M- —_ - —— w. —— — v 'a— - — — v . ‘ . l4 O v V‘— ‘- - M- ‘. “—0—.-Q-MO.OY ’ A ~ - 7-... o-- ‘ . . ~. -. . '6..-ocfi'CO-nDIOC--~O‘--y, THE RELATIONSHIP BETWEEN SYMPTOMATOLOGY AND THE DEGREE OF REPRESSION OF SEXUAL CONFLICT ' Thesis for the Degree of M. A. . MICHIGANfSTATE UNIVERSITY IRA MOSES ‘ 1974 Thaw: “an“... - .1- ~. tail“ “5‘.“ .1! ”W ' . LIE?" " 7" BILLIE? , :ve-‘f: ‘_. E- ‘evl' ’ ‘~"|) & AW?“ L‘ :4; ‘2 LL, .2: . V In ‘ V l J g ' ‘ gerifl'o‘ifl‘"w '$‘fl’$ A'MM" ) [I‘ll AIIINIIII IIIII IIIIEIEN'IIIIIIINI EEII’E‘I ABSTRACT THE RELATIONSHIP BETWEEN SYMPTOMATOLOGY AND THE DEGREE OF REPRESSION OF SEXUAL CONFLICT By Ira Moses A continuing line of research (Reyher 1958, 1961, 1967; Perkins and Reyher 1971; Burns 1975; and Sommer- schield and Reyher 1975) has consistently found a relation- ship between the frequency and type of symptom elicited in the laboratory and the degree of repression of hypnotically implanted sexual and/or anger conflicts. The purpose of the present investigation was to test whether 1) the symptom- repression relationship could be replicated utilizing non- hypnotic techniques and 2) the symptom-repression relation- ship could generalize to symptoms in every—day life: repres- sion would vary for symptoms of skin disorders (which would have the highest repression scores), reSpiratory ailments (which would have intermediate repression scores), and head- aches (which would have the lowest repression scores). With eyes closed, subjects (N=25) were read a false story (paramnesia) designed to arouse sexual feelings towards an attractive older woman. The subject was asked to revisua- l Ira Moses. lize the story and then to describe five minutes of free imagery (whatever images that come to the mind's eye). Subjects were queried each minute for feelings and bodily sensations. The experimental hypothesis could not be tested since §fs reSponses to the Cornell Medical Index could not be categorized into mutually exclusive symptom groups. Unexpectedly, this procedure, compared to the previous research utilizing hypnosis, produced a greater variety of symptoms in the laboratory in a briefer period of time. Analysis of the symptoms elicited in the laboratory showed a significant correlation between.§'s degree of repression of Oedipal conflict and frequency of symptoms. Type of symptom was also shown to vary with the degree of repres- sion. Fluctuation of symptomatology determined by varia- tions in the degree of repression, was also considered in the context symptom change during the course of psychother- apy o Ldjfl»z/22%7’%:K THE RELATIONSHIP BETWEEN SYMPTOMATOLOGY AND THE DEGREE OE REPRESSION OF SEXUAL CONFLICT By Ira Moses A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF ARTS Department of Psychology 1974 DEDICATION To Marsha who taught me the most about psychology by teaching me about love. ii ACKNOWLEDGEMENTS I express appreciation to Dr. Joseph Reyher, not only for understanding my impatience with research, but for exposing me to a contagion of enthusiasm for it. I thank Dr. Norman Abeles for his systematic approach to psychotherapy research, and to Dr. Griffin Freed for helping me articulate my prOposal more clearly. Special thanks to Dr. Albert Aniskiewicz for coming to my rescue by substituting on my committee in Dr. Freed's absence, and for his appreciation of this line of research. Special appreciation goes to my mother-in-law, Frances Belman, for typing this manuscript without censoring the Obscenities rampant herein. iii TABLE LIST OF TABLES o . LIST OF APPENDICES INTRODUCTION . . METHOD . . . . . . Subjects . . OF CONTENTS Materials, Technique and Experimental Setting Procedure . . Scoring . . . RESULTS . . . . . Reliability . EXperimental Hypotheses Unexpected Findings . . DISCUSSION 0 O C O O O 0 Suggestions for Improving Future Research Design and Clinical Validation . . . . . . REFERENCES 0 O O O O O O O O O O O O APPENDICES . iv Page vi 14 16 19 19 19 19 26 34 56 58 41 LIST OF TABLES Table Page 1. Spearman Rank Order Correlations Between Average Drive Scores (Drive), Frequenc of Cornell Medical Index Symptoms (CMI , A-State and A-Trait Anxiety, Total Frequency of Symptoms (f-symp), and Frequency of Different Types of Symptom8(f’type)ooooooooocoo 22 LIST OF APPENDICES Appendix Page A. Verbatim Protocols of Free Imagery . . . . #1 B. Drive Activation Scale . . . . . . . . . . 61 C. Feedback Questionnaire . . . . . . . . . . 75 vi INTRODUCTION In the psychoanalytic tradition, Alexander (1950) prOposed that a specific psychosomatic symptom is a func- tion of a particular constellation of drives and defenses, or as contrastingly proposed by Wolff (1950), a given symptom is hereditarily determined and represents an in- dividual idiosyncratic pattern of reaction. Until recent- ly, due to the lack of a laboratory method for producing psychopathology, these two opposed and influential theo- retical positions could not be evaluated. A reliable method of producing a wide range of psychopathology was first reported by Reyher (1958, 1961, 1967) who found that the degree of spontaneous repression of posthypnotically activated anger (toward an authority figure), combined with a destructive impulse, was related to the type of symptom produced. He (1967) also reported that the GSR, frequency of symptoms, and number of types of symptoms were negatively correlated with the degree of repression. These relationships were subsequently verified by Perkins and Reyher (1971), Burns (1975) and Sommerschield and Reyher (1975). In order to evaluate the theoretical posi- tions of Wolff and Alexander, Sommerschield and Reyher l 2 (1975) compared an anger-aggression conflict with an Oedi- pal sexual striving. No difference in the degree of spontaneous repression or type of symptoms were found. The type of symptom was neither solely attributable to a hereditarily predetermined response to stress nor to the type of drive constellation. Their conceptualization of symptom choice is as follows: We contend that the degree of repression of a drive (any drive) is the crucial factor in the production of a particular symptom. As repres- sion begins to weaken, anxiety is released and produces psychosomatic symptoms. As repression continues to weaken, anxiety increases in inten- sity and affects more physiological functions until, at some point, the drive itself begins to achieve expressive or symbolic representation in the subject's behavior and/or symptoms. Further weakening of repression permits the drive or drive—related impulses to find more direct out- lets with increasing awareness until full aware— ness or consciousness is achieved and the drive ceases to be pathogenic. In terms of this formu- lation, the drive per se has nothing to do with the specific form of a psychosomatic symptom, but it has everything to do with the specific form of a symbolic symptom such as a hand—washing compul- sion or a snake phobia. Nevertheless, the degree of repression determines whether a symptom will be a compulsion or a phobia with the latter represen- ting less repression (Burns 1972). As a means of observing more closely the repressive process and its relationship to symptom formation, Burns (1972) used free imagery instead of the activation of posthyp— notic conflict using conflict words. He confirmed the re- lationship between degree of repression and type of symptom, and showed that the onset of a symptom was concomitant with 5 GSR activation, but not with an increase in drive repre- sentation. Although in the right direction, the correla- tions between degree of repression and both frequency and type of symptom were not significant. The role of demand characteristics appears to be very limited since simulating subjects, with the exception of Burns' investigation, consistently did not report as many symptoms. Burns (1972) found the symptoms in a sim- ulating control group to be significantly less numerous than in the hypnotically treated subjects. The occurrence of symptoms in Burns' simulating §S may very well have been due to his use of a paramnesia involving Oedipal sex as the stimulus for free imagery. Free imagery (Reyher 1962), particularly when it is used in the context of em- ergent uncovering psychotherapy, is intrinsically uncover- ing and readily activates unresolved and pathogenic Oedipal complexes. Reyher and Basch (1970) further substantiated the repression-symptom relationship by the use of a nonhypnotic technique. Correlating self-report, and personality inven- tory items, they found a significant relationship between the frequency of symptoms and the degree of repression. The purpose of the present investigation was to test further the relationship between degree of repression and type of symptom by preselecting subjects on the basis of their having different symptoms in everyday life and com- 4 paring them in terms of the degree of repression of major drives. The symptom types under investigation were skin disorders, respiratory ailments and headaches. It was specifically hypothesized, on the basis of earlier re- search, that the degree of repression of major drives would be greatest for individuals with skin disturbances and least for those with headaches. A formal hypnotic induction was not involved, and no attempt was made to intensify conflict. METHOD Subjects Twenty-five volunteer male undergraduates ranging in age from 17 to 20 years participated in this experiment. Materials, Techniques and Experimental Setting The Cornell Medical Index (CMI), State-Trait Anxi- ety Inventory (STAI), the Stern-Reyher Symptomatic Reaction Scale (SRS), and the Reyher Drive Activation Scale were used to assess S's symptom history, consciously experi- enced anxiety, symptoms elicited in the laboratory, and level of drive expression, respectively. The laboratory was an accoustically quiet room equipped with a comfor- table reclining chair, tape recorder, and a stOp watch. Free imagery was used to produce data for assess- ing degree of drive activation. I Developed by Reyher (1960, 1969), free imagery is used as a psychotherapeutic and research procedure to uncover the aims and objects of repressed drives. By re- questing S to close his or her eyes and describe images "that come into your mind's eye," S is impelled to abandon 5 6 secondary process, symbolic levels of representation (words and speech) for a protosymbolic level (images). Unlike words, protosymbols, according to Warner and Kaplan (1967), contain a physical resemblance to their referrents and therefore bring the subject into a more concrete and intimate relationship with repressed drives (primary re- ferrents). According to Reyher, "there is a reciprocal relationship between visual image and drive; that is, an image will stimulate the drive that it depicts and a drive will produce an image to depict itself (the drive will seek out an appropriate object)." As drives become in- tensified, observes Burns (1974), a disequilibrium between anxiety-producing impulses and the inhibition against them (repression) occurs; this process results in a variety of outcomes: symptomatology, acting out of impulse, or in- creased repression. The CMI was developed (1949) as a nominal self- report scale to collect medical and psychiatric history. The test consists of 195 questions requiring a "yes" or "no" response and takes approximately 10 to 20 minutes to fill out. The questions relate to four classes of func- tioning: bodily symptoms, past illnesses, family history and behavior and mood. Related questions are grouped into 18 categories (e.g. Category A concerns eyes and ears, Category C refers to cardiovascular functions, Category Q to anger, etc.). Broadman (1952) suggests the use of the l7 CMI as an index of emotional disturbance. Questionnaires with more than 10 yes responses checked, with more than six omitted responses, more than three yes and no res- ponses, and in cases where three or more responses have been changed, are all considered indicators of emotional disturbances. Hamilton (1962) found that functional so- matic symptoms, (responses in the A through L categories), increase in proportion to scores of the psychiatric sec- tions of the CMI, (responses in the M through R categories). Matarazzo (1961) found that the number of medical symptom- (A through K) was a good predictor for a number of psy- chiatric symptoms for medical and psychiatric in- and out- patients (N = 160). Symptoms elicited in the laboratory were grouped into a hierarchical scale (referred to as the Symptom Re- action Scale - SRS) based on their respective magnitudes on an index of repression. The SRS represents a "...con— tinuum of repression with different types of psychopath- ology becoming manifest as anxiety producting impulses be- come more blatantly represented in an individual's aware- ness." (Sommerschield, p. 279).’ The SRS, initially developed by Reyher (1961), de- lineated 15 symptom categories. Burns (1972) found a .51 correlation between the rank of the drive scores for the symptoms (N=56) generated in his research and the original Symptom Scale. Subsequent revisions by Burns (1975) which 8 depicted 75 categories and by Stern (1974) which includes 84 categories substantially expanded the original scale. It is the latter revision which is used herein: SYMPTOMATIC REACTION SCALE (Revised June, 1975) RAS, I. Reactions produced by the presumed inhibition (I) of the ascending reticular activating system (RAS) in order of increasing activation: 1. Sleep 2. Sleepiness, yawning 5. Tiredness 4. Feeling of being "drained." ANS, S. Reactions of presumed sympathetic innervation, au- tonomic nervous system (ANS): 5. Tingling 6. Itchiness, weals 7. Sweaty, clammy 8. Abdominal pain and gastric distress, "stomach moving." 9. Belching 10. Feeling of malaise 11. Chest pain 12. Cold sensation 15. Goose flesh, shiver 14. Dryness of mouth 15. Tachycardia, heart pounding, pulse 16. Coughing 17. Breathing heavier SNS. Reactions of presumed somatic nervous system (SNS) innervation: l8. Tics l9. Tremors 20. Stiffness 21. Tightness 22. Muscular aches and pains; also pains described as caused by a Specific external source (e.g., "My glasses are hurting my nose.") 25. Tension 24. Shaking UD. Reactions of an undifferentiated (UD) nature in which the somatic, autonomic, and psychological components cannot be specified: 25. Uncomfortable 26. Fidgety 27; Jittery 28. Nervous 29. Shaky 50. On edge 51. Restless 52. Upset 55. Funny, uneasy 54. Queasy, antsy, stomach empty 55. Excitement, hyper, anticipation 55.5 Surprise, shock (score here only when not iden- tifiable as DA (66) or some other category.) ANS, PC. Reactions of presumed parasympathetic (P) inner— vation (vasodilation), cranial division (C), autonomic nervous system: 56. Sensation of warmth 57. Dizziness, light headed 58. Headache 59. Throbbing in head 40. Pain behind eyes 41. Watery eyes 42. Blushing 42.5 Blood rushing to head Sym. Reactions in which the repressed drive is symbolized by the soma or sensory processes: 45. Hysterical symptoms such as blindness, deafness, anesthesia and numbness. 44. Urges indicating that a conversion of affect has occurred, such as urination being equivalent to ejacu— lation, and hunger being equivalent to sexual impulses. 45. Alteration in body image such as limbs feeling detached, elongated, or fatter; sensation of being heavy, squeezed; A0, Sym. Symbolic acting out (A0): 46. Repressed drive acted-out in behavior without awareness e.g., running pencil through closed loop made by forefinger and thumb. SED. Somatic (S) expression (E) of drive (D). (To be used only for specific paramnesias.) 47. Tingling 48. Pleasant warm feelin s EA. Expression of anxiety (EA%. The neurophysiological pattern of inhibition and excitation represented by repres- sion is sufficiently weak to permit the experience of anxiety. 49. Troubled, uptight, worried. 50. Apprehensiveness 51. Anxiety 52. Scared, frightened 55. Fearful, afraid RSE. Reduction in self-esteem (RSE). Reactions in which there is a perceived disparity between the real and ideal selves. DR. 10 54. Experience of failure, feeling inadequate, feeling dumb, stupid, idiotic, self-conscious, impotent, powerless, helpless. Dissociative reactions (DR) in which there is aware- ness of an unknown force influencing one's affect, think- ing and/or behavior: 55. State of confusion, inability to concentrate, bafflement, inability to think. Includes such reactions as one's thoughts being pushed and pulled but the content of thought cannot be specified; awareness of blocking out something. 56. Strong urges not carried out in behavior, such as wanting to move hands around or to rub something or to get up and dance; feeling confined, restricted, pressured. 57. Something racing up and down. 57.5 Feeling "stoned" or "out of it," or "feel like I'm talking in my sleep," or "even though I'm talk- ing, it's like I'm daydreaming." DR, P0. Disturbance in physical orientation. (P0). 58. Sensation of floating, sensation of rocking or motion. 59. Out-of-one's-body experience. DR, CE. Alteration in perception of time, place and iden— tity which disturbs continuity of experience (CE): DA. 60. Disorientation in direction or place. 60.5 Disorientation in time. For example, " I don't even know how long I've been here." 61. Depersonalization: feels like someone else or experiences a loss of personal identity. Includes talking about oneself in the third person. (Score only when S is not using the third person to make a generic statement, e.g. "It's easier to think with your eyes open.") 62. Amnesic and fugue states. Reactions denoting disturbances of affect (DA) as re- pressed drives approach the threshold of awareness and conscious apprehension: NR. 65. Apathy, blase. 64. Humorous reaction. 65. Ego alien affect -- feeling weird, strange, odd, unreal, unnatural, crazy, spooky, foreign. There must be a distinct reference to a negative feeling, sur- prise, shock. 66. Superego reactions -- feelings of being alone, abandoned, guilty, depressed, disgusted. 67. Feeling bothered, feelings of dislike, frustra- tion, impatience, cynicism. 68. Anger Neurotic reactions (NR) indicating that the threshold of awareness has been reached and psychological mechanisms 11 are activated to prevent repressed drives from being ex- perienced and consciously apprehended as part of one's self: 69. Obsessive behavior: any perseverative thought, image, tune, verse, etc. 70. Compulsive behavior: any intention or behavior designed to increase the order, symmetry or neatness of the room, materials or personal clothing or image. This includes such ”mental games" as placing one's foot on the floor so that it is bisected by a tile line or equidistant from two things; mentally draw- ing lines between things to create pleasing geometri- cal forms; square corners, etc. Also score any urge to take note of or describe items or features of the room. Also score extended imagery which is highly veridical, i.e., which is purely descriptive of re- alistic scenes from S's everyday life, but which does not contain identified people or interpersonal events. Also score imagery describing the room. 71. Phobias: fear of a specific object in the room. 72. Some attenuation of perception: words getting harder to see. 75. Conscious denial of thoughts or affect. PR. Psychotic reactions (PR) in which blatant derivatives of repressed drives in awareness necessitate the defense of projection to prevent derivatives from being conscious— ly apprehended as part of one's self: 75.5 Psychotic withdrawal "I'm tired of the world. It's intruding on me." 74. Delusions. 75. Paranoid thinking. DP. Reactions in which there is profound disturbance of perception (DP): 76. Hallucinations, positive: seeing a word when it was not presented or seeing something other than a word; also auditory or olfactory. 77. Hallucinations, negative: cannot see words pre- sented. 77.5 Perception breaks down entirely, and "everything seems like it's moving and changing." ANS, PS. Reactions produced by presumed innervation of parasympathetic innervation, sacral division, as direct representation in awareness of repressed drives and their objects is imminent and the integration of somatic, auto- nomic and psychological processes begin to deteriorate. I Indicates a failure of defense: 78. Explosive feelings in stomach. 79. Explosive feelings in chest. 80. Flatus. A. Reactions in which the experience of anxiety maintain- ing repression and auxiliary defenses is unattenuated causing the disorganization of behavior: 12 81. Urinary incontinence. 82. Fecal incontinence. 85. Panic. 84. Terror Spielberger (1960) has developed two brief (20 item) measures of two types of anxiety - State anxiety (A—State) and Trait anxiety (A-Trait). A-State attempts to measure one's transitory emotional states of conditions which are relatively situationally specific. As described by Spielberger, the test instructs the S to depict his or her feelings at a particular moment as specified by S. The 20 items attempt to elicit S's subjective, conscious- .gy perceived feelings of tension, apprehension and height- ened ANS activity. Past research, as reported by Spiel- berger, demonstrates that A-State varies with stress situations and relaxation training. The author suggests use of A-State scale to determine levels of anxiety in- duced by stressful experimental procedures. The A—Trait scale is of a similar 20 item construc- tion: however, it requests S to report how he or she Egg- erally feels. A-Trait is considered a measurement of stable dispositional reactions to anxiety. A-Trait with a retest reliability of .80, correlates .76 with IPAT and .79 with the Taylor Manifest Anxiety Scale and therefore can be considered a very reliable, as well as time saving, measurement of anxiety. Correlations between A-State and A-Trait scales 15 are predicted to vary with the type and amount of stress under which the State scale is given. Iowever, median\ correlations between the two is .47. Normative samples based on 982 college freshmen show a mean of 58 for the A-Trait scale with SD of 8.2 for males, and a mean of 58.2 with SD of 8.2 for females. A-State scale has a mean of 40.0 and an SD of 7.8 for males and a mean of 59.4 with an SD of 8.6 for females (Spielberger, 1960). Both A-State and A—Trait scale correlate .70 with Cornell Medical index for normative samples of hospital- ized neuropsychiatric patients. Its independence as an anxiety measure is supported by its lack of correlation with IQ measures and achievement scores. Since this research, as in the previous line of research, involves experimentally activated conflict as well as activation of symptomatology, questions of ethical considerations must be raised. In order to ascertain any detrimental effects attributable to the experimental technique, a brief questionnaire was administered to pro- vide an opportunity for the subject to address himself to these questions. (Appendix C). Included in the ques- tionnaire is an open-ended item to test the presence of any demand characteristics of the experiment. 14 Procedure: The CMI was mailed to S's to be filled out and brought to the experiment. Upon arriving at the experi- mental laboratory, S was instructed to sit in a soft re- clining chair, close his eyes, visualize, and describe a picture of an automobile. There was no casual or anxiety- reducing conversation or rapport established with S prior to the implementation of the procedure. If S asked ques- tions of S,‘S replied in a matter-of—fact tone, "I know you may have a lot of questions and I'll be glad to answer them after the experiment." A stop watch, which was used later in the experiment, was started at this time in order to desensitize S's reaction to the ticking. Criteria for participating in the experiment was S's ability to visual- ize and describe an automobile for at least 50 seconds. If S stopped before describing his image for 50 seconds, ‘S queried, "Can you describe anything more about it?" All S's, however, satisfied this criterion. S was then asked to keep eyes closed and "visualize this story as I read it to you": Eisenbud-Sommerschield Story These events occurred one evening while you were out walking. As you were leisurely walking, your attention was drawn to an attractive, older woman who seemed quite upset. You offered to be of assistance as the woman was about to pass you. Frantically, the woman revealed that she had lost her purse and did not have enough money for her bus fare. Wishing to help the woman, you reached into your pockets and your wallet. You only had a ter dollar bill. You then offered to accompany her to the bus 15 and pay for her fare. She, however, felt very indebted to you and insisted that you accompany her to her apart- ment in order that she might repay you. Somewhat reluc- tantly you agree. Once within her apartment she suggested that you might like to look at her record collection while she left to find some money for the bus fare. When she re- turned, she seemed very friendly and reluctant to have you leave. After talking about the collection, she of- fered you a drink and a snack. She then turned on the record player and you danced awhile with the woman. Grad- ually you became aware of some stimulating, but disquiet- ing thoughts and feelings. She was very good looking and it seemed like such a pity to have all her beautiful soft- ness and curves go to waste. She seemed to be silently inviting you; her closeness, glances, words, and breath- ing, suggested to you that she was becoming extremely sexually aroused. You were just starting to make love to her when suddenly more thoughts ran through your mind. She was older, respectable, perhaps married, and undoubt- edly very experienced. You wondered if you would be able to satisfy her. How traumatic it would be if she laughed at your advances. In spite of these thoughts, you found yourself becoming increasingly excited and