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Journal o f the Royal Society o f Medicine
Implications of cerebral specialization to h y p n o t h e r a p y with
an i n t r o d u c t i o n t o c a m e r a l a n a l y s i s
D L P e d e r s e n MB B S M R C G P The Knoll House, Hinksey Hill, Oxford
Keywords: b r a i n ; l a t e r a l i t y ; dualism; h y p n o s i s ; c ame ral a n a l y s i s
Historical
I n 1 98 0 a N o b e l Prize was awarded to Professor Roger
Sperry for h i s w o r k on i d e n t i f y i n g f u n c t i o n s o f the
brain wh i c h were l at e ral i z e d e i t h e r t o the left o r r i g h t
c e r e b r a l h e m i s p h e r e s 1 . He c o n c l u d e d f r o m h i s w o r k
o n c o m m i s s u r o t o m i z e d humans t h a t :
' [ W e a r e ] Two s e p a r a t e s p h e r e s o f c o s c i o u s a w a r e n e s s , t h a t
i s t w o s e p a ra t e c o n s c i ou s e n t i t i e s r u n n i n g p a r a l l e l i n t h e
s a m e b o n y c r a n i u m e ac h w i th i t s o w n s e n s a t i o n s , p e r c e p t i o n ,
c o g n i t i v e p r oc e s s e s , l e a r n i n g e x p e n r e n c e , m e m o r i e s a n d s o o n . '
B u t 'Dualism - the concept of t w o minds' w a s w e l l
known t o t h e G r e e k s . O v i d ' s f a m o u s d u a l i s t i c
' D e t e r i o r a Sequor' i n w h i c h h e liter a lly l o o k s a t hi s
' o t h e r self' with c o n s i d e r a b l e disapproval is s i m i l a r
indeed t o the left hemisphere's moral c r i t i c i s m o f
c e r t a i n right hemisphere behavioural demands.
T h e Roman ' A l t e r - E g o ' r e f e r s t o b o t h t h e c l i n i c a l
a n d c u l t u r a l split in i d e n t i t y well recognized in
h u m a n f o l k l or e , l i t e r a t u r e , a n d p o e t r y t h r o u g h o u t t h e
a g e s f r o m t h e O d y s s e y o f Homer t o t h e E n d y m i o n o f
Keats.
I n t h e 1 8 t h c e n t u r y Mesmer d e m o n s t r a t e d t h e
presence o f 'another self' in h i s us e o f 'animal
magnetism'. L a t e r , G e r m a n w r i t e r / p h i l o s o p h e r s such
as Goethe, K l e i s t , T i e c k , H o f f m a n a n d Richter
all wrote o f the phenom enon. H o f f m a n i d e nt i f i e d
the double with a s o m e w h a t dangerous part
o f t h e p e r s o n a l i t y a n d R i c h t e r c oi ne d t he t e r m
' d o p p l e g a n g e r ' . T h e r e a r e many l i t e r a r y e x a m p l e s
t ha t c a n b e q u o t e d o n t h e d u a l i t y t h e m e 2 3 .
In 1 8 8 6 , M y e r s wrote a n essay e n t i t l e d Multiplex
p e r s o n a l i t y in w h i ch h e d i s c u s s e d a case o f dual
p e r s o n a l i t y , Fe li d a X 5 . He sug g ested t h at h y p n o s i s
could re-arrange the looms o f the m i n d i n t o a single,
normally functioning p a t t e r n .
D e s s o i r , in h i s book Th e Double Ego6 published i n
1890, discusses cases of spontaneous somnambulism
along with dipsychism and the h y p n o t i c phenomenon.
I n t h e i r w a k i n g s t a t e s o m e o f h i s c a s es w e re f ou nd
to e x h i b i t total amnesia of major events whi c h h ad
occurred in t h e i r s o m n a m b u l e state, but h a d total
recall of these events under h y p n o s i s . This apparent
memory l o s s i s v e r y s i m i l a r t o t h e f m d i n g s f r o m
i n v e s t i g a t i o n s i n t o t h e memory a n d b e h a v i o u r o f
commissurotomized p a t i e n t s a n d wo u l d suggest t h a t
the non-damaged brain c an s i m i l a r l y i n h i b i t inter-
hemispheric communication.
In America, James, in hi s book 'Principles of
p s y c h o l o g y ' , wrote o f a 'hidden s e l f ' 7 a n d , along with
M i t c h e l l and Prince, used the phenomenon of h y p n o s i s
as a n i nd i c at i o n of the presence of the dualistic mind.
Freud's t h e o r y o f the unconscious w a s pure d u a l i s m ,
a s i n d e e d w as t h a t o f J u n g w i t h i t s e x t r o v e r t a n d
introvert, its s ha do w self an d its bad d o u b l e . Fre ud
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Cerebral Specialization
Volume 82 October 1989 579
formulated hi s t h e o r y after witnessing a p o s t - h y p n o t i c B as ed o n
suggestion c a r r i e d out b y a patient wh o, o n l a t e r Presidential
q u e s t i o n i n g b y F r e u d , h a d n o k n o w l e d g e o f why s h e Address to
h a d p e r f o r m e d t h i s a c t b u t n e v e r t h e l e s s made u p a Section of
Hypnosis &
p l a u s i b l e explanation t o t al l y di f f e re nt f rom the r e a l
Psychosomatic
reason.
Medicine,
Until 1960 Freudian theory dominated the field o f 3 October 1988
p s y c h o l o g y but sin ce then Sp e rry ' s ne u ro p h y s i o l o gi c al
df iu sn cc ot vi eo rn i we sh i hc ah vien c ll ue dd e s t oa f ar e sr he -laopopkr aa it s ta hl e oh fy p bn or ta ii cn
phenomenon.
