesia as well). The cue will then be presented under different experimental conditions, to determine the factors affecting response to the suggestion.

(5) In a typical study of tactile anesthesia, blindness, or deafness, hypnotized subjects will receive suggestions for reduced sensitivity in one of these sensory modalities. Their response to, and memory for, tactile, visual, or auditory stimuli will then be tested by various perceptual-cognitive tasks. Most of our experiments will be on partial reductions in sensitivity: on one arm, in one ear, or for a particular portion of the visual field; however, subjects who respond successfully to these suggestions may be recruited for studies of complete blindness or deafness. Of course, these suggestions will be canceled, and full functioning restored, before the subjects leave the experiment.

The typical experiment lasts for 60 to 90 minutes. Most experiments are conducted in single sessions. Participation in any one experiment, or any one session, does not obligate the subject to participate in any others. At no time are subjects asked to experience any suggestion, or engage in any activity, that would be personally embarrassing or threatening.

Revision added 7/11/97: Subjects are thoroughly debriefed at the end of their participation in any of our experiments. During this debriefing, all their questions about hypnosis in general, the experiment in particular, and their individual response are answered. A copy of the debriefing statement used in the context of the HGSHS:A is attached as an appendix to this application.

 

Subjects will receive no psychological, medical, or other personal benefits from their participation. For more than 100 years, however, hypnosis has served psychologists as an important vehicle for understanding the nature of basic cognitive processes involved in perception, memory, conscious awareness, and the voluntary control of action. In addition, hypnosis has a wide variety of applications in medicine, dentistry, and psychotherapy, including the control of pain. Thus, improved knowledge of how hypnosis works, what it can and cannot accomplish, and who can and cannot experience hypnosis, will help clinicians use the technique more appropriately and effectively in their practices.

The available experimental literature indicates that hypnosis involves no risks to subjects providing that certain elementary precautions are taken. In order to minimize risks, all hypnosis sessions are conducted by trained staff members following written protocols. Psychotherapy, personal growth experience, and entertainment are never confused with experimental research. Because hypnosis sometimes involves extended periods (i.e., 30-40 minutes) of eye closure, subjects who wear contact lenses are encouraged to remove them before the sessions begin.

Because I suspect that most members of the CPHS are unfamiliar with modern hypnosis, I provide in an appendix a rather detailed account of the literature on risks associated with hypnosis, and the steps we take to prevent them.

Revision added 04/17/01: This Appendix has been updated with references to recent literature -- literature that in no way undermines the position taken in the rest of this section, and detailed in the Appendix itself.

The best evidence available indicates that the risks and discomforts occasionally associated with hypnosis -- drowsiness or mild headache are by far the most common -- occur in less than 5% of individuals who are participate in hypnosis research (in our laboratory, they occur in less than 1% of subjects). It is important to note that these consequences, when they occur, are transitory, and easily resolved. However, two other points are also critical to evaluating this finding.

First, the incidence of such outcomes is no greater following hypnosis than following other, nonhypnotic procedures. In one experiment, there were no differences in negative aftereffects between subjects who took part in a hypnosis experiment, those who took part in a nonhypnotic experiment on memory, and students who were studied after attending a class or taking and exam. In another experiment, there were no differences in negative aftereffects between subjects who took part in a hypnosis experiment and comparison groups who either sat quietly in a darkened room with their eyes closed. Thus, participating in a hypnosis experiment puts subjects at no greater risk for negative outcomes than participating in a wide variety of other experiences that are not commonly considered to put subjects at risk for adverse outcomes.

Equally important, there are no differences in the incidence of negative outcomes between subjects who are highly hypnotizable and those who are insusceptible to hypnosis. There are wide individual differences in response to hypnotic procedures, and logically any effect of hypnosis per se should be correlated with these individual differences. That this is not the case indicates that hypnosis itself does not put subjects at risk for adverse consequences.

In sum, the risks to subjects from their participation in laboratory experiments on hypnosis are no greater than the risks from their participation in other types of experiments, and other routine academic activities, and do not appear to be attributable to anything about hypnosis per se. At the same time, it is my strong belief, based on more than 25 years of experience with hypnosis research (and it is the strong consensus among other investigators engaged in hypnosis research) that specifying these minimal and transient risks tends to create expectancies that actually increase the likelihood that adverse consequences will occur -- along the lines of the "self-fulfilling prophecy".