aroused. You wanted to make love to her right there, but the telephone rang. While you waited, you became so aroused and excited that you could hardly speak. You made a hurried excuse for leaving, promised to call her back and left the apart- ment. (‘1 After the story was read, 2 was instructed: "Keeping your eyes closed, I'd like you to revisualize the story that I have just read to you and describe it to me as you revisualize it." After revisualization, S instruc- ted S: "Keeping your eyes closed, I'd like you to now describe whatever images that come to your mind's eye, making note of any feelings or bodily sensations that you may have." (Tape recorder was activated while instruc- tions were given.) At the end of the instructions, the stOp watch was restarted, and at each 60 second interval, 16 for a total of five minutes, S inquired of S: (1) ”How are you feeling?", and then after S's reply, (2) "Do you have any bodily sensations?" If S replied, S queried: "In what part of your body?” All other comments by S during the free imagery period followed the standarized guidelines adopted by Burns: 1) "What's happening?" if S was silent for a period of one minute, 2) "Are you des- cribing what's in your mind's eye?" whenever it was not clear whether S was free imaging or free associating; if S says "no", or if it seems necessary, S says: 5) "Can you just wait for things u>come into your mind's eye and describe them for me?" 4) "What was that?" if S speaks too low or indistinctly. After the fifth inquiry, S was instructed to Open his eyes. S was then given three instruments in the fol- lowing order: A—State anxiety scale, experiment feedback questionnaire, and the A-Trait anxiety scale. A debrief- ing session then was held in which S answered S's ques- tions concerning the experiment and his subjective exper- ience. Scoring Drive Activation: Individual protocols of free imagery were scored on an Operational scale as reported by Reyher and Burns (1972) and further revised by Reyher 17 (1974), to determine the degree to which Oedipal drives were activated and represented in visual imagery. The imagery was rated on three dimensions: 1) type of drive present, i.e. the presence of drives of sex, anger, self- esteem, and tenderness all received weighted scores of 2 and nonscorable drives received rates of l; 2) the degree to which the drive is expressed, i.e. if a drive is merely inferred (di) it is weighted by 1, if it is de- picted (dp) explicitly it is weighted by 2, if it is recognized (dr) it receives a weight of 4, and if the drive is experienced by S with apprOpriate affect (de) it is weighted by 8; and 5) the remoteness or blatancy of the derivatives of Oedipal objects, i.e very remote derivatives such as geometric forms and inanimate objects receive very low weights whereas images of parents, woman in the story, etc. receive the greatest weighted scores. Derivatives engaged in interaction are further weighted by scores up to 8. (See Appendix C for further details on scoring.) Each episode of imagery is scored on the three above dimensions and these scores are multiplied to give a drive activation score for each episode. The degree of repression increases as this drive activation score decreases. Repression is viewed as the obverse of aware- ness and implies the active inhibition of the drive. The concept of degree of repression is, therefore, a more 18 comprehensive construct than the degree of awareness. Each symptom elicited by'S was scored according to its respective rank on the Stern—Reyher SRS. RESULTS Reliability The interjudge reliability for the Burns—Reyher Drive Activation Scale was computed by Spearman Rho for ten subjects picked at random. A correlation of r = .82 was found between two independent judges who had no prior interjudge training sessions. Utilizing the revised Reyher Drive Activation Scale, an interjudge reliability of .90 was found based on prior collaboration and train— ing on scoring. Experimental Hypothesis The experimental hypothesis could not be tested because S's responses on the CMI could not be grouped into the exclusive symptom groups under investigation (e.g. S's with headaches also had respiratory complaints,etc.) Unexpected Findings Although only a few symptoms were expected because of the uncovering properties of emergent uncovering psy- chotherapy, we were surprised and amazed by the profusion of symptoms that were produced (Appendix A). Three illus— trative protocols are given below, two of which depict l9 20 high drive scores and corresponding high symptom scores, while the remaining one is indicative of the extensive repression and low drive scores. Code: Q—l How are you feeling? Q-2 Are you having any bodily sensations? Q-5 In what part of your body? Drive Score rank #24 f-symptom rank #25 SUBJECT #1020l (Silence)..should I do it right now?..shall I describe the story again?..(S repeats the instructions).. I'm walking down a lonely street..dark..kind of coldness, being upstairs in the room with her..starting to make love with her..kinda nervousness..very nervous.. my hand is very shaky..eyes kind of jumpy..(Q-l) kind of nervous and kind of relaxed..(Q-2) no..my arms seem kind of stiff..my biceps.. ummm the room being very dark and drabby..I kind of picture myself being in the room kind of out of place..hands in my pockets, shoulder kind of inwards..arms feel real tight.. legs feel that way too and uh that's about it, can't think of anything else..(Q—l) tired..(Q-2) gy chest seems heavy ..head seems kind of high or light..feel like..canrt seem to think of any more images..(Q-I) very tired and kind of small..feel like the chair is bigger than I am..throat seems kind of tight and clogged up and it's cleared my head..seems very weird..seems heavy..hard to describe.. eyes seem nervous..arms seem to be quiverigg..football sta- dium..l see a few peOple in the upper deck..a blue car..an old one, 1949 or something like that..slanty back top..a big thing..big tires..all the leaves on the trees and dif- ferent colors..(Q-l) very tired..hard to describe..speech- less sometimes I can't get the words out..seems as if I m going up and down..next thingAyou know I'm high and then Irm sinkingyin this chaIr..back up and back down..my room ..pretty nice place..kinda drabby..over on Abbott Road.. really nice place, kinda quaint..thinking of the Collings- wood entrance..it's a big mess over there..have to walk around it..weary..arms seem to be just there..head is sink- ing slowly up and down..legs feeI stiff, thath it..(Q-2) a lump in my throat..hands feel funny the way they're gripped. 21 Drive Score rank #15 f-symptom rank ;”24 SUBJECT #lOOO A big eyeball.. one lonely eye out in space..now I see stars..stars moving around..trees..in background.. sidewalks completely empty..early morning sun rising up.. (Q-l) hot..warm, very warm.(Q-2) no feeling from the waist down..I feel cozIfortaolc..tall building..city..lots of peOple..dark clouds..thunderstorm..lots of rain..lot of water over the sea..b1ack sea..huge waves..submarine below the sea..diving and swimming now..(Q-l) no change..(Q-2) no..flying..flying in a helicopter..now I feel like I'm turning around..like I'm spinning..how I'm diving down into a field..closer and closer to the field..back up a- gain..(Q—l) I'm moving back and forth..(Q—2) excitement like I'm fulI’of electricity..it's completely dark..l'm floating in a void..nothing in anyway at all..I'm spin- ning around faster and faster..twirling..feels like my whole body is spinning head over heals..nothing anywhere but me..getting diZzy..now I'm laying flat and Spinning around..(Q-l) dizzy tense..(In what way?)..in my toes and in my head..I' m spinning around still..one haIf isggoing one wav and the other half is g01ng the other way..it' 3 un- comfortaole..l donTt want Eo leave the black void..there's nothing around..I hate getting a bearing..I don't want to see anything or I'll get a bearing and stOp seeing anything.. see the sun..just the sun and the dark, it's pulling me.. getting closer and closer..room is vibrating back and forth.. still spinning around..CQ-1) almost sick, in my head..(Q:2) fingers are cold, chest is sweating, still feel like Irm vibrating. Drive Score rank #11 f—symptom rank #5 SUBJECT #lOOl Patterns.....starting to go around...nothing in my head right now just thinking what this room is like... I can't really remember it..(Q-l) 0K..(Q—2) my feet feel feel cramped....thinking of the tape recorder....thinking of my accounting ....trying to think of my stereo at home..listen- ing to it................(Q— l) a little warm...(Q-2) in mv upper half... thinking of the car again... it is stilI white ...m eyes don't see anything...now I'm thinking of trees... (Q-l fine..(Q— 2) no..thinking of a girl...thinking of walk- ing over here...see Pat...trees...people....(Q— 1) fine... (Q-2) no...thinking of the river now...watching it go over the falls..and the ducks..football field...just walking a- round the campus. 22 Twenty-three out of the 25 Ss made comments scor- able as symptoms on the Stern—Reyher SRS, ranging from 0 to 20 with a mean of 5.7. Table l is a correlation matrix for the five dependent variables. TABLE 1 Spearman Rank Order Correlations Between Average Drive Scores (Drive), Frequency of Cornell Medical Index Symp- toms (CMI), A-State and A-Trait Anxiety, Total Frequency of Symptoms (f-symp), and Frequency of Different Types of Symptoms (f-type) CMI A-STATE A-TRAIT f-symp f-type DRIVE .09 .04 .07 .59** .50 CHI -- .O7 .42** .27 .55** A-STATE -— -- .48** .16 .11 A-TRAIT —— -- -- .16 .15 *p<.05 **p.<.O25 A significant (r = .59, p<.025) correlation was found between the total frequency of symptoms reported and the average drive score (degree of repression), thus sup- porting the previously cited studies. However, the fre- quency of different types of symptoms (f-type), which was computed by scoring only once the appearance of the same symptom just missed reaching a significant correlation (.05 level of confidence equals .55) with the degree of repression. 25 The frequency of CMI symptoms correlated signifi- cantly (r=.42) with trait anxiety but not with state an- xiety. The significant correlation was expected from evidence which has previously demonstrated the relation- ship between anxiety and medical symptomatology. (Spiel- berger 1960). A significant .55 correlation between the frequency of symptom types elicited in the laboratory and the frequency of CMI symptoms was found. Subjects endor- sing more symptoms on the CMI tended to have a larger variety of symptoms in the lab. Since neither measure of anxiety correlated with frequency of symptoms nor with frequency of different symptom types, the experimentally activated symptoms, therefore, cannot be merely attributed to consciously ex- perienced anxiety reactions. The significant inter-test correlation of the state and trait anxiety (r = .42) was consistent with findings reported in the test manual (Spielberger). Degree of repression: The obtained profusion of symptoms afforded us with another Opportunity to verify the relationship between the degree of repression, fre- quency and type of symptoms. Burns scored the degree of drive activation (repression) for the visual episodes be- fore, during and after the appearance of symptoms. Un- fortunately, this degree of precision was not possible in 24 the present investigation because the manifestation of symptoms was usually reported only after a fixed period of time (one minute) when the subject was queried. The lack of such precision in the present investigation pre- sented a serious problem because average drive scores from this fixed interval would not reflect the wide and rapid fluctuations in the degree of drive representation. Imagery depicting sexual intent towards an older female can be followed immediately by remote images such as geo— metrical forms, etc. The average drive score for these two visual episodes might be the same as another subject whose drive score is based on visual episodes depicting intermediate degrees of drive. If the relationship be- tween degree of repression and type of symptom holds for these data, then the former subject should have manifested a symptom which is higher on the SRS than the latter sub- ject. Therefore, the most rational procedure was to com- pute the correlation between the highest drive score and the highest SRS score of the total five minute period of free imagery. As expected, the obtained Spearman Rho cor- relation between highest drive score and the highest SRS score was .75 which is significant at less than the .01 level. The relationship between degree of repression and the number of symptoms was assessed by correlating the highest drive score with the range between the lowest and 25 the number of symptoms was assessed by correlating the highest drive score with the range between the lowest and highest symptom on the SRS. As the drive achieves great— er representation in awareness, it nevertheless still produces psychosomatic symptoms as well as symptoms pro- duced by the drive itself no matter how high their value is on the SRS. The obtained correlation of .65 was sig- nificant at the .01 level. Table 1 represents the same analysis using less precise mean scores instead of highest scores and shows that the .59 correlation between the mean drive activa- tion score and the frequency of symptoms is, as was expec- ted, substantially smaller but nevertheless significant at the .05 level of confidence. The .50 correlation between mean drive and type of symptom just missed achieving the .05 level of significance.