43 DR. KLAAS ALTENA TRANCE AND HYPNOSIS DEFINED WITH MODERN LOGIC: APPLICATIONS TO HYPNOTHERAPY european journal of clinical hypnosis - volume five – issue three – pp. 43-54 TRANCE AND HYPNOSIS DEFINED WITH MODERN LOGIC: APPLICATIONS TO HYPNOTHERAPY ▼ Author: Klaas Altena Kampen, the Netherlands Modern logic can help to define trance and hypnosis. Logic constructs different formal languages. Trance is defined as the mental state in which thoughts are modelled according to one of these formal languages. Hypnosis is defined as the application of techniques that change the accessibility to these languages for a person. The treatment of two cases of Obsessive-Compulsive Disorder, two cases of Delusional Disorder, and an analysis of some aspects of a mainstream approach to hypnosis demonstrate the applicability of this theoretical approach. 44 DR. KLAAS ALTENA TRANCE AND HYPNOSIS DEFINED WITH MODERN LOGIC: APPLICATIONS TO HYPNOTHERAPY european journal of clinical hypnosis - volume five – issue three – pp. 43-54 In modern logic different types of formal languages are constructed. These languages differ in their power to approach the complexities of the natural languages. In this study, it is hypothesized that one of the simplest formal languages, the so-called language of first-order logic, is a good approach to the language used by a person who is in trance. Trance is defined as the state of mind in which essentially only the language of first-order logic is available for mental and communicative operations. If trance is defined in this way then mental problems and paradoxes that depend upon another type of language cannot exist in a state of trance. Two paradoxes with serious cognitive and behavioral consequences, the Liar and the Truth-teller, are presented in this study as examples of this language dependency. The concept accessibility to languages is used to define hypnosis. Hypnosis is defined as the application of a technique that changes the accessibility to types of languages. The hypnotherapist has access to different languages and changes the accessibility to languages for the client. The treatment of some cases of Obsessive-Compulsive Disorder and Delusional Disorder is taken as an illustration of this approach. To conclude this study an analysis is made of some hypnotic language patterns used by Bandler and Grinder (Bandler & Grinder, 1975; Grinder & Bandler, 1981) DEFINITIONS OF TRANCE AND HYPNOSIS The term mental disorder implies that there is a state of mind that can be called mental order. Let mental order be described as the condition in which a valid argument is available for answering questions like: Is it right to think or to act so and so? The term ‘argument’ refers here to the process of reasoning in which a conclusion is drawn. In this study reasoning is used synonymously with argument. Mental disorder implies a condition in which a valid argument is not available. Only where Mental Disorder is capitalized reference is made to diagnoses mentioned in the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994). Formal Languages Modern logic tries to answer the question when an argument is valid. If initial expressions in a formal language of logic are used to derive other expressions, then these initial expressions are called axioms or theorems. If an axiom in such a system cannot be valuated as true or false, this will cause a condition in which valid reasoning is not available if reasoning depends on that very axiom. If valid reasoning is not available to decide if some proposition is true or false, and if as a consequence a vital question cannot be decided upon, then thinking may become obsessive. I.e., the reasoning from premises to conclusion is started again and again but with no success. If reasoning contains a premise that cannot be logically valuated as false without producing a contradiction then no argument of another person can demonstrate the falsity of such a belief. The cognitive, emotional, and behavioral consequences of these disordered mental states can be great. In both cases the level of complexity of the languages the mind uses is important. Formal languages differ in complexity. Some formal languages are so simple that they do not even have the capacity to simulate certain mental disorders. At first sight this would be a reason to reject that language as useless. But this can be reversed. What happens with a mental disorder if the person involved changes the language of the mind to a type of language that cannot even produce this disorder? This approach to a certain domain of mental disorders makes use of formal aspects of languages. Maybe those formal aspects are decisive to solve some mental disorders. The language of first-order logic In order to demonstrate the capacity to analyze sentences from natural language with a formal language some detailed examples of formal expressions are presented. The formal language discussed in this section is called the language of first-order predicate logic, or the language of first-order logic, or just a first-order language. Form is essential for the construction of expressions in a formal language. And form is essential to differentiate between different formal languages. Reasoning cannot be conducted with sentences that are not well formed. E.g., the sentence: All mouthbrooders carry around in the does not conform to the rules for constructing a well-formed sentence. Because reasoning is conducted with sentences that are well formed, the question must be asked: What is the structure of a sentence? A sentence is formed if something is predicated of an entity, e.g., The sky is red. The entity ‘sky’ has the property Red. (In what follows names for entities are italicized. Names for predicates are italicized and capitalised.) This sentence is rewritten, following certain conventions in logic (Barwise & Etchemendy, 1992), as (Red(sky)): The sky is red. To avoid ambiguity in the case of composite expressions an expression is placed between a left and a right parenthesis. The 45 DR. KLAAS ALTENA TRANCE AND HYPNOSIS DEFINED WITH MODERN LOGIC: APPLICATIONS TO HYPNOTHERAPY european journal of clinical hypnosis - volume five – issue three – pp. 43-54 expression (Red(sky)) is a claim about the world. In a more symbolic language the sentence (Red(sky)) can be presented as (R(s)): R for the predicate Red and s for the entity sky. Sentences can be more complex, e.g., Dawn loves reality. The predicate is Loves and there are two entities to be compared. One entity is dawn and the other entity is reality. This sentence is represented in the form (Loves(dawn, reality)): (L(d,r)). The relation Loves is a two-place predicate because two entities are related. If three entities are related, the predicate is a three-place predicate. Dawn is a choice between night and light is represented as (Choice(dawn, night, light)): (C(d,n,l)). The following three sentences result: (R(s)) (L(d,r)) (C(d,n,l)) The capital letters R, L, and C refer to predicates. The small letters s, d, r, n, and l, refer to individual constants, entities in the