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How to cite this thesis
Surname, Initial(s). (2012) Title of the thesis or dissertation. PhD. (Chemistry)/ M.Sc. (Physics)/ M.A. (Philosophy)/M.Com. (Finance) etc. [Unpublished]: University of Johannesburg. Retrieved from: https://ujdigispace.uj.ac.za (Accessed: Date).
A COMPARISON BETWEEN THE CONCEPT
OF WESTERN HYPNOSIS AND AFRICAN TRANCE
BY
CLAIRE HEARNE
A DISSERTATION PRESENTED IN PARTIAL FULFILMENT OF THE
REQUIREMENT OF THE DEGREE
MASTERS OF ARTS
IN
CLINICAL PSYCHOLOGY
IN THE FACULTY OF ARTS
AT THE
RAND AFRIKAANS
UNIVERSITY
SUPERVISOR: DR. M.C. MARCHETTI
January 1994
ACKNOWLEDGEMENTS
My gratitude to the following people cannot be adequately expressed:
- Dr. Maria Marchetti, my supervisor. Without her wisdom, knowledge,
direction, and helping kindness, this work would never have been
accomplished.
- My parents, Prof. George Wiehahn and Dr. Nicoleen Swart, who
initiated my interest in psychology. Their love and support make this
degree possible.
- Prof. Dave Beyers and Prof. Chari Vorster, for their unique and
inspiring contributions to my training.
- My fellow students at R.A. U., for their continuous encouragement and
support
- My husband, Peter, for his love, support and assistance, and
especially for all the valuable time helping me
ii
SUMMARY
The nature of hypnosis and trance is investigated in the context of
Western psychology, and traditional African healing practises. The
historical development, definitions of nature of hypnosis and trance,
and theoretical background of both these phenomena are described.
Similarities and differences between Western hypnosis and African
trance are described. Western hypnosis and African trance are found
to be embedded in the context which provides their meaning. The
similarities and differences between the African healing trance
induction process and the Western context of hypnotherapy are
discussed in terms of the ecosystemic theories. The content and
characteristics of hypnosis in these two spheres are not seen as
important as is the context and process of these phenomena. It is found
that the expected characteristics of hypnosis in Western
psychotherapy, and traditional African trance states, and the
similarities and differences between them, are not absolute realities,
but rather culturally shaped experiences which people come to expect.
iii
OPSOMMING
Die aard van hipnose en die hipnotiese beswyming word in die konteks
van die Westerse sielkunde en die Tradisionele inheemse (Afrika)
praktyke ondersoek. Die historiese ontwikkeling, definisies en aard van
hipnose en die beswymingsverskynsel, en die teoretiese aglergrond
van hierdie verskynsels word beskryf. Ooreenkomste en verskille
tussen die Westerse hipnose en die inheemse beswymingsveskynsel
word van nader bekyk. Die Westerse hipnose en die Afrika
beswymingsverskynsel moet gesien word in die breere verband wat
daaraan betekenis verleen. Die ooreenkomste en verskille tussen die
inheemse beswyming ( die geneeskundige verband) en hipnose en ook
hipnose induksie word in terme van ekosistemiese teoriee bespreek.
Die inhoud en eienskape van hipnose en die inheemse beswyming is
nie so belangrik soos die konteks waarbinne dit gebeur nie. Dit blyk dat
die eienskappe, en die ooreenkomste en verskille van Westerse
hipnose en die inheemse beswyming bepaal word deur die verwagtinge
van die mense in hul bepaalde kulture en dat dit nie as absolute
waarhede gesien moet word nie
iv
TABLE OF CONTENTS
Page
ACKNOWLEDGEMENTS
SUMMARY (ENGLISH)
SUMMARY (AFRIKAANS)
ii
iii
CHAPTER 1 INTRODUCTION 1
CHAPTER 2: HYPNOSIS FROM A WESTERN PERSPECTIVE 5
2.1. THE HISTORICAL DEVELOPMENT OF WESTERN 5
HYPNOSIS
2.2. THE NATURE OF HYPNOSIS 9
2.2.1. DEFINITIONS OF HYPNOSIS, TRANCE, AND 9
SUGGESTION
2.2.2. THEORETICAL APPROACHES TO HYPNOSIS 14
2.2.2.1. STATE AND NON-STATE THEORIES 14
2.2.2.2. PHYSIOLOGICAL AND PSYCHOLOGICAL 15
THEORIES
2.2.2.3.1 HE LINEAR AND ECOSYSTEMIC APPROACH 16
2.3. THE PROCESS OF HYPNOSIS 20
2.4. HYPNOSIS IN A WESTERN CONTEXT 23
CHAPTER 3 :
3.1.
3.2.
3.3.
3.4.
3.4.1.
3.4.2.
3.4.3.
THE AFRICAN APPROACH TO HYPNOSIS
INTRODUCTION
THE HISTORICAL DEVELOPMENT OF AFRICAN
HEALING PRACTICES
THE NATURE OF TRANCE IN AFRICAN HEALING
IfYPNOSIS IN AN AFRICAN CONTEXT
ANIMALISTIC THEORIES
MAGICAL THEORIES
MYSTICAL THEORIES
26
26
28
30
32
33
34
34
CHAPTER 4
CHAPTER 5
CHAPTER 6
BIBLIOGRAPHY
v
COMPARING THE WESTERN AND AFRICAN
APPROACHES TO HYPNOSIS AND TRANCE STATES
DISCUSSIONI
CONCLUSION
36
41
47
(CHAPTER 1J
I,
1. INTRODUCTION
The historical development of transcultural psychology has led to an
emphasis on exploring the psychological needs of societies with cultures
different from those in which Western psychology has developed, with the
further desire to help adapt psychological; teaching (Cox, 1986) and
training to the needs of these societies. However, as a matter of principle,
many researchers such as Murphy, Leff, and Lau (in Cox, 1986) feel that
the influence of local culture on mental health was likely to be far more
relevant, in that specific culture than any Western perspective on mental
health, as applied to that culture (Cox, 1986). For example, in the South
African context, there are numerous theories and influences in the field of
trans-cultural psychology, but few have investigated techniques already
applied by African healers, which could enjoy more relevance in the
African culture, than purely Western techniques.
A combination of knowledge in both an African healing context, and a
Western psychological context could possibly result in more relevant and
acceptable training in South African psychotherapy. One of these
techniques which is used in both the African healing context, as well as the
Western psychotherapeutic context, is hypnosis (Olivier, 1993). As Olivier
(1993) states, "until now, the Western researchers have not been open to
understand lhe wisdom and knowledge that the traditional healers have,
and to utilise this force" (p.7). Buhrmann (1977) finds that to work with
African healers can have a "sobering effect, and an effort to enter thelr
world and share their experiences can be enriching and rewarding, as well
as making the sharing of relevant psychological and psychiatric material
possible and meaningful" (p.464).
2
For this reason it is felt that a study Into techniques already employed by
Africnn healers could be valuable to psychology, in that these techniques
should be culturally relevant, and hypnosis specifically, is a known and
accepted technique in Western psychology. Because hypnosis is a
technique used in both Western and African contexts, it can provide a
comparative and possibly even integrative function in psychology, if
similarities do in fact exist between these two phenomena.
As previously stated, similar studies have been completed, but few within
the South African context. Bilu, Witztum and van der Hart (1990), for
example, found value in an investigation into the effectiveness of healing
devices all over the world, by researching prevailing cultural idioms as a
crucial factor in the healing setting. They found that this healing factor,
however, was not easily attainable in multicultural settings where therapist
and patient did not share the same world view or similar explanatory
models. By investigating the patient's culture and mythic world, and
amplifying the idioms of the patients cultural world, as well as providing the
patient with myth-congruent metaphors which had been previously
investigated, the therapists were able to accomplish a dramatic resolution
of the patients emotional problems. This was because the therapist
understood and was therefore sensitive to, the concept of healing in that
specific culture. Furthermore they found hypnotic and metaphoric
therapies in multicultural settings to be of particular pertinence (Bilu et al.,
1990).
In other words, if a therapist has knowledge of the myths, culture, tradition,
and methods of healing (in this case African medicine) of a specific group,
the efficacy of the therapist might be improved. This study has a similar
purpose to Bilu et al (1990), in that the predicled similarities between
Western hypnosis and the African trance state, could bring about a
beIter understanding, and therefore a more relevant, investigation into
future perspectives in psychology and training in this country, for all
people. Similarly, cultural and mythic influences will be taken into account.
