COMMENTARY ON MY THEORY OF HYPNOSISby Alfred A. Barrios, PhD.
My commentary will cover the following key areas:
COMPARISON OF MY THEORY WITH THE SOCIOCOGNITIVE THEORIES
(1) Both perspectives discuss the importance of the part played by individual differences in affecting initial responsiveness to suggestion. The following are included as individual influencing factors in both perspectives: subjects' expectations and beliefs about hypnosis; motivation and imagination (or fantasy proneness).
Two areas of individual differences mentioned in my theory which I did not notice mentioned in the literature on sociocognitive theories were age of the subject and prestige of the hypnotist in the eyes of the subject. I would expect that the sociocognitive theorists would agree that these are also important individual difference factors. However, the explanation for how these factors play a part according to my theory might differ from the sociocognitive perspective.
With regards to age, for instance, I state that the reason initial suggestibility varies with age
"...may be traced to certain factors that vary with age. One of these is language ability. Since [according to my theory] hypnosis is dependent to a great extent on the conditioned response evoked by words, we can understand why very young children whose language ability is not yet well-developed would make very poor subjects for hypnosis, and thus why we would expect an initial gradual increase in suggestibility with increasing age.
"An explanation for the gradual decline in suggestibility after the age of eight is that with continued increasing age the number of cognitive stimuli competing with a suggestion increases (that is knowledge increases with age) and a corollary to the 'reciprocal inhibition' or 'stimulus dominance hierarchy' postulate is that the more stimuli in the hierarchy, the lower the probability of a reaction to any one of them ... with increasing age there will be a greater number of possible contradictory stimuli [competing with] a suggestion; that is, subjects have more information available with which to verify or contradict the suggestion."
With regards to prestige,
"It is fairly well accepted that the more 'prestige' a hypnotist has in the eyes of subjects, the better his chances of success. It is felt that is so because the statement, commands or suggestions of a person with prestige tend to be questioned less, that is, such a person evokes a greater inhibitory set to begin with. In general, people have previously been conditioned to accept at face value the statements of someone who is an authority in his field. That is, an inhibitory set which inhibits contradictory stimuli [in the stimulus dominance hierarchy] has been previously conditioned (in much the same way as in the hypnotic induction process). This is so because what the authority says has usually turned out to be true!"
It will be recalled that in my theory a positive response to a series of suggestions (the hypnotic induction) conditions in an inhibitory set to automatically inhibit any stimuli’ (cognitive or sensory) in the stimulus dominance hierarchy that would contradict the suggestion.
(2) Another similarity between the sociocognitive and my perspective revolves around the use of what the sociocognitives refer to as "goal directed fantasies" (GDF's). GDF's are defined as "imagined situations which, if they were to occur, would be expected to lead to the involuntary occurrence of the motor response called for by the suggestion." [Spanos, Rivers & Ross, 1977, p.211]; although I would not limit responses to only motor responses. In my theory, Hypothesis IV states: "A suggestion produces the desired response by first evoking a cognitive stimulus which is associated with that response." And a corollary to this hypothesis, Corollary 8 states: "The more (compatible) cognitive stimuli associated with the response evoked by the suggestion, the stronger the response to the suggestion." For example, to increase the probability of producing the involuntary response of salivation and/or the secretion of pepsin, you might want to suggest that the subject was eating a delicious steak or, better yet a thick juicy steak smothered in onions.
(3) A third similarity between the two perspectives is how they apparently both seem to fit in with Milton Erickson's strategic approach to therapy. How Erickson's approach fits in with the sociocognitive perspective is discussed in a very extensive article by Lynn & Sherman (2000). The following includes some examples of how Erickson's ideas parallel mine as presented in my theory:
Relative Importance of Hypnotic Inductions
One major difference between my perspective and the sociocognitive one revolves around the perceived importance of hypnotic inductions. The sociocognitive perspective seems to feel that hypnotic inductions increase suggestibility only to a minor degree whereas I do not agree with this. As Lynn & Sherman (2000, p.298) put it,
"Suggestions can be responded to with or without hypnosis, and the function of a formal induction is primarily to increase suggestibility to a minor degree."
The problem with this perspective is that it implies that all hypnotic inductions are able to increase suggestibility only to a minor degree, and thus it is implied that hypnotic inductions are really not that necessary. Yes, it may be true that the standard hypnotic induction emphasizing relaxation used in many of Barber's studies, for instance, is capable of increasing suggestibility only to a minor degree, but as indicated by Corollaries 5 and 6, following Hypothesis II of my theory, there may be ways of increasing the effectiveness of hypnotic inductions even more. This will be discussed further in a later section of this paper.State vs Non-State
Another significant difference between the sociocognitive and my perspective revolves around the state vs. non-state issue. According to Lynn & Sherman, because researchers like Barber and his colleagues [Barber, 1969; Barber & Calverly 1964, 1969; Barber, Spanos & Chavez, 1974] in demonstrating the importance of individual differenced in hypnotic responding,
"... showed that non-hypnotized subjects exhibited increments in responsiveness to suggestions that were as large as the increments produced by hypnotic procedures. This research supported the idea that despite external appearances, hypnotic responses were not particularly unusual, and therefore did not require the positing of unusual states of consciousness. Accordingly, there is no need for clinicians to insure that their patients are in a 'trance' before meaningful therapeutic suggestions are provided."
There is some truth to this last statement. Some meaningful therapeutic changes can be produced with suggestions even without a formal hypnotic induction. This would be true especially amongst those subjects who were highly suggestible even without a hypnotic induction. And even those who might not initially be highly suggestible could have their initial responsiveness to suggestion increased by manipulating certain individual difference factors such as attitude, motivation and fears, as pointed out on pages 183 & 184 of my theory (see Weitzenhoffer, 1953; Dorcus, 1963; and Barber & Calverley, 1965 as cited in Barrios, 2001, pp.183 & 184).
However, it is felt that by following such recommendations as those presented by corollaries 5 & 6 following Hypothesis III of my theory the effectiveness of hypnotic inductions can be increased considerably more and responsiveness to suggestion as a result raised significantly more than after a standard hypnotic induction. If it is true that certain hypnotic inductions can produce significantly higher levels of suggestibility (even in already highly suggestible individuals), then I feel we can talk in terms of a hypnotic and non-hypnotic state. A hypnotic state could be defined simply as the heightened state of suggestibility (or as Skinner would put it, a "heightened state of belief" [Barrios, 2001, p.171]) produced by the hypnotic induction.
Yes, it is true that on an inter-individual basis, i.e., comparing one individual to another individual, a person can respond to suggestions at the same level without a hypnotic induction as another person who has gone through a hypnotic induction. In this sense there is no difference between states. But if we go on an intra-individual basis; i.e., comparing the same individual before and after a hypnotic induction, the hypnotic state for a given individual can be different than the waking state, especially after an effective hypnotic induction.
Just one more thing, I would not recommend using the term "trance" to designate a hypnotic state as the term trance has "zombie-like" connotations and we know a person can be in a hypersuggestible hypnotic state and still look perfectly normal.Best Way to Measure Hypnotizeability
Also related to the question of whether there is that much difference between waking and hypnotic suggestion is the question of how best to measure hypnotizeability. Many in the field, especially those from the sociocognitive perspective, seem to feel that a measure of suggestibility after the hypnotic induction is more than sufficient to measure hypnotizeability. They feel they need not use the difference between hypnotic and waking suggestion as the measure since they find the correlation between the two to be very high [see especially Kirsch, 1997b, p.213].
However, this high correlation could be due to the fact that the researchers are basing their results on studies where only the standard hypnotic induction has been used, which tends to increase suggestibility "only to a minor degree." As more effective hypnotic inductions are used, I feel this correlation will be less and it will become more appropriate to use the difference between hypnotic and waking suggestibility as the more correct measure of hypnotizeability or hypnotic depth as I prefer to refer to it [Barrios, 1973a].
A COMPARISON OF HILGARD'S NEO-DISSOCIATION THEORY AND MINE
There are a number of similarities as well as a number of key differences between Hilgard's Neo-dissociation theory of hypnosis and mine.
