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International Journal of Clinical and

Experimental Hypnosis
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The Phenomenology of the Experiences

and the Depth of Hypnosis: Comparison
of Direct and Indirect Induction
Techniques
a
Csaba Szabó
a
Kossuth Lajos University, Debrecen, Hungary
Published online: 31 Jan 2008.

To cite this article: Csaba Szabó (1993) The Phenomenology of the Experiences and the Depth of
Hypnosis: Comparison of Direct and Indirect Induction Techniques, International Journal of Clinical
and Experimental Hypnosis, 41:3, 225-233, DOI: 10.1080/00207149308414552

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 THE PHENOMENOLOGY
OF THE EXPERIENCES AND THE
DEPTH OF HYPNOSIS: Comparison of
Direct and Indirect Induction Techniques
CSABA SZAB6'f2
Kossuth h j o s University,Debrem, Hungary

Abstract: The effect of two hypnotic induction styles on subjective

experiencewas measured in an experimentin which 44 subjectspartic-
ipated in both traditional direct hypnosis, induced by the Stanford
Downloaded by [McGill University Library] at 00:32 26 September 2013

Hypnotic Susceptibility Scale, Form A, and indirect hypnosis (pre-

sented in counterbalanced order), followed by 4 minutes of rest before
dehypnosis. The depth of hypnosiswas measured retrospectivelyby a
subjective scale, and the structure of experienceswas measured by the
Phenomenology of Consciousness Inventory. Subjects were subse-
quently administeredthe StanfordHypnoticSusceptibilityScale, Form
B, so that awareness of their hypnotizability would not affect their
subjectivedepth reports.No differenceswere found in a comparison of
subjects' structure of experiences in direct and indirect hypnosis. In
addition, low and medium hypnotizable subjects reported indirect
hypnosis as deeper. This may reflect the possibility that while hypno-
tized different mechanisms come into play for subjects high in
hypnotizability compared to those who are less hypnotizable.

Recently, a growing number of clinicianshave emphasized the impor-

tance of hypnotic communication style and have claimed that indirect
procedures are more effective than traditional, more authoritative ap-
proaches for both hypnotically responsive and unresponsive subjects
(e.g., Barber, 1980;Erickson, Rossi, & RossiJ976; Zeig, 1985).By contrast,
other results have stressed the definitive role of individual differencesof
hypnotizability in the hypnotic process (Hdgard, 1986;Tart,1970).
The behavioral effect of the directness of the induction and the sug-
gestion were investigated, and it was found that the response level was
not affected by the degree of directness of the induction (Matthews,
Bennet, Bean, & Gallagher, 1985),nor was it affected by the fact that the
procedure was standard or individual (Van der Does, Van Dyck,
Spinhoven, & Kloosman, 1989), or whether the style of suggestions was
Manuscript submitted October 15,1990;final revision received January20,1993.
*Theauthor wishes to thank Ronald J. Pekala for providing the PCI, Helen J. Crawford
for her substantive advice, J4nosMath for providing the statistical analysis, and the IJCEH
reviewers for their helpful comments on this article.
'Requests for reprints shodd be addressed to Csaba Szab6, Institute of Psychology,
Kossuth Lajos University, 4010 Debrecen 10, Pf. 28, Hungary.
The lntmrationalJoumlof Uinicaland Erprimentnl Hypnaris, VoL XL.I, No.3, Jdy 1993 225233
(B 1993 The Intrmationnl JavnalqfUinicnl d Experimentd Hypnosis
225
 226 CSABA S U B 6

direct or indirect (Spinhoven, Baak, Van Dyck, & Vermeulen, 1988).

Investigating the effect of the induction style on subjective experiences,
Matthews et al. (1985),in comparing the effect of a traditional induction-
the Stanford Hypnotic Clinical Scale for Adults (SHCS: Adult; Morgan, &
Hilgard, 1978)-and an indirect Ericksonian induction, found that the
indirect hypnosis was deeper than the traditional one. The depth was
measured on a 7-point Likert-type scale. In these experiments, sugges-
tions involving overt behavior were used, and thisprocedure may have
affected the depth reports because of self-pefieption (Bem, 1972). Fur-
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ther, the role of hypnotizability, regardless of whether the depth reports

