Hypnosis, Suggestions, and Psychosomatic Phenomena:
A New Look from the Standpoint of Recent Experimental Studies1
THEODORE X. BARBER, Ph.D.
Proseminar Institute, Research Division Medfield, Massachusetts
A series of investigations are reviewed which indicate that suggestion (a) can block the skin reaction (dermatitis) that is produced by poison ivy-like plants, (b) can give rise to a localized skin inflammation that has the specific pattern of a previously experienced bum, (c) can be effective in the cure of warts, (d) can ameliorate congenital ichthyosiform erythrodermia (“fish skin disease”), and (e) can stimulate the enlargement of the mammary glands in adult women. Experiments are also summarized supporting the hypothesis that the aforementioned suggested phenomena may be due, in part, to localized alterations in blood flow to the skin and other organs that can occur when certain types of suggestions are accepted.
The first part of this paper summarizes recent experiments which indicated that suggestions (a) can prevent the skin reaction (contagious dermatitis) that is produced by plants such as poison ivy, (b) can give rise to a localized inflammation of the skin, (c) can stimulate the remission of warts, (d) can ameliorate congenital ichthyosis (“fish skin disease”), and (e)
can stimulate additional growth of the mammary glands in adult women. The underlying theme throughout the first part of the paper is that “suggestions” (statements that something is occurring or will occur) affect cutaneous and glandular functions when subjects accept the suggestions and incorporate them into their own ongoing cognitions (their ongoing thoughts, images, and feelings). The second part of the paper (a) summarizes recent psychophysiological experiments and biofeedback studies which indicated that our thoughts, images, and feelings affect blood flow to the skin and other organs and (b) postulates that the aforementioned phenomena produced by suggestions – i.e., the prevention of dermatitis, the production of inflammation, the remission of warts, etc. – may be due, in part, to the localized alterations in blood flow that occur when the suggestions are accepted and become part of ongoing cognitions.
Many of the experiments that are described in this paper utilized hypnosis or hypnotic induction procedures. Although the available evidence strongly indicates that hypnotic induction procedures are not necessary, they can nevertheless be helpful in producing acceptance of suggestions (Barber, 1969; Barber, Spanos, & Chaves,
1974) . When hypnotic induction procedures are helpful, it is not because the subject is in a “trance” or “hypnotized” in the popular sense of these terms. Instead, the evidence indicates that they are helpful when they reduce the subjects’ critical attitudes toward the suggestions and thus help them accept the suggestions as believable and harmonious with their own ongoing cognitions (Barber et al., 1974; Ruch, 1975). Although hypnotic induction procedures are effective in reducing critical attitudes in some subjects, more ordinary procedures are often equally effective. Nonhypnotic procedures that have been shown to produce a high level of responsiveness to suggestions, presumably by reducing critical attitudes, include (a) exhorting subjects to try their best to imagine those things that are suggested (‘ ‘task motivational instructions”) and (b) urging subjects to put aside their critical attitudes and to let themselves “think with’’ the suggested themes (“think with instructions”) (Barber, 1969, 1970, 1976; Barber & Ham, 1974; Barber et al., 1974; Barber & Wilson, 1977; Wilson & Barber, 1978). These topics will be mentioned again later in this paper. Let us now look at the empirical data.
Production and Inhibition of Contact Dermatitis
Two Japanese physicians, Ikemi and Nakagawa (1962), reported an experiment demonstrating that suggestions can exert remarkable control over skin responses. The subjects participating in the experiment were 13 high school students who were very sensitive to plants found in Japan that produce reactions resembling those produced by our poison ivy, poison oak, or poison sumac. When these students came in contact with the leaves of the poisonous plants, they showed a dermatitis consisting of an abnormal redness of the skin due to congestion of the blood capillaries (erythema), small circumscribed solid elevations of the skin (papules), and small blisters (vesicles) together with edema, a burning sensation, and itching.
Five of the students were exposed to a hypnotic induction procedure; when their eyes were closed they were told that they were being touched by leaves from the poisonous tree while they were actually being touched by leaves from a harmless tree. The remaining eight subjects were assigned to a nonhypnotic treatment; when their eyes were closed they were also touched by harmless leaves but were told they were being stimulated by the poisonous leaves. There is every reason to believe that both the hypnotic subjects and the nonhypnotic subjects could accept the suggestions as true. Both kinds of subjects had their eyes closed and could not see what kind of leaves were being placed on their arms. Furthermore, the experimenter was a physician with high prestige and the experiment was conducted in a highly respected medical setting. When the physician said that he was stimulating the subjects’ arms with the poisonous leaves, there was no reason why the subjects (high school students) should doubt the physician’s statement.
Skin changes were produced by the believable suggestion that the arm was being stimulated with poisonous leaves (when it was actually stimulated by harmless leaves). When the subjects were led to believe that they were being stimulated by poisonous leaves, the harmless leaves produced a slight to marked degree of dermatitis – e.g., flushing, itching, erythema, and papules – in all five of the hypnotic subjects and in all eight of the nonhypnotic subjects. In 12 of these 13 subjects the dermatitis was observable within 10 minutes to one hour after the suggestion was given; in the remaining subject, the dermatitis was not clearly present until six hours after the suggestion.
In the next part of the experiment, the subjects were told that they were being touched on the other arm with the leaves of a harmless tree while they were actually stimulated by the poisonous leaves. When thus led to believe that the poisonous leaves were harmless, four of the five hypnotic subjects and seven of the eight nonhypnotic subjects did not show the expected dermatitis .
In summary, the data presented by Ikemi and Nakagawa indicate that in individuals who show marked dermatitis when stimulated by the leaves of poison ivy-like plants, (a) at least some aspects of the dermatitis can be produced by a harmless substance when the individual is led to believe it is the dermatitis-producing substance, (b) the dermatitis generally can be inhibited when the individual is led to believe that the poisonous leaves are harmless leaves, (c) formal hypnotic induction procedures are not necessary or especially useful in producing these effects, and (d) it appears that the critical variable in producing the phenomena is the subjects’ belief that a harmless substance is actually a dermatitis-producing substance and, vice versa, that a dermatitis-producing substance is actually a harmless substance.
An Attempt to Produce Blisters by Suggestions
A series of earlier studies, reviewed elsewhere (Barber, 1970; Pattie, 1941; Paul, 1963), appeared to indicate that blisters can at times be produced by hypnotic suggestions. Dr. R. F. Q. Johnson and I recently attempted to validate the earlier studies in a controlled experiment with 40 student nurses. In this experiment (Johnson & Barber, 1976) each student first agreed to participate in a hypnotic experiment in which an attempt would be made to produce blisters by suggestions. To help convince the subjects that suggestions could produce blisters, they were asked to read a passage from a book by a physician which made this assertion. Each student nurse was then exposed to a hypnotic induction procedure and given the suggestion that it was early morning, she was in her kitchen at home, and bacon was being cooked in a red hot frying pan. It was next suggested that she was burned on the back of her hand when she accidentally touched the frying pan, e.g., “. . . the red hot frying pan touches the back of your hand . . . you can still feel the burning sensation . . . soon a blister will form there …”
In this experiment only one of the 40 subjects showed a skin change that was directly attributable to the suggestions. Specifically, the subject manifested an unmistakable inflammation of the hand during the time she was receiving the suggestions for blister formation. The back of the hand became bright red and the inflammation formed an irregular pattern, covering about 75% of the hand including part of the index finger to the first knuckle. The boundary between the inflamed and uninflamed part of the hand was very sharp and distinct. The inflammation was present during the time the subject was receiving the suggestions for blister formation and subsided within three minutes after completion of the suggestion.
Immeadiately upon completion of the experiment, the subject reported that six years previously she had been burned by hot grease on that very spot on the top of the same hand and that the outline of the inflammation coincided with the previously burned area. She further stated that the burn she experienced six years earlier was due to an accident in the kitchen while she was cooking.
It thus appears that in this experiment we reinstated a previously experienced skin condition. The suggestions that we used – the subject was in the kitchen in the morning and was being burned on the top of her hand by a hot frying pan – closely resembled what had actually happened to her six years previously. These fortuitous events led the subject to relieve the experience vividly, e.g., she stated postexperimentally that when she received the suggestions she could feel the “blister” forming. Apparently, the skin changes manifested by this subject were intimately related to the fact that she fully accepted the suggestions and incorporated them into her own ongoing congnitions. We shall return to this experiment again later in this paper when we shall attempt to provide an explanation of the inflammation which was associated with the suggestions.
Treating Warts by Suggestions
Dr. R. F. Q. Johnson and I also recently carried out a controlled experiment to check the assertion that warts can be cured by suggestions. In this experiment (Johnson & Barber, 1978), 22 subjects with warts were randomly assigned either to a hypnosis treatment or a control treatment. The 11 subjects allocated to the hypnosis treatment were exposed to a hypnotic induction procedure comprised of repeated suggestions of relaxation, drowsiness, sleep, and hypnosis. Immediately upon completion of the hypnotic induction procedure, the hypnotic subjects received suggestions for wart disappearance. The remaining 11 control subjects were not exposed to a hypnotic induction; instead, they were told that they were to be treated by “focused contemplation” and then were immediately given the same suggestions for wart disappearance that were given to the hypnotic subjects. When given the suggestions for wart remission all 22 subjects were told to focus on certain warts, to imagine they were tingling, and to feel them beginning to go away. They were also told to continue to imagine the tingling and the warts disappearing henceforth for a few minutes each day.
Three of the 22 subjects showed remission of warts in close association with the suggestive treatment. The subjects were asked to return for two follow-up sessions at intervals of approximately two to three weeks and four and one-haf to six weeks after the treatment session. One subject whose warts had been present for about three years had lost 37 of her 39 warts by the first follow-up session (two and one-half weeks); a second subject with warts of two years duration had lost all five of his warts by the second follow-up session (four and one half weeks); and the third subject who had 13 warts for about one-half year had lost all of the warts by the second follow-up session (six weeks).
Two aspects of this experiment are of theoretical and practical interest. First of all, we confirmed the results of many earlier studies (summarized by Barber, 1970, pp. 169-172) which found that wart regression was at times closely associated with suggestions for wart disappearance. How suggestions for wart disappearance can be causally related to the cure of warts is a difficult topic that we shall discuss again toward the end of this paper.
A second important outcome of this experiment was that all three subjects who showed wart involution were in the hypnotic group – none were in the control group. The three hypnotic subjects who showed wart cures strongly believed that ’ warts could be cured by hypnosis; they were generally responsive to test- suggestions (such as suggestions for arm levitation), and they were highly motivated to participate in the experiment. On the other hand, the subjects allocated to the control treatment had never heard of “focused contemplation” and did not especially believe that it could cure warts. It thus appeared to us that an important variable determining whether a psychological treatment will affect warts is its believed-in efficacy, that is, whether the subjects believe that the treatment is capable of curing warts.
An alternative explanation for the apparently greater effectiveness of the hypnotic treatment is that an altered state of consciousness, specifically, a hypnotic trance state, is necessary for suggestions of wart regression (or other “extraordinary” suggestions) to be effective. Although this type of explanation is more harmonious with traditional theories of hypnosis and is still generally accepted by laymen, a large number of investigations conducted during the past 20 years strongly indicate that it is not valid (Barber, 1969, 1970, 1973; Barber & Ham, 1974; Barber et al., 1974; DeStefano, 1977; Katz, 1975; Sarbin & Coe, 1972). Also, a series of studies pertaining to the treatment of warts, summarized in the next paragraph, indicated that believed-in efficacy rather than hypnotic trance is the critical factor in the successful psychological treatment of warts.
A series of earlier studies (Allington, 1934; Bloch, 1927; Bonjour, 1929; Dudek, 1967; Grumach, 1927; Memmescheimer & Eisenlohr, 1931; Sulzberger & Wolf, 1934; Vollmer, 1946; showed that warts can be cured by direct suggestions (without hypnotic procedures) provided that the patients believe that the suggestive treatment is effective in curing warts. For example, in one early study (Bloch, 1927), the patient’s warts were exposed to an impressive electrical machine; although the motor was started no electrical current actually reached the patient. Next, the warts were painted with an innocuous dye and the patient was told that the dye was a powerful new wart medicine, that the warts were now dead, and that they must not be washed until they disappeared. In this and other early studies, the warts typically began to disappear soon after the suggestive treatment and there is every reason to believe that the treatment possessed believed- in efficacy, that is, the patients believed that the treatment would cure their warts.
Treating Ichthyosis by Suggestions
Congenital ichthyosis (“fish skin disease”) has been ameliorated by suggestions. Let us look briefly at the reports in this area, beginning with the case presented by Mason (1952).
Mason worked with a 16-year-old boy who suffered from a severe form of ichthyosis (congenital ichthyosiform ery- throdermia of Brocq). The skin over his entire body, with the exception of his chest, neck, and face, was black, horny, and covered with papillae. The skin felt as hard as a normal fingernail and, when cut, was of the consistency of cartilage and was anesthetic for a depth of several millimeters. Also, the skin was so inelastic that any attempt at bending would produce a crack in the surface which would then ooze blood-stained serum. Despite the extensive medical treatment that the patient had received, his skin had been progressively thickening from birth. His education had been interrupted because the teachers and students objected to his odor. The boy disliked relating with others because of his distressing appearance and he was shy and lonely. It should be emphasized that the etiology of this disease is unknown and that it is resistant to all forms of treatment.