For this reason, the risks to subjects are actually minimized if they are not detailed to subjects during consent procedures, and I request that I not be required to describe such risks on the consent form signed by subjects, or to include the "injury" language specified on p. 7 of the CPHS Guidelines issued September 6, 1996.

All research assistants in the laboratory, whether graduate or undergraduate, are carefully instructed in the need to maintain confidentiality about subjects' participation in laboratory research. In particular, assistants are instructed never to discuss individual subjects outside the laboratory, or with anyone who is not a staff member. If it should happen that an assistant is assigned to work with a subject with whom he or she already as developed a friendship, that assignment is changed (this is one reason why I employ a full-time non-student research assistant in my laboratory). And, of course, assistants are admonished never to participate in hypnosis outside the laboratory context.

Access to the names and other personal data concerning all subjects, regardless of whether they are hypnotizable, is controlled by me personally. All data that identifies individual subjects is kept in locked cabinets.

Revision added 7/11/97: The key to the code of names of individual subjects will be kept in a separate locked file.

 

A sample consent form is attached to this application. Please note that while we inform subjects that hypnotic suggestions involve alterations in perception and memory, we do not routinely inform subjects precisely what these changes are. The reason for this is that the goal of the research is to study these changes themselves. Hypnotic behavior is strongly influenced by subjects' expectations and beliefs concerning hypnosis, and we do not want to contaminate the experiments by telling subjects what we expect them to do and experience.

In addition, while all the consent forms expressly state that the experiment involves hypnosis, we do not necessarily specify the particular suggestions that are the object of any particular experiment. Again, we omit this information because subjects' hypnotic behavior is strongly influenced by subjects' expectations and beliefs, and we want to minimize subjects' natural tendencies to try to figure out what we expect them to do, and plan their responses to suggestion in advance.

I wish to underscore that we never deceive subjects about the use of hypnosis in our research, and we never employ suggestions that would tend to threaten or embarrass subjects in any way. Also, subjects are informed during the HGSHS:A session, and reminded at every subsequent experiment, that there is nothing coercive about hypnosis, and that if for any reason they do not wish to experience a particular suggestion they have the option of declining to do so.

Revision added 05/21/02: The consent forms have been modified to include new language pertaining to the Department of Psychology Subject Pool.

 

All subjects receive compensation for their participation in this research. Some subjects will receive research participation credit in accordance with the procedures established for the Psychology Department Subject Pool. Others will be paid for their participation at a rate of approximately $8.00 per hour.

The instruments used in our assessment of individual differences in hypnotizability and related personality characteristics are all published and widely used. Copes are available to the CPHS upon request.

_____________________________________

John F. Kihlstrom, Principal Investigator

(Deleted)

In addition to the hypnosis studies described in the Protocol Application approved in 1997 (CPHS #97-6-80), we also propose to conduct nonhypnotic studies of attention, learning, and memory, in order to develop specific procedures for the hypnosis experiments, and also to explore theoretical issues in cognitive psychology whose resolution would affect our interpretation of the hypnosis experiments.

These studies will be conducted in a manner that is consistent with protocols already approved.

The subject recruitment procedures will be the same as described in the approved Protocol Application. There will be no screening procedures.

All of these additional experiments involve standard paradigms in cognitive psychology devised for the experimental study of basic processes of attention, perception, learning, and memory. Typically, the experiments are conducted by means of a computer or written response sheets.

1. In the studies of Attention, the subjects will be presented with color names and other words printed in different colors of ink, and will be asked to name the color of the ink (this procedure is known as the Stroop color-word task). Color-naming latency is recorded by a computer voice key. Sometimes the color denoted by the word is incongruent with the color in which the word is printed, in which case color-naming latency is lengthened. The experiments will explore variables which influence this interference effect.

2. In studies of Recollective Experience, the subjects will be asked to study a list of words, and then to complete a recognition test. For each item endorsed on the test, they will be asked to report the basis for their decision: do they consciously remember the item from the study set? Do they simply know it was in the study set, the way they know their own telephone numbers? Do they intuitively feel it was in the set? Or do they believe it was in the set, based on other knowledge? The experiments will explore variables that influence judgments of recognition, and reports of recollective experience.

3. In experiments on Illusory Memory, subjects will study a list of words, such as bed, rest, awake, and tired which are semantically associated with other, unstudied words, such as sleep, blanket, and snore. The experiments will explore variables that influence the incorrect recall and recognition of these associates.

