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EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 1
An Evaluation of Hypnotherapy in the Creation of False Memories
To what extent does hypnotherapy used for repressed memory retrieval increase the
risk of the creation of false memories?
Subject: Extended Essay
Focus Area: Psychology
Word Count: 3,933
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 2
Table of Contents
Title Page………………………………………...…………………………..……..…………1
Abstract……………………………………………………………………..…………….……3
Introduction……………………………………………………………………………….…4-5
Hypnotherapy……………………………………………………………….………………5-7
False Memory Theory………………………………………………….…………………7-10
Evaluation……………………………………………………………………….….…….10-17
Conclusion…………………………………………………………….….………………17-18
References …………….………………………………………………….…….…….…19-24
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 3
Abstract
This paper is an evaluation of the repressed memory therapy technique
hypnotherapy. Hypnotherapy aims to help repressed memories resurface by creating a
relaxed state in the patient (Fredrickson, 1992, p. 148-152). However this therapy has
been criticized over the accuracy of recovered memories, with some psychologists
arguing that the memories recovered are in fact false memories (Madill & Holch, 2004).
False memories, or false memory syndrome, is a condition where a person has a
memory they believe to be true, but is in fact false, and created through a variety of
conditions (Passer & Smith, 2004). My research question is: “To what extent does
hypnotherapy increase the risk of the creation of false memories?” An overview of the
formatting and application of hypnotherapy is given. Studies on memory, repressed
memory, and false memories are evaluated in relation to hypnotherapy techniques.
Relevant methodological, ethical, and cross cultural concerns of essential studies are
considered. It is concluded that the stages of hypnotherapy allow for a high risk of the
creation of false memories, especially through the stage of suggestion.
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 4
Introduction
Modern psychotherapy relies on one basic principle: working through one’s past
is the key to achieving a healthy future (Madill & Holch, 2004). In one case study,
Sigmund Freud proposed that repressed memories and emotions were the root cause
of both physical and emotional symptoms (Billig, 1999, p. 5-28).
Repressed memory therapy uses a variety of techniques to try to draw out
repressed memories, including visually guided imagery, self-empowerment training,
symbol interpretation, hypnosis, and role playing (Loftus, 1997).
Clinical and research psychologists tend to disagree over the concept of
repressed memory. Clinical psychologists in general argue that repressed memories
and repressed memory theory is accurate, and that through treatment the repressed
memories can be recalled and the symptoms that result from their repression can be
cured. Research psychologists in general argue that memory is malleable and that
repressed memory theory is unsubstantiated, not necessarily inaccurate, but requires
more experimentation through psychological studies to be treated through therapy.
(Madill & Holch, 2004, p. 299-303).
This controversy calls into question the ethics and methods of repression
therapy. This issue’s various implications for practitioners as well as researchers is
made even more confrontational due to the ethical considerations that must be made of
any study researching or trying to implant false memories. For any practicing therapist,
possible victim of abuse, or those accused of being the abuser this debate is particularly
significant. Numerous recent studies, such as Loftus and Palmer (1974), Zaragoza and
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 5
Mitchell (1996), and Zajac and Henderson (2009), as well as theories such as flashbulb
memory theory, support the finding that memory is extremely malleable (Crane &
Hannibal, 2009, p. 91). However, most studies testing for false memories have
methodological limitations such as ecological validity and generalizability because false
memory experiments cannot ethically implant traumatic memories. These small studies
tend to use innocuous memories if any. Therefore, comparisons must be drawn from the
current scientific research and theories to the stages of hypnotherapy. This paper will aim
to evaluate false memory theory with recent, ethical studies, and tie those evaluations to
hypnotherapy.
