Orne, M. T. Hypnotically induced hallucinations. In L. J. West (Ed.), Hallucinations. New York: Grune & Stratton, 1962. Pp.211-219.

Hypnotically Induced Hallucinations

Martin T. Orne, M.D., Ph.D.

Hallucinations are usually viewed as indicative of severe pathology. Many aspects of pathologic hallucinations have been discussed at this symposium. One often feels that hallucinating under any circumstances is indicative of severe disturbances of the ego function. To the layman, anyone seeing things that aren't there is peculiar or "crazy." Because of the strong bias in our culture against hallucinations, it is difficult to obtain honest reports about experiences of an hallucinatory nature. Subjects tend to minimize and deny any such experiences they might have had. It is well known that patients who are very much disturbed by hallucinations are at times exceedingly loath to tell their psychiatrists about them. In particular, hallucinatory experiences convince the patient that something is seriously the matter and often he is sure that his doctor will feel that his case is hopeless if he reveals that he is hallucinating. If patients who are disturbed by hallucinatory experiences are disinclined to discuss them, it is easy to recognize why experimental subjects who have such experiences will attempt to minimize, forget, and repress them. There are, however, cultures in which it is normal or even necessary to hallucinate. The Crow Indian, if he is to be brave in battle, must have a guardian spirit who will appear to him sometime during his development. 2 The youth will go to great extremes in his attempt to experience this hallucination which is vital to his psychological well-being. His status in the tribe will be determined, at least in part, by his ability to have such an hallucinatory experience. Many other instances of culturally approved or required hallucinations could be cited. Even in present day America, when an individual hears God speak to him, it is a


This paper is from the Studies in Hypnosis Project of the Massachusetts Mental Health Center.

This research was supported in part by a grant from the Society for the Investigation of Human Ecology.


211

 

212 HALLUCINATIONS

toss-up whether he will become a successful leader of a new religious sect or will come to the attention of a psychiatric unit.

We would like to point out that hallucinatory experiences are not as rare in normal individuals as one might be led to believe. Normal college students have reported numerous hallucinatory experiences. For example: "I was lying in bed and I heard my room-mate come in and say something to me. When I got up to talk to him, I found I was alone." Or: "I was expecting my boy friend and he always whistles a tune. The other day, I heard him coming and whistling. I found, however, that it had actually been my father who doesn't know how to whistle." The innumerable times one thinks the phone or the door bell has rung, and instances like the above examples, may be passed over without the individual being aware that anything unusual has happened. More frightening are the experiences in a hypnotic state, when a dream almost imperceptibly becomes an hallucination. Again, the individual may shake his head and say to himself, "I was only dreaming." I do not mean to imply that there are no differences between these experiences and the hallucinations with vivid qualities that are associated with acute organic delirium or the semibizarre hallucinations of schizophrenics. The experiences do show, however, that a potentiality for confusing mental content with the perception of something occurring outside the organism exists in the normal individual. In situations in which diminished vigilance is coupled with high expectations of an event that is not at the moment in the focus of consciousness, the probability that such confusion will occur is heightened.

Before we speak of hallucinations occurring in an hypnotic state, it seems necessary to discuss briefly the nature of the hypnotic state, as such. Considerable consensus exists about some attributes of this state, but it is hard to obtain a definition of hypnosis that either contains only its essential aspects, or includes all of the aspects that characterize the hypnotic trance. Many attempt to describe hypnosis along the lines of Webster's Dictionary, 5 as a "state resembling normal sleep, differing in being induced by suggestions and operations of the hypnotizer, with whom the hypnotized subject remains in rapport, responsive to his suggestions." However, consider the individual who is not in a state resembling sleep, but rather is fully alert: when told he is unable to bend his arm, he finds it impossible to do so; when told the room is hot, he begins to perspire; when asked to tell what kind of a necktie the fellow in the empty chair next to him is wearing, he will describe it in detail; and, finally, when asked to wake up from this "wake state," he will do so without memory for what has transpired. We would agree that he was in a trance. Furthermore, if he has no amnesia for the experience, but will show catalepsy

 

213 HYPNOTICALLY INDUCED HALLUCINATIONS

when it is suggested, and visual hallucinations in response to the appropriate cues, we would still agree that he was in hypnosis.

