Manhattan Society of Clinical Hypnosis

Hypnosis and Meditation: A Comparative Analysis
Presented by Karliese Greiner-Laurie, LCSW, CASAC at Manhattan Society of Clinical Hypnosis

Introduction
Our everyday mind is represented by ordinary consciousness, which is an active, semi-arbitrary construction whose shape and style is determined by personal history and the culture one is raised in. We try to control and edit our experience to enhance things we like and eliminate things we don't like. Human suffering is due to our tendency of clinging to thoughts, feelings, ingrained perceptions of reality and habitual ways of acting in the world.

What is "normal consciousness?"
The human mind operates via constant thinking that runs along familiar lines leading us to have familiar [habituated] emotions and actions. This process uses up most of our awareness capacity. It is additionally influenced by extroception, our sense organs and processes that keep us connected to the external environment, as well as introception, our sensing of body and internal processes. These account for a large amount of automatic processing before sensory perceptions reach consciousness.
  Changing our state of consciousness, or producing an altered state, occurs through interfering with stabilization processes either by a] disrupting forces to disrupt baseline, or b] patterning forces to shape desired new state.

Hypnosis and Meditation
Hypnosis and meditation* are multifaceted self-regulation techniques used to promote cognitive and behavioral change, problem solving, and acceptance of a wide array of emotions and thoughts. Hypnosis and mindfulness-based approaches can be used together to create new adaptive response sets and to deautomatize maladaptive ones.
  In general, both hypnosis and meditation** begin with attempts to relax and focused attention. Through this process of focusing and sustaining attention mental states are changed. Two experiments (cited in Holroyd, 2003, p.112), it was found that in deep self-hypnosis and meditation one experiences changes in state of awareness, self-awareness, time sense, changes in imagery vividness, and rationality. Both processes are accompanied by feelings joy and love. The experience tends to be more vivid at medium levels; more equanimity at deep levels for both therapeutic modalities.

Phenomenology
Similar phenomenological changes occur in hypnosis and meditation. Emotions: at mid-level, emotions are very intense, whereas at deep level one experiences mystical feelings of wonder. Experience of Self: as trance deepens there is a temporary loss of self-reflective executive monitoring of psychic' self, which likewise occurs in deep concentrative meditation states.
  Differences are exhibited in categories of body and mind/imagination. Body: Hypnosis medium level: one experiences radical changes in body sensation; deep level: out-of-body, disembodiment. Meditation medium level: body sensations are more intense and strange; at deep level: there is no pleasure and pain. Mind/imagination: Hypnosis mid-level: focus on imagination; deep level: free floating. In meditation there are greater distinctions: object >pleasure >stillness = mindfulness.

Neurophysiology
The neurophysiology of deep hypnosis and deep meditation is similar as exhibited by cortical inhibition, very slow EEG theta waves; which explains the absence of thoughts, emotions, body awareness and sense of self. There is an increase of blood flow in the frontal cortex and anterior cingulate cortex. Through the use of suggestions in hypnosis, the appropriate sensory and motor areas are activated.

Goals and Practice
The difference between hypnosis and meditation is contingent on goals and expectations, suggestion in hypnosis and mindfulness in meditation. Hypnosis patients expect cure in one session and seek symptom removal. Meditators expect to spend years through daily practice for 20 minutes to an hour, sometimes include intense meditation retreats with the long-term goals being spiritual liberation and enlightenment. Hypnosis is operationalized through two people [hetero-hypnosis] or one [self-hypnosis]. Meditation is a solitary endeavor.

Expectancy
People using hypnosis expect greater suggestibility, often entering an altered state. In meditation the expectation is to see reality without bias of prior conditioning or emotion. Meditators see how their perceptions change every moment, aren't reliable, that our sense of self is constructed from ephemeral experience, and our tendency to mentally "clutch" onto these constructs are what cause us suffering.

Suggestion and Suggestibility
The difference between hypnosis and meditation lies in their treatment of mental activity. Hypnosis directs attention to whatever is in the field of awareness and gradually shapes or moves attention inward [Ericksonian utilization technique]. In meditation mental activity = a moving target. Mindfulness is moment-to-moment awareness of the present experience with acceptance and nonjudgment. Thoughts are viewed as mental objects.
  In hypnotic trance, increased suggestibility is due to suspension of critical thoughts or fewer cognitive demands through the induction process. After induction it is typical for a person to have expectancy, therefore expect to be suggestible. Meditators do not expect suggestibility to develop.
  The effectiveness of mindfulness training can be enhanced through hypnotic and posthypnotic suggestions to encourage individuals to practice mindfulness on a regular basis; use of suggestion to overcome obstacles experienced in meditation [i.e., attention wandering, acceptance of what cannot be changed, detachment from feelings as they arise].