Hypnotherapy
Hypnotherapy is the use of hypnosis to treat a variety of ailments according to
the American Association of Professional Hypnotherapists, and Dr. Philip Muskin of the
Columbia University Medical Center defines hypnosis as a focused state of
concentration, where you are open to achieving your goal through suggestion (Hypnosis
FAQ; Loptate & Muskin, 2014). Hypnotherapy has a long history of being used as a
treatment method, in smoking cessation especially, but there is also evidence that it
could be used to treat eating disorders, post-traumatic stress disorder, and even be
used to relieve pain during childbirth (Shubert, 1983; O’Neil, 2015). Delle Jacobs, a
certified hypnotherapist and past president of the Minnesota Society of Clinical
Hypnosis, stressed the merits of hypnotherapy for anxiety and pain management (C.
Young, phone interview, July 7, 2016). Using hypnotherapy to extract repressed
memories remains dubious in the eyes of some researchers, but few clinicians doubt its
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 6
effectiveness. Dr. Michael Yapko attempted to gage therapists’ beliefs about hypnosis
and repressed memory by administering the Memory Attitude Questionnaire and the
Hypnosis Attitude Questionnaire. He distributed the questionnaires to 1,000 therapists
all across the country in 1992, primarily at psychotherapy conventions, and found that a
majority (97 percent) of respondents viewed hypnosis in a positive light (Yapko, 1994).
In hypnotherapy, hypnosis is used to retrieve repressed memories through dissociation,
or distancing oneself from memories during a state of relaxation. Unlike the populace’s
general impressions, hypnosis does not involve posthypnotic amnesia (not
remembering what occurred during the hypnosis) (Fredrickson, 1992, p. 148; Kihlstrom,
2014, p. 141). According to Dr. Reneè Fredrickson in her book Repressed Memories: A
Journey to Recovery from Sexual Abuse, “Hypnosis is effective only if you are ready to
face what happened” (148), meaning only the memories that are ready to emerge will
be recalled. Many hypnotherapists use different methods, but hypnosis in general relies
on four principles: trance induction, directed memory work, suggestion, and return
(Fredrickson, 1992, p. 148-152; Lynn & Laurence, 2015).
Trance induction is the first stage of hypnosis. The hypnotherapist, with some
variations depending on their particular style, will ask the patient to relax their body.
After the patient has entered a state of tranquility they need to voluntarily enter the
hypnotic state, so that they can access memories freely (Fredrickson, 1992; Lynn &
Laurence, 2015).
Directed Memory work varies by hypnotherapist, but relies on directing the
patient’s attention to specific memories, usually of childhood abuse. Different strategies
of directed memory include age regression, imagistic work, and the “going home”
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 7
technique. Age regression can be used to age a person backwards mentally, by
suggesting that they are growing younger and younger until reaching the desired age.
Then, if they were abused, the unconscious is relied upon to move towards that abuse
that can be detected through imagery, feelings, and words. Imagistic work is where a
memory fragment is used as a focal point, and is described in detail by the patient or
simply focused on so the rest of the memory can emerge. The “going home” technique
asks the patient to imagine entering their childhood home. If the patient was abused, the
unconscious should reveal the memories ready to emerge (Fredrickson, 1992, p.
148-152).
Suggestion is the technique of removing or reducing unconscious blocks to
memory. The hypnotherapist can give suggestions that will help to reduce or eliminate
unconscious blocks to memory of abuse. They can also be used to promote healing and
wellbeing in a patient (Fredrickson, 1992; Lynn & Laurence, 2015).
Return is the final stage of hypnosis, where the patient returns to the conscious
world with the help of the hypnotherapist. The hypnotherapist can encourage this return
through various methods, such as using a metaphor to introduce the return or calling for
the patient to count from one to five, suggesting that they grow more awake as each
number passes (Fredrickson, 1992, p. 148-152).
False Memory Theory
False memories are memories of an experience one believes to have happened
that did not actually occur (Crane & Hannibal, 2009). When an event is witnessed, its
memory is not recorded as an exact copy, but an outline that can be changed (Crane &
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 8
Hannibal, 2009; Prozan, 1997). False memories have often been mistaken for
repressed memories, and even the concept of repressed memory is under fire in the
psychological community, because of a lack of evidence supporting its existence
(Passer & Smith, 2004, p. 269-270; Huffman & Smith, 1994). A false memory can be
created and reinforced through several different processes, including the misinformation
effect, source confusion, and suggestion.