Theoretical
In N o v e m b e r 1982 I read a paper t o the Royal
S o c i e t y o f Medicine e n t i t l e d 'Hypnosis a n d the
r i g h t h e m i s p h e r e ' 8 in w h i c h I put forward the
c o n c e p t ' T h a t when we h y p n o t i s e a n i n d i v i d u a l
we a l t e r h i s / h e r s t a t e o f consciousness a n d that
t h i s a l t e r e d s t a t e of consciousness is very s i m i l a r
i n d e e d t o a s u b j e c t known t o b e w o r k i n g i n a
Right H e m i s p h e r e mode'. I quoted W y k e ' s t h e o r y 9
in showing that this w a s n e u r o l o g i c a l l y possible
by activation of the inh ibitory fibres of the caudal
e nd of the brain-stem r e t i c u l a r formation by s t i m u l i
from the s u p e r i o r frontal gyrus via its front-reticular
p r o j e c t i o n p a t h w a y s . A t t h a t t i m e t h e r e w as a
fair a m o u n t o f evidence t o suggest that the s t a t e
o f hypnosis involved the brain f u n c t i o n i n g mainly
i n the r i g h t hemisphere. It m u s t be emphasized
h o w e v e r t h a t n o n e o f t hi s e v i d e n c e , , w h e n t a k e n
individually could, i n any way, be considered a
p r o o f . On t h e o t h e r h a n d , when t a k e n a l t o g e t h e r ,
the weight of t hi s evidence along with the lack
o f a n y evidence t o the contrary p o i n t e d s t r o n g l y
t o r i g h t h e m i s p h e r e media tio n . I n summary t h e
evidence is:
Th e l i n e a r time record
Th e critical factor8
Bot h considered t o be left hemisphere functions a n d
lost w h e n in hypn osis.
Dreams10'16
Dreaming, h a l l u c i n a t o r y and f a n t a s y states, are
mainly r ight hemisphere f i m c t i o n s an d are al so easily
c o n j u r e d u p in the hypnotized subject.
V a r i a t i o n s i n hypnotizabilityl7"18
Th e differences i n h y p n o t i z a b i l i t y of the p o p u l a c e c an
be explained if the r i g h t hemisphere is i m p l i c a t e d in 0141-0768/89/
hypnosis. 100579-05/$02.00/0
©1989
Eye m o v e m e n t s ' 9 - 2 3 Th e Royal
T h e s t u d y o f e y e movements u n d e r h y p n o s i s s u g g e s t Society of
the p a t i e n t is f i m c t i o n i n g in a r ight hemisphere mode. Medicine
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580 Journal of the Royal Society of Medicine Volume 82
Dichotic listening tests
F r u m k i n 2 4 u s e d s u c h t e s t s t o d e mo n s t r a t e c h a n g e s
i n hemispheric lateraliz atio n with hypnosis and
concluded that the s t a t e o f hypnosis w a s a s s o c i a t e d
with the r i g h t hemisphere.
E l e c t r o - e n c e p h a l o g r a p h i c studies25'26
M e as ure me nt s of the alpha activity in the two
h e mi s p h e re s c a n b e u s e d a s a m e a s u r e o f t h e h y p n o t i c
s t a t e . From t h i s i t h a s b e e n s h o w n t h a t t h e r e i s a n
i n c r e a s e i n f u n c t i o n o f t h e r i g h t h e m i s p h e r e when a
s u b j e c t is i n hypnosis similar t o that i n the w a k i n g
s t a t e when t h e s u b j e c t i s p e r f o r m i n g r i g h t h e m i s p h e r e
specific tasks.
Electrodermal r e s p o n s e s
M e a s u r e m e n t s of these responses from both h ands
w h e n i n a n d out o f h y p n o s i s , confirm a r e l e a s e of r i g h t
h e m i s p h e r e a c t i v i t y when i n h y p n o s i s .
Haptic p r o c e s s i n g tests G r u z e l i e r et at27 demonstrated
a s hi ft t o t h e r i g h t i n l a t e r a l c e r e b r a l i n f l u e n c e s i n
s u sc e p t i bl e s u bj e c t s u n d e r h y p n o s i s . .
Intentional m e m o r y a n d involuntary m e m o r y
L u r i a 2 8 s h o w e d i n t e n t i o n a l memory t o be a left
h e m i s p h e r e f u n c t i o n w h e r e a s i n v o l u n t a r y memory i s
r i g h t h e mi s p h e r e . I n v o l u n t a r y m e m o r y c a n b e
recalled under hypnosis.
H i l g a r d ' s 'hidden o b s e r v e r ' p h e n o m e n o n occurring
under hypnosis29
I s explainable in left h e mi s p h e re terms, e x p e r i -
m e n t a l l y v e r i f i e d b y G a z z a n i g a 3 0 u si n g t he Wada
technique t o a n a e s t h e t i z e the left hemisphere ( a n
object w a s identified i n left h a n d by the r ight
hemisphere but v e r b a l l y denied by the left).
If, as I be l i e ve , hypnosis is an a l t e r e d st a t e of
consciousness a s s o c i a t e d with the r i g h t hemisphere
t h e n hypnosis offe rs not o n l y a d i r e c t access t o the
r i g h t hemisphere's c o g n i t i v e f u n c t i o n s but al s o a
direct method of communicating with the r i g h t
hemisphere.
