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Hypnosis
To cite this article: Lauren L. Koep, Mattie L. Biggs, Joshua R. Rhodes & Gary R. Elkins (2020)
PSYCHOLOGICAL MINDEDNESS, ATTITUDES TOWARD HYPNOSIS, AND EXPECTANCY
AS CORRELATES OF HYPNOTIZABILITY, International Journal of Clinical and Experimental
Hypnosis, 68:1, 68-79, DOI: 10.1080/00207144.2020.1682255
Hypnosis has been defined as “a state of consciousness involving focused attention and
reduced peripheral awareness characterized by an enhanced capacity for response to
suggestion” (Elkins, Barabasz, Council, & Spiegel, 2015, p. 382). The process of hypnosis
requires and emphasizes an inward reflection or inward awareness on the part of the
participant. Much of what is asked of a participant during hypnosis is to turn inward and
allow oneself to experience the imagery and feelings that arise throughout this personal
process. Research has indicated that hypnosis is useful in clinical treatment for a variety of
physical and psychological problems (Elkins, 2017; Moore & Tasso, 2008). Hypnotizability
of an individual is one factor that may moderate the experience and effectiveness of
hypnosis (Montgomery, Duhamel, & Redd, 2000). Hypnotizability is defined as “an
individual’s ability to experience suggested alterations in physiology, sensations, emotions,
thoughts, or behavior during hypnosis” (Elkins et al., 2015, p. 383).
The psychological components of hypnotizability are not yet fully known (McConkey,
2008). In the past, researchers have attempted to relate hypnotizability to various personality
factors, such as absorption (De Groot, Gwynn, & Spanos, 1988), locus of control (Austrin &
Pereira, 1978), and empathy (Wickramasekera & Szlyk, 2003). Absorption has been one of the
most consistently investigated potential correlates of hypnotizability. However, these studies
generally demonstrate a weak correlation ranging from an r value of .31 to .43. For example,
the study by De Groot et al. (1988) investigated absorption and hypnotizability, demonstrating
CONTACT Gary R. Elkins Gary_Elkins@baylor.edu Department of Psychology and Neuroscience, Baylor University,
801 Washington Avenue, 2nd Floor, Waco, TX 76701, USA
© 2019 International Journal of Clinical and Experimental Hypnosis
CORRELATES OF HYPNOTIZABILITY 69
that scores on measures of absorption correlated with hypnotizability (r = .32), but only in
women and only when they had been informed about hypnotic testing prior to completing
their absorption questionnaire. Also, Austrin and Pereira (1978) found a positive correlation
(r = .35) between external locus of control and hypnotizability. However, this small correlation
was only found among female participants. Wickramasekera and Szlyk (2003) examined the
relationship between empathy and hypnotizability. A positive correlation was found between
scores on a measure of empathy and scores on a hypnotizability scale (r = .41). Positive
correlations were also found between absorption and hypnotizability (r = .31) and absorption
and empathy (r = .43), suggesting that both absorption and empathy may contribute to
hypnotizability (Wickramasekera & Szlyk, 2003).
A consistently investigated correlate of hypnotizability has been attitudes toward
hypnosis. London, Cooper, and Johnson (1961) found a positive correlation (r = .40)
between attitudes toward hypnosis and hypnotizability. Melei and Hilgard (1964) found
that attitudes toward hypnosis correlated positively (r = .37) with hypnotizability in
participants with no previous hypnotic experience. Barber and Calverley (1964) also
found evidence that attitudes toward hypnosis correlate positively with hypnotizability.
Spanos and McPeake (1975) found a positive correlation (r = .29) between attitudes
toward hypnosis and hypnotizability. Yanchar and Johnson (1981) replicated these find-
ings, demonstrating that attitudes toward hypnosis were positively correlated with hyp-
notic susceptibility (r = .35). Therefore, the research has shown that attitudes toward
hypnosis is a promising correlate of hypnotizability.