(.55). DISCUSSION The experimental hypothesis could not be tested since all subjects reported either a variety of symptoms or symptoms which were not being investigated. In order to test the experimental hypothesis, thousands of Ss would have to be screened with the CMI to locate enough S8 to fill each of the mutually exclusive symptom groups we had set out to study. The extremely pathogenic nature of the procedure was not only surprising but remarkable. The subject mere- ly is asked to close his eyes without ado and to visualize a story that is read, revisualize the story after S was finished, and then report five minutes of free imagery. There are several ways to account for the abundance of symptomatology. One is that the procedure is an indirect hypnotic induction and that the absence of intent to create conflict kept S's defenses at a minimum. Recent investiga— tions (Reyher and Wilson, 1975) have shown that indirect means of hypnosis are just as effective as formal methods. All that is required of S is to remain passive while the operator directs his attention and behavior. In all pre- vious investigations in this line of inquiry, a formal hypnotic induction was performed, during which S was in— structed to push the story (paramnesia) to the back of his 26 27 mind and that upon awakening he would be overwhelmed by impulses upon the presentation of certain cue words. The paramnesia implanted during hypnosis consequently places S in an acute conflict since the female object in the paramnesia (an attractive older woman) is too blatant a derivative of his mother. S's spontaneous derivatives of Oedipal strivings such as experienced in dreams and fantasies, are usually much more remote. This explana- tion is consistent with the fact that most of the sub- jects did not depict a continuation of the paramnesia, nor always depict females, during their five minutes of free imagery. Females appearing in imagery were usually girl friends or other females in non-sexual circumstances. (This is similar to observations reported by Burns.) An alternate explanation is that hypnosis was not involved. Having S visualize himself in a situation with such strong Oedipus complex overtones, stimulates his own unresolved Oedipus strivings which produce anxiety and psychOpathology. The capacity of directed visual imagery as well as free imagery to produce affective responses is well known and is the basis for its use in systematic desensitization and emergent uncovering psychotherapy. Another explanation for the present data is that the demand characteristics of the research were respon- sible for the symptomatic responses of Ss. In support of this explanation is the fact that S was given the CMI be- 28 fore he was run through the experimental procedure and that he was queried five times as to his feelings and sensations. He might have erroneously inferred that we wanted him to act as if he were expected to have symptoms even if the procedure and other aspects of the instruc- tions were not obvious in this regard and the experiment- er was not expecting very much psychopathology. Opposed to this explanation are the results of Veenstra (1969), Karnilow (1971) and Wolfe (1971) in what turned out to be the use of an ineffective paramnesia (Karn;low 1975); they failed to prOduce any psychOpathology in their hyp- notized Ss despite their intent to do so by using obvious conflict-producing procedures which have been standard in this line of research. Larison (1975), using the same in- effective paramensia, incorporated an amnesia versus no— amnesia condition and queries versus no queries condition and found no differences between them on the dependent var— iables. Even though some symptoms were produced, the param— nesia was obviously less pathogenic than the others that have been used. Using the same design and procedure as in his earlier investigation (the ineffective paramnesia), Karnilow (1975) employed the same Odeipus paramnesia used in the present investigation and produced many symptoms. Thus, the productions of symptoms appears to depend upon the paramnesia, not the experimenter, the amnesia, or the inclusion of queries by S. Finally, the most important consideration of all is that the type and frequency of 29 symptoms entered into systematic and significant relation- ship with the degree of repression. Most of the symptoms elicited by S during the experiment (such as shrinking in size, floating, depersonalization, somatic delusions, Spinning around and anesthesias) are clearly of a differ- ent quality than those on the CMI. The transparent symbolism of some of the protocols warrants discussion because of their intrinsic interest. In the protocol of Subject #1021, the subject saw himself starting to make love to the woman during the first minute of free imagery. Inferences of the underlying psychody- namic processes are as follows: the generation of anxiety is indicated by the psychosomatic symptom of being ner- vous and shaky. His repugnance for his Oedipus strivings is represented by the room becoming dark and drab. Since the older woman in the paramnesia was much too blatant a derivative or representation of his Oedipus complex, he was no longer able to see images. Further evidence of S's Oedipus complex was provided by the concomitant feelings of inadequacy manifested by feeling small, his shoulders turning inwards, and his hands in his pocket. Other facets of the Oedipus complex emerge as intimidating symbols of a potent, phallic father in his imagery. These are the big 1949 car with big tires followed by the image of trees, and by his inability to talk (aphonia). Unconscious wishes for intercourse with mother were expressed somatically by BO the delusion of his body moving up and down followed by further expressions of repugnance, viz., drabness, and the Collingwood entrance to the university being a big mess. The wish for intercourse also was represented so— matically by his legs feeling stiff and the resulting guilt was represented by the hysterical symptom of a lump in his throat. The §'s sensation of moving up and down, the stiffness of his arms and legs, feeling heavy, the turn- ing inward of his shoulders, speechlessness, and the lump in his throat are all indications of hysterical symptoms. Protocol #1000 also is of marked interest, as are most of them. Our inferences for this one are that the stimulation of his Oedipus complex produced a feeling of being alone or abandoned (lonely eye, empty sidewalks) as a consequence of his incestuous wishes symbolized by the rising sun (growing erection). At this point the ini- tial symptom of being warm was psychosomatic, indicating that anxiety was being generated, followed by a hysterical anesthesia, including the classical la belle indifference, from the waist down. The tall building, submarine, thun- derstorm, huge waves, diving and swimming and rain sym- bolize the erect penis, intercourse, ejaculation and semen. The helicopter diving and pulling up and the moving back and forth also are symbols of intercourse; and the feeling of excitement and electricity reflect the activation of 51 lust or libido. The spinning sensation is an hysterical, somatic delusion representing intercourse; the sensation of being dizzy in his toes is another of the many illus— trations 'n this and the other protocols of the appen- dages of the body being used as phallic symbols. One of the most remarkable symptoms in all our protocols occurred when he felt that one half of his body was spinning one way and the other half was Spinning in the opposite di- rection; that is, in a clockwise and counterclockwise direction concurrently. This has only occurred twice in our experience with emergent uncovering in psychotherapy and it strongly suggests that one side of the body, the left, symbolizes the bad, repressed impulses and the other side, the right, symbolizes good conscience or superego. The activation of Oedipus strivings stimulates both sides of the conflict simultaneously, thereby producing the feeling of turning in both directions at the same time. This symptom was followed by his statement, "I don't want to leave the black void" which suggest the womb or uterous and a desire of not wanting to get out by getting a bear— ing. Retrospectively this explicates the initial space analogy. Finally he experiences the somatic delusion of being pulled by the sun (attracted by his mother), vi- brating back and forth (intercourse), an intensification of psychosomatic symptoms (feeling sick and sweaty), along with the hysterical reaction of his fingers being cold. 32 Protocol 1001 is indicative of subjects having a relatively low drive score and a paucity of symptomatology. In this subject we can see the instant activation of re- pression as depicted by the remote derivatives (patterns) which immediately followed S's revisualization of the paramnesia. The onset of the first symptom (feet is cramped) appears to follow the image of the room which may be considered symbolic of the womb. Images appear to dissipate into thoughts of his activities at home. (S is approaching closer to the Oedipal object). The symptom‘ changes to a sensation of warmth (sexual arousal) which corresponds to his approach to his mother at home. The images suddenly shift to the car and trees (phallic ob- jects which can be considered derivatives of father). Subsequent to the phallic images there is the appearance of a more acceptable sexual object than the mother in the representation of a girlfriend (Pat) and the symptoms dis- appear. As transparent as these remarkable protocols may be to some observers, in emergent uncovering psychotherapy many clients eventually achieve blatant depiction without the benefit of interpretations of making love to his mother along with the retaliation of the opposite sexed parent, sometimes with mutually murderous confrontation. These often take very regressed expression in the form of infan- tile oral, anal or cannabalistic fantasies; however, these 55 repressed fantasies emerge generally only after months of psychotherapy. Because of the relative blatancy of visual depiction and the outcrOpping of vivid psychOpathology after only five minutes in experimental subjects, we plan to use this paramnesia at the very beginning of psycho- therapy with clients hOpefully to accelerate the process of uncovering. Administering a variety of paramnesas designed to stimulate different commonly encountered re- pressed conflicts may operationally define areas of con- flict that need to be resolved in psychotherapy. Psycho— diagnosis therefore would become more objective and rele- vant. The data of Sommerschield and Reyher (1975), Burns (1972), Karnilow (1975) and the present research all are consistent with Freud's observation that hysterical symp- toms represent a fixation at an early genital stage of libidinal organtion reflecting an unsuccessful repression or resolution of the Oedipus complex. These investiga— tions have in common the use of the same Oedipus param- nesia. This is particularly impressive when considered in relation to the other investigations (Karnilow, 1975; Larison, 1975; Perkins and Reyher, 1971; Reyher, 1958, 1961, 1967; Sommerschield and Reyher, 1975) in this line of inquiry which used an anger—aggression paramnesia ex- clusively, or in addition to the Oedipus paramnesia, and only produced a few hysterical symptoms. 