4. In experiments on Implicit Learning, subjects will memorize a list of letter strings, such as LJF, LCJF, AND FJJFL, which have been generated by a "Markov process" finite-state grammar. They will then asked to study a new list of similar items, and distinguish between those items, such as FJLJL, which conform to the grammar, and other items, such as FJLF, which do not. It is already known that subjects can make this difficult judgment with a significant degree of accuracy. Our experiments will explore the cognitive basis for these judgments.

The subjects will receive no personal benefits for their participation, other than monetary compensation (approximately $8 per hour) or credit in the Research Participation Program.

There are no risks to subjects due to their participation in any of the proposed studies.

All data will be treated as confidential, according to procedures described in the approved Protocol Application.

All subjects will complete a consent form (sample attached to this application).

The literature on the untoward consequences of hypnosis in the laboratory is quite sparse, and is fairly (almost exhaustively) represented by the following articles:

Hilgard, Hilgard, & Newman, "Sequelae to hypnotic induction with special reference to earlier chemical anesthesia" (Journal of Nervous and Mental Disease, 1961, 133, 461-478);

Orne, "Undesirable effects of hypnosis: The determinants and management (IJCEH, 1965, 13, 226-237);

Hilgard, "Sequelae to hypnosis" (IJCEH, 1974, 22, 281-298);

Coe & Ryken, "Hypnosis and risk to human subjects" (American Psychologist, 1979, 34, 673-681);

Crawford, Hilgard, & Macdonald, "Transient experiences following hypnotic testing and special termination procedures" (International Journal of Clinical and Experimental Hypnosis, 1982, 30, 117-126);

Page and Handley, "The effect of preventive measures in reducing aftereffects to hypnosis" (AJCH 1993, 36, 26-37);

Coe, Peterson, & Gwynn, "Expectations and sequelae to hypnosis: Initial findings" (American Journal of Clinical Hypnosis, 1995, 38, 3-12);

Lynn, Martin, & Frauman, "Does hypnosis pose special risks for negative effects?" (IJCEH, 1996, 44, 7-19);

Page & Handley, "In search of predictors of hypnotic sequelae" (AJCH 1996, 39, 93-96);

Page, "Identifying hypnotic sequelae: The problem of attribution" (AJCH 1999, 41, 316-318).

 

The consensus of these studies (and informed opinion among hypnosis researchers as well) is that untoward consequences are more likely to occur when an inexperienced hypnotist is involved, and also during therapeutic, as opposed to experimental, procedures. In research, indeed, they are quite rare (which is probably why they have not received much attention in the literature). In therapy, problems of transference, resistance, and the meaning of symptoms come to the fore, and a manipulative therapist who simply tries to "suggest away" symptoms may encounter problems that stem from his or her own therapeutic "mistakes". They may also occur in stage hypnosis, where the entertainment context has special effects on experience and behavior. Similar events may occur when inexperienced experimenters find it difficult to cope with a minor problem and communicate their lack of competence and self-confidence to the subject, who will then surely proceed to make matters worse.

In experimental situations the occasional problem is usually limited to things like drowsiness or sleepiness or a transient mild headache. In most instances these transient problems can be rapidly traced to some specific expectation on the part of the subject, perhaps derived from inadvertent comments made by a stage performer or television commentator seen recently. Occasionally subjects actually doze off during the procedure, or rest their heads in an uncomfortable position, leading to drowsiness or neck ache upon arousal. In any event, a few minutes of supportive interaction are usually sufficient to deal effectively with the problem. Sometimes a problem occurs in the hypnotic context but is actually not attributable to hypnosis itself, but instead reflects the subject's ongoing levels of stress to tendencies toward "somatization".

I have encountered such experiences very rarely indeed. For example, in my dissertation research at the University of Pennsylvania I ran 588 subjects who were screened and treated in relatively small groups. A few subjects fell asleep transiently during hypnosis, and all but one of these awakened spontaneously at the end of the tape-recorded procedure (the remaining subject was gently shaken by me, and woke up a little chagrined, but none the worst for the experience; she was assured that such events occurred occasionally, and that we could still make use of her data in the experiment). Only one subject showed dizziness and nausea during the experiment -- he actually fainted -- and he was treated with first aid and sent home after resting an hour or two. Upon interview, it appeared that the warmth of the experimental room and the eye-fixation aspect of the induction procedure may have recapitulated an experience he had as a child in church when he felt the preacher's eyes upon him, and he fainted. He had also reported a bad experience with surgical anesthesia. It is worth noting that this subject continued to volunteer for hypnosis experiments, although of course we gently discouraged his participation.