world: persons, things, experiences, imaginations, etc. If the individual constants are replaced by variables, e.g., (R(x)), this formula symbolizes that x is red whatever x may be. This is a formula but not a sentence in logic, because this expression cannot be true or false. (In what follows the term expression is used for both sentences and formulas.) If the variable is replaced by an individual constant, e.g., sky, or light, or dawn, the resulting expression is a sentence because that expression can be true or false. The formula (R(x)) can also be transformed to a sentence if quantifiers are used. There are two quantifiers. The existential quantifier is symbolized as x and means: There exists an entity x such that…. The universal quantifier is symbolized as x and means: For every entity x it is the case that…. If an existential quantifier is placed before the expression (R(x)), the formula (xR(x)) results, "There exists an entity x such that x is red". This expression can be true or false. Another sentence results if the universal quantifier is added. This results in the formula (x Red(x)), which means that every x is red. Sentences can be negated by the expression it is not the case that… symbolized as . The result is a new sentence, e.g., (xR(x)). The expressions that can be generated in this way can be chained together with the help of the conjunct and symbolized as , the disjunct or symbolized as , and the implication if…then, symbolized as . A possible composition of the three sentences above is: (((R(s)) (L(d,r))) (C(d,n,l))) If the sky is red and dawn loves reality, then dawn is a choice between night and light. This composite sentence can be true or false. This composite expression belongs to the language of first-order logic. Grinder and Bandler (1981) provide an example of joining sentences together with the help of the conjunct and. … And as you look about … you can enjoy … the clarity of the air … the distinctive lighting across the sky … and you glance down and see… the surface of the beach … and as you stand there … looking down at the beach you’re standing on … you can see your feet (…). (p. 45) This long sentence can be transformed to a composite sentence using the conjunct several times. In some positions of this sentence the conjunct is implicitly present. The type of sentences belonging to the language of firstorder logic does not suffice to analyze all thoughts and utterances in natural languages. The following sentence cannot be analyzed with the language of first-order logic. And as you look about… you are aware of the redness of the sky… the lucidity of your awareness… the transparency of your thinking about the lucidity of your awareness. Here the property transparency is a property of thinking about lucidity, and the lucidity is a property of awareness. In the formulas of first-order logic there is no place for such constructions. There is a lot more to say about the construction of wellformed sentences, but this will suffice for the purpose of this study. For introductions on modern logic, see Barwise and Etchemendy (1992), Gamut (1991a, 1991b) and Stolyar (1970). Other formal languages If a formal language is constructed in which the object of a predicate is itself a predicate, the language is no longer a first-order language but a second-order language. The sentence: It is unethical to be egoistic is a sentence in which the property of being egoistic (E) is assigned the property unethical (U). In formal symbols: (U(E)). If the phrase is false is understood as a predicate on the same footing as Blue at least a second-order language is needed to construct the sentence: Everything they think of me is false. The phrase everything they think of me refers to a set of properties assigned to the entity me. And whatever property is assigned to the entity me, this property has the property of being false. However, the use of is true or is false as predicates in a sentence creates paradoxes. This use of is true and is false in 46 DR. KLAAS ALTENA TRANCE AND HYPNOSIS DEFINED WITH MODERN LOGIC: APPLICATIONS TO HYPNOTHERAPY european journal of clinical hypnosis - volume five – issue three – pp. 43-54 sentences belonging to a language of higher-order logic, may result in obsessive or irrational thinking. First-order predicate logic constructs expressions as mentioned before. Second-order logic constructs expressions that assign a property to a property or to a set of properties. Third-order languages predicate something of sentences containing predicates that predicate something of a predicate or of set of predicates. Second-order logic therefore has the capacity to analyze sentences that are of a more complex nature than the sentences that first-order logic can analyze. There are other kinds of logic. Modal logic deals with expressions that contain the element it is necessarily so that and it is possible that. Tense logic deals with expressions that contain the elements it is always going to be the case that, it always has been the case that, it will at some stage in the future be the case that, it was at some stage in the past the case that. Suppose a client tells the hypnotherapist, “I have no other choice than to hit my son”. The first impression is that this is a sentence that cannot be analyzed with the first-order language. The language of modal logic can analyze it as the following sentence: It is necessary so that I hit my son. The second impression is that the client is probable not in trance. In a state of trance one does not expect such sentences of the person. The same applies to the sentence: I have always been an honest person. Tense logic can analyze this sentence. If the person who expresses this sentence is expected to be in trance then the hypnotherapist is justified to doubt that this person is really in trance. Again, such impressions tell something about the intimate connection between language en trance. If a person is expected to be in trance, he is not able to think or utter sentences that belong to higher-order logic, modal logic or tense logic and other forms of logic. He will not be able to tell the hypnotherapist: You have possibly at some stage in the induction interspersed some suggestions in your sentences. This means that in a state of trance certain languages are not accessible. PARADOXES THAT CAUSE OBSESSIVE AND IRRATIONAL THINKING predicate is false. One of the sentences this sentence refers to is the English sentence: All sentences formulated in the English language are false. Therefore this sentence refers to itself. If a sentence is produced in the English language, then the question if this sentence is true, cannot be solved. If this sentence is valuated as true, it must be admitted that therefore this sentence is false. But if this sentence is valuated as false, one must admit that therefore this sentence is true. This kind of self-reflexive sentences therefore causes what usually is called the Liar paradox (e.g., Barwise & Etchemendy, 1987). The structure of a sentence of this type can be represented by the expression: This sentence