Furthermore i t offers a d i re c t m etho d for assessing
the r i g h t h e m i s p h e r e ' s v iews o n a s u b j e c t without
them b e i n g i n f l u e n c e d b y t h e l e f t ' s i n t e r p r e t a t i o n .
Ne w p s y c h o l o g i c a l c o n c e p t s o f s i g n i f i c a n c e t o
hypnosis
Hemispheric specialization and hemispheric
independence
Z a i d e l 3 ' a n d B o g e n 3 2 h av e b ee n a b l e t o s h o w that
there are t w o separate p r i n c i p l e s u n d e r l y i n g hemi-
s p h e r i c f u n c t i o n s . Th e first is hemispheric special-
ization and it covers a wide range of tasks. At one end
a r e t h o s e t a s k s t ha t c a n b e p e r f o r m e d e q u a l l y w e l l
by both h e m i s p h e r e s , although each hemisphere uses
a t o t al l y d i f fe r e n t p r o c e s s i n g m e t h o d t o p r o d u c e t h e
s a m e r e s u l t . A t t h e o t h e r e n d a r e t h os e t a sk s t o t a l l y
specific t o one specialized h e m i s p h e r e , for example the
p h o n o l o g i c a l a n a l y s i s o f the printed w o r d is e n t i r e l y
task-specific t o the left hemisphere. Th e second is
hemispheric independence. S p l i t - b r a i n experiments
h a v e s h o w n that both hemispheres are conscious
e n t i t i e s i n t h e m s e l v e s , as indeed d i d i n v e s t i g a t i o n o f
b r a i n - d a m a g e d i n d i v i d u a l s who w e r e known t o h a v e
o n e hemisphere d e s r y e d a n d yet w e r e conscious a n d
c o u l d c a r r y out relativ ely normal a n d m e a n i n g f u l lives.
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Cerebral Specialization
October 1989
C r i t i c s h o w e v e r w e r e qu ick t o p o i n t out t h a t , as these
w er e d a m a g e d b r ai n s, t h e ir very abnormality might
a c c o u n t f o r t h e r e s e a r c h f i n d i n g s . B u t a s r es ea rc h
c onti nues i n t hi s f i e l d it is b e c omi n g m or e obvi ous
that independent functioning o f the t w o hemispheres
is the n o r m rather t h an the exception in ordinary
individuals33.
Th e fact that i t c an be s h o w n that there are t a s k -
specific f u n c t i o n s w h i c h are the s o l e r e s p o n s i b i l i t y
o f o n e h e m i s p h e r e m u s t s up po rt t he c o n c e p t o f
hemispheric independence at work i n ordinary
i n d i v i d u a l s . I f t h i s is so t h e n we h a v e h e r e a source
o f p o t e n t i a l inter-hemispheric conflict.
Hemispheric dissociation
To give a n example, a n experiment w a s c a r r i e d out
on a s p l i t - b r a i n e d p a t i e n t i n w h i c h non-emotional
geometric shapes were randomly presented to both
hemispheres by m e a n s of a tachistoscope34. In the
midst o f these shapes a photograph o f a nude f igu re
wa s sho wn to the right hemisphere only. Th e subject
r e a c t e d b y g i g g li ng a n d b l u s hi n g b u t w a s n e v e r a b l e
t o T vh eirsb ac lo ln yc e ep xt p li sa i n t h i s b e h a v icol ui rn i. c a l
impoitant to psychiatry i n
that it provides a n e u r o l o g i c a l b a s i s for the e m p i r i c a l
i d e a t h a t r e p re s s ed m at e r i a l i s c o n t a i n e d i n a m e n t a l
c omp art me nt i n a c c e s s i b l e t o verbal contact and,
furthermore, c a n a ffe ct the a u to n o m i c n e r v o u s
system . I t a l s o i l l u s t r a t e s how t h e r i g h t h e m i s p h e r e
d r a w s a tten tio n t o a s u r p r is e a n o m a l y b y t he u se o f
b o d y l a n g u a g e a n d t h a t t he a ut o n om i c n e r v o u s
system is part and p a r c e l o f t h i s communication
s y s t e m . A v e r y i m p o r t a n t w ay t h e n o n - v e r b a l
h e mi s p h e r e c o m mu n i c a t e s i s , o f c o u r s e , b y m e a n s o f
b o dy language.
I n t e r - h e m i s p h e r i c antagonism a n d s e p a r a t e realms of
awareness
Levy35 working w i th s p l i t - b r a i n e d patients s h o w e d
that the t w o disconnected hemispheres w o r k i n g
o n t h e s a m e t a s k p r o c e s s t h e same s e n s o r y i n f o r -
mation in distinctly di f f e re nt ways, namely temporal
a n a l y s i s for the left a n d spatial synthesis for the
right.
Th e me t h od o f processing information b y temporal
analysis i nv o l v e s an a n a l y t i c approach in a l i ne ar and
sy l l o g i st i c m 6 d e f o r w h i c h w o rd s are a n i d e a l m e d i u m ;
spatial s y n t h e s i s , o n the other hand, s o l v e s problems
by i n v o l v i n g m u l t i p l e convergent determinants g i v i n g
s u ih to al bi sl te i fc o r m u s i c o r s p a t i a l r e l a t i o n s . B y t h e s e imeans
a a n d emotional overview w h i c h is d e a l l y
the brain h as the tremendous advantage o f being able
t o t a c k l e the s a m e problem f rom t w o d i f f e re nt angles
an d thus doubles the chances o f it being so lved. For
i n s t a n c e one c an navigate a boat mathematically
by using a compass, charts, a clock, and measuring
t h e s p e e d o f t h e v e s s e l ; t h i s w ay w o u l d m a k e u s e o f t h e
l e f t h e m i s p h e r e . On t h e o t h e r h a n d o n e c o u l d u s e t h e
s p a t i a l c a p a b i l i t i e s o f t h e r i g h t h e mi s p h e r e b y l i n i n g
u p various f e a t u r e s o f the landscape or the stars with
t h e p r o w, s i d e s , o r s te rn of t h e b o a t . Fu r t h e r mo r e , o n e
m e t h o d c a n be used to c h e c k the r e s u l t s o f the o t h e r ,
or t o h e l p it, o r b o t h , or t h e y c a n be u s ed i n d e p e n d e n t l y
if r e q u i r e d.
