La construcción 'natural' del alimento en relación con la tierra

Milton H. Erickson and Ernest L. Rossi

This paper is a condensation and synthesis of three unpublished efforts by Milton H. Erickson during the years 1936 to 1970 to illustrate his studies of hypnotic amnesia in clinical and naturalistic settings. The complexity of hypnotic amnesia, long recognized by Erickson as a result of such studies, has become established fact during the ensuing years of controlled laboratory investigations. There still remains a stark contrast between the results obtained in clinical and laboratory settings, however.

A recent interview (Cooper, 1972) of the research literature on hypnotic amnesia summarizes this problem by stating, "What needs yet to be done is to systematize and carefully record the important factors in the clinical situation, and then study their influence in a clinical laboratory setting;

that is, a laboratory setting in which the clinical factors are maximally operative (p. 252)."

As a contribution to recording "the important factors in the clinical situation" a number of Erickson's original studies illustrating the varieties of hypnotic amnesia will be presented together with some of his innovations in producing amnesia. These studies were chosen because they illustrate the complex behavior that may result from investigative work where the clinician is able to explore and utilize the individuality of each patient to enhance the development of hypnotic amnesia. They disclose interesting mental phenomena which are usually overlooked in the usual experimental situation. These phenomena may also account for some of the unreliable findings of the typically standardized and statistical approach, where the significance of individual differences and the psychodynamics of each individual trance situation are presumably neutralized or controlled rather than directly utilized, as they can be in the clinical situation.

A case will then be made for conceptualizing hypnotic amnesia in clinical practice as "state-bound." We will conclude with a summary of the very important place of amnesia in hypnotherapy.

Reprinted with permission from The American Journal of Clinical Hypnosis April, 1974, Vol. 16, No. 4.

Hypnotic Investigation of Psychodynamic Processes

AMNESIA FLUCTUATING IN TIME AND PLACE

Amnesia by Distraction

Example 1. This first example centers about a subject who had often been used for demonstration purposes and who occasionally delighted in deliberately recalling past hypnotic experiences to prove that there was no such thing as hypnotic amnesia. One morning Erickson found him relating to Erickson's secretary a detailed account of the hypnotic demonstration in which the subject had been used the previous evening. Erickson's appearance somewhat embarrassed him, but he was immediately reas-sured that Erickson would be most interested in discovering how adequately he could recall those events. Thereupon, directing his full attention to Erickson, the subject proceeded to give a remarkably complete account of the entire demonstration. During his running narrative Erickson's secretary, without the subject's knowledge, took complete notes. Several days later Erickson gave the typewritten account to the subject with the request that he read and correct it. As was discovered later, he understood Erickson's request to mean merely that he was to proofread a manuscript, a task he had often performed for Erickson. After reading for several minutes he suddenly remarked, "This is most interesting." Since Erickson could not understand his comment, he made no reply. The subject continued his reading and then expressed the wish that he could have seen the demonstration and that he would like to know who the subject was. Not fully comprehending these remarks, Erickson evasively replied that it was just one of his hypnotic subjects.

On a subsequent occasion he was handed the same manuscript to read, but he immediately recognized it as one he had already read. Upon Erickson's insistence, however, he reread it, remarking that it was sufficiently interesting to be worth reading a second time, but he was obviously rather curious about Erickson's insistence. This same procedure was repeated on several more occasions, but it succeeded only in arousing his curiosity as to Erickson's purpose. He even advanced the idea that Erickson was trying indirect suggestion on him so that he himself might give a similar demonstration sometime. At no time did he become aware that it was an account of his own hypnotic experience.

On a still later occasion Erickson rehypnotized him deeply and questioned him about what had happened to him in reference to that specific demonstration. He immediately manifested a full understanding of the total situation and simply explained that after his narration of that experience he had forgotten it completely at a conscious waking level.

