The use of hypnosis to enhance memory can lead to major changes in recall, as well as in the confidence that people hold in the accuracy of their recall. The influence of hypnosis on memory generally has been the focus of substantial investigation and comment (American Medical Association, 1985, 1994; American Society of Clinical Hypnosis, 1995; Laurence & Perry, 1988; McConkey & Sheehan, 1995; Pettinati, 1988, Scheflin & Shapiro, 1989), and the influence of hypnosis on recovered memory has been the focus of two special issues of the International Journal of Clinical and Experimental Hypnosis (October 1994; April 1995). Overall, it is clear that people can believe strongly in the accuracy of their hypnotically enhanced memories, even when those memories are wrong. In summary of the experimental findings about the effect of hypnosis on memory, McConkey (1992) concluded, 'It should be understood clearly that the experimental findings provide no guarantee that any benefits (e.g., increased accurate recall) will be obtained through its use, and that some costs (e.g., inaccurate recall, inappropriate confidence) may well be incurred through its use' (p. 426). For instance, hypnosis can lead to an apparent increase in memory, because it may lead people to generate and report more material as memory than they would if hypnosis were not involved (McConkey & Kinoshita, 1988). Also, hypnotized individuals can accept subtle changes to their memory, incorporate those changes into their memory, and develop confidence in the accuracy of what they report; one of the most consistent findings from the experimental research is that hypnosis may lead people to be inappropriately confident in the accuracy of their memory (Nogrady, McConkey & Perry, 1985; see also Krass, Kinoshita & McConkey, 1988). Finally, hypnosis can lead to the creation of pseudomemory when a hypnotized person accepts a suggestion for false information and subsequently reports that information as a genuine memory (Barnier & McConkey, 1992).
Although some have debated the interpretation and relevance of experimental research on hypnosis and memory (American Society of Clinical Hypnosis, 1995), in their analysis of recovered memories of abuse Pope & Brown (1996) considered that 'because hypnotic technique can enhance suggestibility and lead to the development of pseudomemories in some individuals, its use as a memory enhancement or memory-retrieval strategy seems questionable at best' (p. 59). The importance of understanding the processes involved, as well as the possible risks and benefits, when hypnosis is used to recover memory is thrown into bolder relief by a consideration of selected clinical material.
McConkey & Sheehan (1995; see also McConkey, 1995) presented the case of BT, who was 21 years old when she went to a clinician for help in remembering events that her older sister had said BT had witnessed about 10 years earlier. BT's sister had told police that their father had sexually abused her as a young adolescent, and had said that BT witnessed much of that abuse. BT could not remember this, but underwent four hypnosis sessions at the request of her mother and her sister. Early in Session 1, the following interaction occurred:
hypnotist: Are you aware that in the case of your elder sister, in her relationship with her father, that there are various charges being brought about against him?
hypnotist: Right. As her sister, I am asking you now, as to whether you are a witness in the past to any impropriety that your father may or may not have committed towards your sister?
By the end of Session 1, after using a series of techniques that focused on the father and his assumed acts of abuse, the following interaction occurred:
hypnotist: Are you only aware for the moment at this your first subconscious session, are you only aware of that occasion when you walked into your father's room on a Saturday afternoon and were suddenly aware that [your sister] was in your father's bed with him under the blankets and sheets. Is this the only occasion that you noticed your father was not at all acting out the proper fatherly role?
In Sessions 2 and 3, the hypnotist used various techniques and metaphors to help BT feel secure and confident about whatever events came to mind. By the end of Session 3, BT was answering explicit questions about witnessing multiple sexual interactions between her father and sister. Moreover, she was giving details, such as the precise positioning and movement of the father's hands and genitals, that would have required extraordinary ability not only to witness (since they reportedly occurred under bedclothes), but also to remember so precisely (since they reportedly occurred approximately 10 years previously).
At the end of Session 3, the hypnotist summarized the progress they had made together, and ended treatment with the following interaction:
hypnotist: Your subconscious mind is a memory bank, and you can entrust a third party to help you resolve all that you've seen, all that you've experienced, all that you as a Christian have been coerced to be witness to ... You may feel some satisfaction as you leave here, that your prayers to resolve issues that you've seen can be answered. You are a Christian, are you not?
hypnotist: Yes. So through Jesus Christ, you can pray for this, that these issues be resolved for yourself, as a previous victim and now a survivor, for your sister, the victim but hopefully a survivor, through the grace of Jesus Christ. And you can say Amen.
hypnotist: I'm going to count up from zero to five. On the count of five you will be wide awake, feeling really good. Really alive on the count of five. Knowing that through courage, through revelation, you can proceed on with your life.
BT subsequently made a detailed statement to police about various sexual assaults on her sister by her father. The prosecution, however, considered that the judge would not allow testimony by BT because of the way in which her memories had been recovered. This case highlighted not only how clinicians can get caught up in events, but also how they can have difficulty looking critically at their own behaviour in the clinical setting. Moreover, it highlighted the creativity, if not the recoverability, of memory; BT constructed a personal meaning around a possibility of unremembered events. When one looked at the processes that were involved in BT moving from reporting no memory to reporting exceptionally detailed events from 10 years hence, substantial doubt could be cast on the accuracy of BT's memory reports. Nevertheless, BT developed a strong belief in the accuracy of her memories, and this changed the way in which she thought about her self and other members of her family (McConkey & Sheehan, 1995).