However, there is a d i s a d v a n t a g e . L e v y - " has
d e s c r i b e d the very important observation that the
t w o h e m i s p h e r e s , w o r k i n g o n t h e same t a s k a n d
w i t h t h e sa me s e n s o r y i n p u t , c a n i n t e r p r e t t h e
same i n f o r m a t i o n t o r e a c h d i f f e r e n t a n d c o n f l i c t i n g
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c o nc l u s i o ns , and the re sul t o f this mutual antagonism
s h o w s u p as a behavioural d i s t u r b a n c e . T h e import-
ance o f these t w o fact ors is i n the r e a l i z a t i o n that
t h e human m i n d h a s t w o d i s t i n c t w a y s o f l o o k i n g a t ,
a n d i n t e r p r e t i n g , a s i n g l e e v e n t . What t o t h e l e f t
hemisphere is a logical a nd un-emotional evaluation
o f a n i n ci d en t , t o the r i g h t h e mi s p h e re the v e r y s a m e
i n c i d e n t could be an emotional catastrophe causing
deep-seated f e a r a n d a n x i e t y , b u t , because o f the
verbal dominance o f the left hem isphere i t is
o f t e n only the left hemisphere's evaluation that is
c ommuni c ated in, say, a d o c t o r / p a t i e n t i n t e r v i e w .
In 19828 I ga ve as a n e x amp le a n i n c i d e n t i n a
television programme i n which Frankel hypnotized
a volunteer an d regressed her bac k t o a h a p p y event
i n her c h i l d h o o d . Unfortunately t h i s ' v e r b a l l y ' (left
hemisphere) h a p p y event turned out t o be a n
' e m o t i o n a l l y ' ( r i g h t hemi s p her e) c a t a s t r o ph i c o c c a s i o n
an d the hypnotized patient en d ed u p in tea r s .
A therapeutic advantage c a n , a n d must, be tak en
of being a b l e t o separate t h i s emotional dichotomy by
th e u s e o f h y p n o s i s a n d we m u s t p e r s i s t e n t l y search
in our p a t i e n t ' s past for such e v e n t s .
Th e asymmetrical lateralization of t he m echanism of
memory
Th e work of Luria and S i m e r n i t s k a y a 2 8 of M o s c o w
U n i v e r s i t y h a s s h o w n t h at t h a t t h e human memory
system con sists o f t wo separate c o g n i t i v e f u n c t i o n s
n a m e l y I n t e n t i o n a l Memory - t h a t i s t h e i n t e n t i o n a l
learning o f say a part in a play - a n d Involuntary
M e m o r y where, without a n y c o n s c i o u s effort, o r d i n a r y
events o f everyday life are c a p a b l e o f recall if
n e c e s s a r y . T hey h av e al s o s h o w n that i n t e n t i o n a l
m e m o r y is a left hemisphere f u n c t i o n but i n v o l u n t a r y
memory i s a f u n c t i o n o f t h e r i g h t h e m i s p h e r e .
A s i s w e l l k n o w n , memory r e c a l l u n d e r h y p n o s i s i s
o f t e n q u i t e dramatic a n d involves the recall o f
m a t e r i a l w h e n a b s o l u t e l y n o e f f o r t w a s b e i n g made
by the person t o me mori z e it37, as for instance the
even ts or presents on e received o n o n e ' s fifth
bi rt h day 38 . W h e t h e r t h i s material is a n a b s o l u t e l y
tr u e memory o f p a s t e v e n t s , or w h e t h e r i t c o n t a i n s
d i st i nct elements o f f a n t a s y relevant t o the time o f
the e v e n t s , matters little from the t h e r a p e u t i c point
o f v i e w . What d o e s m a t t e r i s t h e s t r e n g t h a n d
character of the r e p r e s s e d (or f o rgo t t e n) emotional
content a s s o c i a t e d with the event (as both Breuer and
Freud recognized39), and the act of recalling and
r e - l i v i n g it u n d e r h y p n o s i s . H o w e v e r , the v e ry fa ct
that we c a n e n h a n c e t h i s in vo l u n ta r y f o r m o f
memory u n d e r h y p n o s i s n o t o n l y i m p l i c a t e s t h e r i g h t
h e m i s p h e r e b u t e n ab l es u s t o a b r e a c t t h e m e m o r i e s
of r e p r e s s e d i n c i d e n t s i n t h i s hemisphere.
C a m e r a l analysis
M e d i c a l research is designed for the ultimate b e n e f i t
o f t h e p a t i e n t . U n f o r t u n a t e l y many f i e l d s o f r e s e a r c h
tend t o be so compartmentalized t h a t t h e i r disciplines
rem ain se pa r a t e . Although neurology a n d psychology
ha ve developed e x t e n s i v e l y i t is o n l y r e ce n t ly t h a t the
t w o r e s e a r c h f i e l d s h a v e c o m e t o g e t h e r i n t h e ne w
s c i e n c e o f Neuropsychology. D e s p i t e this, f ew are
r e l a t i n g t h e h y p n o t i c p h e n o m e n o n t o t h e s e ne w
concepts, p a r t i c u l a r l y in the practical, that is the
t h e r a p e u t i c a l field.
