American Journal of Clinical Hypnosis

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The Hypnotic Induction in the Broad Scheme of

Hypnosis: A Sociocognitive Perspective

Steven Jay Lynn, Reed Maxwell & Joseph P. Green

To cite this article: Steven Jay Lynn, Reed Maxwell & Joseph P. Green (2017) The Hypnotic
Induction in the Broad Scheme of Hypnosis: A Sociocognitive Perspective, American Journal of
Clinical Hypnosis, 59:4, 363-384, DOI: 10.1080/00029157.2016.1233093

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American Journal of Clinical Hypnosis, 59: 363–384, 2017
Copyright © American Society of Clinical Hypnosis
ISSN: 0002-9157 print / 2160-0562 online
DOI: 10.1080/00029157.2016.1233093

The Hypnotic Induction in the Broad Scheme of Hypnosis:

A Sociocognitive Perspective
Steven Jay Lynn and Reed Maxwell
Binghamton University, Binghamton, New York, USA

Joseph P. Green
Ohio State University at Lima, Lima, Ohio, USA

Researchers and clinicians typically divide hypnosis into two distinct parts: the induction and the
suggestions that follow. We suggest that this distinction is arbitrary and artificial. Different definitions
of hypnosis ascribe different roles to the hypnotic induction, yet none clearly specifies the mechanisms
that mediate or moderate subjective and behavioral responses to hypnotic suggestions. Researchers have
identified few if any differences in responding across diverse hypnotic inductions, and surprisingly little
research has focused on the specific ingredients that optimize responsiveness. From a sociocognitive
perspective, we consider the role of inductions in the broader scheme of hypnosis and suggest that there is
no clear line of demarcation between prehypnotic information, the induction, suggestions, and other
constituents of the hypnotic context. We describe research efforts to maximize responses to hypnotic
suggestions, which encompass the induction and other aspects of the broader hypnotic framework, and
conclude with a call for more research on inductions and suggestions to better understand their role
within hypnotic interventions in research and clinical contexts.
Keywords: hypnosis, hypnosis definition, hypnotic responsiveness, hypnotic suggestion, induction

Hypnosis has fueled the popular and scientific imagination for centuries. The roots of
hypnosis stretch back to prehistory and surely to ancient times, and the ritual induction
of altered experiential states for spiritual and physical healing remains a key feature in
Western and non-Western religious practices as well (Pintar & Lynn, 2008). The now
virtually mythic figure, Mesmer, was an icon of the charismatic person who wields
amazing and ineluctable power over the participant. This image was firmly implanted in
the public mind following the publication of De Maurier’s novel, Trilby (1894/2009), in
which Svengali—whose name today connotes a ruthless manipulator—uses hypnosis to
dominate the hapless Trilby.
The very idea of inducing hypnosis still reverberates with connotations of power and
control, as depicted stereotypically in popular culture, dramatized vividly in books,

Address correspondence to Steven Jay Lynn, Ph.D., ABPP, Psychology Department, Binghamton University,
Binghamton, NY 13902. E-mail: [email protected]
364 LYNN ET AL.

movies, and television. In recent years, the Internet has touted hypnotic inductions that
push the envelope of the bizarre and absurd, claiming that conversational hypnosis can
be used to “get people to do anything you want” (http://undergroundhypnosissecretsre
vealed.blogspot.com/), and males can use special induction techniques to feminize their
bodies to transform each body part into a desired feminine shape (http://www.hypnosis
blacksecrets.com).
Such nonsense aside, practitioners of hypnosis have concocted a potpourri of approaches
to produce whatever at the historical time or the whim of the hypnosis operator has been
considered to be “hypnotic.” A small sample of these inductions include flashing lights;
focusing on the breath; fixating the eyes on an object, such as a moving watch popularized
in the media; applying pressure to participants’ heads; clanging gongs; and suggesting
relaxation and alertness (Gibbons & Lynn, 2010). It seems that the only constraint on the
nature of hypnotic inductions is the imagination of the hypnotist, although the inductions
used in standardized scales of hypnosis, and incorporated in the repertoire of many clinical
practitioners, are generally quite tame, emphasizing relaxation, sleepiness and drowsiness,
imagination, focused attention, and cooperation. Moreover, as we will describe, inductions
differ along multiple dimensions, such as their length, whether the wording is authoritative
or permissive, whether they are individualized, and whether they are standardized for
research or clinical purposes or administered on an individual or group basis or on a self
versus hypnotist initiated basis. These highly diverse possibilities for inductions underscore
the problems inherent in making generalizations about hypnotic inductions and in finding
commonalities among them. Nevertheless, we attempt to identify such commonalities in
our account of the role of the induction in the broader hypnotic scheme in an effort to
move toward a more comprehensive understanding of how the induction works from a
sociocognitive perspective.
Our review is limited to a consideration of behavioral and subjective responses asso-
ciated with inductions. We do not discuss the thorny question of psychophysiological/
neurological correlates or concomitants of inductions, because interested readers will find
an in depth and critical discussion elsewhere of findings and methodological issues
pertinent to this topic examined from a sociocognitive perspective (Lynn, Kirsch,
Knox, & Lilienfeld, 2006).

Definitions of Hypnosis

Given the rich diversity in inductions, it is not surprising that they have been defined
only in the most general terms by three definitions of hypnosis crafted by the hypnosis
division of American Psychological over more than two decades. The 1994 definition
simply states: “The hypnotic context is generally established by an induction procedure.
Although there are many different hypnotic inductions, most include suggestions for
 INDUCTION IN THE BROADER SCHEME OF HYPNOSIS 365

relaxation, calmness, and well-being. Instructions to imagine or think about pleasant

