Misconception 4: Hypnosis is an unusual, abnormal, or artificial condition.

With a little thought, readers will be able to think of dozens of examples of spontaneously induced mental states that are highly similar or identical to a hypnotic trance. The common experience of daydreaming while commut ing to work or becoming completely absorbed in a book to the exclusion of everything else going on around you are common examples. There is a con dition called highway hypnosis, which is produced by a driver staring straight ahead on a monotonously straight road, possibly with the added influence of windshield wipers in steady operation. This phenomenon is probably responsible for an unknown number of highway accidents each year. Good human engineering of highways requires taking this phenomenon into account by providing enough turns in a road to break up the monotony of travel. A straight line may be the shortest distance between two points, but It Is not always the best roadway design. Other common examples of spon taneously induced trance states may be found in a person's staring at a television set or reading a book without noticing what he is watching or reading. Most members of a movie audience exhibit many of the characteristics of people in a hypnotic state.

Misconception 5: Hypnosis is a form of sleep.

There are several reasons for this common misconception. First, the word hypnosis Itself is a misnomer (Goldstein, 1982). It derives from Hypnus, the name of the Greek god of sleep. Second, the lack of facial expression and spontaneous movement coupled with slumping of the head or body fre quently seen in hypnotized people is suggestive of sleep. Last, many methods of induction make use of exhortations directing the subject to sleep. Indeed, it is possible to bore a subject to the point where he will actually fall into a real state of sleep instead of hypnosis.

In spite of the superficial similarity between a hypnotic trance and normal sleep, the two states are quite different (Evans, 1977, 1982). During stage 1 sleep (the phase in which vivid visual dreams are most common), the skel etal musculature is effectively paralyzed, and, thus, reflexes like the knee jerk are diminished. However, under hypnosis, there is no paralysis (unless sug gested), and there is no diminution of the basic reflexes or muscle tone.

Electroencephalograph (EEG) patterns are often said to be different for the hypnotic state and for sleep, but during stage 1 sleep, the EEG pattern is similar to the normal waking state except for the presence of rapid eye movements (REMs). Hence, stage 1 sleep is called arousal or paradoxical sleep. In stage 2, sleep spindles appear on the EEG record. Delta waves begin to appear in stage 3, becoming over 50% of the record by the deeper stage 4. None of these events occurs under hypnosis, where the EEG record is consistently similar to the waking state.

Misconception 6: The subject is under the control of the hypnotist and can be made to do things that he ordinarily would not do or to reveal secrets.

This misconception makes it difficult for some subjects to permit them-selves to be hypnotized because they fear loss of control. It is also the subject of much controversy and will be dealt with in more detail later. The weight of the evidence seems to support the notion that if a subject is directly re quested to do something that is objectionable to him, he will simply refuse to do it or in some cases "awaken" from the trance. On the other hand, It may be possible to get a subject to perform an act he would not normally do by deceiving him into believing a situation is different than it actually is. For example, he may be told that a person that he is being asked to attack It about to harm him.

All subjects should be informed prior to an induction that they will be In complete control; and if the hypnotist suggests anything that offends them, they will be free not to follow the suggestion. Such an instruction will allay the fears of the subject and will also serve to protect the hypnotist from charges of misconduct or of exercising undue influence over the subject. There is no legitimate reason in therapy why a subject would ever be asked to do some-thing repugnant to him. Indeed, one of the great advantages of a passive therapist is that he or she permits a patient to limit the production of anxiety-producing material to what the patient feels he can currently tolerate. This is a built-in safety valve. If the therapist is to make the decision about how much anxiety a patient can handle, he or she had better be an extremely good prognosticator or there is a risk of driving the patient out of therapy.

Although a hypnotist does not have complete control over a subject (and, in fact, if he or she did, hypnosis would be a dangerous procedure at best), the hypnotic state creates an atmosphere where suggestions, if ac ceptable to the subject, are more influential than they would be if the subject were not hypnotized. However, it must be kept in mind that people do influence the behavior of other people with words, whether their listeners are hypnotized or not. Although hypnosis does not produce a zombie-like de pendence on a hypnotist, words can be potent and have the power to cure or harm, whether the recipient is hypnotized or awake. The danger lies not in the hypnotic state but in the use made of it. If any method of psycho therapy has the potential to help a patient, it must necessarily also have the power to harm him if not competently handled.

As an example of the misuse of a valid psychological technique, the prac- tice of a certain industrial plant that utilized a psychological screening test to select its employees may be cited. An applicant had to have a certain personality profile on this instrument before being hired. The net result of this selection process was the hiring of an undue number of neurotic employees and the failure to hire many potentially productive people. The reason for this regrettable state of affairs was not that this particular test or psychological tests in general are not useful. In fact, it was a very good test; for if it caused the selection of neurotic candidates, it could just as readily have been used to exclude them. The real difficulty in this case was caused by the incom petent use of a valid test by an untrained personnel manager. The same is true in the case of many examples cited to show the dangers of hypnosis, which are really examples of the danger of its incompetent use.

