What is the awareness and understanding of the mental processes of others?

Creating the labels

Schemas are automatic mental processes that assist us in navigating the world around us. They help us to sort objects, situations, and even, people. We sort people into categories from the start of an interaction, heavily informed by popular societal categories, into social groupings such as race, ethnicity, gender, age, class, and body type. This process is automatic and can occur without conscious awareness. Once we have labeled a person with a group identity, our mind provides us with a barrage of associations between behaviors, other characteristics, and this type of person. We have an implicit, or unconscious, attitude toward these groups that influence how we interact with members and how we interpret their interactions with us. Arguably, these associations are unavoidable as they are reinforced by cultural folklore, the media, and our selective memory of confirmatory social interactions (remember, confirmation bias?). However, we believe it is imperative to deconstruct the subjective descriptors in clinical material to fully appreciate how bias might operate in their selection and application.

The automatic nature of this process can seem insurmountable; however, it is still possible to autocorrect when needed. A place to start can be understanding that attitudes and stereotypes about social groups are not produced in a vacuum within individuals. We are absorbing popular notions about social groups throughout our developmental trajectories and constantly revising based on personal experiences. Popular knowledge sources include our families, friends, teachers, literature, media exposures, public discourse, and many other unique sources that are valued variably across individuals and groups.

The effect of meditation on sympathetic and parasympathetic systems

Meditation practice emphasizes mental processes but the role of the body (physiology) has often been overlooked in the scientific research of meditation practices. However, body and mind can never be separated in meditation practices or, for that matter, in our daily lives. In addition to brain changes, meditation practice is also accompanied by ANS changes such as greater parasympathetic activity indexed by a lower HR, chest respiratory rate, and SCR. Furthermore, there are greater abdominal breath amplitude (BA) and HF HRV. An earlier study on meditation showed that mantra-based meditation induced physiological changes including lower oxygen consumption, HR, and skin resistance and more alpha waves as measured by electroencephalogram (EEG) (Wallace, 1970). Later studies have used these indexes of ANS activity, including HR, HRV, SCR, respiratory amplitude/rate, and EEG frequencies as biomarkers for monitoring meditative states (Tang, 2017; Tang et al., 2010).

As shown in a recent article on mindfulness of the body, one of the core techniques of mindfulness meditation is paying attention to bodily sensations and feelings (body-focused attention) (Tang, Tang, & Gross, 2019), for example, body scan, which is a meditative practice involving “moving a focused spotlight of attention from one part of the body to another.” However, mindfulness practice that involves a somatic focus is still processed in the mind, but may amplify and strengthen the connection between bodily sensations, feelings, and mental processes (Tang & Tang, 2015; Tang et al., 2019). Interoception is the ability to notice and become aware of physiological signals originating inside the body, such as heartbeat and the sense of hunger or pain. It has often been reported that attending to present-moment body sensations in meditation can result in an enhanced awareness of bodily states and greater perceptual clarity of subtle interoception. Studies have also found that meditators showed greater coherence between objective physiological indexes and their subjective emotional experiences and sensitivity of body regions (Tang, Holzel, & Posner, 2015; Tang et al., 2019). Using functional neuroimaging, subjects were assessed while they judged the timing of their own heartbeats, researchers found that there were enhanced activity in insula, somatomotor, and cingulate cortices, while more sympathetic activity accompanied this task (Critchley, 2004). Although studies did not find evidence that meditators had superior performance than nonmeditators using the heartbeat detection task—a standard measure of interoceptive awareness, neural activity in the right anterior insular/opercular cortex predicted the accuracy of participants in the task (Tang et al., 2015). Another study suggested that the right insula seems to support the sympathetic activity during the heartbeat detection task (Lutz, Greischar, Perlman, & Davidson, 2009). Our study on integrative body–mind training (IBMT), a form of mindfulness meditation, showed that the IBMT group exhibited more left insula activity compared to the relaxation group, consistent with previous findings that the left insula is predominantly responsible for parasympathetic effects (Tang et al., 2010). Taken together these findings suggest that meditation can engage both sympathetic and parasympathetic activities, with the left insula related to parasympathetic activity and the right insula related to sympathetic activity.