After administering a hypnotic induction, Mason suggested to the patient that his left arm would clear. (The suggestion was limited to the left arm in order to exclude the possibility of spontaneous improvement.) Within five days, the horny layer softened and fell off. The skin underneath was somewhat reddish at first but within a few days was normal in color and texture. By the end of 10 days, the arm was normal from shoulder to wrist.
Over a series of treatment sessions, Mason then suggested that the skin would improve first in one part of the body then in another. He summarized his results as follows:
These rapid and dramatic results were obtained during the first few weeks. During the next few months of treatment, there was no further improvement. However, in a subsequent four-year follow-up period, the improvement that had been obtained was mainareas. In the next phase of the investigation the patients were exposed to a hypnotic induction procedure at biweekly intervals for two months and then monthly for a further two months and given suggestions that all affected areas of the skin would improve. Wink presented the following results: Schneck’s (1966) patient was a 20-year- old woman whose entire body was affected by the disease (congenital ichthyosiform erythrodermia). After a hypnotic induction she was given suggestions for overall improvement, was told to visualize herself in a mirror and to see herself as she would like to appear, and was told to watch for gradual improvement. On returning one week later tained and the patient showed additional spontaneous improvement without any type of treatment (Mason, 1955).
|Part of Body||Before Treatment||After Treatment|
|Hands||Completely covered||Palms clear – Fingers not much improved|
|Arms||80% covered||95% cleared|
|Back||Lightly covered||90% cleared|
|Buttocks||Heavily covered||60% cleared|
|Thighs||Completely and heavily covered||70% cleared|
|Legs and feet||Completely and heavily covered||50% cleared|
Mason’s results were confirmed by Wink (1961), Schneck (1966), and Kidd (1966). Wink (1961) worked with two sisters, ages eight and six, who suffered from congenital ichthyosiform erythrodermia affecting most of their bodies. (The younger sister had a less severe form of the disease and the skin on her palms, fingers, soles, and toes was normal.) Each girl was exposed to a hypnotic induction procedure at weekly intervals for eight weeks and given suggerstions that specific affected skin areas would soon start to grow soft and smooth and the thick skin would flake off. The skin condition of both patients improved in some of the specified areas and improvement was also noted in some unspecified there was a “startling change” – a 50 per cent improvement over her entire body. The patient continued receiving similar suggestions in therapy sessions with Schneck over several months. During this period she initially improved somewhat, then regressed, and finally improved again. At the termination of therapy, the degree of improvement was about the same as had been attained dramatically in the first session – about 50 per cent.
Kidd (1966) worked with two cases of congenital ichthyosiform erythrodermia – a father, age 34, and his young son, age four. The father was admitted to a hospital for the treatment of his skin condition. Each day for a three week period (and sometimes twice a day) he was exposed to hypnotic induction together with suggestions that improvement would occur in his skin. By the end of three weeks marked remission had occurred. Treatment was then continued every other day for two more weeks and the suggestions were directed specifically at the areas that were still affected. At the end of the five weeks period, approximately 90 per cent remission had occurred. The four-year-old son was also treated by hypnosis and suggestions. However, the child was inattentive and easily distracted and the treatment did not help him.
The studies described above have broad implications in that they demonstrated that a congenital, severe skin ailment that has been considered to be resistant to all forms can affect this congenital skin disease and the other skin processes that I have described.
Effects of Suggestions on the Mammary Glands
LeCron (1949) used suggestive techniques to induce breast development in 20 women (varying in age from 20 to 35), all of whom had a strong desire for larger breasts. LeCron saw the women at weekly intervals and, after a hypnotic induction, suggested to them that their “inner mind” was going to start the same process of breast growth that had occurred during puberty and that the process would continue
|Reduction in Skin Thickness|
|Older Sister||Younger Sister|
|Palms and fingers||50%||(originally normal)|
|Soles and toes||50%||(originally normal)|
of treatment can be markedly affected by suggestions. In each case, the suggestions for improvement were given together with a hypnotic induction. No attempt was made to ascertain whether the suggestions for improvement were effective alone (that is, with or without the hypnotic induction) or whether variables included in the hypnotic induction also played a role. However, judging from the data previously discussed in this paper (for example, the data presented by Ikemi and Nakagawa) and from the results of a large number of studies presented elsewhere (Barber, 1969, 1970; Barber et al., 1974), it appears that the hypnotic induction procedure is not necessary, although it may be helpful in making the suggestive treatment more acceptable and believable. I shall return to these studies again later in this paper when I shall offer a theory to explain how suggestions until the breasts reached the desired size. Utilizing self-suggestion (or “self-hypnosis”), the women repeated to themselves the suggestions for breast growth and they visualized themselves as they wished to be. They also suggested to themselves that they felt warmth and tingling sensations in the breasts from the increased blood circulation. LeCron reported that 17 of the 20 women showed at least moderate breast growth, of about one to one and one-half inches, and five of these showed growth of about two inches. Although these results are suggestive, they are not definitive, because it is difficult to measure the size of the mammary glands accurately and the measurements were not made in a preplanned careful way.
Fortunately, a more controlled investigation has been presented recently by Williams (1974). This investigation, which ineluded careful measurements of breast size, was comprised of a pilot study and a main study. In the pilot study, three women were exposed weekly to a hypnotic induction and to suggestions for breast development while three other women were exposed weekly to a hypnotic induction but not to suggestions for breast development. At the end of 12 weeks, those women who had been receiving the suggestions for breast development increased their bust measurement an average of one and five-eighths inches, whereas the women exposed only to the hypnotic induction showed no change.
Thirteen women who desired larger breasts participated in the main study. Careful baseline measures of the chest were taken for three weeks. All of the women then received 12 weekly treatments consisting of a hypnotic induction and repeated suggestions to feel again the sensations in the breasts that occurred during puberty. During the baseline measurements, the average bust measurement of the 13 women (after exhalation) was 33.6 inches. After 12 weeks of suggestions for breast development, the average bust measurement (after exhalation) was 35.7 inches. The average increase of 2.1 inches was statistically significant. As a control, the rib cage below the breasts was also measured during the same 12 week period and it did not show a statistically significant change.
The above results were recently confirmed by Willard (1977) who found that (a) all 22 women participating in his study showed some breast enlargement and (b) the women who were most able to visualize the suggested breast change had the greatest increase in breast size. Staib and Logan (1977) also confirmed Williams’ (1974) results and, in addition, found that practically all (81%) of the gains in breast size were still present three months after the end of treatment.
In brief, the data available at present strongly indicate that suggestions of breast growth and increased sensations in the breasts are effective, with at least some women, in stimulating breast enlargement. Another way to state this conclusion is that it appears that some adult women can increase their breast size by focusing on the idea that their breasts are growing. In the next section of this paper I shall discuss how this kind of focused, believed-in thinking, imagining, and visualizing can lead to increased blood flow to the breasts which, in turn, could stimulate breast enlargement.
Control of Blood Flow as a Mediator
I have described the effectiveness of suggestions in producing and inhibiting contact dermatitis, producing localized skin inflammation, curing warts, alleviating congenital ichthyosis, and stimulating the growth of the mammary glands. Although these effects can be attributed to suggestions or hypnosis, the latter terms can easily mislead us into believing that something outside of the patient or subject (suggestions or hypnosis) is producing the effects. It needs to be emphasized that suggestions or hypnosis are effective only to the extent that they become “self-suggestions;” that is, the person accepts the suggestions as part of his own cognitive process (Ruch, 1975).
There is evidence to indicate that changes in blood supply to the skin may play an important role in producing the phenomena discussed in this paper. For instance, when we tried to produce blisters by suggestions (Johnson & Barber, 1976), one subject showed an irregular inflammation of the dorsum of the hand that was due primarily to vasodilation or markedly increased blood supply to the area. It also appears that changes in blood supply to a wart occur when warts disappear spontaneously or in response to suggestions (Barber, 1970, pp. 170-171). Unna (quoted by Samek, 1931) observed histologically that, during the spontaneous healing of warts, the normal skin surrounding the wart shows a distinctive reaction consisting of hyperemia (increased blood supply) and cell proliferation. Other investigators (Al- lington, 1952; Biberstein, 1944; Sulzberger & Wolf, 1934; Vollmer, 1946) also observed a distinct inflammatory reaction immediately before the spontaneous, suggestive, or chemically-induced healing of warts. In histological studies of warts undergoing remission in a patient treated by a suggestive procedure, Samek (1931) found a specific inflammatory reaction in the dermis consisting of dilation of blood vessels, hyperemia, edema, and perivascular infiltration of white blood cells. A number of earlier investigators (Sulzberger & Wolf, 1934; Zwick, 1932) had also hypothesized that vasomotor changes were crucial factors in wart remission and Ullman (1959) concluded from a thorough review of the literature that, when warts are affected by suggestions, an emotional reaction is induced in the patient and the mechanism of healing may depend on local vascular alterations which accompany the emotional reaction.
Similarly, alterations in the blood supply to the skin may play a role in the alleviation of congenital ichthyosis by suggestions. After dramatically ameliorating a case of congenital ichthyosiform erythrodermia by suggestions, Kidd (1966) hypothesized that the suggestions gave rise to an “ideovascu- lar action” wherein nerve impulses acted on the vascular bed of the affected skin areas and influenced ‘‘the disturbed metabolism of affected tissue.” Similarly, the enlargement of the mammary glands that was associated with suggestions may have been related to an increase in vascularity of the breasts. In brief, changes in blood flow and blood volume may be part of the mediating mechanisms that produce the phenomena I have discussed in this paper. This possible mediating mechanism is made more salient by recent studies, summarized below, which have shown that many individuals either can control or can easily learn to control blood flow to localized areas of the skin and can thus also control localized skin temperature.
Cognitive Control of Blood Flow and Skin Temperature
Many individuals are aware from their own experience that strong feelings or emotions are associated with changes in blood supply to the skin; for instance, anger is associated with a red countenance (increased blood supply to the skin of the face) whereas fear is associated with a pale countenance. A series of studies extending back over many years has demonstrated that some individuals can voluntarily shift more blood to a specific area of the skin and can thus make the area warmer. Interesting data along these lines were reported by Wenger and Bagchi (1961) when they went to India to study the psychophysiological effects of yoga training. They found one yogi who was able voluntarily to raise the temperature of and to perspire from his forehead within ten minutes after he began meditation. The yogi stated that he learned to increase his feeling of warmth and to perspire at will when he spent two winters in caves in the Himalayas. Since it was very cold in the mountains, his guru advised him to concentrate on warmth and to imagine and visualize himself in a very warm place such as in the south of India. After about six months of practice, he found that he was able to make himself warm and even to perspire by allowing his cognitions – his imaginings, visualizings, and thoughts – to dwell on warm situations.
Another relevant study was carried out at the Menninger Clinic with Swami Rama (Green, Ferguson, Green, & Walters, 1970). During this investigation, the Swami stated that he was going to make one part of his palm much warmer than another part. Temperature transducers which had been placed on two sides of his palms showed that the temperature began to change and within a few minutes there was a 9°F difference between the two sides of his palm. Apparently, he accomplished this feat by voluntarily increasing the blood supply to one side of the palm and reducing the blood supply to the other side.
A series of additional reports, reviewed elsewhere (Barber, et al., 1974), showed that some individuals can voluntarily produce localized changes in blood flow and skin temperature. For instance, Men- zies (1941) reported that three out of five subjects showed localized vasodilation on the hand (with a concomitant rise in skin temperature) when imagining steam escaping from a valve onto the hand and all five subjects showed localized vasoconstriction (with a concomitant drop in skin temperature) when imagining extreme cold. Duggan and Sheridan (1976) recently presented similar results.
In an earlier study, Hadfield (1920) also found that localized changes in skin temperature could be produced by suggestions. The subject participating in the investigation had exercised vigorously before the experiment and the temperature of both hands had reached 95°F. It was suggested to the subject that the right hand was becoming cold. Within half an hour the temperature of the right palm fell to 68° while the temperature of the left palm remained at 94°. The subject was next given the suggestion that the right hand was becoming warm; within 20 minutes the temperature of the hand rose from 68° to 94°. Although sufficient data were not presented in the report to specify the mediating processes that were involved, I would hypothesize that when the subject was told that the hand was becoming cold or warm, the subject vividly visualized, imagined, and thought about previous cold or warm experiences and these “believed-in cognitions” were associated with the change in skin temperature.
A more recent experiment (Maslach, Marshall, & Zimbardo, 1972; Zimbardo, Maslach, & Marshall, 1970) similarly showed that some individuals can use selfsuggestions to raise and also to lower their skin temperature. The three subjects who took part in this experiment had received practice in hypnosis; that is, practice in relaxing, concentrating, imagining vividly, and dissociating themselves from specific events. In the experimental session, each subject was given suggestions for deep relaxation (a “hypnotic induction procedure”) and then was asked to make one hand hot and the other hand cold. Several images were suggested that might be useful in changing the temperature of the hands and each subject was also encouraged to use self-suggestions and to utilize his own imagery. All three subjects succeeded in lowering the temperature of one hand (by 2° to 7° C) and two of the three were also able to raise the temperature of the other hand (by 2° C). When the subjects increased and decreased blood flow to the hands and thus raised and lowered the hand temperature, they were typically thinking and imagining that one hand was becoming red with anger while the other was becoming white with fear or that one hand was in a bucket of ice water while the other was under a heat lamp (Zimbardo et al., 1970). It appeared that the training the subjects had received in relaxing, concentrating, imagining, and dissociating was an important factor enabling them to alter the flow of blood to the hands and thus alter the hand temperature. Subjects in a control group who had not received this training did not succeed in changing the temperature of their hands.