The misinformation effect is, “the distortion of a memory by misleading post event
information” (Passer & Smith, 2004, p. 265-268). An example of the misinformation
effect in action would be the case of Father Bernard Pagano, who was accused of
armed robbery in Wilmington, Delaware, and confirmed by seven eyewitnesses.
Eventually the true perpetrator confessed and was named the “gentlemen bandit,” after
the kind manner with which he addressed the victims. The perpetrator and the Father
looked very different, thus the distortion of the witnesses’ memory was likely due to two
factors: (1) the manner of the “gentlemen bandit” was associated with priests and led
witnesses to Father Pagano, and (2) the fact that witnesses were told before trying to
identify a suspect that the perpetrator may be a priest, and Pagano was the only
suspect who wore a clerical collar. This is an example of the misinformation effect. The
witnesses’ memories were distorted by the information that the robber may have been a
priest. This inclined them to believe that Pagano was the suspect, as he was the only
one dressed as a priest (Passer & Smith, 2004, p. 265-268).
Source confusion is “the tendency to recall something or recognize it as familiar
but to forget where we encountered it” (Passer & Smith, 2004, p. 265-268). An example
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 9
would be recognizing a familiar face, but forgetting where it was seen. In Mitchell and
Johnson (2003), source misattribution was tested by showing participants a practice
police training video about two teenage burglars breaking into a house, and then a car
chase. They tested the effect of age on source misattribution error by having
participants watch the video and respond to a questionnaire, which emphasized
information like the robber having a gun, or wearing gloves at the time. The researchers
found that of critical items (such as a gun), older adults misattributed more than younger
adults, and were more confident in their misattributions. However, both significantly
misattributed sources, showing the commonality of this error (Mitchel & Jonson, 2003,
p. 107-119).
A final factor that can influence false memories is suggestion. The use of
suggestion has been most studied in interviews with leading questions. Experimentation
has found that leading and suggestive questions can encourage false memories in
participants. A noted experiment involving suggestion would be Loftus and Palmer
(1974), where researchers questioned participants about a video of a car crash they
had watched, asking them to estimate the speed of the cars. They modified the
question, “About how fast were the cars going when they smashed into each other?” by
changing the verb “smashed” to “collided,” “bumped,” “contacted,” or “hi,t” finding that
the verb smashed elicited a higher speed estimate than other verbs (586). Although the
criticism can and has been made that speed estimation would vary naturally from
person to person and this variance could affect the results, that complication would not
have affected the second part of the experiment, where a week later, participants were
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 10
asked if they had seen broken glass in the video. The participants who heard the
question with the word “smashed” were significantly more likely to answer yes, despite
no broken glass being present in the video (Loftus and Palmer, 1974, p. 585-589).
Loftus and Palmer explain the findings through schema theory, or the cognitive map of
mental associations, stating that because the verb “smashed” activates schemas for a
violent accident, the participants absorb that external information and change their
memory (Crane & Hannibal, 2009). The addition of the broken glass, that did not exist in
the video, shows a concrete change in the memory of participants (588). Each verb
used modified the question, suggesting different speeds of the car and the presence of
broken glass. The use of leading questions powerfully altered participants’ memories,
adding speed and even nonexistent glass (Loftus & Palmer, 1974, p. 585-589; Crane &
Hannibal, 2009).