The impact of hypnosis on memory and on self-representation can be seen clearly in cases involving the intentional hypnotic falsification of memory for therapeutic benefit. For example, Janet (1889/1973) believed that successful treatment was based on not only uncovering a traumatic childhood event, but also reconstructing or replacing the original memory with a false, and more acceptable, memory; that is, changing the way in which the client thought about themselves. Janet's famous case of Marie exemplifies this treatment approach (Janet, 1889/ 1973; see also Ellenberger, 1970). Marie suffered from anaesthesia of the left side of her face and blindness of her left eye, both of which had been present for many years. Janet determined through hypnotic age regression that as a 6 year old, Marie had slept with a child of the same age who had impetigo on the left side of her face. After this, Marie developed an almost identical impetigo as well as blindness. Janet hypnotically age regressed Marie to the time of the incident and reconstructed the memory. This treatment was successful, and five months later there were no signs of hysterical symptoms. As Janet (1889/1973) put it, 'I put her back with the child who had so horrified her; I make her believe that the child is very nice and does not have impetigo (she is half-convinced. After two re-enactments of this scene I get the best of it); she caresses without fear the imaginary child. The sensitivity of the left eye reappears without difficulty, and when I wake her up, Marie sees clearly with the left eye' (pp. 436-440).
Contemporary examples also demonstrate the intentional hypnotic reconstruction of memory. Baker & Boaz (1983), for instance, reported the hypnotic treatment of a 30-year-old woman's severe dental phobia. During hypnotic regression, she described being taken to the hospital for a tooth extraction at 9 years of age and becoming terror stricken during the procedure; she could not recall being comforted by anyone. The clinician suggested that as the client thought about being taken into the operating room, she would remember the doctor holding her and stroking her forehead and telling her that she would not be afraid. The client said that she could hear the doctor comforting her, and subsequently reported that her fear was diminished as she re-experienced going into the operating room. A second session involved hypnotic age regression, and repetition of the suggestion that the doctor was comforting her; again, the client reported reduction of her anxiety. During follow-up, she recalled the implanted material as original memory, without awareness of either the construction of the suggested pseudomemory or the trauma associated with the original memory. Thus, the use of hypnosis assisted in the creation of a new memory. The client became committed to the accuracy of the memory to the extent that the constructed events were indistinguishable from the original event and integrated into the understanding and knowledge that the client developed about herself.
Returning to the issue of recovered memory of childhood abuse, Smith (1996) presented the case of 'Cindy' whom he successfully treated by helping her to recover and deal with an apparent memory of being abused by neighbours during childhood. Cindy presented with serious depression, suicidal ideation, and obsessional behaviour; even after admission to a psychiatric hospital, her treatment progressed with no apparent improvement. Although Cindy could recall a college rape incident and an abortion two years later, she had no memories of childhood abuse. However, the referring psychiatrist suspected that some traumatic sexual event may have occurred in childhood. To explore this, and to help Cindy access and master her emotions about present and past experiences, Smith introduced hypnosis into the treatment programme. Across a number of sessions, Cindy was hypnotically age regressed to childhood; during a regression to 8 years of age, she recalled being invited to a neighbour's house, told to undress, encouraged to touch herself and another girl, being fondled by a male neighbour, and having photos taken. She also recalled similar events from 12 or 13 years of age that involved being threatened with a knife. The recall of these events helped her to make sense of the emotions associated with those events, and in her view helped her to understand some of her current problems. By the end of treatment, Cindy's overall functioning had improved substantially and these treatment gains were maintained at a 5-year follow-up.
From this client's point of view, hypnosis was a key factor in her improvement, because it allowed her to 'remember and share intimate details very quickly' (Smith, 1996, p. 124). Notably, however, Cindy made no effort to corroborate her hypnotically retrieved memories of the events at the neighbour's house. Indeed, Smith (1996) acknowledged that 'in the absence of external verification, there is no way to know whether Cindy's memories are authentic or not. They seemed compellingly real to her and to me, but from a scientific standpoint, ''seeming'' real is not confirmation' (p. 124). Nevertheless, these memories, whether accurate or inaccurate, appeared to offer a plausible explanation for Cindy's symptoms, and served as a useful and ultimately successful 'therapeutic leverage for recovery' (Smith, 1996, p. 124).
In commenting on this case, Lynn, Kirsch & Rhue (1996) argued that such memory recovery work can be a gamble, and that clinicians must consider both the risks and benefits of using hypnosis to recover memories; indeed, the emotional, societal, legal, and financial stakes can be very high in such cases. Further, Lynn, Kirsch & Rhue (1996) offered a number of recommendations to help clinicians decide whether the 'benefits of attempting to access potentially forgotten life experiences outweigh the potential risk of distorted memories' ( p. 404). These include warning the client about the risk of memory distortion, exercising caution regarding the wording and implications of therapeutic suggestions, and evaluating the credibility of memories recovered during therapy. Such recommendations underscore the need for appropriate guidelines to assist in ensuring clinical practice is based on reasonable evidence and is consistent with acceptable standards.
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