experiences are also commonly included in hypnotic inductions” (Kirsch, 1994, p. 143).
This definition implies that establishing the context as “hypnotic” is an important, if
not a primary, function of the induction. We agree and cite Sheehan and Perry (1976) to
exemplify this point: “It is not the procedural conditions per se that are important but
whether or not the subject perceives them as part of a context that is ‘appropriate’ for
displaying hypnotic behavior” (p. 72).
We will argue that a key aspect of inductions is that they contribute to and are
embedded in a far broader experiential context that establishes and reinforces the idea
that the transaction between the hypnotist and the participant is “hypnotic” in nature.
That is, the induction contextualizes whatever occurs subsequent to it as “hypnotic” and
as a departure from mundane social interaction and communication, marking the
proceedings as special in kind and conducive to altered and enhanced experiences and
responses.
The induction—simply by framing the situation as hypnosis—potentially expands
participants’ beliefs and expectancies about what is possible to think, feel, and do,
thereby enhancing motivation to respond and involvement in imaginative suggestions.
At its heart, an induction amplifies, focuses, and channels (1) thoughts (imaginings) and
feelings/emotions consistent with a positive response; (2) language, which shapes
suggestions; and (3) behaviors in a call for the participant to respond in keeping with
the implicit and explicit rules of a top-down constructed context. The definition also
correctly notes that relaxation is an element that cuts across many diverse hypnotic
inductions and helps to establish the context as “hypnotic.”
We suggest that hypnotic responsiveness, including the domain of subjective experi-
ences, is intimately associated with a sensitivity to contextual influences and an ability
to experience cognitive-affective-behavioral plasticity in response to top-down gener-
ated rules for responding. These top-down rules are engendered by culturally-based
associations participants develop apart from (e.g., via the media) and within the
immediate context of “hypnosis.” Perhaps the most central rule is to behave and
experience hypnosis in a way that mirrors expectancies and beliefs about how a good
hypnotic subject should respond. Imaginative suggestions, which often are interwoven
through the entire hypnotic proceedings, including the induction, provide more specific,
often more implicit “rules” (e.g., lift your arm and experience the rising as involuntary
in response to a hand levitation suggestion) and vary in terms of their cues and demands
that guide what motivated participants experience. Ideally, suggestions evoke stored
memories, associations, and mental representations and stimulate experiences consistent
with suggested events, which unfold on a more or less automatic basis, as is the case
with most everyday actions and cognitive activities. According to the sociocognitive
perspective, in the hypnotic context, these events are attributed to the influence of
suggestions and “hypnosis” (Kirsch & Lynn, 1999).
366 LYNN ET AL.

According to this view, simply using the word “hypnosis” in the context of what is
perceived to be an induction may be sufficient to establish a rule-governed context for
responding to imaginative suggestions. Yet, we will argue that what precedes and
follows any ritualized induction may be every bit as influential in determining hypnotic
responding as the induction itself.
Turning now to the “next” definition of the hypnotic induction, a decade later, the
American Psychological Association hypnosis division defined the hypnotic induction this
way: “Hypnosis typically involves an introduction to the procedure during which the subject
is told that suggestions for imaginative experiences will be presented. The hypnotic induction
is an extended initial suggestion for using one’s imagination, and may contain further
elaborations of the introduction …” (Green, Barabasz, Barrett, & Montgomery, 2005, p. 262).
One virtue of this definition is that it correctly implies that the hypnotic induction is
merely one aspect of the hypnotic proceeding and that the induction often proceeds
from the information provided by the hypnotist that precedes the induction. Indeed,
perhaps more often than not, there may be no more than a sliver thin dividing line, if
any at all, between activities that precede and follow the induction, and no boundary of
demarcation between suggestions contained in the induction and those that follow. The
definition is also in keeping with the fact that many inductions have in common explicit
suggestions to deflect attention from the external environment (other than the hypnotist
and suggestions) and narrow and focus attention internally on suggestion-related
imaginings and, in so doing, vividly imagine and experience suggested events.
Accordingly, a key point of our thesis is that although hypnosis is typically described as
involving two crucial phases or components—the induction and suggestions—these
components are actually only two of numerous threads in a much broader “hypnotic”
skein. Indeed, it is often imprecise to describe what transpires in terms of clear-cut phases
or stages, so that where the “induction” begins and ends is often a strained, arbitrary, and
artificial distinction. Rather, the induction is often preceded by an informed consent
procedure in research settings; an introduction by the hypnotist, which frames and
contextualizes hypnosis; and questions the participant asks about hypnosis followed by
the hypnotist’s responses. The induction itself is typically comprised of suggestions that
often stream unobtrusively into experimental test or clinical suggestions that are targeted
to achieve research or clinical objectives. As we will illustrate, all of these components
seem to serve a common purpose: (1) to build and validate the top-down constructed
cognitive-affective context—loosely speaking the participants’ “experiential world”—
from which the hypnotic behavior arises, and (2) perhaps to also reduce the impact of
bottom-up input (e.g., distracting sensations) on hypnotic responding.
In certain clinical contexts, the lines between the induction and other aspects of
hypnosis may be further blurred or eliminated. For example, in the popular Ericksonian
tradition the therapist may attempt to induce hypnosis on an entirely informal and
conversational basis, integrating suggestions into stories and anecdotes, metaphors,
and information derived from the person’s past and current everyday experiences in a
 INDUCTION IN THE BROADER SCHEME OF HYPNOSIS 367