Subsequent experience at Harvard, Stanford, New Hampshire, Wisconsin, Arizona, and Yale confirms this experience. Overall, I have seen untoward experiences associated with hypnosis in far fewer than 0.5% of the subjects who have participated; and all of these have been quickly resolved without any lasting aftereffects. This is an extremely low rate of untoward events, but my experience is paralleled by others who work in this area.

Revision added June 16, 2001: The question has been raised whether any subjects are so hypnotizable that they cannot be brought out of hypnosis. No. In a very real sense all hypnosis is self-hypnosis: subjects put themselves "in" hypnosis following suggestions from the hypnotist, and they take themselves "out" of hypnosis in the same way. Research conducted by M.T. Orne and F.J. Evans in the late 1960s and early 1970s showed that when the hypnotist abruptly "disappears" for an extended period of time, subjects simply bring themselves out of hypnosis. There is nothing about hypnosis that prevents even highly hypnotizable, deeply hypnotized subjects from terminating hypnosis, or cancelling any particular suggestion, at any time.

The question has also been raised whether subjects are able to withdraw their consent under hypnosis. Yes. Hypnosis does not involve a loss of consciousness or of self-control. Hypnotist and subject are in constant verbal contact. If a subject does not wish to experience a particular suggestion, or no longer wishes to engage in hypnosis, he or she can simply inform the hypnotist of that fact; the suggestion is omitted, or the experiment is terminated, as appropriate. This rarely happens. Even in the group-hypnosis screening procedure, subjects who no longer wish to participate (usually because they are bored, due to lack of response to hypnosis) simply terminate hypnosis for themselves, and then sit quietly in the room until the procedure is over for the others.

I think that three aspects of the experimental setting are responsible for my success in avoiding difficulties: subject recruitment, experimenter training, and the experimental situation itself, including the relationship between the subject and the experimenter. Also, an appropriate record keeping system is helpful in this regard. Let me discuss each of these points in turn.

Subject Recruitment. My general procedure is to limit our subject population to college students who are enrolled in the introductory psychology course. Even with a wider subject pool, there is no coercion involved in recruitment: subjects have many alternative methods of earning extra credit points. I restrict myself to college students in an attempt to avoid those for whom research participation is a source of income, thrills, or therapy, as well as for the usual reasons of sampling consistency. I strongly feel that research goes better when subjects volunteer whose motives are not mixed, and who harbor no secret agendas.

Training of Experimenters. Anyone can hypnotize. In fact, the busiest hypnotist of all time is a former Boston radio announcer who provides the voice on the tape recording we use in the initial group session described above. Individual differences in hypnotic responsiveness among subjects are far more important than individual differences among experimenters in hypnotic induction prowess. This fact is one of the most important things that a prospective hypnosis researcher can learn. By defining the hypnotist's role as that of a coach or a tutor, whose job it is to help people to have an experience that they are perfectly capable of having on their own (if only they knew how), I reduce the likelihood of power struggles occurring in the laboratory -- and the likelihood of untoward consequences.

That hypnosis is easy to induce does not mean that the experimenter need not be skilled. In fact, quite the contrary. The experimenter needs to have skill in handling the occasional awkward situation that can arise in the best of circumstances, just as an experienced surgeon must be vigilant for, and trained to handle, unexpected complications that may occur in a routine procedure. Experimenters need to be able to assess situations quickly, communicate expertise, and handle themselves competently. They should be good listeners -- attentive to the subject's manifest communications, and also to the subtler meanings that may lie behind them. In the absence of formal clinical training, these skills are usually acquired through experience in running subjects under close supervision.

I invariably conduct the initial group hypnosis sessions. It is my belief that my presence goes a long way toward legitimizing the entire enterprise, and reassuring the subjects that their experimenter has at least minimal competence. All other research assistants in the laboratory are also present at the sessions, acting as helpers and observers. They are introduced to the subjects at the outset of the rapport-building phase (described below).

However, there is no reason why carefully selected, properly trained, and appropriately supervised undergraduate research assistants should not run individual subjects using the standardized procedures developed for assessing hypnotizability in a laboratory context. Hypnosis research is labor-intensive, requiring extensive assessment of hypnotizability before subjects ever participate in formal experimental research. For that reason I have found it convenient to recruit undergraduate research assistants from the ranks of junior and senior psychology majors, who work in the laboratory for independent study credit or (occasionally) an hourly wage. In more 25 years of teaching I have worked with more than 50 such students, many of whom have gone on to graduate training in psychology or medicine.