3
Windle and Samko (1992) also completed a comparative study on
hypnosis, and found that therapist training may be enhanced by
combining modern principles of hypnosis with traditional methods in
different cultures, as it is known that culture penetrates human life in
multitudinous ways, some of which we are just beginning to understand but
much of which still remains to be discovered (Rogier, 1989). For this
reason, attention must be given to the manner in which the characteristics
of the culture influence the research and ultimately the method one wishes
to apply.
The goal of this study is to research the similarities and differences
between the Western concept of hypnosis, and the African approach to
hypnosis, i.e. the concept of "trance". A further goal is to investigate the
historical development, definitions, and theoretical background of both
these phenomena, and to investigate the context in which they occur.
This thesis will take the form of a literature study, with this chapter
accordingly being an introduction, whereby aims and motivation of this
work are described. The second chapter will concentrate on hypnosis from
a Western perspective. This will be an investigation into the historical
development of hypnosis, followed by a summary of traditional and current
approaches to the definitions and theoretical perspectives of hypnosis and
its related features, in other words, hypnosis, trance and suggestion.
Specific attention will be given tolhe concept of Western hypnotherapy,
. followed by a detailed investigation into the context in which these
phenomena occur.
4
The next chapter will focus on African healing, and specifically the African
trance state. In this context, African healing refers to traditional healing
practises by indigenous non-western trained specialists (This will, be an
investigation into its history, its nature, and tile context in which it occurs),
Specific attention will be given to definitions of the concept of the
traditional African trance state.
In order to arrive at an evaluation of these two concepts of hypnosis, it is
then necessary to compare the similarities and differences of these two
approaches in detail, followed by a discussion on the implications of those
findings. The conclusion will follow.
The relevance of culture in mental health will not been neglected, but one
must realise that there are limitations in research, in that no single
investigation can provide a complete answer to any theme. This study will
attempt to mesh the process of inquiry with the cultural cllaracteristics of
the group being studied, As Rogier (1989) states, any considerations
pertinent to the culture, or cultures being studied, become an organic part
of the process, which is every bit as important to the success of tile
research as are the more formal research procedures codified in
epidemiology and clinical research textbooks. This research, will therefore
be made culturally sensitive through an incessant, basic, and active
preoccupation with the culture and history of the groups being studied
throughout the process of research, and this opened flexibility of
ethnograpllic methods, will hopefully create a selling which could indicate
a new focus for research (Rogier, 1989).
5
( CHAPTERZ)
2. HYPNOSIS FROM A WESTERN PERSPECTIVE
2.1. THE HISTORICAL DEVELOPMENT OF WESTERN
HYPNOSIS
Although healing by means of trance induction and hypnosis probably
dates back to prehistoric times, the first concrete evidence of the use of
hypnosis can be found in the ancient writings of the medical men of the
times. As Olivier (1993) finds, the father of Chinese medicine, Wang Tai,
wrote about a medical procedure that involved using incantations and
mysterious passes of the hands over the patient, as far back as 2600BC,
which leaves no doubt about its hypnotic nature. The Hindu Veda, which
was written in about 1500BC, also mentions the use of hypnotic-like
techniques and procedures (Olivier, 1993).
The early Celtic inhabitants of Britain, the Druids, who were physicians,
would often place the patient under a 'Druidic Sleep' in order to cure them
(Olivier, 1993). Zahourek (1990) likewise finds that the earliest roots of
hypnosis can be found in ancient writings. Zahourek (1990) finds evidence
of this phenomenon in the ancient writings of the Egyptians and Hindus.
The Egyptians and Hindus used rhythmic chanting and drumming, often
followed by 'temple sleep' or 'sacred sleep', and it was not uncommon for
the believers to experience 'visions', 'hear voices', or exhibit unusual
physiological endurance, such as lying on a bed of nails or walking across
hot coals (Zahourek, 1990).
6
The revival of modern interest in hypnosis, at least in Western culture,
may be traced directly to the work of Franz Anton Mesmer (1733-1815),
who is generally considered as the father of hypnosis. He was infFuenced
by the teachings of Paracelsus (1493-1541), who felt that the sun, stars
and moon exert an influence over human behaviour by means of their
magnetic fields, and that these bodies had healing effects on the body.
Mesmer decided to investigate the implications of this theory by slowly
drawing small magnets along the bodies of his patients. This was found to
temporarily induce convulsions, fainting,' and the disappearance of a
number of different symptoms, which convinced Mesmer and his followers
that magnetic treatment may constitute an exciting medical breakthrough.
Mesmer soon discovered, however, that he could produce the same
results without the special magnets, thereby concluding that the
'magnetism' in question was coming from his own body (Gibbons, 1979).
Frankel (1990), although also mentioning Mesmer's influence in the
development of hypnosis, recognises dePuysegur's somnambulism, also
known as magnetic sleep, as a greater influence.
According to Baker (in Olivier, 1993), the man most responsible for the
medical community accepting hypnosis, was John Elliotson (1791-1868),
who emphasised the usefulness of so-called hypnosis in the cure of
disease and psychoneuroses. But, the so-called Age of Hypnosis as such,
actually began with the work of James Braid (1795-1860), a Scottish
surgeon, who found that he could induce the trance state by means of eye
fixation on a single point or bright object. In 1842 he approached the
British Medical Association in Manchester to read a paper on hypnotism, a
word first used by him (Olivier, 1993). In 1843, he published an article
called Neurhypnology (Rationale of Nervous Sleep), in which the specific
term hypnosis was first introduced (Zahourek, 1990).
7
However, many scientists were sceptical about hypnosis until it was
catapulted into scientific respectability by Charcot, the most distinguished
neurologist of the 19th century, who developed an interest in it (Reyler,
1969). Although his conclusions about hypnosis were lncorrect, his
. reputation, which was a respected one amongst the medical community,
enabled hypnosis to "leap out of the gutters and make its debut in the
consulting rooms of Hospice de la Salpetiere" (Reyler, 1969, p.5), which
was a prominent medical facility in Europe at that time. There were many
distinguished medical people, including Siqrnund Freud, who came to
observe and study at Hospice de Salpetiere. In 1889, Freud started using
hypnosis. In the early stages of his career, Freud studied with Charcot,
and used hypnosis to help patients recover repressed memories. Freud
noticed that patients could relive traumatic events while under hypnosis.
This process is known as abreaction (Kaplan & Sadock, 1991). Freud and
Breuer discovered that by aiding the patient through hypnosis to talk about
traumatic experiences, symptoms often disappeared (Olivier, 1993). At this
time, however, Breuer, Freud and Janet appear to have been influenced
to a large extent by their work with hypnosis and the similarities in the
phenomenon of hysteria and hypnosis (Frankel, 1990). It is, however
difficult to exaggerate the magnitude of the impact that Freud had upon the
course of psychology and the behavioural sciences as well as the fate of
hypnosis itself (Reyler, 1969). The School of Salpetiere, however,
advocated explanations of hypnosis in physiological terms while the Nancy
school, another development in hypnosis at that time, defended the
psychological point of view (Burrows & Dennerstein, 1980).
Hypnosis came under the spot-light again, during the First World War,
when the development of interest in hypnosis was.rekindled through the
use of it in post-traumatic stress disorder. As Olivier (1993) states, "with
the advent of World War 1 and the need to treat hundreds of men suffering
from battle neuroses, hypnotherapy became a valuable tool for physicians
and psychiatrists. Hypnotherapy was again employed successfully during
World War 2" (p.6). In 1944, Kubie and Margolin made a distinction
between the process of hypnotic induction and the hypnotic state itself,
because these two phenomena, differ both in psychological and
physiological terms. The relations between the subject, the hypnoti,st, and"
the outside world were seen as different in these two conditions (Burrows
& Dennerstein, 1980).
Since then, the concept of hypnosis has established itself in modern
psychology and medicine. In 1955, the British Medical Association
recognised the teaching of hypnosis in medicine and practice. The
American Psychological Association responded in kind in 1958, and in
1960 the American Psychological Association officially recognised the
speciality of hypnosis by establishing a certified board of examiners in
both clinical and experimental hypnosis (Reyler, 1969). The South African
Society of Clinical Hypnosis was founded in the 1950's and at present the
South African Society of Clinical Hypnosis is a member of the International
Society of Hypnosis (Olivier, 1993).
Many of the disparate views through the history and development of the
concept of hypnosis are still relevant in our time. For example, recent
developments of linear versus ecosystemic theory in hypnosis can de
compared to the old issue of state versus non-state theory which will be
described in the next section. Furthermore, centuries after hypnosis was
first described, many theorists are still attempting to define this concept as
a special state, with few changes, which will also become clearer in the
following section. We still find a marked similarity in the current theorising
regarding the subject of hypnosis, as in the early theoretical approaches to
hypnosis. The definitions of hypnosis and its related features, as well as
the theory of hypnosis in Western psychology will therefore be described
in the next section.