seamless manner (see Matthews, Lankton, & Lankton, 1993; Yapko, 2012). In research
settings, the induction will typically be more standardized and more formally demar-
cated from other aspects of the induction of hypnosis than in clinical contexts, although
this issue has not been explored on an empirical basis.
Unfortunately, researchers have not subjected more informal conversational
approaches to hypnosis to scrutiny in a systematic fashion. Nor has the role of socio-
cognitive variables been studied extensively in Ericksonian-type hypnosis, although the
literature we review below on the equivalence of traditional authoritative direct versus
indirect and permissive suggestions, which are mainstays of the Ericksonian approach,
suggests that there is nothing “special” about the latter type of suggestions in terms of
their ability to increase hypnotic responsiveness.
But to return to our point of emphasis, the hypnotic induction and suggestions are
often enfolded within a larger framework of events and potentially complex interperso-
nal transactions (particularly in clinical contexts). Hypnosis unfurls from the inception
of the hypnotist-participant contact and extends to suggestions or instructions to termi-
nate hypnosis (i.e., at the count of 5, you will “come out of hypnosis”), which
effectively deactivates the top-down constructed context, and the parting interaction
of the hypnotist and participant. Moreover, hypnosis—particularly in clinical settings in
which suggestions are typically tailored to the individual—often unfolds as a reciprocal
process in which the patient’s responses influence subsequent hypnotist interventions in
a recursive manner on a moment-to-moment basis.
The second definition also hints at the role of imagination as a mechanism in
producing hypnotic responses. Indeed, many inductions include suggestions that
actively encourage use of the imagination and thinking and imagining along with
suggestions, as well as suggestions that imply that suggested events will occur invo-
luntarily or automatically. Nevertheless, the definition does not explain how using one’s
imagination facilitates responsiveness to suggestions and begs the question of how
participants translate what is imagined into felt sensations and involuntary actions
consistent with the aim of suggestions. Nor is it always the case that inductions
emphasize specifically the use of imagination.
The third and most recent definition of hypnosis (Elkins, Barabasz, Council, &
Spiegel, 2015) states that the hypnotic induction is “a procedure designed to induce
hypnosis.… The definition is designed such that it does not specify what procedures
may be involved or the context in which they occur. This may allow for procedures that
involve interaction between a therapist and client, self-hypnosis procedures, or other
procedures that may be identified in the future in clinical practice of research (such as
through advances in technology” (p. 6).
This definition skirts any attempt to specify attributes of the induction, mechanisms
associated with successful responding, and the place of the induction in the broader
procedures. This latter definition, in an attempt to be “theoretically neutral,” is arguably
a step backwards in developing an operational understanding of inductions and arriving
368 LYNN ET AL.

at even a rudimentary mechanistic explanation for their role and function (see Lynn,
Green, et al., 2015). Generally speaking, the lack of specificity and elaboration in these
three definitions reflects the sparse attention in the literature paid to the induction per se.

The Induction of Hypnosis in the Broader Scheme of Hypnosis

To better understand the role of the induction and its place in the overall scheme of hypnosis,
we will first examine the typical hypnosis setting and the effects of different inductions on
hypnotic responsiveness. We will suggest that the specific nature of the induction appears to
play a negligible role in affecting hypnotic responding. In contrast, we will suggest that
successful responding depends on a constellation of attitudes, beliefs, understandings,
expectancies, motivation, and response sets of participants, and on rapport with the hypnotist
in clinical settings, in particular. These variables, clearly identified with the sociocognitive
perspective of hypnosis (e.g., Lynn, Laurence, & Kirsch, 2015; Kirsch, 1990; Spanos, 1986),
promote cognitive-affective-behavioral plasticity that fosters increased responsiveness to
specific suggestions within the broader hypnotic context. This broad context sets new
parameters for how “reality” is temporarily experienced and how information is processed.
We will further develop this argument in the course of our discussion of commonalities
associated with diverse inductions and the broader scheme of hypnosis, research on the
hypnotic induction, and empirical efforts to increase hypnotic responsiveness.

The Hypnotic Setting

The setting in which hypnosis is typically conducted crucially marks the situation as
“hypnotic.” For example, the setting is characteristically designed to enhance physical
comfort, relaxation, and quiet to limit distractions. The participant may be seated in a
comfortable chair or couch and be encouraged to pay attention to both the hypnotist’s voice
and to get involved with the suggestions and relax. The lighting may be soft or dimmed. The
office or experimental room appointed with paintings or photographs selected to promote a
calm and relaxed state of mind (e.g., bucolic or beach scenes, sunsets). Eye closure is often
one of the first suggestions or instructions presented, and is geared to at once to direct
attention away from the external milieu and to facilitate a more narrow or concerted focus
on imagery and internal experiences as they arise. The hypnotist’s voice, often presented in
a “hypnotic like” pitch and cadence—which mirrors cultural beliefs regarding what is
“hypnotic”—also sets the situation apart from the mundane and can act as nonverbal
suggestion to “go into hypnosis” (Barber, 1985). Together, the effect of the hypnotist’s
presentation may be to amplify the effects of suggestions and top-down influences while
depreciating the impact of bottom-up input (e.g., distracting sensations, perceptions, affects)
that interfere with involvement in suggestions.
 INDUCTION IN THE BROADER SCHEME OF HYPNOSIS 369

Prehypnotic Information

From the first to the last words the hypnotist utters, the intention is to make the
experience of hypnosis less foreign and more palatable to participants and to minimize
anxiety and oppositional resistance while increasing curiosity about hypnosis and
maximizing expectations for positive responding. To facilitate comfort with the idea
of “being hypnotized,” the preamble may liken hypnosis to familiar scenarios, such as
involvement in watching a movie or getting absorbed while driving, or experiencing a
beautiful sunset or a visit to a favorite place. This information counters the widely
prevailing myth that hypnosis involves going into a “trance” far removed from everyday
experience. Alternatively, hypnosis may be presented as involving cooperation, an
altered state of consciousness, or a state of dissociation or heightened suggestibility.
Still, in keeping with our earlier discussion, we suspect that the particular way in which
hypnosis is described may be less important than casting the situation as “hypnotic,”
thereby locating hypnosis within a broader cultural frame, with attendant connotations
of increased responsiveness and heightened expectations. The single, powerful word
“hypnosis,” by meaningfully evoking culture-bound associations regarding what it
connotes to be hypnotized, may, therefore, account for many of the impressive effects
we attribute to the broader, sometimes lengthy and elaborate induction procedure.
An important goal of facilitative prehypnotic information is to counteract misconceptions
about hypnosis and negative beliefs and attitudes that may impede optimal responding.
These misconceptions include the culturally prevalent ideas that (1) hypnosis robs people of
their willpower and they cannot resist or oppose suggestions, and, instead, respond roboti-
cally; (2) hypnosis is associated with gullibility, low intelligence, or a lack of willpower;
(3) people lose awareness of their surroundings or develop spontaneous amnesia for what
occurred during hypnosis; and (4) people will “not be able to come out of hypnosis”
(see Green, Page, Rasekhy, Johnson, & Bernhardt, 2006; Lynn, Rhue, & Kirsch, 2010).
Prehypnotic motivational information can further convey the expectation that many
people are able to respond to a variety of suggestions, the experience of hypnosis will
be enjoyable and relaxing—often directly reinforced with suggestions for relaxation in
the induction—and that people respond to suggestions to different degrees, so as to
minimize negative expectancies arising from less than “perfect” or sub-optimal respond-
ing. Participants may also be instructed to think and imagine along with suggestions and
to experience them to the fullest extent possible, thereby motivating goal-directed and
active responses to suggestions and minimizing bottom-up influences (Barber &
Calverley, 1964; Barber, Spanos, & Chaves, 1972). These efforts are designed to
encourage participants to approach the experience with a positive, motivated, cogni-
tively committed set to respond, rather than face the prospect of hypnosis with fear and
trepidation or passively wait for a response to “just happen.”
To further minimize response-interfering concerns and potential resistance, partici-
pants may benefit from a demonstration that they can respond easily to nonhypnotic
370 LYNN ET AL.

