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The Hypnotic Induction Profile and

Absorption
a b c
Edward J. Frischholz , David Spiegel , Mark J. Trentalange &
d
Herbert Spiegel
a
University of Illinois at Chicago
b
Stanford University
c
New York Medical College
d
Columbia University
Published online: 06 Nov 2014.

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To cite this article: Edward J. Frischholz, David Spiegel, Mark J. Trentalange & Herbert Spiegel (2015)
The Hypnotic Induction Profile and Absorption, American Journal of Clinical Hypnosis, 57:2, 122-128,
DOI: 10.1080/00029157.2015.967065

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 American Journal of Clinical Hypnosis, 57: 122–128, 2014
Copyright © American Society of Clinical Hypnosis
ISSN: 0002-9157 print / 2160-0562 online
DOI: 10.1080/00029157.2015.967065

The Hypnotic Induction Profile and Absorption

Edward J. Frischholz
University of Illinois at Chicago

David Spiegel
Stanford University
Downloaded by [University of Otago] at 02:49 12 March 2015

Mark J. Trentalange
New York Medical College

Herbert Spiegel
Columbia University

This study examined the relationship between scores on the Hypnotic Induction Profile (HIP) and the
trait of absorption in three different clinical groups: Smokers (n = 226), Phobics (n = 95), and patients
with Chronic Pain (n = 65). Two hypotheses were investigated. The first predicted that both the
Eye-Roll sign (ERS) and Induction Score (IND) of the HIP would correlate similarly (r = .30) with
scores on the Tellegen Absorption Scale (TAS), as has been previously reported with other measures
of hypnotic responsivity in student samples. The second was that using a combination of both ERS
and IND scores to predict TAS scores would result in a significant increase in forecasting accuracy
over using either HIP measure alone. Both hypotheses were supported in all three clinical groups.
Correlations between HIP and Absorption scores ranged from .33 to .53. Clinical and theoretical
implications of the findings are discussed.

The Hypnotic Induction Profile (HIP) was introduced in 1970 as a new measure of hyp-
notic responsivity for use in the clinical context. The HIP was developed as an alternative
to existing measures of hypnotizability which many clinicians felt were too lengthy for
routine clinical use. In the past few years, a number of studies have demonstrated that
the HIP induction score (IND) correlates significantly with these longer hypnotizability
scales (Frischholz & Tryon, 1980; Frischholz, Tryon, Vellios, Fisher, Maruffi, & Spiegel,
1980; Orne et al., 1979; Pettinati, Horne, & Evans, 1981) although the intercorrelations
are not high enough to warrant using these scores as interchangeable measures. In

This article was originally published in the American Journal of Clinical Hypnosis, Vol. 30, No. 2, 1987, pp. 87–93.
DOI: 10.1080/00029157.1987.10404168
 HIP AND ABSORPTION 123

addition, a number of studies have also demonstrated the clinical utility of the HIP in
the differential diagnosis of psychopathology (Spiegel, Detrick, & Frischholz, 1982;
Pettinati, Horne, & Evans, 1981), and the prediction of short- and long-term treatment
responsivity (Katz, Kao, Spiegel, & Katz, 1974; Moore & Berk, 1977; Spiegel, Maruffi,
Frischholz, & Spiegel, 1981; Spiegel, Frischholz, Fleiss, & Spiegel, 1986; Spiegel &
Spiegel, 1978; Williams, Spiegel, & Mostofsky, 1978). The present study is an attempt
to expand the “nomological network” (e.g., Messick, 1980) of the HIP by relating it to
the personality construct of absorption in three samples of psychiatric outpatients.
Starting in the 1960s, a number of researchers began to study the relation between
measured hypnotic responsivity in the laboratory and the frequency of spontaneous
“hypnotic-like” experiences occuring in everyday life (As, O’hara, & Munger, 1962;
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Shor, 1960). These studies reported a moderate but consistent relationship (r =