In discussing ways that determine what actions a person will take at any one time, Hilgard talks about a hierarchy of subsystems (habits or cognitive structures) that would vie for dominant position to determine the final common path leading to action. This is very similar to my stimulus dominance hierarchy except I also include sensory stimuli along with cognitive stimuli in the hierarchy.
Hilgard proposes two possible means for determining which subsystem will be in the dominant position of the hierarchy determining which action will take place. One which he considers the old way is where the subsystems would fight for control of the final common path leading to action according to their relative strengths. The other possible way of determining dominant position, and the way he seems to have finally leaned towards is by way of a central regulatory mechanism. As he puts it, the subsystems
"... are actuated according to the demands and plans of the central system. This central regulatory mechanism is responsible for the facilitations and inhibitions that are required to actuate the subsystem selectively. A hierarchy of subsystems is implied, although it is a shifting hierarchy under the management of the central mechanism. Once a subsystem has been activated it continues with a measure of autonomy."
He then states,
"Suggestions from the hypnotist may influence the executive functions themselves and change the hierarchical arrangement of the subsystem."
According to the original version of my theory, I leaned more to the old way of looking at how the subsystems arranged themselves in the hierarchy according to their individual strengths and I saw the inhibitory set part of the hypnotic suggestion as directly influencing the eventual positioning of the dominant subsystem by inhibiting the competing subsystems. But now I also see the possibility of a central function playing a part, as well, in certain situations. This central control function I would describe as the will of the hypnotic subject which can be listed as another of the individual differences of hypnotic subjects which can influence a hypnotic induction. I.e., everyone has a different level of will or free will which they bring with them.
As presented in my paper Science in Support of Religion [Barrios, 2002], I define free will as control over one's involuntary functions (one's subconscious) via the power of belief, belief in one's ability to control one's destiny (control one's involuntary functions). This free will factor can have developed over the years or in a short period of time by means of a series of reinforced self-suggestion much like a self-hypnotic induction where the subjects come to develop their power of controlling their involuntary behavior through the power of belief.
In a hypnotic induction this free will factor could either add to the depth of hypnosis achieved (the amount of heightened belief) or work against it. If the individuals see the suggestions given as working to their benefit, it would work in favor of a deeper induction. If against their benefit, it would work against a deeper induction. It would more likely work in favor of a deeper induction if in the pre-induction talk the subject is assured that all suggestions given will be positive ones or to the benefit of the subject; or if the induction is presented along the lines of self-hypnosis, i.e. as a means of developing even greater control over one's involuntary behavior. Now with regards to how according to Hilgard, does the hypnotic induction rearrange the hierarchy of subsystems, Kirsch and Lynn [1998, p.110] feel that Hilgard
"leaves many unanswered questions: How do the hypnotist's words produce this rearrangement? ... and how does this contribute to the production of suggested responses?"
In fairness to Hilgard, I feel he does present at least a partial explanation or answer to these questions. He posits two ways that hypnosis facilitates this rearrangement of the hierarchy:
(1) "Looked at in other ways, we find that hypnotic procedures are designed to produce a readiness for dissaociative experiences by obstructing the ordinary continuities of memories and by distorting or concealing reality orientations through the power that words exert by direct suggestion, through selective attention and inattention, and through stimulating the imagination appropriately."
(2) "The stress on muscular relaxation, familiar in hypnotic inductions assists in disorientation... The lack of appropriately aroused memories makes the hypnotically responsive person less critical. To be critical requires comparing a present observation with familiar ones to judge its veridicality. If the memory context recedes, criticism also recedes. Hence imagination more readily becomes hallucination... These illustrations show how memory interference has helped produce the dissociations found in hypnosis... Under such circumstances, response to stimulation provided by the hypnotist takes precedence over planned or self-initiated action [the central regulatory mechanism] and the voice of the hypnotist becomes unusually persuasive."
In somewhat different wording, Hilgard is saying the same thing that I am saying as to how and why hypnotic phenomena occur. I say that the suggested response occurs because the stimulus focused on by the suggestion rises to the dominant position in the hierarchy because the inhibitory set produced by the hypnotic induction inhibits the competing cognitive stimuli in the hierarchy (what Hilgard refers to as "critical memories") as well as any present "critical" sensory stimuli – something Hilgard does not include in his explanation. Something else that Hilgard does not include which I do is how this inhibitory set that I refer to is built up during the hypnotic induction through a process of conditioning. Hilgard does talk about selective attention and inattention (both of which have inhibitory components) and stimulating the imagination appropriately (i.e., triggering a cognitive stimulus) as part of the power that words exert through direct suggestion but he doesn't explain why or how the hypnotist's words have become even more powerful after a hypnotic induction – which I explain as the build-up, or conditioning-in, of a strong inhibitory set.
With regards to the part suggestions of relaxation play in producing the state of hypnosis, I do point out in my theory that suggestions of relaxation or sleep may help since the relaxed or sleep-like state "may provide for even greater inhibition of stimuli competing with the suggestion." [Barrios, 2001, p.172]. However, I also feel that a hypnotic state can be produced without any suggestions of relaxation or sleep.Involuntary Behavior and the Subconscious
There is one more thing that I would like to point out regarding similarities and differences between my perspective and Hilgard's (and the sociocognitive & response set perspectives as well). It has to do with the automaticity of most behavior. It appears that all current theories concur with this apparent fact. One difference is that I have gone on to label this behavior as "subconscious behavior" or "the subconscious":
"The subconscious, or subconscious behavior, can be defined as behavior (learned or innate) that is so deeply programmed as to occur automatically without the need for that much conscious attention, if any (i.e. below conscious awareness). Driving a car is an example of learned subconscious behavior. When first learning to drive, you had to be aware of (be conscious of) every little movement. Now all the movements have pretty much become automatic. The 'subconscious' is to be differentiated from the 'unconscious' which can be defined as engrams or memories below immediate conscious accessibility. Most adult human behavior falls under the heading of subconscious behavior. The advantage of subconscious behavior is that it allows us to do many things at once, and relatively quickly. The main disadvantage is that once programmed in, the behavior is so automatic that it becomes difficult to change."
It is the latter fact, i.e. that certain automatic behaviors are so hard to change, that makes hypnosis such a valuable tool. Hypnosis provides us a systematic means of controlling the subconscious, of being able to rearrange the hierarchies of automatic behavior. And the more deeply imbedded this automatic behavior that we wish to change is (i.e. the higher in the hierarchy it is), the more effective a hypnotic induction is needed.
It should be realized that when hypnosis is used in a therapeutic setting there are two ways that a hypnotherapist can help: One is to help add to the suggestibility (belief) factor sufficiently with an effective hypnotic induction in order to transcend or overcome certain negative automatic habits or cognitions that the patients with their own level of free will have been unable to accomplish. The other way the therapist can help is by providing the patients with some good guidance, a good idea of what habits and cognitions need to be changed. Now sometimes the latter is all that is needed and together with a sufficient level of free will to begin with the patients can then bring about the needed restructuring of the hierarchy on their own even without a hypnotic induction. But if the negative behavior is too high in the hierarchy for the patients' own level of free will (own willpower) to rearrange it, this is when an effective hypnotic induction can be especially beneficial.
THE RESPONSE SET AND RESPONSE EXPECTANCY THEORY OF HYPNOSIS
There are a number of similarities and differences between the response expectancy perspective [Kirsch, 1985,1997,2000] and mine. The following will present both the similarities and the differences:
First, a major difference between us is that Kirsch, as do most sociocognitivists, believes that "The induction of hypnosis, for example, has a relatively small effect on the degree to which people respond to typical hypnotic suggestion." [Kirsch, 2000, p.276]. As already pointed out, I feel that although this statement might be true for the standard relaxation-type induction, I feel there can be other more effective types of hypnotic induction.
The second major difference (and similarity) between us revolves around his use of the term "response expectancy". Kirsch seems to feel that the key to increasing hypnotic responding is by increasing the subject's "response expectancy". [Kirsch 2000, p.275]
I would be more inclined to agree with Kirsch if he were use the term "belief" in place of "response expectancy". Kirsch prefers to use the term "response expectancy" to describe what is being manipulated by a hypnotic induction whereas I would prefer to use the term "belief". As Kirsch puts it:
"A path analysis supported the hypothesis that hypnotic inductions enhance responsiveness by altering response expectancies."