In addition to attitudes toward hypnosis, the expectancy of being able to experience
hypnosis has been a focus of research. Cronin, Spanos, and Barber (1971) found that they
were able to alter subjects’ expectancy of their hypnotizability by providing them with
favorable information about hypnosis. This favorable information and subsequent increase
in expectancy resulted in increased responses to hypnotic suggestions (F = 35.15, p < .001;
Cronin et al., 1971). Silva and Kirsch (1992) and Kirsch, Silva, Comey, and Reed (1995)
both found a positive correlation (r = .38) between expectancy and hypnotizability. Later,
Braffman and Kirsch’s (2001) study also highlighted the role of expectancy in hypnotiz-
ability (r = .33). Benham, Woody, Wilson, and Nash (2006) found that an initial measure
of expectancy was positively correlated with hypnotizability (r = .39).
While research has shown that positive correlations between hypnotizability, absorp-
tion, locus of control, and empathy are present, each of these correlations is modest in
nature. In addition, while the literature does reveal that attitudes toward hypnosis and
expectancy of hypnotizability are positively correlated to hypnotizability, further research
is necessary to identify stronger correlates of hypnotizability in order for clinicians to
maximize clinical utility of hypnosis.
Psychological Mindedness
One particularly promising component that has not yet been thoroughly investigated is
the concept of psychological mindedness. Psychological mindedness as a correlate of
hypnotizability can have clinical and research implications and allow for more tailored
hypnosis interventions, and is, therefore, the focus of the current study. The definition of
psychological mindedness has evolved over the years. Appelbaum (1973, p. 36) defined
psychological mindedness as a combination of four components and as “A person’s ability
70 L. L. KOEP ET AL.
to see relationships among thoughts, feelings, and actions, with the goal of learning the
meanings and causes of his experiences and behavior.”
Hall (1992, p. 138) built upon this definition by proposing a model of psychological
mindedness that states that “accurate psychological-mindedness is displayed by an indi-
vidual to the extent that he or she displays both the interest in and ability for reflectivity
about psychological processes, relationships, and meanings, and across both affective and
intellectual dimensions.” Hall’s (1992, p. 138) model went on to claim that “accurate
psychological-mindedness is contributed to and limited by the existence of accurate
intellectual psychological-mindedness and accurate affective psychological-mindedness.”
Drawing upon Hall’s (1992) definition, Grant (2001, p. 12) proposed the following
revised definition: “Psychological mindedness is a form of metacognition: a predisposition
to engage in acts of affective and intellectual inquiry into how and why oneself and/or
others behave, think, and feel in the way they do.” Grant’s (2001) emphasis upon
metacognition arose from his assertion that the ability to think about one’s own thoughts
was an implicit component of all previous definitions of psychological mindedness and
merely had not been previously stated in those terms.
Finally, Denollet and Nyklicek (2004) conducted extensive reviews of the existing
literature regarding psychological mindedness and focused on the construct as it relates
to both mental and physical health. They highlighted how psychological mindedness has
come to be understood as a multifaceted construct, made up of several components.
However, they focused on how psychological mindedness can help individuals cope with
various negative emotional states, consequently impacting their emotional health as well
as their physical health and relaxation. Denollet and Nyklicek (2004) mentioned the
capacity for psychological mindedness to serve as a type of coping skill and stated that
“psychological mindedness is closely related to the willingness to accept the influence of
intrapsychic processes on behavior and on coping with the stress of everyday life.” In sum,
the researchers proposed the following definition of psychological mindedness:
“Psychological mindedness refers to the intrinsic motivation to be in touch with one’s
inner feelings and thoughts by monitoring and analyzing them in an adaptive way”
(Denollet & Nyklicek, 2004, p. 191). This definition greatly influenced the construction
of the Balanced Index of Psychological Mindedness (BIPM; Nyklicek & Denollet, 2009),
which has been utilized in the current study. Based on this definition, if someone is open
to psychological concepts, one could propose that the individual would also be open to
a psychological intervention such as hypnosis. Therefore, it is rational to hypothesize that
people who have more of this trait would be more hypnotizable.