.30) between the two constructs. In addition, Hilgard (1970) found a moderate relation-
ship (r = .30) between scores on the Stanford scales (Weitzenhoffer & Hilgard, 1959;
1962) and a capacity for “imaginative involvement” in a large student population. Based
on these findings, Tellegen and Atkinson (1974) developed a scale which measured a trait
which they called “absorption.” Absorption was described as “a disposition for having
episodes of ‘total’ attention that fully engaged one’s representational (i.e., perceptual,
enactive, imaginative, and ideational) resources” (Tellegen & Atkinson, 1974, p. 268).
The Tellegen Absorption Scale (TAS) was moderately correlated with a group form of
the Stanford scales, but was uncorrelated with an “acquiescence” response set, or the
familiar personality dimensions of stability/neuroticism and introversion/extraversion
which underlie such scales as the MMPI (Hathaway & McKinley, 1966) and the
Maudsley Personality Inventory (Eysenck & Eysenck, 1969). Others have reported sim-
ilar correlations between group forms of the Stanford scales and the TAS in student
samples (e.g., Kilhlstrom, Diaz, McClellan, Ruskin, Pistole, & Shor, 1980).
Stedrak (1980) reported that both the ERS and IND scores of the HIP were signif-
icantly correlated with TAS scores in a student population, extending the finding to a
different measure of hypnotizability. Reanalysis of her data also indicated that using a
combination of both ERS and IND scores resulted in a significant prediction increase for
TAS scores than using either measure alone. This finding is interesting as the relationship
between the Eye-Roll Sign (Spiegel, 1972) and other correlates of hypnotizability has
been questioned on theoretical grounds (Hilgard, 1982). The logic of Hilgard’s (1982)
critique has in turn been challenged (Spiegel, Tryon, Frischholz, & Spiegel, 1982), but
more data are needed so these issues can be resolved empirically.
The present study examined the relationship between both ERS and IND scores and
TAS scores in three different clinical groups. It was hypothesized that both IND and ERS
scores should correlate with the TAS at approximately the same level (i.e., .30) as the
TAS correlates with the Stanford scales in student samples. In addition, a combination of
both ERS and IND scores was expected to yield a better prediction of TAS scores than
either HIP measure alone.
 124 FRISCHHOLZ ET AL.

Method

Subjects

Three clinically distinct groups of consecutive private psychiatric outpatients served as

subjects in the present study. These three groups consisted of: 1) smokers (n = 226);
2) phobics (n = 95); and 3) chronic pain patients (n = 65). All had sought appointments
with a psychiatrist (H.S.) to learn a treatment strategy which adjunctively employed hyp-
nosis in order to enhance control over their stated problems. There were no differences
in age or the distribution of sex among the three clinical groups.
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Procedure

Upon arrival, each patient was administered the 1976 version of the TAS (Tellegen,
1976) and was then invited into the psychiatrist’s office where a brief case history was
taken followed by the administration of the HIP. The psychiatrist was blind to patient’s
scores on the TAS. About 10% of the sample were not administered the TAS because
they arrived late for their appointments. There were no differences among clinical groups
in regard to the number of patients who arrived late. All data were gathered as part of a
routine clinical examination.

Results

Because there were no significant differences between the means and correlations within
and across patient groups (see Frischholz, Spiegel, Spiegel, Balma, & Markell, 1982),
the statistical analysis was performed with all groups combined in order to provide more
stable estimates of the data parameters. There were no significant moderating effects of
sex, so it was ignored in all further data analyses. Age was included in the statistical
analyses because previous studies have suggested that it is negatively correlated with
both ERS and IND scores (Frischholz et al., 1982; Spiegel, Detrick, & Frischholz, 1982;
Stern, Spiegel, & Nee, 1979).
The means, standard deviations, and correlation matrices for each dependent variable
in the total sample are presented in Table 1. As was found previously, age was negatively
correlated with both ERS and IND scores. These correlations ranged from −.09 to −.35.
Interestingly, TAS scores were also negatively correlated with age.
The hypothesis that ERS and IND scores would correlate similarly with TAS scores
was supported. The correlations between IND and TAS scores ranged from .33 to
.44 among the three patient groups and all were statistically significant (p < .05).
Likewise, the correlations between ERS and TAS scores ranged from .32 to .41 (all
r’s, p < .05). The correlations between ERS and IND scores were somewhat lower
(r’s = .16 to .34) and are similar to those found in earlier reports (Orne et al., 1979;
Spiegel, Aronson, Fleiss, & Haber, 1976; Stern, Spiegel, & Nee, 1979).
 HIP AND ABSORPTION 125

TABLE 1
Intercorrelations of Hypnotizability and Absorption Measures

IND ER TAS x SD n

Induction Score (IND) 6.52 2.5 386

Eye-Roll (ER) .30∗ 2.22 .7 386
Absorption (TAS) .41∗ .35∗ 20.1 7.0 345
Age −.12∗ −.19∗ −.16∗ 44.9 13.2 386

