FRANKEL'S HYPOTHESIS OF A RELATION BETWEEN PHOBIC SYMPTOMS

AND HYPNOTIC RESPONSIVENESS: ITS GENERALIZATION

TO AGORAPHOBIA

THESIS

Presented to the Graduate Council of the

North Texas State University in Partial

Fulfillment of the Requirements

For the Degree of

MASTER OF SCIENCE

By

Miles Winnette

Denton, Texas

May, 1987

IMMON .0 offialolwoo, I I -, " . :-Vi" . - - --- loop =-No III go I I

Winnette, Miles, Frankel's Hypothesis of a Relation

Between Phobic Symptoms and Hypnotic Responsiveness: Its

Generalization to Agoraphobia. Master of Science (Clinical

Psychology), May, 1987, 80 pp., 12 tables, references, 48

titles.

The present study was designed to test Frankel and

Orne's hypothesis that persons with a clinically significant

phobia also show high susceptibility to hypnosis. The

hypnotic susceptibility scores of 10 persons who sought

treatment with hypnosis for agoraphobia were compared with

the susceptibility scores of a control group of 20 persons

having comparable motivation to succeed in hypnosis. The

susceptibility measure was the Stanford Hypnotic

Susceptibility Scale: Form C (SHSS:C, Weitzenhoffer &

Hilgard, 1962). The groups were also compared on: a) the

Archaic Involvement Measure (AIM; Nash, 1984); b) the Field

Depth Inventory (FDI; Field, 1965); and c) the Tellegen

Absorption Scale (TAS; Tellegen & Atkinson, 1974).

No significant differences were found between the

groups on the dependent measures. Factors which qualify the

results are discussed.

TABLE OF CONTENTS

Page

LIST OF TABLES iv

FRANKEL'S HYPOTHESIS OF A RELATION BETWEEN PHOBIC SYMPTOMSAND HYPNOTIC RESPONSIVENESS: ITS GENERALIZATIONTO AGORAPHOBIA

Introduction . . . . . . . . .

Method- - a-- - . . .

Results- - - -

Discussion

APPENDICES

REFERENCES

1

22

32

37

46

74

iii

LIST OF TABLES

Table Page

1. Mean, Standard Deviation, and Range for Each Group onthe SHSS:C, the AIM, the TAS, and the FDI . . . . 48

2. Product-Moment Correlations Between Age and Years ofEducation and each of the Four Dependent Measures--TheSHSS:C, the AIM, the TAS, and the FDI . . . . . 49

3. An Analysis of Covariance Comparing the Groupson Hypnotic Susceptibility with Years of Education asthe Covariate . . . . . . . . . . 49

4. Mean, Standard Deviation and Range for Each Group forthe Number of Fears Acknowledged on the FQ at or AboveLevel 4--"Definitely Avoid It", and for the Number ofScored Items on the PSY Scale . . . . . . . . 50

5. Mean, Standard Deviation, and Range for EachGroup for Age and Years of Education . . . . . 50

6. Mean, Standard Deviation, and Range for theOverall Sample for Age and Years of Education . . 51

7. Frequencies and Percentages for Categories basedon Gender, Marital Status, and Experience withHypnosis for Each Group . - . . . . . . . . 51

8. Frequencies and Percentages for Categories basedon Gender, Marital Status, and Experience withHypnosis for the Overall Sample . . . . . . . 52

9. Pearson Product-Moment Correlations Between theDependent Measures--The SHSS:C, the AIM, the TAS,and the FDI - - - - - - - - . . . . . 52

10. An Analysis of Covariance Comparing the Groups onHypnotic Susceptibility with the PSY Scale Scoresas the Covariate . . . . . . . . . . . 53

11. Pearson Product-Moment Correlations Between theDependent Measures--The SHSS:C, the AIM, the TAS,and the FDI for the Control Group . . . . . . 53

iv

List of Tables--Cont.

12. Pearson Product-Moment Correlations Between theDependent Measures--The SHSS:C, the AIM, the TAS,and the FDI for the Experimental Group . . . 43

V

"Aw

Page

FRANKEL'S HYPOTHESIS OF A RELATION BETWEEN PHOBIC

SYMPTOMS AND HYPNOTIC RESPONSIVENESS: ITS

GENERALIZATION TO AGORAPHOBIA

Since the 1960's reliable standardized scales have been

available to measure the behavior and experience considered

typical of hypnotized subjects. Using these scales,

researchers have established that hypnotic susceptibility is

normally distributed in the general population (Hilgard,

1965). Hypnotic susceptibility has also proved consistent

enough to be considered a stable trait (Morgan, Johnson, &

Hilgard, 1974). It is remarkable, therefore, that hypnotic

susceptibility has not been found to be associated with any

particular personality style as measured by such tests as the

Rorschach and the MMPI (Shor, Orne, & O'Connell, 1966). In

view of the failure to find personality correlates to

hypnotic susceptibility, it is surprising that Frankel and

Orne (1976) found a relationship between phobia and hypnotic

susceptibility. The impetus for their study and their

results and conclusions are described below.

Frankel (1976) noted similarities in patients' reports

of the subjective experience of phobia and that of hypnosis.

These similarities include subjective experiences in which

(a) attention narrows to particular thoughts or sensations,

and a larger orientation or awareness of the world (the

1

2

generalized reality orientation) fades (Frankel, 1980),

(b) perceptions of bodily sensations and the environment

are altered and distorted (Frankel, 1978), (c) images and

fantasies become so vivid as to be confused with the world

outside (Frankel, 1976), (d) there is dissociation, or a

split between the observing and experiencing ego, during

which the subject observes herself/himself as if at a

distance, (e) thought and behavior are experienced as

outside one's control, and (f) there is realization of

logical inconsistencies, yet they go unchallenged and the

experience continues (Frankel, 1980).

These similarities suggested to Frankel that there was

an association between phobic symptoms and hypnotizability.

In order to test this hypothesis, Frankel and Orne (1976)

administered either the Stanford Hypnotic Susceptibility

Scale: Form A (SHSS:A, Wietzenhoffer & Hilgard, 1959) or

the Harvard Group Scale of Hypnotic Susceptibility (HGS,

Shor & Orne, 1962) to 24 consecutive phobic patients

applying for treatment with hypnosis. These subjects were

matched with a control group of 24 persons seeking hypnosis

for tobacco addiction. The smokers were not psychiatric

patients and were assumed to have motivation to succeed in

hypnosis similar to that of the phobic group.

On a 13 point scale (0-12) for the SHSS:A and for the

HGS, the mean for phobics was significantly higher than the

mean for smokers (8.08 versus 6.08, respectively).

3

Polyphobics had a significantly higher mean than

monophobics (8.153 versus 7.00, respectively). Frankel and

Orne consider the latter finding to be a further link

between the occurrence of phobic symptoms and

hypnotizability. Scores on the SHSS:A or the HGS were

classified so that 8-12 was considered high susceptible, 5-

7 medium susceptible, and 0-4 low susceptible. Frankel and

Orne found that 57 percent in the phobic group were high

susceptible and 42 percent were medium susceptible. No

phobics scored in the low range of susceptibility. The

corresponding percentages for the control group were 38

percent high susceptible, 33 percent medium susceptible,

and 29 percent low susceptible. A Chi-square analysis

revealed that a significantly greater percent of phobics

scored in the high end of the distribution of hypnotic

susceptibility. These findings support the theory of an

association between phobia and hypnotic responsiveness.

Current research has sought to replicate and extend the

findings of Frankel and Orne. These studies are reviewed

below.

Gerschmann, Burrows, Reade, and Foenander (1979)

studied a sample of the first 40 consecutive persons

receiving hypnotherapy for dental phobia. The Diagnostic

Rating Scale (DRS; Orne & O'Connell, 1957, cited in

Gerschmann et. al.) was used to assess susceptibility. It

was found that 48 percent of the phobics were high

4

susceptible, 35 percent medium susceptible, and 18 percent

low susceptible. The corresponding percentages estimated

for a normative sample were 20 percent high susceptible, 60

percent medium susceptible, and 20 percent low susceptible.

A Chi-square analysis indicated that the percent of high

susceptibles was significantly higher in the phobic group.

However, Frischolz, Spiegel, Spiegel, Balma, and

Markell (1982) note that any conclusions drawn from these

findings are limited by the fact that norms for the DRS

have not been determined. In any case, it is a

questionable strategy in this research to compare a

clinical sample with a normal population as variation due

to subject motivation and experimental context is not

controlled. Also, no indication is given as to when the

phobic sample was assessed for susceptibility--before or

after treatment with hypnosis.

Foenander, Burrows, Gerschmann, and Horne (1980)

carried out a further test of Frankel's hypothesis of the

relation between phobic behavior and hypnotizability. The

subjects were 33 persons consecutively referred by medical

practitioners for treatment of phobic symptoms. Using

Frankel's classification, given above, the phobics'

distribution of susceptibility scores on the HGS was 45.55

percent high susceptible, 48.5 percent medium susceptible,

and 6 percent low susceptible. This distribution was

compared to the expected frequencies for the general

5

population which are 20 percent high susceptible, 60

percent medium susceptible, and 20 percent low susceptible.

Chi-square analysis revealed that the distribution of

susceptibility scores in the phobic group was significantly

different from that expected in the general population.

The direction of the difference was in accord with

Frankel's hypothesis. In contrast to Frankel and Orne,

however, Foenander et al. found that monophobics were

significantly more hypnotizable than polyphobics, and they

found a negative correlation between hypnotizability and

phobic behavior. The authors account for these

contradictions by suggesting that severity and type of

phobia interact to influence susceptibility scores.

The study concludes with a caution that before future

researchers draw definite conclusions regarding the

relation between phobia and hypnotizability, they should

use larger samples and more reliable methods for measuring

the type and severity of phobic behavior. As in the

.Gerschmann et al. study (1979), the internal validity of

this study is reduced because the authors do not control

for variation between groups which may arise from

differences in subject motivation and in the context in

which susceptibility was measured.