of subjects of differing hypnotizability were affected similarly or not by
the different induction styles, was not investigated. In the present exper-
iment, a comparison was made between traditional and indirect hyp-
notic inductions. Subjectsevaluated their hypnotic depth and phenom-
enological experiences following the induction during a Cminute rest
period. To determine whether measured hypnotic susceptibility moder-
ated the experiences in the two inductions, subjects were subsequently
administered the traditional Stanford Hypnotic Susceptibility Scale,
Form B (SHSS:B; Weitzenhoffer & Hilgard, 1959). Based on prior
findings (Barber, 1980; Matthews et al., 1985; Pekala, Forbes, & Con-
trisciani, 1988-1989), it was anticipated that low hypnotizable individ-
uals would report feeling more deeply hypnotized after indirect
induction.
Previous studies have used suggestions of overt behavior in both
direct and indirect hypnosis. Because subjects’ depth reports may be
partially based on their perception of hypnotic behavior, those who
respond to fewer suggestions may report lower depth, thus confounding
the effects of hypnotic ability and depth rating. In the present study, a
scale of hypnotic ability (and suggestions for overt behavior) was ad-
ministered only after the reports from both inductions were gathered,
thus making it possible to minimize the effect of overt behavioral re-
sponse to suggestion on rating of depth.
METHOD
Subjects
initially, 48 undergraduate students (24 males and 24 females) volun-
teered to participate in an experiment-describedas “a study of subjective
experiences in hypnosis.’’ None of them had previous experience with
hypnosis. They received no course credit or finanaal reward for their
participation. One subject did not complete the experiment, and 3 others
were eliminated from analysis because they were inconsistent in their
description of experiences according to a scale assessing reliability em-
bedded in the subjective experiences measure described below. The
remaining 44 subjects’ mean age was 24 years (SD= 2.4 years).
 EXPERIENCE!3ANDDEF’THOFHYPNOSIS 227

Measures
Phenomenology of Consciousness Inventory (PCI; Pekala, 1985). This in-
ventory consists of 53 items that are rated on a %point Likert-type scale
from 0 to 6. The scalehas been factor analyzed and been found to reliably
and validly assess 12 major dimensionsof subjectiveexperience (Kumar&
Pekala, 1985; Pekala & Wenger, 1983). These dimensions and sub-
dimensions are Altered Experience (time sense, meaning, body image,
perception); Positive Affect (joy, sexual excitement, love); Negative Af-
fect (anger, sadness, fear); Visual Imagery (amount, vividness); Attention
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(direction of attention, absorption); Rationality; Arousal (relaxation);

Self-Awareness; Memory; Volitional Control; Internal Dialogue; and
Altered State of Awareness. Differences were found between the struc-
tures of subjectiveexperiencesamong subjects of differinghypnotizabil-
ity and absorption capacity (Kumar& Pekala, 1988; Pekala & Kumar,
1984,1987).Different stimulus conditions were associatedwith different
intensities and patterns of reported phenomenological experience: For
example, experiences in eyes-closed baseline were different from expe
riences in hypnosis (Pekala & Kumar, 1986); eyes closed differed from
relaxation and meditation (Pekala & Wenger, 1983), and hypnosis dif-
fered from progressive relaxation (Pekala & Forbes, 1988; Pekala et al.,
1988-1989).There are two forms of the PCI, each of which has the same
items but in a different sequence. The intratest consistency is measured
by five pairs of items of similar or identical content. If one responds to
these item pairs identically the averaged difference of these pairs is zero.
When the averaged difference is greater than 2, the subjects have mar-
ginal reliability.
Hypnotic depth. Subjects retrospectively estimated their hypnotic
depth on a 10-point scale, where 1is “I was not in hypnosis at all”, and
10 is “Iwas in the deepest possible hypnosis.”
Procedure
Subjects were informed that they would take part in two different
hypnotic experiencesand then describetheir subjective experiencesafter
each. The preliminary introduction to the first induction was in accor-
dance with that given in the manual for the Stanford Hypnotic Suscep-
tibility Scale, Form A (SHSSA; Weitzenhoffer & Hilgard, 1959).
Prior to the experiment proper, subjectswere asked to sit quietly with
their eyes closed for 4 minutes and to observe their experiences. Subjects
were then instructed to evaluate their experienceby completingthe PCI.
This was used to teach the subjectshow to use the PCI. In the experiment,
each subject was presented with two hypnotic inductions: One was a
traditional, direct hypnotic induction, and the other was an indirect
hypnotic induction. Length of the inductions was the same: 9 minutes
for each. Order of inductionswas counterbalanced across subjects.Arest
 228 CSABASZAB6

