Current GPSCH President Catherine Fine, Ph.D. will become President-Elect of the American Society of Clinical Hypnosis (ASCH). Her election means she will serve as ASCH President during the 1998-99 membership year, following a term as President-Elect during 1997-98. Fine will be the second GPSCH executive in 4 years to serve as President of ASCH (following Richard Kluft, M.D.).

Fine currently serves as Vice-President of ASCH, and has served in past years as ASCH Secretary and as the Com-ponent Section representative to the ASCH Board of Governors.

Fine obtained her Ph.D. in Social Psychology from Temple University, and subse-quently completed the Clinical Psychology respecialization program at the Dept. of Psychiatry of the University of Pennsylvania Medical School. In addition to her clinical work, Fine serves as Associate Editor of Dissociation , and as a reviewer for several profes-sional journals, including The American Journal of Clinical Hypnosis.

The Anomalous Experiences Inventory: Reliability and Validity. (1994). Charles Gallagher, V. K. Kumar, and Ronald J. Pekala. The Journal of Parapsychology, 58, 402-428.

Abstract: The Mental Experience Inventory (Kumar & Pekala, 1992) was revised to include additional items dealing with anomalous and paranormal experiences, beliefs and abilities; fear of having such abilities; and drug use. Using cluster analysis, correlations with external criteria, and item analyses, the revised scale was segmented into five subscales: anomalous/paranormal experiences, anomalous/paranormal beliefs, anomalous/paranormal abilities, fear of the anomalous/paranormal, and drug use. These five subscales were combined into one inventory titled the Anomalous Experiences Inventory (AEI). The KR-20 reliability values for the subscales ranged between .64 and .85. Correlations of the AEI subscales with other paranormal beliefs and experiences measures and selected personality measures suggested a moderate degree of convergent validity for the experiences, abilities, beliefs, and drug use subscales.

Among the findings:

Irwin (1993) found that people who believe in paranormal experiences "tend to seek out or engage in a variety of activities such as seeing movies with paranormal themes, taking courses in parapsychology or psychic development, using mind-expanding drugs or other ways of altering consciousness, and practicing as psychics and mediums." The relationship between paranormal belief and involvement in activities with a paranormal theme "'may well be bidirectional or circular, with beliefs encouraging involvement and with involvement serving to reinforce beliefs' (p. 13)."

Irwin also noted that "although not uniformly so, religiosity tends to be correlated with belief" in paranormal phenomena. However, religiosity does not seem to be correlated with paranormal experiences.

In terms of personality characteristics, there seems to be a correlation between paranormal beliefs and experiences with being "fantasy-prone." There may be mediating variables, however. For example, "Irwin (1993) concluded that belief in parapsychological phenomena is associated with the creative personality and that such belief thus correlates significantly with sensation seeking, a construct related to creativity." Some studies also found small but significant correlations between paranormal beliefs and high scores on the Eysenck Personality Inventory neurotocism and extraversion scales. Interestingly, paranormal beliefs may be more related to seeking internal, rather than external, novel experiences (perhaps because the former are more related to fantasizing).

The subjects for this study consisted of 400 undergraduate psychology students at West Chester University. The revised Mental Experience Inventory (the precursor to the AEI) was termed the "Paranormal Beliefs and Experiences Questionnaire" (PBEQ). In addition to the PBEQ, each subject completed the following instruments: The revised Paranormal Belief Scale (PBS), Richard's Scale of Psychic Experiences (RSPE), the Belief in Psychical Phenomena scale (BPPS), the Eysenck Personality Inventory (EPI), Pearson's Novelty Experiencing Scale (NES), and the Magical Ideation Scale (MIS).

As expected, the AEI's experiences, abilities, and beliefs subscales were highly correlated with each other, suggesting that people who believe strongly, and claim abilities, in anomalous/paranormal phenomena also report higher frequencies of anomalous experiences. Contrary to expectations, these three subscales were negatively correlated with the fear subscale, suggesting that anomalous beliefs and experiences were not related to the subjects' fear of such experiences. The AEI drug use scale, which had no direct analog in the other instruments, was positively correlate with sensation-seeking measures. Correlations with the other instruments used in this study generally provided convergent validity to the AEI and its subscales, and met the researchers' expectations that the AEI would tap into both the paranormal and sensation-seeking dimensions, thereby providing the advantage of measuring anomalous/paranormal beliefs, experiences, abilities, fear, and drug use in one instrument.

Irwin, H. J. (1993). Belief in the paranormal: A review of the empirical literature. Journal of the American Society for Psychical Research, 87, 1-39.

Michael D. Yapko's Suggestions of Abuse: True and False Memories of Childhood Sexual Trauma. Simon & Schuster, 1994, 271 pages, hardcover, $22.00.

Psychologist/hypnotherapist/family therapist/author Michael Yapko's latest work may be the first to attempt a balanced inquiry into one of the greatest controversies in contemporary psychotherapy: "repressed" vs. "false" memories of childhood trauma. In the process, he has written an important but flawed book.

Suggestions of Abuse seems to be two books: (1) a relatively scholarly, down-to-earth, and balanced work that raises many serious questions, and (2) a polemic that periodically degenerates into tirades against ambiguously-defined "bad therapists" (which seem to be the majority of us).

The first two chapters introduce and then review his own research on therapists' attitudes about hypnosis and memory (repressed and otherwise). Even taking into account the methodological imprecision of Yapko's instrument and sampling procedures, the results of his study give cause for concern: Far too many therapists are unfamiliar with scientific research on hypnosis and memory--yet psychotherapists are often accepted, by both lay people and the courts, as "experts" in both fields. Yapko makes a strong case for challenging pseudoscientific beliefs about "truth serums," "body memories" and the accuracy of hypnotic regressions. Yapko's chapter on memory is concise and easy for professional and lay audiences alike to follow and understand. He is at his conceptual best when explaining how therapist expectations and countertransference issues can subtly influence some clients to question the validity of their pretherapy memories, and then resolve those doubts by accepting the possibility of "repressed abuse" being at the root of their symptoms.

Perhaps Yapko was trying too hard not to alienate accused families and their allies (the False Memory Syndrome Foundation chief among them). While making liberal use of clinical anecdotes supportive of false memories, he does not balance these out with a similar number of clinical anecdotes of repressed memories (although he does indicate they exist). Similarly, he takes great pain (and many paragraphs) to critique research supportive of repressed memories, while only briefly mentioning without elaboration the possibility of flaws in the research that has claimed to have discredited repression.