9
2.2. THE NATURE OF HYPNOSIS
Since its origin, as discussed, the concept of hypnosis and .relatsd
research has been of both a complicated and often controversial nature.
Many vastly dilferenl theories have been postulated concerning the nature
and theory of hypnosis. As Moss (1965) states:
Over the years many provocative speculations have been
advanced to account for the phenomenon of hypnosis, such
as Mesmer's animalistic belief in magnetic fluid and
Charcot's allegation that hypnosis was pathological in nature.
(p.44)
For this reason, it is necessary to define the nature of hypnosis, and its
related features, in other words, trance, and suggestion. It also becomes
necessary to investigate a broad theoretical background to these
phenomena, in order to better understand these concepts. For this reason,
hypnosis, trance and suggestion will be briefly defined according to
different theorists, followed by a brief description of various theoretical
approaches.
2.2.1. Definitions of hypnosis, trance and suggestion
a) Definitions of hypnosis
Originally, the term hypnosis came from the Greek word hypnos, which
means sleep. Since then, it has been attempted to develop far more"
complex definitions of the process of hypnosis, Traditionally, hypnosis was
regarded as an altered state of consciousness that differs fundamentally
from normal waking states (Kirsch, Mobayed, Council, & Kenny, 1992).
]()
More recent definitions (Zahourek, 1990), however, describe hypnosis
simply as a natural state which is induced for a specific purpose, by
eneself or another person, thereby recognising aspects of self
determination. Gill and Brenman (1959) characterise hypnosis as a
. situation in which critical judgement is set aside by the person, to indulge
in make believe and fantasy. This does not, however, mean that the
judgement ability is completely abandoned. Hilgard (in Edmonston, 1981)
on the other hand, states that familiar reality testing does not continue in
hypnosis, but rather that the "altered background for receiving
suggestions, the state of hypnosis, is one of felt changes from normal in
that the usual orientation to reality has been disturbed," (p.211).
Kaplan and Sadock (1991) describe hypnosis as an "artificially induced
modification of consciousness characterised by a heightened
suggestibility" (p.214). Two of the main features of hypnosis, are trance
and suggestion, and it is important that these features not become
confused. Hypnotherapy involves specific procedures to help the patient
be hypnotised and respond to suggestion. Suggestion is therefore a
process of hypnosis. Persons under hypnosis are also said to be in a
trance state (Kaplan & Sadock, 1991). However, as Frankel (1990) states,
it becomes a matter of "some importance to remember that it is an
oversimplification to regard all hypnotic behaviour and experience as
evidence of trance, which implies that minor events of hypnosis reflect
minor degrees of trance" (p.826). For this reason, these related features
will be described below.
b) Definitions of trance
When a person is under hypnosis, they are said to be in a trance state
(Kaplan & Sadock, 1991). This trance may be a light, medium or heavy
trance state. Kaplan and Sadock (1991) define the characteristics of these
three states as follows: light trance is characterised by changes in motor
activity, the patient's muscles can feel relaxed, the hands can levitate, and
11
parasthesia can be induced. Medium trance is characterised by diminished
pain sensation, and partial or complete amnesia. Deep trance is
characterised by induced auditory or visual experiences, and, deep
anaesthesia. Time distortion varies according to the depth of the trance
state. Spiegel and. Spiegel (1978) found that the trance state, (which is
often seen as synonymous with the hypnotic state), is characterised firstly
by a modified sensorium, Le., a level of heightened or decreased sensory
state. The word 'sensorium' refers to a state of functioning of the special
senses which is sometimes used as a synonym for consciousness (Kaplan
& Sadock, 1991). Secondly, the trance state is characterised by an altered
psychological state, characteristically minimal motor functioning, a wakeful
dissociative state of intense focal awareness, and maximum involvement
with one sensory precept at a time (Spiegel & Spiegel, 1978). More simply
stated, a person in a trance state can therefore be seen as someone who
is possibly more receptive and focused in the situation.
A more traditional definition of the therapeutic trance state, according to
Milton Erickson, which is similar to the definition above, is that "the limits
of one's usual frame of reference and beliefs are temporarily altered so
one can be receptive to other patterns of association and modes of mental
functioning that are more conducive to problem solving" (Erickson & Rossi,
1979, p.3).
The definitions above describe the trance in terms of a specific state or
set. Olivier (1993), describes the phenomenon of the hypnotic trance in
state terms, as follows:
• Hypnosis and trance are states of dissociation in which the person
can carryon two independent mental processes more effectively
than when in the non-trace state (Baker, 1990).
• Hypnotised patients remember what occurred while hypnotised
unless they are given suggestions to the contrary (Spanos &
Chaves, 1974).
•
••
•
•
•
12
The phenomenon of hypnotic "analgesia" can occur. Hilgard (1974)
demonstrated that while in hypnosis a part of the patient can not
experience pain previously experienced, while the 'hidden
observer', another part of the patient, is still aware of pain.
Patients in the hypnotic trance can confabulate (Orne et aI., 1988).
Erickson ( in Baker, 1990) stated that everyone is capable of beingI·
hypnotised.
During the hypnotic trance, catalepsy (a peculiar state of muscle
tonus which parallels cerea f1exibilitas) occurs (Rossi, 1980).
During the hypnotic trance spontaneous reduction in body
temperature occurs (Kline, 1966).
During the hypnotic trance dilation of the pupils and rapid eye
movement may occur (Rossi, 1980).
In a different approach to a definition of trance, Winkelman (1986)
presents a psychophysiological model of trance states and relates it to the
basic structure and physiology of the brain. It is argued that "many trance
induction techniques lead to a state of parasympathetic dominance in
which the frontal cortex is dominated by slow wave patterns originating in
the limbic system and related projections into the frontal parts of the brain"
(p.174)
c) Definitions of suggestion
Suggestions are produced by the hypnotherapist to bring about a change
in the focus of the subject being hypnotised, and is often used as part of
the induction procedure, which will be described in a following chapter.
Barder (1957), on the other hand, attributes the effect of hypnotic
suggestion to "a 'perceptual-cognitive restructuring' and contends that the
resulting phenomena can be understood in terms of one general principle:
the good subject accepts the hypnotist's words as. true statements, he
13
'perceives' and conceives reality as the operator defines it" (in Moss,
1965, p.48).
Suggestions are described by Zahourek (1990) as being direct (obvious)
or indirect (metaphor; stories; double binds; and embedded commands).
He further states that suggestion is:
...a behaviour that is uncritically carried out without the
individual's logical processes interfering and is I
enhanced by the client's motivation, expectation, and
trust in the operator as well as by the frequency and
manner in which a suggestion is given. (Zahourek,
1990, p.5)
Kroger, Fezler, and Orne (in Zahourek, 1990) describe four types of
suggestion, which can be summarised as follows: firstly, there is the verbal
suggestion, which includes words and any kind of sound. There is also the
non-verbal suggestion, which applies to body language and gestures.
Intra-verbal suggestion, relates to the intonation of words, while the extra
verbal suggestion, utilises the implications of words and gestures that
facilitate the acceptance of ideas.
Krogler (in Zahourek, 1990) emphasises however, that suggestibility
tendencies (the susceptibility of the patient to the effect created by
suggestion) is significantly determined by the way a subject learns to
respond to suggestions in the past (in Zahourek, 1990).
It is not enough, however, to simply define hypnosis and its related
features, because hypnosis is, by nature a complex phenomenon. The
nature of hypnosis can be further clarified by a summary of the main
theoretical perspectives of this concept in psychology.
14
2.2.2. Theoretical approaches to hypnosis
Besides the various definitions of the concept of hypnosis, suggestion, and
trance state, there seem to be two encompassing theoretical approaches
to the nature of these phenomenon. The first approach is the state versus
the non-state theory, which will be described first. This will be followed by
the second approach, which is based on the physiological versus the
psychological theory of hypnosis. In conclusion, a recent development to
the theory of hypnosis will be described, namely the ecosystemic
approach.