In my original theory I do refer more to "suggestibility" as what is being manipulated by a hypnotic induction. However, I have come to see the term "suggestibility" as having some negative connotations, with some people possibly relating it to the term "gullibility". I, consequently, now prefer to follow Skinner's lead of using the term "belief" in describing hypnosis. As Skinner put it:
"With respect to a particular speaker, the behavior of the listener is also a function of what is called belief (a term very similar to suggestibility)... our belief in what someone tells us is similarly a function of, or identical with, our tendency to act upon the verbal stimuli which be provides. If we have always been successful when responding with respect to his verbal behavior, our belief will be strong... Various devices used professionally to increase belief of a listener (for example by salesmen or therapists) can be analyzed in these terms. The therapist may begin with a number of statements which are so obviously true that the listener's behavior is strongly reinforced. Later a strong reaction is obtained to statements which would otherwise have led to little or no response. Hypnosis is not at the moment very well understood, but it seems to exemplify a heightened 'belief' in the present sense (see Skinner, 1957, pp.159-160)."
Now getting back to "response expectancy" and why I prefer the term "belief" to "response expectancy": One problem with the latter term is that it implies that there is a visible response connected to the expectancy. Yes, you can get someone to produce the visible response of "arm rising" if he has a strong response expectancy of "arm rising". But where is the visible response when the response expectancy is that the subject will see the color red? Not all cognitions necessarily have a clearly visible response attached to them.
Next comes the question of how does response expectancy or belief produce responses. Kirsch himself poses the question thusly:
"To accept a suggestion is to believe or expect that these events will in fact happen. So the real problem is to understand the effects of response expectancy on experience, behavior and physiology. How does response expectancy produce these changes?"
Kirsch's answer to this question is to posit some underlying substrate or connection between actual responses and the expectancy of that response. As he puts it,
"if we assume that there is a physiological substrate for any experiential state, then a change in perception is always a change in physiology, as well. For that reason, expectancy induced changes in experience will always be accompanied by at least some physiological change."
"Just as the expectation of an experiential response tends to generate that response, so too the expectation of an overt automatic response promotes its occurrence."
In my theory I take a more in-depth approach to explaining how expectancy or belief produces the response. First, let's look at how I would define belief. If I am now saying that "belief" and "suggestibility" are interchangeable terms, then I would define belief as the propensity to respond to suggestion. So, from my definition of suggestion (see Barrios 2001, p.170), I would define belief as the ability to respond to suggestion with (1) a cognitive stimulus associated with the suggestion together with (2) an inhibitory set which would inhibit stimuli (sensory or cognitive) incompatible with the cognitive stimulus evoked. And as stated in Corollary 3 of Postulate III of my theory, the cognition is evoked by the suggestion as a result of the fact that
"words can act as conditioned stimuli which can evoke... responses similar to those evoked by the original unconditioned stimuli."
The main difference between Kirsch's explanation and mine for how belief/response expectancy leads to responses is that first of all, I explain how there is a response connected to the suggestion (as a result of classical conditioning – see Pavlov quote on page 167 of my theory) and, secondly, I explain the heightened response to hypnotic suggestion as resulting because of the greater inhibitory set produced by the hypnotic induction which inhibits competing stimuli.
A third major difference between our perspectives is how we explain how response expectancy/belief can be increased in hypnotic situations. According to Kirsch:
"There are three kinds of cognitions that ought to affect response expectancies in hypnotic situations: (a) perceptions of the situation as more or less appropriate for the occurrence of hypnotic responses; (b) perceptions of the response as being appropriate to the role of a hypnotized subject... and (c) judgments of one's hypnotizeability."
As for his first two ways (a & b), I cover these in my theory under the heading of "Subjects' expectation" in the section on "Individual differences factors influencing hypnotic induction" [pp.181-183]. I point out that (as a result of the expectancy of being hypnotized,
(a) "subjects are more likely to ascribe correctly the occurrence of the 'strange' phenomena to the hypnotist than to some external cause."
(b) "Subjects' expectations of what hypnosis is like can influence hypnotic induction in other ways. For example if the subjects are told that a catalepsy of the dominant hand occurs when they go under hypnosis."
Then as subjects feel themselves responding, they are also indirectly being given the suggestion of catalepsy of the dominant hand. This response can, in turn influence the hypnotic induction, as any positive responses to previous suggestions [p.183].
With regards to how Kirsch describes methods of affecting response expectancies by manipulating "judgments of one's hypnotizeability", I differ somewhat with Kirsch. What he describes as one way of manipulating judgments of hypnotizeability by surreptitiously provided experiential feedback simply as "an expectancy modification procedure" [Kirsch, 1989, p.762], I would directly refer to as an actual hypnotic induction according to Corollary 6 following Hypotheses III of my theory which states that surreptitiously provided feedback would facilitate a hypnotic induction [p.180].
As indicated on page 171 of my theory, I define hypnotic induction as the giving of two or more suggestions in succession so that a positive response to one increases the probability of responding to the next one. And Hypothesis III states:
"A positive response to a suggestion will induce within the responding person a more or less generalized increase in the normally existent tendency to respond to succeeding suggestions."
It's interesting that Kirsch states that
"According to response expectancy theory, people's beliefs about their hypnotic ability are one of the determinants of the number of suggestions to which they are able to respond successfully."
Now if he would also say that the number of suggestions to which subjects are able to respond successfully is in turn a determinant of people's belief about their hypnotic ability, he would be coming very close to saying what I say in Hypothesis III of my theory.
FURTHER SUPPORT FOR THE THEORY
Further support for the theory since its original writing (Barrios, 1969) comes from at least three areas: (1) Studies on the use of subtle sensory reinforcement; (2) The area of biofeedback; and (3) Studies on sensory deprivation.Subtle Reinforcement Studies
Corollary 6 following Hypothesis III of the theory states: "An hypnotic state can be facilitated if, along with each of the first few suggestions given in a hypnotic induction, the actual sensory stimuli which would ordinarily evoke these suggested responses accompany the suggestions without the subject's knowledge." There are at least three studies whose results support this Corollary. The first was part of a Ph.D. dissertation submitted in 1967 [Wilson, 1967], which I did not become aware of until after I had submitted my dissertation. Wilson had subjects experience surreptitiously provided reinforcement of suggestions.
"After suggesting that subjects imagine the color red, for example, Wilson imparted a faint red tinge to the room via a hidden light bulb. Subsequent testing of waking suggestibility on the Barber Suggestibility Scale (Barber, 1969) revealed substantially higher scores among these subjects than among controls."
A subsequent study by Wickles & Kirsch  essentially confirmed Wilson's findings. They found that 53% of the group that had been provided surreptitiously provided experiential feedback scored as highly hypnotizable as compared to only 6.7% of the control group.
In a follow-up study Kirsch, et al.  found that, once again, surreptitiously provided experiential feedback significantly increased responsiveness to suggestion. And this time an additional important fact was determined – that for this to occur it was important that the subjects not be aware of the artificial source of the reinforcement (as so stated in Corollary 6). Those subjects that were allowed to detect that the reinforcement was artificial showed no increase in responsiveness.Biofeedback Support
Biofeedback can be defined as the use of special devices to amplify automatic responses for the purpose of gaining greater control of these responses. For the most part, the typical responses have been relaxation-related such as GSR, heart rate, EMG and fingertip temperature, although biofeedback need not be limited to just relaxation responses. A typical procedure might involve having the subject focus on thoughts of relaxation and be given the goal of causing the movement of the biofeedback measure in the appropriate direction; for example, slowing the heart rate down or raising fingertip temperature.