For a book that initially tries to rely heavily on objectivity and science, Yapko does not clearly distinguish between science and polemic. When being argumentative and opinionated, his primary target is psychotherapy. He criticizes therapists for "adding new perspective to old experiences... [in which] a 'loving a protective mother' may become 'co-dependent.' (They used to just be 'Mom and Dad.')" He notes that "while the number of therapists in the country has roughly doubled in the last decade, the mental health of the country has not improved accordingly." (p. 88) Personally, I am perplexed by people who seem to suffer from distorted conscious memory as they pine for "the good old days" (of Jim Crow and lynchings, of rampant child exploitation by industry, of flagrant oppression of women, of institutionally-sanctioned humiliation and persecution of addicts and the mentally ill--not to mention the Holocaust). I do not accept as a fact that the "general mental health" of the world or this country was "better" prior to the second half of this century.

Similarly, Yapko takes a stand that seems to agree with the revisionist notion that we live in an era in which America is becoming the "land of victims." "Few people want to say, 'I guess I'm just a loser.' It is much easier to say, 'It's Mom and Dad's fault.'" (p. 145) I have not found this to be the case at all with abused clients; unfortunately, my patients have had no trouble calling themselves "losers." They tend to be extremely protective of their parents and families, even when there is plenty of objective evidence of chronic and extreme abuse. In my clinical experience, sexual abuse survivors too often fail to see themselves as victims, and are overly critical and harsh with themselves (i.e., they victimize themselves). I wonder if Yapko is confusing media hype and television talk shows with sociology.

Yapko also claims that "since psychotherapy started to become more widely accepted and available...therapists have intensely emphasized personal fulfillment, personal happiness...[with the underlying message of] you don't have to live up to anyone else's expectations...you don't have to honor commitments that later become inconvenient, you don't have to do things you find unpleasant..." (p. 139). He speculates that "the cultural climate invites [false memories of abuse] by encouraging individuals to believe they are entitled to whatever they want, however unrealistic and irresponsible." Therapists encourage clients "to lay the blame elsewhere when [they] are disappointed." (p. 142) I have not encountered many therapists who confuse "personal fulfillment" with irresponsibility in this manner; if anything, the therapists I have encountered are strong proponents of the cognitive therapy paradigm that exhorts clients to be responsible for their beliefs, feelings, and behaviors. I have a similar problem with Yapko's unrelenting attack on the "recovery movement," often by quoting media-guru John Bradshaw. Again, Yapko's experiences do not match my own. People at meetings of Alcoholics Anonymous talk at length about their own foibles, not their parents.'

Fortunately, Yapko does balance this tirade with the admonition that "parents can get caught in a similar trap." (p. 146) Still, Yapko criticizes therapists for making premature generalizations from incomplete data (in the first two chapters of his book), but then often demonstrates the same tendency. A story in Time magazine (with which Yapko begins a section entitled "America: The Land of Victims") hardly constitutes scientific data.

The final chapters in Suggestions of Abuse are better constructed, but incomplete. His advice to survivors and accused family members is fairly sound, and the sections on "If you are the spouse of the accused" and "If the accuser is your sibling" are well thought-out. To the accused family members, he clearly states that "[if] you instigated or participated in acts directly or indirectly involving abuse, the painful but moral response is to admit it. ...Admitting that abuse occurred is often an opportunity for the offender to make important life changes." (p. 183) On the other hand, on the next page he states "the important thing is to keep the lines of communication open between all family members..." (p. 184) When the accused perpetrator continues to deny abuse in the face of overwhelming evidence, ongoing communication can be traumatic for the survivor, and trigger dangerously self-destructive behaviors. Yapko also warns bona fide survivors against getting "stuck" in their pain, but does not mention the equally important (and given the current managed care environment) problem of "moving on" too fast. Among my clients, I have seen far more premature attempts at "putting the past behind me" than chronic wallowings in pain and self-pity.

Chapter 7 ("How Can You Be Sure?") is important, and raises some good points. I especially agree with Yapko's criticism of therapists who universally prescribe confronting alleged perpetrators. While confrontation may be necessary at some point, I have not found it helpful at all to encourage it according to some "formula." On the other hand, I found Yapko's sections on "The Need to Know" and "Is Knowing Necessary?" to be insensitive to survivors. The survivors I have worked with have been tortured souls who have often felt crazy for a great deal of their lives. Often, they have been misdiagnosed (e.g., Borderline Personality Disorder), mismedicated, and mistreated. They want validation, and they want it desperately--and not just out of some trivial or neurotic curiosity. On the other hand, Yapko is right when he asserts that very often we can never know, and that the goal of therapy often must be "to learn to live with the uncertainty and get better anyway." (p. 169)

Yapko gives short shrift to the extremely important issue of choosing a competent therapist. In the section on "Choosing a Therapist" he advises people to seek referrals from AAMFT, which "can be especially helpful in providing a local family therapist who is sensitive to these [abuse] issues." In my experience, I have not found AAMFT members to be, as a whole, any better or any worse than other qualified therapists on abuse issues. Yapko leaves out other possible referral sources (and there are many), including the Family Psychology and Psychological Hypnosis divisions of APA, the American Society of Clinical Hypnosis, and the Society for Clinical & Experimental Hypnosis. ASCH in particular has taken a highly balanced view on the repressed memory issue, and certified members of ASCH are now being required to obtain specific training in this area. On the other hand, Yapko fails to provide warnings about lay hypnotists, non-credentialed "recovery therapists," and addictions counselors with no formal psychotherapy training who are practicing unethically beyond their limits.

All told, Suggestions of Abuse is an extremely important book for anyone working with trauma and abuse. The importance of Yapko's message in the first three and final two chapters of this book outweighs some of its pedantic flaws.

This review also appeared in: Dubrow Eichel, S. (1997). Suggestions of abuse [Book review of Suggestions of abuse: True and false memories of childhood sexual trauma]. Advances in Medical Psychotherapy & Psychodiagnosis, 9, 208-210.