is false. A proposition is that what is expressed in a sentence: uttered, written down or symbolized in some other form. The set of propositions in an axiomatic system that refer to themselves and cause this kind of logical trouble, is called here the set A. Propositions belonging to this set are called in the present study A-propositions. If an A-proposition functions as a premise in an argument, or the truth of at least one of the premises depends on this A-proposition, then the argument cannot be concluded. Especially in the case of vital or moral questions of the general form: Is it right to think or to act so and so? This may result in obsessive thinking. If it is possible that such an Aproposition changes into a proposition that is either true or false but not both, then that problem is solved. The existence of Liar-like paradoxes is a symptom of something, namely that a person can reflect upon his own language constructions or upon his own thinking. This view suggests that the need to reflect upon one’s owns thoughts and to negate the content of these thoughts at the same time, is at the source of the problem. Suppose the following argument in which P and Q are propositions that can be expressed as a sentence: Premise 1: If (it is the case that) P then (it is the case that) Q Premise 2: (it is the case that) P Conclusion: Therefore (it is the case that) Q An example is: The Liar A sentence is formed if something is predicated of an entity. But what happens if something is predicated of a property or of a sentence or predicated of a class of properties or a class of sentences? E.g., when the sentence is formed: All sentences formulated in the English language are false. This sentence refers to a set of sentences and contains the If I am responsible for my children (P) then I have the responsibility to check whether their drinks are safe (Q). I am responsible for my children (P), Therefore I have the responsibility to check whether their drinks are safe (Q). 47 DR. KLAAS ALTENA TRANCE AND HYPNOSIS DEFINED WITH MODERN LOGIC: APPLICATIONS TO HYPNOTHERAPY european journal of clinical hypnosis - volume five – issue three – pp. 43-54 This reasoning from two premises to a conclusion is straightforward. But suppose now that the truth of proposition P depends upon an A-proposition. An example of an A-proposition that might function as an axiom or theorem for the argument presented above is expressed in the following sentence: I am not responsible for my thoughts about responsibility. In that case it is not possible to construct an argument in the form cited. The argument cannot be concluded how often you try to reach a conclusion. The proposition I am responsible for my children is a thought about responsibility. On the ground of the Aproposition, I am not responsible for this thought. But if I am not responsible for a certain thought then I am not responsible for the conclusion of an argument that contains this thought. Even this last thought is a thought about responsibility and falls under the scope of the same Aproposition. If the matter at hand is of any urgent or vital interest, then thinking from premises to conclusion is a necessary step but cannot be concluded and has to start again and again. And that is a characteristic of much obsessive thinking. Confusion likewise results if the A-proposition is all my thoughts about responsibility are false. In that case it seems not even possible to think the first and second premise, because it is not possible to valuate them as true. The argument given above is but one type of argument that causes logical confusion if it falls under the scope of an Aproposition. The Truth-teller Another kind of paradox results from the Truth-teller. The Truth-teller is expressed by the sentence This sentence is true. This sentence, like the Liar, refers to itself. At first sight this sentence does not seem problematic. But if the question is asked if the sentence as a whole, namely This sentence is true, can be possibly false, logical problems arise. The argument runs as follows. A sentence is an expression that can be true or false. Consider the following possibilities: This sentence is true, is true This sentence is true, is false First consider possibility (1) that the expression is true is considered to be a logical valuation as it appears as part of the italicized sentence. In that case things seem to be consistent. But if in (2) the first appearance of is true is a logical valuation, it contradicts the valuation is false outside the italicized sentence. If in some reasoning, This sentence is true functions as a premise and is valuated false, then this reasoning cannot proceed because of this contradiction. Therefore, a Truth-teller belongs to the type of Apropositions. In the case of the Truth-teller a sentence can be constructed such as All my thoughts about responsibility are true. This sentence as a whole contains its own truth predicate and a contradiction results if one tries to valuate this whole sentence as false. Suppose the following argument in which P and Q are propositions: Premise 1: Either P or Q Premise 2: not-P Conclusion: Therefore Q Now suppose that P is a Truth-teller, then premise 2 is a contradiction and the conclusion therefore Q is not possible. The conclusion is not simply false. The proposition P cannot be false and this proposition forms a possible source of irrational ideas that cannot be corrected. A mental disordering may result. The language of the Liar and the Truth-teller In the foregoing an A-proposition is described as a type of proposition that may contain its own truth predicate as in the following sentences: This sentence is false, and, This sentence is true. But this rests on the assumption that is true and is false are properties on the same footing as the properties Red, or Loves, Between, Egoistic, and Unethical. If simple sentences are composed like, This ball is blue, and, This ball is true, the difference between is blue and is true is evident. A ball may be blue but a ball cannot be valuated as true. Nor can a ball be valuated as false. For a discussion of this and related topics see Soames (1999). In first-order logic a sentence is composed of a predicate and an object. In first-order logic the expressions is true and is false cannot be used as predicates on the same footing with other predicates. Suppose it is made impossible to use a language in which the expressions is true and is false function as predicates. Or suppose it is made impossible to use a language that does allow the construction of a sentence that refers to itself. In those cases an A-proposition cannot be presented as a wellformed formula. And that eliminates the problems with these A-propositions. But how can the person involved reconsider the syntactic and logical function of the terms is true and is false? This question is especially difficult to answer when the use of the predicate is deeply buried in the process of thinking and reasoning. And it is too difficult an enterprise to teach the client to change the position of the valuations is true and is false. 