The training of both undergraduate and graduate research assistants follows three phases. First, they receive a number of lecture presentations about the nature of hypnosis and the laboratory's mission, in which their own questions about the phenomenon and research are addressed They are also given a set of reference readings: at present, these include the "Hypnosis" article from the 1974 Encyclopaedia Britannica and the book, Hypnosis for the Seriously Curious, by Kenneth S. Bowers (1976), as well as a selection of publications from my own laboratory. They then view a series of educational films about hypnosis, and observe a number of assessment sessions conducted by experienced researchers in the laboratory. Then they practice administering the procedures to themselves, with the experienced researchers observing. Only when I feel they are ready, are they permitted to run actual subjects. These first trials are again observed by senior staff. Thereafter, all experimenters in the laboratory (including myself) are periodically observed to ensure compliance with the laboratory's protocols.

The Setting and the Subject-Experimenter Relationship. When all is said and done, however, I think the nature of the experimental situation demands fullest attention. This includes, but also goes beyond, the subject recruitment and experimenter training procedures. As noted earlier, the best description of the setting that we seek to build is "episodic". To that end, the experimenter must engage in an appropriate rapport-building encounter with the subject before the experiment, explaining what will happen as completely as possible, inquiring as to the subject's prior experience, motivation, information, and expectations concerning hypnosis. Further, the experimenter must put the subjects at ease by answering any questions that they may have with general but informative answers that have been carefully worked out in advance.

In the group session, this rapport-building takes the form of a formal lecture on hypnosis, after which subjects have the opportunity to answer whatever questions may occur to them. In the individual sessions, this encounter is more conversational. In either case, the hypnotic induction does not proceed until the experimenter is satisfied that all outstanding questions have been answered. Subjects are never, under any circumstances, given information about hypnosis that is not strictly factual -- even if to do so means sacrificing the purposes of the experiment (this rarely happens, for the simple reason that my laboratory does not engage in research involving deception).

Three specific points are always covered before hypnosis begins.

First, it is emphasized, truthfully, that while hypnosis is a very interesting experience, it is not really all that different from certain experiences that may be familiar from the ordinary course of everyday living -- such as becoming highly absorbed and involved in an interesting book or film. This demystifies hypnosis to some degree. Furthermore, subjects are informed that while they may have some unusual experiences while they are hypnotized, they will always remain in contact with reality and in control with what is going on. These points serve to counteract to some degree the false expectations of those who have been led by the popular press and other sources to the false impression that hypnosis is in some respect a substitute for drug-induced psychedelic experiences. Finally, to keep verbal and nonverbal modes of communication congruent, experimenters conduct themselves in a businesslike manner and dress modestly and conservatively.

Second, subjects are told, again truthfully, that hypnosis is a somewhat different experience for everyone, and that in the research we are interested in the nature of some of these individual differences. This point is important because it puts the emphasis on what the subject, rather than the experimenter, does -- and thus tends to obviate power conflicts, control fantasies, and related issues. The emphasis on individual differences also legitimates subjects' failure to respond positively to hypnosis. No subjects, no matter how unresponsive to hypnotic procedures, are ever permitted to perceive themselves as having had a failure experience in the laboratory. The investigators present themselves as interested in whatever the subjects experience, appropriately reinforcing their honesty in reflecting on their responses. Hypnotizability assessments are useless unless subjects feel they can reflect candidly on their response to the hypnotic procedures. Although my present research plans emphasize the 5-10% of the student population that is very highly responsive to hypnosis, we never say anything that would lead subjects who prove unresponsive that their participation was a waste of our time.

Third, the subjects are told, again truthfully, that they will not be changed in any way by the hypnotic experience, aside from accruing information about hypnosis and a few extra credit points or a token monetary sum. As I usually put it: "If you couldn't play the piano before you came in, you won't be able to play it after you leave"; it gets the point across. I also explicitly reassure subjects that they will not be asked to perform any acts, or reveal any information, that may prove embarrassing to them. Subjects will occasionally ask experimenters to slip a therapeutic suggestion (e.g., to lose weight, stop smoking, or study harder) into the experimental procedures. These requests are invariably denied: it is explained to subjects that although we hope that our research will enable practicing clinicians to use hypnosis more effectively and appropriately in the practice of medicine, dentistry, or psychotherapy, we are a basic research unit and do not employ hypnosis therapeutically. These subjects are also referred to student health services or their family physicians for consultation and referral. If subjects insist on therapeutic services, they are immediately dropped from the experiment. Instead of receiving a hypnotic induction, they receive a questionnaire about experiences related to hypnosis, reimbursed for the full scheduled time of the experimental session, and gently referred to the appropriate agency.

