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The classic hypnosis research also demonstrated that some or all people respond differently to suggestion under different conditions. Relatively little work has gone into determining the precise details of how each suggestion effect occurs, because so much of the focus has been on determining that 'something happens.' The situation is not too far from what we come across in modern anomaly research. In both areas, we need to move forward to detail what is going on in each case, rather than simply prove that something interesting is happening.
Today, there is basic agreement among most researchers that such a thing as hypersuggestibility does occur in some sense. This means that under certain conditions, unusual feats of attention control, psychosomatic regulation, perceptual distortion, and cognitive dissociation can be consistently produced in some subjects, whereas under other conditions the same subjects can seemingly not deliberately produce those same behaviors. Opinions are split about exactly what conditions cause hypersuggestibility; i.e., whether it is a unique biological state or whether it is the result of responding to the social demands and expectations of the situation. Also, there is controversy over the relationship between hypersuggestibility and cognitive dissociation. Another thing that most researchers today do agree on is that hypnosis is not the only procedure whereby such hypersuggestibility (or dissociation) may be produced.
The original conception of dissociation was as an anxiety defense strategy, a way of avoiding 'stress,' while gratifying other psychological needs. Without the emphasis on an anxiety defense, this idea persists today, as one standard medical reference puts it :
"... A process whereby specific mental contents (memories, ideas, feelings, perceptions) are lost to conscious awareness and become unavailable to voluntary recall..." (16th ed. Merck Manual)
This seemingly straightforward view of dissocation as mental contents lost to conscious awareness, and as an anxiety defense, is complicated however by the psychoanalytic tradition that organic disease can result from harbored resentments, disease which appears in a metaphorical form expressing the patient's unconscious feelings in a symbolic physical way. This provides a link between dissociation and psychosomatic effects. "Hysterical" or "conversion" symptoms are of psychogenic origin, and mimic organic diseases (as opposed to organic diseases being the result of psychological stresses).
Such conversion symptoms consist of about 5% of the 'neuroses' or minor anxiety disorders treated by psychiatrists, according to one 1980 study. Typical examples are unusual allergic reactions, simulated pregnancy, pseudo 2nd-degree sunburns, hysterical blindness or deafness, visual or auditory hallucinations, and other sensory or motor aberrations. Conversion symptoms appear temporary, though they may 'move' from one type or body system to another as each is addressed therapeutically.
Conversion symptoms and other psychosomatic effects are associated with high hypnotizability scores on standard scales, and also with a previous history of conversion and dissociative symptoms, implying a stable trait-like quality. This quality appears to have a genetic aspect and an early developmental trigger as well. The correlation of psychoanalytic dissociation and hypnotic suggestibility is further supported by the observation that hypnosis is frequently helpful in alleviating conversion symptoms, yet often results in symptom substitution, and that hypnosis is also frequently helpful in dissociative disorders as well.
This is the opposite of what we would expect from the prototype "fantasy prone personality," (of Wilson and Barber, for example) who might well be described as an imaginative and even visionary individual. This seems to tell us that psychosomatic effects are not as limited to a particular personality type as some theories in the past had proposed. It also seems to further implicate internally-directed emotional self-awareness as a factor in intentional control of psychosomatic regulation, rather than in psychosomatic illness (or healing) itself. This also makes sense in light of the various theories which propose that the limbic system, in conjunction with the frontal cortical lobes, is critical for intentional psychosomatic self-regulation.
The controversial case of the 'hidden observer' in hypnotic analgesia (apparently independent responses from the same person at the same time under certain experimental conditions) appears to be swaying the argument in favor of a dissociation view of hypnosis in the case of exceptional subjects, but this debate is likely not over yet. It seems likely that social psychological factors will need to be considered as well in considering how suggestibility varies.
The common link between most situations of hypersuggestibility appears to be a narrow selective focus of attention. This is something which seems to result from such diverse conditions as sensory isolation, relaxed attentiveness, and extreme fear. There does not appear to be a single common general EEG pattern in hypersuggestibility, or which makes hypnotized individuals distinguishable from awake ones, though there are hints of possibly unique evoked potential responses during periods of enhanced suggestibility.
One of the more intriguing recent theories is that hypersuggestibility may somehow also be mediated by the immune system and other chemiclly linked autonomic systems rather than the brain alone. A two-way chemical feedback loop has been discovered to operate between the nervous and immune systems, but it will take further research to determine its relationship to suggestibility and psychosomatic illness and healing in general.
This is an expression of the popular culture view of 'left-brained' and 'right-brained.' As for most behavior, there will likely be evidence for a differential contribution from the asymmetric cerebral hemispheres in hypersuggestibility, but so far differential hemisphere activity itself does not seem to be the primary mechanism of enhanced suggestibility.
We have good reason at this point to think of enhanced suggestibility as a common endpoint toward which a number of methods can lead in some or all human beings. Hypnotic induction is only one of these methods. There are also very good indications that there is something special about some forms of dissociation that merits further investigation into just what cognitive functions become split, under what conditions these splits occur, and how they occur. It is also of great interest how dissociation relates to various anomalous phenomena (such as extrasensory perception, psychokinesis, and others) that have long been associated with 'dissociative states.'