48 DR. KLAAS ALTENA TRANCE AND HYPNOSIS DEFINED WITH MODERN LOGIC: APPLICATIONS TO HYPNOTHERAPY european journal of clinical hypnosis - volume five – issue three – pp. 43-54 There are several extensions of first-order logic. These extensions generate more complex sentences than can be constructed in the language of first-order logic and are therefore more suitable to describe the sentences of natural languages. But the Liar paradox and the Truth-teller described above, need just such an extension of the language of first-order logic. If this is true, then a restriction of mental activity to the language of first-order logic does not permit the construction of paradoxes like the Liar paradox and the Truth-teller. And this is the place where trance and hypnosis enter the story. THE DEFINITION OF TRANCE A state of trance induced in hypnosis seems a rather strange and inexplicable state. But this depends on the perspective one chooses. The instructions given by the hypnotherapist to the client form a key to understand what happens in trance. The instructions often imply that the client must concentrate on sensory-grounded experiences or sensory-grounded fantasies. A state of mind is then created in which the client forms and uses sentences that are of the type constructed in the language of first-order logic. Therefore: Trance is defined as the state of mind in which only sentences are used which belong to the language of first-order logic. This definition implies that in trance only sentences can be formed which connect a predicate with an individual object. The object of a predicate cannot be a property, a set of properties, a sentence or a set of sentences. And a sentence constructed in a state of trance cannot contain its own truthpredicate. This excludes in a state of trance the formation and use of propositions that are expressed by sentences like: 1. The light feeling in my left arm is a pleasant feeling. 2. My right arm lifts as an utterance of my will. 3. This particular sentence I think is not of my own making. 4. All what you (the therapist) tell me is sensorygrounded. 5. You (the therapist) apply the technique of pacing and leading. The state of trance includes the possibility of sentences like: 1. My left arm feels relaxed. 2. It is not the case that my right arm is relaxed 3. My right arm is lifting. 4. I imagine a cloud drifting through the sky. 5. I see a rabbit This means that in a state of trance, the client is not able to judge if his reactions, e.g., sensorimotor responses, happen out of free will or not! If this judgement should be made, some sentence such as, My right arm lifts, as an utterance of my will, must be constructed. But this sentence contains the expression Lifts as a predicate and this predicate is the object of the predicate Is an utterance of my free will. Such a sentence belongs to the language of higher-order logic. In a state of trance therefore the client cannot make a judgement about what the therapist wants or what the client wants. This is characteristic for a trance situation. Any observator can tell that a client lifts his arm because the hypnotherapist wants that to happen. But the client experiences an estrangement and cannot tell you if he does comply with the therapist or not. The same reasoning applies to the instructions the therapist utters. The method to induce a state of trance is to instruct the client to concentrate exclusively on individual objects, e.g., a spatial object, a finger, or an image, or other sensory impressions. This concentration results in a sensorygrounded experience. The instruction, You feel the warmth in your right hand, helps to induce trance. But not the instruction, Judge if the warmth in your right hand feels good or bad. The instruction, Concentrate on the force that lifts your left arm, furthers the state of trance. But the instruction, See if your left arm lifts fast enough, does not further the state of trance. It is important to note that the truth-value of the sentences used by the therapist or client does not really matter. Even if sentences uttered by the therapist are logically false assertions or false predictions, if they induce a tendency to direct attention to sensory-grounded experiences they enhance the probability that the client uses a language of first-order type. This explains why the therapist can make use of a predictive sentence like: Your arm slowly stiffens. It is not necessarily the case that the arm is stiffening slowly. The effect of the prediction is in any case that the attention of the client is directed on sensory experiences in the arm. Relaxation techniques often induce a trance. The person who instructs relaxation directs the focus of attention to the experience of one’s bodily state. For a discussion of the concepts, theories and techniques with respect to relaxation, see Poppen (1998). To direct attention to a physical state is to induce in the person the tendency to construct formulas in the language of first-order logic. If the relaxation technique is instructed according to the rules, the language of first-order logic can represent the language used, whether or not relaxation is 49 DR. KLAAS ALTENA TRANCE AND HYPNOSIS DEFINED WITH MODERN LOGIC: APPLICATIONS TO HYPNOTHERAPY european journal of clinical hypnosis - volume five – issue three – pp. 43-54 effectively reached. It should be noted in passing that in therapeutic approaches that rely on conversations and analysis of the cognitive activities, e.g., irrational thoughts, of the client, a language is required that must be represented by a formal language that is more complex than the language of first-order logic. thinking. But a better explanation is that the person who is in trance has not access to language constructions that may describe these inconsistent perceptions. The person in trance has not even access to constructions that use the expression inconsistent perceptions because then at least a higher-order language must be used. But such a construction would contradict the state of trance. THE DEFINITION OF HYPNOSIS The hypnotic distortion of time is another phenomenon that can be explained using the meaning of trance as defined in this study. It is commonly reported that in the absence of specific suggestions of time speeding up or slowing, subjects underestimate time spend in a trance. But generally time estimates are poor. In a state of trance time estimates bring the person out of trance because time estimates require a language with tense constructions. Therefore, if time estimates are asked for an episode in which no tense constructions could be used, these estimates will be inaccurate. Language L1 is accessible from language L2 if sentences belonging to language L1 can be reflected upon in sentences belonging to language L2. Language L1 is inaccessible from language L2 if in sentences belonging to language L2 no reflection is possible upon sentences belonging to language L1. If a hypnotherapist uses hypnotic language patterns the hypnotherapist prevents the hypnotized person to reflect