Frischolz et al. (1982) also examined the association

between phobias and hypnotic susceptibility. In addition,

they expanded their inquiry in an effort to test Frankel's

6

theory (1976) that phobics, and other high susceptible

subjects, possess a unique type of cognitive functioning

which allows greater responsiveness to stimuli such as

those involved in a hypnotic induction. Frankel and Orne

(1976) have described this functioning as a mental process

in which fantasy becomes so real as to be confused with the

external world. Frischolz et al. noted that the latter

description of this mental process was similar to accounts

of absorption. Tellegen and Atkinson (1974), for example,

described absorption as a personality trait or disposition

for having episodes of total attention that fully engage

one's representational resources. The latter authors

believe that this kind of functioning results -in a

heightened sense of the reality of the attentional object,

imperviousness to distracting events, and an altered sense

of reality in general. To measure absorption, Tellegen

devised the Tellegen Absorption Scale (TAS; Tellegen,

1976), a self-report measure of subjects' trance

experiences outside hypnosis. Frishcholz et al. employed

the TAS in their study. They reasoned that if phobics and

other high susceptible subjects were found to have

significantly more trance experiences outside hypnosis than

controls, then these results would support the idea that

the association between phobia and hypnotic susceptibility

might be the result of a cognitive process unique to highly

susceptible subjects. Frischolz et al. used the Induction

-;-mw

7

(IND) of the Hypnotic Induction Profile (HIP; Spiegel &

Spiegel, 1978) to measure hypnotic susceptibility.

Subjects were 95 phobics (54 polyphobics, 41

monophobics), 226 smokers, and 65 chronic pain patients.

Their scores were compared using a one-way ANCOVA with

symptom category as the independent variable and age as the

covariate. Age was used as a covariate because the mean

age of subjects was close to 45 years and hypnotic

susceptibility is believed to decline after the mid-

thirties. The hypothesis that phobics are high susceptible

and readily experience trance phenomena outside hypnosis

was not confirmed as no significant differences were found

between groups either on the IND or on the TAS. The mean

susceptibility scores for the polyphobics, monophobics and

smokers were 6.65, 6.61, and 6.61, respectively.

Unfortunately the authors did not indicate the range of

susceptibility scores for the IND scale.

It should be noted that there are methodological

problems which cast doubt on the validity of this study's

findings. First, the hypnotist was not blind to the

subject's group. Second, the IND is based on a multiple

scoring of the single test of arm levitation so that much

information about the subjects' hypnotic ability is lost,

and the scores lose predictive value (Hilgard & Hilgard,

1979). More germane to the present discussion,

correlations of the HIP Induction scores with scores from

8

the SHSS:A and the SHSS:C (Stanford Hypnotic Susceptibility

Scale: Form C; Weitzenhoffer & Hilgard, 1962) indicate

that only a small positive relation exists between these

measures. It is unlikely, therefore, that similar traits

are being measured by the HIP and the Stanford Scales

(Hilgard & HIlgard, 1979; Orne, Spiegel, Spiegel, Crawford,

Evans, Orne, & Frischolz, 1979). Finally, John, Hollander,

and Perry (1983) comment that the findings of this study

may be due to a "floor" effect, that is, the mean age for

each subject group exceeded 40 years, and hypnotic

susceptibility has been shown to decline in the mid-

thirties. These authors conclude that perhaps there was

not enough susceptibility left among the subjects to show a

difference.

John et al. attempted to improve on the Frischolz et

al. study by using the Stanford Scales, which allow

comparison with Frankel's results. As an additional means

of evaluating the response of the phobic sample, these

authors made an item analysis comparing the phobic pass

percentage with the item difficulty in a normative sample.

They also limited age effects by using phobics with a mean

age close to 30.

Fifty-four female small-animal phobics participated in

a treatment program designed to alleviate phobics'

symptoms. The first twenty volunteers from this group were

individually tested in small groups of 8-20 women using the

9

same tape-recorded HGS:A. Fifty-five percent of the

phobics were high susceptible, 20 percent were medium

susceptible, and 25 percent scored in the low range of

susceptibility. The corresponding percentages in the

normative sample were 29.4 percent high susceptible, 24.4

pecent medium susceptible, and 46.2 percent low

susceptible. A Chi-square analysis indicated that the

percent of high susceptibles was significantly higher in

the phobic group than in the normative sample. Increases

in item difficulty in the normative sample were accompanied

by increases in pass percentages in the phobic group,

although pass percentages were significantly different only

on items 2 and 10. The authors acknowledge that they did

not control for differences in recruitment method, context,

and samples under consideration. The study also did not

report whether hypnosis was used in the phobics' therapy.

In another study, Kelly (1984) assessed the hypnotic

susceptibility of patients seeking hypnotherapy. Of 134

patients, 22 sought hypnosis for phobias, and 112 sought

hypnosis for a variety of other complaints--most often

obesity, smoking, pain, or anxiety. Subjects' hypnotic

susceptibility was assessed on one of three measures: the

SHSS:A, the HIP, or the Stanford Hypnotic Clinical Scale

(SHCS; Morgan & HIlgard, 1975). Kelly found that 79

percent of the phobics were high susceptible, and 21

percent medium susceptible. No phobics scored in the low

10

range of susceptibility. The corresponding percentages in

the control group were 33 percent high susceptible, 48

percent medium susceptible, and 19 percent low susceptible.

A Chi-square analysis revealed that a significantly greater

percent of phobics than controls scored in the high range

of susceptibility. There are problems with this study,

however. First, subjects' scores were combined across

measures of susceptibility even though correlational

studies indicate that these scales do not measure the same

traits (Hilgard & Hilgard, 1979). Second, patient

evaluations and assessment of susceptibility were carried

out by the author alone. The latter procedure sharply

reduces the external validity of the study.

In summary, although methodological difficulties

cannot be ignored, five of the six studies to date have

indicated that phobic subjects are more susceptible to

hypnosis than controls. The present study will test the

relationship between hypnotic responsiveness and a

specific type of phobia: agoraphobia. Agoraphobia is

characterized by multiple phobias and by avoidance which

greatly reduces the individual's range of activities.

Frankel and Orne propose that the mental functioning which

produces such phobic symptoms is also responsible for

susceptibility to trance experiences. Thus, if Frankel and

Orne are correct, then the number of phobias and their

severity among agoraphobics leads us to expect that

11

agoraphobics will demonstrate considerable capacity for

this kind of mental functioning. Such well-developed

capacities should be apparent in measures of susceptibility

to hypnosis, and in measures of hypnotic depth and trance

experiences outside hypnosis. Therefore, the use of

agoraphobics in this study seems to offer the possibility

of a substantial test of Frankel and Orne's theory through

extending that theory to the complex polyphobic disorder of

agoraphobia

Epidemiology of Agoraphobia

Agoraphobia is the most disabling and distressing of

the phobic disorders, which account for two to three

percent of all psychiatric diagnoses. The distress and

extensive interference with normal activities imposed by

agoraphobia may explain why agoraphobics constitute 8

percent of the phobics at large, but make up 50 percent of

the phobics in treatment (Marks, 1969; Agras, Sylvester, &

Oliveau, 1969). Extrapolating from the incidence in a

Vermont community (6.3/1000), 1.25 million Americans suffer

from this problem (Agras et al.). Surveys indicate that

2/3 or more agoraphobics are women, the majority of whom

are married. Symptoms appear in young adults between ages

18-35, with peak ages of onset at approximately age 20 and

between ages 30-35.

12

Clinical Description

The most consistent symptom of the disorder is a

typical cluster of phobias which appear in varying

combination in any individual case. Thorpe and Burns

(1983) describe the following components: (a) Fear of

environmental situations such as (1) public places (e.g.

streets, shops, crowds), (2) enclosed spaces (e.g.

theatres, churches, elevators), (3) travel on public

transport (e.g. trains, buses, or planes), (4) travel over

bridges or into tunnels, and (5) being home alone; and

(b) fear of confinement or restriction of movement in

situations which seemingly offer no line of escape, such as

sitting in a barber's or a dentist's chair, standing in

line, sitting in a bus, or talking to a neighbor.

Onaet

The distinguishing feature of the onset of agoraphobia

is spontaneous panic attacks, which are followed by

anticipatory anxiety and phobic avoidance (Chambless &

Goldstein, 1980a; Liebowitz & Klein, 1979). The attacks

often have no clear precipitant, though it is not unusual

for agoraphobics to have a history of generalized anxiety

(Snaith, 1968). Symptoms which occur during an attack may

include feelings of unreality, the heart pounding rapidly

and heavily, generalized sweating particularly in the

palms, dryness in the mouth, feeling as if there were a

lump in the throat, stiffness in the back or neck, chest

13

pain or discomfort, trembling or shaking, feeling faint, a

choking or smothering sensation, dizziness, feeling as if

one's surroundings are whirling about, nausea or diarrhea,

and a strong urge to run or scream.

Though unexplained panics occur in social phobias and

other anxiety disorders, agoraphobics may be distinguished

by the specific consequences which they fear will occur if

they panic. These consequences include fear of losing

control, becoming confused, becoming mentally ill, having a

heart attack, being unable to reach a place of safety,

fainting in public, or being surrounded by unsympathetic

onlookers. One can link the clinical description of

agoraphobia to its onset by noting that the situations for

which agoraphobics develop phobias are ones in which it may

be difficult for them to reach a place of safety or trusted

others if a panic attack occurs. These situations often

include the possibility of being surrounded by strangers

who will not understand or accept the agoraphobic should

she/he panic.

.CUra

Following the initial panic attack, agoraphobics are

said to develop a "fear of fear", that is, they become

anxious about feeling anxious. This is because they

believe that the mental and physical symptoms of anxiety

will lead to much worse consequences. In a self-

perpetuating cycle, agoraphobics become hypervigilant to

14

anxiety cues, exaggerate the significance of bodily

sensations, and anticipate the onset of anxiety, all of

which increase the likelihood that they will experience

anxiety. In fact, many agoraphobics experience panic at

times other than on exposure to a circumscribed phobic

stimulus. Chambless (1985) has suggested that agoraphobics

may become phobic of certain physiological sensations

associated with anxiety.

Thus the problem of panic is central to the

understanding of agoraphobia. These attacks are highly

noxious unconditioned stimuli. Places, thoughts, and

feelings associated with panic quickly become anxiety

provoking themselves (Chambless, 1985). Through a process

of generalization from initial panic attacks, the disorder

may ultimately result in a housebound person who is

dependent on others for even the smallest venture outside

home. According to Marks (1969), many cases may be

shortlived, but if the phobia is untreated and persists

over a year, complete remission is unlikely.

In a national survey (Thorpe & Burns, 1983), 89.5

percent of agoraphobics reported that their symptoms

fluctuate from relapse to partial remission on a daily

basis. Also, many agoraphobics can more comfortably enter

a feared situation if they carry a certain object which

reassures them.

4".'