Evaluation
Because of the current criticisms of repression theory and hypnotherapy’s
unorthodox methods, hypnotherapy has been under skepticism in the psychotherapy
community (Billig, 1999; Huffman & Smith, 1994). In a famous 1990 repressed memory
case, Eileen Franklin came forward and accused her father, George Franklin, of
murdering Susan Nason, a childhood friend of Eileen. Eileen claimed that she had
witnessed the murder as a child, but had repressed the memory for more than twenty
years (Loftus & Ketcham, 1994, p. 38-66; Passer & Smith, 2004, p. 269-270). This case
was solely based on the repressed memory of Eileen Franklin, and became based in
the validity of repressed memory. After just one day of deliberations, the jury decided
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 11
the memory was reliable, and declared George Franklin guilty of first degree murder
(Loftus & Ketcham,1994 p.64-65).
Evidence based solely on repressed memory was admissible to a jury, but a
judge later had different ideas. In 1996 a judge overturned the conviction, exonerating
Franklin, upon discovering that the repressed memory had been retrieved with the use
of hypnosis, which the state supreme court had ruled unreliable. Also, later accusations
by Eileen Franklin accusing her father of two more murders were proven with DNA
evidence to be false (Denzel, 2012). In California at least, hypnotically recovered
repressed memories are seen to be unreliable in courts.
The legal precedent is then set: repressed memories reproduced by
hypnotherapy are not reliable, thus hypnotherapy as a practice is unreliable for memory.
However, a judge’s conclusion is not carefully reviewed scientific evidence, which is
necessary to make claims about the reliability of a practice. Studies on specific factors
that affect the reliability of memory, such as the misinformation effect, source confusion,
and suggestion, can provide insight into hypnotherapy, as these factors can be linked to
the hypnotherapy stages of directed memory work and suggestion. Hypnotherapy is an
unreliable practice: the stages of directed memory work and suggestion increase the
risk of false memory syndrome through the misinformation effect, source confusion, and
suggestion.
Hypnotherapy begins in a relaxed state, one in which the person is, on purpose,
"open to suggestion." (Fredrickson, 1992). This could allow the patient to intake certain
information that is false, and later believe that it is true. During directed memory work,
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 12
the patient undergoes a variety of methods to bring them back to the portion of their
lives where they were abused such as age regression, the “going home” technique, or
imagistic work (Fredrickson, 1992, p. 148-152). Imagistic work poses the greatest threat
to memory, as it focuses on an image or a fragment of a memory and asks the patient
to describe the image, making it more detailed, and allows the therapist to ask “concrete
questions” (Fredrickson, 1992, p. 150). The goal of this is to encourage the expansion
of the memory fragment, a practice which can cause the “imagination inflation” effect
over repeated sessions, where the more one remembers something, in this case the
abuse, the more convinced one is that it occurred (Fredrickson, 1992; Loftus, 1997).
This could allow for the mistake of leading questions, which are suggestive of answers
in themselves, and lead the patient to incorrect answers. Loftus and Palmer (1974)
showed the power of leading questions in their experiment where, by manipulating the
verb in a question asking participants the speed of cars crashing into each other in a
video, they found that the estimated speed varied by almost 10mph in the “smashed”
compared with “contacted” conditions. They concluded that researchers’ word choice
activated different schemas in the brain, where “hit” and “smashed” were associated
with higher speeds than “contacted” (Loftus & Palmer, 1974). Hypnotherapy increases
the risk of false memory formation as these leading questions can cause incorrect
information. When a hypnotherapist asks patients about a memory fragment, leading
questions could alter what a patient remembers in the same manner as in Loftus and
Palmer (1974).
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 13
Suggestion
Suggestion is the technique of removing or reducing unconscious blocks to
memory. The hypnotherapist can give suggestions to the patient during this phase that
promote healing and remove blockage (Fredrickson, 1992). In this stage the patient
could develop a false memory through the misinformation effect, suggestion, and
source confusion.