What I would like to emphasize is that a decision as to whether or not an individual is or has been in an hypnotic trance is a clinical decision, and it is not in fact predicated upon his apparent passivity or the sleep-like aspect usually ascribed to hypnosis. Actually, I'm very hard put to define the hypnotic state. It is remarkable that we can agree with such high consensus about certain states being hypnotic trance, and yet be so unable to delineate it adequately.

I would like to propose a point of view toward hypnosis which tries to define it in terms of the subjective experiences of subjects in hypnotic trance. All individuals who experience deep hypnosis describe their experience in trance as somehow different from the waking state, but, as a rule, they are unable to define this difference. In some fashion, the trance is discontinuous with the waking experience. For example, if trance is rapidly induced using a previously established post hypnotic cue, and if, subsequently, the subject is returned to the same position he occupied prior to trance induction, he will, on awakening, tend to carry on the activity in which he was engaged prior to trance induction, and he may ignore the very complex activities he has carried out in hypnosis. Also, when trance and wakefulness are alternated, one can observe a trance-to-trance continuity much like that of wake-to-wake continuity. Because of this type of observation, the concept of dissociation has gained widespread acceptance.

Another universally reported aspect of hypnosis is the subject's feeling that he has to follow the suggestions given by the hypnotist. While it is clear that this is the implicit contract governing the hypnotic relationship, the subject often is surprised by the actual experience. At times he may feel merely a disinclination to refuse to follow a suggestion, and, at other times, a definite compulsion to carry out the suggestion. This feature of hypnosis is so basic in all descriptions of the state, irrespective of who is reporting it, that an accurate description cannot omit it.

The third essential characteristic of hypnosis is the subject's ability to respond with hypnotic phenomena to appropriate suggestions designed to elicit such phenomena. Thus, the hypnotic state can be seen as a state of readiness to respond in a way that is different from the way of response to the same cues in the waking state. In this context, a hypnotic phenomenon is a distortion of perception, memory, or emotion, based upon the explicit or implicit cues given by the hypnotist. We would like to emphasize that hypnosis, as such, does not produce distortion of perception, memory, or emotion, but does provide a state of readiness to distort in response to appropriate cues.

 

214 HALLUCINATIONS

The ability to hallucinate in response to appropriate suggestion is one of the basic trance phenomena. Not all individuals in deep hypnosis are able to have visual hallucinations, but, if we consider the common phenomena of hypnosis, it is clear that many of them are of an hallucinatory nature. Masserman 3 defines hallucination as "an auditory, visual, tactile or other apperception accepted as real by the subject but occasioned by no apparent external sensory stimuli." (p. 278) The concept of rapport, namely, that the subject in hypnosis responds to suggestions of the hypnotist but remains totally unresponsive to other individuals, implies negative auditory hallucinations. Anaesthesia actually is negative tactile hallucination. The suggestion that the room is warm or cold is frequently used to establish that the subject is in a trance, and, in effect, produces hallucinations of temperature change. Similarly, taste, smell and touch are modalities that are relatively easily influenced. In this discussion, however, we would like to confine ourselves primarily to visual hallucinations, which may or may not be accompanied spontaneously by hallucinations of other perceptual modalities.

When a subject in deep hypnosis is told to observe someone sitting in a chair that is empty, he will behave in one of two ways: he may look and act as though he perceives the hallucination, or he may indicate his disturbance over not seeing the hallucination. The latter reaction may be due either to his "not being in a deep enough trance," or to a specific disinclination on his part to experience visual hallucinations. (Disinclination occasionally is encountered in subjects who associate visual hallucinations with extreme pathology. Erickson reports a case in which the very fact that he was a psychiatrist inhibited the subject's development of visual hallucinations; after this fact was discussed, the subject was able to develop them with ease.)