There has been one previous study with regard to psychological mindedness and
hypnotizability. McKnight (1980) provided an early investigation of personality correlates
and hypnotizability. In his study, 100 undergraduate volunteers were administered the
Harvard Group Scale of Hypnotic Susceptibility (Shor & Orne, 1962) in groups of 20 to 30
via a public address system in classrooms. Subsequently, the complete California
Psychological Inventory (Gough, 1956) was administered. However, the impersonal
group setting in which the hypnotizability scale was administered during this study
prevented researchers from closely observing participants’ responses to the items on the
scales and collecting qualitative data. Additionally, the personality inventory was adminis-
tered to participants after the hypnotic induction, potentially affecting their responses to
the California Psychological Inventory. Furthermore, the measure of psychological
CORRELATES OF HYPNOTIZABILITY 71
mindedness utilized by McKnight does not accurately represent current definitions of this
concept.
Although no specific relationship between one particular scale of the California
Psychological Inventory and hypnotizability was predicted, multiple regression was utilized
to predict hypnotizability from a combination of personality measures included in the
complete California Psychological Inventory. Initial results identified eleven subscales that
were significantly correlated with hypnotizability (McKnight, 1980). However, McKnight
(1980) found that after accounting for the interrelationship among the variables by utilizing
a multiple regression analysis, only the subscales of “Responsibility” (r = − .39) and
“Psychological Mindedness” (r = − .43) were significantly correlated with hypnotizability.
These results indicated that psychological mindedness was a correlate of hypnotizability;
however, since psychological mindedness was not investigated independently, this correlation
should be interpreted with caution. Therefore, in order to achieve more clarity regarding the
connection between the two constructs, it is necessary to further examine the relationship
between psychological mindedness and hypnotizability, as this current study aimed to do.
A review of the literature, as mentioned above, demonstrates an overarching theme that
psychological mindedness is a construct that involves introspection, intrapersonal insight,
understanding and acceptance, and openness to experience. These are personal character-
istics that may be relevant to the hypnotic experience. Furthermore, the ability to
experience hypnosis to the fullest extent varies between individuals. Therefore,
a reasonable hypothesis is that psychological mindedness and hypnotizability could be
related. While McKnight (1980) found a modest negative correlation between psycholo-
gical mindedness and hypnotizability, the current study aims to build on this by investi-
gating psychological mindedness independently as a correlate of hypnotizability as well as
utilizing a measure that reflects the current definition of psychological mindedness.
The primary objective of the current study was to examine the relationship between
hypnotizability and psychological mindedness to determine if there is a positive correla-
tion between the two constructs. The secondary objective was to replicate the previous
findings regarding the relationship between hypnotizability, attitudes toward hypnosis,
and expectancy of hypnotizability. In addition, the study sought to highlight the relation-
ship between psychological mindedness and expectancy of hypnosis.
Methods
Participants
Participants were 91 undergraduate volunteers drawn from Baylor University. Some
participants were offered course credit at the discretion of their professor for participating
in the study. Flyers were posted to advertise the study and request volunteers for the
investigation of “factors impacting hypnosis.” The Department of Psychology and
Neuroscience’s website for recruiting research participants (SONA systems) was also
utilized to recruit volunteers by providing a way to read about and enroll in the study
online.
Participants were required to be at least 18 years of age and have a minimal reading level to
ensure the participant’s ability to complete study measures. Individuals with a previous
diagnosis of borderline personality disorder or schizophrenia (or related psychiatric disorder
72 L. L. KOEP ET AL.
involving psychosis) were excluded from the study. As outlined by Walker (2016), these
exclusions were utilized since psychosis involves a distortion of reality and hypnosis blurs the
boundaries of the subject’s external reality. Individuals who had prior experience with clinical
hypnosis were also excluded from the study. Prior to recruitment of participants or initiation
of the study, approval for the study was attained by the Baylor University Institutional Review
Board (IRB).