Kluft urged clinicians to engage in their own research by marking their records when dissociated memories are confirmed. "If you don't take into account the available data [then] you have thrown away your scientific perspective." Kluft noted that, as a psychiatrist in Reading, PA, he had access to longitudinal clinical data spanning a generation, and he summarized several case histories in which recovered memories of abuse were confirmed. In 1995, Kluft reviewed the charts of 34 patients with Dissociative Identity Disorder, many of whom were already integrated. The 34 patients had been in therapy from between 3 months and 19 years (for an average of 5.5 years). Of these, 19 (56%) had recalled and confirmed childhood abuse. Ten of these 19 also had conscious memories of abuse; however, 13 of the 19 obtained documentation of additional abuses recovered in therapy.

Confirmation came in a variety of ways, including confirmation by siblings, confirmations by the other parent (not related to custody disputes), police records, and perpetrator confessions. Sibling confirmations "were interesting because many of these same siblings initially denied any abuse."

In addition, Kluft found that patients who were in therapy for longer periods of time were more likely to eventually confirm recovered memories of abuse. He noted that patients in short-term therapy were either too disorganized to obtain confirmation of their abuse, or their families initially reacted to their abuse reports by trying to maintain the status quo. Some family members who later confirmed the abuse were motivated by other reasons (e.g., inheritances) to initially deny the abuse.

In conclusion, Kluft reminded the audience that "there are many forms of memory. Treating memory as a uniform process as studied in the laboratory seems misguided."

The October 1996 issue of the ASCH Newsletter contains an interesting tidbit: a "Request for Information on Lay Hypnotherapy" by James R. Council, President of Division 30 (Psychological Hypnosis) of the American Psychological Association and Chair of the ASCH Legislative Committee. I have also read and heard elsewhere that several prominent members and officials of Division 30 and ASCH plan to make squashing "lay hypnotherapists" a priority over the next several years. I find this goal to be interesting--and one that I am at best highly ambivalent about.

Clarification of Terms

To simplify reading this article, I will refer to those clinicians who have received (or would qualify for) ASCH-approved training as "clinical hypnotists" who practice "clinical hypnosis." I will refer to all others as "lay hypnotists" who practice "lay hypnosis."

Therefore, clinical hypnotists are individuals who possess at least a Masters degree from a regionally-accredited program in the healing arts, and whose training (if not received directly from an ASCH-approved organization or individual) matches the guidelines set forth in Standards of Training in Clinical Hypnosis (Hammond and Elkins, 1994).

Who are the "lay hypnotists?" A lay hypnotist is anyone who is not trained and credentialed as an advanced-degreed health professional, and practices hypnosis or "hypnotherapy." Since ASCH will not train anyone who is not at least in formal training toward an advanced-degree in the health sciences, it is safe to assume that lay hypnotists are generally trained by one of dozens of lay hypnosis training institutes and/or organizations, many of which also offer some form of credentialing in hypnosis and/or hypnotherapy. Among the larger (or at least more vocal) lay hypnosis organizations are the National Guild of Hypnotists (NGH), the American Board of Hypnotherapy (ABH), and the American Council of Hypnotist Examiners (ACHE). One of the earliest such organizations, the Association to Advance Ethical Hypnosis (AAEH) appears to be inactive and/or no longer exists, with many of its former leaders now actively involved with NGH or other similar organizations.

What's the big deal?

The official position held jointly by ASCH, the Society for Clinical and Experimental Hypnosis (SCEH), and APA Division 30 is that lay hypnosis and the training of lay hypnotists are unethical. The ASCH By-Laws and Ethics Code are clear and specific: hypnosis is a treatment modality--not a treatment in and of itself--that should be strictly limited to qualified practitioners of the healing arts. Of course, ASCH has over the years modified its view of who is "qualified." For example: When I first inquired about membership in ASCH, I was a Masters-level licensed psychologist and was told I could not join (as a full member) because I lacked a doctorate. ASCH has since changed this requirement, and now allows Masters-level mental health professionals to become full members, and to seek certification.

Nobody knows how many lay people have received training in hypnosis, and how many of those are practicing lay hypnotists. NGH claims thousands of certified members. It is safe to assume that there are several thousand more who have been trained and certified by other lay hypnotist organizations. I do not know how many patients or clients have paid for the services of lay hypnotists over the past decade or so, but it is probably safe to assume they number well into the tens of thousands. At worst, this means thousands have received incompetent treatment, or treatment of at least dubious value. Certainly, lay hypnotists have (wrongly, according to organized clinical hypnosis) cut into the practices (and incomes) of clinical hypnotists.

Conflicting Paradigms

After examining the literature, brochures, and training protocols of the NGH, ABH, and ACHE (as well as those of ASCH and SCEH), I found two fundamental--and defining--differences that distinguish the paradigms of hypnosis espoused by lay vs. clinical hypnotists.

Commitment to science. Clinical hypnosis is predicated on rigorous scientific investigation. SCEH and ASCH distinguish between "soft science" (e.g., case studies, nonexperimental research) and "hard science" (e.g., quasi- and "true" experimental research), and shares the bias of all formal sciences that the latter is ultimately more valid than the former. Lay hypnosis does not appear to make this distinction. There is a very clear preponderance of uncontrolled anecdotal studies in the lay hypnosis articles I have read. In fact, "hard" research is almost entirely missing from this literature, and in some cases is even denigrated. The exception (in my limited reading) has been when hard research appears to support the aims and purposes of lay hypnosis (e.g., I found several references to NIH's recent positive review of hypnosis as a valuable adjunct to traditional medical treatment of cancer and pain).

Hypnosis as a distinct profession. The other difference between lay and clinical hypnotists is more politically volatile. ASCH and SCEH are quite adamant in their belief that hypnosis is a valuable clinical activity but does not by itself constitute treatment. Lay hypnotists vehemently disagree. They view hypnosis as a treatment that can be used in addition to, but is distinct from, other medical and/or psychological treatments; consequently, hypnosis is viewed as a distinct profession. The ABH informational brochure, for example, states that among its purposes are "to promote the recognition of hypnosis as a viable therapeutic modality" and "to promote the recognition of hypnotherapy as a separate and distinct profession" (American Board of Hypnotherapy, 1994).