As I see it, the reason biofeedback has proven to be so effective for gaining control of involuntary physiological responses is that in actuality, subjects being treated with biofeedback are being put through a form of hypnotic induction as defined by my theory. A hypnotic induction "is defined as the giving of two or more suggestions in succession so that a positive response to one increases the probability of responding to the next one." [Barrios, 2001, p.17] Suggestions (or goals) of relaxation, whether instigated by the biofeedback operator or by the subjects themselves, produce initial minute relaxation responses which are immediately amplified by the device and thus made more visible to the subject. This acts as an immediate reinforcement letting the subjects know that they have responded positively to the suggestions of relaxation. The resultant heightened belief should in turn allow the subjects to respond even more strongly to succeeding suggestions of relaxation.
Although the widespread use of biofeedback devices has been around only since around the 70's, the basic principle behind biofeedback has been used to facilitate hypnotic induction long before that if we can look upon the Chevreul Pendulum as a hypnotic aid device; for if you stop to think about it, the Chevreul Pendulum is in actuality a biofeedback device. What the pendulum does is amplify minute ideomotor movements of the hand when the thought of a particular movement is suggested. Many in the hypnosis field recommend use of the Chevreul Pendulum as a "warm up" procedure to get subjects in a more receptive mood for hypnosis [e.g., Lynn & Sherman, 2000, p.202]. I, in fact, have devised a complete hypnotic induction procedure starting with suggestions that the pendulum will first swing from left to right, then more in a circular direction; then proceed from there to suggestions of hand, fingers and arm movements followed by suggestions of relaxation. This technique has proven to be quite popular with my students and clients [Pendulum technique in Barrios, 1985, pp.36-38].
There has been at least one study where the use of biofeedback did lead to an increase in suggestibility. Wickramasekera  using forms A & B of the Stanford Hypnotic Susceptibility Scale found a significant increase (p=.001) in suggestibility upon using EMG biofeedback to reinforce suggestions of relaxation. There is, however, one caveat to this study. One does not know whether it was the deepened state of relaxation or the use of biofeedback, or a combination of the two that increased suggestibility. One way to truly test the hypothesis that the use of biofeedback devices, per se, sans relaxation suggestions, can increase suggestibility is to not use relaxation suggestions. For instance, one could use a temperature biofeedback device with suggestions of coldness in the hands (e.g., "as if you were placing your hand in cold or ice water") to cause the device to indicate a drop in hand temperature. One could also use a heart rate biofeedback device to feed back heart rate increase in response to suggestions of heart rate increase ("as if you were in an athletic competition").Sensory Deprivation Studies
Corollary 9 following Hypothesis V of the theory states that "Suggestibility should be increased if sensory stimulation is curtailed." Further support of this corollary was provided by a number of different studies: Sanders & Reyher  using the Stanford Hypnotic Susceptibility Scale (SHSS) forms A & B and working with ten subjects initially resistant to hypnosis and an equivalent control group found sensory deprivation did significantly increase enhancement of hypnotic susceptibility. Also using SHSS forms A & B, Wickramasekera in two separate studies [1969, 1970] achieved similar results.
BENEFITS OF THE THEORY
Explanation of the Hallucinogens
One of the benefits of the theory is that it led to my theory on the hallucinogens [Barrios, 1965]. The same principles of inhibition and conditioning used to explain the behavioral and therapeutic effect of hypnosis presented in the hypnosis theory including the Stimulus Dominance Hierarchy concept were used to explain the behavioral and therapeutic effects of the hallucinogens. These effects are seen as resulting from the hypersuggestible state produced by the inhibitory aspects of the hallucinogens in the same way as the hypersuggestible state of hypnosis is produced by the inhibitory set aspect of hypnosis.
One important point that needs to be made is that for one to achieve therapeutic effects from use of the hallucinogens' hypersuggestible state, it is most productive if it is a controlled state. In the controlled state positive suggestions can be properly directed at whatever positive therapeutic changes are needed. If uncontrolled, the hypersuggestible state can lead to a number of problems. It can lead to uncalled for hallucinations and delusions which to someone not fully understanding what is going on, not in control, can become quite frightening. It is felt that the many cases of psychotic breakdowns reported as resulting from unsupervised ingestion of hallucinogenic drugs could very well have been due to this uncontrolled state of hypersuggestibility with resultant frightening hallucinations and delusions and the (heightened) belief that they would be permanently occurring; the latter being possibly the main reason for the psychotic state continuing long after the drug effects wore off.
One may wonder if something very similar to this frightening state of uncontrolled hypersuggestibility isn't at the bottom of non-drug induced psychotic breakdowns. One question that would need to be answered here of course, is what could have led to this state of uncontrolled hypersuggestibility in the first place. We know that a certain percentage of the population is highly suggestible to begin with. Is it possible that a state of high stress or anxiety or certain negative thinking could cause this suggestibility to get out of control? And if uncontrolled heightened suggestibility does play a part leading to psychoses, such as schizophrenia, could a form of controlled hypersuggestibility (such as hypnosis) be used to somehow reverse the psychoses; e.g. cure the psychoses? Could it be used to reverse the belief that the psychotic symptoms would be permanent? We know hypnosis could be used to remove the causes of any precipitating high stress, anxiety or negative thinking. There are some interesting possibilities here. [Barrios, 1985, pp.23 & 24 was an example of where hypnosis was used to successfully cure a case of paranoid schizophrenia.]An Explanation of the Effectiveness of Biofeedback
As already pointed out above in the section on further support for the theory, the effectiveness of biofeedback in gaining control over involuntary behavior is explained by pointing out that putting a person through a biofeedback procedure is in actuality putting the person through a form of hypnotic induction (as defined in the theory on page 171) where the biofeedback device acts to amplify initially minute responses to suggestion. The amplification of the response greatly facilitates getting a positive response to the suggestion. It was pointed out that although most responses usually controlled via biofeedback are relaxation connected, other non-relaxation type responses can also be controlled via biofeedback. In fact, one such non-relaxation biofeedback response discussed is that of the automatic hand movements, which are part of the Chevreul Pendulum phenomenon. The initial minute automatic movements of the hand in response to suggestions that the pendulum will begin swinging in a particular direction are amplified by the length of the pendulum. A small minute movement at the top of the pendulum where the fingers are holding it is amplified to a large swing at the bottom end of the pendulum.
What I say is occurring in biofeedback is that, with each suggestion or thought of, for example, a movement of the hand (in the case of the Chevreul Pendulum) or of relaxation (in the use of relaxation oriented biofeedback devices such as: EMG machines; GSR devices; or fingertip temperature measuring devices), the initial minute response is immediately seen thanks to amplification and thus immediately confirmed. With each positive initial response, the belief factor is being built up - the belief that you can control this particular automatic response. This belief can be used to get an even stronger response (e.g., even deeper relaxation) to repetition of the initial response or a positive response to another response. For instance, in my Pendulum SPC technique, although I start with suggestions of the pendulum swinging in one direction, I then switch to the pendulum swinging in another direction, then the fingers beginning to open, the arm beginning to come down, etc. With each positive response the belief factor is increased. By the end of the procedure, the overall belief factor (belief in what is suggested) should be heightened.
Another example of how biofeedback can be combined with other types of suggestion to increase the overall belief factor is how I make use of my invention the Stress Control Biofeedback Card (a thermal biofeedback device using liquid crystal as the temperature measuring device) to help people gain control over the ability to relax. As part of the SPC program for stress control, a person may first be put through one of the SPC hypnotic induction techniques with the goal that the individual will be able to react more calmly to situations that previously caused a great deal of stress or anxiety. The suggestion is also given that the subjects will see proof of this control in being able to turn the Stress Card blue (i.e., a response of 95°F fingertip temperature or higher, indicating relaxation) whenever they start to feel stressed.Helping Towards a More Comprehensive Theory of Learning
We know that dramatic, all-encompassing changes can take place in hypnotherapy, sometimes overnight. This often means that all the negative habits, attitudes and beliefs associated with a patient's negative behavior can be transformed even after just one hypnotic session (case in point see pages 23 and 24 of Barrios, 1985 where I present the dramatic results of a paranoid schizophrenic cured in one hypnotherapy session).
"Understandably, a learning theorist might hesitate before accepting the possibility that it is a process of conditioning which underlies the dramatic changes produced in hypnotherapy. One-trial conditioning and functional autonomy are not commonly encountered in the laboratory."