suggestions, such as an easy to pass suggestion for arm levitation, or head falling, as
included in the Harvard Group Scale of Hypnotic Susceptibility: Form A (HGSHS:A;
Shor & Orne, 1962). Or to counteract common fears of relinquishing control, the
hypnotist may encourage deliberate and active resistance to a suggestion, such as
hands moving together (as if pulled by a magnetic force), to “prove to participants
and the hypnotist” that they can actively resist (Gfeller, Lynn, & Pribble, 1986). For
some participants (typically highly suggestible) who respond—despite instructions to
resist the hypnotist (see Lynn, Nash, Rhue, Frauman, & Sweeney, 1984)—the hypnotist
can comment on how their strong response suggests that they are excellent hypnotic
subjects. The hypnotist might add that if a suggestion were provided to engage in an
action that violated their ethics or personal standards or values, they could easily resist
(Coe, Kobayashi, & Howard, 1973).
Can the preamble make a difference? Lynn, Vanderhoff, Shindler, and Stafford (2002)
compared the impact of prehypnotic instructions that informed participants that the ability
to experience hypnosis depended on their ability to achieve an altered state of conscious-
ness or “trance” versus their willingness to cooperate. The latter instructions are included
in the Carleton University Scale of Hypnotic Responsiveness (CURSS; Spanos, Radtke,
Hodgins, Stam, & Bertrand, 1983). Participants who received the altered state set
indicated prior to hypnosis that they would respond to fewer suggestions and later
responded to fewer suggestions compared with participants who received the standard
instructions that emphasized cooperation. We interpreted these findings as indicating that
participants’ expectancies about successful responding are dampened by the prospect of
entering a trance state that may be perceived to be difficult to achieve, or associated with
negative connotations, and that when their experience fails to match their expectations, it
diminishes their responsiveness to suggestion (see Lynn, Green, Jaquith, & Gasior, 2003).
In another study, Accardi, Cleere, Lynn, and Kirsch (2013) found no differences in
participant responsiveness across rationales that experimenters provided regarding hypnosis
when we equated the rationales for induced expectancies about successful responding.
More specifically, in one condition we presented hypnosis in keeping with the preamble that
accompanies the HGSHS:A (Shor & Orne, 1962), which informs participants that hypnosis
is “largely a question of willingness to be receptive and responsive to ideas, and to allow
these ideas to act on you without interference.” We compared the effects of this rationale
with one that indicated that hypnosis could be used as a non-deceptive placebo (Kirsch,
1994). This rationale informed participants, “Hypnosis acts very much like a placebo … in
this study, we can use hypnosis as a placebo because hypnosis can be used without any
deception at all … and like a placebo, hypnosis seems to work by mobilizing people’s
positive expectancies” (p. 108).
To control for expectations, in both conditions we told participants that hypnosis
works by mobilizing participants’ positive expectancies, but no mention of hypnosis
being a placebo was presented in the standard condition. We found that participants
responded comparably in terms of average hypnotic attitudes, prehypnotic expectances,
 INDUCTION IN THE BROADER SCHEME OF HYPNOSIS 371

behavioral responsiveness to suggestions, and hypnotic experiences assayed on a post-

hypnotic basis, compared with the standard hypnosis rationale. Unfortunately, research
on the effects of the rationale and the provision of prehypnotic information is scant;
much more work needs to be done.

Comparing Hypnotic Inductions

Given commonalities we referred to across inductions and other aspects of the hypnotic
proceedings, it follows to ask whether the nature of the induction per se has much of a
bearing on hypnotic responsiveness. Researchers have discovered that it appears to
make no difference in behavioral responding whether the induction is (1) administered
in a group or on an individual basis (Bentler & Hilgard, 1963); (2) relatively long or
short (Klinger, 1970); (3) administered live or via audio tape (Fassler, Lynn, & Knox,
2008); (4) administered using a traditional eye closure induction or a standardized
Chiasson (1973) technique (hand moves toward face and when it reaches the face, the
participant experiences a deep state of hypnosis; Page & Handley, 1991); (5) taken from
the Carleton University Responsiveness Scale induction or a modified version of the
Stanford Hypnotic Susceptibility Scale, Form C; and (6) presented as heterohypnosis or
self-hypnosis (Hammond, Haskins-Bartsch, Grant, & McGhee, 1988).
Additionally, researchers have examined the effects of inductions in terms of whether
the suggestions contained in them are direct versus indirect. Direct suggestions are
statements that are specific, clear, directive, and command like, often delivered in an
authoritative manner (O’Hanlon, 1987), such as “Your arm will rise up off the resting
surface” and “You are very deeply relaxed.” In contrast, indirect suggestions (Matthews
et al., 1993; Stone & Lundy, 1985) typically share one or more of the following
features. They are permissive, often nonspecific or ambiguous, and allow for choice
and a range of appropriate responses, such as “You may experience a light, deep, or
medium trance today. I wonder just how deep you will go?”
Researchers have generally found no differences in behavioral responses to direct
versus indirect inductions and suggestions (see Lynn, Neufeld, & Mare, 1993). Lynn,
Neufeld, and Matyi (1987) is one of the few studies that manipulated the induction
wording independent of suggestion wording. The wording of the induction had no effect
on subjects’ responsivity and their ratings of subjective involvement or suggestion-
related involuntariness.
Nevertheless, aside from the induction, some studies (Lynn et al., 1987; Lynn,
Weekes, Matyi, & Neufeld, 1988; Matthews, Bennett, Gallagher, & Bean, 1985;
Matthews & Mosher, 1988; Weekes & Lynn, 1990) have found that direct suggestions
produce greater subjective involvement, feelings of involuntariness, and diminished
resistance (Matthews & Mosher, 1988). Yet, when Matthews and Mosher (1988)
equated the inductions for length and delivery time, they failed to replicate their earlier
372 LYNN ET AL.