54 Two of the items on the questionnaire considered the ethical issues of this technique which activates symptoms. The subjects' responses apparently reveal that this procedure was not particularly stressful or upsetting. Eighty—four percent (21) of the subjects reported they were treated "very well" or ”fairly". Sixteen percent (4) reported some negative feelings about the experiment; however, these reactions do not appear to be uniquely at- tributable to this procedure: "treated like a statistic", "guinea pig”. Criticisms of the experiment were distri- buted as follows: seventy-two percent reported no criti— cisms, twelve percent complained of some frustration of the task to report images, and 16 percent (4) felt uncom- fortable with equipment in the room or with the presence or the S. Suggestions for Improvinngesign and Future Research Since S's usually did not report symptoms spon- taneously, but rather waited until queried, some accuracy in assessing the degree of repression was sacrificed. Ad- ditional instructions which would facilitate the timing of S's responses may be ameliorative. Since it has already been shown that demand characteristics for symptom produc- tion are minimal, the additional instruction of "describe any feeling or bodily sensation you have immediately" may clarify the procedure for S and increase the preciseness 35 of repression scores. Previous research, Sommerschield (1975), has shown no significant differences for Oedipal as compared to anger conflicts. A duplication of this study utilizing non-hypnotic techniques as employed in this experiment appears to be in order. Furthermore, the Oedipal conflict per se must be viewed as not merely a sexual conflict but rather a complex constellation of conflicts: sexual drives towards Opposite sex parent, aggressive and hostile fantasies toward same sex parent, fear of loss of love and retaliation, feelings of inadequacy. Which components or combinations of these conflicts are attributing to the symptom production remains unanswered. The use of a series of paramnesias is indicated for comparison of relative pathogenicity. Hahl's (1971) discussion of objectively unpleasant stimuli offers some suggestion for future par- amnesias: frustration, threat to physical integrity, loss of love object, separation, loss of self esteem, etc. A comparison of various paramnesias can provide further data on the role of drive constellations on symptom etiology. Expanding the subject pOpulation to include fe- males, clinic populations, and increased age ranges are some logical extensions of this research. Perhaps a large N study to collect normative data on symptom frequency, types, and repression would be another step towards a systematic study of experimental psychopathology. )0 Since the CHI excludes many symptoms appearing on the SRS and many psychogenic symptomatology, no adequate comparison could be made between the symptoms appearing in the laboratory and those in S's everyday life. Future research is planned which will utilize the SRS and a psy- chological symptom checklist as a subject feedback ques- tionnaire which will be administered after the experimen- tal procedure. Interesting comparisons could also be in— vestigated between degree of repression, experimentally activated symptomatology, and physical disease patterns reported by subjects. Clinical Validation Clinical validation of theoretical constructs developed in the laboratory is always desirable. Fortu- nately, this researcher was engaged in psychotherapy train— ing during the course of this research project. The fol- lowing protocol provides a quite dramatic verification of the degree of repression theory. The client, male, age 26, seen 5 times per week for psychodynamic psych therapy, quite spontaneously elicits a complaint about a recent change in symptomatology: Session #55 Client: "....psycho-somatic like symptoms are coming up.. my skin is giving me more problems now...more so than my anxiety.. TH: could you tell me more about that? 57 I've been breaking out more often...scales on my skin...since about Friday... I guess I've got them all over my body now...comp1etely scaled over this weekend...itching all over....least I'm rid of some anxiety..I haven't notice my pouncing up and down in my belly..I wonder what happened to that.... I'm feeling a little bit of that (anxiety) right now... Clien' (‘1‘ 0. TH: '.-'.'hat can you make out of that? Client: I think they're (stomach feelings-anxiety) be- in: crushed more then ever...(l) feel pressure of work and school.. TH: Crushed? Client: As I begin to got more self control I say to my- self-get to work!...I'm putting aside all my anxiety feelings...making them subservient to my feelings of get to work! do my thesis! get up!.. the way I'm dealing with my feelings..I'm sup- pressing them (during the day) then I deal with them during therapy....the pressure and tempo feels that instead of dealing with my feelings and spending time on them I brush these anxiety feelings aside... the anxiety comes on but I brush them aside.....I still don't read the newspaper... ..still anxious about my kid..(etc.) 1 The client's presenting problem was massive and diffuse anxiety, guilt, and concerns about hOSpitalizing himself. As free imagery proceeded to uncover more specific sources of anxiety (Oedipal strivings towards his mother, incestuous impulses towards daughter, hostility towards father and wife), he reported that he was gaining more control over his anxiety and was becoming his "old self" again, though this time he is aware that feelings of anger and tenderness are not spontaneously available to him. It appears that the course of therapy has definitely altered the degree to which his Oedipal and anger aggression con- flicts were repressed. REFERENCES Alexander, F. Ps chosomatic medicine: Its rinci les and appIications. New YorE: Norton, I958. Broadman, K. et a1. Cornell Medical Index Health Ques- tionnaire ManuaI. New YorE: ‘Cornell University Medical College, 1949. Burns, B. The activation of posthypnotic conflict via free imagery: A study of repression and psycho- pathology. Unpublished doctoral dissertation, Michigan State University, 1972. Fenichel, O. The s choanal tic theor of neurosis. New York: W. W. Norton, I955. Karnilow, A. A comparison of Oedipal and peer sex through the use of hypnotically implanted paramnesias. Unpublished doctoral dissertation, Michigan State University, 1975. Larrison, G.R. Spontaneous repression of impulses and psychotherapy. Unpublished master's thesis, Michigan State University, 1973. Karnilow, A. An attempt to produce psychOpathology: the posthypnotic stimulation of hypnotically induced conflict. Unpublished master's thesis, Michigan State University, 1971. Mahl, G.F. Ps cholo ical Conflict and Defense. New York: Harcourt Brace Uanov1c5, 1971. Matarasso, R. The relationship between medical and psychi- atric cymptomatology in medical and psychiatric patients. Acta Psychologica. 19, 1961, 863-864. Perkins, K.A. & Reyher J. Repression, psychopathology and drive representation: An experimental hyp- notic investigation of impulse inhibition. Amer— ican Journal of Clinical Hypnosis, 1971, 15, 38 59 Reyher, J. A paradigm for determining the clinical rele- vance of hypnotically induced psychOpathology. Psychological Bulletin. 1962, 59, 544-552. Reyher, J. Free imagery: An uncovering procedure. Jour- nal of Clinical Psychology. 19, (4), 454-455. Reyher, J. Brain mechanisms, intrapsychic processes and behavior: A theory of hypnosis and psychopath- ology. American Journal of Clinical H nosis. 1965, 7, - . Reyher, J. Emergent Uncovering. Paper presented at meeting of American Psychological Association, Washington, D.C. 1969. Reyher, J. & Basch, J.A. Degree of repression and fre- quency of psychosomatic symptoms. Perceptual and Motor Skills. 1970, 50, 559-562. Reyher, J. Hypnotically induced conflict in relation to subception, repression, antisocial behavior and psychosomatic reactions. Unpublished doctoral dissertation, University of Illinois, 1958. Reyher, J. Posthypnotic stimulation of hypnotically in- duced conflict in relation to psychosomatic re- actions and psychOpathology. Psychosomatic Medicine. 1961, 25, 584-591. Reyher, J. & Wilson, J.G. The induction of hypnosis: indirect vs. direct methods and the role of anxiety. American Journal of Clinical Hypnosis. 1973, 15,‘229-233- Sommerschield, H. & Reyher, J. Posthypnotic conflict, repression and psychopathology. Journal of Abnormal Psychology. 1975. Spielberger, C.D. et a1. STAI Manual. Palo Alto: Con- sulting Psychologist Press, Inc., 1970. Veenstra, G.J. The effectiveness of posthypnotically aroused anger in producing psychopathology. Un- published master's thesis, Michigan State Uni- versity, 1969. Werner, H. & Kaplan, B. Symbol Formation. New York: Wiley, 1973- no Wolfe, A.M. Critical factors in the artificial induction of conflicts: A hypnotic paradigm for repres- sion. Unpublished master's thesis. Michigan State University, 1971. Wolffe, H.S. Life stress and bodily disease: A formula- tion. In Proceedin s of the Association for Research in Nervous and NentaI Nisease. BaIti- more: WiIIiams E WiIEins, I955 APPENDICES APPENDIX A VERBATIM PROTOCOLS OF FREE IMAGERY Subject #101 In my room, I've been working all nite and I'm sound asleep, that's the way I'd like to be...I see a pic- ture of my girlfriend..not doing much just sitting there.. (pause)...at the ocean..just sitting and letting my mind wander..thinking Johnathen Livingston...(Q-l)..not too bad I feel kind of peaceful inside..(Q-2)no..groggy head haven't been sleeping (sigh)...back at the ocean...just sitting on the rocks watching the waves come in..not do- ing very much..just sitting and watching grey..warm inside.. I suppose... I'm thinking ahead to my chem class. I've got a quiz today..not doing much..(Q-1) queasy inside.. its our first test..wondering how I'm going to do on it (0-2) nervous stomach, I suppose..at home now..sitting and having dinner with my parents...just sitting and talk- ing..not really doing a whole lot just talking...feeling kinda good inside...back to the ocean, I'm afraid all my thoughts end up there..just sitting on the rocks..(Q-l) warm inside, feel good (0-2) kind of feeling good and happy..nothing but the ocean comes to mind..afraid I could sit there all day and not do much of anything, I 41 42 could probably think about it all day too...thinking about the concert now..(Q-1) good inside..rea1 good inside...the inner rhythm is starting to go..um.. (Q-2) well just a warmth (0-5) in my stomach...High School football game... watching it, the game where I get hurt...a lot peeple on the sidelines...just excrutiating pain, rain on my face.. (Q-l) shoulders just twinged...that's what happened to me that day...(Q-2) should is sore. Subject #120 I'm supposed to do this now?..(silence)...(Q-1) I feel really relaxed (0-2) no....(si1ence) (Q-l) really relaxed (Q-2) no.....see a football game going on...MSU is being beaten...(silence) (Q-l) same (0-2) no....(silence) ....(Q-1) same (Q—2) no.....(silence) (Q-l) no change.. floating on a cloud, relaxed...(Q-2) numb in the foot... feel really relaxed. Subject #105 (Silence for one minute)....(Q-l) little nervous, what's going to happen..(Q-2) no..(silence)...(Q-1) all right...(Q-2) no....(silence for one minute) (Q-l) fairly relaxed, little bit uneasy trying to think (Q—2) feel pretty comfortable...I'm thinking of the next class I'm in - it's a pretty big class, thinking about every time you go into class everyone goes in and sits down and pulls 43 up their newspapers; thinking that it gets kind of repeti- tous...(Q-l) all right; nothing really..about the same... (0-2) no..si1ence...(Q-1) about the same (Q-2 no Subject #146 (Silence..a11 I visualize is the bus stop..fee1 very relaxed..no images..no one at the bus stop..(pause) ..(Q-l) Relaxed. (0-2) Not that I can perceive..sti11 see- ing that bus stop..the neighborhood seems to be 1920's, old style buildings..beat up asphalt street..1ike narrow streets in New York..there's a fire hydrant near the bench near the bus stop..the bus step sign..seems to be fall...there are leaves near the bus stop. (Q-l) relaxed. (Q-2) N0..(pause)..seems to be a very gray day like today.. cool..I'm looking at the bus stop from the window of the apartment..from the distance of a block or two..pe0ple at the bus stop..the bus is there..it's silver and green. (Q-l) Relaxed. (Q-2) No.. my view is moved back from the window of the apartment..I see the wall that the window is on..a smoky gray wall with dark wood on the sill... 01d type of register..there's a desk on the adjacent wall. (Q-l) Really relaxed. (0-2) N0. . piece of paper on the desk..p1aced as if someone is going to write a letter.. little figurines above the desk cabinet..nothing specific.. just nebulous figurines..there's a very monotone type of painting..du11 color..vague images. (Q-l) Relaxed. (Q-2) No. 44 Subject #206 I don't really have any..(silence for one minute). (Q-l) Fairly relaxed. (0-2) No. (Just wait for images to come to your mind's eye and describe them to me)...only thing I was thinking about was the story..the picture of the woman as I described her before..thinking of us danc- ing again..thinking that once I left I'd feel sad and lonely..(Q-l) Sad when I'm thinking about the story.. (0-2) None in particular. I was just going over the story again..my arms are isolated from the rest of my body..it kinda feels like I'm floating..(Q-2) Tingling in arms..seems like my arms and legs are very long and heavy..seems like the room is much bigger than I remem- ber it being..(Q-1) Still pretty relaxed. (Q-2) Still tingling in my arms..seems like I'm very small..when compared to the room..seems like I'm laying flat on my back and floating..seems like my legs feel long and heavy.. still tingling sensation in my arms..1egs feel weak. Subject #141 I'm thinking about how weird the story was.. (0-1) OK. (Q-2) Not really, maybe I'm a little nervous.. (just wait for things to come to your mind's eye and des- cribe them to me)..