How is this possible and still be explainable in terms of principles of conditioning? First of all, we would have to establish that, as stated in Hypothesis VI of the theory: "Suggestion leads to behavior change by a form of higher-order conditioning called C-C conditioning." This hypotheses is given considerable support by Mower's theoretical formulations on the sentence (a form of suggestion) as a conditioning device. [Mowrer, 1960, pp.141-2, 147]
But we would still have to explain the fact that suggestions are not always readily accepted, that sentence conditioning does not always take place. As I point out in the theory [Barrios, 2001, pp.194 & 195]:
"We will find that the answer to this question will begin to throw some light on the part played by hypnosis in facilitating C-C conditioning. Osgood perhaps best answered this question in his presidential address to the American Psychological Association when discussing Mowrer's concept of the sentence as a conditioning device. According to Osgood (1963), if the assertion made by the sentence (the suggestion) is incongruent with subject's previously held beliefs and attitudes (the cognitive environment) or their present perceptions (the sensory environment), it will tend to be suppressed... Since incongruent or incompatible beliefs, attitudes, perceptions, etc., tend to suppress the cognitive stimuli to be paired, they thus interfere with the conditioning. Therefore, we hypothesize that anything that would eliminate such interfering stimuli should facilitate C-C conditioning... This leads to the part played by hypnosis in the facilitation of conditioning. Hypnosis, it is felt, provides an especially effective means (the inhibitory set) whereby interfering stimuli can be readily inhibited."
And this inhibitory set can be so efficient as to have the conditioning take place in only one trial.
Regarding the functionally autonomous nature of the post hypnotic response:
"It is felt that the functionally autonomous nature of the post-hypnotic conditioned response can best be explained if an interference theory explanation of extinction is assumed. This theory states that in order for a response to become extinguished, another incompatible response must become conditioned to the CS. An implication from this interference theory would be that if the CR is stronger than a potentially interfering response, the latter will be the one inhibited. Thus, as long as there is a strong enough CR to begin with, it can keep itself from being extinguished."
As implied above in pointing out how the strong inhibitory set aspect of hypnosis can lead to strong one trial conditioning, we can see how this strong inhibitory set can also lead to functionally autonomous post-hypnotic responses.
The large part played by the inhibitory set in facilitating conditioning and leading to strong conditioned responses is supported by the work of Harry Harlow (1959) and his error-factor theory, who considered much of learning to involve the inhibition of what he referred to as error-producing factors, what I refer to as competing stimuli.Explaining the Placebo Effect
In discussing the broad implications of the definition of hypnotic induction, it was stated that the theory could also be used to explain "the hypnotic effects (placebo effect) of psychotherapists and doctors of medicine" [Barrios, 2001, p.171]. The question is how? The section of the theory on prestige helps throw some light on this question:
"the statements, commands or suggestions of a person with prestige tend to be questioned less; that is, such a person evokes a greater inhibitory set to begin with. In general, people have previously been conditioned to accept at face value the statements of someone who is an authority in his field. That is, an inhibitory set which inhibits contradictory stimuli has been previously conditioned (in much the same way as in the hypnotic induction process). This is so because what the authority says has usually turned out to be true."
The placebo when given by a doctor or person of authority works in the same way as hypnotic suggestion, for the person is in a heightened state of belief. For example, when the doctor gives a patient an injection "to kill the pain", he is essentially giving the suggestion "this is going to ease your pain". The actual pain relief occurs even if the injection is an inert saline solution because of two factors associated with suggestion. First, the cognitive stimulus "pain relief" with its associated endorphin (the body's natural pain killing substance) release into the bloodstream. Secondly, the inhibitory set of the suggestion is evoked that would inhibit anything that might interfere with the cognitive stimulus, such as any doubts about the doctor's skills, or doubts about the pain killer's effectiveness, or even the sensory pain stimulus itself.
As another example, when the doctor gives the patient any medicine or treatment that he says will cure the patient, the cognitive stimulus "healing" is evoked with its attendant immune associated response (e.g., release of t-cells, macrophages, etc.)
The next question that needs to be answered is from whence do the cognitive stimuli "pain relief" or "healing" derive their meaning; i.e., how did the words or thought "pain relief" come to be associated with endorphin secretion or how did the word or thought "healing" come to be associated with the immune response? I would say the answer is: through a process of higher-order classical conditioning. As Pavlov so aptly put it:
"Speech, on account of the whole preceding life of the adult, is connected up with all the internal and external stimuli which can reach the cortex, signaling all of them and replacing all of them, and therefore can call forth all those reactions of the organism which are normally determined by the actual stimuli themselves."
In other words, at some point in a person's life, the words or thought "pain relief" were associated with the body's own natural pain relieving endorphin secretion response; and the word or thought "healing" was associated with the body's own natural healing response while the person was experiencing same.
There, of course, is another way that a placebo response can occur. This would be more from a form of first-order classical conditioning. For instance, when a person or animal is injected a number of different times with a pain killing medication, the stimuli associated with the injection (e.g. the syringe, the person giving the injection, etc.) are the conditioned stimuli (the CS). The pain relief (the UCR) produced by the actual pain killer, let's say morphine (the UCS), becomes associated with the CS such that the CS can eventually produce a conditioned response (CR) of pain relief. This CR can then also be looked upon as a placebo – in this case produced via first order conditioning. I believe this is what is behind the conditioning explanation of the placebo response of such researchers as Gliedman [et al, 1957], Hernstein, , Knowles , and Wickramasekera .
I believe the above two-fold (first-order and higher-order conditioning) explanation may help throw some light on the questions raised in the section on placebos in Kirsch's 1985 paper on response expectancies. This should help eliminate the apparent clash between the "conditioning" and the "response expectancy" explanation of placebos if we can look upon the terms "response expectancy" and "belief" as being similar as I have previously discussed, and see that conditioning is also a factor in the "expectancy" placebo, although higher-order as opposed to first-order.
One other area that should also be cleared up by the above higher-order conditioning explanation of placebos is the question raised by Kirsch: How can one explain placebos in terms of conditioning when placebos often exhibit functional autonomy? As put by Kirsch:
"A second interesting finding of the Montgomery (1995) study is that instead of extinguishing, the placebo effect increased over the course of 10 extinction trials. This is inconsistent with classical conditioning, models of placebo-effects, but is consistent with clinical data indicating that placebo effects can be remarkably persistent."
One can see from the previous section "Helping Towards a More Comprehensive Theory of Learning", how one can establish some fairly strong functionally autonomous responses via the conditioning power of the belief or response expectancy aspect of placebos.Providing a Natural Explanation for Faith-Based Phenomena
In the theory, the statement was made that the theory can also be used to explain "hypnotic effects (faith) of ministers and faith healers" or to put it more broadly, the theory also provides:
In many religions the foundations of belief can be traced to the fulfillment of certain predictions, expectations or prophecies. The following are four key examples of such predicted or suggested outcomes in religion:
This would fit right in with Hypothesis III of the theory that states that belief, or response to a suggestion, is built up if you have a positive response to a previous suggestion.Examples of Religious Phenomena the Theory Provides a Natural Explanation For
Demons, Exorcism and Born Again Transformations
The above section on how hypnosis can lead to one trial conditioning and functionally antonymous responses as a result of the heightened state of belief under hypnosis also helps to explain the overnight and long lasting changes that can occur as a result of the heightened state of religious belief. As I put it in my article, "Science in Support of Religion: From the Perspective of a Behavioral Scientist” [Barrios, 2002, p.6]:
"Looking at belief in this new light can also help us better understand the concept of exorcising (blocking out) of demons or the devil (negative programming) within us and the role belief can play... This also helps us to more fully understand the far-reaching and in-depth changes that can often be produced (almost instantaneously) by a 'religious experience'; how it can indeed be possible to be reborn or born again as a result of such an intense heightened belief experience."The Phenomenon of Free Will
Religionists tell us that of course we have free will, that God gives us a choice in life, gives us the power to choose between good and evil, between happiness and misery. But then the realists point to all the miserable people in the world and say, "Are we to believe that all these people have freely chosen to be miserable?" Is there free will or not? In order to answer this question, again we need to define our terms.
