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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 [Unpublished]: University of Johannesburg.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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