(si1ence)..am I supposed to be think- ing about the story?..(si1ence)..(Q-l) 0K. (0-2) No.. 45 (silence)..I really can't think of anything..(silence).. (Q-l) 0K. (Q-2) No.. I'm a little thirsty..(silence).. just thinking..really not seeing anything..I just saw that car..just thought about that story again..trying to put things together..(Q-l) 0K. (Q-2) N0..(si1ence)... just thinking about that story. (Q-l) OK. (Q-2) No. Subject #148 (Silence)..What am I supposed to do? (g repeats instructions) (Silence)...(Q-l) Pretty relaxed. (Q-2) Legs feel spaced..head is kinda dizzy. I see a pelican.. see a bird..see the ocean..a tower in it.. one of these lighthouses..(silence)..I see a fog..(silence)..I see a rectangle just floating in space. (Q-l) Dizzy. (Q-2) No.. I see a nude body of a girl..(silence)..(Q-l) No. (0-2) just feel light..just revisualizing the story..see the guy making love to her..see the pelican again..see the sun setting in the ocean..now I see..now I see a plane, a jet (Q-l) Same. . the Jet's going around in circles. (0-2) Dizzy. Subject #125 (Silence) I'm not sure exactly what you want me to do. (g repeats instructions). Right at this moment you mean? I see face of an older woman..the thoughts keep coming back of whether I should have left or stayed [+6 . and how much I would have done, if any. (Q-l) Warm. (Q-2) I seem not so much sexually bodily more like.. I feel far from that situation..I seem to see her expres- sions when she was trying to keep me to stay..image of her putting record on record p1ayer..casua1 talk..see me running out again..thoughts should have stayed or gone, that's pretty predominant. (Q-l) I feel that I'm further.. I feel like that situation wouldn't happen. (0-2) I feel I wish it would happen..I wonder what it would be like..I see her with a soft voice but still somewhat of one that can control you..more or less being able to tell you what to do without saying anything. (Q-l) Wishing that situation would be at this moment. (Q-2) (Pause) I'm not sure what you mean.. (Do you have any sensations in your body?) Warmth. (0-5) Upper parts. I keep seeing situation of me going out the door..it seems to occur over and over..I can see her reaching out and say- ing "come back".. (Q-l) Warmer. (Q-2) I feel stronger to- wards her, like I know her better, like a close personal relationship..I see us walking through the door just ar- riving at her apartment..just talking casually as we were good friends for a long time..it seems like we've known each other for a long time. (0-1) Like I have some sort of affection for this person. (Q-2) Wanting to be near or with her. 47 Subject #205 Just anything? Right now I see inside of a volleyball court, a handball court. I like to play hand- ball...I was looking around for someone to play handball with but most of the kids were home so I did my laundry and my homework...I still thinking about doing handball today or some tennis.. I saw someone playing tennis on the way here..I see the tennis courts..I see the gym... stadium..inside the stadium..reminds me of the crowd. (Q-l) Alright. (Q-2) Nothing. There's a lot of peeple, crowds make me feel so insignificant..my roommate's one of the football p1ayers..I see the party we had last night..hundreds of kids..everybody stands around the foot- ball players. (Q-l) Funny, I don't know just funny. (Q-2) Starting to sweat. (0-5) In my hands. I see my room..my stereo is in the window..open view..I've got to get a ladder..it's an old rickety thing to fix the room. (0-1) More relaxed than just a few minutes ago. (Q-2) Nothing other than sweaty hands..the ladder, kind of a shaky thing.. when I was making the loft, I slipped with the hammer and put a hole in the wall..I see the hole in the wall, car- peting in the room..it's kind of dirty..I forgot to vacuum.' (0-1) A little nervous, running out of things to say. (Q-2) Feet are going to sleep. See the cafeteria..I go to break- fast every morning..I see the same kids there every morn- ing..the food is lousy..I see one of those Sunday afternoon 48 dinners, it's really appetizing...I see a turkey.. I like turkey, it makes my mouth water. (0-1) Hungry. (0-2) No. Subject #145 Just thoughts of my roommate..not getting enough sleep..still thinking about that last story.. worrying about home..it's hard to visualize.. (0-1) Relaxed, but not seeing anything.. (0-2) No.. (Just wait for images to come to your mind's eye and describe them to me).. (Pause)..there's a girl about 5 feet one, brown hair.. I see a basket ball..I see all my roommates sleeping.. I see all my teachers giving a lecture. (0-1) Jumpy. (0-2) What do you mean? No. . I see one of my teachers 1ecturing..for some reason I see a toilet stool.. I see a long corridor..a door..looking out the window..see ev- erything out of our window..riding along on a bicycle... see trees and nature. (0-1) Relaxed. (0-2) N0..noticing peOple..see peeple..football stadium..I still see the front of my dorm..cars.. (0-1) Relaxed. (0-2) No... I see the dorm across the street..I see the girl walking.. I give this girl a ride on my bike..I see my classroom. (0-1) A little tense..in my muscles. (0-2) No. 49 Subject #147 Just red...see person's face..f1ipping on and off..probab1y person from that story..the car..trying to see that lady..the old lady..see books..lots of books.. (0-1) Good. (0-2) Just, ah, kind of a nervous chill... seems to be just more tense from waist down..ny arms are relaxed..I see a friend..she has black hair..chubby face.. her arms..red..see the sky in the planetarium..the Mars thing..see visions of things that happened this morning.. just passing real fast through my mind. (0-1) Relaxed.. ...Probably a little tense. (0-2) Feel like I'm hotter.. probably because I'm struggling and trying to think..my hands are sweating a little..a water bottle..I have to drill a hole in it and put a gold fish in it..I'm doing an act in Shakespeare..I see the characters in it..I'm blocking out a scene I'm doing an act in..football.. frizbee in the hall..stereo. (0-1) Really relaxed..some of the tension has eased. (0-2) None that I can describe.. I see a bicycle..it's racing..made out of light metal.. I see books that I haven't read this year..I see my room.. (0-1) Relaxed..kinda tingling.. (0-2) in my shoulders and arms..I see a stereo system..it's a combined two sets with a lot of wiring..I feel the light that's on in the room.. mental images are passing rapidly..school..campus.. (0-1) Relaxed. (0-2) None. 50 Subject #142 (Silence)..I see a watch..see a taperecorder..I see you..I see 01ds Hall..See some guy taking pictures of his wife..(0-l) A little tired. (0-2) Just feel re- laxed..my eyes closed in a comfortable chair..see that car again..see my room..see a refrigerator..my, I sort of have a little body sensation..my head is sort of turning around a little bit Cause of that noise.. (0-1) Getting progressively tired.. (0-2) I get the feeling that things are coming in and out of me like I'll see a light coming in and out..sort of half image, half sensation..sort of makes my head feel like its moving when its not..see the stadium..see all the cOps come by..see an alarm clock.. see chemistry building..see my house..(0-l) About the same. (0-2) Not really..I see the tape recorder..(Mumbles) and the bed..I see the room..I feel sort of like when your leg goes to sleep and wakes up..tingling, I sort of feel like that..(0-1) I feel like my whole body is asleep and waking up. (0-2) Just that. I see all those school buses and bands..I see the 1ibrary..administration building..I see the river. (0-1) I feel more tired. (0-2) They come and go..I sort of feel like I can feel the blood rushing through my body. (0-5) My arms. 51 Subject #201 I feel warm..I can see like an overcast sky where there's like verticles in the clouds..it isn't raining..it's just one of those overcast days where there is nothing happening..it's cold and dismal..wind's blow- ing just slightly..it looks like it's winter..or fall.. late fall or early winter..all the leaves are off the trees and I can see the trees..you know, just without any foliage on them..then there's the river, (0-1) I feel not as warm as I did before.. (0-2) for some reasoning, I have a tingling in my calves, warm in my chest..There's that river and it's flowing like over a lot of rocks and stuff rather fast..it's a rapid stream..fast moving stream..it isn't so rapid that there are white caps or anything..it's going over a lot of rocks..water itself looks kind of dark..it matches the sky..it's dark and dismal..you can't see the bottom row..(pause)..I think there is little patches of snow around, but there isn't anything that's strange..it's just a slight breeze..there isn't anyone around..it's in the forest. (0-1) I still have that tingling feeling in my calves..um.. (0-2) don't feel any different..there's dead leaves..it's kinda muddy.. like it just got through raining..there isn't anything I can say offhand..I see a cave..like the river could have gone into a cave or something..it reminds me of the time 52 I went into a cavern in Arizona..it reminds me of it.. all the stalagtites and stalagmites and stuff..how dark it is..it's really dark.. total darkness. (0-1) All the pains are gone. (0—2) My stomach still hasn't settled from that walk that I just finished..I walked here after lunch..still hasn't settled, but I don't feel that my toe feels hot..I'm in this cave..it's really total dark- ness..I feel there is like a path..it's like Jules Verne's voyage to the Center of the Earth..(pause)..that's enough of that story..flash back to that car..this time it's a blue car..it's a Datsun 240Z and it's got a black interior and it seems like I'm driving it down the road..a four lane highway and it's in Kentucky or Tennessee..the grass is really green..(0-l) I have a warm sensation. (0-2) Around my stomach and chest..going down the highway..every- thing looks healthy..the trees look healthy and stout... the grass is thick and green and it's a nice drive.. a nice sunny day..not much traffic at all..I have a tape player on..it's a really good thing..I see a picture of me driving..it must be Kentucky..it reminds me of the mountains in Arizona..I used to live there..that's where my parents are right now. (0-1) No different..still feel a little bit warm. (0-2) Tingling in my calves still, warm in my chest. 53 Subject #209 (Silence)..Am I supposed to say anything? (g repeats instructions). Right now it's a little blank as such. (0-1) A little hot in my arms..a11 over. (0-2) Heartbeat is kind of (mumbles loud or low).. (silence).. I'm a blank..I'm not sure exactly what to think..I see a face. (0-1) Relaxed. (0-2) Nothing..(1aughs)..a blurred face..there's not real form to it as such..there's a lady. (0-1) I don't know.. (0-2) No..it's an old lady as such..it's starting to get foggier..my mind is starting to wander..that's strange, I kind of visualized a watch.. still kind of hyperactive..I've had a lousy day..haven't calmed down as I should..heartbeat is still going up.. I had a Bio test and right after the Bio lab, it takes time to wind down. (0-1) Basically the same. (0-2) I still feel very warm, maybe it's because of the sweater, I don't know..(si1ence)..I just saw my parents very close... (si- lence).. (0-1) A little warmer. (0-2) Heart is up a little. Subject #204 First thing I notice is my hands are sweaty..my mind seems to be drifting back, I don't know why, and kind of chills are running through my body..I don't know why either..I'm not really focusing on anything..like looking at a white wall or something..a blank wall. (0-1) Feel 54 kinda warm. (0-5) Stomach. (0-2) No. (Silence) It seems to have gotten brighter..see myself getting up out of bed.. (silence). (0-1) Pretty good, I usually get up out of bed feeling dead. (0-2) Yeh, I'm feeling warm all over instead of just my stomach. I seem to be going over to turn off the TV..I don't know why it was on though..there's a girl in the room too..I'm talking to her..I don't know what we're talking about. (Q-l) Kinda embarrassed. (0-2) warm- ness has left. We're leaving the room, going outside.., now we're fighting..that's why I'm embarrassed..I'm shak- ing now, I don't like to get mad..it looks like we're having a fight. (0-1) Angry. I'm still embarrassed. (0-2) I'm not warm any more. (Pause) Switch to a dance.. everybody is dancing except me..now I'm dancing...I don't like to dance..I feel like I'm drifting..1ike I'm a lot higher than I am..I'm sitting here in this chair..I'm way up above you..it's strange. (0-1) Really light and airy. (0-2) Hard to describe..feeling that I could do just about anything, fly or anything..it's so light. Subject #116 (Silence-one minute)..(0—l) feel kinda hot and sweaty..