Implications

The political ramifications of this paradigm dispute are manifold. If one accepts hypnosis as a distinct profession, then hypnotists can and should be separately trained and credentialed, and perhaps even licensed. In a sense, this question can be reframed as "Who owns hypnosis?" There are several precedents to this conflict. Organized medicine's initial opposition to the licensing of psychologists was based on a rejection of clinical psychology as a distinct profession separate from the practice of medicine. A similar battle has been waged by organized psychology against the licensing of counselors; several state psychology associations (including, at one point, the Pennsylvania Psychological Association) argued that counselors and other Masters-level therapists should not be licensed because "counseling" or "psychotherapy" are activities performed by psychologists, and as such do not merit recognition as distinct professions. I imagine organized psychology might have taken clinical social work to task on this point as well, had well-recognized forms of social work credentialing (e.g., the ACSW) not preceded psychology licensure in many states.

[Side note: A primary issue here involves two terms whose presence in a licensing law are central to the health professional's right to independent (i.e., medically unsupervised) practice: diagnosis and treatment. Since treatment (as we have all been taught) ensues from diagnosis, to be truly independent a health professional must be legally authorized to perform both. Just as physicians once argued that, without formal medical training, psychologists are not competent to diagnose and then treat mental disorders, psychologists have argued that "counselors" are inadequately trained to diagnose and treat individuals with psychological problems.]

During its early battles for licensure, organized psychology successfully pointed to organized medicine's inability to prove that patients were being harmed by psychologists who in fact were already practicing independently (or under very nominal medical supervision). Organized counseling has made the same argument when faced with opposition to counselor licensure from state psychology associations. Now we are hearing the same argument being espoused by organized clinical hypnosis in our efforts to shut down lay hypnotists. It is important to note here that anecdotal evidence of harm has been found by most state legislatures to be inadequate as an argument against licensure. For the same reason, state attorneys have been hesitant to prosecute uncredentialed/unlicensed mental health practitioners on the sole basis of practicing a healing art without a license. Clearly, one hears far more anecdotal complaints against physicians and psychologists than against lay hypnotists. Where is the hard evidence that lay hypnotists are harming people? Or is this battle merely part of a larger turf war, waged to protect practitioners (as opposed to consumers) in an era of shrinking health dollars? If the latter is the case, do we want our limited resources to be used in the pursuit of the professional equivalent of the Vietnam War?

Hypnosis as Technology

Although many questions about the nature of hypnosis remain, the one characteristic all experts seem able to agree on is that hypnosis involves a specialized form of rapport. Rapport, as we all know, is the core ingredient of all therapeutic conversations. Therefore, hypnosis can be described as a specialized form of therapeutic conversation.

One argument used to combat the false memory syndrome proponents is that a growing body of research indicates that hypnosis is no better (and no worse) than other forms of therapeutic conversation at persuasion or undue influence (e.g., iatrogenic distortion of memory). Here I find that the clinical hypnosis community engages in some double-talk. On the one hand, we state that clinical hypnosis is no more dangerous than any other form of therapeutic conversation; on the other hand, we say it is too dangerous to allow individuals without graduate-level training to learn and utilize it. Yet logically, if hypnosis is no more dangerous than other forms of therapeutic conversation, then we should be able and willing to teach it to the same populations we teach counseling to--including, for example, addictions counselors, B.A.-level mental health workers, and peer counselors--in other words, "lay" people.

There was a time when the "technology" of psychotherapy (e.g., techniques for establishing and maintaining empathy and rapport) was considered too difficult to learn outside formal graduate-level training programs. Many psychologists were suspicious of programs that involved training peer or "lay" counselors. As peer counseling programs like Women in Transition and Women Organized Against Rape proliferated in the 1960s and 1970s, however, a growing body of research began to allay our fears: With supervision, and when generally limited to problem-focused and/or time-limited approaches (e.g., short-term support groups), well-trained lay counselors were found to be at least as effective as professionals with a broad range of problems, including serious psychological disturbances. I am unaware of any research indicating that lay counselors pose a greater threat to client wellbeing than professional therapists.

Therefore, I wonder: What really is the harm in teaching the "technology" of hypnosis to lay people, especially if the content of their education were regulated, and the practice of "hypnotechnology" were supervised, by professionals?

[Side note: Many qualified clinical hypnotists have, at one time or another, trained with lay hypnotists. In fact, while I was attending APA in Toronto this past summer, one prominent member of Division 30 confided to me that, prior to entering graduate school, he earned part of his living as a stage hypnotist.]

Problems Galore

The lay hypnosis organizations I have studied profess to define, support, and adhere to a limited scope of practice. An article about the Council of Professional Hypnosis Organizations (COPHO), a lay hypnosis umbrella organization that includes the National Guild of Hypnotists, states that:

The member organizations in COPHO [the Council of Professional Hypnosis Organizations] teach hypnotherapy as a vocational practice. That is, hypnosis is understood as a helping tool to assist persons with non-clinical or non-medical issues such as routine smoking cessation, minor weight management, the finding of lost objects, general relaxation, time management and performance enhancement at work. The member organizations of COPHO do not teach or allow members (unless qualified to do so by another credential) to use hypnosis as a tool for the diagnosis or treatment of mental or medical conditions. (Giles, 1995, p. 10)

After studying lay hypnosis literature, however, I find that lay hypnotists consistently violate this limited scope of practice with what appears to be the sanction of their lay hypnosis organizations. I analyzed the content of the 1995 "NGH Annual Convention and Educational Conference and Summer Institute" published in the June 1995 issue of The Journal of Hypnotism. The Summer Institute listed 30 courses, 12 of which were concerned with material I would consider appropriate only for graduate-level counselors or therapists (e.g., "The Application of Hypnoanalytic Technique in the Practice of Clinical Hypnosis," "Addictions Hypnotherapy," "Parts Therapy as Practiced by Charles Tebbets"). The conference itself listed well over 100 seminars and workshops. Some (with titles like "Hypnosis for Drug Addiction," "Rational[-Emotive] Hypnotherapy," and "Dealing with Traumatic Memories in Hypnotherapy Practice") sounded completely inappropriate for lay hypnotists. Other seminars and workshops appeared to involve attempts to teach medicine, however as I am not a physician or dentist, I do not feel qualified to make a judgment about these topics.

An opportunity to set professional standards?

Clearly, lay hypnosis is a problem, and it is a problem that is not going away. Because lay hypnotists are not regulated (I have great difficulty accepting as legitimate the dozens of self-proclaimed "certifying" organizations whose requirements for certification seem dubious at best), there is nothing that even comes close to uniformity of training and education standards. In my opinion, there are three realistic possibilities regarding lay hypnotists:

• Maintenance of the status quo, in which lay hypnotists will continue to be trained by other lay hypnotists, and will practice without regulation; or
• Lay hypnosis will achieve some form of legitimization, either through licensing and/or state registration acts, or through unionization (the latter is already occurring, through the National Federation of Hypnotists, OPEIU Local 104 of the AFL-CIO); or
• Clinical hypnosis could "adopt" lay hypnosis as a legitimate paraprofessional activity, and have a voice in the training, supervision, and regulation of lay hypnotists.