15

Diagnosis

Thorpe and Burns (1983) report it is conventional to

diagnose agoraphobia if the major presenting features are:

fear of leaving home, fear of crowds, confined places, and

public transport, and fear of fear. Liebowitz and Klein

(1979) point out that agoraphobia may be distinguished from

Generalized Anxiety Disorder and Panic Disorder by its

characteristic feature of avoidance of many situations due

to anticipation of panic attacks. Presence of marital

discord, low self-sufficiency, and a tendency to deal with

interpersonal conflict indirectly is said to further

substantiate the diagnosis (Thorpe & Burns, 1983) . In

addition, phobic disorders need to be differentiated from

phobic symptoms which are a minor accompaniment of another

major psychiatric disturbance. DSM III cites the following

diagnostic criteria:

(A) The individual has a marked fear of and thus

avoids being alone or in public places from which

escape might be difficult or help not available

in case of sudden incapacitation, e.g., crowds,

tunnels, bridges, public transportation.

(B) There is increasing constriction of normal

activities until the fears or avoidance behavior

dominate the individual's life.

(C) Not due to a Major Depressive Episode, Obsessive-

Compulsive Disorder, Paranoid Personality

16

Disorder, or Schizophrenia (DSM III, 1980,

p.227).

Other Complaints

Agoraphobia commonly presents in the context of

several additional complaints including depression and

interpersonal problems. For example, Buglass, Clarke,

Henderson, Kreitman, and Presley (1977) found that 93

percent of the 30 agoraphobic housewives they studied

suffered from fears and phobias apart from agoraphobia.

Fear of heights and fear of enclosed spaces were the most

common. Eighty percent of the 30 agoraphobic housewives in

Buglass et al. (1977) typically experienced free-floating

anxiety, regardless of the immediate situation. The

anxiety may be constant or may fluctuate for no apparent

reason. In the 90 phobic cases Shafar (1976) reviewed, 75

percent of the agoraphobics exhibited personality traits

harmful to the subjects' social and marital adjustment.

Nearly 1/3 of agoraphobic housewives were conspicuous for

their high level of neurotic symptoms of all kinds, and a

similar percent of cases exhibited depression (Buglass et

al., 1977).

Fifty-three percent of Buglass' subjects gave

responses indicative of hypochondriasis, though most

recognized that their symptoms were irrational. Harper and

Roth (1962) reported that 37 percent of their subjects

experienced depersonalization, that is, feeling temporarily

17

strange, unreal, dreamlike, or far away from the

environment. Briefly, the agoraphobic can be expected to

present with (a) avoidance of clearly defined situations

which have the characteristic elements of distance from a

safe person or place, crowds, and/or confinement, (b)

several additional phobic disorders, and (c) a wide range

of non-phobic symptoms including free-floating anxiety,

interpersonal conflict, and depression.

Pro lem

In studies of the relationship between hypnotic

susceptibility and phobia, researchers have used samples

composed either of a variety of different types of phobias,

or composed of a single type of simple phobia. Thus, the

question remains whether the relation between hypnotic

susceptibility and phobia can be generalized to polyphobic

disorders. Furthermore, researchers have relied primarily

on behavioral measures when testing for a relationship

between phobia and hypnotic responsiveness. Consequently,

it has not been confirmed that the relationship between

phobia and hypnotic responsiveness is also evident in the

subjective experience of the hypnotic subject. Moreover,

though there is not a consensus in the literature, several

authors (Goldstein & Chambless, 1978; Chambless &

Goldstein, 1980b; Thorpe & Burns, 1983) have described

agoraphobics as very dependent people who perceive

themselves as incapable of functioning without someone to

18

take care of them. It therefore seems likely that

agoraphobics, more than controls, would exhibit a

regressive and dependent mode of relating to the hypnotist.

Finally, Frankel and Orne believe that their findings

lend empirical support to the theory that phobics and high

susceptible subjects share a predisposition for hypnotic-

like experiences. Thus, in addition to responsiveness

during hypnosis, phobics and high susceptible subjects may

share certain traits during the waking state. For example,

Shor (1980) found that individuals with a high or medium

capacity to experience trance in hypnosis also experience

spontaneous trance-like episodes in their daily lives. If

the capacity for these experiences is related to the trait

which produces hypnotic responsiveness, then phobics could

be expected to have such experiences also.

In fact, Frankel and Orne propose that phobic symptoms

originate from spontaneous trance experiences. Phobic

symptoms are said to be generated in the following manner.

Individuals who have a capacity to readily experience

trance attempt to cope with anxiety by spontaneously

entering a trance state. This escape into trance

backfires, however, because the trance produces perceptual

distortions which actually heighten the individual's

anxiety. These cognitive distortions, and the increase in

anxiety that accompanies them, are now both associated with

the stimuli that first led the individual to feel anxious.

19

As a result, these stimuli are now feared and avoided to

such an exaggerated degree that the individual's behavior

in regard to these stimuli would be labelled "phobic" by an

objective observer.

The hypothesis that a capacity for spontaneous trance

experience plays a central role in the development of

phobic symptoms has received little attention in the

research literature however. Frischolz et al. (1982) are

the only authors who have examined phobics' experience of

trance phenomena outside hypnosis. They found no

difference between phobics and controls in the number of

different forms of spontaneous trance experience each

reported having.

Purpose

The purpose of the present study was to replicate and

extend Frankel and Orne's finding that phobics are markedly

responsive to hypnosis. First, the hypnotic

susceptibility of agoraphobics was compared to that of

control subjects seeking treatment with hypnosis for

tobacco addiction or for weight control, to see if the

relationship between hypnotic responsiveness and phobia can

be generalized to this polyphobic disorder. Second, the

trance depth of agoraphobics and controls was compared to

determine if the relationship between hypnotic

responsiveness and phobia was evident in the subjective

experience of the experimental subjects. Third,

20

agoraphobics and controls were compared on the extent to

which regressive or transference needs were projected onto

the hypnotist.

Fourth, agoraphobics and controls were compared to

ascertain if agoraphobics have more types of trance

experiences outside hypnosis. If agoraphobics have

significantly more of these experiences, and they are

highly susceptible to hypnosis, it would support the theory

that they possess a trait which may be related to hypnotic

responsiveness. Last, the present study avoids the

methodological errors of past replications by using a

comparable control group, and a standard measure of

hypnotic susceptibility. The study also controls for the

effects of age, sex, education, previous experience with

hypnosis, level of pathology, and type of phobia.

Research Ouestion

Are agoraphobics more susceptible to hypnosis than a

comparable control group?

Means of Assessment. Subjects were administered the

Stanford Hypnotic Susceptibility Scale: Form C (SHSS:C;

Weitzenhoffer & Hilgard, 1962).

Research Hypothesis. The mean hypnotic susceptibility

score for agoraphobics will be significantly greater than

the mean susceptibility score for controls.

21

Research Question

Do agoraphobics experience greater trance depth in

hypnosis than controls? In other words, do agoraphobics

report having experienced in hypnosis more of the kinds of

subjective experiences which are considered typical of

hypnotized persons?

Means of Assessment. Subjects were administered the

Field Depth Inventory (FDI; Field, 1965) .

Research Hypothesis. The mean FDI score for

agoraphobics will be significantly greater than the mean

FDI score for controls.

Research Ouestion

Do agoraphobics experience more archaic involvement

with the hypnotist during hypnosis? Archaic involvement is

a temporary displacement, or transference, onto the

hypnotist of ". . . core personality emotive attitudes

formed in early life . . ." (Shor, 1962, p.162).

Means of Assessment. Subjects were administered the

Archaic Involvement Measure (AIM; Nash, 1984).

Research Hypothesis. The mean AIM score for

agoraphobics will be greater than the mean AIM score for

controls.

Research Ouestion

Do agoraphobics experience more forms of spontaneous

trance outside hypnosis?

22

Means of Assessment. Subjects were administered the

Tellegen Absorption Scale (TAS; Tellegen, 1976).

Research Hypothesis. The mean TAS score for

agoraphobics will be greater than the mean TAS score for

controls.

Method

Subjects

A total of 30 subjects were used in the study. Ten

were selected from clients seeking treatment with hypnosis

for agoraphobia. The other 20 subjects were selected from

non-phobic clients seeking treatment with hypnosis either

for tobacco addiction (1) , or for weight control (19).

The non-phobic clients were to provide a control group

comparable to the agoraphobic group in demographic features

and in motivation to succeed in hypnosis. Subjects were

recruited from treatment groups within community agencies.

The Psychopathology scale (PSY, Overall & Eiland,

1982) was used to screen all the subjects for severe

psychopathology. The PSY scale consists of 58 items taken

from the first 168 items of the MMPI. These 58 items were

chosen because they showed the greatest difference in

frequency of endorsement between medical school applicants

and psychiatric patients. The cut-off for severe

psychopathology on the PSY scale was a T-score of 70 which

represents the 98th percentile of the 731 medical school

applicants on whom the scale was normed. This means that

23

any control subject who endorsed more than 25 of the 58 PSY

scale items, that is, any control subject with a T-score

above 70, was excluded from the study. However, seven

agoraphobic subjects exceeded the cut-off point by anywhere

from 1 to 8 scored items. These subjects were allowed in

the study if the total number of fears they acknowledged at

or above Level 4 did not exceed twice the number of

agoraphobic fears they acknowledged at or above Level 4 on

the FQ. Thus, agoraphobic fears could be assumed to play a

major part in their symptomatology. The rationale for the

inclusion of these subjects is that it is consistent with

the current literature on this disorder that the majority

of the agoraphobic sample had PSY scale scores indicative

of severe pathology.

An abbreviated form of the Anxiety Disorders Interview

Schedule (ADIS; Dinardo, O'Brien, Barlow, Waddell, &

Blanchard, 1982) was employed to select subjects from the

agoraphobic sample who met DSM III criteria for

agoraphobia. The ADIS provides a detailed examination of

phobic symptoms. The Fear Questionaire (FQ; Marks, 1979)

was also used to test for the specific fears, phobic

avoidance, and extensive interference with everyday life

which characterize agoraphobia.