The misinformation effect is when a memory is distorted by information learned
after the event, or post-event information (Passer & Smith, 2004, p. 265-268). In a New
Zealand study by Zajac and Henderson (2009), undergraduate student participants from
the University of Otago participated in an experiment to examine the effect of
misinformation by a “co-witness” on how a participant remembers a perpetrator’s
appearance. Pairs of participants watched a short video of a crime, and then answered
questions concerning the video. The researcher left the room with an excuse and asked
the pair to either think about (control trial) or discuss (experimental trial) the accomplice’s
appearance. In the experimental trial the confederate suggested that the accomplice’s
eye color was blue, when it was really brown. After the researcher returned and the
confederate was excused, the participant described several features of the accomplice.
Following a short filler task, participants picked the accomplice from a lineup with similar
people, and indicated how confident they were in their choice (267-270). Before receiving
misleading information, the majority of participants said they did not know the eye color
of the accomplice. In contrast, participants in the misinformation trial were significantly
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 14
more likely to say that the accomplice had blue eyes (269). The researchers concluded
that the misinformation did affect eyewitness reports (Zajac & Henderson, 2009).
This experiment can be compared to hypnotherapy. In the stage of suggestion,
the hypnotherapist can ask leading questions, and is essentially acting the part of the
“co-witness” in Zajac and Henderson (2009). They suggest something the patient may
remember or not remember well, and then the patient is significantly more likely to
believe their suggestion. Though compelling, this experiment does have methodological
issues such as the use of undergraduate students, which would not likely overlap with
the population of child sexual abuse (CSA) survivors or hypnotherapy patients, making
the study less generalizable. Also participants may have felt social pressure to agree
with the confederate or were affected by demand characteristics, only agreeing to
please the researcher, even if they thought that the confederate was wrong. However,
this pressure could be representative of the pressure a patient may feel to not
disappoint their hypnotherapist. And though the misinformation effect is unlikely to occur
with correct usage of hypnotherapy, the risk of a mistake, of receiving misinformation
through suggestions during sessions, is still present. The difference between a direct
suggestion and leading question is small. For example, it is the difference between the
two sentences “Is there anyone else in the room with you?” and “Who else is in the
room?” These two sentences are both questions, though one (the leading question)
leaves a possibility for a negative answer while the other (direct question) leaves no
possibility for a negative answer in the question. The misinformation effect could pose a
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 15
threat if the therapist is not extremely explicit with their use of language, and risks
increasing the likelihood of false memory syndrome.
Suggestion is when one person suggests information to another usually through
leading questions or suggestive statements which imply the desired answer ( Zaragoza
and Mitchell, 1996; Loftus and Palmer, 1974). In Zaragoza and Mitchell (1996),
researchers aimed to investigate how suggestion affects eyewitness suggestibility
(294). In the experiment, undergraduate participants watched a video of a burglary and
were later asked questions that contained misleading suggestions. Some of the
participants had the questions repeated to them, some did not. The researchers then
tested participants’ memories for the source of the suggested information. They found
that with repeated exposure to suggestion, participants were more likely “to (a) claim
with high confidence that they remembered the suggested events from the video… and
(b) claim that they consciously recollected witnessing the suggested events” (Zargoza &
Mitchell, 1996, p. 294-299). Hypnotherapy sessions can continue for several weeks (C.
Young, phone interview, July 7, 2016). This could allow information to be repeated
during sessions, inflating or creating false information in patients’ memories through the
imagination inflation effect (Loftus, 1997). In the stage of suggestion, the hypnotherapist
is encouraged to use suggestive questions to help draw out the participant’s memory
(Fredrickson, 1992, p. 151). Using open ended suggestions, a style studied by Milton
Erickson, the hypnotherapist can ask questions meant to widen the subject’s memory
(Erickson & Rossi, 1979). But leading questions can provide false information. Asking
“Is there anyone in the room with you?” implies that there is another person present,
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 16
and may make the subject more likely to think there is, just as suggesting misleading
information posed as questions in the robbery experiment caused falsified memories.