Biofeedback and SelfRegulation of Blood Flow
Important recent studies utilizing biofeedback suggest that everyone may have the potential ability to control voluntarily the flow of blood to specific areas of the skin. Before we describe these studies, let us explain briefly how biofeedback is used.
Biofeedback means simply that an individual is obtaining information pertaining to what is occurring inside or on the surface of his body. The simplest form of biofeedback is when we measure our own heart rate by placing our hand on our chest above the heart or by picking up our pulse near the wrist or above the carotid artery. During recent years, however, a large variety of electrical or electronic instruments have been utilized to feed back information to the subject pertaining to what is occurring on his skin or internal organs. For instance, temperature sensors attached to the skin can inform subjects that their skin temperature is rising or lowering, and electrode leads attached to the back of the scalp can inform the subjects that certain “brain waves” such as the alpha rhythm are increasing or decreasing. These and other instruments – heart monitors, monitors of the electrical conductance or resistance of the skin, monitors of muscle activity, etc. – can provide information concerning what is happening in specific organs or parts of the body. This information is typically presented to the subject by a tone that varies in pitch or a visual display that varies in brightness as the function being monitored decreases or increases.
Using these type of biofeedback procedures, Taub and Emurian (1972) set out to train individuals to control voluntarily the flow of blood to (and thus the temperature of) an index finger. Twenty subjects participated in four brief (15-minute) training sessions in which variations in finger temperature were indicated by variations in the brightness of a light. The subjects were told to try to make the light more intense or less intense; that is, to increase or decrease finger temperature and blood flow. To achieve the intended self-regulation of finger temperature, they were encouraged to imagine hot or cold stimuli impinging upon the finger. By the end of the four brief training sessions, 19 of the 20 subjects had attained control of finger temperature; on the average, they could voluntarily raise and also lower the finger temperature by about 2.5°F. After additional training, they were able to raise and also to reduce the temperature of the finger as easily with or without biofeedback, and they retained the ability to vary the temperature when retested after an interval of four to five months.
Subsequent work by the same investigator (Taub, 1977) showed that, after receiving additional training, some subjects (a) could raise or lower the temperature on localized areas of the skin as much as 8° to 15° F in 15 minutes, (b) could maintain a considerable increase in localized skin temperature for about 45 minutes while performing a concurrent task, and (c) could keep their skin warm when placed in very cold environments.
These studies have broad implications. They indicate that we can learn, within a reasonably brief period, to produce substantial changes in blood flow to the periphery of our body, we can maintain this changed blood supply over substantial periods of time, and we can use this skill for practical purposes such as keeping warm in a cold environment. Taub (1977) has also pointed out that the self-regulation of temperature through control of blood flow could also be useful in (a) protecting against cold injury, (b) producing temporary sterility in males by elevating the temperature of the scrotum (cf., French, Leeb, & Fahrion, 1974), (c) treating ailments such as migraine headaches and Raynaud’s disease which involve impaired circulation, (d) reducing edema and pain following tissue damage, (e) reducing the size of warts or tumors by influencing blood flow to the area of the tumors, and (f) promoting the healing of wounds by increasing blood flow to the affected area (Chapman, Goodell, & Wolf, 1959).
Cognitive Control of Blood Supply to Sexual Organs
Before we close our discussion on the self-regulation of blood flow and temperature, let us glance briefly at how normal individuals control the flow of blood to one specific part of the body; namely, to the genital organs. Sexual arousal is basically a blood flow phenomenon. As a man becomes sexually aroused, more and more blood enters and remains in his penis. Similarly, as a woman becomes sexually aroused, more and more blood flows into the sexual organs and gives rise, for example, to enlargement of the breasts, erection of the nipples, erection of the clitoris, and engorgement of the labia.
The important point here is not just that sexual arousal is intimately related to blood flow and temperature change in the genital areas, but that normal men and women are able to self-regulate this blood flow by their cognitions; that is, by their thoughts, images, imaginings, and feelings. A man does not become sexually aroused by a woman that he finds unappealing; he becomes aroused when he thinks, feels, or “cognizes” the woman in a positive way. Similarly, arousal in a woman is related to how she perceives the man. In other words, thoughts, feelings, and imaginings or, in more general terms, “cognitions” affect the flow of blood to the sexual organs.
It needs to be underscored that blood flow to the genital organs can be controlled voluntarily. A series of recent studies (Laws & Rubin, 1969; Henson & Rubin, 1971; Rosen, Shapiro, & Schwarz, 1975) have demonstrated that most men are able to produce a small degree and some men are able to produce a large degree of penile tumescence or erection when they are simply asked to do so. These studies also showed that ‘ ‘this normal ability to produce penile engorgement can be increased by biofeedback procedures” (Rosen et al., 1975), but the important point here is not that biofeedback can improved the performance but that normal men can voluntarily control blood flow to the penis by controlling their cognitions. As Rosen et al. (1975) pointed out, “It seems that subjects who are readily able to conjure up sexual images or fantasies are able to utilize these images to ‘voluntarily’ control the engorgement of the penile corpora. ” In other words, healthy men are either able to or can potentially control blood flow to the genital areas by deliberately focusing or shifting their thoughts and imaginings. For instance, they can produce an erection by turning their thoughts and visualizations to a woman they love and then focusing on those aspects of her being that they view as especially pleasing and desirable; and they can then lose the erection by turning their thoughts away from the beloved woman to other extraneous concerns.
The way our cognitions affect blood supply to the genital areas is the most dramatic and clearest example of how our thoughts, images, and feelings, produce variations in the blood supply to various parts of odr body. The data summarized in this paper suggest the exciting possibility that blood flow not only to the genital areas, but also to other parts of the body, for example, to the skin, is continually affected to some degree by how we are thinking, feeling, and experiencing.
Integration and Summary
Let us now integrate the data pertaining to blood flow and relate them to the five phenomena we described in detail in the first part of this paper.
- Blood flow to the sexual organs is affected by cognitions; that is, by thoughts, feelings, and imaginings, this phenomenon occurs in all healthy individuals regardless of whether or not they are aware of how their cognitions affect their sexual organs.
- Many individuals are aware, and apparently all healthy individuals potentially can become aware, that they can shift blood to the sexual organs by thinking, fantasizing, or imagining arousing sexual situations.
- Although there can be little disagreement that cognitions affect blood flow to the sexual organs, it is not as obvious that cognitions also affect blood flow to the skin (and other organs). Nevertheless, data, such as the following, indicate that our thoughts, feelings, and imaginings alter the blood supply of localized cutaneous areas: (a) Many individuals are experientially aware of changes in blood supply to the skin that are associated with strong feelings or emotions – the red face of anger or rage, the pallor or pale countenance of fear, and the blush of shame, (b) Some individuals can clearly self-regulate blood flow to the hands or to localized cutaneous areas. In general, these individuals shift blood to specific areas by thinking or imagining that cold or warm objects are stimulating the area, (c) Recent data indicate that, with a short period of training, e.g., one hour, possibly all healthy individuals can learn to increase and decrease blood flow to localized areas of the skin. The training that seems especially helpful involves biofeedback; that is, the individual tries to increase or decrease the temperature at a specific area on his skin (and thus to increase or decrease the blood flow to the area) while receiving continuous information pertaining to moment-by-moment variations in the temperature of the area.
- We can begin to explain the phenomena discussed in this paper if we accept the contention that blood supply not only to the sexual organs but also to the skin (and possibly other organs of the body) is affected by thoughts, feelings, imaginings, and other cognitive processes. If we accept this contention, then we can postulate that “believed-in suggestions,” which are incorporated into ongoing cognitions, affect blood supply in localized areas and the altered blood flow, in turn, plays a role in producing all five of the phenomena that were described in detail in the first part of this paper. Specifically, the altered blood flow plays a role in (a) reducing the dermatitis produced by a poision ivy-like plant (Ikemi & Nakagawa, 1962), (b) giving rise to a degree of dermatitis when the poisonous plant is not actually present (Ikemi & Nakagawa, 1962), (c) producing a localized skin inflammation that has the specific pattern of a previously experienced burn (Johnson & Barber, 1976), (d) curing warts that have been present for a long period of time (Johnson & Barber, 1978), (e) ameliorating congenital ichthyosis (Kidd, 1966; Mason, 1952; Schneck, 1966; Wink, 1961) and, (f) stimulating the enlargement of the mammary glands (Staib & Logan, 1977; Willard, 1977; Williams, 1974). Further research is needed to delineate much more precisely how suggestions which are accepted and incorporated into ongoing cognitions are related to changes in blood flow and how alterations in blood flow, in turn, are related to the phenomena I have described in this paper.
Proseminar Institute, Research Division P.O. Box 312 Medfield, MA 02052
Allington, H.V. Sulpharsphenamine in the treatment of warts. Archives of Dermatology and Syphilology, 1934 , 29, 687-690.
Allington, H. V. Review of psychotherapy of warts. Archives of Dermatology and Syphilology, 1952, 66, 316-326.
Barber, T. X. Hypnosis: A scientific approach. New York: Van Nostrand Reinhold, 1969. (Republished in 1976 by Psychological Dimensions, Inc., 10 W. 66 St., New York, 10023.)
Barber, T. X. LSD, marihuana, yoga and hypnosis. Chicago: Aldine, 1970.
Barber, T. X. Experimental hypnosis. In В. B. Wolman (Ed.) Handbook of general psychology. Englewood Cliffs, N. J.: Prentice-Hall, 1973. P]p. 942-963.
Barber, T. X. (Ed.) Advances in altered states of consciousness and human potentialities, Vol. I. New York (10 W. 66 St.): Psychological Dimensions, 1976.
Barber, T. X. & Ham, H. W. Hypnotic phenomena. Morristown, N.J.: General Learning Press, 1974.
Barber, T. X., Spanos, N. P. & Chaves, J. F. Hypnosis, imagination, and human potentialities. Elmsford, N.Y.: Pergamon Press, 1974.
Barber, T. X., Wilson, S. C. Hypnosis, suggestions and altered states of consciousness: Experimental evaluation of the new cognitive-behavioral theory and the traditional trance state theory of “hypnosis”. Annals of the New York Academy of Sciences, 1977 , 296 , 34–47.
Biberstein, H. Immunization therapy of warts. Archives of Dermatology and Syphilology, 1944 , 50, 12-22.
Bloch, B. Ueber die Heilung der Warzen durch Suggestion. Klinische Wochenschrift, 1927, 6, 2271-2275, 2320-2325.
Bonjour, J. Influence of the mind on the skin. British Journal of Dermatology, 1929, 41, 324– 326.
Chapman, L. F., Goodell, H. & Wolff, H. G. Increased inflammatory reaction induced by central nervous system activity. Transactions Association of American Physicians, 1959, 72, 84–109.
DeStefano, R. The “inoculation” effect in think- with instructions for “hypnotic-like” experiences. Doctoral dissertation, Temple University, Philadelphia, 1977.
Dudek, S. Z. Suggestion and play therapy in the cure of warts in children: A pilot study. Journal of Nervous and Mental Disease, 1967, 145, 37-42.
Dugan, M., & Sheridan, С. Effects of instructed imagery on temperature of hands. Perceptual and Motor Skills, 1976, 42, 14.
French, D., Leeb, С., & Fahrion, S. Self-induced scrotal hypothermia: An extension. Paper presented at meeting of Biofeedback Research Society, Colorado Springs, 1974.
Green, E. E., Ferguson, D. W., Green, A. M., & Walters, E. D. Preliminary report on Voluntary Controls Project: Swami Rama. Topeka, Kansas: Research Department, Menninger Foundation, 1970.
Grumach, L. Ueber Suggestivbehandlung von Warzen. Miinchen medizinisch Wochenschrift, 1927, 74, 1093-1094.
Hadfield, J. A. The influence of suggestion on body temperature. Lancet, 1920, 2, 68-69.
Henson, D. E., & Rubin, H. B. Voluntary control of eroticism. Applied Behavioral Analysis, 1971, 4, 37-44.
Ikemi, Y., & Nakagawa, S. A psychosomatic study of contagious dermatitis. Kyushu Journal of Medical Science, 1962, 13, 335-350.
Johnson, R. F. Q., & Barber, T. X. Hypnotic suggestions for blister formation: Subjective and physiological effects. American Journal of Clinical Hypnosis, 1976, 18, 172-181.
Johnson, R. F. Q., & Barber, T. X. Hypnosis, suggestions, and warts: An experimental investigation implicating the importance of “believed-in efficacy » .American Journal of Clinical Hypnosis, 1978, 20, 165-174.
Katz, N. W. Comparative efficacy of sleep/trance instructions and behavior modification procedures in enhancing hypnotic suggestibility. Doctoral dissertation, Washington University, St. Louis, Mo., 1975.