All of the laboratory's hypnotic procedures are strictly standardized, presented by tape recording or read verbatim to subjects. This practice lets the subjects know that they are participating in a structured experience along with literally tens of thousands of subjects who have gone before them. The group and individual hypnotizability assessment procedures provide a graduated introduction to hypnosis. No formal experiment that we would ever perform is not at least hinted at in these scales. Therefore, by continuing to participate in our research the subjects truly give us their informed consent.

Support Systems. Signed consent forms are retained permanently. Research assistants are instructed to report immediately any subject who reports a negative reaction to the hypnotic procedures; these (rare) incidents are investigated by senior staff, and the subject's name is deleted from the list of those available for future studies.

Before we begin the hypnosis part of the experiment I'd like to take just a couple of minutes to introduce ourselves to you, talk some more about hypnosis and the research project.

First, let us introduce ourselves. I'm John Kihlstrom, a professor in the Department of Psychology, and it's my laboratory that does this research. In the rear of the room are some other people involved in the laboratory -- you might be working with one or more of them later in the semester: [name individuals].

I'm sure that all of you have had some contact with hypnosis at some point in your lives. You may have been hypnotized yourself, or know someone who has. Certainly you've read about it, or seen it in the movies. We are interested in hypnosis as a means of studying basic psychological processes -- how people perceive, think, and remember; the relations between behavior and experience, and between personality and social processes.

As I'm sure you know, hypnosis has a number of clinical applications as well. It's often used by physicians and dentists to help control pain, by psychotherapists to help people relax and free up the flow of ideas and memories. We hope that by finding out more about hypnosis, what it can do and what it can't, who can be hypnotized and who can't, we can help clinicians to use hypnosis more appropriately and effectively in their practice. But we are strictly a research outfit, and don't do any therapeutic work ourselves.

Probably the single most important thing about hypnosis is that it reflects an ability that people have. Hypnosis is a skilled activity, very much like playing the piano or tennis. What that means is that probably everyone can experience hypnosis to at least some degree, with practice. But some people experience hypnosis quite readily, while others need some practice than others. And even with a great deal of practice, some people can have many experiences, and others only just a few. Most of us fall somewhere in the middle, between these extremes. But the important thing to realize is that hypnosis is an ability, a capacity, which normal people have.

Because of this fact, the role of the hypnotist is actually very limited. The hypnotist functions as a sort of a coach or tutor, whose role is to assist people to experience hypnosis -- to do something that they're perfectly capable of doing on their own, if only they knew how. It doesn't really take any skill to induce hypnosis. Of course, it takes a great deal of skill and training to use hypnosis appropriately in a clinical or research situation, but hypnosis itself is quite simple: the subject does all the work.

The proof of this is the hypnotist you'll be working with today. The voice on the tape you'll hear belongs to the most experienced hypnotist of all time. He's a former Boston radio announcer whose only qualification was that he lived next door to the researchers who developed this procedure. He's never had any training in hypnosis, and he's never hypnotized anyone in person; but by virtue of this tape, which has been use for more than 20 years, literally tens of thousands of people like yourselves have been able to experience hypnosis.

What's going to go on? The tape presents a kind of a "script" for a hypnotic experience. It begins with an induction procedure that asks you to get as comfortable as you can, to relax, focus your eyes on a target, and pay close attention to the voice. Eventually you'll probably close your eyes, and at that point the tape will go on to give you some suggestions for the kinds of experiences that hypnotized people can sometimes have.

What we'd like you to do is to take each suggestion, work with it, and see what happens. Some of you will experience many of the things that are suggested, others will experience only just a few, and most of you will fall somewhere in between. We are interested in the entire range of response to hypnosis -- we're are as interested in people who experience lots of the suggestions as we are in those who don't experience much of anything. So just concentrate on having the experiences. Don't push an experience that isn't happening, but don't hold back on it either. Just let things happen as they happen, because we're interested in whatever you experience.

Let me say something more about the purpose of this experiment. We sometimes call hypnosis a "special state of consciousness", but it isn't really all that different from certain experiences that each of you have had in the ordinary course of everyday living. Hypnosis is a lot like those occasions when you're reading a book or watching a movie, and you get really absorbed in what is going on, perhaps you identify with one of the characters and feel what they feel. You're not paying too much attention to other things that are going on, so that they don't distract you from the imaginative experience that you're having. Hypnosis is largely a matter of focusing your attention on one particular thing, to the exclusion of everything else. In these studies, were are interested in determining how hypnosis related to other instances in everyday life where attention is intensely focused in this manner.