findings. And still other research has found no difference between direct and indirect
suggestions on measures of involuntariness (Stone & Lundy, 1985) and subjective
experience (Matheson & Shue, 1987).
Since Lynn et al.’s (1993) review, the majority of studies have found no differences in
behavioral and/or subjective responses between direct suggestions and inductions and
their indirect counterparts (Groth-Marnat & Mitchell, 1998; Hawkins, Liossi, Ewart,
Hatira, & Kosmidis, 1998; Maurer, Santangelo, & Claiborn, 1993; Pitsch, Sapp, &
McNeely, 2001; Szabó, 1993). Although the findings regarding subjective measures are
somewhat mixed, there is little ambiguity regarding conclusions that can be drawn with
regard to behavioral (i.e., objective) responses: virtually no support exists for the advan-
tage of indirect suggestions over direct suggestions. It appears to be the case that the
differences in wording between direct and indirect inductions and suggestions are incon-
sequential at the level of semantic processing and activation in the hypnotic context.
This lack of difference among inductions does not preclude differences in individual
preferences for one induction over another. Spinhoven, Baak, Van Dyck, and Vermeulen
(1988) used a version of the Harvard scale adapted with indirect suggestions and found
that subjects who received the indirect and direct Harvard scales had identical average
hypnotizability scores. Nevertheless, 20 subjects indicated a preference for the Harvard,
whereas 15 subjects preferred the indirect scale, and five were neutral in their
preference.
Researchers have also compared a traditional induction with a more unconventional and
arguably indirect induction. Matthews, Kirsch, and Mosher (1985) tested Bandler and
Grinder’s (1975) claim that the so-called double induction is superior to traditional hypno-
sis. Half of the right-handed subjects received the Stanford Hypnotic Susceptibility Scale,
Form C (SHSS:C; Weitzenhoffer & Hilgard, 1962) induction, and the other half received a
stereo delivery of two simultaneously presented audio tracks. The audio track that was
directed to the subjects’ dominant hemisphere (left ear) used Erickson’s hand levitation
induction, while what the researchers referred to as “child-like grammar messages,” such as
“wondering,” ‘‘hands lifting,” “sleep,” and so forth, were delivered to the nondominant
(right ear) hemisphere. The following day the order of inductions was reversed. No
differences in hypnotizability scores were evidenced following either induction; however,
subjects who received the double induction first were later less responsive to suggestions
following both inductions than were subjects who received the standard induction first. The
findings contradict Bandler and Grinder’s (1975) assertion that the double induction is an
especially powerful means of inducing hypnosis (… one of the most powerful techniques
which we have developed is the double induction…, p. 194).
As many different hypnotic inductions share a common element—they provide
suggestions for physical and/or mental relaxation and behavioral stillness—an arguably
greater departure from the traditional relaxation-based induction is the so-called active-
alert induction. Bányai and Hilgard (1976) compared an active-alert induction, in which
participants received suggestions for increased alertness with their eyes open, while
 INDUCTION IN THE BROADER SCHEME OF HYPNOSIS 373

riding a bicycle ergometer, with a traditional relaxation induction (i.e., eye fixation with
instructions to relax) followed by suggestions from a standardized scale (SHSS:B;
Weitzenhoffer & Hilgard, 1959). The researchers found no differences in hypnotic
responding between the two inductions in the context of a within-subjects design with
randomized alternation between alert-active and traditional inductions. Across both
inductions, highly suggestible participants reported that they achieved “altered states.”
More recently, Wark (2006) summarized the findings across multiple studies (e.g.,
Cardeña, 2005; Malott, 1984; Miller, Barabasz, & Barabasz, 1991) that substituted an
alert or hyper-alert induction for a more traditional relaxation-based induction and
concluded that there were practically no significant differences across suggestion types.
Cardeña, Alarcon, Capafons, and Bayot (1998) conducted an interesting study that
provided a creative demonstration of the value of induction preparation. The researchers
developed a set of energizing exercises to prepare subjects for an “active hand”
induction in which participants were invited to recall or imagine experiences intended
to increase heartbeat, respiration, and wide visual expansion. The actual induction
involved moving the right hand vertically up and down rapidly and then suggesting
increased heartbeat, respiration, and alertness. The researchers found that participants
were significantly more responsive and more likely to stay in the study compared with
Bányai and Hilgard’s (1976) bicycle induction.

Increasing Responsiveness to Hypnosis

Our discussion has emphasized the value of considering the induction in terms of the
broader events of hypnosis. Cardeña et al.’s study highlights the potential of instruc-
tional efforts to increase responsiveness as influential in the induction of hypnosis.
Relatedly, Vickery, Kirsch, Council, and Sirkin (1985) provided participants with
information and experimenter demonstration regarding imaginative cognitive strategies
to respond effectively to suggestions followed by practice in using the cognitive
strategies. When this “cognitive skill induction” was preceded by a traditional hypnotic
induction, subjective responses to hypnosis were enhanced significantly and objective
response was enhanced marginally, compared with the traditional induction. However,
when the order was reversed, the inductions did not produce differences in subjective or
objective responses. The traditional induction engendered greater alterations in con-
sciousness, prompting the researchers to comment, “… the skill induction teaches
subjects cognitive strategies that enhance responsivity to suggestions in subsequent
hypnotic experiences independent of the alterations in consciousness elicited by trance
induction” (p. 131).
Around the time of this research, Gorassini and Spanos (1986) initiated a line of studies
that focused on efforts to systematically enhance hypnotic suggestibility by teaching not
only cognitive strategies, but also enhancing response expectancies, minimizing or
374 LYNN ET AL.