Hence he had been able to read the typewritten account with the full

Varieties of Hypnotic Amnesia 7&

conscious belief that it concerned someone else. When asked if that amnesia at a conscious level of awareness would persist in the future, he replied that it probably would unless Erickson gave him instructions to the contrary.

No such instructions were given, and, although the subject has since spontaneously recalled various experiences of subsequent trances, this particular amnesia still persists. Nor has additional reading of the account done more than remind him of his previous readings.

To summarize, a hypnotic subject recalled in detail a prolonged hypnotic experience and described it adequately to others. Subsequently he developed a spontaneous amnesia, not only for the hypnotic experi-ence itself, but also for the conscious waking experiexperi-ence of recalling and verbalizing it. This amnesia persisted, and even the record of his performance aroused no memories. Nevertheless, in a new trance state full understanding was found, but in the subsequent waking state the amnesia was again present.

A spontaneous amnesia together with full recall of trance events in another trance constitutes the classical evidence for hypnotic amnesia;

there is a continuity of memory from one trance to another and from one awake state to another, but there is an amnesia between trance and awake state. What is unusual in this account is the fact that the subject apparently had a full memory of all trance events in the awake state until he developed a spontaneous amnesia at a later time.

The relevance of this example of hypnotic amnesia developing at a later time, after a full recall of all trance events had taken place in the awake state, for experimental work is obvious. The typical research design testing for hypnotic amnesia immediately upon trance termination misses the spontaneous and suggested amnesias that develop at a later time.

Erickson, in fact, makes it a routine practice not to talk to the patient about trance events immediately upon awakening. The trance state persists for a few moments after the appearance of wakefulness. Ques-tioning during this period frequently permits full recall. Erickson typically engages the patient in casual conversations, anecdotes, and shaggy dog stories very remote from the hypnotic experience for a while after trance termination to effect an amnesia by distraction. Alternatively Erickson will sometimes "rush" a patient out of the office to avoid talk about trance. He will distract and do just about anything he can to make the waking situation very different from the trance situation and thus promote

Amnesia by Indirect Suggestion

Example 2. Another example illustrating the development of a sug-gested amnesia at a later time and place after the subject had actually

74 Hypnotic Investigation of Psychodynamic Processes rehearsed all trance events in the awake state is as follows:

A professional psychologist related to Erickson her history of failing to go into a deep trance with a number of different hypnotherapists. She claimed that an amnesia for all trance events would be a satisfactory criterion of trance depth. She very much wanted to be surprised by her amnesia. Erickson acknowledged her story with the compound waking suggestion, "You haven't failed this time since we haven't started yet."

This is a favorite approach with Erickson: The suggestion contained in the first half of the sentence, "You haven't failed this time," tends to be I accepted when associated with the obvious truth of what follows, "since | we haven't started yet." I Erickson then proceeded to fixate her attention: "You haven't looked at this glass paperweight before, therefore you don't know what effect it will have on a deep trance." This is another compound suggestion: This time an obvious truth is in the first half of the sentence, with a suggestion implying deep trance in the second half. Erickson then proceeded with a typical induction which included a 20-minute period during which the psychologist was instructed to go deeper all by herself. Immediately upon awakening the dialogue went as follows:

Subject: I was in a pretty deep trance, but I remember everything.

Erickson: Isn't that all right?

Subject: I expected an amnesia.

Erickson: When?

Subject: Immediately.

Erickson: Is it necessary that it happen immediately? Won't you be ? surprised when you find it has happened?

Thus Erickson implied the possibility of a later amnesia by the indirect suggestions contained in his questions. His last comment, "won't you be surprised . . . " is an effort to utilize her expressed wish to experience a surprise.

The psychologist then verbalized all trance events to prove she had no amnesia and actually rehearsed them on her long drive home from Arizona to California. On arriving home she began writing a letter to Erickson stating she still recalled all trance events but left the letter unfinished when she went to bed. The next morning she awakened with an amnesia for all trance events, even though she recalled that she had been to Arizona to visit Erickson.