Finally, let me say again that we don't use hypnosis as a tool for changing people. In fact, hypnosis is a particularly bad technique for controlling behavior and changing people. People can't be hypnotized against their will, and even if they're deeply hypnotized they can't be led through suggestion to do things, and experience things, that they don't want to. It goes without saying that we won't be asking you any personal questions while you're hypnotized -- we're not going to be prying into your deepest, darkest secrets. And we won't ask you to do anything that might embarrass you -- we won't ask you to run around like a chicken or anything like that.

But at a somewhat different level, we want you to be assured that you'll leave the experimental session the same person as you were when you arrived. You won't have any fewer problems or hangups than you did before -- but you won't have any more, either. You'll be somewhat richer for the experience -- you'll be better informed about hypnosis, and you'll have some extra cash in your pocket or some research participation credits, but I'm sorry to say that if you couldn't play the piano before you came in, you won't be able to play like Rubenstein after you leave.

We'll have a chance to talk more about hypnosis after you've had a chance to try it. But before we begin the next phase, I'd be pleased to address any questions that any of you might have about hypnosis, the laboratory, or the experiment. Anything at all? [answer all questions before proceeding].

All right, you'll be having your eyes closed for some time during the hypnosis. For that reason, we suggested that those of you who wear contact lenses might want to remove them before the session. If you wish to remove your lenses, but haven't already done so, this is the time to do it. If you forgot your case, and they're hard lenses, we have some tissues here that you can wrap them up in. We also have some wetting solution that you can use to get them back in. If you should leave your lenses in, and for any reason they get uncomfortable, just open your eyes, blink to wet them a little, and then close your eyes and go back into hypnosis. This won't detract from the experiment in any way.

One thing that really gets in the way is chewing gum. It is very hard to concentrate on being hypnotized when you're trying to remember where your gum was last time you noticed it. For that reason, we ask -- actually, we insist -- that you dispose of your gum for the rest of the experiment. Again, we have some tissues that you can use if you need them.

All set? All right, you won't be doing any writing during the tape, so you can put your materials down on the floor where they won't get in the way. Make yourselves comfortable -- but not too comfortable. The tape will talk to you for a while before it gets down to business.

When you've completed the response booklet for the Harvard Scale, that concludes the experiment for you. If you have not finished the personality questionnaire which we asked you to fill out at the beginning of the session, please go back and complete that now, as we do need that data for this experiment. When you're done with everything, just put all the materials back in the envelope, and give it to one of us. Please don't seal the envelope, however, because we reuse these envelopes in other experiments.

We want you to know that, by virtue of your participation in this study, you become eligible for other experiments, on hypnosis and other topics, that we are doing in our laboratory. You are not under any obligation to participate in any of these studies, but don't be surprised if I or one of the other people in the laboratory calls you up and invites you to come in for some more research. We'll always identify ourselves and describe the experiment: if you're interested and have the time, we'll be pleased to work with you, and we can reimburse you for your participation, sometimes with cash, sometimes with research participation credits; if you're interested but don't have the time, we'll call again sometime; if you're not interested, just tell us that and we'll go away!

As far as this study is concerned, when you give us your packet of materials, we'll give you in return a credit slip recording your participation in the experiment, or ask you to sign a receipt for your cash payment. These are tokens of our appreciation for your participation in our research, but they don't really say what we mean. We couldn't do our research without your cooperation, and we are really grateful for your participation. We hope you enjoyed your participation in this study, and we look forward to working with you again.

If you have any comments or questions about hypnosis in general, or this experiment in particular, just ask any one of us while we're collecting the materials, or feel free to call me in my office or send a note on E-mail.

Thanks again for your help in this study.

Note added 05/21/02: The individually administered SHSS:C is also accompanied by "debriefings" of this sort, delivered immediately before and immediately after the scale is administered.

Sample Consent Forms

Name:___________________________________________________________ Date:____/_____/_____

Campus or Local Address:______________________________________________________________

___________________________________________________________________________________

Sex: M F Date of Birth:____/____/____ Campus or Local Telephone:_______________________

___________________________________________________________________________________

You have been asked to voluntarily participate as a subject in a research study on hypnosis conducted at the Department of Psychology, University of California, Berkeley in the laboratory of Prof. John F. Kihlstrom.