Based on previous research we have proposed that mindfulness states can be achieved in two ways: through mental processes (e.g., mindfulness) and through bodily processes (e.g., bodifulness). Bodifulness refers to the gentle and holistic adjustment and exercise of body posture with a full awareness in order to achieve a presence, balance, and integration in our bodies (Tang & Tang, 2015; Tang et al., 2019). For instance, in eastern traditions, practices like IBMT, TCM-based methods (e.g., tai chi, qigong, yoga) emphasize body–mind balance and interaction to facilitate meditative states, thereby achieving positive outcomes (Tang, 2017; Tang & Tang, 2015). Mindfulness involves an explicit process (e.g., counting your breath) through CNS (brain/mind), but bodifulness mainly involves an implicit process (e.g., visceral or interoceptive awareness) regulated by ANS. Autonomic control needs less effort and is supported by the anterior cingulate cortex (ACC) and adjacent medial prefrontal cortex. In a review article we divided meditation into three different stages of meditation practice, namely early, middle (intermediate) and advanced, that involve different amounts of effort (Tang, Rothbart, & Posner, 2012). The early stages of meditation require conscious cognitive control with effort and is often supported by the lateral prefrontal and parietal cortex. The more active lateral prefrontal and parietal cortex may reflect the higher level of mental effort when participants struggle to obtain the meditation state in the early stages. In this situation the sympathetic system likely plays a key role in supporting the early stages of meditation. However, in the advanced stages when practitioners become more skilled in meditation, prefrontal-parietal activity is often reduced or eliminated, but the activities of some brain regions such as ACC, striatum, and insula remain stable, suggesting the dominance of the parasympathetic system that requires less effort (Tang et al., 2015). Moreover, when the mental process of meditation through cognitive control becomes automatic and could be internalized through the body (via autonomic control), a state of bodifulness is formed. Cognitive and autonomic control are important components of self-control, which facilitate meditative states and underlie behavior and habit formation (Tang, 2017; Tang & Tang, 2015; Tang et al., 2019). Whether effort has a key role in sympathetic and parasympathetic systems during or following meditation needs further investigation.

Because meditation, such as IBMT, changes the state of the body through autonomic control, we hypothesize that ANS activity, especially parasympathetic activity, will increase during, and following, meditation. For example, in a randomized study including five sessions of experimental (IBMT) or control (relaxation) groups, we measured the HRV, SCR, respiratory amplitude, and rate―indexes of sympathetic and parasympathetic activity. During and after training, the IBMT group showed significantly better physiological reactions such as lower HR and more abdomen respiratory amplitude when compared with the relaxation control group. We also found that compared to relaxation training, IBMT significantly improved HF HRV and reduced SCR, suggesting better parasympathetic regulation. Of note is that IBMT does not intentionally exercise or change breathing patterns from chest to abdomen, instead practitioners naturally move toward the direction of a more abdomen respiratory pattern. Although our observations suggest that IBMT may initiate our innate autonomic system to induce these positive changes, the underlying mechanisms warrant further investigation (Tang, 2017; Tang et al., 2010). In the same vein, a comprehensive review of mind–body practice (e.g., yoga) showed the same effects―increased vagal tone (more HF HRV) that facilitates autonomic balance (Tyagi & Cohen, 2016). Taken together, meditation practices tend to increase parasympathetic activity as indexed by more HF HRV (increased vagal tone), abdomen respiratory amplitude, and lower SCR (Gerritsen & Band, 2018). It should be noted that if one devotes more effort and control into meditation practices, then the practices would likely be similar to performing a task with a high workload. Therefore it is possible that such practice may then induce more sympathetic activity. One study examined effort and SCR in a patient without a feeling of mental effort and suggested that SCR is a sensitive biomarker of effort (Naccache et al., 2005). This result indicates that we could use SCR to monitor and evaluate the amount of mental effort involved in meditation and assess the stage of meditators. Nevertheless, research examining the coordination of parasympathetic and sympathetic interaction is limited and data seem to suggest respiration patterns may play a key role in the regulation of both parasympathetic and sympathetic activities, which is in line with our IBMT findings showing the relationship between abdomen respiration and the parasympathetic system (Tang, 2017).

