Let us now consider what phenomena we may expect to find in the very earliest or hypnoidal stage. First of all there is complete physical relaxation, so that a patient who has shortly before been complaining bitterly of his inability to relax, now remains sitting quietly in the chair without troubling to move. The eyelids may flutter for a time and then the eyes remain closed. There is an appearance of drowsiness in the patient and a considerable degree of mental relaxation. Usually a feeling of heaviness appears in the limbs and the patient feels inclined to sleep. Nevertheless, he will be completely conscious and perfectly well aware of everything that is going on. So much so, that after the session he will usually deny any real effects at all—although perhaps admitting that he felt relaxed and a little drowsy.

It is not at all unusual, however, for suggestions given in this state to take effect; and a great deal can be done to help the patient by means of reassurance, persuasion and re-education.

If a mild hypnoidal state such as this has been reached at the first session, then it is usually possible to induce at least a light stage of hypnosis at the next attempt—provided, of course, there is not too great an interval of time between the sessions.

The light stage is characterized usually by complete mental and physical relaxation and an inhibition of all voluntary movement. There is a considerable degree of lassitude, and the patient often feels that he cannot be bothered moving, talking, thinking or acting in any way.

At this stage there may often be catalepsy of the eyelids, so that the patient may be unable to open the eyes even when challenged to do so. It is also possible that there may be partial catalepsy of the limbs, and the subject may be unable to raise the arm, for instance. Afterwards the patient may say that he was sure he could open his eyes or move his arm all the time, but that he did not do so when challenged because he felt he ‘couldn’t be bothered’. The very fact that he doesn’t bother to try indicates a degree of hypnosis, as such behaviour is not what one would expect in the ordinary waking state.

There is always some feeling of heaviness which may be confined to the arms or extend over the whole body. In many cases there is a feeling of detachment as though the mind is separated from the body. The breathing is slow and regular as a rule, and the patient gives the outward appearance of one asleep.

The fact that the patient can remain completely still, often in an awkward position, for some considerable time, is strong evidence that at least the first stage of hypnosis has been reached. It is quite impossible for anyone in the normal waking state to remain perfectly motionless for perhaps half an hour.

The experienced hypnotist prefers to rely on observations such as these rather than challenging the patient to open his eyes or move his arm. Some subjects even in the deepest stages of hypnosis may be able to resist such challenges. Certainly if a challenge fails, especially in the early stages, it is extremely likely to result in loss of confidence in the hypnotist and the entire procedure. This light stage is very useful for medical purposes, as very often simple posthypnotic suggestions will be carried out. The patient is, of course, conscious all the time and knows everything that is going on. He can hear the hypnotist speaking and, as there is no amnesia, remembers everything that has been said in the trance. For this reason he is quite likely to deny that he was hypnotized at all. A common remark is: ‘You know, Doctor, I don’t think I was really "under". I’m sure I wasn’t "asleep, I could hear everything you said." 

In view of this it is wise to explain to the patient that hypnosis is not sleep and that he is expected to hear the hypnotist’s suggestions. The light stage may often be reached at the very first attempt and is extremely useful in medicine.

Next in degree we have the medium trance. In addition to the foregoing phenomena there may be partial amnesia for events in the trance, especially if suggested by the hypnotist. For this reason the patient often has a feeling that ‘something has happened’ and is more likely to feel satisfied in his mind that he has achieved hypnosis.

In this state, too, it is often possible to develop anaesthesia, or rather analgesia, so that the patient is unable to feel the pain of a sterilized pin passed through the skin of the hand.

It is often possible to develop rigid catalepsy of the whole body so that the subject may be able to support the weight of the hypnotist while stretched between two supports. Further, automatic movements may be induced so that any action which has once started will continue until stopped by the hypnotist. These automatic movements are harder to obtain than ordinary limb rigidity or catalepsy. Sensory hallucinations such as those of touch, taste or smell may be induced in this stage.

Finally, we have the deep form of hypnotic trance known as somnambulism. In this state the patient can open the eyes, walk, talk, and behave generally as if awake. The eyes, when open, show a fixed stare, and the pupils are dilated. Generally there is complete and spontaneous amnesia for the trance. Positive and negative visual and auditory hallucinations may be obtained during the trance and post-hypnotically.

Complete amnesia may be developed, and there is often considerable control over the bodily functions. Age regression, recall of lost memories, and stimulation of dreams can all be obtained in this state.

Automatic writing and crystal gazing may be used to obtain forgotten material. Chiefly because of the amnesia, the patient is usually highly impressed by the somnambulistic trance, and this is of great value in rare cases where it is desired to adopt an authoritative attitude in order to remove a symptom by direct command. Sleep walkers and ‘psychic’ people who can do automatic writing or crystal gazing often make very good somnambulists. The mediumistic trance is identical with the hypnotic state, and such people are generally very good subjects.

Not all patients, however, can reach the stage of somnambulism, although a good proportion can do so with repeated training. The phenomena mentioned under the various stages are typical enough of these degrees of trance, but it must be remembered that it is not essential for them all to be present to establish the depth of hypnosis.

Occasionally a patient in the very deepest trance is able to resist a challenge which another patient may be unable to resist even in the light stage.

Although some of the phenomena usually found only in the deep state may occasionally be elicited in the lighter stages - such as the ability to follow a simple post-hypnotic suggestion or dream - the more bizarre characteristics of somnambulism such as positive and negative visual hallucinations and the ability to open the eyes without waking, cannot be expected to be present in the earlier degrees of hypnosis. Any attempt to obtain age regression, for instance, in the light stages, would be bound to fail and destroy the confidence of the patient in hypnosis.

Now the phenomena which can be elicited in hypnosis are of the greatest importance; but, although they have been known for centuries, it is only recently that efforts have been made to investigate and test them scientifically. They are of interest not merely because they enable us to judge the extent of the hypnosis. They also provide striking and visible proof of the powerful effects which can be brought about in the trance state. Further, practically all the phenomena of hypnosis can be produced in the ordinary waking state. They may often be seen in ordinary normal people and can frequently be observed to a marked degree in those suffering from nervous complaints.

The importance of this is that hypnotism plays a far greater part in everyday life than most people imagine. More will be said about this wider aspect of the subject later, but when we consider that all the phenomena may be induced in a patient by selfhypnosis, and that, in many cases, they resemble the symptoms of nervous complaints, the importance of a thorough understanding of what can be evoked by hypnosis becomes apparent.