upon those very hypnotic language patterns. If the state of trance can be defined as a state in which the person has only available a first-order language, then other levels of language are not accessible from this state. Sentences, thoughts or utterances that require for their analysis a second-order language or other complex formal language are not accessible from a state of trance. It is therefore not possible in a state of trance, to formulate complex sentences such as, The relaxed feelings I experience are temporary feelings. In that particular sentence a property of feelings, namely being relaxed, is attributed the second-order property of being temporarily. Language constructions that involve modal or tense constructions are likewise not accessible from a state of mind that only uses a first-order language. It is possible that the hypnotherapist uses a tense construction to produce a posthypnotic effect. But the production of a posthypnotic effect rests upon the assumption that the person in trance does not reflect upon sentences with a tense construction. So in order to produce a posthypnotic effect, the hypnotherapist uses another language than the person in trance. The language of the person in trance is accessible from the language of the hypnotherapist but not vice versa. This nonaccessibility of certain levels of language from a state of trance explains some trance phenomena. In Udolf (1987, chap. 4) some trance phenomena are described and two of them are explained below. Trance logic refers to the ability of a hypnotized subject to tolerate, without apparent disturbance, the coexistence of two or more logically inconsistent perceptions or ideas. An example is the perception of a hallucinated person in one location and the real person in its actual location simultaneously. This phenomenon is explained as the suspension of critical The definition of hypnosis in this study does not refer to the state of mind the client is in but to the activity of the hypnotherapist: Hypnosis is the technique to change the accessibility of languages. The hypnotherapist is thus considered capable to use language in order to restrict or to enlarge the set of languages for thinking, reasoning and communication of a client. This definition has consequences for the interpretation of ideomotor responses. Not the content or meaning of a response is important, but the form. Imagine a possible hypnotic technique the application of which results in the raising of the right and left arm. The therapist usually induces the raising of the arms by instructions in the language of first-order logic, e.g. Your arm feels light, In your arm you feel a lifting power, Your arm lifts. This happens under the condition of high concentration on sensory-grounded experiences. If movements of arms or fingers are used as utterances of the valuations is true and is false the term ideomotor response is used. Often it is agreed between therapist and client that following a sentence uttered by the therapist, a client's movement of the right hand means is true or yes and that a movement of the left hand means is false or no. But it is of no importance which valuation is associated with the movement of the right and left hand. It is of importance that the client learns a two-valued response. The client either valuates the sentence of the therapist as true or as false, but not 50 DR. KLAAS ALTENA TRANCE AND HYPNOSIS DEFINED WITH MODERN LOGIC: APPLICATIONS TO HYPNOTHERAPY european journal of clinical hypnosis - volume five – issue three – pp. 43-54 both true and false at the same time. The client should not be tempted to rethink the utterances of the therapist and reflect upon these utterances. This would reintroduce for the client the necessity of constructing sentences that belong to more complex languages. This would end, by definition, the state of trance. APPLICATIONS the client in trance concerned her ways of finding true answers for the problems that bothered her. A great deal of the sessions was devoted to create a lifting of the arms such that the client experienced an estrangement with respect to the lifting of her arms and the is true-is false answers. There were 12 sessions and the positive effects of the procedure became manifest in de months following. The symptoms disappeared. Case 2 The Liar and the Truth-teller In this section a hypnotic procedure is described that was successful in the treatment of two clients suffering from an Obsessive Compulsive Disorder. Another hypnotic procedure is described that was successful in the treatment of two clients suffering from a Delusional Disorder. It is assumed that the two Obsessive Compulsive Disorders resulted from a Liar type paradox. Furthermore it is assumed that the two Delusional Disorders resulted from the Truthteller paradox. The application of the procedure followed in case 1, describing the treatment of a client suffering from an Obsessive Compulsive Disorder, was so surprisingly effective that this required an explanation. This explanation is developed during applications and modifications of the technique. The successes and failures lead to the theory presented in this study. The Liar: cases Case 1 In case number 1 the person repeatedly doubted if she had performed an act such as having accidentally contaminated the food and drinks of her children. The care for her children caused problems because she constantly doubted if she had not endangered them. This symptom was part of the more general fear to have any noxious effect on the health and well-being of others. But she had also great doubts if she did the things she thought she did and if she had made the statements that she thought she made to others. She feared having said the wrong things to other persons. But she could not remember what she had said. And she suffered great uncertainty because she thought she acted not responsible. And she was constantly in doubt about the truth of what she had said. It was supposed that an A-proposition like All my thoughts about my responsibility are false, caused her problems. A trance was induced and a procedure was followed in which both arms levitated. A movement of the right hand in response to an utterance of the therapist was regarded as a sign for is true. An involuntary movement of the left hand was regarded as a sign for is false. The questions asked to In case number 2, the client also repeatedly doubted whether she had performed an act such as having accidentally contaminated the food and drinks of her children. The other symptoms were present too. This time the client was brought in trance and under this condition questions were formulated in terms of first-order language. These questions were chosen directly from the pool of questions that bothered her. A few applications of this procedure reduced her problems to a subjective level of 4060% within a few weeks. No further progress was made in the weeks following. A few months later the diagnosis of her problem was approached from another angle. When asked if she felt unique, she admitted with a blush and full