Notice that I do not see the outlawing of lay hypnosis as a realistic option here.

The above implies that clinical hypnosis organizations can do one of three things:

• Actively combat lay hypnotists;
• Nothing;
• Engage is some form of partnership with lay hypnotists.

The first option is, as I have already opined, a waste of valuable resources. The second option is easiest, and has the additional emotional advantage of "keeping our hands clean." The third option, while very difficult, holds the most promise. Given that it is highly improbable (at best) to outlaw lay hypnosis, this option holds the most promise of regulating it. It also presents clinical hypnosis with a unique economic opportunity: if we are to continue to lose our traditional "turf" to lay hypnotists, why not gain new turf by engaging in their training and supervision?

However, if we completely miss the boat--if lay hypnosis achieves some form of legitimization without input from clinical hypnosis--it is unlikely that we will gain much of anything. Lay hypnotists will continue to capture a slice of our "pie" as they continue to train and supervise their own with little or no input from us.

American Board of Hypnotherapy.  (1994). American Board of Hypnotherapy [Brochure]. Irvine, CA: Author.

Giles, C. S. (1995). Legislative and governmental concerns. The Journal of Hypnotism, 10 (2), 10-11.

Hammond, D. C., & Elkins, G. R. (1994). Standards of Training in Clinical Hypnosis. Des Plaines, IL: American Society of Clinical Hypnosis.

Psychological Inquiry (1996, Vol. 7, No. 2) contains a fascinating debate between several prominent hypnosis experts on the nature of UFO abduction memories. This debate is important, because most scientists agree that UFO abductions can not be factual memories; hence--unlike sexual abuse memories which may be real and can, theoretically, be false--UFO abduction reports are almost universally believed to be "false" or pseudomemories. Since hypnosis has often been utilized (at some point) in the investigation of UFO abduction claims, this debate has direct implications for clinicians and researchers concerned with "repressed" (dissociated) memories of childhood abuse. The debate centers around an article by Newman and Baumeister (pp. 99-126), who contend that hypnosis is a potent source of spurious abduction memories. In a commentary, Martin Orne and his colleagues (pp. 168-172) support this position, stating once again that hypnosis provides a license for fantasy and involves inherent contamination of memory--even for medium and low hypnotizables. Lynn and Kirsch (pp. 151-155) rebut the "hypnosis inherently creates false memories" position, noting that a growing body of research indicates that "false" or pseudomemories are not any more reliably produced by hypnosis than without hypnosis.

GPSCH member Julie Linden, Ph.D. recently published "Trauma prevention: Hypnoidal techniques with the chronically ill child." Linden concluded that, by interfacing principles of development, understanding trauma, and hypnotic techniques that emphasize empowerment, mastery, and ego-strengthening, clinicians can help prevent medical procedures from becoming traumatic for chronically ill children. Her article appears in Hypnos (1996, Vol. 23, No. 2, pp. 65-75).

In his introduction to the CD release of the classic rock opera Tommy, author and The Who biographer Richard Barnes states that "the story line was influenced by [Who songwriter/guitarist Peter] Townshend's rejection of psychedelic drugs and simultaneous discovery of mysticism...[he] was working on a metaphorical story device that put across the idea of different states of consciousness. The premise was that we had our five senses but were blind to Reality and the Infinite."

We, however, are also struck with the congruence between Tommy's story line and the processes of traumatic dissociation, reenactment, and a somewhat misguided healing.

We will assume most readers are at least somewhat familiar with Tommy. Our interpretation of the story follows (quotes are from the lyrics included with the album and CD):

Sometime toward the end of World War I, Tommy's father (Captain Walker) becomes missing in action. Mrs. Walker subsequently gives birth to Tommy, and takes a lover. Almost three years after the end of the war, Captain Walker surprises his wife and her lover by reappearing. The Walkers dispatch of the lover, presumably by murdering him in full view of their young son.

Mother: What about the boy? What about the boy?

What about the boy? He saw it all!

Tommy, horrified by this experience, has his reality denied (the denial of trauma is a common theme in dissociative patients, and seems to increase the psychological impact of the traumatic event):

Mother & Father: You didn't hear it. You didn't see it.

You won't say nothing to no one ever in your life...

Tommy responds to this trauma and his parents' subsequent injunction by, according to Barnes, becoming autistic. Autism, as far as we know, does not develop or progress in this manner. Diagnostically, Tommy meets the criteria for two conditions with frequent comorbidity: Conversion Disorder (e.g., "hysterical" blindness, deafness, and mutism) and Dissociative Disorder.

In the following songs, we find that Tommy is not disturbed by his sensory isolation:

Deaf, dumb and blind boy, he's in a quiet vibration land.

Strange as it seems, his musical dreams ain't quite so bad.

This lack of concern (la belle indifference) is a common feature of conversion disorders. His parent's, however, are highly concerned, and they will soon orchestrate a series of experiences in an attempt to cure their son. As is typical with the parents of abused children, however, the Walkers--while consciously intending to protect and help their son--in fact fail to protect him and the boy becomes repeatedly retraumatized. First, we learn that Tommy is often left alone with his cousin Kevin, who tortures the boy. Later, he is left in the care of his uncle Ernie--in spite of the uncle's known proclivities.

Mother: Do you think it's all right to leave the boy with Uncle Ernie?

Do you think it's all right? He's had a few too many...

Father: Yes, I think it's all right.

Uncle Ernie's abuse is well-described in the classic Who song, "Fiddle About."

Uncle Ernie: I'm your wicked Uncle Ernie,

I'm glad you won't see or hear me

as I fiddle about...

Your mother left me here to mind you,

now I'm doing what I want to: fiddling about!

Down with your bedclothes, up with your nightshirt!

Fiddle about!

You won't shout as I fiddle about,

Fiddle about!

There are two songs that are devoted to describing failed attempts at "curing" Tommy. In "Eyesight to the Blind," a hawker (pimp) tells Tommy (or Tommy's parents--the audience is unclear) that they should see his woman:

Hawker: You talk about your woman, I wish you could see mine...

