Orne, M.T. A book review of Gill, M.M, & Brenman M. Hypnosis and related states, psychoanalytic studies in regression. In Psychosomatic Medicine, 1962, 24, 317-318.
This book is the product of 10 years of clinical investigation by the authors since their original monograph Hypnotherapy (1947). Except for an excellent theoretical paper by Kubie and Margolin (1944) and the monograph by Schilder and Kauders (1927), it represents the only major statement of the psychoanalytic position regarding the nature of hypnosis. It is clearer and more systematic than Schilder and Kauders' work and has a level of sophistication far beyond the authors' own original work.
Hypnosis and Related States takes the reader along the laborious yet exciting paths followed by the authors in their studies. Part I, comprising over half the book, is well integrated; it presents the authors' theoretical position and oftentimes ingenious quasi-experiment work. Part II deals with the relationship of hypnosis to kindred phenomena. This section presents interesting ideas; however, the authors base their conclusions on secondary sources, and the section lacks the self-imposed discipline of the first part. Part III relates to the use of hypnosis and psychotherapy. From a clinical standpoint this section is most worthwhile and shows the authors' sensitivity and skill as therapists; however, in the context of the book as a whole, the section stands apart, with little integration of the earlier theoretical portions.
The main thesis which the authors set forth in their new volume is that hypnosis is at once both a (1) transference phenomenon, by which it is meant that the subject engages in regressive interpersonal relationships and (2) an altered state of functioning, controlled by a less differentiated ego subsystem. In their earlier statement the authors dealt with these aspects of
318 BOOK REVIEWS
hypnosis as distinct, however, in this book the two bodies of data relating to these aspects are united conceptually through an elaboration of the concept of transference. Previously, transference was viewed by the authors as a regression in the id; however, here a distinction is drawn between two types of regression: (1) regression proper, wherein id, ego, and superego are altered and (2) regression in the service of the ego, wherein a regressed subsystem is set up within the ego, which simultaneously controls the altered aspects of ego functioning and engages in regressive interpersonal relationships. The authors place hypnosis in the latter category, viewing it as a state of loss of autonomy where the regressed subsystem within the ego is dominated by a part of the social environment, the hypnotist.
The authors feel that it is important conceptually to separate the induction phase of hypnosis from the established state of hypnosis They view the induction phase as chaotic, the established state as stable and organized The authors account for the discrepancy between the organization of the phases by postulating that the total ego is very involved in the regressive process during the induction phase, whereas once hypnosis is established the regressed subsystem has gained control of the other ego apparatuses, the process has "settled," and the over-all ego has taken a position in the background, at all times however maintaining a nonhypnotic reality-oriented relationship with the hypnotist.
The transference which relates to hypnosis is distinguished by the authors from the usual transferences occurring in psychotherapy Within their theoretical framework the transference which underlies hypnosis is viewed as being comprised of the strivings of the regressed subsystem whereas the usual transferences of therapy are seen as the manifestations of the relationship of the over-all ego with the therapist.
In the authors' view, hypnosis can be initiated either by sensori-motor deprivation or by the stimulation of an archaic relationship to the hypnotist. However, whether the ego is unseated by one means or the other, both sets of phenomena occur, inextricably linking the transference and altered-state aspects of hypnosis.
This elaboration of the concept of transference clarifies conceptually the importance of the hypnotic relationship. Of particular interest is the authors' emphasis on the countertransference well as the transference aspects of the phenomenon. They aptly characterize hypnosis as a "complex dovetailing relationship between the two participants wherein the over role taken by the one is the covert fantasy of the other" (p 98).
The authors' systematic presentation of the psychoanalytic point of view unfortunately does not readily lend itself to translation into operational terms. In view of the authors' clinical frame of reference, this criticism is not directly relevant to their essential purpose; nonetheless this reviewer would hope that their theory will eventually be phrased in more systematic terms, making hypothetico-deductive testing possible.
This book must be recommended to anyone seriously interested in hypnosis and it will also fill a real need for many who would not choose to utilize the technique but would wish to know more about the nature of hypnosis. The obvious sensitivity of the authors toward the phenomenon, the richness of their clinical experience, and the links which are formed with this and other phenomena cannot help but make the book a significant contribution.
MARTIN T. ORNE
The preceding paper is a reproduction of the following book review (Orne, M.T. A book review of Gill, M.M, & Brenman, M. Hypnosis and related states, psychoanalytic studies in regression. In Psychosomatic Medicine, 1962, 24, 317-318). ©1962 by American Psychosomatic Society, Inc. It is reproduced here with the kind permission of Lippincott Williams & Wilkins ©.