period of 5 minutes between the two conditions was provided for the
subjects.
The indirect hypnotic induction was a slightly revised version of the
induction technique published by Bassman and Wester (1984). In order
to correspond to a n experimental setting, the concrete therapeutic sug-
gestions were eliminated. This induction placed emphasis upon the
subjects' responsibility for the hypnotic process and defined the hyp-
notic situation as being totally controlled by the subjects. Subjects were
asked to raise their arms,clench their fists tightly, and stare at a point on
their fist. They were told that they themselves would control the deep-
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ening of hypnosis by lowering their arms at their own pace. They were
also informed that the natural consequenceof thistenseness was to strain
and that the tension would begin to decrease, and further, that by
lowering their arms their eyes would blink, then close. They would be
more and more relaxed and go into trance. After this,age regression
suggestions were given and this was followed by the deepening. At the
end of the induction, the story of the North Wind and the Sun was used
to deepen the hypnosis further?
The traditional, direct hypnotic induction was the verbatim induction
from the SHSS:A manual. This induction begins with also fixating on a
point and concentrates mainly on relaxation. To be analogous to the
indirect induction story, at the end of the induction, subjects were asked
to imagine a sun covered by clouds and the wind beginning to blow so
that their coat is nearly tom off.Then the clouds leave with the wind and
the sun begins to shine, warming all parts of their bodies.
The main differencebetween the inductions was the level of directive-
ness involved. A further difference was that the direct induction accen-
tuated relaxation more, whereas the role of imagery in the indirect
induction was more important because of the age regression sugges-
tions. At the end of each induction, subjects were told to rest further and
to observe their experiences for a 4-minute period. Subjects were then
dehypnotized. Finally, after each condition, subjects were asked to com-
plete the PCI,to report their experiences during the 4-minute rest period,
and to rate their hypnotic depth at that time. Subjects were then admin-
3"Once there was a disagreement between the North Wind and the Sun. The North
Wind boasted of being more powerful, and the Sun merely smiled. Just then a traveler came
into sight, and they agreed to test the matter by hying to see which of them could make
the traveler remove his coat. The pompous North Wind was the first to try, while the Sun
watched from behind a gray cloud. The North Wind blew a furiousblast and nearly toxv
the coat from its fastenings, but the traveler only held the coat closer in desperation. The
North Wind was surprised by this resistance, and its fearsome gales were soon spent.
Shocked by the traveler's resilience,the wind withdrew in despair. "I don't believe you
can do it either, mighty Sun."Then out came the kindly Sun in all its splendor, dispelling
the clouds that had gathered and sending its warmest and rekshing rays down upon the
traveler's head,. . . neck, . . . shoulders, . . . chest, . . . stomach, . . .legs,. . . feet. The trav-
eler smiled at experiencing such a wondrous spring day, and thought that this was such a
day to take off a coat and greet the spring. . . " (Bassman &Wester, 1984, p. 252).
 EXPERIENCESAND DEF"H OF HYPNOSIS 229

istered the SHSB. This 12-itemscale permitted a systematicassessment

of their hypnotic susceptibility.
&SULTS
Phenomenology of Experiences
A 2 (Induction) x 2 (Order) repeated-measures MANOVA was per-
formed on the PCI scales.' The experiences in the direct and indirect
hypnosis, measured with the PCI, did not differ sigruficantlyfrom each
other. A sigruficant effect for Order was found, Pillais test value = .62,
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approximate, F = 3.01, hypothetical df = 15, p < .01. Subsequent t tests