Response Sets Response sets are conditioned patterns of associations composed of expectancies, intentions, and cognitive-representations or constructions of the self. Hypnosis and mindfulness approaches are complementary in key respects. Mindfulness can deautomatize response sets and create space for the formation of new ones. Hypnosis is a viable method for creating positive response sets as well as deautomatizing dysfunctional response sets.
  The starting places for most work in clinical hypnosis, and creation of new response sets is acceptance. Mindfulness is commonly defined as acceptance of one's moment-to-moment present experience. Erickson claimed that the most effective aspect of any suggestion is that which stirs the listener's own associations and mental processing to automatic action. He pioneered the utilization approach which is the radical acceptance of the client's current reality and responses as a foundation to build new response sets by numerous strategies [i.e, reframing, paradoxical interventions, use of permissive and indirect suggestions].

Clinical Application
The goal of each clinical modality is to promote acceptance and minimize behavioral avoidance. Various clinical applications can include mindfulness-based techniques or hypnotic approaches such as behavioral rehearsal, i.e., imaging future events and coping with them during visualization, hypnotically controlled desensitization, cue-controlled relaxation to facilitate encountering a feared situation among others.
  Through hypnosis, patients are invited to listen receptively and nonjudgmentally to suggestions, and to let themselves become deeply absorbed in their internal experiences. In mindfulness meditation, patients are instructed to observe their flow of thoughts and emotions in an accepting, nonevaluative manner. Both modalities typically involve eye closure and sitting still. And both can reduce anxiety and autonomic arousal. It is important to note that relaxation is not imperative for a response to hypnotic suggestion, nor is it the purpose of mindfulness training.
  Differences: Self-hypnosis involves self-referential thinking, intense emotions and memory changes. Whereas meditation involves greater awareness of bodily processes, changes in time perception, and the sense that bodily processes slow down. A participant's attention [e.g. focused vs. "free floating"] and subjective responses to hypnosis and meditation will depend on specific suggestions and the instructional set used. For example, mindfulness vs. concentrative meditation focus is on a single thought, object, sound, or self- vs. hetero-hypnosis involves patient's willingness and ability to respond to perceived task demands.
Conclusion Both self-hypnosis and mindfulness skills are portable. Hypnotic suggestions can be constructed to build positive response sets that can be automatically activated in everyday life when maladaptive, habitual patterns might predominate. Mindfulness fosters awareness and acceptance of maladaptive response sets, along with a sense of detachment from problematic ways of thinking and feeling thereby enabling the discovery of more adaptive options in the moment.

* This includes both concentrative meditation, which emphasizes letting go of thoughts and perceptions, and insight [mindfulness] meditation, which emphasizes noticing thoughts, perceptions, and sensations.
** Note while relaxation is generally established in a majority of hypnotic inductions, it is not a requirement for hypnosis to be effective as evidenced by the successful use of waking hypnosis, for example, in enhancing athletic performance. Mindfulness meditation can be practiced and developed with eyes open while doing tasks [meditation in action: walking, standing, gardening].

References:
• Holroyd, J. (2003). The Science of Meditation and the State of Hypnosis. American Journal of Clinical Hypnosis, 46 (2), 109-128
• Tart, C.T. (2001). Meditation: Some Kind of (Self-)Hypnosis? A Deeper Look. Presented at the 109th Annual Convention of American Psychological Association at San Francisco, California, 1-35
• Lynn, S.J., Das, L.S., Hallquist, M. & Williams, J.C. (2006). Mindfulness and Hypnosis: Cognitive and Clinical Perspectives. International Journal of Clinical and Experimental Hypnosis, 54 (2), 143-166
• Mindfulness and Psychotherapy. 2005. The Guilford Press. New York, NY. Edited by Christopher K. Germer, Ronald D. Siegel, Paul R. Fulton.

About the presenter:
Karliese Greiner-Laurie, LCSW, CASAC, graduate of Yeshiva University:
Wurzweiler School of Social Work, is an alcoholism/substance abuse counselor, psychotherapist and Ericksonian hypnotherapist. She has worked in both harm-reduction and abstinence-based agencies; specializes in HIV/substance abuse, gay men's issues and sexual addiction.
  She maintains a private practice in Manhattan, which integrates the modalities of hypnosis, psychodynamic, and schema-focused cognitive behavioral therapies and mindfulness-based techniques.

Karliese Greiner-Laurie, LCSW, CASAC
Psychotherapist/Consultant
19 West 34th Street, Penthouse
New York, NY 10001
Tel: 212/947-7111 x332
Fax: 212/239-0948