More germane to this discussion is the first alternative response, in which the subject acts as if he saw the hallucination, i.e., he actually may talk to it, fix its necktie or interact with it in a variety of ways that occur either spontaneously or in response to requests by the hypnotist. When the subject subsequently is asked about his hallucinatory experience in the waking state (and one has made certain that he is able to recall the experience), he may give one of four distinct types of response.

He may report that he did not see anything, that he was fully aware that the chair was empty at all times, but that he felt compelled to act as if he did see somebody. As a rule, such a subject will express considerable discomfort about the situation; he will relate that he felt peculiar going through the behavior but that, at the same time, he was compelled to do so. If, during the trance, the subject was asked to describe details of the clothing worn by the hallucinated individual, he will readily de-

 

215 HYPNOTICALLY INDUCED HALLUCINATIONS

scribe the thought process by which he constructed the description, and, as a rule, he will discuss how he thought out what would be appropriate. He usually will report some concern or resentment about this behavior and continue to emphasize his inability to resist it.

A second subject may report that he experienced a visual image of the hallucination, but, also, that he was aware at all times that it was in his own mind. He clearly realizes that he was visualizing something, and his description is based on what he visualized. He may feel quite satisfied with his performance. At times, he may express the feeling that this phenomenon was not much different from what he might experience in vivid day-dreaming.

A third subject will describe an hallucination that looked real and had the quality of being external to himself, as though it were a perception based on objective reality. However, the hallucination will have completely illogical aspects to it. For example, he may describe someone sitting in a chair, yet report that he could see the chair through the person. Although the subject realizes that there was something strange about his experience; he will report that it seems stranger in retrospect than it did at the time it occurred.

A fourth subject will describe hallucinations that were indistinguishable from real perceptions. Both of the last two types of subjects experience no difficulty describing details of the hallucination's dress or mien.

Direct observation of behavior during the trance does not permit even an experienced observer to distinguish between these four types of reaction to the suggestion to hallucinate. Only careful inquiry can distinguish them. Individuals who once respond in a certain way tend to have similar responses subsequently, if they reach adequate trance depth. If they vary their type of response, they alternate either between the first and second types (that is, not seeing the hallucination or seeing it as an image), or between the third and fourth types (that is, seeing the hallucination as real, either in part or in its entirety).

We shall consider as true hallucinations only the reactions of the third and fourth types. In such individuals, the distinction between mental content and perception either fades or is eliminated entirely, a quality that appears to be essential in a true hallucinatory experience.

One of the principal problems encountered in studying the hypnotic state is the tendency of the experimenter to produce unwittingly whatever phenomena he expects to find, by subtly suggesting them to the subject. This observer bias in hypnotic research not only colors the perception of the subject's response, but also may determine the response itself. To deal with the problem of bias, we have developed a technic of blind experimentation, an idea related to the controls used in drug research

 

216 HALLUCINATIONS

for the same reason. The technic makes it necessary to have a group of fully awake subjects who, to the experimenter, are essentially indistinguishable from subjects in hypnosis. Despite numerous statements in the literature to the contrary, we have been able to motivate subjects in a manner that enables them to simulate hypnosis well enough to deceive experienced hypnotists. 4

A brief description of the procedure follows. A lecture is given to a psychology class, and volunteers for hypnotic experiments are solicited. One hypnotist tests the volunteers for hypnotizability. Only those who demonstrate great facility for entering hypnotic trance are used as hypnotic subjects. Volunteers who fail repeatedly to enter hypnotic trance are used as subjects for the faking control group. These latter are given the following instructions: "We would like you to try to fool another hypnotist. You have been unable to enter hypnosis so far, but we would like you to make him think, when you work with him, that you are going into deep hypnosis. It is possible to fool him; some subjects have been able to do so. He will know that some subjects may be trying to fake, but he will certainly not know which subjects. If he catches on to the fact that you are faking he will discontinue the experiment immediately. Therefore, if you think you give yourself away, don't stop, because unless he discontinues the experiment he did not catch it."