Kidd, С. B. Congenital ichthyosiform erythrodermia treated by hypnosis. British Journal of Dermatology, 1966, 78, 101-105.
Laws, D. R., & Rubin, H. B. Instructional control of an autonomic sexual response. Applied Behavioral Analysis, 1969, 2, 93-99.
LeCron, L. M. Breast development through hypnotic suggestion. Journal of the American Society of Psychosomatic Dentistry and Medicine, 1969, 16,58-61.
Maslack, С., Marshall, G., Zimbardo, P. Hypnotic control of periopheral skin temperature. Psychophysiology, 1972, 9, 600-605.
Mason, A. A. A case of congenital ichthyosiform erythrodermia of Brocq treated by hypnosis. British Medical Journal, 1952, 2, 422-423.
Mason, A. A. Ichthyosis and hypnosis. British Medical Journal, 1955, 2, 57.
Memmesheimer, A. M., & Eisenlohr, E. Unter- suchungen fiber die Suggestivebehandlung der Warzen. Dermatologie Zeitschrift, 1931, 62, 63-68.
Menzies, R. Further studies of conditioned vasomotor responses in human subjects. Journal of Experimental Psychology, 1941, 29, 457–482.
Pattie, F. A. The production of blisters by hypnotic suggestions: A review. Journal of Abnormal and Social Psychology, 1941, 36, 62-72.
Paul, G. L. The production of blisters by hypnotic suggestion: Another look. Psychosomatic
Medicine, 1963, 25, 233-244.
Rosen, R. C., Shapiro, D., & Schwartz, G. E. Voluntary control of penile tumescence. Psychosomatic Medicine, 1975, 37, 479-483.
Ruch, J. C. Self-hypnosis: The result of heterohypnosis or vice versa 1 International Journal of Clinical and Experimental Hypnosis, 1975, 23, 282304.
Samek, J. Zum wesen der Suggestiven War- zenheilung. Dermatologische Wochenschrift, 1931, 93, 1853-1857.
Sarbin, T. R., & Coe, W. C. Hypnosis: A social psychological analysis of influence communication. New York: Holt, Rinehart, & Winston, 1972.
Schneck, J. M. Hypnotherapy for ichthyosis. Psychosomatic-s, 1966, 7 233-235.
Sulzberger, M. B. & Wolf, J. The treatment of warts by suggestion. Medical Record, 1934, 140, 552-557.
Taub, E. Self-regulation of human tissue temperature. In G. E. Schwartz and J. Beatty (Eds.) Biofeedback: Theory and research. New York: Academic Press, 1977.
Taub, E., & Emurian, C. S. Self-regulaion of skin temperature using a variable intensity light. In J. Stoyva, T. X. Barber, L. V. DiCara, J. Kamiya, N. E. Miller, and D. Shapiro (Eds.) Biofeedback and self-control: 1972. Chicago: Aldine, 1973, p. 504.
Ullman, M. On the psyche and warts: I. Suggestions and warts: A review and comment. Psychosomatic Medicine, 1959, 21, 473-488.
Vollmer, H. Treatment of warts by suggestion. Psychosomatic Medicine, 1946, 8, 138-142.
Wenger, M. A., & Bagchi, В. K. Studies of autonomic functions in practioners of Yoga in India. Behavioral Science, 1961, 6, 312-323.
Williams, J. E. Stimulation of breast growth by hypnosis. Journal of Sex Research, 1974, 10, 316-326.
Wilson, S. C., & Barber, T. X. The Creative Imagination Scale As A Measure of Hypnotic Responsiveness: Applications to experimental and clinical hypnosis. American Journal of Clinical Hypnosis, 1978, 20, 235-249.
Wink, C. A. S. Congenital ichthyosiform eryth- rodermia treated by hypnosis: Report of two cases. British Medical Journal, 1961,2, 741-743.
Zimbardo, P. G., Maslach, C., & Marshall, G. Hypnosis and the psychology of cognitive and behavioral control. Department of Psychology, Stanford University, 1970.
Zwick, C. G. Hygiogenesis of warts disappearing without topical medication. A rchives of Dermatology and Syphilology, 1932, 25, 508-521.
BREAST DEVELOPMENT POSSIBLY INFLUENCED BY HYPNOSIS: TWO INSTANCES AND THE PSYCHOTHERAPEUTIC RESULTS
. by Milton H. Erickson, M.D.1
Common experience has demonstrated repeatedly that unconscious attitudes toward the body can constitute potent factors in many relationships. Learning processes, physical and physiological functioning, recovery from illness, are, among others, examples of areas in which unrecognized body attitudes may be of vital significance to the individual. Hence, the question is pertinent: To what extent can specific forms of somatic behavior be influenced purposefully by unconscious forces, and what instances are there of such effects? The two following cases, aside from their hypnotic psychotherapeutic significances, are presented as indicative of a possibly significant problem for future research concerning unconscious purposeful influence upon breast development.
A twenty-year-old girl was brought by her older sister for a single hypnothera- peutic interview because of failure of breast development, despite good nipple development. The girl was found to be seriously maladjusted emotionally, had failed some of her college courses, and was afraid to seek employment. She was, and since childhood had been, deeply relip’ous, but her religious understandings and convictions included an undue element of austerity and rejection of the physical body. Additionally, it was learned that she was engaged to be married to a 47- year-old alcoholic welfare recipient, because, as she resentfully declared, with no breasts she was not entitled to more.
She readily developed a medium-to-deep trance, and manifested a markedly passive attitude. The suggestion was offered to her that she read carefully and assiduously the Song of Solomon, and that she recognize thoroughly that it glorified the Church, and before the time of the Church, it glorified the human body, particularly the female body in all its parts. She was admonished that such should be her attitude toward her body, and that perhaps an attitude of patient expectancy toward her breasts might aid in some further development. It was further explained to her. that as she obeyed instructions she was to feel with very great intensity the goodness of her body, particularly the goodness of her breasts and to sense them as living structures of promise, and in which she would • have an increasing sense of comfort and pride. These suggestions variously phrased were repetitiously presented to her until it was felt that she had accepted them completely.
The outcome almost two years later of this one hypnotherapeutic session may be summarized as follows:
- The breaking of the engagement to the alcoholic.
- Weekly reading of the Song of Solomon.
- Return to college and successful completion of the courses previously failed.
- Enlargement of social and recreational life.
- Successful employment.
- Recent engagement to a young man of her own age group whom she had known for several years.
- Independent reports from her and her sister that breast development had occurred to the extent of “one inch thick on one side, about one and one-half inches on the other side.”
That significant therapy was accomplished for this patient can not be doubted. That her breasts actually enlarged is not a similar certainty, since an objective confirmatory report was not obtainable. But there is a definite possibility that physical processes, comparable in nature and extent to those which occur in “psychosomatic illness,” may have resulted in what might, as a parallelism, be termed “psychosomatic health.”
A seventeen-year-old girl was first seen in her home because of her seriously pathological withdrawal responses to the failure of her breasts to develop, despite the adequacy and maturity of her physical development otherwise. She had a history of extensive medical treatment, extending over five years, with much experimental endocrinological therapy. The only results had been an increasing failure of emotional adjustment, and the possibility of a mental hospital was under consideration.
She was found hiding behind the davenport, and, upon her being discovered there, she rushed behind the piano. When she learned that “no more medicines or needles” would be employed, superficially good rapport was established, possibly because she regarded the situation as offering a better means of escape or withdrawal. She was found to be a good hypnotic subject, developing a light-to-medium trance readily.
The first interview, after several hours’ effort in winning her cooperation, was spent primarily in appraising her personality assets, both in and out of the trance state. During the interview she was found to have a Puckish sense of humor, with dramatic overtones, and this was utilized as the opening gambit for the therapeutic approach. This was initiated by reminding her of the old song about how the toe-bone is connected to the foot-bone, etc. When her interest had been fully aroused, a paraphrase was offered in relationship to the endocrine system, and it was pointed out that, even as the foot-bone is connected to the ankle-bone, so is the “adrenal bone” connected with the “thyroid bone,” with each “supporting and helping” the other.
Next she was given suggestions to feel hot, to feel cold, to have her face feel uncomfortably hot, to feel tired, and to feel rested and comfortable. She responded readily and well to these suggestions, whereupon it was suggested effectively that she develop an intolerable itch upon her feet. This itch she was then to consign with dramatic intensity, not to the nethermost depths, but to the “barren nothingness” of her breasts, a fitting destination for so intolerable an itch. However, in further punishment of it, the itch would become a constantly present, neither pleasant nor unpleasant, noticeable but undefined feeling, rendering her continuously aware of the breast area of her body. This involved series of suggestions was formulated for the multiple purposes of meeting her ambivalences, puzzling and intriguing her, stimulating her sense of humor, meeting her need for self-aggression and selfderogation, and yet doing all this without adding to her distress and in such fashion and so indirectly that there was little for her to do but to accept and to respond to the suggestions.
Then the suggestion was offered that, at each therapeutic interview, she was to visualize herself mentally in the most embarrassing situation that she could possibly imagine. This situation, not necessarily to remain constant in character, would always involve her breasts, and she would feel and sense the embarrassment with great intensity, at first in her face, and then, with a feeling of relief, she would feel that weight of embarrassment move slowly downward and come to rest in her breasts. She was given the additional post-hypnotic suggestion that, whenever she was alone, she would regularly take the opportunity to think of her therapeutic sessions, and she would then develop immediately intense feelings of embarrassment, all of which would promptly “settle” in her breasts in a most bewildering but entirely pleasing way.
The rationale of these suggestions is rather simple and direct. It is merely an effort to parallel in relationship to her breasts, but in a pleasant, constructive manner, such unfortunate destructive psychosomatic reactions as “terrible, painful knots in my stomach over just the slightest worries.”
The final set of hypnotic instructions was that she was to have a thoroughly good time in college. (By these suggestions, all discussion of her withdrawn behavior and college attendance was effectively bypassed.) It was explained that she could, in addition to handling her academic work adequately, entertain herself and mystify her college mates delightfully by the judicious w’earing of tight sweaters and the use of different sets of “falsies” of varying sizes, sometimes not in matched pairs. She was also instructed to carry assorted sizes in her handbag in case she decided to make an unexpected change in her appearance, or, should any of her escorts become too venturesome, so that she could offer them a choice with which to play. Thus her Puckish activities would not lead to difficulties.
She w’as first seen in mid-August and given weekly appointments thereafter. The first few of these were kept by her in person and they were used to reiterate and reinforce the instructions previously
given her and to insure her adequate understanding and co-operation.
Henceforth she kept, by permission, three out of four appointments “in absentia.” That is, she would seclude herself for at least an hour, develop, in response to post-hypnotic suggestions, a medium-to- deep trance state, and in this state, as far as could be learned, she would review systematically and extensively all previous instructions and discussions and whatever “other things” that might come to her mind. No effort was made to determine the nature of those “other things,” nor did she seem to be willing to volunteer information, except to ‘the effect that she had thought of a number of other topics. The other appointments she kept in person, sometimes asking for information, sometimes for trance induction, almost always for instructions to “keep going.” Occasionally she would describe with much merriment the consternation she had caused some of her friends.
She entered college in September, adjusted well, received freshman honors, and became prominent in extra-curricular activities. During the last two months of her therapy, she kept her visits at the level of social office calls. In May, however, she came in wearing a sweater and stated with extreme embarrassment, “I’m not wearing falsies. I’ve grown my own. They are large medium size. Now, tell them to stop growing. I’m completely satisfied.”
Her college career was successful and subsequent events are entirely satisfactory. At the writer’s request, she underwent a complete physical examination, with special reference to her breasts, a report of which was sent this writer. She was physically normal in every regard.
Whether or not the hypnotherapy had anything to do with her breast development is not known. Quite possibly the development may have been merely the result of a delayed growth process. It may have been the result of all the medication she had received. Or it may have been a combined result of these, favorably influenced by her altered emotional state. But at all events, the psychotherapeutic results that derived from getting her to enter college and to enjoy life, instead of a continuing of her previous pattern of psychopathological withdrawal, cannot be denied.
However, in all fairness, it must be recognized that there is a significant possibility that the therapy she received, through the mobilization of unconscious forces by hypnosis, may have contributed greatly to her breast development.
Hypnotic Stimulation of Breast Growth
ALLAN R. STAIB AND D. R. LOGAN University of Houston
An experiment was designed in an attempt to replicate the findings of a previous study which indicated that hypnosis could be used effectively to stimulate breast growth in adult women. Three adult women were given a series of hypnotic treatments in which sensations of breast growth were suggested. It was found that hypnotic stimulation of breast growth did result in larger breasts. A three month follow-up, not included in the previous study, demonstrated that while some decrease had occurred during the three months after the cessation of treatment, 81% of the gains made were retained. The authors agree with Williams (1974) that with further development this procedure could become a desirable alternative to surgical methods of breast augmentation.
Few would disagree that physical appearance plays an important role in all of our lives. As a people, we spend billions of dollars every year on clothing, diet foods, exercise equipment and various other products all geared toward enhancing our physical appearance.