(0-2) can't feel my body right now, my head is spinning..see myself studying this afternoon..see a foot- ball game..don't have any tickets..see rain..cloudy, dark.. see myself in a room while the house is quiet..(0-l) same. 55 (0-2) more relaxed..feel in my stomach just ate lunch.. continue walking in rain..get wet..everything keeps going back and forth..footba11 game..studying..see my roommate.. see my friends..gathering together in room..to have a party..(Q-1) kinda high..like my body is floating..(0-2) numbness..(Q-5) in my feet and hands..I can see the whole school quarter pass by..going home at Christmas..I see myself ice skating..p1aying in the snow..now I'm looking way ahead to next year..(0-l) down, sad and depressed... I know what's going to happen next year..probably go to summer school..can't find a job...(Q-2) can't feel my hands and feet...I can see my girlfriend back home.. I can see her at her house..go out and have a good time on the weekend..seeing ourselves goofing around..p1aying around in the spring.. (0-1) better, happier, not de- pressed..(Q-2) feel high, like my body is floating.. Subject #128 (Silence-one minute)..(What's happening?) getting bored..listless..(0-l) relaxed..(Q-2) no...see girls walk- ing and talking..playing football now..(silence)..(Q-l) cool.. (in what way?)..my skin feels cool..(0-2)no..run- ning around on a football field catching a ball..riding a motorcycle..laying in bed resting..(0—l) tired..(in what way?)..muscles seem tired and relaxed..(Q-2) sorta hot... 56 (0-5) neck and back..c1eaning up the room..sweeping it out and straightening everything up..collecting the garbage.. playing music..drinking beer..(Q-l) cool again..(0-2) um, sweaty..(Q-5) in my legs..walking around the dorm..looking at everything..1ooking in the mailbox..getting some mail.. reading letters..going back to talk to friends..(Q-l) cool and relaxed..(0-2) No. Subject #102 (Silence)....See a train. . It's got 25 cars..out of state railroad..it's going to Pennsylvania..(0-1)..Fine. (0-2) No. ... (silence)...I see some 1ightning...it struck a tree and fell. (silence)...(Q-l) 0K...(0-2) No bodily sensations..I see a comet..yellow and streaking through the sky..getting smaller and smaller..going out of the solar system..(silence)..(0-l) 0k.. (0-2) No..see a bus load of peOple travelling to New York City..get side swiped by a truck..everyone is killed except the bus dri- ver..(silence)..(0-l) 0K.. (0-2) No.. see a burglar..out- side in back of house, trying to get into the windows and the doors..he cannot get in..the police come but he's hiding..they go away..(0-l) 0K.. (0-2) No.. Subject #127 (Silence)..don't see anything..just kinda relaxed.. 57 I feel relaxed and comfortable..no images..(silence).. (0-1) fine.. (0-2) no, just comfortable, not tense.. nothing particular, I just visualize myself here.. as part of the experiment..for a second I sorta tensed up.. no particular visions are coming..maybe it's just being here not knowing what to expect..maybe I'm nervous or something..I'm not as relaxed as I was a couple minutes ago..(0-l) 0K.. (0-2) maybe just a little bit of ting- ling all over..(0-5) not specific..nothing particular.. (silence lasts one minute)..(0-l) I don't know, can't seem to picture anything..can't figure anything out... (0-2) sweat a little bit but no bodily sensations... (silence)..sorta picture someone walking..(silence).. (0-1) nothing formulates, maybe I'm trying to formulate, that's why I'm not getting anything..(silence)..(Q-l) 0K..(0-2) nothing in particular. Subject #100 See the river by the dorm as I walked by this morning how it is brown and polluted..runs like molasses hardly moving at all..see all around a dark gloomy day.. the bridge over the river I think it's Farm Road..just walking along the bridge looking to either side seeing on the right an Open field where everyone plays football and peOple walking along all the time..but no one was there today..and just the emptiness as I walked over here 58 in the streets..c1asses hadn't gotten out yet..hardly anyone was around..(Q-l) strange sensations..I'm used to seeing peOple all around..I don't know, couldn't describe. (0-2) just feel a little numb in the back...I remember walking past Bessie Hall and I don't remember the rest it isn't as clear as by the river..(silence)..there isn't any images I get right now while my eyes are closed that are really distinct...(Q-l) same as before.. (0-2) my back is numb, very relaxed..ah, right now I see the bi- cycles..before classes let out..sxamining numbers how 20 to 50 come right after class lets out by you..big crowds of people by Shaw Lane where everyone is trying to cross the street..a lot of people on bicycles but mostly people walking...it‘s a very crowded scene..quite often during the day..I see myself walking to class..(0-l) same as before.. (0-2) back and shoulders are very relaxed, so are my legs from the knees up..below the knees just feel- ing very normal..my head is just not moving at all.. I haven't moved it in either direction for a long time cause my eyes are closed..it's different, I don't even know if I opened my eyes where I'd be looking..my whole body is very relaxed..thinking of the football game last Saturday, how I put on all these clothes to sit in the rain, then it stOpped raining then I had to take off my rain gear and it made where I was sitting more crowded and I can't remember everything..(Q-l) ah, a little more 59 sorta twinge around my facial muscles where I am talking.. (0-2) overall numbness especially in my back and shoulders.. ah, I remeber I was back home in Massachusetts just driving along Route 9..looking at all the things..remembering all the things on the sides of the roads..shopping centers.. which I haven't seen for quite a while and the traffic lights along the way from my house into Boston..(0-l) same as before..(0-2) numbness. Subject #1000 A big eyeball..one lonely eye out in space..now I see stars..stars moving around..trees..in background.. sidewalks completely empty..early morning sun rising up.. (0-1) hot..warm very warm..(0-2) no feeling from the waist down, I feel comfortable..tall building..city... lots of people..dark clouds....thunderstorm..lot of rain.. lot of water over the sea..b1ack sea..huge waves..sub- marine below the sea..diving and swimming now. (0-1) no change..(Q-2) no...f1ying..flying in a helicopter..now I feel like I'm turning around..like I'm spinning..now I'm diving down into a field..closer and closer to the field.. back up again..(Q-l) I'm moving back and forth..(Q-2) excitement like I'm full of e1ectricity..it's completely dark..I'm floating in a void..nothing in anyway at all.. I'm spinning around faster and faster..twir1ing..feels like my whole body is spinning head over heels..nothing 60 anywhere but me..getting dizzy..now I'm laying flat and spinning around..(Q-l) dizzy tense (in what way?) in my toes and in my head...I'm spinning around still..one half is going one way and the other half is going the other way..it's uncomfortable..I don't want to leave the black void..there's nothing around..I hate getting a bearing..I don't want to see anything or I'll get a bear- ing and stop seeing anything..see the sun..just the sun and the dark it's pulling me..getting closer and closer.. room is vibrating back and forth..still spinning around. (0-1) almost sick..in my head..(0-2) fingers are cold, chest is sWeating...still feel like I'm vibrating. Subject #126 (Silence for one minute)..(Q-l) my eyes are twitching.. (0-2) no..(what's happening?) (silence-one minute)..(Q-l) ok, relaxed and comfortable..(just wait for images to come to your mind's eye)...imagining a football game..(0—l) 0K..(0-2) no.. bunch of football players run- ning back and forth every which way..(si1ence)..(0-1) 0k, a little more excited..(0—2) heartbeat increased...looks like the team is more orderly..in line..set for play.. all the people starting up and cheering..(Q-1) 0k.. (0-2) no. APPENDIX B DRIVE ACTIVATION SCALE Burns and Reyher (1972) develOped a scale for the express purpose of determining the degree to which the aims and objects of drives implanted in.§ under hypnosis were depicted in his visual imagery during a subsequent post- hypnotic period of free imagery. Since the paramnesia that was implanted was designed to activate,§'s Oedipal complex, the scale was generalized to better suit the purposes of the present research as well as preserving its distinctive ability to tap Oedipal strivings. We felt that it was particularly important for the modified scale to retain this capacity because almost all of our clients undergoing emergent uncovering psychotherapy sooner or later become involved in pathogenic unresolved oedipal strivings. This is true for all the client-sub- jects in Group C. The modified drive activation scale includes all those drives which have been shown to be capable of pro- ducing psychopathology in the context of emergent uncover- ing psychotherapy. Unlike the Oedipus Complex Activation Scale of Burns and Reyher, the present Drive Activation Scale includes inferences concerning covert drives as well 61 62 as the scoring of drives expressed overtly in S's visual imagery. The particular advantage of these scales over the Holt scales is an assessment of the degree to which the aims and objects of drives are gratified inlfi's visual imagery, the ultimate gratification being the act- ing out of,§'s sexual interest in the Opposite sexed parent. The scale also assumes that spontaneous imagery is regulated by repressed drives. This assumption is based upon several considerations. Visual images, unlike words, are not consciously shaped or formed; they are un— bidden and present themselves without apparent meaning. Visual imagery is not a vehicle of representation, like words, but a vehicle of presentation. Visual images, therefore, are not involved in semantic relationships with their referents for the apprehension of meaning. They do not exist as lexical units in a semantic-syntactic field in which meaning is presented linearly by symbols (words) that are clearly differentiated from their refer- ents. The aims and objects of repressed drives consti- tute the referents of visual imagery which are fused with the images, and are presented simultaneously rather than linearly as in language. The particular form of the images is determined by gradients of stimulus and response simil- arity which includes such analogical mechanisms as meta- phor, simile and allusion as is commonly found in dreams. 65 In psychoanalytic terms, formation of images is under the sway of primary process. In their scale, Burns and Reyher (1972) weighted the component drives of the Oedipal complex in accordance with their presumed pathogenicity. These were Sex (16), Anger (8), Feelings of Inadequacy (4), Guilt (2) and Anxiety (1). We thought that we could widen its appli- cability by adding love and placing guilt and inadequacy together in a category comprising affects stemming from a reduction in self-esteem. The affective dispositions to love and receiving love from hated, rejecting parents is-in our experience with emergent uncovering psycho- therapy--the last and most disturbing repressed affective disposition to emerge. Nevertheless, we decided that a tankingof drives in terms of their relative pathogeni- city is premature in a more naturalistic situation wherein particular conflicts are neither implanted nor selectively piqued. Although anxiety is both a symptom of conflict and a drive, we have treated it only as a symptom. For our present purposes a pathogenic drive is defined as any response-producing affective disposition that can generate sufficient anxiety to impair cue functions and organized, adaptive behavior. Repression is conceptualized as a neurophysiological, negative feedback mechanism that in- hibits the intensification of a pathogenic drive (Reyher, 1965; Sommerschield and Reyher, 1975) which, therefore, 64 permits the individual to sustain an optimal level of cue functions and maintain adaptive behaviors necessary for physical survival. Visual Episode Defined Each visual episode is scored for one or more of the drives below, a visual episode being a cohesive se- quence of images demarcated from adjacent episodes by a change in either objects (animate or inanimate) and/or situation. Whenever a situation remains the same and the objects change, as in a walk on campus, each new object is scored as an episode; or in a bar scene, the focus may change from the bar, to the stage, to the people sit- ting around a particular table. Degree of Drive Representation (R) A drive may be inferred (di) or implicit in'§'s imagery or it may be depicted quite explicitly (dp) with- out'§ recognizing its nature. Then again‘S may recognize the nature of the drive (dr) or he might even experience it as an affect (de). Consequently, each scorable drive is weighted according to the degree it is represented in awareness: di=l, dp=2, dr=4 and de=8. These four degrees of drive representation are weighted in a geometrical series to insure that the product of lower degrees of drive representation is never larger than the weight of the next higher degree of drive representation. 