2.2.2.1 State and non-state theories
a) State theories
Kirsch et aI., (1992), found that although state theorists differ considerably
in their views of the concept of hypnosis, they do share the following
premises. Firstly, they postulate that hypnotic induction's produce altered
states of consciousness in susceptible persons. These hypnotic states are
introspectively distinguishable from waking consciousness and from other
altered states (e.g. sleep or intoxication). Secondly, state theorists believe
that people are more responsive to suggestion in hypnotic states than in
non-hypnotic states, and that heightened suggestibility is not the only
characteristic of the hypnotic state.
b) Non-state theories
The approach of non-state theorists, is different to the state theories in
that they believe in the influence of personal factors such as attitudes
and beliefs in the outcome of hypnosis. This theory has been misread in
that it was thought that the theorists saw hypnotic responses as simple
compliance, or more simply stated, as faking. But as Kirsch et aI., (1992)
states, rather than doubting the veracity of the hypnotic experience, non-
15
state theorists seek to explain them in terms of the same factors that
account for non-hypnotic experiences and behaviours. In other words,
hypnotic experiences are not due to an altered state of consciousness, but
instead are produced by a persons' beliefs and expectations, role
involvement, and imaginative strategies and abilities (Kirsch et aI., 1992).
I·
2.2.2.2 Physiological and psychological theories
The second theoretical approach to the nature of hypnosis is the
physiological versus the psychological theories.
a) Physiological theories
Numerous theories contend that hypnosis is a result of physical changes
in different parts of the brain. Early investigators regarded hypnosis as a
form of artificially induced sleep, as noted in earlier definitions, and the
emphasis on a physiological state still remains a widespread tendency
amongst some theorists of hypnosis. Pavlov, for example, claimed that
hypnosis, like sleep, involves a spread of cortical inhibition (Moss, 1965).
Kubie and Margolin (1944) speak of hypnosis as resulting from the
creation of a focus of central excitation with surrounding areas of
inhibition. Moss (1965) found from research that "hypnosis limits
conduction at synaptic nerve junctures by altering biochemical substances
in the neural system, shifts nervous energy from the central nervous
system to the vasomotor system, or results in an inhibition of the ganglion
cells of the brain" (p.4S).
b) Psychological theories
On the psychological side, the importance of transference phenomena'and
attitudes related to hypnosis, therapist and self' is acknowledged in
response to hypnotic behaviour. Kubie and Margolin (1944) emphasise
that a constellation of conscious and unconscious attitudes arise between
16
the hypnotist and the subject. White (in Zahourek, 1990), maintains that
'Hypnotic behaviour is meaningful, goal-directed striving, its most general
goal being to behave like a hypnotised person as this is continuously
defined by the operator and understood by the subject' (p.483). This
statement can be compared with the non- state theories, and role-playing
theories. I·
Sarbin extends White's hypothesis (in Zahourek, 1990), concentrating on
the more social-psychological phenomenon of hypnosis. Specifically, he
"conceives of hypnosis as a form of more general behaviour known as role
playing-the subject strives to take the role of the hypnotised person"
(Moss, 1965, p.4l). As Sarbin (in Zahourek, 1990) states, if the subject
has an adequate perception of the role, and if his perception is not
incongruent with his self-perception, then he has an appropriate amount of
role taking aptitude, and will therefore produce all the dramatic
phenomena of hypnosis merely because lithe operator talks to him"
(p.268-269).
The psychological theories, and the non-state theories began the so-called
contextualist movement (Lifschitz & Fourie 1990) which sees the context
as the most important factor in any outcome of behaviour. This recent shift
in psychological theory, has brought about a new development in the
theory of hypnosis, namely the ecosystemic approach, which will now be
discussed in terms of theory of hypnosis.
2.2.2.3 The linear and ecosystemic approach
Due to the development of ecosystemic theories, one can now divide
hypnosis into two distinct theories, namely the linear approach, and the
ecosystemic approach. A short summary will follow on the differences'.
between these developments according to Fourie (1991):
17
• the linear approach is based on an epistemology that sees the
individual as the site of hypnosis,
• in the linear approach hypnosis is seen as something that happens
with (or within) an individual,
• not only does the focus seem to be on the subject/client as the site
of hypnosis, but also as the site of any psychopathology, I
• there is a sustained focus on the individual,
• a subject is viewed as the locus of hypnosis,
• the client is viewed as the locus of psychopathology,
• the hypnotist is seen as inducing by means of certain techniques,
• onlookers (if any) are seen as playing no significant role,
• symptomatic behaviour is induced in the client and the client by the
family,
• . the therapist induces hypnosis in the client and the client utilises
internal resources made available by means of the hypnosis,
• there is a focus on intrapsychic occurrences,
• there is a postulated existence of an 'unconscious' mind and a
related dichotomy between this mind and the 'conscious' mind,
• there is the hypothesis that there are untapped resources inside the
individual which could be utilised in various ways,
• hypnosis is used to bypass the 'conscious' mind in order to access
these 'unconscious' resources,
• there is a focus on linear causality,
• it is clear that in hypnosis there is an implicit agreement that
hypnosis is caused, in a more or less direct or linear way, by
something or somebody,
• there is a focus on objectivity of observation,
• and finally, the hypnotherapists act as if they are objective
observers of the subject.
18"
The ecosystemic approach (Fourie, 1991), on the other hand, revolves
around the following ideas:
•
••
•••
•
•
•
•
the realisation that no single specific perspective can be the only
valid view of hypnosis,
there is no monopoly on the 'truth' about hypnosis, I·
all observations are coloured by the epistemology of the observer
and by the way of observing,
there is no absolute 'truth',
this is a rejection of the Newtonian idea of objectivity of observation,
hypnosis is not an entity, such as a state of consciousness or of
internal focus, but a concept used by an observer to describe
particular classes of behaviour in particular classes of situations,
. hypnotic behaviours are ordinary behaviours which are mutually
and recursively qualified as 'hypnotic' by everybody present in the
particular situation,
the process of mutual qualification depends on the socio-cultural
definition of the situation,
this qualification process is so potent that subjects can experience
the phenomena of so-called 'deep' hypnosis, such as hallucinations
or amnesia. Even physiological changes like vasodilation, changes
in body temperature, change of the heart rate, etceteras, can occur,
the process of mutual qualification is an ongoing one with each 'bit'
of behaviour either qualifying or disqualifying preceding and/or
subsequent 'bits' of behaviour of that same person and/or of other
people present in the situation. (Fourie, 1991)
Therefore, it becomes evident that in an effort to formulate a satisfactory
definition of hypnosis, no reliable objective criteria can be developed
which will unequivocally identify the hypnotic state. This is true in regard to
physiological and psychological criteria. In the absence of the reliable
objectivity of criteria, one can only describe hypnosis in terms of the
19
subjective events which the hypnotised individual experiences, and the
hypnotherapist 'observes' (Orne, 1961).
As can be seen, hypnosis has had a long historical development, with.-
many different theories and approaches. Perhaps by lncorporalinq all
these theories and definitions, as well as by comparing different
approaches, one may achieve a global understanding of what hypnosis
means in Western psychology. It is evident, however, that whether a
specific "truth" of hypnotic observation and description in theory exists, is
irrelevant. What is relevant, and important in the process of
psychotherapy, is that hypnosis does exist for those that make use of it,
whether it be the patient or therapist.
20
2.3. THE PROCESS OF HYPNOSIS
In psychology, any therapeutic situation involves a process, involving both
the therapist and the patient. In hypnotherapy the therapist makes use of
certain induction procedures to induce a so-called hypnotic state in the
patient. Within the context of Western hypnotherapy the followinq
procedures are associated with the induction process:
1. The therapist defines the situation as hypnosis for himself or
herself, and for the patient
2. The therapist removes any fears and misconceptions the patient
may have, by educating the patient in hypnosis
3. The therapist secures the patients co-operation before proceeding
4. The subject is asked to keep his or her eyes closed
5. Relaxation, sleep, and hypnosis is suggested by the therapist
6. The therapist elaborates and varies the wording and tone of
suggestions
7. Suggestions are coupled with actual events
8. The therapist tries to prevent the subject's failure to pass
suggestions by reinterpretation (Barder, Spanos & Chaves,
1974).
Hypnosis is a process which has many applications. Some of these clinical
applications of therapeutic hypnosis are in connection with its use in the
following areas:
1. Differential diagnosis
2. Uncovering repressed material (hypnoanalysis)
3. Behavioural modification
4. Symptom alleviation, removal or displacement '.
5. Treatment of phobias (sexual and social anxiety,
hypnodesensitization)
21
6. Motivational stimulation
• Toward social participation
• To increase participation in the treatment programme, i.e.. adhering to
dietary and/or exercise regimes, etc.