Procedure
Participants were presented with basic information about the study and provided
informed consent by the investigator or a qualified research assistant. Upon completion
of informed consent, all participants were asked to complete a demographic questionnaire,
the BIPM (Nyklicek & Denollet, 2009), the Attitudes Toward Hypnosis Scale (Spanos,
Brett, Menary, & Cross, 1987), and the self-rating of estimated hypnotizability. The EHS
(Elkins, 2014), a hypnotic procedure and assessment of hypnotizability, was then admi-
nistered to participants individually by the investigator or a research assistant who
completed training in hypnosis and administration of hypnotizability scales. All partici-
pants were offered debriefing and, if necessary, provided with a referral and contact
information for professional mental health consultation.
Measures
Psychological Mindedness
Psychological mindedness was assessed using the BIPM as this was the most contemporary
and well-validated scale. The BIPM is a 14-item self-report questionnaire assessing the
different components of psychological mindedness. Items are answered on a 5-point Likert
scale with a score of “1” representing Not at all and a score of “5” representing Very much. The
psychometric properties of scores from this measure were examined in two community
samples and one mental health patient sample in the Netherlands. The total score from this
measure demonstrated good internal consistency (Cronbach’s α = .85), test-retest reliability
(r = .75), and construct validity (r > .40 with related constructs such as private self-
consciousness and attention to feelings) (Nyklicek & Denollet, 2009). In the current study,
this measure demonstrated good internal consistency (Cronbach’s α = .79).
Hypnotizability
Hypnotizability was measured using the Elkins Hypnotizability Scale (EHS). This scale is
a hypnotic procedure and is administered individually by a research assistant specifically
trained in hypnotic induction and assessment procedures. The scale begins with
a hypnotic induction that includes suggestions for relaxation. The participant is then
guided through a series of hypnotic suggestions for experiences ranging from simple
motor responses to more involved imagery and posthypnotic amnesia. Items are adminis-
tered in order of progressing difficulty within the context of a continuous hypnotic
procedure. A participant’s responses to items are scored numerically based upon extent
of response to the hypnotic suggestion given. A total score, ranging from 0 to 12, is then
calculated to indicate the participant’s level of hypnotic responsiveness. The scale takes
approximately 30 minutes to administer and provides a sample of hypnotic responsiveness
CORRELATES OF HYPNOTIZABILITY 73
(Elkins, 2014). The EHS was chosen for this study because it is a brief and safe measure to
use with clinical and research participants. Additionally, the EHS has demonstrated
adequate internal consistency (Cronbach’s α = .78), its items have shown good discrimi-
nating ability, and scores of the EHS and the Stanford Hypnotic Susceptibility Scale, Form
C (Weitzenhoffer & Higard, 1962) were highly correlated (r = .86), indicating that the EHS
is a reliable and valid tool to assess hypnotizability (Kekecs, Bowers, Johnson, Kendrick, &
Elkins, 2016).
Expectancy of Hypnotizability
Expectancy of hypnotizability was self-rated by participants on a visual analogue scale with
a length of 100 millimeters entitled “Estimated Hypnotizability.” Scores were determined
by measuring the point that the participant marked on the scale, resulting in a score
between 0 and 100. The literature on visual analogue scale methods of measurement
suggests that scores demonstrate satisfactory test-retest reliability (for example, r = .73), as
well as criterion validity (for example, r = .71 – .78 with an established instrument of the
same construct). Visual analogue scales have been described as “providing a convenient,
easy and rapidly administered measurement strategy that is useful in a wide variety of
clinical and research settings to measure a number of subjective phenomena,” while also
demonstrating satisfactory psychometric properties (Wewers & Lowe, 1990, p. 233).