I have tried t o fill in this void.
What f o l l o w s i s a v e r y b r i e f d e s c r i p t i o n o f a m e t h o d
w h i c h u t i l i z e s t h e s e ne w c o n c e p t s i n a p r a c t i c a l a n d
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Cerebral Specialization
Journal o f t h e R o y a l S o c i e t y o f M e d i c i n e V o l u m e 8 2 O c to b e r 1 9 8 9 581
t h e r a p e u t i c w a y, b ut a lt h ou gh s o m e o f t h e t e c h n i q u e s
a r e w e l l known t o p s y c h o t h e r a p y t h e r e i s a d i s t i n c t
d i ff e re n ce i n t h e i r m o d e o f a p p l i c a t i o n .
T h e o r e t i c a l l y the left hemisphere's m o d u s operandi
is b y m e a n s o f 'temporal a n a l y s i s ' , a n d is un-
e nc umbe re d by emotional i n t e r f e r e n c e . Temporal
a n a l y s i s has distinct communicative limitations; i t is
f r e q u e n t ly i m p o s s i b l e t o e x p l a i n , i n t e r m s o f t e m p o r a l
anal y s i s , a s o l u t i o n derived by spatial s y n t h e s i s ( t h e
m o d u s operandi o f the r i g h t hemisphere), a n d , o f
c o ur s e, v i c e v e r sa . F u r t h e r m o r e , t h e r i g h t h e m i s p h e r e
has t o incorporate i n t o its s o l u t i o n the o f t e n
illogicality o f emotion. This c a n l e a d t o conflict. In my
opinion the o r i g i n s o f a neurosis c an lie in inter-
hemispheric conflict. Th e conflict a r i se s out of the
possibility o f holding di f f e re nt i n t e r p r e t a t i o n s o f the
s a m e in co m in g s t i m u l u s . N a t u r a l l y , i n the majority
of i nt e rp re t at i o ns , the c o n c l u s i o n s reached are the
same, or sufficiently s i m i l a r t o avoid an y conflict.
Where, however, conflict does occur evidence showse
that only one o f the i n t e r p r e t a t i o n s w i l l be t o l e r a t e d
which, i p s o facto, m e a n s the other h a s t o be r e p r e s s e d
in o r d e r f o r t h e b o d y a s a w h ol e t o r e a c t t o t h e s t i m u l u s .
T h e u s e o f r e p r e s s i o n i n t h i s w ay m ay r e s u l t i n a
s a t i s f a c t o r y c o n c l u s i o n p a r t i c u l a r l y i f t h e s t i mu l u s
w a s a minor one and the eventual outcome w a s o f n o
particular significance. If, however, the decision
i n v o l v e d a vital l o n g - t e r m emotional result, r e p r e s s i o n
would al s o continue long t e r m a n d d e m a n d a great
d e a l o f mental energy to s u s t a i n . U n d e r these
circumstances it is o f t e n difficult t o maintain a
c o m p l e t e r e p r e s s i o n ; t h i s m ay r e s u l t i n t h e s u r f a c i n g
of symptoms in dictin g the conflict.
I f t h i s is so, a n d the source o f neurotic s y m p t o m s
emanates from the c l a s h o f d i s c o r d a n t i n t e r p r e t a t i o n s
o f t h e sa me input by the t w o hemispheres,
t h e n i n o r d e r s te on s uo cr cy e s s f u l l y t r e a t s u c h s y m p t o m s t h e
t h e r a p i s t m u s t first o f all (1) und erstand both
i n t e r p r e t a t i o n s , a n d then (2) r e s o l v e the conflict
b y m e a s u r e s w h i c h a r e b o t h u n de r s ta n da b le a n d
a c c e p t a b l e t o each hemisphere.
In my 1982 paper I first mentioned a t h e r a p e u t i c
method designed t o do ju s t this.
Cameral analysis is, what it implies, namely single
chamber a n a lysis (camera=domed chamber) in which
the left a n d r i g h t c h ambe rs (hemispheres) are
interviewed ( a n a l y s e d ) i n t w o separate mod es a nd in
t w o separate s t a t e s o f consciousness.
Th e first m o d e is that o f the left hemisphere a nd
the t h e r a p i s t q u e s t i o n s in depth the left hemisphere's
i n t e r p r e t a t i o n o f th e presenting problem. In other
w o r d s o n e t ak es t he u s u a l m e d i c a l a n d p s y c h i a t r i c
h i s t o r y by verbal questioning o f the p at i e nt . It is
p a r t i c u l a r l y i m p o r t a n t a t t h e sa me t i m e t o o b s e r v e
any body language the p a t i e n t communicates and to
make n o t e s o f i t a n d i t s c o n t e x t a t t h e p o i n t a t w h i c h
i t o c c u r r e d . S u c h s i g n s as for i n s t a n c e , s i g h i n g ,
blushing, hand-to-face movements, finger tapping,
h e a d m o v e m e n t s e t c. o f t e n d r a w attention to, or
n e g a t e , s t a t e m e n t s made v e r b a l l y . S p i e g e l t e l l s o f a
p a t i e n t o f h i s w h o m , when a s k e d t h e q u e s t i o n ' d o y o u
l o v e y o u r h us ba nd ?' a n s w e r e d v e r b a l l y ' O f c o u r s e I
d o ! ' w h i l s t a t t h e same t i m e s h a k i n g h e r h e a d f r o m
side to side!