The FQ includes a list of the 15 most common phobic

stimuli. These 15 stimuli are to be rated on a 9 -point

scale (0-8) for the degree of avoidance associated with

24

each. Ratings on the scale range from 0--"would not avoid

it" to 8 -- "always avoid it." Based on data from factor

analytic studies of fear surveys, Marks (1979) proposed an

Agoraphobia Subscore consisting of 5 of the above 15 phobic

stimuli. These five items are: #5--traveling alone by

bus, #6--walking alone on busy streets, #8--going into

crowded shops, #12 --going alone far from home, and #15--

large open spaces. The items in the Agoraphobia Subscore

were used to further substantiate the diagnosis of

agoraphobia. To be included in the study, agoraphobics had

to acknowledge three or more of these five items at or

above Level 4 --"definitely avoid it" on the avoidance

scale. The final item on the FQ is a Likert-type scale onwhich subjects rate the degree of disturbance or disability

associated with their phobic symptoms. This is a 9 -point

scale (0-8) which lists increasing degrees of severity from

0--"no phobias present," to 8--"very severely

disturbing/disabling." Any agoraphobic subject who rated

the degree of their disturbance or disability less than

Level 4 -- "definitely disturbing/disabling, "was excluded

from the study. Finally, on the demographic questionnaire

agoraphobics had to report that the duration of their

phobic symptoms exceeded one year. If not, they were

excluded from the study.

The FQ was also used to screen the control group for

the presence of phobia. Phobia is defined here as rating

25

the degree of disturbance or disability associated with any

phobic-like symptoms at or above Level 4--"definitely

disturbing/disabling" on the final FQ item. The criteria

for subject selection are summarized in appendices A and B.

Instruments

Demographic Ouestionnaire. Both groups were

administered a questionnaire in order to confirm that they

were comparable on relevant demographic variables.

Information was collected on the following areas: marital

status, age, sex, income, education, duration of present

symptoms, previous experience with hypnosis, and use of

medication

Diagnostic Interview. An advanced graduate student

in psychology conducted a brief, 10 minute interview with

each agoraphobic subject. An abbreviated form of the

Anxiety Disorders Interview Schedule (ADIS; Dinardo et

al., 1982) was used to determine that these subjects met

DSM III criteria for agoraphobia.

Using excerpts from the ADIS, the interviewer obtained

a brief description of the subject's presenting complaint

and checked for the presence of phobic anxiety and panic

attacks. The interviewer asked the subject questions

regarding: any extremely stressful or traumatic event

currently affecting the client, fear or avoidance of

situations because the client might be unable to leave in

case of panic, fear/avoidance of situations in which the

26

client might be humiliated in front of others, recurrent

unreasonable or nonsensical thoughts or images, symptoms of

major depressive episode or mania, and drug abuse. Such

information allowed the interviewer to make a differential

diagnosis between agoraphobia and related anxiety

disorders, such as Social Phobia, Panic Disorder, and

Generalized Anxiety Disorder. In addition, the procedure

allowed the examiner to rule out Major Depression,

Schizophrenia, Organic Brain Syndrome, Substance Abuse,

Obsessive-Compulsive Disorder, Paranoid Personality

Disorder, and other disorders whose symptoms may resemble

those of agoraphobia.

Stanford Hypnotic Susceptibility Scale: Form C., The

Stanford Hypnotic Susceptibility Scale: Form C (SHSS:C;

Weitzenhoffer & Hilgard, 1962) was used to assess hypnotic

susceptibility. It provided an index of subjects' unique

hypnotic abilities and provided a rigorous test of

differences in susceptibility between the agoraphobic and

the control group. It is a 12-item test with possible

scores from 0-12. Subjects' scores are classified so that

scores from 8-12 are considered high susceptible, from 5-7,

medium susceptible; and from 0-4, low susceptible.

Susceptibility is defined by the number of times the

subjects act like a hypnotized person when hypnosis is

induced by a standard procedure, and opportunities to react

are presented in a standard manner. Using the Kuder-

27

Richardson Method (Formula 20), the reliability of the

SHSS:C was estimated at .85 (Weitzenhoffer & Hilgard,

1962).

It is appropriate here to point out how the SHSS:C is

related to the Stanford Scale, the SHSS:A, which Frankel

and Orne (1976) used in their phobia research. Hilgard

(1979) has stated that the Stanford Hypnotic Susceptibility

Scale: Form A (SHSS:A; Weitzenhoffer & Hilgard, 1959) is

a standard against which other scales can be judged due to

its demonstrated reliability and validity. One shortcoming

.of this scale, however, is that it is primarily weighted

with tests of motor functions. Therefore, Weitzenhoffer &

Hilgard (1962) designed the SHSS:C to better represent

cognitive functions. Several items on the SHSS:A were thus

replaced by items which include: age-regression, hypnotic

dreaming, and positive and negative hallucinations in

several sensory areas (vision, audition, taste, and smell).

The SHSS:C is believed to measure the same ability as the

SHSS:A because total scores on the SHSS:C correlate .72

with those of the SHSS:A. In addition, their score

distributions are very similar, though the distribution of

the SHSS:C is positively skewed due to the difficulty of

the SHSS:C items.

Field Depth Inventory. The Field Depth Inventory

(FDI; Field, 1965) was used to measure subjective changes

during hypnosis. The inventory consists of true-false

128

items which are believed to reflect the typical experiences

of hypnotized subjects. From a pool of 300 items, Field

chose those 38 which correlated significantly with the

Harvard Group Scale (HGS; Shore & Orne, 1962). The odd-

even reliability of the 38 items, as corrected by the

Spearman-Brown Prophecy formula, is .915. The Pearson r

concurrent validity coefficient between HGS and the 38

items is .745. In a cross validation by the author, the

retest reliability of the inventory was .87. The validity

coefficient was .43 in the replicaton . The range of

possible scores on the inventory is from 0-38.

Archaic Involvement Measure, The Archaic Involvement

Measure (AIM; Nash, 1984) was used to assess the extent to

which the hypnotic subjects projected "transference-like"

modes of relating onto the hypnotic relationship. Twenty

items were adapted from Shor's (1979, cited in Nash, 1984)

description of subjects' reports of experiences of archaic

involvement. Each of these items is to be rated on a

Likert-type scale allowing one choice from 8 scale points

which range from (1) "I did not feel at all this way,

to (7) "I felt very strongly this way." Possible total

scores range from 20 to 140.

Nash found a Spearman-Brown reliability for the AIM of

.90, and an alpha reliability coefficient of .95. The

measure was found to correlate significantly with the HGS

(r = .41). This correlation is comparable to correlations

'-,OEU " A.;. 1-41* 4f-,MLI . I lwb -

29

between hypnotic susceptibility and ratings of absorption,

and between hypnotic susceptibility and ratings of hypnotic

depth. Using a principle component analysis, with Varimax

rotation, three factors emerged out of data from 299

subjects' scores on the AIM. All three factors correlated

significantly with hypnotic susceptibility.

Tellegen Absorption Scale. The Tellegen Absorption

Scale (TAS; Tellegen & Atkinson, 1974) was also

administered to all subjects. The TAS is an inventory of

37 items describing "hypnotic-like" experiences that occur

in daily life, or tendencies thought to be specifically

related to hypnotic talent. Absorption has shown positive

correlations with indicators of hypnotizability (Tellegen

& Atkinson, 1974). Roberts and Tellegen (1973), for

example, found correlations of .27 and .43 with a modified

version of the Harvard Group Scale. They also found that

the TAS correlated .42 with the Field Depth Inventory.

MMPI-168. As noted above, the present study used the

MMPI-168 to screen subjects for severe psychopathology.

The form was first employed by Overall and Gomez-Mont

(1974) who instructed subjects to complete only the first

168 items of the MMPI Form R test booklet. Overall and

Eiland (1982) subsequently calculated percentile norms for

the MMPI-168 scale scores of 731 medical school applicants.

In addition, they developed percentile norms for the

medical school applicants on the Psychopathology Scale

30

(PSY; Overall et al., 1982). The latter scale consists of

58 items taken from the MMPI-168. Ninety-six percent of

the borderline patients sampled were found to exceed the

90th percentile on this scale, with only 10% of the normal

population exceeding this percentile (Lloyd, Overall, &

Click, 1983). Lloyd et al. (1983) conclude that the

percentile norms for medical school applicants on the MMPI-

168 scales and on the PSY scale are adequate for use in

psychiatric screening, when such screening involves the use

of cut-off points applied to individual scale scores.

Fear Questionnaire, As indicated previously, the FQ

was used as a screening device for agoraphobia, and for

phobias among the control group. The Fear Questionnaire

(FQ; Marks, 1979) is derived from a series of factor

analyses of agoraphobics' responses to fear surveys, and it

has been widely used as an outcome measure in studies of

treatment for agoraphobia. The FQ provides the following

information . The subject lists the main phobia for which

treatment is sought and rates the degree of avoidance

associated with it (1 item, score range 0-8). Next the

subject rates the degree of avoidance (0-8) associated with

each of 15 of the most common phobic stimuli (15 items,

score range 0-120). The avoidance scale for the phobic

stimuli has ratings ranging from 0--"would not avoid it" to

8--"always avoid it." From these 15 items, subscores may

be derived for three common phobic symptom clusters--social

31

phobia, blood-injury, and agoraphobia (5 items per

subscore, score range 0-40 per subscore). The subject also

rates the degree of disturbance (0-8) associated with five

affective symptoms common among phobics (5 items, score

range 0-40). Last, the subject rates the severity of the

disturbance or disability associated with the phobic

symptoms (1 item, score range 0-8). Ratings on the

severity scale range from 0--"no phobias present" to 8--

"very severely disturbing/disabling."

Interrater reliability for the main phobia has been

found to range from .80 to .95 (Marks, 1979). Michelson

and Mavissakalian (1983) administered the FQ to

agoraphobics at 4, 10, and 16 week intervals. They found

that retest reliability within subscales ranged from .58 to

.90. The agoraphobic factor averaged .83 reliability, and

the measure of severity of phobic symptoms had an average

reliability of .83 (Marks, 1979). Marks reports that

reliabilities for individual items and for items versus

subscore correlations were .5 or greater. He also claims

that the FQ is sensitive to clinical improvement in pre-and

post-test mean scores, and that FQ ratings of dysfunction

correspond well with the clinical state of patients, with

relatives' accounts of them, and with other ratings of

their adjustment. Marks does not provide statistical data

to support these claims, however.

w -,*Wwwoq ,

32

Procedure

The 10 experimental subjects were referred by the

Denton Agoraphobia Center, where they had applied for

treatment which included hypnosis. The 20 control subjects

were recruited from community courses offered at North

Texas State University. The courses were advertised as

offering hypnosis for treatment of tobacco addiction or for

weight control. Each subject was scheduled for an

appointment with a hypnotist. The hypnotist was an

advanced graduate student in psychology with more than one

year's experience in hypnosis research. The hypnotist

first had the subject sign a consent form and then

administered the SHSS:C. After the hypnotic procedure, the

hypnotist left, and an assistant asked the subject to

complete the AIM, the FDI, the TAS, the FQ, the MMPI-168,

and a demographic questionnnaire. Administration of the

SHSS:C and the other measures took a total of 90 minutes.