of shame that she considered herself a unique person. She also thought that other persons knowing her were probably so jealous of her that they would find pleasure to humiliate her. When the procedure was applied again, formulating first-order questions referring to her uniqueness, the effect was decisive. The symptoms of the Obsessive-Compulsive Disorder disappeared rapidly to a subjective level of 5%. The Liar: hypnotic procedure As a first step the client suffering from an ObsessiveCompulsive Disorder was informed that hypnosis would be applied and that levitation of both arms would result. Then the client was informed that a movement of the right or left hand should be interpreted by the hypnotherapist as a response to a statement of the hypnotherapist. A movement of the right hand would be interpreted as the valuation is true and a movement of the left hand as the valuation is false. This was the instruction in the first reported case. In the second reported case the client was told that the movement of a hand meant is true or is false but not both. The client was also told that de meaning of a movement was not fixed but could vary over sentences responded to. The instructions for the second case were intended to prevent any tendency of the client to interpret responses to sentences of the therapist. Such a tendency would bring the patient out of trance. A generalisation of the procedure is the following. 51 DR. KLAAS ALTENA TRANCE AND HYPNOSIS DEFINED WITH MODERN LOGIC: APPLICATIONS TO HYPNOTHERAPY european journal of clinical hypnosis - volume five – issue three – pp. 43-54 When the client is in trance, the therapist asks questions related to the obsessions of the client. The sentences that are uttered by the therapist should be derived from the set of expressions that describe the problem of the client. They should be reconstructed as sentences belonging to the language of first-order logic. After the utterance of such a sentence the therapist waits until an unambiguous ideomotor response is true or is false is seen by him and unambiguously is felt as a movement by the client. The hypnotherapist then proceeds until all selected sentences are uttered and responded to. This procedure can be repeated using the same set of questions or another set of questions, depending on the definition of what constitutes the Liar paradox in that particular case. In applying this procedure, the hypnotherapist should (1) avoid interpreting the answers, and (2) avoid searching for logical consistency of the answers. The Truth-teller: cases Another hypnotic technique was applied in two cases of a Delusional Disorder. It was hypothesized that the relevant delusional or irrational thoughts and reasoning are dependent on sentences that contain their own truth-predicate is true. These delusional thoughts therefore belong to the class of Truth-tellers. Case 3 In one client the Delusional Disorder was of a Persecutory Type: the belief that the client was being conspired against, that he was spied upon by spies from his native country, and that his brain should be poisoned by spies from that country. This thought occupied his mind continuously, made it not possible to make sufficient progress in his work, ruined his sleep and threatened his marriage. It was supposed that somewhere in the mind of this client an A-proposition was operating that made it impossible to valuate a certain proposition as false. A trance was induced by asking the client to concentrate unremittingly on the feeling in his back and his head. It was supposed that this eliminated the possibility of forming Truth-teller paradoxes. After this first episode of concentration the client was asked to concentrate on his back and his head while at the same time thinking the thought that his mind would be poisoned. This procedure consisted essentially in two subsequent episodes of two minutes and was repeated several times in episodes of one minute. The whole procedure was repeated six times over a series of 14 sessions, each time with a different aspect regarding the persecution. At home he exercised frequently. His unwavering conviction became unstable. He began to doubt his formerly unwavering convictions about persecution, and at last decided that his convictions were only valid in the past. Case 4 In the other client the Delusional Disorder was of a Somatic Type. The initial Diagnosis was Vaginismus. After a series of sessions it became clear that she suffered from a Delusional Disorder. She was convicted that the right half of her face was ugly and misshapen. She tasted blood in her mouth. And she also thought her breasts and vagina were ugly and misshapen. In this case it was also supposed that in her thinking a proposition was operating that would make it impossible to valuate convictions about her selfimage as false. In the first application of the procedure she was brought in trance by instructing her to concentrate on a sensory experience. The next episode she was asked to concentrate on a sensory experience and at the same time on the thought that parts of her body were ugly misshapen. In the subsequent session the standard procedure, as described in the next section, was applied twice. This standard procedure appeared to work well. After the second session she reported that her image of mutilated face, vagina, and breasts was fading away. She presented a rather large and colorful drawing of herself, the image of herself how she felt she really was. Case 5 This client was obsessed by compulsive imaginations about bad behaviors, e.g., causing a deadly fall of his grandchild from the stairs or steering his car to the wrong side of the road in order to cause a fatal collision. Treatment of this client as if the problem was caused by a Liar-type Aproposition had no success. Both hands responded with large amplitude in answer to each question. This did not satisfy the criterion of an unequivocal is true-is false response. Application of the Truth-teller procedure during one session and exercises at home had success. The force of the obsessions and compulsions reduced to a subjective level of 20%. This reduction was deemed enough by the client and therapy was ended. The Truth-teller: hypnotic procedure The technique in standard form resembles the technique of systematic desensitization. In the first episode in this procedure the client concentrates two minutes incessantly and unremittingly on the experience of feeling support of the body given by the chair, e.g., the support felt in the back. In the second episode the client is instructed to think two minutes with a high degree of concentration the relevant irrational thought while at the same time unremittingly concentrating on the feeling of physical support. The hypnotherapist indicates when it is time to change. 