As presented in Towards Greater Freedom and Happiness [Barrios, 1985, p.16] free will is defined as "the ability to transcend ones automatic side, one's subconscious, by means of inner speech or thought, by focusing sufficiently on the appropriate thought." The key words here are 'by focusing sufficiently on the appropriate thought'. Not all people have developed the ability to focus on the appropriate thought when they wish to. Very often, conflicting and opposite thoughts interfere and do not allow the full positive response. This is why the belief factor is so important. Belief is the key to allowing an individual to tap into his free will potential. Remember, the definition of belief used herein is: "concentration on a thought to the exclusion of anything that would contradict that thought". [Barrios, 2002, pp.7 & 8]
So we see that the answer to the question, "Does man have free will?", is that all humans have the potential for free will because they have the potential to build up belief in their ability to control their automatic behavior via a form of self-hypnosis over time (as discussed earlier in the section comparing my theory to Hilgard's). And this is why we find that people differ from one another in their level of free will.The Phenomenon of Faith Healing
Many studies in recent years have shown that a person's state of mind and lifestyle can definitely play a key role in determining his or her state of health. This includes, for example, the effect of stress on diseases such as stroke and heart disease [Friedman & Rosenman 1974] as well as the effect of the mental state of hopelessness on the immune system and resultant diseases such as cancer [Temoshok, 1993; Cousins, 1989]. The following excerpts from Barrios, 2002 [pp.11-16] help present the case for the power of belief and faith to heal the body:
"If we accept the fact that a person's state of mind and lifestyle can play a significant role in affecting the body, then it should be obvious that anything that can play a major role in affecting the mind, such as belief and faith, could be a major factor affecting health and well being.
"Evidence of the power of belief to affect the body health wise can be found in many studies on the power of the placebo (see for instance the book "Timeless Healing: The Power and Biology of Belief", 1996 by Herbert Benson, and the section on placebos in Cousin's book "Head First", 1989. However, there is something that needs to be made clear. Although strong belief of being healed can be very effective in producing at least temporary improvement in one's health (by allowing for a stronger immune response and creating greater peace of mind at least for the moment), in order for this temporary improvement to remain permanent, the belief factor must also be used to help fully absorb the guidance factor [see subsequent section on making post hypnotic suggestion more effective by adding a guidance factor] so that the immuno-suppressive psychological factors can be more likely to be permanently removed [Barrios, 1985, pp 124,125 & 154]. Thus we can see that one way of differentiating between the concept of belief and the concept of faith is to point out that faith usually means 'guided' belief or belief in a certain way of life...
"One way of determining how much more effective faith is than belief alone in affecting permanent healing would be to do a thorough search of the placebo literature or to do further studies on the placebo to determine whether the positive effects of the placebo (or belief alone) are long lasting if there was no significant lifestyle changes also taking place.
"This basic idea that belief alone is not as effective for insuring permanent healing to take place as when the belief is also used to bring about positive lifestyle changes is illustrated when the case of Jolee Marshall is contrasted with some of the other cancer patients I have worked with:
"It should be pointed out that I am not the only one to report such long lasting recoveries from cancer where a more complete 'faith healing' approach is taken. In her book, Temoshok cites numerous cases of successful cancer cures brought about by her and other researchers in the field using this more complete healing approach [Barrios, 2002, p.16]. See especially the spectacular survival of Irwin whose initial testicular cancer had spread to his lymph nodes, chest and lungs and who had been given three to four months to live with zero chances of survival. Under hypnosis he was much more open to healing suggestions aimed at opening up blocks in his capacity to love and be loved and to work on achieving his long term life goals. Within six months, he had resolved his love problems and gotten married and was ordained as an Episcopal priest – a lifelong goal. On the very day he was ordained, he got the news that his follow-up x-rays showed no more evidence of cancer. His lymph nodes and lungs were completely clear. This seeming miracle occurred six months after his initial diagnosis... Today,thirty three years later, Irwin is alive, well and cancer free.
"It should be pointed out that my presentation of the above anecdotal evidence of cancer cures through a form of faith healing is done more as support for rather than definitive proof of the ability to cure cancer by using a mental/spiritual 'faith healing' approach. For this definitive proof we will need larger, controlled studies.
"In such studies, among other things, all the important variables can be studied systematically and under scientifically controlled conditions. For instance, such studies would include accurate and more complete measurements of how strong the belief factor was and how complete were the necessary life changes for each individual case. The latter would I feel help throw light on the question often posed: 'How do you explain counter anecdotal cases whereby terminally ill patients have tried to pray for their recovery substantially but to no avail?' One answer to such a question might be that the degree and length of healing would be directly correlated to the strength of belief and depth of relevant life changes that took place."More Effective Methods of Hypnotic Induction
There are a number of ways I feel my theory has helped increase the effectiveness of hypnotic induction both in terms of providing a proper pre-induction talk as well as providing more effective hypnotic induction techniques. The ideas to be discussed were first presented in a paper I delivered at the VIth International Congress for Hypnosis on July 3rd, 1973, in Upsala, Sweden [Barrios, 1973b].
With regards to a proper pre-induction talk, several basic areas that need to be addressed according to the theory are:
Misconceptions are eliminated by defining hypnosis as a state of heightened belief produced by responding positively to a series of suggestions (as per the theory) and not a state of sleep or unconsciousness. In fact, it is recommended that the hypnotic induction be referred to as inducing a state of Self-Programmed Control or SPC and define SPC as a method for giving an individual greater control over his automatic behavior.
As for eliminating the fear of losing control, one can see that by referring to the induction as a means of developing self-programmed control, you help the individual see that he will in fact be gaining greater control rather than losing control.
Fear of the unknown is eliminated in the pre-induction talk by providing a rational explanation for how this state of greater control is developed as the result of the power of words, the power of thoughts, the power of belief to control automatic responses. The demonstration of salivating to the thought of biting into a sour lemon is used to help get across this point.
The negative effects of failure are minimized by telling subjects that "because of individual differences there may be some suggestions that work very well for some people but not for others, and therefore it should not bother them if they do not respond to a suggestion. In such a case, they should just wait for the next one."
As for providing for more effective hypnotic induction techniques, as suggested by the theory, anything that would insure a positive response to suggestion would help heighten the belief factor and thus increase the effectiveness of the hypnotic induction. Several ways of doing this are recommended by the theory: The use of easy to respond to suggestions to begin with (see Corollary 5, following Hypothesis III); the use of naturally occurring responses and the use of subtle reinforcement of suggested stimuli or responses (see Corollary 6) and the use of biofeedback devices. The following are some of the SPC techniques I developed as a result [Barrios, 1985, pp.36-42]:
One of the techniques developed by following these guidelines was the already mentioned: The Pendulum Technique. In this technique there is first the biofeedback amplification provided by the length of the pendulum to amplify the minute automatic movements of the hand. First, swinging from left to right is suggested; then swinging in a circle. Then there are a series of other naturally reinforced suggestions starting with the suggestion that the fingers will automatically begin to creep open and as a result the pendulum will soon be dropped. This response occurs naturally as the hand slowly begins to bend at the wrist as suggestions are given that the hand will relax. This is followed by suggestions that the hand and arm will be floating down as the state of relaxation continues to deepen (another natural response).
The Concentration Spiral technique also takes advantage of naturally occurring phenomena. This technique involves having the subjects looking at a spinning spiral. I lead them through a series of suggestions of visual phenomena which I devised by mirroring the subtle visual effects I experienced myself as I visualized the spinning spiral. The following suggestions are given: As your mind becomes more and more concentrated, you will begin to see a fuzziness or waviness in the lines of the spiral; you will see a yellowish fluorescent-like fringe to the black lines; dark rays will appear to spin off the edge of the disk; you will feel as if you were riding backwards on a train in a spiral tunnel looking out the rear window. And throughout, suggestions that the spiral was concentrating the power of the mind continue to be given. Then, to emphasize this point, the suggestion that upon looking away from the spiral at the clock on the wall (or some other object like a plant in the room) the clock (or plant) will be magnified and appear to grow larger. This very dramatic effect, unbeknownst to the subject, is a natural occurring illusion as a result of looking at the spiral spinning in a clockwise direction. Of course, by following the series of previous suggestions, the effect is magnified that much more.