The procedure for the agoraphobic group also included a

brief diagnostic interview. Due to the nature and severity

of the agoraphobics' fears, five of these subjects were

tested at home. The remaining subjects were tested on the

campus of North Texas.

Results

The control group met the screening criteria for the

study and it can therefore be assumed that they did not

experience symptoms of clinical phobia or symptoms of

33

severe psychopathology. The experimental group met the DSM

III criteria for agoraphobia, that is, they reported having

the cluster of fears associated with agoraphobia, and they

reported a pervasive interference with daily activities

which resulted from a fear of panic attacks. Table 4 lists

the mean, standard deviation, and range for each group for

the number of fears they acknowledged at or above Level 4--

"definitely avoid it"--on the FQ, and for the number of

scored items they had on the PSY scale. The mean score on

the PSY scale for the control group was 14.8, or the 40th

percentile for the norm group of bright, young college

graduates (Lloyd, Overall, & Click, 1983). The mean score

for the agoraphobics was 25, representing the 98th

percentile on this scale. An ANCOVA (Table 10) indicated

that differences in the PSY scale scores did not

significantly affect the group comparisons on the SHSS:C.

The following statistical procedures were used to

assess the similarity of the comparison groups.

Differences between the group means on age and education

were analyzed using t-tests for independent samples. Chi-

square tests for independent samples were used to compare

the group distributions of marital status, gender, and

experience with hypnosis. Income was not used in a group

comparison because only 6 of the 20 control subjects, and 6

of the 10 experimental subjects supplied this information.

34

A t-test for independent samples was used to compare

the mean age for the 20 control subjects with the mean age

for the 10 experimental subjects. The latter means are

37.35 and 31.20, respectively. With 28 degrees of

freedom, the resulting !-value (t = 1.26) has a two-tail

probability of .181. Thus, it can be concluded that there

are no significant differences between the groups with

respect to age.

A t-test for independent samples was also used to

compare the mean number of years of education for the

control group with the mean years of education for the

experimental group. The latter means are 13.95 and 12.30,

respectively. With 28 degrees of freedom, the resulting

t-value (t = 2.75) has a two-tail probability of .010. The

results indicate that the comparison groups significantly

differ at the .05 level in the number of years of education

they have undertaken.

A 2 X 2 Chi-square test for independent samples was

used to determine whether the two groups were significantly

different in their number of male and female subjects.

Four of the 10 experimental subjects were male, while one

of the 20 control subjects was a male. The calculated x2

value of 1.76683 has a probability of .1838 with 1 degree

of freedom. The results suggest that the comparison groups

have comparable numbers of male and female subjects.

35

A 2 X 3 Chi-square test for independent samples was

used to determine whether the two groups differed

significantly in their frequency of subjects within three

categories of marital status--l) married, 2) single, and 3)

divorced. The observed frequencies for the control group

were 6 single and 14 married. The corresponding

frequencies for the experimental group were 9 married and 1

divorced. The calculated x2 value of 5.34783 has a

probability of .0690 with two degrees of freedom. The

results indicate that the groups do not have significantly

different frequencies within the marital status categories.

A 2 X 3 Chi-square test for independent samples was

used to determine whether the two groups contained

significantly different numbers of subjects with one of

three levels of experience with hypnosis--l) none, 2), from

1 to 10 hours, and 3) more than 10 hours. The observed

frequencies for the control group were 13 (none), 6 (1-10

hours), and 1 (more than 10 hours). The frequencies for

the experimental group were 3 (none), 6 (1-10 hours), and 1

(more than 10 hours). The calculated x2 value of 3.28125

has a probability of .1939 with two degrees of freedom. It

is reasonable to conclude, therefore, that the two groups

do not significanty differ in their frequency of subjects

within levels of experience with hypnosis.

In summary, the two groups are comparable on the

selected relevant variables except for years of education.

36

An ANCOVA (Table 3) revealed that this difference did not

significantly affect the group comparisons on the SHSS:C.

Table 2 lists correlations obtained between age and each of

the four dependent measures: the SHSS:C, the AIM, the TAS,

and the FDI. The table also lists correlations between

years of education and the dependent measures. Tables 5,

6, 7, and 8 present descriptive statistics for the relevant

variables for each group and for the overall sample.

A t-test for independent samples was used to compare

the mean hypnotic susceptibility score on the SHSS:C for

the 20 control subjects with the mean for the 10

experimental subjects. The latter means are 7.15 and 6.2,

respectively. With 28 degrees of freedom, the resulting t

value (t = 1.26) has a two-tail probability of .218. Thus,

the two samples means are not different enough to conclude

with a high degree of confidence that their population

means differ. These results fail to support the conclusion

that significant differences exist in the two groups'

susceptibility to hypnosis. A median test failed to

support the hypothesis that the groups' scores on the

SHSS:C came from populations with different medians.

A Hotelling's T2 was used to determine whether there

was a significant difference between the two groups on one

or more of the following dependent variables--the AIM, the

TAS, and the FDI. The two-samples T2 statistic had a

value of .20958. The approximate F associated with this t-

37

value is 1.67665, with 3 and 24 degrees of freedom. Under

the hypothesis of equal mean vectors the probability of

exceeding such an F value is approximately .199.

Consequently, it is likely that the two groups have the

same population mean within each dependent variable. It

can, therefore, be concluded that the experimental and

control groups made comparable responses on these three

measures. Table 1 presents the mean, standard deviation,

and range for each group on the dependent variables. Table

9 provides a correlation matrix for these variables.

Discussion

While few personality correlates to hypnotic

susceptibility have been reported, Frankel and Orne (1976)

found a relationship between hypnotic susceptibility and

phobia. Their subjects were taken from a clinical

population of persons seeking treatment with hypnosis

either for phobias or for tobacco addiction. The mean

hypnotic susceptibility score for phobics was significantly

higher than the mean for smokers. The latter means were

8.08 and 6.08, respectively.

Four of five subsequent studies found evidence in

support of Frankel and Orne's (1976) findings. However,

none of the five replications used both a measure of

hypnotic susceptibility comparable to the Stanford scales

and a comparable control group who could be assumed to have

38

motivation to succeed in hypnosis similar to that of the

subjects seeking treatment with hypnosis for phobia.

The purpose of the present study was to replicate

Frankel and Orne's (1976) study using an experimental group

of persons suffering from agoraphobia. Agoraphobia is

characterized by the presence of a number of phobias and by

extensive interference with daily living. Its major

presenting features are: fear of leaving home, fear of

crowds, confined places, and public transport, and fear of

fear. It can be distinguished from other anxiety disorders

by its characteristic feature of avoidance of many

situations due to anticipation of panic attacks. The

hypnotic susceptibility scores of persons who sought

treatment with hypnosis for agoraphobia were compared with

the susceptibility scores of persons who sought treatment

with hypnosis for weight control or for tobacco addiction.

The measure of hypnotic susceptibility was the SHSS:C.

The groups were also compared on three other dependent

measures: 1) the AIM--a measure of subjects'

"transference-like" involvement with the hypnotist, 2) the

FDI--a measure of subjective experiences which are

considered typical of responsive subjects during hypnosis,

and 3) the TAS--a measure of trance experiences outside

hypnosis. Mean susceptibility scores for both groups were

within the medium range of susceptibility. Group

differences on mean susceptibility scores were not

WAR'.

39

statistically significant, and no significant differences

were found between the groups on the other three dependent

measures.

Thus the present findings do not support the

hypothesis that phobics, in general, and agoraphobics, in

particular, are highly susceptible to hypnosis. The

results should be considered in light of several

qualifications however. First, when negative results occur

with a small sample, there is no way to rule out the

possibility that had a larger sample been used there might

have been sufficient power to produce significant results.

In fact, Frankel and Orne (1976) did find significant

differences in hypnotic susceptibility between phobics and

controls using a sample size of 24 for each group.

Consequently, the results of this study are difficult to

interpret, and any conclusions based on the experimental

sample may only be considered exploratory, pending further

investigation with larger samples.

Second, confidence in the external validity of the

study is reduced because the hypnotist was not blind to

group membership due to the distinctive clinical features

of the groups being compared, and due to the fact that five

agoraphobics were tested at home rather than in the

research office at North Texas.

Third, several distinct differences suggest that

agoraphobia may be qualitatively different from other

40

phobias. A study by Arrindell (1983) revealed that

agoraphobia does not appear in a mild form as other phobias

do, that is, agoraphobic fears do not appear in factor

analyses of self-report data for students, adolescents,

"non-phobic" psychiatric patients, or even for

miscellaneous specific phobics. Using a higher-order

factor analysis, Arrindell noted further that the

agoraphobia factor is independent of the phobia factor.

Clinical impressions also suggest distinctions

between agoraphobia and other phobias. Phobias are defined

as unreasonable fears in response to discrete cues. While

agoraphobics respond to specific situations with anxiety,

they also experience panic attacks without exposure to any

circumscribed phobic stimulus. Unlike other phobics,

agoraphobics experience seemingly random, sometimes daily,

fluctuations in their symptoms from partial remission to

relapse, and they can enter a feared situation more

comfortably if they carry a certain object or if they are

accompanied by a trusted friend. In addition, while other

phobias are most successfully treated with desensitization,

agoraphobic anxiety and panic attacks respond best to

direct exposure methods (Thorpe & Burns, 1983). On the

other hand, long-term follow-up studies (Marks, 1969; Munby

& Johnson, 1981) indicate that the central agoraphobic

symptoms of anxiety and avoidance around clearly defined

situations remain stable over many years. While the

41

classification of agoraphobia as a phobia may or may not

change in the future, the fact remains that agoraphobia is

in many ways unlike other phobias. Thus, it is reasonable

to wonder whether agoraphobics' responses to hypnosis may

not also in some way be atypical, and therefore,

unrepresentative of other phobias.

Fourth, it is possible that different perceptions of

the experimental procedure differentially affected each

group. It seemed that agoraphobics more often expressed

reservations about hypnosis. For example, several of them

expressed concern that they might lose control under

hypnosis. As a result, the experimenter often had to give

these subjects lengthy reassurances about the safety of the

procedure. Several agoraphobics expressed doubt that they

would be good subjects because they felt they would not

"let go". In fact, two subjects indicated that they had

resisted the procedure to some extent. There were at least

three occasions when agoraphobic subjects stopped the

procedure in order to postpone it to another day, or to

look around the room, or to go to the bathroom. Two or

three agoraphobic subjects simply left the session and did

not reschedule. The need for lengthy reassurance and

interruptions of the procedure were minimal in the control

group. While these observations are not systematic or

objective, they do suggest that a high level of anxiety and

concerns about hypnosis may have affected agoraphobics'

42

responsiveness to hypnosis to a greater extent than it did

controls.