52 DR. KLAAS ALTENA TRANCE AND HYPNOSIS DEFINED WITH MODERN LOGIC: APPLICATIONS TO HYPNOTHERAPY european journal of clinical hypnosis - volume five – issue three – pp. 43-54 The procedure is repeated with episodes of one minute: first one minute concentration on the support felt in the back, then one minute concentration on the support felt in the back and concentration on the relevant thought. The total time of this exercise is 11 minutes. After repeating the whole procedure a number of times it can be expected that the emotive content and behavioral impact of the irrational thought decreases. The explanation is that the high level of concentration on a real physical experience restricts the language of the mind to the level of first-order logic and therefore excludes the possibility to construct sentences that contain the predicate is true. Therefore this technique changes sentences of the Truth-teller type into first-order sentences. The amount of exercise determines the growth of the ability to access different levels of language. A variant of this procedure replaces the concentration on a thought by concentration on the image that this thought calls up. This image is then projected on an imaginary plane at a distance of a few meters from the client. During the application of this procedure the images may change spontaneously. This change in images expresses a change in underlying propositions that belong to the language of firstorder logic. Therefore this change should not be interpreted by the hypnotherapist or by the client, because this would mold the propositions into another type of language. This possibly annuls the positive effects of this procedure. Application of this procedure in case of anxiety provoking thoughts appeared to be effective for many clients. DIFFERENCE IN TREATMENT PROCEDURE FOR THE LIAR AND THE TRUTH-TELLER There is a difference between the procedure applied to the Liar and the procedure applied to the Truth-teller. This difference is with respect to the valuation. In case of the Liar an explicit is true-is false valuation by the client of sentences uttered by the hypnotherapist is build in. In case of the Truth-teller only a thought must be thought by the client, no explicit valuation is required and the hypnotherapist presents no sentences. This difference in procedure has to do with the valuation problem the clients have. In case of the Liar, a sentence is false when true and true when false. The consequence is that valuations jump rapidly from is true to is false to is true and so on. This jumping must be explicitly counteracted in the treatment. In case of the Truth-teller there is no such jumping between truth-values. The Truth-teller valuates itself as true and this continues all the time. Premises or arguments that are not in line with this Truth-teller lead to contradiction and therefore must be rejected as happens when in scientific reasoning the reductio ad absurdum is applied. This is reflected in the procedure. The same thought is presented to the person without interruption during a certain episode. The transition to episodes in which no thought was presented was deemed necessary to keep the person in trance. INTERPRETATION OF THE NLP APPROACH TO TRANCE AND HYPNOSIS The theory expounded in this study can be labeled as a linguistic approach to hypnosis. The approach of the NLP, Neuro-Linguistic Programming, is also a linguistic approach. The following analyses are intended to demonstrate that some core aspects of the NLP approach are consistent with the theoretical view of the present study. If Grinder and Bandler (1981) induce a state they call trance then the client’s language for thinking and expressing thoughts becomes restricted to a first-order language. Pacing, as described by Grinder and Bandler, is the technique to make accessible those thoughts that refer to sensory-grounded experiences. Hypnotic language patterns uttered by the hypnotherapist amplify these sensory-grounded experiences. The state of mind that develops in this way conforms to the definition of trance in the present study. Leading is the technique to suggest experiences while the accessibility of other languages that allow reflection upon these suggestions, is excluded. Leading therefore is a process that leads a person out of a language that allows reflection. If you are in a state in which you are limited, and you try to make changes in those limitations with your normal state of consciousness, it’s a “catch-22” situation. Those limitations will constrain the way you deal with the limitations, and you are going to have a lot of difficulty. (Grinder and Bandler, 1981, p. 31) This confirms the hypothesis that the technique of pacing and leading is in agreement with the definition of hypnosis in the present study. Utilization is the technique to utilize resources of the unconscious. A closer look at the wordings reveals that the hypnotherapist often uses expressions of the type There exists some x such that x is y. An example is And you can allow your unconscious to present you with some memory from the past that you can enjoy…(Grinder & Bandler, 1981, p. 101). A translation of this expression into the language of first-order logic is, You will have a memory (x) such that this memory (x) is enjoyable. The structure of this 53 DR. KLAAS ALTENA TRANCE AND HYPNOSIS DEFINED WITH MODERN LOGIC: APPLICATIONS TO HYPNOTHERAPY european journal of clinical hypnosis - volume five – issue three – pp. 43-54 expression belongs to the language of first-order logic. In this form the expression is a formula but not a sentence. A sentence is an expression that can be true or false. Because the expression cited is a formula, the client in trance changes the formula into a sentence by giving the variable x a value. This happens because trance is by definition a state of mind in which sentences are formed and used, not formulas. The expression uttered by the hypnotherapist becomes true if there is a memory that satisfies this sentence. The unconscious therefore can be understood not as an undefined source of solutions but as the capacity to utilize the formulas of the hypnotherapist to create true sentences. Some hypnotic language patterns make use of presuppositions. There are several techniques available to the hypnotherapist to state what the hypnotherapist does not leave open for discussion or opinion. The examples given by Grinder and Bandler (1981) can be commented upon as follows. If the client questions the expressions containing presuppositions, the client must form sentences that are reflections upon sentences of the hypnotherapist. But in that case the client is by definition out of trance. If the client stays in trance and therefore cannot reflect upon the expressions of the hypnotherapist, no presupposition is signalled. Take the following utterance of a hypnotherapist I don’t know if your right or your left hand will lift with unconscious movement (Grinder & Bandler, 1981, p. 245). The structure of this sentence is (A B) Sentence A is true or sentence B is true or both sentences are true. Grinder and Bandler assume that this presupposes that one of your hands will lift. This argument is valid only if it is presupposed that the whole disjunction between parentheses (A B) is true. (A and B are called disjuncts, the whole expression (A B) is called a