65 Scorable Drives Only those drives which are subject to repression are scored for degree of drive representation. In addi- tion to receiving any one or more scores for degree of drive representation (di, dp, dr, de), each scorable drive is multiplied by a factor of 2 to distinguish it from non- scorable drives which will be discussed later on. Since dr and de are objective in‘S's frame of reference, scor- ing presents no problem; however, this is not the case for scoring di and dp for which criteria are needed for determining what is explicit or implicit (inferred). These criteria are given below: Sex SS). Any genital or pregenital expresion of the sex- ual drive is scored. Implicit depiction (di): penis: any protuberance or long, slim object; either animate (ant-eater, snake, goose, etc.) or inanimate; any object that grows bigger; dots, pellets, rain or aggregates of small objects de- noting sperm, particularly if they are mobile; anything that rises such as a bird, helicOpter, sun, baloon; objects in groups of three. vagina: any hole or enclosed space such as a vase, purse, tunnel, cave, entrance, hallway; a small furry animal such as a pussy cat and a beaver. 66 breast: any rounded object or rounded feature of terrain. intercourse: ascending steps; swimming or simi- lar physical, rhythmical activity, more vigorous than walking. additional criteria: incidental physical contact; a pleasant, exciting or sensual, physical sensa- tion; bed, bedroom, bathroom, underwear, tight fitting clothes. Explicit depiction (dp): nude body(ies), genitals, two figures dancing, kissing, embracing; seductive expressions or poses; such comments as "I feel groovy, horny, or sexy." The context determines whether physi- cal contact should be scored as love-tenderness (i.e., holding hands). Anger-aggression (AA). Implicit depiction (di): an accident or mishap, or the result of same be- falling some object, including himself; contact sports; the situation depicted by the imagery implies anger-aggression (i.e., the boys in my class are devils, I can see them jumping up and down). 67 Explicit depiction (dp): any action that physically or psychologically hurts some object (inanimate or animate); or him- self; person or organism marring, defacing or destroying inanimate objects; angry or disagree- able facial expressions; any human behavior, animal or object (i.e., gun, tank, bomb) that has the potential of hurting, doing harm or des- troying; a disparaging remark. Self-esteem (SE). This affective disposition is not a drive that can be depicted or directed towards other peOple; other people do the rejecting and this behavior is scored for dp and dr. The effect here is feeling despised, un- lobable, not being good for anything. Implicit depiction (di): compensatory images of being exhalted such as be- ing king or astronaut; audience applause for a good performance; caricatures such as images of elves, dwarfs, etc., or crippled or incomplete animals and humans which depicts,§'s negative self-image; images of an object being avoided or left out by other objects. Objective score: any situation or behavior whereinIS's self-image is negatively affected such as a loved person 68 turning away; being discharged by an employer; looking ugly, fat, tiny or skinny; making an error or mistake. Love-tenderness (L). Implicit depiction (di): images of the symbol of'g's alma mater or a fraternal, political or professional organization; mementoes, letters, scrapbook of an intimate friend or family member; someone doing something that implies admiration and respect; verbalized admiration. Explicit depiction (dp): images such as hugging, tucking in bed, grooming and feeding; watering plants; washing, polishing and tinkering with car, motorcycle or some machine. These must be differentiated from sex by context. Since most behavior is overdetermined, it is permis- sable to score an episode for more than one drive. Nonvisual Scorable Drives When an object is aluded to verbally but not visual- ized, it is assumed that visual depiction at the moment is associated with a prohibitive degree of anxiety. In this case, only the Drive and Drive Representation scales are scored, as if it were visualized. The Derivative scale is scored to prevent zero values for the visual episode. 69 Nonscorable Drives (NS) If none of the above criteria apply to an episode of visual imagery, multiply the degree of drive representa- tion (R) by a factor of l (NS=l). Anxiety itself is not scored as a drive because marked increases in electro-physiological activation in connection with drive laden material usually is not accompanied by verbalized anxiety. We therefore consider these spontan- eous periods of arousal (orienting responses) during free imagery to be an indicator of signal anxiety; that anxiety which is sufficiently intense to activate repression, a negative feedback mechanism, to reduce the intensity of the drive that is producing the anxiety. Cognitive mech- anisms dissociated with consciousness (Freud's censor), perhaps similar to those of REM sleep, mediate the degree of distortion necessary to keep the intensity of anxiety below a definite limit. The fluctuating changes in de- gree of drive representation inl§'s visual imagery coin- cidentally with transitory periods of electrophysiological activation illustrates the dynamic interplay between re- pressed drives pressing for gratification signal anxiety and the inhibitory mechanism of repression. Remoteness of Derivatives (Dr) The remoteness of the derivatives serving as a ve- hicle for the expression of the drive was assessed by 70 referring to the generalized derivative scale below. Since the repressed aims and objects of.§'s drives, in- cluding the Oedipus complex, involve‘§'s parents and ori- ginate in childhood, the scale begins with geometrical forms and ends withl§ himself and his parents. 1. Geometric and nongeometric forms 2. Words (seen not just heard) 5. Inanimate objects Plants 5. Non-human, animate objects or parts including blood. 6. Person of unidentifiable sex 7. " " caricature 8. " " " " "icon" (snap shot, 9. statue)" n n body part 10. " " " " person 11. Unknown person of identifiable sex 12. " " caricature 13. n n n n "icon" 14. " " " " body part 15. " " " " person 16. Known person's name 17. " " caricature 18. " " "icon" :9. g g body part 0. person 21. Friend's name 22. " caricature 25. " "icon" 3;. 2 body part . person 26. Cousin's name 27. " caricature 28. " "icon" i8. 3 body part a P333801]. 51. Sibling' 3 name 52. caricature 55. " "icon" 54. 2 body part 55. person 56. Son or daughter's name 57. " " caricature 38. n N '1 "icon" 59. " " " body part 40. " " " person 41. 42. 45. 44. 45. 46. 47. 48. 49. 50. 51- 52. 55. 54. 55. 56. 57- 58. 59- 60. 61. 62. 65. 64. 65. 66. 67. 68. 69. 7o. 71 Girlfriend's, boyfriend's, or spouse's name " " " caricature " n I? [1 "icon" " " " " body part n n n n Person Aunt or uncle's name " " " caricature I! 11 fl "icon" :1 n :1 body part " " " person Grandparent's name caricature fl "icon" " body part " person Employer, supervisor, or teacher " " " " caricature " n fl '1 "icon" :1 n n n body part " " " " person Experimenter or psychotherapist " " " caricature '1 n 3! "icon" n n n body part " " " person Subject' 3, parent' s, or paramnesia' 3 object name caricature II fl '3 fl flic on" n n n n body part n n n n person Each visual episode is scored for three or less ob- jects constituting the family oedipal triangle (the sub- ject and his two parents). Since there may be a variety of scorable objects (0) in a given visual episode, score those three with the highest values on the derivative scale. objects is scored (crowd of people). Only one object in a group of the same or similar If'§ describes a situation in which he must be present, such as driving a car, in a room, on a boat, walking in the park, etc., but he does not say that he sees himself, the Sa/2 (S absent) category is scored rather than the Sp (S present) category 72 whereI§ describes seeing himself in the situation. Sa/2 is not scored if the images are not part of some physical setting or context, such as a fleeting image of mother. If‘S is describing a scene from the perspective of an onwatcher, like being in the audience, do not score Sa/2. Score Sa/2 if he is on stage, in the set as part of the scene. Sa/2 takes account of the distancing involved in the imagery of himself. If S changes his mind about the identity of an object, this may either be an intensifica- tion or weakening of defense. Only score the higher of the two, e.g., § reports a bird and then changes it to an airplane. There are affectively toned dimensions to some objects that reveal cogently the true object of the subject's ima- gery. Whenever § sees fierce, large or powerful machines, animals or humans or sees very tall phallic symbols, such as the Washington monument, or makes comparisons between the size or power or status of objects, he is alluding to feelings of inadequacy vis a vis parents and/or fear of them. An allusion to an object being old or a setting in past time once again alludes to parents. These added sources of information are utilized by increasing,§'s derivative score. The score of the object seen is sub- tracted from the score of a parent on the derivative scale and the difference divided by 2 and then added to the score of the object. In this way, the score of the object ap- 75 proaches but never equals the image of a parent. For ex- ample, if'§ sees a huge, fierce monster 500 feet tall approaching him, its score of 5 is subtracted from 68 (68-5 a 65) and the difference is divided by 2 (65/2 a 51.5). The new derivative score for the monster is now 56.5 (5 + 51.5)- Necessary_Conditions for Drive Satisfactions (NC) For a drive to be "satisfied" in'§'s visual imagery in terms of its aim and object, thelg's visual imagery must be kinetic rather than static and the images must be embedded in an interpersonal relationship. Kinetic images indicate that a drive has achieved motility and is closer to being gratified, therefore, kinetic images are multi- plied by a factor of 2. Since drives can be gratified only in an interpersonal relationship or encounter, images that interact are multiplied again by a factor of 2 (2 x 2 . 4). An interaction is scored for any combination of inanimate and animate objects such as lightning hitting a tree, a dog shaking a collar, a man shooting a gun and two people talking. The Activation Score (A = D x R x Dr x NC) The activation score (A) for each drive in a visual episode is the product of the drive (D), its degree of representation (R), the remoteness of the deprivative (Dr), and conditions present for drive satisfaction (NC). When 74 two or more drives are involved, the activation score for the visual episode is the highest of the drive activation scores for each of the component_drives. Let us take the following example: if.§ reports that he sees a nude fe- male acquaintance lying on a bed (D . 2; dp = 2) whom he approaches and caresses (dr - 4), then says that he feels sexually excited (dp - 8), D equals 2 and R (2 x 4 x 8) equals 64. If she becomes carried away with laughter over his clumsy attempts at love-making and falls out of bed, knocking herself out, Anger-aggression is inferred (D a 2; di = l). The three objects are‘S himself (68), the woman (18) and bed (5); therefore, Dr (68 + 18 + 5) equals 89. Since the images are kinetic (2) and interactive (2), NC (2 x 2) equals 4. NC and Dr are the same for both Dsex and D Thus, anger' A = (2) (64) (89) (4) - 45568 sex Aanger = (2) (1) (a9) (4) = 712 Since the value of AS value of A is 45568. is larger than A the ex anger, APPENDIX C FEEDBACK QUESTIONNAIRE Very often, subjects in this experiment visualize images which they feel reluctant or embarrassed to des- cribe to the experimenter. These images appear to the subject as either too unusual, silly, ugly, sexual, etc. Every image you visualize, however, is very important for this research. This questionnaire is for the pur- pose of permitting you the opportunity to report any imagery you may have visualized but did not report to the experimenter, for whatever reason. Please describe any imagery you did not report to the experimenter during the session. 1. 2 3: 4. 5. 6. 7. 8. 9. 10. (1) What symptoms did you have during this experiment? (2) Describe what you think this experiment is about. (5) What criticisms do you have about the experiment? (4) How do you feel you were treated as a subject? (5). Are there still some images that you have chosen not to describe either on this form or during this session? YES NO IM /im 6-75 75 HICHIGQN STQTE UNIV. LIBRQRIES ll|ll||||4|IllIII}||llil|||||ll|||||lllllllllVllllllllHllllllll 31293100296957