When someone uses suggestion without realizing it, how can the suggestion be focused yet flexible enough to be adapted by different individuals who each have differing capacities for attention and response? When one uses suggestive strategies to elicit highly subjective experiences that necessarily involve dissociation and other hypnotic phenomena (such as time distortion in order to “hold this moment in awareness” or “sense the timelessness of this moment,” sensory alteration in order to “just ride; surf the feeling the sensations of the breath,” or positive hallucination in order to see and experience a “shy animal sunning itself on a tree stump”), how can these techniques be used deliberately and skillfully if one isn’t even aware of employing them? In Kabat-Zinn’s guided meditation, his suggestions for eliciting these phenomena were general in nature, direct in structure, and given permissively in style. Might his suggestions have had greater impact if they were offered in other structures and another style? Could the responses have been fuller if he’d known what responses he was suggesting instead of suggesting them unintentionally? The hypnosis literature says yes.
The field of clinical hypnosis has studied intensively individuals’ abilities to become absorbed in and responsive to the guidance (suggestions) of another. The findings are unequivocal: people differ widely in their capacities to focus attention and generate nonvolitional responses. How then does a mindfulness practitioner determine who is and who isn’t likely to respond well to such experiential processes? Should it just be assumed that everyone is capable to the same extent? Is telling people to “just practice harder” enough to enhance responsiveness? The research in hypnosis addresses this subject in depth and offers many insights into the nature of hypnotic responsiveness and the variable effects of practice over time. Studying the gifted meditators and discovering their presumably desirable thicker cortices offers no evidence that nongifted meditators, or those whose meditations are limited in time and frequency, will achieve anything close to the same.
Successfully adapting the delivery of hypnosis or guided meditations to the uniqueness of the particular client requires many skills, including the ability to observe and accurately determine someone’s information-processing style and tailor the wording of the message or suggestion to fit that style. To be more effective, you must throw away the script, acknowledge in experiential terms the uniqueness of your client, and adapt your methods to those individual differences. No matter how many times you conduct a scripted GMM body scan or an awareness exercise, you’ll always be conducting a standardized procedure on people who respond idiosyncratically.
The field of hypnosis has examined the role of dissociation in generating nonvolitional responses, such as those that spontaneously arise during the course of a guided meditation. These are the hypnotic phenomena of age regression (the experiential utilization of memory), age progression (the experiential utilization of expectancy), analgesia (the capacity to reduce sensation selectively), catalepsy (the inhibition of voluntary movement), positive and negative hallucinations (having sensory experiences with no external cause, or not having sensory experiences despite the presence of a stimulus), time distortion (the constriction or expansion of one’s subjective sense of time), and other marked perceptual shifts that highlight how malleable subjective perceptions can be. These capacities for transforming perception are amplified during experiences of mindfulness and hypnosis, making it necessary to be exceptionally clear about what one is suggesting and why. Global explanations of “an awakening” or “becoming mindful” seem poor substitutes for an in-depth knowledge of the interface between receptive, dissociative, focused states and suggestions—for hypnotic phenomena disguised as “sacred meditations.”
When people don’t understand the mechanism behind something that seems extraordinary, they can too easily conclude it’s magic or divinely inspired. Even those practitioners of hypnosis who aren’t well grounded in the science of hypnosis can resort to global philosophies such as “trust your unconscious to know the meaning of the metaphor” or “trust your unconscious to know what to do when the time is right.” When people don’t recognize their participation in co-creating some experience, they may conclude it’s the “inner sage” or “the Buddha within,” and have little or no insight about the role suggestion played in eliciting the hypnotic phenomenon that seemed so unexpected.
Clinicians who use guided mindful meditations need to become more aware of what they’re doing, how and why these experiential processes work, and how they can improve their own practice of these powerful methods. The field of clinical hypnosis has gone far in explaining the key structural factors underlying GMM and hypnosis: the skilled application of suggestions to a client who is in an attentive and receptive dissociated state. Understanding this can benefit not only mindfulness practitioners, but therapists and even other health care professionals. After all, every therapeutic intervention you can name, whether medical or psychological, will necessarily involve some degree of skilled—and suggestive—communication with an individual within the context of a therapeutic alliance.
Key points to remember regarding the process of suggestion are:
- Dissociation is critical to developing positive automatic responses that foster greater self-trust and greater emotional regulation. As neuroscientists focus on the nature of attention, they commonly describe different but related attentional subsystems in the brain. The most salient point is that attention isn’t a singular mechanism—it’s comprised of multiple, interactive conscious and unconscious processes. Different qualities of attention will be elicited by different qualities of suggestion. It’s interesting, but hardly surprising, to discover from neuroscience that different areas of the brain regulate the different types of attention. Thus, it’s predictable that there are differences in brain activity across different types of suggestive experiences.
- When you conduct experiential processes, you can’t avoid giving suggestions. This means that whatever comes up for a person during a session is, at least in part, your co-creation. The study of hypnosis indicates that what generates an effect isn’t only what you say: it’s also what you imply. Your influence on the client is inevitable. The science and art of suggestion, or hypnosis, is found in learning to use that influence skillfully and benevolently.
- All people are different, and not equally capable of focused attention, dissociation, and mindfulness. If you wish to enhance your effectiveness with a broader range of clients, you can’t use the same techniques and wording with everyone. Many people who find it hard to “focus on the breath” or do a “body scan” might do well with another approach tailored to their personal style.
Years ago, when psychologist Neil Jacobson asked, “What is it about cognitive-behavioral therapy (CBT) that works?” his research suggested it was much less correcting cognitive distortions than behavioral activation—the action-orientation of CBT interventions—that helps mobilize the immobile. The fact that mindfulness works isn’t in question today. But does it work in the way advocates have suggested?