disjunction.) But the expression in this case is more complex. The hypnotherapist utters an expression beginning with the epistemic phrase, "I don't know". Epistemic phrases cannot be accounted for in the language of first-order logic. Given the truth of the whole expression (A B) without epistemic phrase, the client has the freedom to make this expression true by lifting the right hand, the left hand, or both hands. Assuming that (A B) as a premise is true, A, or B, or both A and B will be valuated true. This is perfectly reasonable. Therefore one hand or both hands will lift. The reasoning of the person in trance conforms to logic, assuming that this person only uses the language of first-order logic. But if the person involved is not in trance other things may happen. The epistemic phrase, "I don't know", may then become part of the argument. And also the person can doubt the presupposition of the utterance. The same capacity to reason according to laws of logic therefore will probably have another outcome if the person is out of trance and uses another type of language. The way the hypnotherapist composes elementary expressions to composite expressions using verbal and nonverbal means is decisive for the expression the person in trance will notice. Non-verbal signs that separate or unite utterances to elementary or composite expressions are therefore extremely important because this information is decisive for the composition of an expression and therefore is decisive for the response. An example (Bandler and Grinder, 1975, p. 24) may clarify this: (1)…I knew a man once who really understood how to feel good about… (2)…I knew a man once who really understood how to feel good about… The phrase in bold feel good receives non-verbal emphasis. Expression (1) can be analyzed as a composite expression (1) ((I knew a man once) and (That man really understood how to feel good about x)) The structure of this expression is (A1 B1). If this expression as a whole is accepted as true, then logic prescribes that the two constituent expressions A and B both must be true. Expression (2) is also a composite one, but if the fragment Feel good receives an intonation that contrasts with the context then the composite expression might be (2) ((I knew a man once who really understood how to y) and (Feel good about x)) Expression (1) and (2) are quite different. If the person in trance gives the variables y and x values, then (1) and (2) will have different results. This analysis emphasizes the importance of the non-verbal dimension. If this dimension is accounted for, the reasoning of the person in trance may seem more logical. Discussion The results of this study allow the following conclusions: 1. The definitions of trance and hypnosis can be stated in terms of formal languages. A detailed comparison with other theoretical orientations falls outside the scope of this study. But the following 54 DR. KLAAS ALTENA TRANCE AND HYPNOSIS DEFINED WITH MODERN LOGIC: APPLICATIONS TO HYPNOTHERAPY european journal of clinical hypnosis - volume five – issue three – pp. 43-54 remarks can be made. Sometimes it is suggested that in hypnotic states of consciousness reasoning is illogical. But this point of view is disputable as is argued in this study. The argument is as follows. Reasoning depends on premises. Some premises that are well-defined expressions in one formal language cannot even be formulated in another formal language. The laws of logic however do not differ. Therefore, reasoning of a person in trance may seem to be illogical from the point of view of the hypnotherapist who uses perhaps premises that cannot even be formulated by the person in trance. Some definitions refer to language and communication. A recent example is the book Hypnotic language: Its structure and use, in which book Burton and Bodenhamer (2000) state, "All communication invites the receiver into a hypnotic trance.” In this text, a hypnotic state or trance refers to a focussing of attention on a thought, idea, concept, thing, etc. which excludes all other focussing on anything else" (p. 4). The definition of Burton and Bodenhamer agrees with the definition of trance in the present study only if the person focuses on sensory-grounded experiences. If a person focuses upon thoughts, ideas, or concepts, according to Burton and Bodenhammer a hypnotic trance is also created. In the definition of the present study this state of mind is by definition not a state of trance. REFERENCES 2. This study shows that some forms of obsessive and irrational thinking can be analyzed in terms of formal languages and treated with hypnotherapeutic methods. Is the language dependency restricted to the few cases discussed in this study or applicable to the type of Disorders discussed? These questions await further answers. Grinder, J. & Bandler, R. (1981). Trance-formations: Neuro-Linguistic ProgrammingTM and the structure of hypnosis. Moab UT: Real People Press. 3. Different approaches to trance and hypnosis can possibly be analyzed from the point of view of formal languages. The present study is limited to an analysis of some aspects of the NLP approach. The usefulness of the approach discussed in the present study can be verified by increasing the scope of these analyses. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association. Bandler, R. & Grinder, J. (1975). Patterns of the hypnotic techniques of Milton Erickson, M.D. (Vol. 1). Capitola CA: Meta Publications. Barwise, J. & Etchemendy, J. (1987). The Liar: An essay on truth and circularity. New York: Oxford University Press. Barwise, J. & Etchemendy, J. (1992). The language of firstorder logic (3rd ed.). Stanford, CA: Center for the Study of Language and Information. Burton, J.J. & Bodenhamer, B.G. (2000). Hypnotic language: It's structure and use. Trowbridge, Wiltshire, UK: The Cromwell Press. Gamut, L.T.F. (1991a). Logic, language, and meaning: Introduction to logic (Vol. 1). Chicago: The University of Chicago Press. Gamut, L.T.F. (1991b). Logic, language, and meaning: Intensional logic and logical grammar (Vol. 2). Chicago: The University of Chicago Press. Poppen, R. (1998). Behavioral relaxation, training and assessment. London: SAGE Publications. Soames, S. (1999). Understanding truth. New York: Oxford University Press. Stolyar, A.A. (1970). Introduction to elementary mathematical logic. New York: Dover Publications. Udolf, R. (1987). Handbook of hypnosis for professionals (2nd ed.). New York: Van Nostrand Reinhold Company. Part of the manuscript was presented at the 9th Congress of the European Society of Hypnosis in Psychotherapy and Psychosomatic Medicine, Rome, Italy, September 25-29, 2002: Hypnosis and the Other Therapeutic Modalities in the New Millennium. The abstract of this presentation is titled: Formal logic, Mental Disorder and Hypnosis. The author is greatly indebted to Henk Broer, Prof. of Mathematics, and Eric Vermetten, MD, for their comments on drafts of the manuscript. Address correspondence to Klaas Altena, Zegge 35, 8265 CM Kampen, the Netherlands. Or e-mail, klaasaltena@planet.nl