Finally, the distribution of the SHSS:C is positively

skewed due to the difficulty of its items. It is possible

that this test may reduce some of the variability within

groups, especially toward the higher levels of

susceptibility. Consequently, the instrument may not have

been sensitive enough to detect differences between the

groups in the low range of susceptibility.

It is consistent with the finding of no significant

differences in hypnotic susceptibility on the SHSS:C that

the groups did not differ on measures correlated with the

SHSS:C--the AIM, the TAS, and the FDI. The lack of

differences on the FDI means that subjects reported similar

frequencies of subjective experiences which are considered

typical of hypnotized persons. Thus a behavioral measure

(SHSS:C) and a measure of subjective experiences (FDI)

converge in depicting similar overall responsiveness to

hypnosis between these groups.

The groups did not differ significantly in their AIM

scores, that is, the extent to which they reported a more

regressive, or archaic, relationship with the hypnotist.

Archaic involvement is similar to transference in that

early need and attitudes, which usually developed in

relation to parents, are now projected onto others.

Because some authors have associated agoraphobia with

43

dependency, it was hypothesized that the regressive aspects

of the hypnotic situation might elicit a more pronounced

"transference-like" dependency on the hypnotist among the

agoraphobic sample. The results suggest that agoraphobics

are not more likely to respond in this way during hypnosis

than are controls. Moreover, it is not clear that

subjects' responses to the AIM in any way reflect

dependency needs or regressive tendencies outside hypnosis.

A comparison of TAS scores found no difference between

phobics and controls in the number of different forms of

spontaneous trance experiences each reported. This outcome

supports a similar finding in an earlier study by Frischolz

et al. (1982). Thus, there has been no support in this

study for the contention that phobics and high susceptible

subjects share a predisposition for hypnotic-like

experiences (Frankel and Orne, 1976). Indeed, the phobic

group proved to be neither high susceptible nor unusually

prone to "trance-like" experiences outside hypnosis. The

credibility of these findings is very much in doubt,

however. This is because Tables 11 and 12 show many

negative and non-significant correlations between the

dependent measures for the control and for the experimental

group. Previous research indicates that these correlations

are usually positive and significant. Therefore, the

present findings are highly suspect and may indicate that

extreme variation in experimental procedure occurred among

-c" In A* WwA I - 1 .11

44

the hypnotists. To summarize, the present study found no

evidence to support Frankel and Orne's (1976) contention

that phobics are highly susceptible to hypnosis.

Agoraphobics and controls showed no significant differences

on the SHSS:C, the FDI, the AIM, or the TAS. The overall

mean for the study on the SHSS:C (x = 6.833) is within the

medium range of susceptibility. Factors which may have

affected the outcome were discussed, as well as the limited

credibility of the findings in light of the surprisingly

low correlations among the dependent measures.

Future research in this area should use stringent

criteria for screening the experimental and the control

groups for phobia. It would be well for a set of research

criteria for phobia to be standardized for this purpose.

In order to test Foenander et al.'s assertion that type and

severity of phobia may interact with hypnotic

susceptibility, further studies could compare agoraphobics

with other specified phobics, as well as with a comparable

control group. Also, a comparison could be made to see if

the SHSS:A is in fact more sensitive than the SHSS:C in

discriminating among these groups.

Based on experiences from this study, it seems

important to systematically assess how fearful clients are

of hypnosis (regardless of their motivation to succeed in

treatment), and to ask subjects directly how they think

their attitude toward hypnosis might have affected their

45

hypnotic performance. Furthermore, it is important to use

large samples and a single blind procedure. The latter

procedures seem to be ideal rather than practical, however,

because the nature and severity of agoraphobics' fears

reduce the number of subjects able to participate in

hypnosis research, and because agoraphobics' behavior in

the experimental setting appears likely to distinguish many

of them from the control subjects commonly used in this

research.

This study has implications for the treatment of

agoraphobia in that practitioners who plan to use hypnosis

can be aware that a moderate degree of responsiveness is

possible from many of these clients, in spite of their

fears and anxiety.

46

APPENDIX A

Agoraphobic Subject Selection Criteria

To be included in the agoraphobic sample:

1. The subject must apply for treatment with hypnosis for

agoraphobia.

2. The subject must meet DSM III criteria for agoraphobia

as determined by a 10-minute interview using the ADIS.

3. The subject must not have any elevation above a T-score

of 70, i.e., the 98th percentile, on the PSY scale of

the MMPI-168. This means a subject may not endorse

more than 25 of the 58 PSY scale items to be included

in the study. (Subjects with an actual range from 12-

33 endorsed items were included.)

4. The subject must rate three or more of the five items

on the Agoraphobia subscale of the FQ at or above Level

4--"definitely avoid it." The rating is made on a 9-

point (0-8) avoidance scale. The Agoraphobia subscale

consists of items 5, 6, 8, 12, and 15.

5. The subject must rate the level of disturbance

associated with their phobic symptoms at or above Level

4--"definitely disturbing/disabling," on the 9-point

(0-8) FQ rating of overall severity of symptoms.

6. The subject must report a duration of agoraphobic

symptoms which exceeds one year.

. - ., L , -I, ""Jim" m I I I I,

47

APPENDIX B

Control Group Subject Selection Criteria

To be included in the control group sample:

1. The subject must apply for treatment with hypnosis for

tobacco addiction or for weight control.

2. The subject must not have any elevation above a T-score

of 70, ie., the 98th percentile, on the PSY scale of

the MMPI-168.

3. The subject must report that the degree of disturbance

associated with any fears or "phobic-like" symptoms is

below Level 4--"definitely disturbing/disabling" on the

9 point (0-8) FQ rating of the overall severity of

symptoms.

48

APPENDIX C

Tables

Table 1

Mean, Standard Deviation, and Range for each group on theSHSS:C, the AIM, the TAS, and the FDI

GroupTest Control (n=20) Experimental(n=10)

SHSS:C m = 7.15 m = 6.2S.D. = 1.872 S.D. = 2.09Range = 4-10 Range =4-11

AIM m = 73.421 m = 64.600S.D. = 22.816 S.D. = 30.310Range = 32-115 Range = 33-127

TAS m = 27.526 m = 22.700S.D. = 5.660 S.D. = 7.319Range = 15-35 Range = 11-33

FDI m = 22.550 m = 18.400S.D. = 5.326 S.D. = 5.892Range = 12-33 Range = 6-27

,Q ,- im- --- .. , -1 Imi maluft 0 - -- 1-4mmffQwk%%wh&mWl%"ll'l

Appendix C--Cont. 49

Table 2

Product-moment Correlations between Age and Years ofEducation and Each of the Four DependentMeasures-- the SHSS:C, the AIM,

the TAS, and the FDI

Independent DependentVariables Variables

SHSS:C AIM TAS FDIAge -.2340 -.1606 -.0602 -.1171Education .3785* .0585 .0550 .1882

*significant at the .05 level.

Table 3

An Analysis of Covariance Comparing the Groups onHypnotic Susceptibility with Years of

Education as the Covariate

Source Sums of Degrees of Mean E Sign.Squares Freedom Square of F

Main effects .462 1 .462 .130 .721Explained 16.530 2 8.265 2.333 .116Error 95.637 27 3.542Total 112.167 29 3.868

Appendix C--Cont. 50

Table 4

Mean, Standard Deviation, and Range for each Group forthe Number of Fears Acknowledged on the FQ at orabove Level 4--"Definitely Avoid It", and forthe Number of Scored Items on the PSY scale.

GroupTest Control (n=20) Experimental (n=10)

FQ m = 2.850 m = 5.8S.D. = 1.981 S.D. = 1.476Range = 0-9 Range = 4-8

PSY Scale m = 14.800 m = 25S.D. = 5.227 S.D. = 7.257Range = 6-24 Range = 12-33

Table 5

Mean, Standard Deviation, and Range for Each Groupfor Age and Years of Education.

IndependentVariable Control (n=20) Experimental (n=10)

Age m =37.350 m = 31 20C

Years of Education

S.D. = 13.971Range = 20-80

m = 13.950S.D. = 1.468Range = 12-16

S.D. = 7.843Range = 24-49

m = 12.300S.D. = 1.703

Range = 9-14

Appendix C--Cont. 51

Table 6

Mean, Standard Deviation, and Range for the OverallSample for Age and Years of Education.

Independent Overall SampleVariable (n=30)

Age m = 35.300S.D. = 12.477Range = 20-80

Years of Education m = 13.400S.D. = 1.714Range = 9-16

Table 7

Frequencies and Percentages for Categories based onGender, Marital Status, and Experience with

Hypnosis for each Group.

Independent GroupVariable Control (n=20) Experimental (n=10)

Sex Male = 1 (5)9 M l -)

Female = 19 (95%)

Marital Status

Fa e = 7 (0%)Female= 7 (70%)

Single = 6 (30%) Single = 0 (0%)Married = 14 (70%) Married = 9 (90%)Divorced = 0 (0%) Divorced = 1 (10%)

Hours of Experiencewith Hypnosis

0 = 13 (65%)1-10 = 6 (30%)>10 = 1 (5%)

0 = 3 (30%)1-10 = 6 (60%)>10 = 1 (10%)

I I li 111 .. .

Appendix C--Cont.

Table 8

Frequencies and Percentages for Categories based onGender, Marital Status, and Experience with

Hypnosis for the Overall Sample.

I d d t-=n/% --' 1 JV I

VariableOver iSample

(n=30)

ext, -.

Marital Status

Hours of ExperienceWith Hypnosis

Male = 4 (13.3%)Female = 26 (86.7%)

Single = 6 (20%)Married = 23 (76.7%)Divorced = 1 (3.3%)

0 = 16 (53.3%)1-10 = 12 (40.0%)>10 = 2 (6.7%)

Table 9

Pearson Product-moment Correlations Between theDependent Measures--the SHSS:C, the AIM,

the TAS, and the FDI

SHSS:C AIM TASFDI .2827 .5880** .4984*

-. 2635

-. 2727

.5737**

* p < .01** p < .001

52

TAS

AIM

.qSt-- z

Appendix C--Cont. 53

Table 10

An Analysis of Covariance Comparing the GroupsHypnotic Susceptibility with the PSY Scale

Scores as the Covariate.

on

Source Sums of Degrees of Mean E Sign.Squares Freedom Square of E

Main Effects .842 1 .842 .219 .644Explained 8.279 2 4.139 1.076 .355Error 103.888 27 3.848Total 112.167 29 3.868

Table 11

Pearson Product-moment Correlations between theDependent Measures--the SHSS:C, the AIM, the

TAS, and the FDI for the Control Group.