In return for your participation in this study, you will receive a payment of $8.00, or credit toward your participation in the Research Participation Program of the Department of Psychology.

Your participation in the research is voluntary and you are free to withdraw your consent and discontinue participation in the research at any time. If you participate in the study, you may refuse to answer any question(s) that might make you feel uncomfortable and still receive full credit.

The purpose of this experiment is to study certain phenomena associated with hypnosis. Hypnosis occurs when one person (called the subject) becomes absorbed in imaginative experiences that have been suggested to him or her by another person (called the hypnotist). Not all people respond in the same way to these suggestions, and this experiment is concerned with these differences between people.

During the experiment you will be asked to listen while a prepared script is read. The script will ask you to relax, to focus your eyes on a target, and to pay attention to the voice of the experimenter. It will then be suggested that you relax and focus your attention even further, and eventually close your eyes. The experiment will continue with suggestions for the kinds of experiences that hypnotized individuals can have, and later the hypnosis will be terminated. The entire experiment will last for approximately 1-1/2 hours.

There are no discomforts or risks involved in participating in this study. In particular, you will not be asked any personal questions while you are hypnotized; nor will you be asked to do anything that might embarrass you.

You have the right to ask questions of the investigator, and to decline to answer any questions posed in this study. Questions that may influence the outcome of the study may be deferred until the end of the study.

Your responses in this experiment are confidential. Personal information about you gathered in this study will, unless compelled otherwise by law, be disclosed only to the investigator and his collaborators and not to anyone else (the likelihood of required disclosure is minimal).

If a publication or any other educational use results from this experiment and case reports are presented, no subjects will be identified in any published materials, and all potentially identifying information will be substantially modified.

You are free to withdraw from the project at any time without incurring ill will or affecting your student status, course grades, or compensation.

This is solely a research project, and you will receive no psychological, medical, or other personal benefits from my participation.

There are no costs to you for your participation, other than the time involved for the experiment itself.

Nor are there any benefits to you personally, other than your compensation, and perhaps satisfaction of your curiosity about hypnosis.

Please sign below to indicate that you have read this "Subject's Consent". The nature, demands, risks, and benefits of the project have been explained to you, and you agree to participate in the study as described.

Date: _____/_____/_____ Signature:________________________________________

Name:___________________________________________________________ Date:____/_____/_____

Campus or Local Address:______________________________________________________________

___________________________________________________________________________________

Sex: M F Date of Birth:____/____/____ Campus or Local Telephone:_______________________

___________________________________________________________________________________

You have been asked to voluntarily participate as a subject in a research study on attention, learning, and memory conducted at the Department of Psychology, University of California, Berkeley in the laboratory of Prof. John F. Kihlstrom.

In return for your participation in this study, you will receive a payment of $8.00, or credit toward your participation in the Research Participation Program of the Department of Psychology.

Your participation in the research is voluntary and you are free to withdraw your consent and discontinue participation in the research at any time. If you participate in the study, you may refuse to answer any question(s) that might make you feel uncomfortable and still receive full credit.

The purpose of this experiment is to study certain aspects of attention and memory during the learning process.

During the experiment you will be asked to perform various experimental tasks involving words, pictures, or sentences. The entire experiment will last for approximately 1-1/2 hours.

There are no discomforts or risks involved in participating in this study. In particular, you will not be asked any personal questions, nor will you be asked to do anything that might embarrass you.

  You have the right to ask questions of the investigator, and to decline to answer any questions posed in this study. Questions that may influence the outcome of the study may be deferred until the end of the study.

Your responses in this experiment are confidential. Personal information about you gathered in this study will, unless compelled otherwise by law, be disclosed only to the investigator and his collaborators and not to anyone else (the likelihood of required disclosure is minimal).

If a publication or any other educational use results from this experiment and case reports are presented, no subjects will be identified in any published materials, and all potentially identifying information will be substantially modified.

You are free to withdraw from the project at any time without incurring ill will or affecting your student status, course grades, or compensation.

This is solely a research project, and you will receive no psychological, medical, or other personal benefits from your participation.

There are no costs to you for your participation, other than the time involved for the experiment itself.

Nor are there any benefits to you personally, other than your compensation.

Please sign below to indicate that you have read this "Subject's Consent". The nature, demands, risks, and benefits of the project have been explained to you, and you agree to participate in the study as described. .

Date: _____/_____/_____ Signature:________________________________________