The subjects are then presented to the hypnotist and will either be subjects well trained to go into deep hypnosis or subjects with simulating instructions. The hypnotist in fact does not know which of the subjects are simulators. This is a vital point since if the hypnotist does know that certain subjects are simulating, he will detect innumerable flaws in the subjects' "hypnotic" behavior. The same hypnotist, however, when confronted with a subject whom he does not know is simulating, will experience difficulty in deciding whether the subject is a simulator and will guess wrong in a large proportion of cases. With very few exceptions, he will experience considerable subjective uncertainty even in those instances when he guesses correctly. Further, contrary to widely held belief, moderately painful stimuli cannot be used successfully to discriminate which subjects are simulators, since our simulating subjects have tolerated painful stimulations at levels equal to and higher than that tolerated by subjects in deep hypnosis.

The use of the real-fake type of experimental design produces some differences, particularly with respect to hallucinatory behavior. The differences are of interest since they cannot be accounted for on the basis of the demands of the experimental situation nor can they be understood fully in terms of role play theory. It must be realized that the simulating subject is highly motivated to role play hypnosis. Furthermore, he is

 

217 HYPNOTICALLY INDUCED HALLUCINATIONS

exposed to the same cues to desired behavior as is the hypnotic subject, since the experimenter does not know which subjects are faking and which are real.

In view of these considerations, we attribute differences in the manner of hallucinating to the actual effect of hypnosis above and beyond any attempt on the part of the subject to please the experimenter. The simulating subject, when asked to hallucinate, will almost always pretend to accept the hallucination and act as if it were real. He tends to describe it as a true perception, and he reports no logical inconsistencies. For example, if he is asked to describe the clothing of the hallucination he describes clothing that would be appropriate. His performance has the quality of describing a percept which would be seen if the hallucination were an actual perception. The real subjects, on the other hand, tend to react somewhat differently. While they occasionally perform in the way the faking subjects do, most of them show what we have termed trance logic. They describe the hallucination as being "out there," but they add inconsistent and illogical aspects of the real world which are not appropriate to the hallucinated percept, and there is a certain blandness in the manner with which they combine reality and hallucination. As was mentioned above, they may see an individual sitting in a chair, yet see the chair through him; they may report seeing and touching an individual, and, in some strange way, being able to touch through him. Even though these experiences strike the subject as somewhat strange, yet his hallucinations remain real to him and he is not particularly troubled by the inconsistency. This type of reaction, which is very frequent among real subjects, is never seen in a simulating subject.

This phenomenon is illustrated in the following situation. The subject is told that an observer is sitting in a chair opposite him, in the place where the actual observer had been sitting, but from where he has quietly moved during trance induction. After the hallucination is induced and the subject clearly is reacting to it, he is told to turn around and identify the individual standing behind him, i.e., the observer who has moved behind the subject and well outside his range of vision.

In this situation the truly hypnotized subject is almost invariably startled, and will look back and forth between the observer and the chair where he has hallucinated the same individual. His behavior resembles what is known colloquially as a "double take." He will then identify both perceptions as Dr. _______ ; and may in a puzzled way ask why there are two of them. A highly intelligent subject who is acquainted with hypnotic phenomena may say, "I guess one of them is an hallucination." Such a subject, when asked which of his perceptions is real, will study first one and then the other before deciding. In order to make the distinction

 

218 HALLUCINATIONS

some subjects have hit upon the ingenious idea of "thinking" that the observer should raise his hand, and reasoning that the image which did so was the hallucination. (Dr. Milton H. Erickson 1 has described this situation as having occurred in his experience, and I have confirmed its occurrence repeatedly.)