Every time she starts to lovin'

she brings eyesight to the blind...

Every time we start shakin' the dumb begin to talk...

Just a word from her lips and the deaf begin to hear.

Another classic Tommy song, The Acid Queen, describes the ill fated attempt to cure Tommy's disorder with LSD (and sex):

Gypsy: If your child ain't all he should be now

This girl will put him right.

I'll show him what he could be now,

Just give me one night.

I'm the Gypsy - the Acid Queen,

Pay before we start.

I'm the Gypsy - the Acid Queen,

I'll tear your soul apart.

 

Give us a room and close the door.

Leave us for a while.

Your boy won't be a boy no more

Young, but not a child.

 

Gather your wits and hold on fast.

Your mind must learn to roam...

How similar to the confabulated paths of many trauma survivors, at once reenacting their trauma while seeking healing. As we know, this path often involves intense sexual experiences and substance abuse.

Captain Walker hears about a special doctor, a "doctor I've heard could cure the boy!" Following good medical practice, the doctor first determines that Tommy's condition is not physiological:

Doctor: He seems to be completely unreceptive.

The tests I gave him show no sense at all.

His eyes react to light, the dials detect it.

He hears but can not answer to your call.

The hope for a cure, the doctor realizes "lies with him and none with me." The doctor then introduces Tommy to a mirror (a metaphor for psychotherapy?). Tommy becomes enthralled by his own image, much as trauma patients must initially become highly self-preoccupied. Much like the family members of many trauma patients, Mrs. Walker becomes impatient with this process, and she is narcissistically wounded by what she perceives as her son's self-indulgence:

Mother: You don't answer my call with even a nod or a twitch

but you gaze at your own reflection!

You don't seem to see me but I think you can see yourself.

How can the mirror affect you?

Can you hear me? Or do I surmise

that you fear me. Can you feel my temper rise?

Do you hear or fear or do I smash the mirror...

Mrs. Walker smashes the mirror, probably prematurely and in a way that seems to liberate Tommy but in fact subtly retraumatizes him. We make this interpretation based on Tommy's later behavior. Although smashing the mirror does have the desired effect ("Extra! Extra! Read all about it, pinball wizard in a miracle cure!"), Tommy emerges from his trance a narcissistic cult leader. We are impressed with this twist in the story, having known several trauma survivors who have (in our opinion) become "Recovery Gurus" who demand rigid adherence to "treatment modalities" that are dogmatic at best and traumatic at worst. Tommy hits the lecture/workshop circuit as the "new messiah" promising freedom to those who will follow him:

Tommy: I'm free! I'm free! And freedom tastes of reality.

I'm free! I'm free! And I'm waiting for you to follow me.

Tommy opens up "Tommy's Holiday Camp" (which sounds strikingly similar to some "recovery centers" or "retreats"). Ironically (but not for those who have worked with trauma survivors who are not fully integrated!), Tommy hires one of his old perpetrators--Uncle Ernie--to help run the camp.

In the final song, "We're Not Gonna Take It," we find Tommy insisting that his path to recovery is the ONLY path:

Tommy: Welcome to the camp, I guess you all know why you're here.

My name is Tommy, and I became aware this year.

If you want to follow me, you've got to play pinball.

And put in your ear plugs, put on your eye shades.

You know where to put the cork!

Hubris (arrogance) is the cause of the hero's fall in Greek tragedies. Tommy suffers from hubris; he believes he is now "whole" (he is not) and that his recovery is a model for everyone (it is not). In fact, Tommy appears to be on the road to coercing--and thereby traumatizing--those he consciously seeks to serve:

Tommy: Hey, you gettin' drunk, so sorry, I got you sussed.

Hey, you smokin' mother nature, this is a bust.

Hey, hung up mister normal, don't try to gain my trust.

'Cause you ain't gonna follow me any of those ways,

although you think you must!

The campers begin to rebel, chanting "We're not gonna take it!" Tommy insists they follow, and coerces them into experiencing the sensory deprivation he himself experienced while dissociating:

Tommy: Now you can't hear me, your ears are truly sealed.

You can't speak either, your mouth is filled.

You can't see nothing, and pinball completes the scene.

Here comes Uncle Ernie to guide you to your very own machine.

The rebellion grows, as the campers' protest grows louder and more threatening:

Chorus: We're not gonna take you!

We forsake you! Gonna rape you!

Let's forget you...better still.

We can speculate here that Tommy, now the target of his enraged followers, does in fact get raped. The album closes with Tommy crying out "See me, feel me, touch me, heal me!" just as he did while initially dissociated. Thus, the circle is closed. Tommy's reenactment--in part, facilitated by an imperfect and subverted therapy--is now completed.

---

In Memoriam

GPSCH sadly acknowledges the untimely passing of long-time member Dr. Frances Rothman, who died recently of cancer. Dr. Rothman, a licensed psychologist and certified school psychologist, maintained an active private practice with her husband, psychiatrist and GPSCH member Dr. Irwin Rothman. We extend our sincerest condolences to her family.

---

Additional Observations on Lay Hypnosis: What Are We Doing Wrong?

The controversy surrounding lay hypnosis was alive and well at the 1997 annual meeting of the American Psychological Association in Chicago. I attended several Div. 30 (Psychological Hypnosis) sessions that featured comments about this volatile issue. I learned about attempts (largely on the part of state psychological associations) to legislate lay hypnosis out of existence, and I learned why some of these efforts may be doomed to failure (can you say "antitrust suit"?).

I also attended a conversation hour hosted by Div. 30 President Jim Council, who has been active in studying the lay hypnosis issue, and who heads the division's ad hoc committee on lay hypnosis.