Thought Process and Content

Depressed patients often describe impaired concentration and forgetfulness. Executive functioning can also be impaired. In severe cases, this results in a decreased ability to perform basic activities of daily living.

Thought content tends to be negatively biased, such as recurrent thoughts of guilt, failure, worthlessness, and self-criticism. Patients in a depressed episode are at increased risk for suicide. Suicidal thoughts may range from vague notions that life is not worth living (passive) to fully envisioned suicide plans with definitive intent to kill themselves (active). All depressed patients must be questioned about suicidal thoughts. Because patients are not often forthcoming with their thoughts on suicide, a thorough review of risk factors and protective factors needs to form the basis of clinical decisions for providing the necessary level of care.

Patients with severe depression may have psychotic symptoms. The hallucinations and delusions that accompany depression are usually mood congruent, meaning that the themes of the psychotic content are consistent with the depressed mood.

Attention deficit hyperactivity disorder (ADHD)

Voluntary attention is a critical mental process. Its main function is to control and organize behavior and cognitive flexibility (Luria, 1973; Vygotsky, 1956). “Voluntary attention has complex organization, including at least three components. These are wakefulness (activation component), maintaining the required level of activity (motivational component), and selective processing of the relevant signal (information component)” (Machinskaya & Dubrovinskaya, 2003, p. 310). The overall level of activation depends upon the reticular formation of the brain stem, the motivational aspect of the attention occurs within the structures of the limbic system, and the informational one within the frontothalamic regulatory system (Machinskaya & Dubrovinskaya, 2003).

Hyperactive adolescents and adults also have various forms of oppositional and deviant behavior, including aggression as well as alcohol and drug abuse. Often, children with ADHD engage in criminal behaviors in their teens. One of the mechanisms of this is a reduced sensitivity to weak stimuli, including signals of danger. It is important to note that the human brain is not only a reactive system, but also a system anticipating and controlling the future behavior of the individual. Children with ADHD have difficulties distinguishing and reproducing time intervals.

Studies of hyperactive children show frequent (up to 50%) family hyperactivity, i.e., hyperkinetic symptoms and disorders of attention both in children and in adults.

Since 1987, this disorder has been highlighted as a separate neurological unit and included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) of the American Psychiatric Association (2000), and the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), a system used by physicians and other healthcare providers to classify and code all diagnoses, symptoms, and procedures recorded in conjunction with hospital care in the United States. Quite often, however, hyperactive disorders accompany various anomalies of mental ontogenesis, such as mental retardation, early infantile autism, etc. In recent years, according to many Russian and American researchers, the presence of ADHD in pediatric populations has risen to threatening dimensions (up to 43% of the total population of children and up to 81% of LD children).

The primary symptoms of this disorder are disturbances of attention concentration (i.e., instability, low selectivity, distractibility with frequent switches of attention) and increased unstructured activity. The latter is expressed in agitation, fussiness, many movements not adequate for the situation (i.e., without purpose and functional significance), an inability to sit still in one place, and talkativeness. During a diagnostic assessment, children with ADHD often start talking on abstract themes, refuse to perform tasks, rise from the seat, and touch everything that can be seen. In class, they often interrupt teachers, cannot sit still at their desk for a long time, often drop their belongings to move under the desk, and can suddenly get up and go out of the class, etc.

Usually, the first symptoms of ADHD appear in the first 5 years of life, but deviations are especially evident in primary school age. This is due to the transition from external regulation in the nursery to self-regulation in school. The existence of ADHD is a risk factor for disturbances of child-parent relations and communication with peers, dissatisfactory school achievement, and school maladjustment.