eliminating negative beliefs about hypnosis, and enhancing rapport and minimizing
resistance to responding to suggestions. More specifically, the Carleton Skills Training
Program (CSTP) the researchers developed includes the following components: (1)
information to instill positive attitudes about hypnosis and motivation to respond;
(2) instructions regarding how to use imaginal strategies to promote successful respond-
ing and instructions regarding how to interpret suggestions (e.g., enactment instructions
that one must actually lift the hand while imagining it is rising by itself); (3) exposure to a
video-taped model who enacts successful responses to suggestions and verbalizes
imagery-based strategies to facilitate subjective response; and (4) practice in responding
to suggestions. The selection of variables to target in this program was inspired by the
sociocognitive model of hypnosis (see Kirsch, 1990; Lynn, Laurence, & Kirsch, 2015;
Spanos, 1986, 1991), which holds that attitudes, beliefs, expectancies, motivation,
responsiveness to nonhypnotic imaginative suggestions, and cognitive strategies are
variables key to understanding and potentially facilitating hypnotic responsiveness.
Spanos and his associates (see Gfeller & Gorassini, 2010; Gorassini & Spanos, 1999)
have determined that approximately 50% of initially low suggestible subjects who
underwent the CSTP scored as high suggestible at post-testing with standardized
inductions. Importantly, researchers have documented large magnitude CSTP treatment
gains that have persisted for two and a half years (Spanos, Cross, Menary, & Smith,
1988) across studies in Spain (Cangas & Pérez, 1998), Poland (Niedzwienska, 2000),
and England (Fellows & Ragg, 1992). Because the CSTP produces increases in both
objective and subjective responsiveness to hypnotic suggestions, with gains general-
izing to novel test suggestions (Spanos, 1986), it is possible that suggestibility training
can increase responsiveness to clinically relevant suggestions related to hypnotic
suggestibility, such as for pain control (see Lynn, 2004; Lynn & Sherman, 2000).
Before leaving this topic, it bears mention that rapport is another aspect of the
hypnotic situation that is amenable to modification. Lynn et al. (1991) tested high and
low suggestible participants in either a high or a low rapport condition. In the high
rapport condition, the hypnotist was friendly, smiled, and disclosed to the participant on
relatively intimate topics selected from a list ranked in intimacy. In the low rapport
condition, the hypnotist was formal in demeanor and disclosed on only the most
superficial topics. Initially low responsive participants passed more than 2.5 suggestions
and, on average, scored in the medium hypnotizable range after the manipulation of
positive rapport, whereas the initially highly suggestible participants were unaffected by
the rapport manipulation.
Researchers have also shown that rapport also exerts an effect on the impact of CSTP
training. Gfeller et al. (1987) reported that 25% of initially low suggestible participants
tested as highly suggestible after training in a relatively “neutral” rapport condition
compared with 50% of participants who tested as highly suggestible after training in a
condition designed to facilitate rapport with the trainer. Unfortunately, typically little is
done to increase rapport, at least in the context of experimental hypnosis, which is
 INDUCTION IN THE BROADER SCHEME OF HYPNOSIS 375

perhaps one reason why it seems to matter little whether instructions are provided in a
live format or via an audio recording (Fassler et al. 2008), or whether hypnosis is
defined as self-hypnosis and participants are trained to administer self-suggestions
(Barber, 1985).
The CSTP program has not been without its critics, as justifiable questions linger
regarding the extent to which post-training gains reflect instructed versus more sponta-
neous, ability-related cognitive and experiential processes (see Lynn et al., 2015).
Nevertheless, following Gfeller and Gorassini (2010), we suggest that it may be fruitful
to include many of the elements associated with the CSTP into relatively brief proce-
dures initiated prior to and during inductions, because research has substantiated the role
of elements of the CSTP as accounting for substantial variability in hypnotic responding
(see Lynn, Laurence et al., 2015).
As we have indicated, prehypnotic information can be used to bolster positive expec-
tancies, increase motivation, correct misconceptions about hypnosis, and facilitate rapport
with participants. It may also be worthwhile to attempt to minimize top down impedi-
ments to hypnotic responding in hypnotic suggestibility modification programs and
inductions more generally. For example, participants could be instructed to accept that
initially distracting thoughts and sensations may arise in the course of events, and “that is
perfectly fine, just know that they are natural occurrences and should not get in the way at
all with your ability to experience suggestions … you can easily become absorbed in your
experiences as you find that these thoughts and sensations recede into the background of
your consciousness as you get more deeply involved in your experience of hypnosis.”
Methods and suggestions intended to enhance rapport, motivation, and positive
expectancies, could be included in hypnotic inductions and conceivably be individua-
lized based on a careful assessment of the person with an eye toward optimizing
hypnotic performance. The effects of individualizing inductions and procedures is
clearly an understudied area, with only one study to date comparing a standardized
hypnotic suggestibility scale, based on a relaxation induction, with an individualized
version of the same scale to determine whether individualizing the induction enhances
hypnotic responsiveness. In research conducted by Van Der Does, Van Dyck,
Spinhoven, and Kloosman (1989), participants were tested twice; once with the stan-
dardized Stanford Hypnotic Clinical Scale: Adult (Morgan & Hilgard, 1978) and once
with an adapted, individualized version of the same scale in which the hypnotherapists
(experienced members of the Netherlands Society of Hypnosis) were “… free to use
whatever induction procedures and wording of suggestions seemed appropriate for a
particular S” (p. 183). The researchers found no differences across the standardized and
individualized version of the scale. Nevertheless, the criteria for individualizing the
procedures were neither standardized nor theory-based, so much research needs to be
done on individualizing suggestions to guide and facilitate clinical work.
A novel way to increase hypnotic suggestibility may be to provide instructions or
suggestions to facilitate goal-directed behavior in the hypnotic context. Gollwitzer
376 LYNN ET AL.

(1999) has distinguished between goal setting and implementation intentions.