Much of what I heard has confirmed the thoughts I presented in the last issue of In Focus. Let me sum up these thoughts: Folks, lay hypnosis is here to stay. And if we can't fight them (and we certainly don't want to join them!), we should at least admit they aren't going to disappear, and begin to dialog with them. I give Jim Council great credit for beginning to do just that. I know for a fact that he has encountered considerable opposition (and maybe some anger) in so doing. I refer you to the Summer 1997 issue of Psychological Hypnosis, the Div. 30 newsletter, for an in-depth discussion of Div. 30's nascent work on the lay hypnosis issue. On page 5 of this issue of In Focus, you will find a reprint of an article written by Rev. C Scot Giles, D. Min., of the National Guild of Hypnotists. While I tend to agree with some of his points, I also found some of them to be (in my opinion), misleading. For one, my own ongoing review of material from several lay hypnosis associations' newsletters and conference announcements leads me to conclude that, contrary to Rev. Dr. Giles' contentions, lay hypnotists often do overstep their bounds and engage in psychotherapy. At the very least, they certainly conduct conference workshops that are clearly teaching psychotherapy techniques to lay people. While this fact concerns me deeply, I agree with the gist of what I gleaned from the presentations I heard at APA: there is nothing we can do to stop these practices outright. Unless, of course, we attempt to contain the lay hypnotists by ending our battles and instead throwing our collective weight behind supporting lay hypnosis certification (or registration, or even licensing) laws that clearly specify what a lay hypnotist can and can not do, especially without professional supervision.

Begrudgingly, I have to admit that there is much ASCH could learn from the lay hypnosis associations. Over the past several months, I have made a conscious effort to check the referral suggestions of a variety of health-oriented periodicals and books that cover hypnosis. Much to my chagrin, I found most of them referring readers to lay hypnosis organizations, at times without even mentioning ASCH. One such association, the International Medical and Dental Hypnotherapy Association, seemed to crop up everywhere I looked. The IMDHA is a small association that appears to be operated (if not owned) by a lay hypnosis school in Indiana, yet they have apparently done an incredible marketing job! And for those of you connected to the Internet, try a Yahoo or Alta Vista search on "hypnosis." You will be directed to the National Guild of Hypnotists (among other lay hypnosis institutes and associations), but not to ASCH! And, to be honest, the NGH web page seems far more comprehensive than the ASCH page.

Perhaps it's time we stop counting the mistakes made by lay hypnotists and begin acknowledging what we may be doing wrong.

Did you know that hypnosis significantly improves the efficacy of cognitive-behavioral therapy? In an article by Krisch, Montgomery and Sapirstein (1995), over 70% of those clients who received hypnotically-enhanced cognitive-behavioral therapy showed significantly better therapy outcome than those whose therapy did not involve hypnosis. The abstract of this article follows:

ABSTRACT: A meta-analysis was performed on 18 studies in which a cognitive-behavioral therapy was compared with the same therapy supplemented by hypnosis. The results indicated that the addition of hypnosis substantially enhanced treatment outcome, so that the average client receiving cognitive-behavioral hypnotherapy showed greater improvement than at least 70% of clients receiving nonhypnotic treatment. Effects seemed particularly pronounced for treatments of obesity, especially at long-term follow-up, indicating that unlike those in nonhypnotic treatment, clients to whom hypnotic inductions had been administered continued to lose weight after treatment ended. These results were particularly striking because of the few procedural differences between the hypnotic and nonhypnotic treatments.

Kirsch, I., Montgomery, G., & Sapirstein, G. (1995). Hypnosis as an adjunct to cognitive-behavioral psychotherapy: A meta-analysis. Journal of Consulting & Clinical Psychology, 63, 214-220.

Wilkomirski, Binjamin. (1995). Fragments: Memories of a wartime childhood. Translated from the German by Carol Brown Janeway (1996), Schocken Books, New York. NY.

Ever since I signed up to write a book report for our GPSCH newsletter in May, I have been wrestling with the book I felt compelled to choose: Fragments by Binjamin Wilkomirski, which I had first read in 1996, when it, appeared in German under the title "Bruchstucke" (literally: "Broken off Pieces") and then reread when it was published in English a year later. Fragments is a small book, a mere 155 pages long, and yet it contains one of the most powerfully written documentations of experiences of trauma and dissociation, forgetting and remembering, that I have encountered. With its unmitigated, brutally direct, unexplained, and unexpected views of the unexplainable Binjamin Wilkomirski faced as a small boy in the midst of the death camps during the Holocaust, it weighs in at the almost unbearable end. I hid Fragments from my children; I tried hiding it from myself, dragging my brain over months of trying to escape the writing of this book report. I wasn't prepared for such a parallel process of going into a state of wordless dissociation, while struggling to conceptualize how to present this book with all its unfathomable experiences to you, my fellow colleagues. What meaning might the book hold for a hypnosis community? Did it have any relevance for today's clinicians? Maybe this book really wasn't appropriate for the GPSCH newsletter? Maybe it was just too personal? Too direct, without the protective boundaries of a mediating, intellectual approach? Whom was I protecting, though, and from what?

It took the author 50 years of his life to find words for the fragments in his mind of what he had lived through as a child, not knowing then what "it" was, and not being able to give "it" meaning until much later, far into his childhood. In his written account, he does not theorize from a safe distance about the fragmentation of his childhood experiences in the death camps, or the fragmented process of remembering. Instead, Wilkomirski gives his reader an opportunity to experience a fraction of what he lived through as a young child. In the process of reading his Fragments, one piece after the other of disjointed, discontinuous life jumps out at the reader, as it probably jumped out at the little boy, fifty some years ago, without the soothing and softening refraining and distancing of adult explanations or preparations of things to come. Like the abrupt opening of the shutter in front of a camera lens, so do the different chapters of Fragments put the reader into the eye-level perspective of a 3 year old boy, into the midst of the relentless, uncontrollable, daily events of terror, death and survival by chance inside the camps. Anybody willing to follow Wilkomirski 's remembered Fragments will understand the phenomenon of spontaneous dissociation for survival viscerally and emotionally.

This book is, of course, written against the forgetting, his own as well as ours, of experiences that can hardly be put into words in the first place, Wilkomirski therefore also writes about the second round of dissociation after the liberation of the camps - the dissociation from his own memories, finding no welcoming place or containing structure for them in his new post-war environment. His Swiss adoptive parents, teachers, and schoolmates (and, yes, this book was written before the banking scandal forced the Swiss to remember at least a little bit) reacted with anger and downright disbelief to the glimpses of life inside the concentration camps the perhaps then 9 year old Binjamin related matter of factly. He is forced to forget what he knows, and encouraged to "just" lead a normal life. Wilknmirski almost succeeds - except for recurring, frightening, unexplainable images as a grownup, married man, and father. Before, during, and after his therapy, Wilkomirski pieces the fragmented images together and achieves a limited-focus, detached narrative of those early, perhaps 4 years in the camps, accurately mirroring in his writing the state of dissociation and frozenness he acquired for survival. Not knowing his true name or date and year of birth, these images are a vitally important thread that hold him and his personhood together. He obtained independent corroboration to verify as many of his image-fragments as he could. This helped to establish a historically accurate context of the events which determined his early life, and gave important credibility to his remembered fragments of experienced traumata.