Neuroimaging (MRI) techniques identify, in ADHD children, a brain volume decrease in frontal areas, caudate basal ganglia, and the cerebellum. Functional magnetic resonance imaging (fMRI) shows the relation of emotion regulation processes with the balance between the amygdala and the premotor cortex. The amygdala is formed first and is responsible for the initial reaction of the child; its imbalance causes impulsivity. Both provide regulation and inhibition of reactions. The psychopathic reactions are also related to reduced activity of the amygdala and increased activity of the premotor structures on fMRI. The impulsiveness reflects an increase in the activity of the amygdala and a decrease of frontal activity. Thus, ADHD is explained by immaturity of frontal-subcortical relationships.

Thus, ADHD is a neurodevelopmental, not a behavioral, disorder that interferes with learning. Focusing difficulties disrupt a child’s working memory. Thus, encoding, retention, and decoding are often impaired. If a child cannot pay attention for the first 3 s of an exercise, he has not learned the first step (e.g., in mathematics) in order to move on to the next step. For girls, the problem is often less obvious than for boys, who are typically more disruptive in the classroom. Medication and behavioral intervention are often very helpful, if the medicines do not inhibit the ADHD child’s already poor mental activity. The neuropsychological approach to ADHD problems is one of the most productive and informative. The use of medication alone is not enough; rather, a comprehensive intervention plan is needed.

The Psychological Approach

Psychology is often defined as the scientific study of behavior and mental processes (e.g., Myers, 2013). Thus, psychology is a very broad discipline that subjects all facets of the human experience to scientific inquiry, including all kinds of overt actions, speech, and social interactions, as well as less easily observed processes such as thoughts, feelings, attitudes, and the biological mechanisms underlying all of these in the brain and nervous system. As scientists, psychologists derive knowledge about people from direct, systematic, objective observation using predominantly empirical, quantitative research methods. Psychological research methods include controlled laboratory experiments in which one variable is manipulated to observe its effect on other variables, as well as correlational approaches in which variables are operationally defined and quantified, and their association across individuals is assessed.

Psychologists engage in both basic and applied research. The goal of basic research is to make new discoveries about people, to contribute new knowledge to our understanding of behavior and mental processes. In contrast, the goal of applied research is to solve specific, practical problems by conducting research in real-world settings or applying findings derived from basic research to real-world situations.

The centrality of humor to the human experience makes the study of humor applicable to disciplines of psychology that emphasize basic research as well as those that have a more applied focus (R. A. Martin, 2000). Basic researchers in the area of cognitive psychology may be interested in the mental processes involved in the perception, comprehension, appreciation, and creation of humor. The functions of humor in interpersonal relationships and in broader social contexts are topics that interest social psychologists. Developmental psychologists may focus on the way humor and laughter develop from infancy into childhood and throughout the lifespan. Personality researchers might examine individual differences in sense of humor and their relation to other traits and behaviors. Biological psychology can shed light on the physiological bases of laughter and the brain regions underlying the comprehension and appreciation of humor. Similarly, psychologists in applied disciplines such as clinical, health, educational and industrial-organizational psychology conduct and apply research to address real-world problems relating to mental health and psychotherapy, physical health, teaching and education, and workplace productivity, respectively. In sum, researchers from nearly every branch of psychology potentially could make interesting contributions to the study of humor. Indeed, a complete understanding of the psychology of humor requires an integration of findings from all these areas. Table 1.1 provides a summary of the study of humor across different disciplines of psychology.