Th e s e c o n d mode is t h at o f the right h e m i s p h e r e , this
i n v o l v e s (a) questioning the r i g h t hemis p here w i t h
the p a t i e n t i n h y p n o s i s . (b) R e g r e s s i n g t he p a t i e n t
unde r hypnosis t o i n c i d e n t s r e l a t i v e to h i s / h e r
problem and opening up t he i nvo l u nt ary memory store
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582 Journal o f the Royal S o c i e t y o f Medicine Vo l u me 82 October 1989
t o more pre ci se an d emotional details. (c) E n c o u r a g i n g
the abreaction o f relevant events under hypnosis a n d
thus allowing the patient t o r e - l i v e the event at a
much m o r e m a t u r e p e r i o d i n h i s life w h e n h i s
maturity enables h i m t o cope with such a situ atio n,
rat h e r t h an h av i ng t o r ep r es s i t , as p r e v i o u s l y , i n
o r d e r t o mentally s u r v i v e . [ S h e l l s h o c k is a n extreme
e x a m p l e o f t h i s w h e r e t h e m e m o r y o f t h e i n c i d e n t m ay
i n c l u de t h e i n e v i t a b i l i t y o f d e a t h . B y a b r e a c t i n g t h e
i n c i d e n t i n w h a t i s no w a s u r v i v a l s i t u a t i o n , t h e
p a t i e n t r e l e a s e s t h e h o r r o r o f t h e e m o t i o n a l memory
a n d begins t o logically a c c e p t hi s s u r v i v a l as being
the true fact] (d) U s i n g r e - e d u c a t i v e s y m p t o m
exposure techniques w h i l s t under hypnosis t o change
the emotional o r i e n t a t i o n o f a n event (past, p r e s e n t ,
or on-going) into a more acceptable interpretation
involving l e s s f ea r , a n x i e t y , anger, f r u s t r a t i o n , etc.
These r i g h t hemisphere techniques utilize music,
p o e t r y , s o n g , mime, d a n c e , fa n ta sy, guided imagery,
t r a n s i t i o n a l objects, dreams, w r i t i n g etc. F or example,
w i t h t h e p a t i e n t u n d e r h y p n o s i s , I m ay u s e a C h o p i n
nocturne t o accompany e g o - s t r e n g t h e n i n g s u gge s t i o ns ,
o r I m ay p l a y a p i e c e o f m u s i c ( o r a s o n g ) o f e m o t i o n a l
s i g ni f i c anc e t o the patient t o a ssist the recall o f
involuntary m e m o r y o r l i f e crises, etc. Verbal
s ug g e s t i ons a re much m o r e po w er f u l i f a c c o m p a n i e d
b y m u s i c ; o n e s u n g hymn w i t h v e r y simple w o r d s p ut s
over a religious message more p o w e r f u l l y and
permanently than a hundred sermons from the pulpit!
Similarly, under hypnosis, if one wants to re - arrang e
the r i g h t hemisphere's i n t e r p r e t a t i o n o f a n event use
the language of the r i g h t hemisphere - g i v e the
message in a holistic, gestalt form like a p arabl e ; the
r i g h t hemisphere understands parables a n d this is
why t h e y h a v e s u c h a g r ea ter em o tio n a l i m p a c t .
Again, w i t h the patient u n d er h y p n o s i s , I w i l l
choose a p o e m with a metaphoric content the s a m e
as, or s i m i l a r to, the suggestion I w i s h t o convey, then
read i t t o the patient m a k i n g sure that they r e l a t e
i t t o themselves. T h e y do not n e c e s s a r i l y r e l a t e
v e rbal l y , but more with the metaphoric and pr osodic
comprehension of the r i g h t hemisphere.
P ro s o dy 4l , the melodic contour o f s p e e c h , is r e s p o n -
s i b l e f o r m o d u l a t i n g t h e grammar a n d s e m a n t i c s o f
the spoken w o r d a nd as a r e s u l t i n t r o d u c e s the s u b t l e
meanings a nd emphasis values so important i n the
u n d e r s t a n d i n g o f l a n g u a g e . Pr o s od y h a s b e e n s h o w n
t o be a right hemisphere c o n tr ib u tio n to la n gua ge4 2
and p la ys a prime role in poetic impact.
P o e t r y i s a v e r y i m po r ta n t f a c t o r i n t h e c o n c e p t o f
cameral analysis. S o m e p a t i e n t s write poetry, and i f
they do, then this is a n added bonus, t h e i r p o e m s are
o f t e n m ore informative tha n t h e i r d r e a m s .
I actually encourage p a t i e n t s i n their leisure hours
t o write p o e t r y o n t h e t h e m e o f t h e i r problem b e c a u s e ,
i n m y o p i n i o n , p o e t r y i s t h e m o s t p o w e r f u l w ay o f c o m -
b i n i n g both hemispheres into co-operating in a single
task a n d h e l p s i n t h e i r mutual understanding of the
p roble m. T h r o u g h o u t h i s t o r y p o e m s h a v e b e en u s ed t o
h e l p t h e p o e t overcome p e ri o ds of stress and a n x i e t y of a
p e r s o n a l a nd p u b l ic n a t u re : t h e c l s i c a l L o i v e r s lament
help t o reduce the a b j e c t - d e s p a i r o f the r e j e c t e d s u i i t o r :
the pictorial image of England i n Robert Browning's
Home T h o u g h t s f r o m A b r o a d h e l p e d him o v e r c o m e
h i s h o m e s i c k n e s s . T h e r e a r e e n dl e s s e x a m p l e s .