A major component of the female’s physical appearance has always been her breasts. The advertising media is filled with various devices to affect the appearance of the breasts in a number of different ways. All of these devices are designed to help the woman more closely approach our society’s idea of the perfect breast. As a result of the importance placed on the woman’s breasts in our society as a measure of her femininity and sexual attractiveness, many women suffer anxiety over what they consider to be inadequate breast development. Various products, frequently advertised in women’s magazines, offer the woman tremendous gains in breast size in a very short period of time. Unfortunately, these products seldom measure up to the woman’s expectations.
The medical profession has approached the problem with a number of methods. The most successful appears to be a surgical method involving the implantation of a bag filled with a silicone solution between the existing breast tissue and the muscle tissue below (Brown, 1968). Unfortunately, this procedure is expensive and involves a stay of several days in a hospital. In addition, this procedure involves the risks intrinsic to any major surgery.
Even though augmentation mammo- plasty does have some disadvantages, a recent study (Kolin, Baker and Bartlett, 1976) indicates that surgical augmentation of the breasts does often result in a number of positive effects. A follow-up of breast augmentation surgery patients demonstrated that feelings of increased sexual satisfaction, self-esteem, self-confidence, and a positive body image gained by the surgery were lasting. The authors were careful to point out that the woman’s motivation for the surgery was an important factor in determining her level of satisfaction with the surgery. Some women expected the surgery to resolve significant marital problems, which the authors pointed out were problems best dealt with by psychological counseling.
Since breast augmentation does appear to have a positive effect on women who feel that they are inadequately developed, it would seem that research into better and safer ways of stimulating breast development is justifiable. The possibility of stimulating breast growth in adult women using hypnotic suggestion of growth sensations has been recently investigated by James Williams (1974). The results of this study indicated that at the end of 12 weekly sessions using hypnotic suggestion, 13 subjects averaged an increase in the circumference of the breasts of 2.11 inches. No follow-up data was reported to demonstrate whether these gains were retained.
The purpose of this study is to replicate Williams’ study adding a three month follow-up to determine if any of the gains made are lasting. If this method does prove to be effective, it would seem a desirable alternative to surgical methods of breast augmentation.
The theoretical underpinning of the hypnotic method as proposed by Williams (1974) lies in the ability of the emotions to affect endocrine metabolism. It has been established that nerve pathways exist between the visceral brain and the hypothalamus which would provide for emotional involvement in endocrine functioning (Reichlin, 1968). For a discussion of the role that the endocrine system plays in the development of secondary sex characteristics see Brasel and Blizzard (1974).
In addition to the physical capability, there are references in the literature that associate changes in emotions with augmentation of secondary sex characteristics in females (Hitschmann, 1928; Groddeck, 1921; Deutch, 1926; Mohr, 1925; Brazel and Blizzard, 1974). The case reported by Brazel and Blizzard (1974) involved a young woman, age 15 years and 4 months, who came from a disruptive home environment. At the time of the first interview, she showed below average overall size and a total absence of secondary sex characteristic development. She was removed from the adverse environment and after six weeks the breasts were noted to be developing and she had grown in height one inch. By age 16 she had grown about four inches, showed substantial breast development, and a fair growth of pubic hair. By age 16 years and 11 months, she had grown to a height six inches taller than when first seen, showed normal breast development as well as a normal growth of pubic hair.
It has been reported that hypnosis can be used to control blood circulation to various parts of the body (Clawson and Swade, 1975). Given this capability, it may well have been vasocongestion, rather than endocrine metabolism that affected the changes that Williams (1974) noted. If the changes noted were the result of endocrine metabolism changes, one would expect some changes in other secondary sex characteristics as well. This would follow since the hormones that stimulate breast growth also stimulate other changes as well. One of the physiological changes that often occurs with breast growth in adolescence is a pronounced contouring of the body in females. Williams (1974) did note a decrease of five-eighths of an inch on the average of the circumference of the chest below the breasts. This may have indicated that changes in body proportioning were in fact taking place.
To test for the presence of a proportioning effect, in this study measurements of the waist were taken in addition to various measures of the chest. It was thought that if the weight stayed constant and the waist measurement correlated at a significant negative level to the number of days since the first treatment, that this would be a finding that would support the hormone theory proposed by Williams (1974). However since body proportioning in women varies a great deal from one woman to the next, the absence of a significant effect on waist size will probably not disprove the theory.
In summary, the purpose of this study is to attempt to replicate Williams’ (1974) findings, perform a three months follow-up on any treatment gains, and to test for concurrent augmentation of body proportioning.
Subjects. The subject population consisted of three adult female volunteers referred to as A, B, and C. The ages of A, B, and C were 27, 26, and 23 respectively. Subject В has borne two children and subjects A and C are nulliparous. Subjects A and C were taking hormones orally in the form of birth control pills. The educational level of the subjects varied. Subject A has completed a bachelors degree, subject В has completed one year of college, and subject C is a high school graduate. All subjects reported that their weight had been constant, within five pounds, for the six months preceding the experiment. The details and procedure used by Williams (1974) were discussed with each subject. Each subject was also familiarized with the hypnotic methods we were using and told that she could withdraw from the study at any point she should decide to.
In addition to these three subjects, two women began the experiment but failed to complete the study. One of the women who left the study did so after only one session as a result of a conversation with a friend who convinced her that the hypnosis might cause her permanent harm. The second subject who left the experiment did so after four irregularly spaced treatments. Her leaving was the result of acute personal problems.
Apparatus. The apparatus for this experiment consisted of one 150 cm. flexible measuring tape, a Polaroid camera, and a weighing scale.
Procedure. One week prior to the first treatment the following measurements were taken by the experimenter and recorded: (a) the circumference of the chest just above the breasts, (b) the circumference of the chest at the horizontal plane of the nipples, (c) the circumference of the chest just below the breasts, (d) the span of the nipples, and (e) the circumference of the waist. To control for posture, all measurements were taken with the subject standing erect. Lung volume was controlled by taking the measurements with the lungs expired. Before beginning the first treatment, one week later, another complete set of measurements were taken and recorded. These two sets of measurements were averaged and the resulting set of values used as the baseline data. The same measurements were taken and recorded at each subsequent session.
Subjects A and C were given 12 treatments and due to subject В having personal problems at the end of the study she was given 10 treatments. The treatments were given at approximately one week intervals. Each treatment consisted of a measurement session and about 50 minutes of hypnosis. The hypnosis was broken down into three components as described by Williams (1974). The first component consisted of the actual trance induction. The induction method used was a combination of the systematic relaxation method and the arm levitation method, both described by Wolberg (1948).
The second component consisted of asking the subject to imagine herself going back in time to an age somewhere between the ages of ten and twelve years old. As a result of Williams’ (1974) conclusion that actual regression was not important, we simply asked the subject to orient herself at this age and did not attempt to evaluate whether a truly regressed state had been achieved. At this point, the subject’s hands were placed on her breasts and suggestions for sensations of growth were given. These suggestions included swelling sensations, tightness of the skin over the breasts, slight tenderness, and the suggestion that she could feel her hands being gently pushed upward as her breasts grew larger. Usually, the subject’s hands would be observed to rise a few inches off of the chest during the course of the suggestions.
The third component of the treatment consisted of telling the subject that she was at a point in time two or three years after the completion of the study. It was suggested that she had just finished showering and that she was standing nude in front of the bathroom mirror. She was asked to inspect her appearance noting the larger and more attractive breasts that had resulted from the study.
Before awakening, each subject was given the suggestion that at the next session she would go into a very deep sleep when the experimenter said a certain combination of words to her. This helped to reduce the amount of time required for trance induction in subsequent sessions.
After awakening the subject, another complete set of measurements were taken and recorded. The measurements from before and after each session were plotted and the subjects were allowed to view them at will. In addition to the graphs, photographs were taken periodically during the course of the treatments and the subjects allowed to view them.
One week after the last treatment, another set of measurements was recorded. The measurements taken prior to the last treatment and these measurements one week later were averaged and the resulting set of values used as the posttreatment data. Approximately three months later, two sets of measurements were made one week apart. These were also averaged and the resulting values used as the follow-up data.
Results and Discussion
In part of the study reported by Williams (1974), six subjects were divided into two groups of three; one a control group, and one an experimental group. Both groups were hypnotized and had measurements taken at each session. Only the experimental group was given suggestions for breast growth. Williams found that the group that was given the suggestions for breast growth showed some enlargement of the breasts but that the control group showed no change in breast size. This finding coupled with the unlikelihood of finding women willing to volunteer to have their breasts measured weekly for three months and again three months after that led us to choose not to run a concurrent control group. Instead, each subject acted as her own control.
In the planning stages of this study it was recognized that changes in body proportioning, posture, and lung volume could confound the standard breast measurement (the circumference at the plane of the nipples). For example, if the woman lost an inch in the circumference below the breasts, an inch in the circumference above the breasts, while the circumference at the nipples stayed constant, her breasts would indeed have gotten larger in proportion to her body. The standard breast measurement, however, would not have reflected this change. Similarly, if the woman was holding more air in her lungs on one occasion than she had on previous occasions, the circumference at the nipples would show an increase but so would the circumference above and below the breasts resulting in no real increase in breast size.
We were left with the problem of arriving at a breast size index that would measure the difference between the circumference of the base that the breasts rest on (the chest) and the circumference of the breasts measured at the plane of the nipples. We arrived at the following method of measurement. The measurements above the breasts and below the breasts were averaged to determine the base circumference and the resulting value subtracted from the circumference at the nipples. This value was called the breast size index. Thus, an increase of one inch in the breast size index would indicate that the circumference at the breasts had increased one inch in relation to the size of the chest. We believe this to be an adequate indicator of actual breast size.
As can be seen in Table I, all three subjects did show an increase in the breast size index between the pretreatment values and the posttreatment values. The average increase was 5.00 cm. (1.97 in.). The increases ranged from 3.6 cm. (1.42 in.) to 7.2 cm. (2.44 in.). The follow-up indicated an increase of 4.04 cm. (1.59 in.) over the baseline measurements on the average for the three subjects.
sets of measurements if we got significant correlations they would be meaningful.
A number of interesting correlations did, in fact, result. The breast size index correlated to the number of days since the first treatment at .90 (p.<.005), .90 (p.<.005), and .84 (p.<.005) for subjects A, B, and C respectively. This demonstrates that it is highly probable that the increase in breast size noted is related to the course of the treatments. It could be argued that we had merely superimposed our treatments onto the natural cycle in breast size that tends to take place during the menstrual cycle. Since this cycle is not linear when looked at over several cycles, it is unlikely that it could account for the strong correlation coefficients that we encountered.
Correlations of the circumferences above and below the breasts to the circumference at the nipples ranged from –.19 to .13. These low correlations indicate that the increase in breast size noted was independent of the chest base. If the measured increases in breast size were related to anything but actual enlargement of the breasts, one would expect high correlations between these variables. The only way to increase
Measurement Summary of Breast Size Index cm. (in.)
|Baseline||5.4 (2.13)||7.2 (2.83)||9.1 (3.58)|
|Post Treatment||11.6 (4.57)||12.4 (4.88)||12.7 (5.00)|
|Net Increase||6.2 (2.44)||5.2 (2.05)||3.6 (1.42)|
|Follow Up||10.8 (4.25)||11.7 (4.61)||11.2 (4.14)|
|Increase Retained||5.4 (2.13)||4.5 (1.77)||2.1 (0.83)|
Statistical treatment of the data consisted of taking the 13 sets of measurements for subjects A and C and the 10 sets for subject В and computing a correlation matrix for each subject. Even though three subjects is a small sample, we felt that using 10 to 13 the diameter at the nipples outside of an actual enlargement of the breasts would be to expand the lungs or to enlarge the back and chest muscles. This would have increased the measurements above and below the breasts as well resulting in positive correlations between both above and below breast measurements when correlated to the circumference at the nipples. Not only were the correlations very low, but four out of the six were negative. Further, none of the subjects reported having done any exercises that could have accounted for these increases.
We also explored the possibility of the increases being strictly temporary in nature. The excitement phase of the female sexual response cycle involves a swelling of the breasts. This swelling is the result of vasocongestion of the breasts (Masters and Johnson, 1966). Two of the subjects did in fact report arousal on several occasions as a result of the prolonged concentration on breast sensations. Even though the measurements were taken before each session, it would seem possible that the hypnosis could have become a conditioned stimulus for arousal and, likewise, since the measurements directly preceeded the hypnosis, the measurement session itself could have become a conditioned stimulus resulting in the response of arousal. This would have taken place gradually which could account for the linearity of the increases. No arousal would have been experienced at first because the measurements would have been a neutral stimulus. As the number of pairings of the measurement session with the consequent arousal grew larger, the measurement session would have gained more strength as a conditioned stimulus presumably eliciting a stronger arousal response and the resulting breast engorgement and swelling.
In an attempt to rule out this variable, measurements were also taken after the hypnotic session and usually the posthypnosis measurement indicated an increase had occurred over the prehypnosis measurement. The pre/post increase varied randomly, showing no tendency to become larger as the treatments progressed. If arousal were responsible for the increases in breast size noted, one would expect the pre/post difference to decrease as repeated pairings occurred. Since this did not occur, we do not believe this variable to be responsible the increases in breast size. Further, there is the fact that one subject experienced the same types of results while reporting no arousal at any time during the experiment.