.3256AIM TAS

.4714 * .4695 *

-.2887 .5917 **

-. 3146

*p < .05**p < .01

FDI

TAS

AIM

Appendix C--Cont. 54

Table 12

Pearson Product-moment Correlations between the DependentMeasures--the SHSS:C, the AIM, the TAS, and the

FDI for the Experimental Group.

SHSS:C AIM TASFDI .0108 .7090 * .3793

TAS -.5602 * .5108

AIM -.3883

* p < .05

55

APPENDIX D

Raw Data

Raw Data for the Weight Control Group

Marital Hyp.SHSS AIM TAS FDI Age Educ. Sex Status Exp. FQ MMPI

1. 6 1002. 8 533. 9 944. 9 665. 9 1156. 9 637. 5 X8. 7 639. 10 34

10. 6 8811. 5 6912. 6 9213. 9 6114. 10 6515. 4 9916. 5 6017. 7 6818. 7 3219. 7 10320. 5 70

30 22 35 1425 21 44 1229 26 21 1317 26 20 1430 33 21 1530 27 32 1530 25 45 1220 18 80 1315 15 40 1526 22 33 1329 28 56 1530 15 36 1629 26 28 1433 27 37 1629 18 38 16X 19 43 13

32 23 48 1620 12 38 1235 28 21 1334 20 31 12

FFFFFFFFFFFFFFFFFFFM

MMSSSSMMMMMMSMMMMMSM

>100

1-101-100

1-10000

1-101-1000000000

1-10

11335014291242234244

1414222476

15189

1819112211151222101512

MMillinhl 1 li 1 -

Appendix D--Cont

Raw Data for the Agoraphobic Group

Marital Hyp.SHSS AIM TAS FDI Age Educ.Sex Status Exp. FQ MMPI

1. 11 65 19 25 28 14 M M 0 6 142. 8 47 23 15 24 12 F M 1-10 4 273. 6 62 14 17 36 14 M M >10 8 274. 4 127 33 27 34 9 F M 0 8 305. 5 56 26 16 25 11 F M 1-10 5 306. 6 33 21 6 24 12 F M 1-10 7 337. 7 58 11 18 25 12 M M 0 5 318. 6 48 19 17 49 14 F M 1-10 5 209. 5 40 30 21 32 14 F M 1-10 6 26

10. 4 110 31 22 35 11 F D 1-10 4 12

56

57

APPENDIX E

Demographic Questionnaire

Name:

Address:

Phone: (home)

(work)

Date of Birth:

Sex:

Education:

Marital Status:

Married

Single

Separated

Divorced

Widowed

Other

Duration of present agoraphobic symptoms:

Less than 1 year

Less than 3 years

More than 3 years

Previous experience with hypnosis:

None

1-10 hours

More than 10 hours

Please list any medication you are currently using:

58

APPENDIX F

Fear Questionnaire

Name Age Sex Date

Choose a number from the scale below to show how much youwould avoid each of these situations listed below because offear or other unpleasant feelings. Then write the number youchoose in the space opposite each situation.

Q - 1-2 3 4 5 6 7 8Would not Slightly Definitely Markedly Alwaysavoid it avoid it avoid it avoid it avoid it

1. Main phobia you want treated (describe in your own words).

2. Injections or minor surgery3. Eating or drinking with other people4. Hospitals5. Traveling alone by bus or coach6. Walking alone in busy streets7. Being watched or stared at8. Going into crowded shops9. Talking to people in authority

10. Sight of blood11. Being criticized12. Going alone far from home13. Thought of injury or illness14. Speaking or acting to an audience15. Large open spaces16. Going to the dentist17. Other situations (describe)

How would you rate the present state of your phobic symptomson the scale below?

0 1 2 3 4 5 6 7 8No phobias Slightly Definitely Markedly Very severelypresent disturbing disturbing/ disturbing/ disturbing/

not really disabling disabling disablingdisabling

Please circle one number between 0 and 8.

59

APPENDIX G

Consent Form

NAME OF SUBJECT:1. I hereby give consent to to perform orsupervise the following investigational procedure ortreatment:

2. I have (seen, heard) a clear explanation and understandthe nature and purpose of the procedure or treatment;possible appropriate alternative procedures that would beadvantageous to me (him, her); and the attendant discomfortsor risks involved and the possibility of complications whichmight arise. I have (seen, heard) a clear explanation andunderstand the benefits to be expected. I understand thatthe procedure or treatment to be performed is investigationaland that I may withdraw my consent for my (his, her) status.With my understanding of this, having received thisinformation and satisfactory answers to the questions I haveasked, I voluntarily consent to the procedure or treatmentdesignated in Paragraph I above.

WitnessSigned:

Signed:

Subjector

Person Responsible

RelatinsqhinInstructions to persons authorized to sign:If the subject is not competent, the person responsible shallbe the legal appointed guardian or legally authorizedrepresentative.If the subject is a minor under 18 years of age, the personresponsible is the mother or father or legally appointedguardian.If the subject is unable to write his name, the following islegally acceptable:John H. (His X Mark) Doe and two (2) witnesses.

Signed:

Signed:

Date

60

Appendix H

SCORING BOOKLET: FORM C

To be used in connection with Weitzenhoffer and Hilgard's Stanford lyp'-notic Susceptibility Scale: Form C, Consulting Psychologists Press , Inc.,Palo Alto, California.

Subject No. . . . . . . . . Date . . . . . . . . Total Score . . . . . . .

Name . . . . . . . . . . - . . - - - - - . . Hypnotist . . . . . . . . . .

Summary of Scores Score

Details on the pages that follow_+0. Eye closure (not counted in total score) ( )

1. Hand Lowering (Right Hand)

2. Moving Hands Apart

3. Mosquito Hallucination

4. Taste Hallucination

5. Arm Rigidity (Right Arm)

6. Dream

7. Age Regression (School)

8. Arm Immobilization (Left Arm)

9. Anosmia to Ammonia

10. Hallucinated Voice

11. Negative Visual Hallucination (Three Boxes)

12. Post-Hypnotic Amnesia

Total (+) score . . . . . . .

Record of Recall in Test for Amnesia

Order of Order ofMention Mention

Hand lowering ....... Age regression ......

Moving hands apart .Arm immobilization .......

Mosquito hallucination Anosrmia to ammonia .......

Taste hallucination Hallucinated voice .......

Arm rigidity . 0.. ..0 Negative visual

Dream .a .. *..hallucination .......

Total number of items recalled *.......

Distributed by Consulting Psychologists Press. Inc.., 577 College Ave.,

Palo Alto, Calif. (c) 1962 Ly the Board of Trustees of Leland Stanford

junior Univers'v.

APPENDIX H--Cont.

1IZIM SCOPZ0. RESPONSE TO INDUCTION

a. (If Eye Closure used)

Eyes :i : : close without forcingdo do not (Not

b. (If other method of induction used) Methodcounted)

Response

l. HAND LOWERING (RIGHT HAND)Remarks:

Score (+) if hand has lowered at least six inches by end of10 seconds.

2. MOVING HANDS APARTRemarks:

Score (+) if hands are six inches or more apart at end of10 seconds.

3. MOSQUITO HALLUCINATIONRemarks:

Score (+) for any grimacing, movement, or acknowledg-ment of effect. (3)

4. TASTE HALLUCINATION

A. Taste of sweet: : : : :none vague weak strong

Overt signs:...yes -no

B. Taste of sour:none vague weak strong

Overt signs:.::yes no

Remarks:

Score (+) i f:o t_ tastes are experzencez and e:ithir onestrong ;r one w.:. ver: "ovements. S(.;)

61

APPENDIX H--Cont.

ITEM

S. ARM RIGIDITY (RIGHT ARM)Remarks:

Score (+) if there is less than 2 inches of arm bending inlC seconds.

6. DREAM(Record dream here, if any;thoughts, fantasies, etc.)

or any report of passing

Score (+) if subject dreams well (i. e., has an experiencecomparable to a dream--not just vague, fleeting experi-ences, or just feelings or thoughts without accompanyingimagery). It is possible to obtain a plus score, eventhough the subject may insist it was not a real dream,provided the hypnotist notes that the imagery and actionare not under volitional control. (6)

I

-M- -. -- wlwwwat Quw *Alm-w-1Wl4M omomwwimi poppowa www*Aw. I

62

APPENDIX H--Cont.

ITM ~~SCORE

7. -AGE REGRESSION (SCHOOL)

a. Verbal evidence: Fifth Grade

How old are you?

Where are you?

What are you doing?

Who is your teacher?

Other information

Rating:No regression Fair Good

b. Verbal evidence: Second Grade

What is your name?

And how old are you?

Where are you?

Who is your teacher?

Other information

Rating:

No regression Fair Good

c. Handwriting evidence

Fifth grade:

no change some change striking change

Second grade:no change some change striking change

Score (+) if clear change in handwriting between the pre-sent and oneof the ;egressed ages (7)

8. ARM IMMOBILIZATION (LEFT ARM)Remarks:

Score (+) ii arm r:ses less than one inch in 10 seconds. (8)

63

APPENDIX H--Cont.

ITEM SCP

9. ANOSMIA TO AMMONIA

Smell of ammonia:.,, ... . ,..:............. :none vague weak strong

Overt signs: :yes no

Remarks:

Score (+) if odor of ammonia denied and overt signsabsent ----

10. HALLUCINATED VOICERecord conversation, if any:

Score (+) if subject answers realistically at least once (10)

11. NEGATIVE VISUAL HALLUCINATION: THRE BOXES

Subject reports 3 boxes:,

Subject reports 2 boxes: Colors and

What is color of third box?

Remarks:

Score (+) if hallucination is present, wnether or not sus-

tained. Sometimes t:ie thiir: zcx is perceived vauely as

a colored spot or shacow. The score is still (+). (ll

64

APPENDIX H--Cont.

ITEM

12. POST-HYPNOTIC AMNESIA

(1) Please tell me now in your own words everything thathas happened from the time that (refer to inductionused). (Mist items in order of mention. If blocked,ask, "Anything else ?" until subject reaches a fur-ther impasse.)

Anything else ?