• To aid patients who are suffering physical disabilities, to exercise limbs,
etc.I·
• To increase personal effectiveness in study or work situation
7. . To relieve pain
• Headaches
• In particular, all forms of psychogenic pain
• In anaesthesia
• Obstetrics
• Dentistry
•. Minor surgery
8. To alleviate anxiety
• Preoperative anxiety
• Interpersonal anxiety (overcoming anxiety, e.g.,
related to participating and communicating in
groups)
• School or work anxieties. (Miller, 1979)
More specifically, in the context of Western science, Olivier (1993) finds
that hypnosis is utilised:
a) In psychology, for the treatment of psychological problems such as
phobias, sexual disorder with a psychogenic origin, personality
disorders, anxiety disorders, the dissociative disorders, depression,
post-traumatic stress disorders and marital problems. In the
treatment of children, hypnosis is often used for exam anxiety,
enuresis, encopreses, sexual and physical abuse and post-
traumatic stress disorders. :.
22
b) In medicine, for the treatment of medical problems such as pain
analgesia and anaesthesia, to counteract the side-effects of chemo
therapy, to expedite the healing process, infertility and to lessen the
shock impact of major surgery. Operations have also been
performed using hypnosis alone such as caesarean section and
hysterectomy.
c) In sport psychology and training for the enhancement of sport
performance.
d) In dentistry, to help the patient relax and to alleviate pain and
stress. In dentistry hypnosis is also used to prevent excessive
bleeding and to expedite the healing process.
However, regardless of the process of hypnosis, it is well known that
contextual factors can influence physiological and psychological
functioning, both of which are involved in the process of hypnosis. Fourie
(1991) uses the example of the changes occurring in panic situations to
describe this idea, because both the physiological symptoms and the
psychological symptoms are influenced by context. He describes the
psychological and physiological changes that occur in a panic reaction to
illustrate how a specific context can influence functioning. The influence of
context in hypnosis in Western psychology will therefore be discussed in
more detail in the next section.
23
2.4. HYPNOSIS IN A WESTERN CONTEXT
The concept of hypnosis and the context in which it occurs does carry
certain connotations which influence the patient's interpretation of the
situation. Expectations can also be built by positive or neqatlve
suggestions from the environment concerning this context. The context of
hypnotherapy was recognised as an explanation for hypnosis by Sarbin (in
Hilgard & Lebaron, 1984), in his formulation of the role-theory. He
regarded hypnotic subjects as enacting the role expected of a hypnotised
subject. He states that:
Hypnotic behaviour is a form of social response and, as
such, is inevitably conditioned by the experiences of early
childhood within the context of home and family, community,
and school. In the development of all personal-social
behaviour, however, both hereditary and environmental
influences are at work. (Hilgard & Lebaron, 1984, p.202)
Context, therefore can be seen as playing a vital role in the success or
failure of the hypnotherapy. The hypnotherapist can therefore define the
context of hypnosis, for the patient, as a setting where safe, innocuous
methods of relieving anxiety, pain and tensions are provided (Miller, 1979).
Zahourek (1990) states that the two most important ingredients for
hypnosis is firstly, establishing the context of the therapist as the helper
and thereby enlisting the client's co-operation, and secondly by simply
getting and maintaining the client's attention. Furthermore, by "explaining
the meaning of certain organic symptoms, dispelling any misconceptions
or fears, and communicating expectations of positive results" (Zahourek,
1990, p.12), therefore providing this 'safe' context.
24
Although in the procedure of hypnosis, the therapist does make use of
many different techniques, these are not essential features of induction,
depending on the context of the therapy. It has also long been recognised
that hypnosis occurs within a complex network of relationships (Fourie,
1991), and the context of hypnotherapy can therefore be interpreted in
many different ways, depending on the expectations and attitudes of both
the therapist and the client. For example:
'Hypnosis' still carries the connotation of magic, loss of
control, and being influenced by another or being put' under
a spell'. Some respond positively to the feelings of 'magic'
and 'mystery', as if something special and powerful is about
to be done to them. If'suggestive techniques' are mentioned,
the patient may interpret the word 'suggestion' to mean their
symptoms are all of a psychogenic nature and purposely
experienced for secondary gain. The power of 'imagination'
is usually acceptable and carries with it the connotation of
something fun, like a game. (Zahourek, 1990, p.5)
The context of hypnosis can therefore be seen as a situation where there
is a hypnotist, who is seen in the role of the facilitator and helper, and the
subject, who is seen as receiving this help. It is usually defined as a 'safe'
context, were the patient can feel relaxed and at ease, and it is the
responsibility of the hypnotist to create this context. This however, can be
described as a linear approach to the description and theory of the
concept of hypnosis.
lifschitz and Fourie (1990), on the other hand, take a different approach to
the problem of context, namely the ecosystemic one, where the subject's
hypnotic performance is defined according to a description of a fit of ideas
between all the participants in the hypnotic system. The behaviour
included in a definition of hypnotic responsiveness is therefore not
explainable. as arising solely from within the subject's psyche, nor
25
explainable as being the result of specified situational variables. It would
be more appropriate to describe behaviour as indicating hypnotic
responsiveness, "at the place where the hypnotist, subject and audience
interface" (lifschitz & Fourie, 1990, p.30).
Within this frame of reference, the participating members within:' this
context of hypnosis add a new dimension to the context, in that they co
evolve patterns of relationships as well as an ecology of ideas around their
notions of hypnosis, in other words, their participation and attitudes
towards hypnosis will change the context in any given situation (Lifschitz &
Fourie, 1990). In the ecosystemic approach to hypnosis then, the context
of hypnosis can be summarised as the following. The hypnotist cannot
consider himself or herself to be hypnotising a subject, but rather to be
experimenting for the best concept of behaviour that will define the
subject's behaviour as hypnotic. The hypnotist's behaviour is viewed as
reciprocally connected with those of the subject, including any others who
are part of the subject's hypnotic experience: What the therapist, client
and other participants are responding to, therefore, is the feedback in the
system (lifschitz & Fourie, 1990). "The hypnotist, subject and any other
participant in the context are connected through the socio-feedback in the
system as they all co-operatively co-evolve and maintain a reality called
hypnosis" (lifschitz & Fourie, 1990, p.37).
Western hypnosis can be approached from many theoretical avenues,
because of its complicated nature. Both in its history, nature, application,
process, and context, Western hypnosis can be defined according to many
different sets of ideas. For this reason it should at present only be
compared in its' application, and not its' theory, as will become evident in
the comparison between Western hypnosis and African trance.
26
(CHAPTER 3 J'3. THE AFRICAN APPROACH TO HYPNOSIS·
I·
3.1 INTRODUCTION
It has often been noted that African views of healing are vastly different
from those of modern Western medicine, and unfortunately as Hull, (1933)
states:
All sciences alike have descended from magic and
superstition, but none has been so slow as hypnosis in
shaking off the evil associations of its origin. (in
Marcuse, 1959)
But, despite acculturation and increasing acceptance of modern Western
medicine, African healing practices are still widely held, particularly in
rural settings (Edwards, Grobbelaar, Makunga, Sibaya, Nene, Kunene, &
Magwaza, 1983). There is therefore increasing recognition by modern
Western trained mental health professionals to investigate African healing
practices, in an attempt to improve their diagnoses and treatment of Black
psychiatric patients.
It is also known that culturally relevant information should shape
suggestion in hypnosis (Buhrmann, 1977), for it to be relevant and
understood by the subject, and it is therefore important have some
knowledge of the traditional background and of the language, which, in
African healing practices, is very rich in symbolism and has many
subtleties which are usually completely lost in tile usual interpretation at
consultation (Buhrmann, 1977).
27
Culture, customs, beliefs, philosophy of life, and views on illness and
health, playa vital role in African medicine, (as in all medicine) and these
concepts therefore play an important role in the use of hypnosis and
hypnotic trance. As Edwards et aI., (1983) states: "This is particularlyt-
understandable owing to the individual and social homeostatic effects of
these beliefs and practices over the generations" (p.214). In addition, in
African culture, the philosophy of causality of illness is bound up in their
interpretation of African ways of viewing health and disease, and the use
of hypnosis is interpreted in this specific context, which will be discussed
later.
In this context, Buhrmann (1977) states that to assess the insight and
judgement of the African patient, the Western world will have to "accept
that their psychic world is different from ours in many respects, and we
must drop our preconceived ideas about 'normality', 'superstition', 'false
beliefs' and other Western concepts, and make every effort to enter their
world" (p.466). The historical' development, nature, and context of the
trance state in African healing will now be discussed.
~ .