A study by Clawson and Swade (1975) indicates that hypnosis can influence the circulation of blood to different parts of the body. It is possible then that the prolonged suggestions of breast growth sensations could have resulted in vasocongestion not related to sexual arousal. This could also account for the pre/post increase we usually observed. On two occasions we checked breast measurements the day after a session and found the breasts had returned to approximately the prehypnosis size. This would support vasocongestion as the source of the pre/post increase but it still does not account for the gains made over the course of the treatments. Since the measurements were made before the hypnosis, they should be independent of this vasocongestion.
The data and correlations also indicate that a change in body proportioning took place. (See Table II). Two of the subjects’ weights were about the same before and after the experiment and the other (subject B) had gained seven pounds. Even though none of the subjects lost weight, their waist measurements decreased by 3.8 cm. (1.59 in.), 1.2 cm. (0.47 in.), and 5.6 cm. (2.20 in.) for A, В, and C respectively. Note that subject В had actually gained weight and yer her waist still decreased by almost one half inch. The correlations of waist size to the number of days since the first treatment for subjects A and C were strong; –.87 (p.<.005) and –.74 (p.<.005). For subject B, who had gained weight, the correlation was only . 14. It seems likely that it was the weight gain that canceled the shaping effect on subject В thus resulting in a nonsignificant correlation. If no shaping effect had occurred, one would have expected her waist to increase as her weight went up. Again, none of the subjects were engaged in any exercise which would have contributed to these decreases. It is also interesting to note that none of the subjects anticipated losing inches in their waist as a result of the experiment. When the graphs began to show the decrease two of the subjects did express a desire for their waists to become smaller.
Measurement Summary of Waist Size cm. (in.)
|Baseline||64.3 (25.3)||69.5 (27.4)||68.9 (27.1)|
|Post Treatment||60.5 (23.8)||68.3 (26.9)||63.3 (24.9)|
|Net Decrease||3.8 (1.5)||1.2 (0.5)||5.6 (2.2)|
|Follow Up||61.9 (24.4)||69.6 (27.4)||66.0 (26.0)|
|Decrease Retained||2.4 ( 0.9)||-0.1 ( 0.0)||2.9 ( 1.1)|
The follow-up data demonstrated that on the average 81 % of the gains in breast size had been retained and that 52% of the decrease in waist size had been retained. It is possible that vasocongestion was partly responsible for the breast growth noted and that the 81% retained reflects the true real growth. On the other hand, it might be that the gains made during the study may continue to deteriorate over time.
It is difficult to explain the increase in waist size from the posttreatment measurement to the follow-up measurement. Part of it is due to the fact that one of the subjects gained weight in the interval. This would not, however, explain the whole difference.
We feel that the results of this study and the study conducted by Williams (1974) justify further research in this area. There are a number of variations that may prove to be more effective. It is possible that longer hypnotic sessions or sessions closer together might prove fruitful. It is also probable that this procedure could be adopted to be used with groups.
The level of success we attained using this method obviously falls short of what can be done currently with surgical methods. We do feel, however, that our results confirm the findings of Williams (1974) and that with further refinement this procedure could approach the surgical methods’ results and possibly surpass them in some respect.
Brasel, J. A., Blizzard, R. M. The influence of the endocrine glands upon growth and development. In R. H. Williams (ed.), Textbook of Endocrinology, (5th ed.). Philadelphia: W. B. Saunders, 1974.
Brown, W. E. Cosmetic surgery. Cited by J. E. Williams, Stimulation of breast growth by hypnosis. Journal of Sex Research, 1974, 10 (4), 316-326.
Clawson, T. A. Jr., Swade, R. H. The hypnotic control of blood flow and pain: the cure of warts and the potential for the use of hypnosis in the treatment of cancer. The American Journal of Clinical Hypnosis, 1975, 17 (3), 160-173.
Deutsch, F. Der gesunde und der Kranke korper in psychoanalyticher Betractung. Cited by J. E. Williams, Stimulation of breast growth by hypnosis. Journal of Sex Research, 1974, 10 (4), 316-326. Groddeck, G. Uber die Psychoanalyse des organi- shen im menschen. Cited by J. E. Williams, Stimulation of breast growth by hypnosis. Journal of Sex Research, 1974, 10 (4) 316-326. Hitschman, E. Psychoanalyse trotz hormonen. Cited by J. E. Williams, Stimulation of breast growth by hypnosis. Journal of Sex Research, 1974, 10 (4), 316-326.
Kolin, I. S., Baker, J. L. & Bartlett, E. S. Sex after breast augmentation. Medical Aspects of Human Sexuality, 1976, 10 (3), 123.
Masters, W. H. & Johnson, V. E. Human sexual response. Boston: Little & Brown, 1966.
Mohr, F. Psychophysische behandlungs methoden. Cited by J. E. Williams, Stimulation of breast growth by hypnosis. Journal of Sex Research, 1974, 10 (4), 316-326.
Reichlin, S. Neuroendocrinology. Cited by J. E. Williams, Stimulation of breast growth by hypnosis. Journal of Sex Research, 1974, 10 (4), 316-326.
Williams, J. E. Stimulation of breast growth by hypnosis. Journal of Sex Research, 1974, 10 (4), 316-326.
Wolberg, L. R. Medical hypnosis. New York: Grune & Stratton, 1948. 2 Vols.
Excerpt from Report of the Experiments of Animal
Magnetism by J. C. Colquhoun, Arno Press,
New York, 1975:
Arrived at the termination of our labours, before closing this report, your committee have asked themselves, whether, in the precautions which we have multiplied around us, in order to avoid all surprise; whether in the feeling of continual distrust, in which all our proceedings were conducted; whether in the examination of the phenomena observed, we have scrupulously fulfilled our commission. What other course could we have followed? What means more certain could we have adopted? With what distrust more decided and more discreet could we have been actuated? Our conscience, gentlemen, proudly answers, that you could expect nothing from us but what we have done. In short, have we been honest, exact and faithful observers? It is for you who have long been acquainted with us, for you who see us continually near you, whether in the intercourse of the world, or at our frequent meetings, – it is for you to answer this question. Your answer, gentlemen, we expect from the long friendship of some of you, and from the esteem of all.
Indeed, we dare not flatter ourselves with the hope of making you participate entirely in our conviction of the reality of the phenomena which we have observed, and which you have neither seen, nor followed, nor studied along with us. We do not, therefore, demand of you a blind belief of all that we have reported. We conceive that a great proportion of these facts are of a nature so extraordinary, that you cannot accord them such a credence. Perhaps we ourselves might have dared to manifest a similar incredulity, if, in changing characters, you came to announce them here to us, who, like you, at present, had neither seen, nor observed, nor studied, nor followed any thing of the kind.
We only request that you would judge us, as we should judge you, – that is to say, that you be completely convinced, that neither the love of the marvellous, nor the desire of celebrity, nor any views of interest whatever, influenced us during our labours. We were animated by higher motives and more worthy of you – by the love of science, and by an anxiety to justify the expectations you had formed of our zeal, and of our devotion.
Breast Enlargement Through Visual Imagery and Hypnosis
RICHARD D. WILLARD, M.D.
Institute of Behavioral and Mind Sciences
Twenty-two female volunteers ranging in age from nineteen to fifty-four were asked to practice self-hypnosis and visual imagery in an attempt to enlarge the breasts. All subjects had some enlargement. The subjects who were able to visualize the greatest percentage of times tried had the greatest increase in breast size.
In 1973, Baker presented a paper on the psychosexual dynamics of patients undergoing mammary augmentation. He reported, “Augmentation mammoplasty is becoming one of the most frequently requested cosmetic operations in the United States.” He also reported the increased demand for augmentation indicates that there are thousands of women with feelings of inadequacy about the size of their breasts. His study revealed many positive affects of the increased breast size that were reported by patients following surgery, including increased interest in sex, increased frequency of intercourse and increased ability to climax. Two patients reported that they obtained orgasm for the first time. They all reported feeling happier in all areas of life with decreased selfconsciousness and increased self-esteem. His study also found that, “Many felt that their interpersonal and marital relationships improved.”
Many authors have studied the psychological and physical aspects of breast augmentation (Hurwitz, 1974; Fisher, 1973; DeSaxe, 1974). There are thousands of augmentation mammoplasties done yearly. It would appear from the statistics that this number is still on the increase. Although advances in surgery and anesthesia continue to reduce the risk, it was felt an alternative method of breast augmentation should be investigated.
The use of visual imagery to affect phsyiological responses has been studied by Simonton, О. C. and Simonton, S. S., 1975; Reeves and Segal, 1973; Redmond, Gaylor, McDonald and Shapiro, 1974; Clark and Forgione, 1974. Psychobiological changes can be obtained by hypnotic suggestion which are quite impossible to achieve in the normal waking state (Wolberg, 1948; CanPelt, 1964; Reiter, 1965). The successful use of hypnosis to stimulate breast growth was demonstrated by Williams, 1974. After consideration of the success which has been obtained with visual imagery in affecting physiological responses and after reviewing Williams’ work on the use of hypnosis for breast growth, it was decided to initiate a study using the visual imagery and hypnosis in order to attempt to obtain breast enlargement by combining the visual imagery with hypnosis.
Subjects. The subjects consisted of 22 female volunteers. These subjects were obtained by placing a notice for volunteers on the bulletin board of a local university. The ages ranged from 19 to 54 years of age with a mean of 28. Forty percent were on birth control pills. Those on birth control pills at the beginning of the study were still on them at the conclusion. The subjects took no medication just before or during the study except those on the birth control pills. No other form of breast augmentation was used by the subjects during the period of the study.
Measurements. There were five individual breast measurements taken at the beginning of the study, at six weeks and at twelve weeks. The data presented here will be from the first twelve weeks. The study is being continued at this time at the request of some of the subjects. The circumference is the measurement around the chest at the nipple line with sufficient pressure to pull the nipple down flat with the surrounding breast tissue. Bilateral-vertical measurements were taken from the midclavicular line with the edge of the tape at the inferior edge of the clavicle down over the nipple to the base of the breast. Bilateral- horizontal measurements were taken from the anterior-axillery line over the nipple to the mid-sterum. A physician who was not involved in the design of the experiment made the measurements.
Procedure. The subjects had a practice session in the clinic once a week for the first six weeks and every two weeks for the second six weeks. Using cassette tapes, the subjects were asked to visualize a wet, warm towel over their breasts and to allow this to produce a feeling of warmth. If they were unable to obtain the feeling of warmth with this visualization, they were to add the visualization of a heat lamp shining on the warm towel to facilitate the feeling of warmth. After they were able to obtain a feeling of warmth in the breasts, they were then asked to concentrate on a feeling of pulsation in the breasts, becoming cognizant of their heartbeat and allowing the heartbeat or pulsation from the heart to flow into the breasts. They were then instructed to practice the same imagery and relaxation at home once a day. On the initial visit, each patient was induced into a hypnotic trance using the standard arm levitation method and then instructed in progressive relaxation as a means of obtaining a light trance. They were asked to practice the progressive relaxation on each visit to the clinic as well as in their practice sessions at home. Each patient kept a record of the total number of practice sessions, the total number of times they obtained the feeling of warmth and the total number of times they obtained a feeling of pulsation.
At the end of 12 weeks, 28% had reached the goal they had set at the beginning of the program and desired no further enlargement. There were 85% who could tell a significant enlargement in their breasts had been accomplished, and 46% found it necessary to buy a larger brassiere. Forty- two percent had a loss in weight of greater than 4 pounds and still had enlargement of their breasts. The average increase in circumference was 1.37 inches; the average increase in the vertical measurement was 0.67 inches and the average increase in horizontal measurement was 1.01 inches. It was gratifying to note that 78% of the subjects noticed other positive changes in their lives while participating in the experiment, such as: better bowling scores, improved golf games, etc. At the end of 12 weeks, 85% of the patients could obtain a spontaneous feeling of warmth of pulsation in their breasts by just thinking about the breasts or drawing their attention to their breasts while doing other things, such as driving a vehicle, working, watching television, etc.
In this study, 63% of the subjects had had children and complained of pendulous breasts. These subjects expressed a desire to regain the fullness and contour of the breasts which they had before the pregnancies. All of these subjects reported they were very pleased with the increase in fullness and firmness of their breasts at the end of the study.
The subjects were asked to practice once a day at home. A record was made of the number of times practiced, the number of times they obtained the feeling of warmth, and the number of times they obtained the feeling of pulsation. Some of the subjects practiced more than once a day; therefore, their percent times practiced were logged at greater than one hundred percent. The percent of times warmth and pulsation was obtained was calculated as a function of the number of times practiced versus the number of times obtained. This is shown in Table 1.
There was no direct or indirect correlation between the total number of times the exercise was practiced, the total number of times the warmth or pulsation was felt and the amount of increase in the breast size. Contrary to speculation at the beginning of the experiment, the size of the breasts at the beginning of the experiment could not be correlated with the amount of increase that was obtained.
|6 Weeks||12 Weeks|
It would appear from this study, that the subjects who were able to obtain visual imagery, quickly, easily and a large percent of the time that they attempted it, had the greatest increase in the mass or the size of their breasts. As actual blood flow studies were not done in this part of the program, nor were we able to measure vascular dilitation, the actual mechanism or reason for the growth was not elicited. It is felt that further study should be done to determine the actual cause or mechanism of this enlargement and growth. The only two subjects who subjectively felt there had been no significant increase, did have a measurable increase in size. Both subjects had difficulty obtaining the visualizations. All of the subjects reported an increase in firmness of the breasts. All of the subjects who began the study with one breast smaller than the other found them to be equal in size at the end of the twelve weeks. Table 2 shows the circumference measurements before treatment and at twelve weeks and the mean vertical and horizontal measurements in the beginning and at twelve weeks.