To minimize any feelings of deception for the few that may think of the spiral technique as pure illusion, prior to going through the technique I first point out that everything the subjects are going to see is naturally there but as a result of the concentrating effect of the procedure, everything will be seen that much more clearly and strongly (which is true). I even tell the subjects afterwards that some people do not experience any of these effects (which is also true, if they are not paying attention).
Other SPC techniques making use of natural occurring phenomena are the Light Bulb, the Rapid Deep Breathing, and the Hand Levitation techniques. In the Light Bulb technique, use is made of the after-image produced after staring into a 40-watt light bulb for a short while. In the initial steps the subject is told he will see a yellow colored balloon after he closes his eyes and that it will be changing in color – from yellow to red to magenta to blue (which would be the natural color changes the after image would go through). Also suggestions are given that the balloon will begin to float up and the head will also begin to float up. The subject is told that the latter will occur with each breath he takes in. Unbeknownst to the subject, there is a natural tendency of the head to rise with each breath taken in. (Conversely, there is a natural tendency of the head to sink with each breath let out so one can reinforce suggestions of head sinking in a similar way.) The Rapid Deep Breathing technique (an adaptation of the hyperventilation method discussed by Kroger [1977, pp.77 & 78] takes advantage of such naturally occurring responses to hyperventilation as tingling, light-headedness, greater awareness of heart beating, etc. In my adaption of the hand levitation hypnotic technique, I have the subjects begin by first pressing the hand as flat as possible against the surface, with the fingers spread as far apart as possible. I tell them to push down as hard as they can initially. Thus, when suggestions are given that the hand will start to rise and the fingers will start to come together as the hand relaxes this is what would naturally occur as they stop pushing down and relax, thus reinforcing the suggestions.
I have presented these theory-derived basic principles for increasing the effectiveness of hypnotic inductions in such a way that one should be able to extrapolate from them and develop other similar naturally reinforced techniques.More Effective Methods for Giving Post-Hypnotic Suggestion
How does the theory lead to ideas for increasing the probability of producing positive behavioral changes via post-hypnotic suggestion? The answer to this question comes from Corollary 8 (following Hypothesis IV) of the theory, "The more compatible cognitive stimuli associated with the response evoked by the suggestion, the stronger the response to the suggestion." This basic concept underlies the value of using imagery (visualization) to insure the suggestion would hold in a variety of situations and guidance to give the suggestion depth.
For example, let's say a patient was suffering from a deep depression due to a poor self-image and a sense of being a failure in life. Compare the effectiveness of (1) just giving the simple, general, suggestion "You will no longer feel depressed." to (2) giving this general positive suggestion followed by the giving of a series of more in-depth suggestions that included the proper guidance for how to become more successful in life, more positive about oneself; and then having the patients visualize themselves in a number of different typical situations responding in these more positive ways.
Along the lines of enhancing post hypnotic suggestion with imagery, I have developed five variations of visualization for effectively programming in one's goals. These include [see Barrios, 1985 pp.43-50]:
Following along the lines of enhancing post hypnotic suggestion with positive guidance, the second part of my book, Towards Greater Freedom and Happiness [Barrios, 1985, pp.57-196] offers a wide range of positive guidelines to choose from. This includes positive guidance in the following areas: mental attitudes, emotions, health, and education.Development of Self Programmed Control and Its Positive Applications
The combining of effective of hypnosis (and self-hypnosis) techniques with more effective methods of giving post hypnotic suggestions, including a comprehensive guidance component, led me to develop a general program for helping people achieve self-actualization, which I christened Self-Programmed Control or SPC.
Although Maslow, in defining self-actualization, had done a magnificent job of outlining the ultimate high goals one should strive for in life [Maslow, 1971], I feel he never really outlined an effective systematic method of achieving these goals. It's one thing to tell a person what he needs to strive for to feel more fulfilled in life; it's another to get him to change in this direction. I feel the SPC program provides this missing link to achieving self-actualization.
This section of the paper will further describe the essence of SPC and will present some of the positive results achieved in its application in a number of different areas: education, welfare, industry, medicine, and drug rehabilitation.Education
A month or two after finishing my Ph.D. dissertation [Barrios, 1969], I was given the opportunity to develop a program at East Los Angeles Community College to help students (primarily Mexican American) on scholastic probation avoid dropping out. I became one of the instructors teaching the Psychology 22, Developmental Study Skills class that had been devised to help these students. Instead of just teaching study skills as did the other instructors, I used a three-pronged approach to help the students survive [Barrios, 1973c]. The first part consisted of the set of self-hypnosis techniques I had developed from the theory (see the techniques mentioned above). Soon after I started, the school administration asked me if I couldn't use another term in place of self-hypnosis because of all the misconceptions associated with the concept of hypnosis. It was at this point that I came up with the euphemism Self-Programmed Control or SPC. Although originally the term specifically referred to the self-hypnosis techniques which were now referred to as SPC techniques, Self-Programmed Control came to refer to the entire program of SPC techniques plus guidance.
The main purpose of the SPC techniques was to help the students develop a greater belief in the power of their minds and as a result a greater belief in their capabilities. Eight years later, Albert Bandura would coin the term "self-efficacy" for such capabilities. As he at the time so correctly pointed out, without such a belief, people would not even make the effort to help themselves. Or as he put it,
"It is hypothesized that expectations [belief] of personal efficacy determine whether coping behavior will be initiated, how much effort will be expended, and how long it will be sustained in the face of obstacles and aversive experience."
In a prior study by Losak , the lack of belief in their capabilities was felt to be the reason why remedial programs alone were found to be of no help for students at risk of failing.
The second part of the three pronged approach was aimed at helping eliminate any school – or outside-of-school-related stress/anxiety problems that can also often interfere with learning and test-taking capabilities. The SPC techniques played a part here also by helping to program in an automatic relaxation response in times of stress as well as stress-reducing positive attitudes. In later years the term "emotional intelligence" was coined to describe the importance of learning to effectively deal with anxiety and emotional problems in order to succeed in life [Goleman, 1995].
The third part of the program, the part especially geared for improving students' scholastic abilities, was made up of study, problem solving, and test-taking techniques, many of which were taken from Studying Effectively [Wrenn & Larsen, 1955].
Following from the theory, a basic theme underlying this three pronged approach was to provide as much immediate positive feedback as possible to increase the belief factor that much more. As previously indicated, the SPC techniques had built-in immediate positive feedback as recommended from the theory. And this same immediate feedback approached was followed with the other two components of the program thus further adding to the overall positive belief factor. For instance, the stress control biofeedback card (originally called the "Colorimeter") was used to immediately reinforce the relaxation response. And with regards to the learning skills section, I started with two memory techniques that provided immediate feedback: (a) The "numbers" technique where the students were amazed to see how quickly they could memorize a 23 digit number using grouping and association techniques; and (b) the "names" technique where the students were equally amazed to find out how easy it was to memorize the first names of all the students in the class using association techniques. These techniques in turn whetted the students' appetites for other even more practical techniques such as the "SQ3R" study technique which itself produced immediate positive results in the quizzes which quickly followed.