revealed that the effect of Order was sigruficant only in the Meaning
subscale of the PCI (sample item: "I experienced very profound and
enlightening insights of certain ideas or issues"). Altered meaning fol-
lowing the direct induction was greater if indirect induction came first
(M = 2.07, SD = 1.34) than if it was the second (M = 1.27, SD = L3), t =
2.00, df= .42,p = .05. Similarly,meaning followingindirectinduction was
greater if it was first (M = 2.07, SD = 1.3) than if it was second (M = 1.45,
SD = I.O8), t = 3.54, d f = 42, p < .001.
Overall, meaning was more accentuated if indirect induction was
first. The reason for this may be that indirect induction, especially the
North Wind story, contained more meaning manipulations and the first
induction may have affected the experiences of subjects in the second
induction.
Relationship Between Hypnotic Depth and
Subsequently Measured Hypnotic Susceptibility
Based on SHSSB assessment, subjectswere divided into low (0-4; n =
14, M = 2.6),medium (5-7, n = 14, M = 6.1), and highly (8-12;n = 16, M =
9.75) hypnotizable groups. A 3 (Hypnotic Group) x 2 (Induction) x 2
(Experimental Order) repeated-measures ANOVA was performed.
There was a sigruficantmain effect for Induction, F(1, 38) = 8.11, p c .01.
Subjects reported greater hypnotic depth following the indirecthypnotic
induction ( M = 6.5, SD = 1.92) than the direct induction (M = 5.8, SD =
1.94).Reports of the two conditions correlated .70 (p < .OOl).
A sigruficant interaction between Induction and Experimental Order
was found, F(1,38) = 6 . 3 2 , ~< .05.The indirectinduction was deeper than
the direct one if it came after the dired induction (indire&M = 6.72, SD =
2.45; direct: M = 5.5, SD = 2.61), t = 3.41, d f = 21, p < .01, but there were
no sigruficantdifferences if the indirect induction came first (indirect M =
6.18, SD = 1.89;direct: M = 6.13, SD = 2.27), t = .12, df = 21, n.s.
Finally, there was a significant interaction between Hypnotic
Group and Induction,F(2,38)= 4.23, p < .05.Subsequent t tests, reported
$ecauseofthegreatnumberofPCIscales,thecomputationneededmorememoryspace
than was available, so the Positive Affect and Negative Affect scales were omitted from
analysis.
 230 CSABA SZAB6

Table 1
Reported Depth of Subjects of Different
Hypnotizability in the Direct and Indirect Hypnosis
Direct hndirrct
SHSS M SD M SD t df P
~

0-4 3.79 1.97 4.79 2.12 2.65 13 .05

57 5.86 2.32 7.14 1.75 2.39 13 .05
8-12 7.56 1.41 7.31 1.82 0.59 15 n.s.
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in Table 1 along with the means and standard deviations for each group,
revealed that low and medium hypnotizables reported themselves to be
in deeper hypnosis with the indirect induction than with the direct
induction. High hypnotizables reported comparable hypnotic depth
following both inductions.
DISCUSSION
As the data show, the factor that had the closest relationship with the
reported depth of hypnosis was hypnotic susceptibility. The subjects
having higher hypnotizability reported deeper hypnosis; this is in accor-
dance with earlier findings. The PCI did not indicate that differences
between direct and indirect inductions existed. There may have been
differences in certain aspects of the experiences, which are not mapped
with the PCI, such as archaic involvement or access to the unconscious
(Shor, 1979).
Subjects reported a deeper hypnosis following the indirect induction,
which is in accordance with the findings of Matthews et al. (1985). A
factor that may have contributed to the result was that in the present
experiment subjects sat quietly after the induction, without suggestion
being made which would involve any overt behavior. The SHSS:B
measures, which had occurred following the experiment, did not affect
their reports. In addition, a sigruficantorder effect was found, which may
reflect the importance of the first induction.
Of importance was the finding that low and medium hypnotizable
individuals reported greater depth during the indirect hypnosis experi-
ences. This supports contentions of the Ericksonian investigators that
less susceptibleindividuals are more responsive to indirect suggestions.
These results in conjunction with other work suggest that indirect ap-
proaches may be more effective with less hypnotizable individuals in
the clinical setting. For the highly responsive individuals, either the
indirect or the direct technique provides similar altered experiences.
In the future, explorations of a somewhat different approach are
needed. Independent group design with different subjects to clearly
separate the effect of the inductionsis desirable. The effects of indirectiv-
 EXPJXENCESAND DEPTH OF HYPNOSIS 231

ity and imagery must also be separated.Similarinductionsmustbe used,

with the only difference being directivity Further, another technique by
which experiencescould be explored more completely (e.g.,Experiential
Analysis Technique; see Sheehan & McConkey, 1982) would be useful.