Mime h as a very s p e c i a l part t o play i n c a i n r a l
a n a l y s i s i n so far a s it i s almost pure r i g h t hemisphere
l a n g u a g e b u t i t i s no t a l l p a t i e n t s who c a n respond.
Th e i d e a i s t o give the patient a s h o r t s c e ne , r e l a t i v e
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Cerebral Specialization
t o the p a t i e n t ' s problem (e.g. the horror of a
claustrophobic when h a v i n g t o u s e a l i f t ) , a n d a s k t h e
p a t i e n t t o mimne it. D u r i n g t h i s performance p a r t i c u l a r
n o t e i s m a d e o f t h e s t r en gt h a n d c h a r a c t e r o f t h e b o d y
language the p a t i e n t uses t o express say , panic o r f ea r
or a n g e r , because f r o m - t h e s e observations it is p o s s i b l e
t o ' r e a d ' t h e s y mb o l s u s e d b y t h e r i g h t h e m i s p h e r e .
T h e s e s y m b o l s a pp ea r a g a i n a n d a g a i n d u r i ng
o r d i n a r y c o m m u n i c a t i o n a n d m ay e v e n o c c u r i n
d r e a ms . A c t i o n s p e r f o r m e d d ur i ng a mime h av e , l i k e
d r e a m , a manifest a n d a l a t e n t c o n t e n t , a n d t o
i n t e r p r e t t h e m s u c c e s s f u l l y m ay l e a d t o a g r e a t e r
understanding o f the p a t i e n t ' s problem.
M ost o f the techniques used i n cameral a n a l y s i s are
w e l l known t o p s y c h o t h e r a p y , t h e d i f f e r e n c e l i e s i n
t h e i r i n t e r p r e t a t i o n in r i g h t a n d left hemisphere
f un ct io n a nd , o f c o u r s e , t he e v e nt ua l u s e o f t h i s
knowledge in helping the t wo hemispheres t o com e
- t o t e r m s w i t h e ac h o t h e r . C a m e r a l a n a l y s i s i n c o r -
porates t hi s - i n t e r p r e t i o n o f brain function i n t o a
workable therapeutic m e t h o d capable o f treating the
psychoneuroses in a comparatively q u i c k , efficient,
a n d effective manner. In t h i s very b r i e f introduction
I h av e t r i e d t o illustrate the general o u t l i n e o f its
methodology an d the b a s i c pri nci pl e s o f its c o n c e p t i o n .
F o r m y own pa r t I f i n d i t h a s a v e r y p r a c t i c a l v a l u e
a n d the r e s u l t s of its u s e are rewarding.
References
1 S p e r r y RW. M e n t a l u n i t y f o l l o w i ng s u r g i c a l d i s o o n n e c t i o n
of t he c er eb r a l hemispheres (Harvey lectures, series 62).
Ne w Y o r k : A c a d e m i c P r e s s , 1 9 6 8
2 Tymms R. Doubles i n literary p s y c h o l o g y . Cambridge:
B o w e s & B o w es , 1 94 9
3 Mi l l e r K. D oub l e s. S t u d i e s i n literary history. Oxfor d :
Oxford University Press, 1985
4 WG ir egeann, ALL o. n, g Tmhaen sd ,u a l1 i8t 4y 4 o f t h e m i n d . L o n g m a n , B r o w n ,
5 Myers F W . M u l t i p l e x pe rsonal i t y The Nineteenth
Century 1886;648-66
6 D e s s o i r M . Th e double ego. Leipsig: E Gunther 1890
7 J a m e s W. T h e p r i n c i p l e s o f p s y c h o l o g y . L o n d o n :
Macmillan 1910
8 P ed e r s e n D L . H y p n o s i s a n d t h e r i g h t h e m i s p h e r e . P r o c
B r S o c Med D e n t H y p n o s i s 1 9 8 4 ; 5 : 2 - 1 4
9 Wyke B . P r o c D e n t Med S o c S t u d y H y p n o s i s 1 9 6 0 : 2 1
10 H u m p h r e y M E, Z a n g w i l l O L . C e s s a t i o n o f d r e a m i n g
after b r a i n injury. J Neurol Neurosurg P s y c h i a t r y
1951;14:320-5
11 P e n f i e l d W , Lamar R . S p e e c h a n d b r a i n m e c h a n i s m s .
Princeton NJ: P r i n c e t o n U n i v e r s i t y P r e s s , 1959
12 Pv ei ns fu ia el l de xWp ,e r Pi ee rn oc te , P . aT hf ei n ba lr a isnu' ms mr ea croyr d ao nf da u dd iistc ou rs ys iao nn .d
Brain 1963;86
1 3 Penfield W . Th e m y s t e r y o f t he mind. P r i n c e t o n , NJ:
Princeton University P r e s s , 1975
14 Bogen-Joseph E . Th e other s ide o f the brain 11: a n
a p p o s i t i o n a l m i n d . BuU L o s A n g e l e s N e u ro l S o c 1 9 6 9 ; 3 4 :
135-62
15 A u s t i n M D . Dream r e c a l l a n d t h e b i a s o f i n t e l l e c t u a l
activity. Nature 1971231:59-60
16 C o h e n B . C h a n g e s i n REM d r e a m c o n t e n t d u r i n g
the ni g h t . I m p l i c a t i o n s for a h y p o t h e s i s i n c e r e b r a l
d o m n i n a n - ec r o s s R E M p e r i o d . P e r c e p t M o t S k i l l s 1 9 7 7 ;
44:1267-77
17 MacLeod-Morgan C, Lark L. H e m i s p h e r i c specificity a
physiological c o n c o m i t a n t of hypnotisability.