Implementation intentions involve establishing contingent “if-then” relationships to
better effect the realization of a particular goal. For example, a generalized goal might
be “I would really like to experience hypnosis,” whereas an implementation intention is
subordinate to the generalized goal and typically better specified. Accordingly, an
implementation intention might be “If I think and imagine along with suggestions,
then I will get more absorbed in them” or “If I get really absorbed with suggestions,
then I will be more responsive to suggestions.”
The implementation intention, thus, introduces if-then rule sets, parameters for experi-
ence and behavior that could become an integral part of the cognitive-affective-behavioral
context, which, we expect, would increase hypnotic responsiveness more efficiently and
less ambiguously than generalized goals. In clinical practice and research, such imple-
mentation intention instructions could be incorporated into inductions and even framed as
suggestions (e.g., “If you think and imagine along with the suggestion for your arm to rise,
then you will experience your arm rising), and/or presented in the context of prehypnotic
information. To facilitate possibly even deeper cognitive processing, the hypnotist could
couch the instructions more in terms of a question along the lines of: “What if you think
and imagine along with the suggestion for your arm to rise, and then experience your arm
rising?” We are currently investigating whether including information and suggestions to
facilitate implementation intentions will facilitate hypnotic responding compared with
information and suggestions specifying more generalized goal contemplation. We suggest
that when the positive components of hypnotic responsiveness we identified are included
in hypnotic procedures, including in the induction per se, participants will respond closer
to the limits of their abilities to experience suggestions.

Conclusions, Reflections, and Research Recommendations

In this article, we have taken note of the tremendous variability in hypnotic inductions
and procedures that render it difficult to draw unambiguous conclusions and interpreta-
tions regarding the nature, role, intended purpose, and impact of inductions on hypnotic
responding. We now suggest that the problem of disambiguating the induction from
other elements of the broader scheme of hypnosis begins even prior to the hypnotic
session. More specifically, it is difficult to disentangle the effects of an induction from
information provided prior to even starting the hypnosis session in the informed consent
procedures in a research context, or in the earliest informal or nonstandardized com-
ments by the hypnotist in a clinical setting. Indeed, how the session is cast (e.g., what is
the nature of hypnosis; why is it being used; what is the probability that it will help in a
particular circumstance), as well as information about myths and potential risks, may
vary widely among hypnosis sessions and studies and exert important and as yet often
under-appreciated effects on hypnotic responding.
 INDUCTION IN THE BROADER SCHEME OF HYPNOSIS 377

We suggest that the impact of formal and informal pre-session information on

hypnotic responsiveness should be carefully considered, even when using standardized
scales of hypnotizability. Formal inductions, the wording of suggestions, and the
amount of time between suggestions delivered are often carefully scripted and well-
elucidated. Nevertheless, unscripted or non-standardized information presented before
the hypnosis session even begins may be just as important as what transpires after the
session starts in determining research or clinical outcomes. Indeed, virtually no attention
has been devoted to prehypnosis session information conveyed to participants in
informed consent procedures and in the description of the nuts and bolts of the study,
which may differ widely across laboratories and clinics and may be presented on a more
or less informal basis.
Investigators would well serve the field by summarizing the information they present
to participants at all stages of their research in published reports, as such information is all-
too-rarely presented in both research and clinical accounts. In fact, with participant
consent, it would be valuable to archive in DVD format or on a password protected site
on the Internet an entire interaction, from start to finish, with a single participant or group
undergoing hypnosis to be made available to researchers interested in acquiring detailed
information about the research for purposes of evaluation of the study and/or replication.
An interesting aspect of pre-session information, and actually the conduct of the
entire study, is that it may be subject to extra-experimental influences and pressures. For
example, some institutional review boards (IRBs) may insist that prospective partici-
pants be presented with a list of potential risks that have been reported in the literature
previously, such as the possibility of headaches, muscle stiffness, and tiredness, whereas
other IRBs may not require such information. Pre-session information may also differ in
terms of the extent to which information about participants’ ability to resist suggestions,
should they choose to do so, is emphasized or ignored. Simply providing a “common
example” of a type of suggestion that participants might expect to receive during the
procedure proper may serve to shape, strengthen, or alter prehypnosis expectancies and
might make findings across studies difficult to compare and interpret to the extent that
this information differs or is absent across studies.
In one of the few studies that addressed very “early” information that participants
were provided with, Coe, Peterson, and Gwynn (1995) reported that individuals who
received brief instructions before hypnosis, which provided very specific warnings of
negative aftereffects (i.e., “approximately one half of subjects have reported mild, short-
term aftereffects, such as headache”) with no positive information about hypnosis,
reported more negative aftereffects than did participants in which no mention was
made of positive or negative aftereffects, or more balanced information was presented
(i.e., “some mildly unpleasant experiences,” plus “most persons report their experiences
to be pleasurable and interesting”). Page and Handley (1996) later reported significant
correlations between hypnotic suggestibility and the report of aftereffects and number of
somatic complaints.
378 LYNN ET AL.

The therapist’s explanation for why hypnosis is considered to be a useful adjunctive