Misconception 1: Hypnosis is a condition induced in the subject by the hypnotist.

This erroneous idea is the natural result of our use of English. We collo quially refer to hypnotizing subjects, and books are written and courses are given to train therapists and others "to hypnotize" subjects. Actually all hyp nosis is self-hypnosis in the sense that any effect produced, including the trance state itself, is produced by the concentration and imagination of the subject, not the operator. The real role of the hypnotist is to guide and teach the subject how to think and what to do to produce the desired result. The operator no more imposes this state on a subject than a teacher learns the content of a course for a student. Both teacher and hypnotist can only fa cilitate the efforts of the student or subject.

Once a trance state is induced, the hypnotist may seem to utilize it for whatever result is sought, but even in the area of trance utilization, whatever phenomena occur do so because of the imagination of the subject, not the operator. For this reason the term trance capacity is preferable to the more common term hypnotic susceptibility to refer to the likelihood of a given sub ject's achieving a given trance depth. The latter term implies that the subject is having the state imposed on him, while the former recognizes that the capacity to achieve a given trance level is an ability of the subject, not the operator.

This is not to imply that the hypnotist is not important or does not have to be highly skilled. Self-hypnosis is extremely difficult to achieve without help and training from an external hypnotist in the beginning. Even with experi ence in self-hypnosis, it is always easier to achieve and utilize the trance state with the help of an external operator.

Inexperienced subjects should always be advised that they, not the hyp notist, are responsible for producing whatever results are obtained. This will have the effect of taking the onus of any difficulty in induction away from the operator and preventing the subject from losing the confidence in the hypnotist's ability that is so essential to a successful induction. Also, it is the truth. Some feel it undermines the probability of success in the induction if the hypnotist uses such equivocal language as "We will try to hypnotize I you," or "We will see how deep a state you can attain." They believe that the hypnotist should always speak as though the induction is certain to be successful. If the responsibility for the success of the induction is placed fully on the subject, such unprofessional assurances of success are unnecessary. It is possible to reflect confidence in the subject's success by both word and manner without adopting the unwarranted behavior of a charlatan.

Misconception 2: A hypnotist must be a dynamic, forceful, or charismatic person.

Since the subject and not the hypnotist is ultimately responsible for the induction of the trance state, it follows that the abilities of the subject and his motivation for hypnosis are more important than the personality of the hyp notist—unless this personality is such that it is incompatible with the needs or expectations of the subject. Different subjects require different types of hypnotists or different techniques. Some subjects can respond successfully to a wide range of hypnotists; others may require a specific type of approach to be successful. Certainly if the hypnotist is personable and has a good rap-port with the subject, it is a positive factor. On the other hand, some out standing hypnotists are not very good speakers and often have poor diction or marked accents. These characteristics evidently do not interfere with their success.

Kroger (1977b) makes the point that hypnosis is a "prestige" type of phe nomenon and that it is the belief in the imminence of hypnosis that produces it. Hence, it is an advantage to a hypnotist to be known to the subject as an authority in the field or to have a title like "Doctor," for this will enhance the subject's expectations of success. For this reason, psychotherapists who use hypnosis frequently in their practice would do well to have their diplomas and degrees on exhibition in their office or waiting room.

Misconception 3: Hypnosis involves a battle of wills with the hypnotist, who needs a stronger will than the subject.

This is a common misconception of many subjects that probably came from watching old Bela Lugosi movies. Unless it is dispelled, it can make the induction of hypnosis difficult or impossible since the subject will see it is an admission of inferiority. If a subject comes to the therapist's office with the attitude that he is chal lenging the latter to be able to hypnotize him, he must be informed that there is no contest and if he chooses to resist hypnosis he will, of course, be suc cessful. He must be made to understand that the hypnotic state can be pro duced only with his active cooperation and help. Incidentally, it is possible to achieve a hypnotic state without the subject's being aware that he is being hypnotized. This can be done simply by avoiding the use of the words hypnosis or sleep in the induction procedure, or by saying that what the hypnotist is trying to do is get him to relax deeply. On the surface, this may seem as if the operator is unethically hypnotizing a sub ject without his consent, but bear in mind that no effect will occur unless the subject is willing to produce it. Such a procedure may be justified in the case of a patient who could profit from hypnosis but who cannot get over his fear of being hypnotized because of some unfounded ideas he has about it. A good question to ask at this point is whether there is any real difference be tween a deep state of relaxation as produced by the Jacobson method (see p. 66) and hypnosis? In other words, what is being suggested is that hypnosis often occurs in therapy when even the therapist does not consciously intend to produce it. In any event, this issue deals more with names than with reality. Not only is the ability to be hypnotized not a sign of a weak will, gullibility, or stupidity, but it in fact requires a good degree of intelligence in order to be able to concentrate and to think in the unfamiliar manner that the operator requests. Generally the author has found that bright people make good sub jects, and it is a good idea to so inform subjects prior to induction attempts.