28
3.2. THE HISTORICAL DEVELOPMENT OF AFRICAN
HEALING PRACTICES
Although there is evidence of a long history of hypnosis in African healing
practices, (Olivier, 1993) very little of this can be found in theoretical
literature. Reyler (1969) states that the induction of trances has been
known from time immemorial as part of the mythical and occult practices of
the shaman, medicine man, and witch doctor, but more information than
this is difficult to obtain prior to the 1960's. As Olivier (1993) states,
although African healing is as "old as Africa itself' (p.6), it was "only in the
1960's that researchers started doing research on traditional African
practice of medicine" (p.6).
Furthermore, as Olivier (1993) states, the problem with regard to
knowledge of hypnotic phenomenon utilised in African medicine is the fact
that in the past Western medical practitioners tended to reject African
medicine "because of a lack of knowledge and the belief that it should be
rejected because of ancestral spirit worship" (p. 7). Olivier (1993) gives an
example of this through the writing of Wright (1974) who states that ...·it is
largely because he (the witch doctor) is so obviously controlled by outside
forces that the witch doctor's authority comes to be accepted' (p. 208). The
'outside forces' which he refers to is the ancestors. Also the term 'witch
doctor' was a phrase which was, used by Western researchers in which
they wanted to indicate unnatural negative influences (Olivier, 1993).
Through a detailed historical investigation, however, one finds that the use
of trance in African medicine, seems to have the same origin as hypnosis
in Western psychology, namely through the Egyptian influence. The son of'.
the first King of Egypt, Menes, practised these techniques as far back as
3200 Be (Sana, 1993). The ancient Egyptians made use of rhythmic
chanting and drumming, in their healing practises, which resulted in
strange physiological and psychological features, which are often
29
associated with trance (Zahourek, 1990). These practises are very similar
to the healing rituals which are used in African healing practises today.
These will be described in the following section, where the nature of
trance in African healing will be described. The phenomenon of an altered
state of consciousness was first described by Van der Hooft in 1979 during
the rituals of the Molopo cult members, and later observed by Olivier
(1987), and was found to resemble the hypnotic trance as known by
Western hypnotherapists.
30
3.3. THE NATURE OF TRANCE IN AFRICAN HEALING
Van der Hooft (1979), Boersema (1984) and Olivier (1987) have
investigated and observed the nature of the trance state in African h~aling
procedures (in Olivier, 1993). They find that the following phenomenon
occur in the trance state during the African healing rituals:
• During the trance state a spontaneous reduction in body
temperature occurs. A reduction in the body surface
temperature, specifically was found. Although the persons
concerned had danced for hours and were sweating profusely,
their hands were often cold and their bodies cool.
• A spontaneous development of the trance state due to the beating of
the drums and the monotonous chanting of the people attending the
ritual occurs.
• During the trance state catalepsy occurs. Catalepsy occurred in the
group of dingaka and mediums in a trance.
• During the trance state dilation of the pupils and rapid eye movement
occurs. Dilation of pupils and rapid eye movement were present at
the onset of the hypnotic trance.
• Complete amnesia and other memory alterations for the occurrences
during the trance state occurs. The dingaka and mediums suffered
from complete amnesia regarding all trance events (Olivier, 1993).
Olivier (1987) also finds from the literature that ritual dancing forms an
intrinsic part of the therapeutic procedure of most traditional African
healers. The healers also reported that they could not recall the events
they experienced while in a trance, and that they lost their sense of time,
but as Olivier (1987) states, "it should be borne on mind that the passage
of time is traditionally less important in Africa" (p.181). Olivier (1987) also
finds that:
31
The altered state of consciousness that occurs while they
(the healers) are dancing have the same external signs as
" those known to occur during the hypnotic trance. In many
cases the trance is induced by the beating of drums, the
music, the rhythmic singing of the participants and by the use
of marijuana or cannabis. (p.174)
r-
It must be noted, however, that it is often the healer who enters the trance
state, and not necessarily the patient. This is for the purpose of making
contact with the 'ancestral spirits' who are often seen as the causal factor
in many complaints of the patient. This will be described in the following
section. When the patient himself or herself enters the trance state, it is for
self-healing purposes, and the opportunity to enter the trance state is
provided by the traditional African healer (Olivier, 1993).
32
3.4. HYPNOSIS IN AN AFRICAN CONTEXT
In African healing practises, the consultation is between the healer,
patient, family, and often their whole community is involved on some level.
It has been found that in group situations, which is the context in which
African healing occurs, the subjects react more in accordance with the
traditional patterns and norms, than in other situations (Coetzer, 1977).
Likewise, if a context is "punctuated as one of spiritual healing, pathology
or ancestral influence, behaviours and so-called phenomena or symptoms
of the expected order would be discerned by the participants" (Lifschitz &
Fourie, 1990, p.29). For this reason, the context in which healing occurs,
and the classification of illness and health in African medicine must be
described.
Ngubane (1977) finds that traditional assessment and treatment of illness
amongst traditionally orientated patients is usually by one or more of three
broad categories of practitioners; the traditional diviner, doctor, or faith
healer. The faith healer can be seen as an outgrowth of the influence of
urbanisation, acculturation, Christianity, and the African independent
church movement, and it has been argued that many of the traditional
roles of the traditional diviner have been assumed by the faith healer
(Ngubane, 1977). "It should, however, be mentioned that there are a
variety of additional treatment options (other than modern Western
medicine), such as patent medicine stores, muthi-shops (shops selling
traditional Zulu medicines). and homeopaths, especially for urban people"
(Ngubane, 1977, p.214).
Olivier (1993) finds that the trance state during the' traditional African
healing ritual is utilised for:
(a) A self-healing process to lake place within Ihe individual
during Ihe time Ihe individual is in a trance stale.
33
(b) For the students of the power doctor, sangoma or healer
to experience the possession of the ancestral spirits under
the guidance of the power doctor or healer. When the power
doctor, sangoma or healer experiences the trance state he or
she can also communicate with the ancestral spirits and
receive guidance from them in dreams at night following the
awakening from the trance state. (p.13)
Murdock, Wilson, and Frederick (1980), have developed a comprehensive
classification of theories of illness different traditional societies throughout
the world, and make a distinction between theories of natural and
supernatural causation. They refer to the explanation of illness by natural
causation, (this category is recognised by modern medical science with itst
empirical traditions, for example, as in the case of infection, stress, organic
deterioration, epilepsy, asthma and accident) by supernatural causation,
which literally refers any disorder that can't be explained by natural means
(Murdock et aI., 1980).
Ngubane (1977) finds that there are three major explanations of
supernatural causation of illness, namely animalistic, magical and
mystical, which can best be conceptualised as "three different traditionally
acceptable attributions made by the afflicted to explain the affliction"
(p.215). These theories are described below:
3.4.1. Animalistic theories
Animalistic theories ascribe the, disorder to the behaviour of some
personalised supernatural agent, such as a spirit or God. For example,
withdrawal of protection of the ancestral shades, mostly caused by
disharmony in the home; failure to perform necessary rituals, such as
sacrifices to the ancestral shades; failure to indllige in abstinence
behaviour during a period of mourning believed to result in a form of
compulsion neurosis; a 'creative illness' following the calling by the
34
ancestral shades to become a diviner, a religious conversion illness;
aggressive spirit possession occurring by chance (Ngubane, 1977).
3.4.2. Magical theories
Magical theories attribute the disorder to the covert action of a
malicious human being who employs magical means to injure his victim:
for example, spirit possession attributed to sorcery; poisoning attributed to
sorcery; genito-urinary disorders attributed to sorcery; disorder attributed
to stepping over a harmful concoction of a sorcerer; crying attacks
attributed to sorcery of love potions; anxiety attributed to sorcery aimed at
lowering the defences; bodily pains attributed to sorcery; witchcraft
through a familiar, the supernatural agent of a witch (Ngubane, 1977).
3.4.3. Mystical theories
Mystical theories explain disorders in terms of an automatic consequence
to some act or experience of the afflicted person: for example,
experiencing illness or adversity because of contact with places of people
immediately associated with major life events, such as birth, death, and
menstruation; a dangerous track, or ecological health hazard such as
lightning (Ngubane, 1977).
While the focus of Ngubanes' paper is on Zulu-speaking people,
"variations of these theories are common to most traditionally orientated
African theories" (Ngubane, 1977, p.215). So, one can generally say that
everything animate and inanimate-words, thoughts and dreams, is
believed to be charged with some kind of power or vital force (Buhrmanri,
1977).
35
It is evident, therefore, that there is no sharp distinction between the
various specialisation's in the traditional health delivery system because of
the nature of the African healing philosophy, which does not always
distinguish illness according to various physiological criteria as in the.'