Psychophysiology 1 9 8 2 ; 1 0 : 6 8 7 - 9 0
18 H i l g a r d J R. Per son a lity a n d hypnosis. C h i c a g o : Chicago
University P r e s s , 1970
19 D a y M E : . An e y e m o v e m e n t p h e n o m e n o n r e l a t i n g t o
attention, thought and a n x c i e t y . Percept Mo t Skills 1964;
19:443-6
4/5
 8/3/2019 Cerebral Specialization
Journal of the Royal Society of Medicine Volume 82 October 1989 583

20 B a k a n P. H y p n o t i s a b i l i t y , l a t e r a l i t y o f eye m o v e m e n t 31 Zaidel E. Callosal dynamics and right hemisphere

and fun ction a l brain asymmetry Pe rce pt M ot Skills, language. Neurol Neurobiol 1985;17:435-9
1969;28:927-32 32 B o g e n JE. P a r t i a l hemis p her ic in dep en den ce w i t h the
21 G u r R E, G u r R C. Cerebral a c t i v a t i o n as m ea s ur e d b y neocommissures intact. In Brain circuits an d f u nc tio ns of
subjects l a t e r a l eye m ov e m e nt s , influenced b y t he mind. Cambridge: Cambridge University P r e s s , 1987
experimenter location. Neuropsychologica 1 9 7 5 ; 1 3 : 33 Ottoson D. Duality a n d u n i t y of t he brain. London:
35-44 Macmillan 1986
22 E r l i c h m a n H , W e i n b e r g e r A . L at er al e y e m o v e m e n t s 34 S p e r r y RW. H e m i s p h e r i c d e c o n n e c t i o n a n d u n i t y i n
a n d hemispheric asymmetry. Psychol Bull 1 9 7 9 ; 8 5 : c o n s c i o u s a w a r e n e s s . Am P s y c h o l 1 9 6 8 , 2 3 : 7 2 3 - 3 3

23 G1 r0 a8 h0 a- 1m 0, 1 P e r n i c a n o . A u t o k i n e t i c e f f e c t s u n d e r h y p n o s i s . 35 Lc eh iv my eJr, iTc r ef vi ag ur rt eh se nf oC l, lSopweirn rg y hReWm .i sP pe hr ec re pi tc i od ne co of nb ni le ac tteiroa nl

Am J C l i n P s y c h o l 1 9 7 9 ; 2 2 : 2 Brain 1972;92:61-78
24 F r u m k i n LR, Ripley H S , Co x GB . Changes i n c e r e b r a l 36 L e v y J. Information processing in the disconnected
l a t e r a l i z a t i o n with h y p n o s i s . Biol Psychiatry 1 9 7 8 ; 1 3 : hemispheres. Unpublished thesis. C a l i f o r n i a n I n s t i t u t e
741-50 of Technology, 1970
25 U l e t t G , A k p i n a r S, I t i l l T . Quantitative EEG Analysis 37 R e i f f R , Scheera M . M e m o r y a n d h y p n o t i c age regression.
d u r i n g h y p n o s i s . Am J P s y c h i a t r y 1 9 7 4 ; 1 2 8 : 7 9 9 Ne w Y o r k : I n t e r n a t i o n a l U n i v e r s i t y P r e s s , 1 9 5 9
2 6 M e sz ar o s I , B a n y a i E, G r e g u s s A . E v o k e d p o t e n t i a l 38 E r i c k s o n MH. A s p e c i a l e n q u i r y w i t h A l d o u s H u x l e y
correlates of ve rbal v imagery c o ding in hypnosis. I.S.H., i n t o the nature and character o f various s tates of
9 t h . Int. Cong. G las g ow 1982 c o n s c i o u s n e s s . Am J C l i n H y p n o s i s 1 9 6 5 ; 8 : 1 7
27 G r u z e l i e r , J G, e t a l H y p n o t i c s u s c e p t i b i l i t y : a l a t e r a l 39 B r e u e r , F r e u d . S t u d e n uber Hysterie. Leipsig: S D e u t i c k e ,
predisposition and altered cerebral asymmetry under 1895
hypnosis Int J Psychophysiol 1984;2:131-9 40 L e v y J, Trevarthen C. P e r c e p t u a l , semaitic a n d p h o n e t i c
28 Luria A R , Simernitskaya EG. Interhemispheric a s p e c t s of l a n g u a g e p r o c e s s e s i n s pl i t -b ra i n p a t i e n t s .
rN ee luart oi po sn ys c ah no ld o tg hi ec a f u1 n9c7t7i;o1n5s : 1o 7f 5t h e m i n o r h e m i s p h e r e . 41
Brain 100:105-8
Monrad-krohn GH . Th e prosodic qualities of speech and
29 Hilgard ER. Divided consciousness. London: John Wiley its disorders. Acta P s y c h o l Neurol S c a n d 1 9 4 7 ; 2 2 : 2 5 5 - 6 9
1986. 42 W e i n t r a u b S, et al. A r c h Neurol 1981;38:742-4
30 G a z z a n i g a M S . O n e b r a i n - t w o m i n d s . Am S c i 1 9 7 2 ; 6 0 :
311 ( A c c e p t e d 2 M ay 1989)

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