You have forgotten (all the, many, a few) things which-happened. Can you tell me a little what it feels like ?(If necessary, probe in order to ascertain nature ofamnesia i.e., whether true, verbal inhibition, etc.)

(2) Listen carefully to my. words. Now you can remembereverything. Anything else now? (List in order of men-tion.)

Remind subject of omitted items. Remarks on natureof amnesic experience ("about your in.abiliry to recalla while ago, how real was it -to you ?.")

Score (+) if subject recalls 3 or iewer items before "Nowyou can remember everything."

Y -

65

I srnp-E I

(12).. )i

66

Appendix I

ARCAIC INVOLVEMENT MEASURE

1. Sometimes I felt some very strong bonds to the hypnotist, like an-affection that I usually feel only for parents, special teachers,and special friends.

I did notfeel at allthis way

2 3 4 5 6 festrgly verythis

way

2. For some unknown reason, I really wanted to please the hypnotista whole lot.

I did notfeel at allthi s way

2 3 4 5 6 7 lst

3. Every word or action of the hypnotist seamed to have an effect onmy feelings.

I did notfeel at allthis way

ythisway

2 3 I felt very2 3 5 6 7 stogythis

way

4. I felt like everything the hypnotist did and said deeply mattered.I did notfeel at all Ithis way

I felt very2 36 7 strongly thisway

5. While I was hypnotized, I felt like the hypnotist was almost aperfect person.

I did notfeel at all. 1thi s way

I felIt very2 3 4 5 6 7 stronglythisway

6. The hypnotist felt very powerful to me.

I felt very6 7 strongly this

way

7. It felt like the .hypnotist was very wise.

I did notfeel at all Ithis way

I felIt very2 3 4 5 6 7 strongly thisway

I did notfeel at all Ithis wy

APPENDIX I--Cont.

. I especially admired the hypnotist.

I did notfeel atall 1 2 3 4 5 6this way

9. Inaway, it wasneat to share in thepoweroft

I did not6feel at all 1 2 3 4. 5 6'this may

10. I really wanted the hypnotist to think I was OK.

I did not -feel at all 1 2 3 4 5 6this way

11. In sawe ways, I felt like a child relating to hiithan an adult relating to the hypnotist.

I did notfeel at all 1 2 3 4 5 6this way

12. 1 felt like the hypnotist was a leader and I was

I did notfeel at all 1 2 3 4 5 6this way

13. I wanted the hypnotist to take care of me whileI

I did notfeel at all 1 2 3 4 5 6this way

14. 1 wanted the hypnotist to tell me what to do.

I did notfeel at all 1 2 3 4 5 6this way

15. I wanted the hypnotist's attention.

I did notfeel at all 1 2 3 4 5 6this way

I felt very7 strongly this

way

he hypnotist.

I felt very7 strongly this

way

I felt very7 strongly this

way

S/her parents rather

I felt very7 strongly this

way

a follower.

I felt7 strongly

I was hypnotized.

I felt7 strongly

verythis

way

verythis

way

I felt very7 strongly this

way

I felt very7 strongly this

way

67

APPENDIX I--Cont.

11- Wihan I COuldn't do what the hypnotist said, t mde me feel guilty.

'1 did not I felt veryfeel at all 1 2 3 4 5 6 7 strongly thisthis my way

17. I was worried that the hypnotist wouldn't like me.

I did not I felt very.feel at all 1 2 3 4 5 6 7 strongly thisthi& way way

18. 1 wanted to avoid disappointing the hypnotist.

I did not I felt veryfeel at all 1. 2 3 4 5 6 7 strongly thisthis way way

19. I wanted to avoid the hypnotist becoming angry at me.

I did not I felt veryfeel atall 1 2 3 4 5 6 7 stronly thisthis way way

20. Sometimes I couldn't tell who the hypnotist was.

I did not I felt veryfeel at all 1 2 3 4 5 6 7 strongly thisthis way way

68

69

APPENDIX J

Field Depth Inventory

trite ?TRU or FALSZ in the blank space after each numberafter you give careful thought about your answer to thestatement.

1..Time stood still.

2.....IAy are trembled or shook whes I tried to sove it.

3.... felt dazed.

4....1i felt aware of my body only where it touched thechair.

5......= felt I could have tolerated pain sore easily duringthe esperisent.

6..,.? could have awakened any time I wanted to.

7... was delighted with the experience.

.... The ezperimentorts voice seemed to come from very faraway.

9....I tried to resist, but I could not.

10. Everything happened automatically.

11...Sometimes I did not.know where I was.

12...__It was like the feeliaq I have just before waking up.

13...hen I case out I was surprised at bow such time hadgone by.

14.. I case out of the trance before I was told to.

15. Ouriag the eperiseet I felt I understood thingsbetter or sore deeply.

16...I was able to overcome some or all of thesuggestions.

17. . At times I was deeply hypnotized and at other times Iwas only lightly hypnotized.

18....Durinq the finai "countdowno to vwke me up I becamesore deeply hypnotized for a mosent.

19...._At times I felt completely unavare of being in anexperiment.

20....I did not lose all sense of time.

APPENDIX J--Cont.

31,..t seemed completely different from ordinaryexperience.

22. .xI was is a sodium hypnotic state, but no deeper.

23.. Things seemed unreal.

20 ____Parts of my body soved without my consciousassistance.

25.. .. I felt apart froa everything else.

26. .. It seems as if it happened a long time ago.

27...1 I felt uniahibited.

28.. ..At times I felt as if X had gone to sleepsomnatarily.

29...*.I felt quite conscious of my surroundings all thetime.

30.. .SIverything I did while hypnotized I can also do whileI as not hypnotized.

31.. 1.I could not have stopped doing the things theexperimenter suggested even if I tried.

32.. .bIt was a very strange experience.

33.____I felt asa'zed.

34. ?.N rom time to time I opened my eyes.

31. .M 1 couldn't stop movements after they got started.

36.. .I bad trouble keeping sy head up all during theex perinent.

37...U y mind seemed empty.

38. ____It seemed mysterious.

7 0

71

APPENDIX K

Tellegen Absorption Scale

lameseae: Sex:

?lease read each statement and decide whether it ismostly true or mostly false as applied too you. If youdecide a statement is true or mostly true, circle TRUR. Ifa statement is false or ostly false, as applied to yo,circle FALS?. (There are no right or wrong anwers.)

1. Soeetimes I feel and experience things as I did whes Ivis a child. (a) Tue, (b) False.

2. I cam become deeply involved when reading or hearingabout someone else's experiences. ( s) True. (b) False.3. When I watch a boat on the lake, I can almost feel hatit would be like to be on it. (a) True, (b) False.4. I can be greatly moved by eloquent or poetic language.(a. True, (b) False.

5. While watching a movie, a T.T. how, or a play, I saybecome so involved that I forget about myself and mysurroumdinqs and experience the story as if it were real andas if I were taking part in it. (a) True, (b) False.6. If I stare at a picture and then look away from it, Ican sometimes see& am imaqe of the picture. almost as if Iwere still looking at it. . (a) True, (b) false.

7. Sometimes I feel as if my mind could envelop the wholeworld. (a) True, (b) False.

8. I like to watch cloud shapes change in the sky. (a)True, (b) False.

9. If I wish, I cam imaqlie (or daydream) some things sovividly that they bold my attention is the way a good movieor story does. (a) True, (b) False.

10. I sometimes Ostep outside* my usual self and experiencesa entirely different state of being. (a) True, (b) False.

11. I think I really know what some people sean when theytalk about mystical experiences. (a) True, (b) False.

12. Textures-such as wool, sand, wood-sometimes remind seof colors or music. 4e) True. (b) False.

13. Sometimes I experience things as if they were doublyreal. (a) True, (b) False.

14. When I listen to music, I can qet so caught up in it

_ss,_,_ ' l'' --ri I 'r.II-I i i i i i i F Illis41 r 1 -P"I I'l-2. - MEd't MIMik litet.NIU~fTill 3...-3-1- ilei.lass'i. r-a.ii.rois, --4..=- ... . . .,. ... ,, .asm.memen.sam

APPENDIX K--Cont.

that I doat sotie anything else. (a) True# (b) False.15. If I wish, I can imagine that my body is so heavy thatI could not move it if I wanted to. (a) true. (b) False.16. Often I can somehow sense the presences of anotherperson before I actually see or hear hia(her). (a) true,(b) False.

W. The crackle and flames of a wood fire stimulate myimagination. (a) True* (b) False.

10. It is sometimes possible for se to be completelyimersed in ature or in art and to feel am if my wholestate of conciouseess has somehow bees temporarily altered.(a) True, (b) False.

19. 1 cam sometimes recollect certain past experiences inmy life with such clarity and vividness that it is likelining them agais or almost so. (a) True. (b) False.-

20. I as able to wander off into my own thoughts whiledoiaq a routine task and actually forget that I am doing thetask, and then find a few minutes later that I havecompleted it. (a) True, (b) False.

21. I have attempted to write poetry or fiction. (a) True,(b) False.

22. Different colors have distinctive and special earningsfor me. (a) True, (b).

23. Things that miqht seem meanisless to others often makesese to s. (a) true, (b) False.

25. While acting is a play, I think I could really feel theemotions of the character and become 6 him (her) for thetime being, forgetting both myself and the audience. (a)True, (b) False.

25. By thoughts often don't occur as words but as visualimages. (a) true, (b) False.

26. I often take delight in small things (like the five-pointed star shape that appears when you cut as apple acrossthe core or the colors is soap bubbles). (a) True, (b)False.

27. When listening to organ music or other powerful music,I sometimes feel as if I as being lifted into the air. (a)True, (b) False.

- 'm*a-

72

APPENDIX K--Cont.

26. Sometimes I can chamqe noise into music by the way Ilist to it. (a) True, (b) False.

29. Some of my most vivid memories are called up by scents&ad smells. (a) Tre. (b) False.

30. Certain pieces of music remind me of pictures or soviagpatters of color. (a) True# (b) False.

31. 1 often know what someone Is going to say before he orshe says it. -(a) True, (b) False.

32. 1 often have Ophysical sesoriess; for example, afterI've bees swimming I may still feel like Its is the water.(a) true, (b) aie.

33. The soma4 of a voice can be so fascinating to se that Icas just go @ listening. to it. (a) true. (b) False.

34. It times I somehow feel the presence of someone who issot physically there. (a) True. (b) False.

35. Sometimes thoughts aad images come to se without theslightest effort on my part. (a) True, (b) False.

36. I find that different odors have different colors. (a)True, (b) False.

37. 1 can be deeply moved by a sunset. (a) True, (b)False.

73

74

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