treatment may be critically important in the clinical context. The following variables
may further impact how clients respond to and view hypnosis (e.g., as a primary care
intervention versus a “last ditch” effort to bring about change): (1) whether the decision
to use hypnosis or a particular induction is based on a unilateral therapist decision
versus a collaborative one, (2) the timing regarding when to bring hypnosis into
treatment, and (3) the decision regarding whether to implement hypnosis in conjunction
with other strategies (e.g., acceptance-mindfulness based interventions). Accordingly,
research examining the potential effects of these variables on hypnotic responding or
clinical outcomes would be welcome.
Participant preference for different hypnotic inductions, which may be especially
important in the clinical arena, is also a little studied area, as induction preference may
be associated with positive treatment expectancies and may be impactful in terms of
subjective, if not objective, response to suggestions and the overall hypnotic procedures.
It would be interesting for researchers to examine the effects of preference for induc-
tions in the context of providing individuals with the opportunity to observe models that
undergo different inductions and verbalize their responses to the inductions. Such
observation might provide participants with valuable information regarding which
induction would be most appealing and thereby elicit the most positive response
expectancies. There is also a pressing need to examine potential differences between
formal/standardized inductions, well-demarcated from other aspects of the procedures,
and more free-flowing, informal, and conversational inductions and interventions in
keeping with the Ericksonian tradition.
Additionally, we suggest that researchers explore the effects of the mere inclusion of
the word or label of “hypnosis” and matching inductions with abilities. If all the induction
does is to establish an hypnotic context, and little more, engaging top-down processing,
than labeling virtually any activity, ranging from taking a few breaths, to walking, to
closing one’s eyes, to feeling relaxation in a single body part would be expected to
produce outcomes equivalent to a more elaborate and lengthy induction. It would also be
interesting to determine whether it would be possible to increase hypnotic responsiveness
by matching the nature of induction to participants’ abilities. For example, researchers
might ask whether highly imaginative people would benefit from inductions that played
to their imaginative abilities by emphasizing the use of imagination or by priming
imaginative responses prior to hypnosis, relative to participants with less well-
developed imaginative abilities.
The fact that an elaborate induction is apparently not necessary in the case of self-
hypnosis also bolsters the hypothesis that the formal induction of hypnosis can play a
minimal role in engendering and determining responsivity to suggestions. From a socio-
cognitive perspective, the same variables that affect so-called hetero-hypnosis, also
probably come into play when the methods are defined as self-hypnosis. Merely labeling
the procedures as “hypnosis,” particularly after the person is first “hypnotized” or
 INDUCTION IN THE BROADER SCHEME OF HYPNOSIS 379

participants are told that “all hypnosis is really self-hypnosis,” as is often the case, likely
activates attitudes, beliefs, and expectancies regarding hypnosis that are deeply rooted in
our culture. Still, limited research has directly compared responsiveness to hypnosis when
the procedures are defined as self- versus hetero-hypnosis, and research that compares the
role of sociocognitive variables across hetero- versus self-hypnosis is certainly warranted.
Clinical practitioners and researchers not infrequently encounter participants who
deny the fact that they were “hypnotized” or minimize their responsiveness to hypnotic
suggestions, despite the fact that they display a high level of behavioral responsiveness
to suggestions. These types of reports have not been studied systematically, and deserve
such scrutiny, although they may simply be indicators of mismatches between partici-
pants’ experience and their expectancies regarding how “good” or “excellent” hypnotic
subjects experience hypnosis. For example, if participants do not believe that they
achieved the proverbial and poorly defined “trance state,” they may report after
hypnosis that they were “not hypnotized.” In fact, researchers have shown that partici-
pants who test at the extremes of hypnotic high suggestibility do not tend to rate their
responsiveness in accordance with their actual objective performance, because there are
no clear-cut widely accepted subjective criteria that determine whether a person is
“hypnotized” or not (Martin & Lynn, 1996).
Clinicians will also encounter individuals who are initially highly skeptical of their
ability to experience hypnosis. However, most initial suggestions in research protocols,
and many suggestions in psychotherapy contexts, are easy to pass (see Barber, 1985) and,
if passed by initially skeptical participants, may provide strong and compelling positive
expectations for subsequent successful responding (“Well, here I thought I could not be
hypnotized, so I must be more hypnotizable than I thought” or, “Hypnosis must be very
powerful if I could respond despite my skepticism”) in these individuals. This phenom-
enon has not been the subject of study in the laboratory. Expectancies arise not only
during the induction, but also as a function of participant self-observation of their
responsiveness to imaginative suggestions, which generally produce equivalent levels
of responsiveness, regardless of whether they are preceded by an induction or not (Meyer
& Lynn, 2011). Studies of the link between different types of inductions and changes in
expectations over the course of a hypnosis session have not been reported to date.
Note that the sociocognitive perspective does not discount the possibility that
researchers will, one day, isolate an as yet unidentified “ability factor” that is reliably
and robustly associated with the transformation of verbal suggestions into involuntary
experiences. Unfortunately, the search for such ability has not proved to be very
rewarding to date. For example, measures of dissociation and absorption account for
only a small percent of variability in hypnotic responding, especially when hypnotic
suggestibility and measures of these constructs are administered in separate test contexts
(see Council, Kirsch, & Grant, 1996; Kirsch & Lynn, 1998). Still, it is worthwhile to
continue to search for one or more abilities, in isolation or in combination, which can
account for significant variability in hypnotic responding and experience.
380 LYNN ET AL.

The sociocognitive model holds that the experience of suggestion-related involuntariness

is related to participants’ expectancies, the passive wording of suggestions, the presence of
goal-directed fantasies contained in suggestions (i.e., “imagined situations which, if they
were to occur, would be expected to lead to the involuntary occurrence of the motor
response called for by the suggestion”: Spanos, Rivers, & Ross, 1977), and a response set
to “let things happen” (see Lynn, Rhue, and Weekes, 1990 for an in-depth examination of
this topic). Previous studies have not assessed, in light of the aforementioned variables, the
potentially distinct experiences of involuntariness associated with the suggestions in the
induction versus those that follow.
In closing, we wish to underscore the point that it is problematic to consider hypnosis
narrowly as consisting of only two broad phases: the induction and the suggestions, and
to ignore the role of procedures and variables in the broader hypnotic scheme key to
account for individual differences in hypnotic responding. Participants probably respond
to a broad gestalt of variables and subtle and not so subtle conscious and unconscious
influences, many of which, nevertheless, can be identified, isolated, quantified, and
studied in a programmatic manner. These variables come together in the language of
suggestions before, during, and after the induction that play an instrumental role in
constructing the cognitive-affective-behavioral context of hypnosis.
Although our preference is to view a conglomerate of sociocognitive variables as particu-
larly influential, variables from other traditions and perspectives, such as dissociation theories
of hypnosis, are also worthy of investigation, and Lynn and Green (2011) have suggested the
possibility of rapprochement between sociocognitive and dissociation theories of hypnosis.
Acquiring a better understanding of what researchers and clinicians can do to enhance
participants’ ability to respond to suggestions should also be a priority. Clearly, different
inductions, as well as other constituents that shape the totality of experiences that we call
“hypnosis,” deserve continued and closer scrutiny by researchers and clinicians alike.

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