It will be noted that while this was a suggested amnesia, it was indirectly suggested. This type of indirectly suggested amnesia is vastly more effective for clinical purposes than the baldly asserted direct suggestions used in most experimental work (e.g., the Stanford Hypnotic Suscep-tibility Scale, Form A, uses the following direct suggestions: "You will

Varieties of Hypnotic Amnesia 75 have difficulty in remembering; you will have no desire to try to recall . . . " ) . When such direct suggestions had been used in this patient's previous hypnosis work with other therapists, they were conspicuously ineffective in producing amnesia.

The reason for the greater effectiveness of indirect suggestions may be formulated as follows: In most trances some consciousness is invariably present in the form of an observer attitude; the subject is in part lost in the experience, but in part the ego is quietly observing what is happening, just as it can in dreams (Rossi, 1972 a, b).

When a direct suggestion for amnesia is given, the observing ego takes note of it, just as it quietly takes note of most direct suggestions. Having noted the suggestion, the ego later has the power of choice as to whether or not the suggestion shall be carried out. When the subject has this awareness of a suggestion, he can debate with himself regarding its merits and decide about carrying it out. When a suggestion is made indirectly, however, even the observing ego tends to miss the fact that a suggestion has been given. With little or no awareness of the suggestion there is little or no ability to debate and negate it. Indirectly administered suggestions are programmed more easily into preconscious or unconscious levels and can then emerge more naturally in the patient's ordinary course of behavior.

Amnesic Material in Dreams

Example 3. This example concerns a graduate nurse who was hypno-tized on many occasions and invariably had a spontaneous amnesia for all trance events. Even the reading of a full stenographic account of her trance behavior would not awaken a sense of recognition for the items described. Upon being rehypnotized, she would disclose a full recollection of the hypnotic experience, but upon awakening the amnesia would again become manifest.

One day this subject approached Erickson and reported that she had a most interesting dream and proceeded to give an adequate account of a previous hypnotic demonstration before a group. Full notes made of her dream and subsequently compared with the stenographic account of that demonstration proved the correctness of her dream account.

Uncertain as to her purpose in such a communication, Erickson inquired cautiously as to the possible relationship of this dream to hypnosis. She explained that she always dreamed quite vividly for some nights following hyponotic trances, but this was the first occasion on which she had had so extensive and interesting a dream. Further questioning disclosed her to be entirely sincere in her belief that her account was only a dream and that Erickson would naturally be interested in it for

76 Hypnotic Investigation ot Psychodynamic Processes psychiatric reasons. Asked why she knew her account to be a dream and not the recovered memory of a forgotten trance, she explaiend that dreams are characterized by a quality of unreality. This unreality permitted unreasonable things to occur. And in her dream she and Erickson had been alone in a large room in which there had suddenly and inexplicably appeared an inconstant audience which came and went, or grew large or small for no apparent reason, and which sometimes included people she knew definitely could not have been at a hypnotic demonstra-tion.

No effort was made to explain that these peculiarities of the audience, as the stenographic account itself disclosed, really resulted from the hypnotic suggestions she had been given.

For some time the subject was encouraged to report her dreams.

Further investigation disclosed that in the trance state she had an adequate understanding of her dreams as indirect recoveries of trance memories. However, specific hypnotic instruction had to be given for her to recall in the waking state both the trance experience and the dream revival of it before she could go through a slow process of fusing them into a single understanding.

In summary, this hypnotic subject developed spontaneous amnesia for trance experiences but spontaneously recovered that amnesic material in the form of dreams. She thus had a complete amnesia for one experience (trance) and a full awareness of an entirely different kind of an experience (dream) with an identical content.