The simulating subject reacts differently in this situation. When asked to look at the actual observer he tends to avert his eyes. If he is forced to look at him he may do one of three things: refuse to admit that anyone is there; say that he does not recognize the individual, or ascribe a different identity to him; or admit it is the observer and report that he no longer sees him sitting in the chair. Only rarely will he act as though he perceives two observers in the manner of the real subject. In fact, we have observed this to occur, almost exclusively, only in faking subjects who had the opportunity to see a real subject respond in this manner. When the subject is asked afterward why he refused to recognize the observer, or why he misidentified him, his characteristic response is, "You told me that he was sitting in the chair so he could not be behind me, since there is only one of them." Such a response assumes the sole existence of one real world in which applies the principle of exclusive and unique location, but this sort of logic characteristically is absent in the hypnotic state and, even more specifically, in the hypnotic hallucinatory experience.

There are similar contrasts between fake and real hypnotic behavior in other situations. For example, when asked to hallucinate a picture on the wall, a faking subject tends to locate the picture in a suitable empty wall space, whereas a real subject tends to locate it where there actually is a picture, mirror, or something hanging on the wall. In the absence of other reality supports, a mere smudge on the wall may determine where he locates his hallucinated picture.

Negative hallucinations, with which we have only casually experimented, also reveal the peculiar nature of hypnotic hallucinatory phenomena. In this situation the subject is asked not to see an object that is in the room, 6 for example, a chair, and he will respond verbally as though the chair were not present. Yet, when asked to walk about the room he does not walk into the chair, but rather avoids physical contact with it. If the situation is structured as a test of negative hallucination, and the subject is requested specifically to walk straight ahead, he may walk into the chair and express surprise that something touches him. Even in the test situation, however, some subjects will walk around it. The subjects' actions demonstrate that at some level they are aware of the chair. Most of them report not having seen the chair while in trance, but having seen an empty space that was "somewhat more empty than the

 

219 HYPNOTICALLY INDUCED HALLUCINATIONS

rest of the empty space in front of them," (i.e. they may describe an area of absolute nothingness where the chair had once been). We have not tested this situation extensively with faking subjects, but a few faking subjects have been observed. They will walk into the chair, and give as their reason the fact that they were not supposed to have seen the chair and that walking around it would be an indication of seeing it.

In many ways this paper has dealt as much with hypnosis as with hallucinations. However, all hypnotic phenomena are either hallucinations or are intimately related to them. The process of trance-induction itself can be viewed as a gradual increase of potentiality to experience suggested alterations of the environment as subjectively real phenomena. The part of the environment that is not altered by the hypnotist's suggestion is perceived accurately. Thus, we can observe the peaceful coexistence of incompatible, incongruent perceptions. It is possible to conceptualize hypnosis as one of perhaps several situations that permit the voluntary relaxation of some reality testing functions. In hypnosis, the areas where reality testing is relinquished are limited to those legitimized by the hypnotist.

REFERENCES

1. Erickson, M. H.: Personal communication.

2. Lowie, R.: The Crow Indian. New York, Rhinehart, 1956.

3. Masserman, J.: Principles of Dynamic Psychiatry. Philadelphia, London, W. B. Saunders Co., 1946.

4. Orne, M. T.: The Nature of Hypnosis, Artifact and Essence. J. Abnorm. & Social Psychol. 58: No. 3, May, 1959. To be published.

5. Webster's Collegiate Dictionary, based on Webster's New International Dictionary, Second Ed., G. & C. Merriam Co., Springfield, 1956.

6. White, R. W.: Personal communication.


The preceding paper is a reproduction of the following book chapter (Orne, M. T. Hypnotically induced hallucinations. In L. J. West (Ed.), Hallucinations. New York: Grune & Stratton, 1962. Pp.211-219.).