There are many questions which remain unanswered in this study. Number one – What is the mechanism of the growth which occurs? Number two – What length of time is required for the majority of the subjects to reach their stated goal? Number three – Is continued practice necessary to maintain the growth already obtained and if so, what frequency of practice would be necessary to accomplish this? Number four – Are there better techniques or methods of visual imagery or better techniques or methods other than visual imagery to obtain the same results? Number five – the main reason for doing this experiment with breast enlargement was to see if it was possible to make an organ enlarge or grow through visual imagery in order to ask this most important question: If it is possible through visual imagery to enlarge the breasts, external organs, then might it be possible through visual imagery to enlarge other organs internally, such as the kidney, liver, spleen, heart, or lung?
|Subject||Circumference||Mean Vertical||Mean Horizontal|
|Start||12 Weeks||Start||12 Weeks||Start||12 Weeks|
As Williams found in his study, it appears that one is able to affect enlargement of the breasts through hypnosis and from this study, it would appear visual imagery may be a tool or adjunct to this. In the study done by Williams, age regression to the time when the breasts were growing was used to recapture the feeling and sensation of the breasts enlarging. He also age progressed the subjects to a time when the breasts would be the size they desired. This technique requires a direct operator-to- subject relationship. The time element therefore limits the number of people who can be treated at any one time.
One of the purposes of the present study was to see if the instructions and visual imagery could be accomplished by a cassette tape program effectively. There were 20 of the 22 subjects who felt the instructions and the method was satisfactory and were able to visualize as requested. The other two felt the instructions and the method as satisfactory but were unable to visualize as requested. By using self-hypnosis and visual imagery, the operators time was minimal (1 hour and 15 minutes per subject for 12 weeks) and the subjects were given a technique they could utilize anytime.
There has been considerable speculation for some time on the possibility of the human to be able to increase or decrease the circulation to a given area of the body. The use of biofeedback has shown that one can definitely warm or increase the circulation in a given area of the body (Green, E. E., Green, A. M. & Walter, E. D., 1970). Whether we may someday be able to shut off the blood flow to a cancerous tumor by biofeedback or through visual imagery is pure speculation. Until we better understand the role of the “host’s immune mechanism” in combating cancer, we cannot be sure if it would be better to shut off the blood flow to starve the tumor or to increase the blood flow to increase the availability of the host’s defense mechanism.
All of these questions remain unanswered but are certainly worth investigation.
This report reveals the results after 12 weeks of teaching the subjects relaxation and visual imagery in an attempt to enlarge the breasts. All subjects had some increase in breast size. Twenty-eight percent of the subjects obtained the goal they had set at the beginning of the experiment. Eighty- five percent were aware of a significant increase in their breasts, and 46% found it necessary to increase their brassiere size due to the enlargement which occurred. Forty-two percent of the subjects had a spontaneous weight loss greater than four pounds and still had an enlargement of the breasts. It would appear from the study that the subjects who were able to obtain the visual imagery, quickly, easily and a large percent of the time have the greatest increase in the size of their breasts. This preliminary report shows that through hypnosis and visual imagery, the size of an organ can be affected and, specifically in this experiment, can be enlarged. As in most research, it produces as many questions as answers. It is my hope that this paper may stimulate even greater questions and speculations to the possibilities visual imagery may hold for the science of the mind.
Baker, J. L. Jr., Kolin, I. S., & Bartlett, E. S. Psychosexual dynamics of patients undergoing mammary augmentation. Plastic & Reconstructive Surgery, June, 1974, 652-659.
Clark, R. E. & Forgione, A. G. Gingival and digital vasomotor response to thermal imagery in hypnosis. Journal of Dental Research, 1974, 53, 792-796.
DeSaxe, В. M. Breast augmentation. South African Medical Journal, 1974, 737-740.
Fisher, S. Aniseikonic perception by women of their own breasts. Perceptual and Motor Skills, 1973, 36, 1021-1022.
Fuchs, K., Hoch, Z., Paldi, E., Abramovici, H., Brandes, M. M., Timor-Tritsch, I., & Kleinhaus, M. Hypno-desensitization therapy of vaginismus: Part I. “In Vitro” Method. Part II. “In Vivo” Method. International Journal of Clinical and Experimental Hypnosis, 1973, 21, 144– 156.
Green, E. E., Green, A. M., & Walter, E. D. Voluntary control of internal states: Psychological and physiological. Journal of Transpersonal Psychology, 1970, 2, 1-26.
Hurwitz, A. Enhancing a symbol of beauty. Australian Nurses’ Journal, 1974, 3, 13-18.
Redmond, D. P., Gaylor, M. S., McDonald, R. H. Jr., & Shapiro, A. P. Blood pressure and heart-rate response to verbal instruction and relaxation in hypertension. Psychosomatic Medicine, 1974, 36, 285-297.
Reeves, A. & Segal, S. J. Effects of visual imagery on visual sensitivity and pupil diameter. Perceptual and Motor Skills, 1973, 36, 1091-1098.
Reiter, P. J. The influence of hypnosis on somatic fields of function. In L. M. Le Cron (Ed.). Experimental Hypnosis. New York: Citadel Press, 1965.
Simonton, О. C., & Simonton, S. S. Belief systems and management of the emotional aspects of malignancy. Journal of Transpersonal Psychology, 1975, 29-47.
VanPelt, S. J. Will hypnosis revolutionize medicine? In R. Rhodes (Ed.), Therapy Through Hypnosis. New York: Citadel Press, 1964.
Williams, J. E. Stimulation of breast growth by hypnosis. Journal of Sex Research, 1974, 10, 316-326.
Wolberg, L. R. Medical hypnosis. New York: Grune & Stratton, 1948.
Stimulation of Breast Growth By Hypnosis
JAMES E. WILLIAMS Abstract
A frequent compaint among women is the failure of the breasts to develop to a fashionably desirable size. An experiment was designed to determine whether hypnotic suggestion could influence the physiological mechanisms associated with breast growth. The first phase compared hypnosis with and without suggestions for breast growth in six subjects. The second phase examined the effectiveness of hypnotic suggestions of breast growth in thirteen subjects acting as their own controls. Analysis of the data indicated that hypnosis per se had no direct effect on breast growth, but that hypnosis with suggestions for breast growth was effective in stimulating breast growth. Further investigation may show this to be a satisfactory alternate method to surgical breast augmentation.
The bosom is a major sex symbol in our culture. Because of this, many women are concerned with the appearance of their breasts. Some who feel their breasts are too small, sag an unusual amount, or otherwise deviate measurably from the ideal image, often feel deformed or suffer anxiety and self-consciousness. Since the female breast currently holds a place of prominence as an index of female sexuality in our culture, a frequent complaint among women is the failure of the breasts to develop to a fashionably desirable size. In keeping with other American values, “big” is equated with “good” (Winch, 1952). To this end, manufacturers of foundation garments claim styles designed to “lift”, “separate”, “pad”, “cradle”, “form”, and “shape” in such a way that they enhance the contour of the breasts and give the impression of greater size.
Superficial enhancement of this sort has never been completely satisfactory to all women. The extent to which females are concerned with exhibiting breasts deemed provocative and desirable by popular standards is reflected in the variety of mechanical exercisers, cosmetic preparations, and surgical procedures which have been employed from time to time in an effort to produce lasting enlargement of the breasts.
The paucity of empirical data which might support the effectiveness of mechanical exercisers precludes an evaluation of their worth. Little more is available regarding the effectiveness of cosmetic preparations. Estrogen creams applied to the breasts usually result in stimulation of the nipples, but there is little, if any, resultant breast growth in the woman who has normal circulatory levels of estrogen. Simultaneous administration of prolactin and estrogen in large amounts may stimulate the breasts of the normal woman, but evidence for this is not good (Lloyd and Leatham, 1964; Lloyd, 1964, 1968).
Early attempts at surgical breast augmentation were effective for a time, but ultimately proved to be either troublesome, uncomfortable, or harmful. Fatty tissue from the buttocks grafted beneath the breasts was successful for a time, but in some instances the fat was absorbed into the system, leaving the breasts reduced to their previous size. Injections of paraffin tended to migrate from one part of the breast to another, and to form lumpy deposits. Injections of liquid silicon appeared successful in increasing the breast size, but the Food and Drug Administration forbade its use because it was felt it might not be safe.
An apparently successful solution was an operation involving the implantation of a flexible silicon rubber bag filled with liquid silicon between the breast tissue and the chest wall. After healing, breasts treated by this method retained the natural feel and appearance of untreated breasts (Brown, 1968). The disadvantages of this procedure are that the operation necessitates hospital confinement of about one week, and is relatively expensive.
Normal maturation and growth of the female breasts depends on the development and functioning of the pituitary-gonadal-adrenal mechanism in the production of gonadotropic hormones. There are temporary imbalances in the amounts of the numerous hormones secreted during the period of development, as well as individual differences in the responsiveness of the sexual end-organs to the various hormones (Brasel and Blizzard, 1968).
The anterior pituitary controls the activity of the final effector organ, but it is regulated by the hypothalamus. Nerve pathways exist which bring the hypothalamus under the influence of the “viceral brain”, which is recognized to be the anatomic substrate of emotion. It is through these pathways that emotional states can alter gonadotropic function (Reichlin, 1968).
Hitschmann (1928) reported such changes in his analytic treatment of frigidity. In the woman he treated, he found such masculine signs as flat breasts, little mustaches, and large hands. Hitschmann did not consider it proven that there was a change in the endocrine metabolism in these women when they changed during an analysis, but the breasts grew and the figure became better rounded. Groddeck (1921) and Deutsch (1926) reported cases in which psychic factors were decisive in producing breast growth. During psychoanalysis in these cases, anomalous breast changes occurred in women in whom one breast had been retarded in development Mohr (1925) reported the case of a girl in whom strong emotions during puberty resulted in a psychically conditioned inhibition of pubescence for a period of ten years. When psychotherapy was initiated, pubescence was completed in a few months, with menses, development of the breasts, increase of the thyroid, and disappearance of hairiness of the chin which had been present at the beginning of treatment. Mohr expressed no doubts that endocrine factors had played a considerable role as a connecting link, but was equally certain that the psychic factors were primary, activating the endocrines secondarily. Mohr stressed the fact that here “psychic” is by no means synonymous with “suggestion”; that this psychosomatic interaction occurred without any suggestion.
That suggestion can play an active role has been more than amply demonstrated, however. Hypnotic suggestion can produce a variety of effects which transcend normal voluntary capacities. Even in light hypnosis there is increased control over the autonomic nervous system, and all the glands and organs it supplies. It is practicable to influence any reactive system within the organism. Many of the phenomena which have been reported lend evidence to the thesis that hypnotic suggestion can bring about psychobiologieal changes in the organism which are quite impossible to obtain in the waking state (Gorton, 1949; Reiter, 1965; Van Pelt, 1964; Weitzenhoffer, 1951; Wolberg, 1948).
Among these phenomena, hypnotic regression is one of the most remarkable. There is evidence that when some individuals are regressed, experience and behaviors which existed at the earlier age are reactivated, and the organic conditions of that period may be reestablished. Wolberg (1945) described this as an actual organic reproduction of an earlier period of life in which past patterns of ideation
and behaviors are revived. Experiences subsequent to the regressed age appear to have no influence on the subject’s awareness or behavior (Le Cron, 1965; Norgarb, 1965; Weitzenhoffer, 1957 Wolberg, 1948).
Kupper (1945) reported appearance of a pre-convulsive normal electroencephalogram in an epileptic patient during hypnotic regression to an age that pre-dated the onset of his epilepsy.
Girdo-Frank and Bowersbuch (1948) reported the recovery of the Babinski sign of plantar dorsiflexion in three adult subjects regressed to the age of five or six months. They also found that changes in peripheral chronaxie accompanied the change in plantar reflex. Le Cron (1965) confirmed their findings, using three different subjects. At the regressed age of five months, he also found that the sucking reflex of infancy revived.
Conversely to age regression, Erickson (1954) employed a technique of “time projection” as an hypnotherapeutic procedure. With this procedure of orientation into the future he reported the patient was able to achieve a view of what he believed at the moment he had already accomplished.
Klemperer (1953, 1954) reported on changes of the body image in directed regressions and visualizations during hypnoanalysis. She reported the occurrence of seen and felt changes in tissue, organs, and body systems, accompanied by perceptions and emotions.
Research suggests that these hypnotic procedures of age regression, time projection, and changes in body image may produce psychological phenomena which are capable of stimulating a variety of physiological responses. The purpose of this study was to determine whether these procedures could influence the physiological mechanisms associated with breast growth to produce a significant increase in breast size in an adult female population
The subjects consisted of nineteen volunteer female university students. Five were graduate students and the remaining fourteen were undergraduates. Subjects ranged in age from eighteen to forty years, with a mean age of twenty-four years. Fifty-three per cent of the subjects were married. Of the married subjects, sixty per cent had borne children. Sixty per cent of the married subjects and fifty-five per cent of the single subjects reported they were taking birth control pills. The age of menarche ranged from nine years to fifteen years, with a mean age of twelve years. All subjects reported their weight had been constant (within five pounds) for a minimum period of six months preceding the experiment.