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Die Phinomenologie der Erlebnisse und der Tiefe der Hypnose:

Ein Vergleich der direkten und indirekten Induktionstechniken

Csaba SzabB
Abstrakt: Der Effekt von zwei Hypnoseinduktionsstilen auf ein subjektives
Erlebnis wurde in einem Experiment gemessen, in dem 44 Subjekte an
traditioneller, direkter Hypnose teil nahmen, die durch die Stanford-
Hypnoseempfindlichkeitsskala,Form A, induziert wurde, sowie an indirek-
ter Hypnose (in gegenbalancierter Anordnung prasentiert), der 4 Minuten der
Ruhe vor der Finthypnotisierung folgten. Die Tiefe der Hypnose wurde
riickschauend an einer subjektiven Skala gemessen, und die Erlebnisstruktur
wurde an einem Bedtseinsinventar der Ph2nomenologie gemessen. Da-
nach unterzogen sich die Subjekte der Stanford-Hypnoseempfind-
lichkeitsskala Form B, so daB das BewuBtsein ihrer Hypnotisierbarkeit nicht
ihre Berichte uber subjektive Tiefe beeinflussen konnte. Es fanden sich keine
Untemhiede bei einem Vergleich der Erlebnisstruktur der Subjekte in direk-
ter und indirekter Hypnose. Weiterhin berichteten schwach und magig
hypnotisierbare Subjekte uber indirekte Hypnose als tiefer. Dies mag die
Moglichkeit reflektieren daB, wahrend in Hypnose, unterschiedliche
Mechanismen fur Subjekte auftreten, die stark in Hypnotisierbarkeit sind im
Vergleich zu Subjekten, die weniger hypnotisierbar sind.

Ph6nominologie des exphriences et profondeur de I'hypnose:

comparaison des techniques d'induction directe et indirecte

Csaba Szab6
RCsumC: Les effets deux types d'induction hypnotique sur I'expirience sub-
jective ont 6ti mesurCs par une etude, dans laquelle 44 sujets ont subi
l'induction hypnotique traditionnelle selon l'Echelle de Suggestibilite
hypnotique de Stanford, forme A, et une induction indirecte (les deux
pr6sent6es de facon contrebalanc6e),suivi d'une pCriode de 4minutes de repos
avant le riveil de l'hypnose. La profondeur de l'hypnose a it6 mesur6e
ritrospectivement par une ichelle subjective, et la structure des expiriences a
it4 mesuse I'aide de I'Inventaire Phdnom6nologique de la Conscience. Les
sujets se sont vus par la suite administr6s l'kchelle de Suggestibiliti
Hypnotique d e Stanford, forme B, afin que la connaissance de leur
suggestibilitd ne puisse pas affecter leurs rapports subjectifs de profondeur.
 EXPERIENCES AND DEF'TH OF HYPNOSIS 233

I1 n'y a pas eu de diffCrence entre I'hypnose directe et indirecte au niveau de

la structure des expCriences. D'autre part, les sujets faiblement et moyenne-
ment hypnotisables ont jug6 l'hypnose indirecte comme Ctant plus profonde.
Ceci peut reflCter la possibiliM que, durant I'hypnose, des mkcanismes
diffdrents entrent en jeu selon qu'un sujet est fortement ou faiblement
hypnotisable.

La fenomenologia de la experiencia y la profundidad de la hipnosis:

Comparacidn de tCcnicas de inducci6n directas e indirectas
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Csaba Szabd
Resumen: En este experiment0 se midieron los efectos sobre la experiencia
subjetiva de doe estilos de induccibn hipn6tica. Participaron 44 sujetos en
ambos tipos de hipnosis la tradicional directa, inducida por la Stanford
Hypnotic Susceptibility Scale, Form A, y la hipnosis indirecta (presentada en
orden equilibrado) seguido pox cuatro minutos de descanso luego de cada
inducci6n. La profundidad de la hipnosis f u C medida retrospectivamente con
una escala subjetiva y la estructura de las experiencias h e medida pox el
Phenomenology of Consciousness Inventory. Subsecuentemente se les
administr6 a 10s sujetos la Stanford Hypnotic Susceptibility Scale, Form B, de
mod0 que el conocimiento de su hipnotizabilidad no afectara sus reportes de
profundidad subjetiva. Comparando 10s sujetos en experienaa de hipnosis
directa o indirecta no se encontr6 diferencia en su estructura. AdemQs,10s
sujetos de baja y mediana hipnotizabilidad reportaron la hipnosis indirecta
como siendo m i s profunda. Esto puede reflejar la posibilidad que mientras se
est6 hipnotizando juegan diferentes mecanismos para 10s sujetos de alta
hipnotizabilidad comparados con 10s sujetos que son menos hipnotizables.