Western systems. The role of hypnosis in African healing will not be
understood until we have a clearer framework for the nature of the healing
process in general. Despite this limitation, one can still formulate
hypotheses regarding this procedure, as in Western hypnotherapy. So,
although the context of African healing, and in particular, the trance state,
do seem to be vastly different from Western approaches to hypnosis, one
can, through careful investigation, find many similarities in these two
approaches. The following chapter will deal with these similarities and
differences.
36
( CHAPTER 4J4. COMPARING THE WESTERN AND AFRICAN
I·
APPROACHES TO HYPNOSIS AND TRANCE STATES
In an analyses of data on Western hypnosis and the African trance state, it
is necessary to discuss the similarities and differences of all the elements
of these concepts in detail. However, due to the complexity of the theory of
hypnosis, only the characteristics of these phenomena, and related issues
will be compared. Differences and similarities between the hypnotic trance
in hypnotherapy and the trance state during African healing rituals are
compared according to the characteristics of the trance states and the
context in which they occur.
According to Olivier (1993) it seems clear that the similarities between the
characteristics of hypnotic trance during hypnotherapy and the trance state
in African healing rituals are:
(a) Catalepsy.
(b) Dilation of the pupils and rapid eye movement.
(c) Reduction in body temperature.
(d) The induction into the trance is self-induced or induced
by means of music or in the case of hypnotherapy by the
therapist (p.10).
Olivier (1993) could not, however, find clarification on whether there is a
similarity in the experience of dissociation in both Western and African
trance states, as it is "still unclear if in the france state during traditional
African healing rituals the individual who enters the trance state
experiences dissociation, as the person after emerging from the trance
state has complete memory loss" (p.10).
37
The differences between the characteristics of the hypnotic trance state
during hypnotherapy and the trance state in African healing rituals are:
(a) From the Western perspective, while in hypnotherapy, the
patient seldom experiences memory loss of the events that
occurred during the hypnotherapeutic session, unless the
. patient is given suggestions to the contrary. The trance state
during African healing rituals is followed by complete
memory loss.
(b) During the trance state in African healing rituals the
individual power doctor or healer does not talk to the person
or actively work with the person. The individual deals with his
own internal processes on his own.. In hypnotherapy, the
hypnotherapist actively works with the patient by means of
different hypnotherapeutic techniques and procedures. Direct
and indirect suggestions are often made by the therapist
during hypnotherapy.
(c) There is no research evidence to substantiate the fact
that regression occurs during the trance state while the
individual participates in the African healing ritual while
enough research evidence exists of the phenomenon of
regression in hypnotherapy in the Western context. The
individual participating in the African healing ritual, however,
has no memory recall of a regression experience due to total
memory loss (Olivier, 1993).
In an analyses of cross-cultural data on trance state induction procedures
and characteristics, Winkelman (1986) presents a model of a single type
of trance state associated with magico-religious practitioners, (or
traditional African healers for that matter), and shows it to be significantly
better than a model representing trance states as discrete types,
supporting the theoretical position that there is .a common set of
psychophysiological changes underlying a variety of trance induction
38
techniques, as also found by Olivier (1993). In this context, Winkelman
(1986) states that differences do exist among practitioners with respect to
trance state because there is a difference between deliberately induced,
trance states, i.e. hypnotic induction, and those resulting from
psychophysiological predisposition's toward entering trance states, as
found in African trance induction, in that the so-called African trances are
significantly associated with symptoms of temporal lobe discharge. I,
Olivier (1993), finds that the most important difference between the
hypnotic trance in Western hypnotherapy and the trance state in African
healing is the fact that "hypnotherapists actively treat patients while in the
hypnotic trance while power doctors, sangomas or healers in traditional
African healing rituals gives the individual the opportunity to utilise the
natural phenomenon of the trance state for self-healing purposes" (p.13).
However, one could argue that the patient in hypnotherapy also utilises
the hypnotic state for 'self-healing' purposes. In Western psychology,
consultation is also usually more on a one-to-one basis 'between the
psychologist and his or her client. In African healing, the consultation is
between the patient, his or her family, and often the community.
Psychological treatment or healing in both the Western and African setting
depends also largely on the prestige of the therapist, which tends to
enhance reassurance and suggestion in both contexts (Cox, 1986).
The context in which hypnosis occurs in a traditional African healing
setting, or in a Western hypnotherapy setting, designates a context
imposing a certain order on the events which will be followed (lifschitz &
Fourie, 1990). Thus, if a hypnosis context, or an African trance context, is
distinguished, a situation will be created in which the participants would
come to expect and discern appropriate behaviour, whatever that context
may be, Le. the African context, or the Western context. As lifschilz and
Fourie (1990) stale, there are points of correspondence between the'.
participants' conceptions of hypnotic behaviours within any different
context. Each person's conception can also be expected to be
39
idiosyncratic in some way. For example, "when the subject is declared to
be in a 'deep trance' a correspondence of ideas would be found as
reflected by the consensus of opinion expressed and the reactions of all
concerned" (lifschitz & Fourie, 1990, p.30 ).
Probably the most important factor in these two approaches is that they
are often of benefit to the patient, in a healing context, which can be seen
as. an important common factor, and ultimately, the occurrence or non
occurrence of hypnosis is conceptualised by the patient, Le. if a context is
defined as a healing setting in which hypnosis occurs, the effect of the
context on the patient may be greater than the hypnotic communication
itself. The so- called 'healing' process is therefore an interaction between
the patient, the therapist or healer, and the environment, and this
interaction is common to both the African and Western systems. The
patient or family goes to the therapist or healer with some kind of
expectation. The patient mayor may not develop faith and confidence in
the therapist or healer. With these factors, the healing process may be
affected in a number of ways, be they seen as negative or positive. The
therapist or healer is seen as having knowledge and expertise in their
specific field, and is often held with respect and status in that system.
There are great similarities between the traditional healer and the modern
therapist as regards there factors (Cox, 1986). One could therefore say
that the context of hypnosis has a greater effect on the patients'
experience of hypnosis and the hypnotic relationship, than on objective
responding to suggestions, but as Lynn, Weekes, Matyi, and Neufeld
(1988) state:.
It is important to replicate .and extend these findings by
contrasting the effects of traditional hypnotic suggestions
with the effects of diverse types of indirect suggestions,
including metaphors and binds. (p.300)
40
In both the Western context and the African healing context, hypnotic and
trance behaviour can be usefully understood to be embedded in a context
which provides their meaning. Each change in the subject's hypnotic and
trance state provides meaning to all the participants. The subjects will
respond according to the meaning this bit of behaviour has for them, and
in . so doing reciprocally provide meaning to the subject's ongoing:.
performance. In this way the therapist, healer and all other the participants
will provide and derive meanings from each other's behaviour, including
from those which are included into the definition of hypnotic and trance
state responsiveness (Lifschitz & Fourie, 1990).
The patient and the hypnotist, or African healer and participants, therefore
have ideas about hypnosis and trance and partake in the process of
qualification of these phenomena, not only through what they do, but in
how they do it (Fourie, 1991), and how they perceive and describe the
situation.
Since psychology and African healing are based on the concept of health,
and also on the view of the position of the participants within this, the
differences in these areas seem insignificant. The history of man suggests
that all mankind started with similar concepts of health, and to the position
of the individual in those different contexts. The differences that have
developed over the years are due to climatic, geographical, environmental
and sociological factors.
41
( CHAPTER 5J5. DISCUSSION
As previously stated, in both the Western context of hypnosis and;.
hypnotherapy, and the African healing context, hypnosis and trance
behaviour can be usefully understood to be embedded in a context which
provides their meaning. The similarities and differences between the
African healing trance induction process and the Western context of
hypnotherapy can be seen in terms of the ecosystemic theories, where the
content and characteristics of hypnosis in these two spheres are not seen
as important as is the context and process of these phenomenon. As
Lifschilz and Fourie state: "Behaviour called 'hypnotic', like all other
behaviour, has a fit with a context and therefore is likely to co-vary with a
context declared to be changed" (p.32). In other words, although there are
obvious similarities and differences between Western hypnosis and
African trance, the theory of 'response' remains the same.
This can describe the different behaviour of both the hypnotist and the
subject, in two different settings, which can both be described as hypnosis.
In Maturana's (1975) terms (in Fourie, 1991) a domain of consensus co
operatively evolves between all participants regarding the meaning of the
situation and the meaning of particular behaviours of those involved. In
this context, this epistemology can be summarised as follows:
- Hypnosis and the trance state is therefore not caused by the hypnotist or
the African healer. Neither the hypnotist, healer, nor the subject causes
the subject's behaviour to be qualified as hypnotic.