Example 4. Another subject was found who reviewed in her dreams many events of the trance session. She was aware, however, of the nature of her dreams and purposely utilized dream activity to overcome hypnotic amnesia. Her explanation was that she had an intense curiosity about what occurred in trance, but her hypnotic amnesia had constituted an effective barrier until she spontaneously dreamed about a trance session and recalled the dream the next morning. In reviewing the dream she became aware that it was a valid recollection of trance events. Thereafter, whenever she wished to know what she had done in a trance state, she circumvented the hypnotic amnesia by dream activity.

Further investigation disclosed that her dreams were much less exten-sive than the first subject's, and that the dream content related only to those things of most interest to her. When this was pointed out to her by having her read a complete stenographic account which contained much material she did not recall, she responded that night with a more extensive dream. In this dream she recovered approximately all of the details of another trance experience.

The behavior of these subjects who circumvented hypnotic amnesia by dream revivals is most informative. It strongly suggests that neuro- and psychophysiotogical processes of normal sleep can be employed as a

Varieties of Hypnotic Amnesia 77 medium by which to gain access to experiences not available to the waking state. Hence, the assumption seems justified that extensive neuro- and psychophysiological processes are involved in hypnosis and in hypnotic amnesia.

Amnesia by the Displacement and Distortion of Memories Example 5. This example concerns an investigation of suggested hypnotic amnesia in an informal setting. The subject, in a deep trance, was instructed that after awakening he was to smoke a special Russian cigarette which would be furnished at a given cue. Upon lighting the cigarette he was to join enthusiastically in the general conversation with those present. Upon finishing the cigarette he was to extinguish the butt and then develop a complete amnesia for all occurrences between the giving of the cue and the discarding of the cigarette.

This sequence of events developed as intended, and notes were made of the subject's behavior and the topics of conversation. For some minutes after disposing of his cigarette the subject seemed to be self-absorbed.

These few minutes of self-absorption may be understood as a spon-taneously generated posthypnotic trance (Erickson & Erickson, 1941), which was required for the profound neuropsychological changes to effect the suggested amnesia. Then, suddenly, he joined in the conversation of the group. Shortly the topic of smoking was raised, the subject was questioned about his habits, and then, in a progressive and systematic fashion, he was questioned more and more closely about the events of the presumably amnesic period.

At first no evidence of any recollections could be secured from him, but after some 30 minutes of insistent questioning with extensive use of the notes made, particularly those relating his expressed opinions on contro-versial topics, the subject suddenly began to recover his memories of the entire period. When an adequate recall finally had been obtained, he was asked to account for his previous failures to recognize items that had suddenly become familiar. He proceeded by offering various rationaliza-tions and then began to insist, with obvious sincerity, that he had not experienced amnesia at all. He claimed he had merely simulated it by evading questions, misunderstanding remarks, and by deliberate suppres-sion. Checking these assertions against the notations that had been made of his actual behavior, however, suggested the probability of a retrospec-tive falsification.

The experiment was then apparently discontinued, and more than an hour was spent in casual conversation on other topics. Finally references were again made to (he events of the amnesic period. It was immediately apparent that the subject was confused by such references, and he was

78 Hypnotic Investigation of Psychodynamic Processes again amnesic for the entire period between lighting and extinguishing his cigarette. This second amnesia also included the questioning that led to the breakdown of the original amnesia and all his assertions and rationalizations about it.

The subject now believed that on another occasion three months earlier, in a different social group (that included only one of the present group) and under entirely different circumstances, he had smoked a Russian cigarette while discussing the conversational topics about which he had just been questioned. Extensive inquiry about this new belief disclosed that the content of the amnesic experience had been displaced in time and setting; it had been interpolated into an older and different experience. In this new belief the subject could not be shaken.

In summary, this subject developed an extensive amnesia, recovered the amnesic material under mass social stimulation, and then unaccounta-bly developed another amnesia that included both the original material and the associated experience of recovering it. He then recovered the

In summary, this subject developed an extensive amnesia, recovered the amnesic material under mass social stimulation, and then unaccounta-bly developed another amnesia that included both the original material and the associated experience of recovering it. He then recovered the