Measuring apparatus consisted of Starett ten-inch outside calipers, Johnson No. 46 vernier calipers, and a seventy-two inch flexible measuring tape.
The study consisted of two phases. The first phase was a pilot study designed to compare two treatments. The experimental group consisted of three subjects who were hypnotized once weekly and received suggestions for breasts growth. The control group consisted of three subjects who were hypnotized once weekly, but received no suggestions for breast growth.
At the initial treatment period of each subject, the expired breast measurements were taken around the bust on the horizonal plane of the nipples. Each subject, under the direction of the experimenter, took the measurements of another subject during the initial and all subsequent treatment periods. In addition, all measurements were verified by a third subject. Then hypnosis was induced and suggestions were given.
The suggestions given to each subject in the control group consisted only in the establishment of a variety of sensory hallucinations. The suggestions given to each subject in the experimental group consisted of regression to a period when the breasts were developing, and the sensation of breast growth was suggested during this period. Then suggestions of time projection to an unspecified future date were given and the subject was directed to visualize her body image with increased breast size.
Treatment periods averaged about one hour, and were continued for a period of twelve weeks. Each subject’s expired breast measurements were recorded at each of the weekly hypnosis sessions. The same suggestions each subject received during the initial treatment period were repeated at each subsequent session.
The second phase of the study involved the remaining thirteen subjects. These subjects acted as their own controls to determine the effectiveness of hypnotic suggestion in breast enlargement.
Each subject’s breast measurements were taken weekly for a period of three weeks to establish a baseline prior to the initiation of the treatment procedure. Inspired and expired measurements were taken around the bust on the horizontal plane of the nipples. Expired measurements were taken around the chest on the horizontal plane immediately below the base of the cup of the breasts. Measurements were also taken from the base of the cup to the nipple, from the sternum to the nipple, from the lateral periphery to the nipple, and the span from nipple to nipple. Each measurement throughout the baseline and treatment procedure was made by the experimenter and confirmed by the subject, and verified by a second subject.
During the baseline period no hypnosis was induced, and no suggestions were given for breast growth. Immediately following each subject’s final baseline measurements on the third week, hypnosis was induced and the treatment procedure was initiated.
The treatment procedure consisted of a series of suggestions for regression to a period when the breasts were developing, and the sensations of breast growth were suggested during this period. Suggestions were then given for time projection to an unspecified future date, and the subject was directed to visualize her body image with increased breast size.
Treatment periods averaged about one hour, and the treatment procedure was followed once weekly for a period of twelve weeks. Immediately following each treatment procedure, the same measures used to establish the subject’s baseline were taken and recorded. The same suggestions given during the initial treatment period were repeated at each subsequent treatment period.
The first phase examined, in the pilot study, whether hypnosis with suggestions for breast enlargement was significantly more effective in stimulating breast growth than was hypnosis without specific suggestions for breast enlargement.
The criterion for effectiveness was an increase in the breast measurements of the subjects between the initiation and termination of the treatment procedures. There was no change in any of the subjects in the control group, while all subjects in the experimental group experienced an increase in breast measurement. Average increase was one and five-eighths inch.
Differences between the treatment groups were examined using the Mann-Whitney U test described by Siegel (1956). Results indicate there was a significant difference (U = 0, p. < .05) between the control group (weekly hypnosis without suggestions for breast enlargement) and the experimental group (weekly hypnosis with suggestions for breasts enlargement).
The second phase provided a further examination of the effectiveness of hypnotic suggestion in the stimulation of breast growth.
Criterion for the effectiveness of the treatment was an increase in breast measurements. Expired breast measurement taken on the horizontal plane of the nipples was selected as the primary index of breast enlargement.
Each subject’s record of breast measurements for the three weeks prior to initiation of the treatment procedure was averaged, and this mean was used as the baseline measure. The breast measurements taken during the last three weeks of the treatment procedure were averaged and this mean was used as the treatment measure.
All breast measurements were recorded in fractions of an inch. To facilitate machine computation, decimal equivalents were substituted for all fractions of an inch.
Baseline expired breast measurements ranged from 30.21 inches to 39.08 inches, with a mean measure of 33.64 inches. Treatment expired breast measurements ranged from 32.33 inches to 41.33 inches, with a mean measure of 35.75 inches. The mean increase for the group was 2.11 inches. Individual increases ranged from a minimum of 1.00 inches to a maximum of 3.54 inches. Table 1 presents the data on the individual breast measurement means for the second phase.
Paired comparisons of baseline and treatment data were examined, using the Wilcoxon signed-rank test described by Siegel (1956). An analysis of the data indicated there was a significant increase in breast dimensions following the treatment procedure (T=0, p.<.005).
As a control measure, expired chest measurements taken at the base of the breasts concurrently with the expired breast measurements were compared. Baseline expired chest measurements ranged from 28.00 inches to 35.00 inches, with a mean measure of 29.94 inches. Treatment expired chest measurements ranged from 27.00 inches to 34.00 inches, with a mean measure of 29.27 inches. The mean decrease for the group was .67 inch.
Expired Breast Measurements
|Subject Number||Baseline Mean||Treatment Mean|
The remainder of the breast measurements taken were examined, and a comparison of baseline and treatment means of these measures is presented in Table 2.
In phase one, which was primarily a pilot study, no increase in breast measurements was observed in the control group when they were hypnotized weekly without suggestions for breast growth. All subjects in the experimental group exhibited an increase in breast measurements when they were hypnotized weekly with suggestions for breast growth.
Several extraneous variables were held constant for both groups. The control and the experimental group each contained one married and two single subjects. Each of the married subjects had borne children. Each group included one subject over thirty years of age. The average age in each group was twenty-seven years, and the average age at menarche in each group was twelve years, with none occurring earlier than eleven or later than thirteen years.
Since the experimental and control groups were approximately equal in marital status, child bearing, age, and age at menarche, it does not appear that these factors influenced the results to any significant degree.
Supplemental Breast Measurement Means
|Area of Measure||Baseline
|Nipple to cup base|
|Nipple to sternum|
|Nipple to lateral periphery|
This preliminary evidence suggests that hypnosis per se had no direct effect on the breast enlargement, but that hypnosis with suggestions for breast growth was effective in stimulating breast enlargement.
In the second phase, each subject acted as her own control in examining the effectiveness of hypnotic suggestions in stimulating breast growth. Baseline data taken prior to treatment was compared with the data of the last three weeks of treatment and it was determined that increases in individual breast measurements ranged from one to three and one-half inches. All subjects experienced enlargement following treatment, with an average increase of two and one-eighth inches.
Expired chest measurements were taken weekly to determine if the increase in breast measurements might be due to enlargement of the rib cage or upper torso. To the contrary, it was found that the chest measurements decreased an average of five-eighths on an inch in association with the increase in breast measurements. Supplementary breast measurements indicate the increase in breast size was symmetrical, with average increases of about one-eighth of an inch from the cup base to the nipple and the sternum to the nipple, three- eighths of an inch from the lateral periphery to the nipple, and one-fourth of an inch in the span of the nipples.
An examination of the background data failed to disclose any factor which might have significance in selecting the population with which this particular procedure might be most effective. The average increase in breast measurement was somewhat less in the married subjects than in the single subjects, but married subjects who had borne children exhibited slightly larger average increases than those who had not.
There were no significant differences in breast growth between subjects who were taking birth control pills and those who were not. Two subjects discontinued birth control pills midway through the procedure without noticably altering their growth curve.
The only variable which might appear to influence the degree of breast enlargement was the age of menarche. The subjects who had an age of menarche of eleven years or less showed an average increase of about one and one-fourth inch, compared to the group average of two and one-eighth inches. However, with a sample of only four subjects in this category, little can be inferred from this data without further investigation.
The basic method of hypnotic induction used was a variation of the hand levitation procedure described by Wolberg (1948). No attempt was made to achieve stability in depth of hypnosis between subjects, since one of the extraneous considerations of the study was to determine if depth of hypnosis was a significant factor in the degree to which suggestions could influence breast growth. Since some subjects who were not able to achieve deep hypnosis showed a greater increase in breast size than some who were, it appeared that depth of hypnosis was not a significant factor.
No attempt was made to verify true regression by test. It was not considered that the presence or absence of true regression would influence the outcome of the procedure.
It was not within the scope of this paper to determine what, if any, changes in the hormonal sphere were brought about through the treatment procedure investigated. Whatever the psychobiologic changes which are involved in the mechanisms associated with breast growth, it appears a reality that hypnotic suggestions can influence them to a significant degree.
Brasel, J. A. and Buzzard, R. M. The influence of the endocrine glands upon growth and development. In R. H. Williams (Ed.), Textbook of Endocrinology, (4th ed.), Philadelphia: W. В. Saunders, 1968.
Brown, W. E. Cosmetic Surgery. New York: Stein & Day, 1968.
Deutsch, F. Der gesunde und der kranke Korper in psychoanalyticher Betrachtung. Cited by H. F. Dunbar, Emotions and Bodily Changes, (4th ed.), New York: Columbia University Press, 1954.
Erickson, M. H. Pseudo-orientation in time as an hypnotherapeutic procedure. Journal of Clinical and Experimental Hypnosis, 1954, 2, 261-283.
Girdo-Frank, L. and Bowersbuch, M. K. A study of the plantar response in hypnotic age
i regression. Journal of Nervous and Mental Disorders, 1948, 107, 443-458.
Gorton, В. E. The physiology of hypnosis, I & II. Psychiatric Quarterly, 1949, 23, 317-343, 457-485.
Groddeck, G. Ueber die psychoanalyse des organischen im menschen. Cited by H. F. Dunbar, Emotions and Bodily Changes, (4th ed.). New York: Columbia University Press, 1954.
Hitschmann, E. Psychoanalyse trotz hormonen. Cited by H. F. Dunbar, Emotions and Bodily Changes, (4th ed.). New York: Columbia University Press, 1954.
Klemperer, E. Changes of the body image in hypnoanalysis. Journal of Clinical and Experimental Hypnosis, 1954, 2, 157-162.
Klemperer, E. Hypnosis and hypnoanalysis. Journal of American Medical Women’s Association, 1953, 8, 164.
Kupper, H. L. Psychic concomitants in wartime injuries. Psychosomatic Medicine, 1945, 7, 15-21.
Le Cron, L. M. A study of age regression under hypnosis. In L. M. Le Cron (Ed.), Experimental Hypnosis. New York: Citadel Press, 1965.
Lloyd, C. W. Problems associated with sexual maturation and lactation. In C. W. Lloyd (Ed.), Human Reproduction and Sexual Behavior. Philadelphia: Lea & Febiger, 1964.
Lloyd, C. W. The ovaries. In R. H. Williams (Ed.), Textbook of Endocrinology, (4th ed.). Philadelphia: W. B. Saunders, 1968.
Lloyd, C. W. and Leathem, J. H. Growth and development of the breast and lactation. In C. W. Lloyd (Ed.), Human Reproduction and Sexual Behavior. Philadelphia: Lea & Febiger, 1964.
Mohr, F. Psychophysische Behandlungsmethoden. Cited by H. F. Dunbar, Emotions and Bodily Changes, (4th ed.). New York: Columbia University Press, 1954.
Norgarb, B. A. Rorschach psychodiagnosis in hypnotic regression. In L. M. Le Cron (Ed), Experimental Hypnosis. New York: Citadel Press, 1965.
Reichlin, S. Neuroendocrinology. In R. H. Williams (Ed.), Textbook of Endocrinology, (4th ed.). Philadelphia: W. B. Saunders, 1968.
Reiter, P. J. The influence of hypnosis on somatic fields of function: In L. M. Le Cron (Ed.), Experimental Hypnosis. New York. Citadel Press, 1965.
Siegel, S. Nonparametric Statistics. New York: McGraw-Hill, 1956.
Van Pelt, S. J. Will hypnosis revolutionize medicine? In R. Rhodes (Ed.), Therapy Through Hypnosis. New York: Citadel Press, 1964.
Winch, R. F. The Modern Family. New York: Henry Holt, 1952.
Weitzenhoffer, A. M. The transcendence of normal voluntary capacities in hypnosis: An evaluation. Personality, 1951, 272-282.
Weitzenhoffer, A. M. General Techniques of Hypnotism. New York: Grune & Stratton, 1957.
Wolberg, L. R. Hypnoanalysis. New York: Grune & Stratton, 1945.
Wolberg, L. R. Medical Hypnosis. New York: Grune & Stratton, 1948. 2 vols.
 Although I shall refer often simply to “blood flow” as a mediating variable in producing the effects discussed in this paper, other aspects of blood circulation are also involved. For instance, although changes in skin temperature are highly correlated with changes in blood flow, many other variables — e.g., blood pressure, blood volume, heart rate, and resistance of the vessels — also play complexly interrelated roles in affecting either or both blood flow and skin temperature.
 This paper was originally presented to James Millham, Ph.D., at the University of Houston in return for independent research credit.
 The authors wish to gratefully acknowledge the assistance of Becky Morris and Ellen Sutphin in planning this study.