Results
The final sample comprised 91 undergraduate volunteers. Table 1 provides the frequencies
and percentages associated with gender and race. Of the participants, 20.9% (n = 19) were
male and 78.0% (n = 71) were female. In terms of race, 61.5% of the participants identified
as Caucasian, 11.0% identified as African American, 11.0% identified as Asian, 3.3%
identified as American Indian, and 13.2% identified as being of other ethnic backgrounds
(not specified). The average age of participants was 20 years of age. None of the partici-
pants endorsed having previous experience with hypnosis. Additionally, descriptive sta-
tistics of the measures utilized in the study were calculated and can be found in Table 2.
74 L. L. KOEP ET AL.
Discussion
The objectives of the current study were to understand the relationship between hypnotiz-
ability and psychological mindedness as well as replicate the previous findings regarding
the relationship between hypnotizability, attitudes toward hypnosis, and expectancy of
hypnotizability. The construct of psychological mindedness, defined by Denollet and
Nyklicek (2004) as “the intrinsic motivation to be in touch with one’s inner feelings and
thoughts by monitoring and analyzing them in an adaptive way,” was investigated in
relationship to hypnotizability. Despite findings by McKnight (1980) that revealed
a negative correlation between psychological mindedness and hypnotizability, the present
CORRELATES OF HYPNOTIZABILITY 75
study did not reveal any statistically significant correlations between psychological mind-
edness and hypnotizability or expectancy of hypnotizability.
While the correlation from the current study did not reach statistical significance, by
examining the 95% confidence intervals around the correlation of .113, there is a possible
range from −.09 to +.30. This suggests that while there is a small chance of again finding
a negative correlation between the two constructs as McKnight did, the most likely
correlation is actually small but positive. What can be concluded at this time is that no
significant correlation was found between psychological mindedness and hypnotizability
in this particular population.
It was hypothesized that attitudes toward hypnosis would be positively correlated with
hypnotizability, and the analysis revealed a significant, positive correlation between these two
constructs. This finding is highly consistent with previous literature (Barber & Calverley,
1964; Melei & Hilgard, 1964; Spanos & McPeake, 1975) and indicates that hypnotizability
and attitudes toward hypnosis are positively related to one another. This finding confirms
attitudes toward hypnosis as a consistent positive correlate of hypnotizability.
Furthermore, it was hypothesized that expectancy of hypnotizability would be posi-
tively correlated with hypnotizability. The analysis revealed a significant, positive correla-
tion between these two constructs. This finding is also highly consistent with previous
literature (Braffman & Kirsch, 2001; Silva & Kirsch, 1992) and indicates that hypnotiz-
ability and expectancy of hypnotizability are positively related to one another. This finding
confirms expectancy of hypnosis as another consistent positive correlate of hypnotizabil-
ity. These positive correlations between attitudes toward hypnosis and hypnotizability, as
well as between expectancy and hypnotizability, indicate that an individual’s thoughts and
beliefs about the benefit of hypnosis, including his or her prediction of how much he or
she will be impacted by hypnosis, are indeed related to that individual’s degree of
hypnotizability. As more positive beliefs and expectancies about hypnosis are held, an
individual is increasingly hypnotizable.
Conclusions
While no significant correlation between psychological mindedness and hypnotizability was
observed within the current study’s population, other study populations may yield different
results. Expectancy and attitudes toward hypnosis have been consistently demonstrated to be
positive correlates of hypnotizability, therefore future research aimed at determining what
factors may predict positive expectancy and positive attitudes toward hypnosis may be
a productive avenue to identify which individuals may benefit most from hypnosis.
Finally, discovering ways of increasing self-ratings of expectancy of hypnotizability may be
a beneficial focus for future research as demonstrated by the significant correlation found
between self-ratings of expectancy of hypnotizability and the EHS. Additionally, as demonstrated
by the significant correlation between attitudes toward hypnosis and the EHS, discovering ways
of increasing individuals’ positive attitudes toward hypnosis may also be a productive focus of
research to increase the number of individuals experiencing maximum benefit from hypnosis in
clinical settings.
Disclosure statement
No potential conflict of interest was reported by the authors.
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