A multiple regression analysis was used to test the second hypothesis that ERS and
IND scores were uniquely related to TAS scores. Regression equations were computed
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within each patient group and for all groups combined. In each case, IND scores were
entered into the equation first. Then ERS scores were added and an F test was computed
to see if there was a significant increase in the prediction of TAS scores. In each patient
group, adding ERS scores into the regression equation resulted in a significant increase
in the prediction of TAS scores. Table 2 presents this analysis for the combined patient
groups. The percent increase in TAS variance accounted for can be calculated by dividing
the squared overall multiple R by the squared simple correlation between IND and TAS
scores. The increase in TAS variance accounted for ranged from 19 to 78% across the
three patient groups.
Another way to examine the generalizability of the above multiple regression analysis
involves using the technique of cross-validation (Mosier, 1951). In the present study, the
regression weights for ERS and IND scores in the smoking group were utilized to predict
TAS scores in a combined group of phobics and pain-control patients. The correlation
between the predicted and observed TAS scores in this clinically heterogeneous group
was .459. This cross-validated correlation is somewhat lower than the observed mul-
tiple correlation for smokers (.48) due to sampling error. However, it clearly indicates
the generalizability of using HIP scores to predict absorption among different clinical
groups.

Discussion

The results of the present study extend earlier findings by relating the personality trait of
absorption to measured hypnotic responsivity in the clinical context. In addition, using

TABLE 2
Regression Analysis of Relationship Between Hypnotizability and Absorption

n∗ Independent Variables Step Dependent Variable F p Multiple R

345 IND 1 TAS 40.06 .01

345 ERS 2 TAS 6.88 .01 .48
 126 FRISCHHOLZ ET AL.

both ERS and IND scores of the HIP resulted in better predictions of individual differ-
ences in absorption than using either of these variables alone. These findings have both
theoretical and clinical ramifications for the construct validity of the HIP and provide
further confirmation of the absorption construct.
Recently, some laboratory studies on absorption and hypnotizability have suggested
that the observed correlation between these two constructs is mediated by subject’s
response expectancies (e.g., Council & Kirsch, 1983; Council, Kirsch, & Hafner, 1986;
Council, Kirsch, Vickery, Carlson, 1983; Rhue & Lynn, 1986). For example, when the
TAS was not administered in the context of a hypnosis experiment, it failed to correlate
with a subsequent measure of hypnotic responsivity (e.g., Council & Kirsch, 1983). The
authors concluded that absorption might be an “expectancy-mediated artifact” rather
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than a real personality construct. Yet, the logic of their conclusion can be shown to
be circular. Perhaps, experimentally created response expectancies can obscure the true
relationship between hypnotic responsivity and absorption rather than vice versa. This
remains a topic for future research.
Patients in the present study sought psychiatric treatment with adjunctive hypnosis.
Perhaps it might be argued that the expectation of being hypnotized stimulated these
patients to think more readily about natural everyday experiences traditionally associ-
ated with hypnosis (e.g., Kirsch, 1985). The correlations between HIP scores and TAS
scores in each patient group ranged from .33 to .53. These correlations are similar to
those observed in the laboratory in the context of a hypnosis experiment (e.g., Kihlstrom
et al., 1979; Tellegen & Atkinson, 1974). It is unclear whether the correlation between
these two personality measures would be affected if the patient had not expected to be
hypnotized.
What is clinically important about the link between HIP scores and TAS scores? First,
one must consider that TAS items refer to experiences that subjects have in their every-
day lives. These items do not make any reference to hypnosis. Instead, they refer to
spontaneous “trance-like” experiences that occur outside the clinic. Therefore, it is inter-
esting that the controlled dissociative experience measured by the HIP was found to be
related to the patient’s description of spontaneous dissociative experiences outside the
therapist’s office.
Knowledge about a person’s tendency towards absorption can facilitate clinical work.
One example involved a couple in marital therapy who were in constant conflict. One
of the wife’s major complaints about her husband was that he was too engrossed in his
work and recreational activities. She claimed that he always became so involved that he
seemed to be in his own world, deliberately ignoring her. At the therapist’s suggestion,
both the husband and the wife completed the TAS. The husband scored 32 and the wife 7.
The significance of these scores was then explained and therapy proceeded by teaching
both to appreciate the differences in their perceptual styles. This reduced their conflict
over the type of attention they paid to one another.
The above example illustrates how knowledge about a person’s tendency to become
“absorbed” can be useful in understanding his/her behavior outside of the therapeutic
 HIP AND ABSORPTION 127

context. In addition, more recent work on the absorption scale (Tellegen, 1981) has pro-
vided further elaboration on the clinical and theoretical significance of the absorption
construct. Because of its brevity, the HIP can be easily administered in the course of an
initial diagnostic interview. Since both ERS and IND scores are significantly correlated
with TAS scores, these measures can be used to make probabilistic statements about
the patient’s tendency to become “absorbed” outside the therapist’s office. It is hoped
that future studies will provide additional information about the relationship between
hypnotizability and absorption.

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