Another source of immediate feedback was the Progress Report, a form of journal I asked each student to keep. On the first page of the progress report they were to make a list of the goals they wanted to achieve and at the end of each week they were to look back and note down any positive results they had already achieved regarding these goals. And at the beginning of each class meeting I would ask for people to stand up and share any successes they had already achieved. This was especially helpful in getting through to those in the group who for whatever reason still found it hard to believe that SPC could produce results. [See pages 200-207 in Barrios, 1985 for examples of these student Progress Reports.]Similarities Between SPC and Bandura’s Self-Efficacy
What amazes me is how many similarities there are between my SPC approach to helping these students and Bandura's overall approach to building self efficacy. Bandura [1977, pp. 195-200] refers to four basic ways in which self-efficacy can be built: performance accomplishments, vicarious experience, verbal persuasion and physiological states. Let's look at each of these areas as it relates to some of the methods used in building the belief factor in the SPC program:Performance accomplishments
Examples of the use of positive performance accomplishments in the SPC program to build belief in oneself, to build self-efficacy, include:
Bandura's discussion of the use of modeled successful behavior to build self efficacy is similar to my having the students get up at the beginning of each SPC class and share their successes with the class. As Bandura puts it:
"Seeing others perform threatening [difficult] activities without adverse consequences can generate expectations in observance that they too will improve if they intensify and persist in their efforts. They persuade themselves that if others can do it, they should be able to achieve at least some improvement in performance."
One difference here is that Bandura is referring to actually seeing the other person perform the threatening or difficult task as what is helpful, whereas I am saying that hearing the person relating that he has successfully performed the task is also reinforcing.Verbal Persuasion
SPC is of course to a great extent founded on the potential power of verbal persuasion (in the form of hypnosis). However, although Bandura does acknowledge that suggestion can influence one's level of efficacy, he tends to downplay it a bit. As Bandura puts it:
"People are led, through suggestion into believing they can cope successfully with what has overwhelmed them in the past."
However, Bandura then goes on to say:
"Efficacy expectations induced in this manner are also likely to be weaker than those arising from one's own accomplishments... In the face of distressing threats and a long history of failure in coping with them, whatever mastery expectations are induced by suggestion can be readily extinguished by disconfirming experiences... Simply informing participants that they will or will not benefit from treatment does not mean that they necessarily believe what they are told, especially when it contradicts their other personal experiences."
Nowhere in his section on verbal persuasion does Bandura bring in the potential usefulness of hypnosis in making verbal persuasion more effective. But judging from the following statement of his, it would appear that he would agree that heightening the state of belief (e.g., via an effective hypnotic induction) would most likely make verbal persuasion more effective in building self-efficacy:
"The impact of verbal persuasion on self-efficacy may vary substantially depending on perceived credibility of the persuaders, their prestige, trustworthiness, expertise, assuredness. The more believable the source of information, the more likely are efficacy expectations to change."
There is one more important point that Bandura makes regarding the overall effectiveness of verbal persuasion at building self-efficacy:
"However, to raise by persuasion expectations of personal competence without arranging conditions to facilitate effective performance will more likely lead to failures that discredit the persuaders and further undermine the recipients; perceived self-efficacy."
This is of course why the SPC program for students also included giving them effective study, problem solving and test-taking techniques (with lots of immediate positive feedback) as well as a set of positive guidelines to life (originally supplied via the book Psychocybernetics [Maltz, 1972]).Emotional Arousal
Bandura definitely agrees with my pointing out the need of the students to effectively deal with anxiety and emotional problems if they are to succeed in school. The way he puts it is to say that self-efficacy level will definitely be affected by emotional or anxiety problems:
"Because high arousal usually debilitates performance, individuals are more likely to expect success when they are not beset by aversive arousal than if they are tense and viscerally agitated."Results of the Application of SPC in Education for Reducing Dropout
A total of 194 students took part in the study of East Los Angeles Community College (ELAC). There were 105 enrolled in my (SPC) Psychology 22 class (the experimental group) and 89 students taking the regular Psych 22 class (the control group) where only study skills were taught and by instructors other than myself. The two main dependent variables compared between the two groups were Dropout Rates and Grade Points (GPA x Units Completed) over a 1½ year period. During this period the dropout rate for the study-skills-only (control) group was a whopping 56% (not surprising considering Losak's 1972 finding). The dropout rate for the SPC class (the experimental group) was 16%. As for the grade points, there was an average increase of 3.80 grade points for the experimental group and an actual average 5.45 grade points decrease in the control group (also not surprising to Losak). The total difference of 9.25 grade points between the two groups was statistically significant at the .02 level [Barrios, 1973c].
There was also an interesting side benefit to the program in terms of reduced substance abuse and addictions (reduced habits of excess) amongst the students in the SPC classes. The following results were obtained from an anonymous questionnaire given to a total of 236 students at the end of the class (the above original 105 SPC students plus an additional 131 that took subsequent SPC classes). In those students indicating excess in the following areas these percentages cut down:
The interesting thing about this curtailment of excesses is that it occurred primarily as a side benefit of the program. No concentrated attack had been made on curtailing excesses. It is felt to have occurred mainly because of three major changes resulting from the program: the general increase in the ability to relax; the greater enjoyment of other areas of life; and the greater amount of self control. Most excesses or addictions can usually be traced to a deficit in one or more of these areas.
Corroborating the results achieved at ELAC were those achieved at UCLA in 1972 with 372 freshmen where the SPC program was introduced as part of an overall program to help minority students survive at UCLA. Interestingly enough, one of the students benefiting from this 1972 UCLA class, a former high school dropout prior to taking the class, recently became Mayor of Los Angeles and having seen first hand the benefits of the program has indicated plans to introduce the program to the Los Angeles School District as a means of reducing the current high dropout rate in the Los Angeles schools (55%).Welfare and Work Incentive Programs
The positive results achieved with incorporating SPC into work incentive programs to help get people off welfare [Barrios, 1985 pp.32, 208 & 209] tend to support a theory I have regarding welfare recipients:
"Many feel that people on welfare are just plain lazy malingerers and don't really want to work. I don't believe this. It's my theory that these people remain on welfare not because they want to but because their low self-image [self-efficacy] makes them feel incapable of anything else".
The essence of what the program can do for these people was captured by the comments of two CETA (Comprehensive Employment and Training Act) instructors who saw the results of what SPC was able to do for their students. First the comments of Maria-Luisa Lopez, CETA instructor in East Los Angeles. She stated that after much searching, she had at last found (in SPC) a means of dealing with the all important attitudes and fears of her students that had continued to plague her ability to get through to them. In her own words:
"In the past (prior to SPC exposure) many of our trainees who were sent out on interview by the staff Job Developer would not even show up, or if they did they projected a negative or insecure attitude and were rejected in many instances. Since SPC exposure, all have acquired a more positive, self-confident attitude which has helped them during the interview and subsequently while learning their duties as new employees. Of the 18 trainees I had in my class when I started using SPC, all have found jobs, ten of them completely on their own – something unheard of before as in the past those who had found work found it as a result of the Job Developer's efforts. Needless to say, I am completely sold on the SPC concept."
And, in the words of CETA counselor Suzanne Bourg in Pasadena California:
"After seeing the response of the students and hearing examples of their applications of Dr. Barrios's concepts and techniques, I feel strongly that this is an important part of job training that has never been previously recognized. CETA can train a person to obtain job skills, but if he has no self confidence, no sense of control over his own destiny, no previous pattern of success, he has great difficulty getting and holding down a job. It is this strategic area of Dr. Barrios's course which applies so directly to our CETA trainees."Industry
One can also see that there could also be positive use of SPC in industry. Inefficiency and absenteeism would be diminished. Work morale would be higher; there would be a definite lessening of friction among personnel; there'd be considerably less stress problems; absenteeism due to illness would be much less; all resulting in increased productivity. That such results are possible with SPC was borne out in a study done at Rockwell International and reported in the Journal of Employee Recreation, Health and Education [Barrios, 1975; see also Barrios 1985, pp.209-213].Medicine
"One can also see the possibilities of SPC in the area of medicine. Although no study has been done with the specific purpose of testing the effectiveness of SPC for improving health, one can see from many of the above reports as well as others scattered throughout the book that SPC can be considerably effective with such health problems as: high blood pressure, ulcers, arthritis, asthma, pain, headaches, insomnia, anxiety, depression, smoking, obesity, diabetes, alcoholism, heart disease and cancer."Drug Rehabilitation
As has already been reported, one of the side benefits of the SPC program for students was considerable reduction in a number of habits of excess or addictions including a number of different drug addictions. The following excerpt from Towards Greater Freedom and Happiness [Barrios, 1985, pp.214-216] will give you an idea of its effectiveness with hard-core drug addicts and alcoholics:
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