- The hypnotist/African healer merely plays an executive role as is
expected of him/her in a situation designated ashypnosis, or African
trance. He/she structures the situation so that the subject is in focus,
42
because such a structure fits with people's expectations of a hypnotic or
trance situation.
- The higher in status the hypnotist or African healer is perceived to be, the
more weight other participants are likely to attach to his/her o[pinions in
the qualification process. :.
- In the same vein an hypnotic or trance state induction process also does
not cause hypnosis. or trance. It merely serves as a vehicle for the
qualification process and punctuates the flow of events, in an expected
fashion for Western or African contexts, to indicate that subject's
behaviours subsequent to that point in time could be seen and responded
to as hypnotic.
- Techniques are part of the process of qualification and provide ideas to
all the participants in both the Western and African healing context, to
which everybody call react in ways which fit, both with the individual
participant and with the domain of consensus as it exists at the particular
time.
- The task of therapy (but not of the therapist/healer alone) would therefore
be to confirm the individual(s) involved. Therapy and 'healing' should
therefore provide the subject with a source of ideas which are new to
them, but not so different that they cannot understand them. (Fourie, 1991)
This epistemology of hypnotic theory is in contrast with the traditional
theoretical position that hypnosis is an internal, altered state of
consciousness determined by the subject and the hypnotist. As lifschitz
and Fourie (1990) state, the "view expressed here proposes that the
qualification of particular behaviours as hypnotic (or otherwise) would
depend on the fit these behaviours have within the particular context they
occur" (p.31 ).
"
From this perspective, the expected characteristics of hypnosis in Western
hypnotherapy and traditional African trance states, and the differences in
induction and content, for example, 'depth', 'resistance', 'involuntariness'
of hypnotic behaviours, and change or stability, are not absolute realities
43
(Ufschitz & Fourie, 1990), but rather culturally shaped experiences which
people come to expect. This is confirmed by the ecosystemic viewpoint
that hypnosis and trance or African healing is founded on a cultural
consensus and finds expression in the use, by the hypnotist and ~frican
healer, of the depth and involuntary concepts, as well as in the subsequent
experiences and reports by the subject (Lifschitz &Fourie, 1990).
It is therefore vitally important that the hypnotist in any different context,
continually examine the effect of his or her intervention within the specific
context that they are placed, to discover the most appropriate approach
within the context that they find themselves. As Lifschitz and Fourie (1990)
find, in contradiction to previous statements, even Erickson's work reflects
this approach in that he:
...tinkered for the best fit between himself and the subject's
way of thinking and categorising reality. He tailored each of
his interventions to fit the particular client with whom he was
working at the time. In so far as Erickson attempted to
connect the hypnotist and the subject through an ecology of
ideas, his approach can be said to have been ecosystemic.
(p.36)
Prest and Keller (1993) have usefully employed this attitude, and find that
the beliefs, myths, and metaphors of traditional and non-traditional
spirituality, for example, may be successfully used in therapy to
accomplish a number of goals. They find that the ecosystemic focus which
encourages an awareness of different levels of systemic interaction rarely
encourages the therapist to explore the spiritual dimension of the clients'
life, and find that by doing so one may enrich the understanding of the
metaphors and meanings which inform their existence and perhaps, their
problems. As Prest and Keller (1993) state that previously there was an
attitude amongst researchers that subjective constructs (e.g., spiritual
power, psychic energy, and divine intervention) are harder to observe and
44
measure. As a result it has been easy for professionals to move to the
logical inference that alternative mediums of therapy, whether traditional or
non-jradlnonal, has no place in the therapy setting, a setting the very"credibility of which is based on the scientific method.
The subject in the Western context of hypnotherapy and the African trance
context has beliefs which shape, and are shaped by thoughts and cultural
language, and these beliefs are reciprocally influenced by and related to
different constructions of reality. The therapeutic system, therefore, may
need to "expand or reframe the belief system of the client in order to
achieve the therapeutic changes desired by the client" (Prest & Keller,
1993, p.140). In other words, the task of the therapist or African healer is
to help the client see new possibilities within his/her belief system and thus
achieve the flexibility needed to change how the subject views his/her.problem (Prest & Keller, 1993). Therefore it could be possible for a
therapist to enter many varying contexts, and still maintain an effective
process, if the therapist remains flexible, and open to a new shared reality,
Le. a consensual domain. It should also be noted that, until recently, most
African communities have access to the African healing system, but not to
Western psychology. So the prospect of a "greater convergence of clinical
and experimental methodologies should yield rewards to the clinician and
researcher alike" (Lynn et aI., 1988, p.300), and the fact that different
cultures can be defined as similar through 'behaviour in context' and
symbolic meaning systems, could lead to a new dominant perspective in
psychology (Rohner, 1984).
Although there are some who consider the relevance of ethnics and
culture as a smoke screen to frustrate the coming about of a unified, non
racial society (Bisheuvel, 1991), to provide a large South African
population with medical services on a unitary level might be impossible. As
Bisheuvel (1991) states:
45
A broadly ethnical obligation for action towards the fullest
possible realisation of human potentialities is implicit in the :'
demands for relevance, but how to reflect this in a definition
without infringing legitimate value differences poses a
problem. (p.133)
Since the findings point towards some compatibility of the two systems,
namely the traditional African and Western medical approach, "future
research on assessment and treatment methods of traditional
practitioners, in particular, is warranted, with a view towards establishing a
register of such practitioners as advocated in other developing countries"
(Edwards et aI., 1983, p.220). This research can also help to co-ordinate
and enhance medical services and health care systems, (Edwards et aI.,
1993).
Olivier (1993) also states that it is important that a hypnotherapist actively
working with a patient in the hypnotic trance have adequate training, and
that they only use hypnosis in the field of expertise in which they were
trained originally.
Furthermore, Edwards et aI., (1983) found that, "Concomitant with
increasing modernisation, there is increasing demand, by indigenous
African peoples for modern Western medicine in general and psychiatry in
particular" (p.213). But, as they also found, despite this increasing
acceptance and need for modern Western medicine, traditional Atrtcen
beliefs and practices are still widely followed. This means that there is an'.
increasing need for psychologists to take cultural factors into account in
the diagnosis and treatment of Black psychiatric patients. Edwards et. al.
(1983) also stated that:
While for many Black psychiatric patients, traditional beliefs
and practices are irrelevant with respect to both the patient
and treatment, the present findings emphasise the need for
46
the trans-cultural mental health professional especially to be
generally tuned to cultural factors for the facilitation and
assessment of treatment. (p.219)
I-
This is because "long-term effectiveness ... enhanced as a more culture
compatible frame of reference, which is developed in the treatment setting,
gains more support from the community to which the patient must
ultimately return" (Edwards, et. aI., 1983, p.220). Thereby, by researching
and understanding a technique already applied in traditional African
medicine, and also established in Western medicine, we can possibly
improve on cross-cultural psycho-therapeutic techniques.
-..47
( CHAPTER 6J6. CONCLUSION
The.present comparative study was limited by the fact that the nature of a;.
study for the partial fulfilment of this degree does not necessitate a broad
exhaustive discussion. This would be beyond the scope of the study.
Psychology is also not static, it changes according to fads, and with new
knowledge. For this reason the study did not intend to compare the
theories underlying Western hypnosis and traditional African trance.
Secondly the epistemology of the author cannot but describe from a
Western point of view, which might harm the understanding of possible
theories behind traditional medicine. For this reason, the observable was
described, that is, the practice of hypnosis in both Western and traditional
medicine. The author however wishes to state that in describing the
practices of traditional hypnosis, the interpretation of mostly Western
orientated researchers was used. The descriptions may thus be biased.
One cannot describe another person's epistemology but through one's
own eyes or epistemology. As Cox (1986) states, one cannot make the
same generalisations for Africa as one can make for the West. In any
multicultural setting, concensus is not easily attainable, especially where
the author may not share the same world view or explanatory model. The
comparison and the discussion may thus be insult or injustice to the way
the healer may see and describe the practice of trance and hypnosis.
This does not mean that this argument leaves the researcher without any
grounds to do the research. The present study is an attempt to come to' a
possible understanding of the processes at hand. All of these factors, and
more, have implications for psychology, if not in terms of treatment, but in
terms of recognition and tolerance in training. Since psychology is usually
48
based on some concept of mental health and illness, and also on the view
of the individual within this, the differences in these areas could also
further the difficulties, in that it determines further differences in
psychology. However, the history of man suggests that mankind all over
the world, started with similar concepts of the position of the individual;.
(Cox, 1986). It is against this background of differences and similarities
that Africa and the West can be examined.
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