Hypnosis is a state of extreme self-focus and attention in which minimal attention is given to external stimuli. In the therapeutic setting, a clinician may use relaxation and suggestion in an attempt to alter the thoughts and perceptions of a patient. For individuals who are especially open to the power of suggestion, hypnosis can prove to be a very effective technique, and brain imaging studies have demonstrated that hypnotic states are associated with global changes in brain functioning (Del Casale et al., 2012; Guldenmund, Vanhaudenhuyse, Boly, Laureys, & Soddu, 2012). Historically, hypnosis has been viewed with some suspicion because of its portrayal in popular media and entertainment (Figure 4.20). Therefore, it is important to make a distinction between hypnosis as an empirically based therapeutic approach versus as a form of entertainment. Hypnosis is conducted by trained professionals, with consenting clients, often in the context of ongoing therapy. While hypnosis may be useful in enhancing memory or a skill, such enhancements are very modest in nature (Raz, 2011). Figure 4.20 Popular portrayals of hypnosis have led to some widely-held misconceptions. How exactly does a hypnotist bring a participant to a state of hypnosis? While there are variations, there are four parts that appear consistent in bringing people into the state of suggestibility associated with hypnosis (National Research Council, 1994). These components include: The participant is guided to focus on one thing, such as the hypnotist’s words or a ticking watch. The participant is made comfortable and is directed to be relaxed and sleepy. The participant is told to be open to the process of hypnosis, trust the hypnotist and let go. The participant is encouraged to use their imagination. These steps are conducive to being open to the heightened suggestibility of hypnosis. People vary in terms of their ability to be hypnotized, but a review of available research suggests that most people are at least moderately hypnotizable (Kihlstrom, 2013). Hypnosis in conjunction with other techniques is used for a variety of therapeutic purposes and has shown to be at least somewhat effective for pain management, treatment of depression and anxiety, smoking cessation, and weight loss (Alladin, 2012; Elkins, Johnson, & Fisher, 2012; Golden, 2012; Montgomery, Schnur, & Kravits, 2012). How does hypnosis work? Two theories attempt to answer this question: One theory views hypnosis as dissociation and the other theory views it as the performance of a social role. According to the dissociation view, hypnosis is effectively a dissociated state of consciousness, much like our earlier example where you may drive to work, but you are only minimally aware of the process of driving because your attention is focused elsewhere. This theory is supported by Ernest Hilgard’s research into hypnosis and pain. In Hilgard’s experiments, he induced participants into a state of hypnosis, and placed their arms into ice water. Participants were told they would not feel pain, but they could press a button if they did; while they reported not feeling pain, they did, in fact, press the button, suggesting a dissociation of consciousness while in the hypnotic state (Hilgard & Hilgard, 1994). Taking a different approach to explain hypnosis, the social-cognitive theory of hypnosis sees people in hypnotic states as performing the social role of a hypnotized person. As you will learn when you study social roles, people’s behavior can be shaped by their expectations of how they should act in a given situation. Some view a hypnotized person’s behavior not as an altered or dissociated state of consciousness, but as their fulfillment of the social expectations for that role (Coe, 2009; Coe & Sarbin, 1966).