Wilkomirski, like many others, has needed to live many years of his adult life, experience adult success and stability, before dissociated early trauma and haunting images from childhood could be faced, processed, and finally shared. In its immediacy and authenticity, the account of his Fragments holds an important clinical lesson for any therapist dealing with childhood trauma, dissociation, and the process of remembering: insight into how the reality of trauma is experienced and "explained" by a young child, how the sequelae of it reaches hauntingly into adolescence and adulthood, and don't truly disappear until integrated. This book is a valuable initiation to the novice in child-trauma therapy, and a valid confirmation of what childhood trauma constitutes, for the more seasoned clinician. It is powerful training for any reader in staying in touch with one's own feelings while absorbing the presented material; training in resisting the urge to not fully be "there" with the one who remembers; training in facing one's need to quietly slip away into one's own dissociation for comfort in the face of the unspeakable. Fragments gives any reader-clinician the opportunity to learn and relearn the lessons of staying connected in the face of suffering.

As we encounter wave after wave of youngsters traumatized by different wars and genocides, invited through humanitarian aid to partake in the American Dream, we need to be prepared, as clinicians and fellow human beings, to help these children and adolescents not just to assimilate into our culture, but to honestly face, and constructively express, the other, traumatized, side of who they are - in the midst of their and our American way of life. This other side may be called Tuzla or Banja Luka, Mostar or Sarajevo, Terezin or Buchenwald. Trauma-time stands still. It does not go away on its own. It waits to be found, recognized, and welcomed. Only then is healing at the core and true moving on possible. Germany's "Third Reich" and the atrocities against humanity committed in its name officially ended May 8, 1945, more then half a century ago. The process of unequivocal sharing, however, the difficult and easily avoided integration into our collective consciousness of the dissociated and fragmented material of what human beings, in this case children, endured during the Shoah and afterwards, has not ended. Sometimes I wonder, if this process has just begun. Perhaps only now, from the distance of the years, are we able to hear and understand intellectually and emotionally the full impact early trauma has across the life span.

The children from "then" and "there" are now at the age of grandparents. Perhaps, after letting yourself be exposed to Wilkomirski's Fragments you will recognize them more easily around you, in your work and in your life. Perhaps, some lessons of the Holocaust learned, the children and adolescents who survived the "ethnic cleansing" slaughter in the Balkans do not have to wait 50 years before they dare to speak, and before we dare to ask and listen. It takes courage to talk about suffered trauma, and it takes courage to listen, to want to know, to witness, to counter the omnipresent societal pressure to dissociate from knowing about committed horrors. I wish and hope that many of us can be courageous and stay present in the face of remembered trauma, overcoming dissociation and the urge to move on without due process, even in cases where absolute truth and absolute guilt cannot be established in a court of law. I hope that those who find the courage to speak about their terrifying and traumatic images of events 50 years ago during WWII, or 5 years ago during the genocide in the former Yugoslavia, will find listeners who will listen with their minds and with their hearts. In the case of the survivors of the Holocaust, we all need to create a place in our minds that can serve as a Yad V'Shem - a place that will provide a memorial, an everlasting name, to those who perished as well as to those who lived and remember.

Edgette, John, & Edgette, Janet Sasson. (1995). The Handbook of Hypnotic Phenomena in Psychotherapy. Brunner/Mazel, New York. NY.

I'm going to start this brief review with my conclusion: I thought so much of this book that I made it required reading for a class on trauma, dissociation and hypnosis that I recently taught for Chestnut Hill College's counseling psychology program.

This book does not break much new ground. Its strengths are in its organization and presentation, which I found uniquely useful for students learning hypnosis. Although my Chestnut Hill College students were all "beginners," I found myself being reminded a lot of previously-learned material, learning some new things, and above all being more organized in my own thinking about hypnotic phenomena as I read through the Edgettes' book.

The book is organized by phenomena, which are grouped into five sections: Memory Functions, Toying with Time, Duality of Reality, Dissociated Movement, and Modifying Perception. The overall emphasis is clearly on clinical applications and interventions. Each chapter has a brief section explaining the phenomenon. The sections that follow: review the history of, and experimental studies related to, the phenomenon; review indications and contraindications for eliciting the phenomenon; provide suggestions for eliciting the phenomenon. These suggestions usually include selected transcript materials, which are particularly useful to the practitioner.

Most of the GPSCH community is aware that the Edgettes are co-directors of the Milton H. Erickson Institute of Philadelphia, and yes, this book has a clearly-stated "Ericksonian" predilection. However, do not expect anything that approaches the amorphous chaos, or pseudoscience and condescending preachiness, of some popular "Ericksonian" books. This book is highly understandable, exceptionally well-organized, generously complemented with notations from scientific studies, and devoid of grandiose claims.

The Handbook generally lives up to its title. In some ways, it reminds me of the famous "Big Red Book" on clinical hypnosis edited by Cory Hammond; however, while less comprehensive, the Edgettes' book does not give one the sense of being a compilation of techniques. It has a warm and personal "flow" and yet avoids sacrificing utility in the name of being overly "user-friendly."

All in all, the Edgettes have written a tour de force for those of us who practice--and perhaps even more so, for those of us who teach or plan to teach--clinical hypnosis.

[The following is a reply from (I presume) a lay hypnotist who (again, I presume) read the above editorial and decided to comment on it. The email was received on 9/26/02. It has not been edited in any way. You may form your own opinions. - Steve]

Greetings!

A piece of your pie?! This is pathetic. I've had more than one PH.D. Psychology Professor in school that attempted to explain Hypnosis and had no Idea what they were talking about. I then had to correct them. I am back in school studying Psychology because of people like you. Leaving my little girls for hours of the day. You area of work does nothing for your clients and you know it. This is why you are stuck on Hypnosis. You love it don't you. You are just angry because you went to school for so many years and then found something you loved. Hypnosis as you should know is a naturally occurring state. Unlike you I do not need to take credit for my clients improvement. They know they create all their changes. Get over it and leave us alone. It is definately not just your pie. It is people like you that show us a PH.D. means ----!!! Blessed Be Butt Head. sp; T.Valiente