This is also similar to Loftus and Palmer (1974), where, by changing only the verb in the
question, “About how fast were the cars going when they hit each other?" the resulting
speed estimate was significantly changed (Loftus and Palmer, 1974). Incredibly small
changes can make huge differences when it comes to memory, making it far too
dangerous to use hypnotherapy to retrieve repressed memories. However, there are
limitations to how these studies apply to hypnotherapy. This experiment is hard to
generalize because it used undergraduate students, a group different from CSA
survivors and hypnosis patients. It also is not directly testing hypnotherapy, but only
aspects that could occur during hypnotherapy.
Another risk in repressed memory therapy is where, through repeated sessions,
the therapist’s additions and suggestions become indistinguishable from the
participant’s memories (Loftus & Ketcham, 1994). This is essentially source confusion,
where a person believes that some information they gained is from their memory, when
actually it is from an outside source (Passer & Smith, 2004, p. 265-268). In an
experiment by Brown, Deffenbacher, and Sturgill (1997), a class of students were asked
without prior warning to pick a “criminal” from a series of mugshots. The “criminals” had
come into the class earlier that day and handed out exam materials to the class. A few
days later, class members picked “criminals” from a lineup. According to Barber (2015)
who gave an overview of the experiment, “The proportion of criminals ‘indicted’ if their
faces were seen at the mugshot phase as well as the original occasion of the ‘crime’
was 0.45. The proportion of indictments for those not seen at the crime or mugshot
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 17
phases was 0.18.” The indictment rate for when the face had been seen at the mugshot
phase and not at the crime was 0.29, which is much higher than when the person had
not been seen before. This shows source confusion because the person viewing the
line-up mistakes the person they have seen before as being a part of the robbery rather
than when they came to the classroom to hand out papers (Barber, 2015, p. 41). In the
stage of suggestion, the hypnotherapist may encourage the patient to use mental
imagery (Loftus & Ketcham, 1994, p. 156-158). This would cause the patient to
misremember their abuser’s face, perhaps assimilating a face they had seen earlier, or
in a different situation. Through the suggestion stage of therapy, incorrect information
could become a part of the patient’s memory, until the point at which they are unable to
tell the therapist’s suggestions from their memories. If the patient is going through
repeated theory sessions, the idea of abuse is repeated consistently, making the
information more likely to be believed (Mitchell & Zaragoza, 1996). Through single
therapy and repeat sessions, source confusion can occur, adding to or solidifying false
memories. However, the information in Brown, Deffenbacher, and Sturgill (1997) was in
the form of video, while the information hypnotherapy patients would receive would be
audio. This difference in mediums, and the use of student participants, makes the study
less generalizable to hypnotherapy patients.
Conclusion
Though hypnotherapy holds promise as an effective technique for a variety of
ailments such as smoking cessation, anxiety, and pain, because of the complex nature
of memory, especially traumatic memories, hypnotherapy is far too dangerous to
practice for repressed memory therapy as it increases the likelihood of creating a false
EVALUATION OF HYPNOTHERAPY AND FALSE MEMORIES 18
memory in a patient (O’Neil, 2015; Loftus and Ketcham, 1994). Ethical guidelines
guaranteeing basic mental and physical safety prevent more direct experiments in the
research community from being conducted, but connections can be drawn from the
process of hypnotherapy to the current knowledge on how false memories are formed.
From the experiments discussed including Loftus and Palmer (1974), Zaragoza and
Mitchell (1996), Zajac and Henderson (2009), and Brown et al. (1997), the dangers of
suggestion, misinformation, and source confusion have been clearly demonstrated and
linked to the stage of suggestion in hypnotherapy. Though these experiments were
conducted mostly with university students in environments unlike a hypnotherapist’s
office, this abundance of compelling evidence showing that simply the addition of a
word or phrase can change the resulted memory of an event shows that hypnotherapy,
though beneficial in lower risk scenarios such as for smoking cessation, increases the
likelihood of false memory creation and is far too dangerous to use on something as
malleable and ephemeral as memory
AN EVALUATION OF HYPNOTHERAPY IN THE CREATION OF FALSE MEMORIES18
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