Table 1.1. The Study of Humor Across Different Psychology Disciplines

Psychology DisciplinePrimary Research Emphases Related to HumorCognitive•

Structural qualities of humor stimuli and the mental processes involved in the perception and appraisal of incongruity

The way humor affects other cognitive processes, particularly memory and creative thinking

Humor as a personality trait (sense of humor) describing general, stable tendencies in the way people perceive, respond to and initiate humor in daily life

Relationship between sense of humor and other psychological variables and behaviors

Development in the cognitive, emotional and social capacities to understand, enjoy and produce humor over the life span

The changing social and emotional functions of humor over the life span

The functions of humor in interpersonal relationships and broader social contexts

Areas of the brain and neural processes underlying the cognitive-perceptual, emotional and behavioral elements of humor

Potential benefits of humor for facets of mental health (e.g., subjective wellbeing, ability to cope with stress)

Applications of humor in psychotherapy

Potential benefits of humor and laughter for physical health and wellness including immunity, pain tolerance, blood pressure, and longevity

Potential benefits of humor as a teaching tool to make learning enjoyable, stimulate attention, increase retention and performance, and promote creativity

Potential benefits of humor in the workplace including better relations among workers, and more creative thinking and problem-solving

Appendix B – Mental processes involved in prediction and representation

There’s much that can be learned about the mental processes involved in both exteroception and interoception by considering vision. Photons of light enter the eye via the cornea, passing through the aqueous humor, the lens and the vitreous humor before impinging on light sensitive rods, cones and ganglion cells embedded in the retina on the back inside surface of the eyeball. Through a process known as visual phototransduction, these light sensitive cells convert light into electrical signals that are transmitted via the optic nerve to the thalamus and thereafter to the primary visual cortices located toward the back of the brain. The thalamus is often described as a ‘relay station’ through which sensory inputs from vision, audition, gustation (taste) and touch pass, en route to other areas of the brain, particularly the cerebral cortex. Olfaction (smell), arguably the earliest exteroceptive sense to evolve, is the only sense that doesn’t route through the thalamus.

Until recently, it was thought most likely that the visual representations that we’re aware of (i.e., what we actually ‘see’) arise in the visual cortex. This being the case and because of the assumed direction of information flow, it might be anticipated that the number of neurones traveling from the thalamus to the visual cortex should greatly exceed the number of connections traveling from visual cortex to thalamus. By the same rationale, it might also be anticipated that the number of neural connections entering the visual cortex from the thalamus would greatly exceed those arriving from other parts of the cerebral cortex. Both of these assumptions are incorrect! It transpires that there are ten times as many connections extending from the visual cortex to the thalamus than vice versa (Murray Sherman & Guillery, 2002). One possible explanation might be that the brain only needs to receive a relatively modest amount of sensory information about the stimulus before issuing a stream of predictions about the possible nature of the stimulus, based on past experiences. These predictions are directed back to the thalamus where they are cross-referenced with the incoming stream of sensory inputs to create multiple simulations of the stimulus. The simulation with the greatest probability of fit ‘wins’, and it’s this representation of the stimulus that you ultimately become aware of (Gilbert & Li, 2013).

There are two principal reasons why the brain may have developed the capacity to make early predictions based on incomplete information; the need for speed and limitations in the brain’s information processing capacity. As with all of the senses, the visual system receives a mind-boggling amount of sensory information from the outside world in every fraction of every second. If it was necessary to absorb and process all of this huge information load before a creating a representation of the outside world, it would take much too long, and the brain’s processing capacity would quickly become overwhelmed. The same principle applies to the other exteroceptive and interoceptive senses, albeit to a lesser extent (Zimmerman, 1989). Inevitably there will be some degree of error in these early predictions, particularly if the stimulus is novel or if a previously familiar stimulus has changed subtly in character, causing it to be misrepresented to some extent. These discrepancies, known as prediction errors, must be resolved by the brain. This happens via a prediction loop, where details of the discrepancy are fed back to the brain to influence future predictions (Barrett 2017, pp. 62–68). There are, of course, compelling evolutionary reasons why it would be more beneficial (or less harmful, perhaps), to be slightly wrong rather than slightly too late!

Prediction discrepancies can be addressed in two ways: (1) Modify the prediction, and consequently the simulation, in order to reconcile the discrepancies. (2) Remain with the original prediction and filter-out incoming sensory inputs that are inconsistent with the prediction. Anecdotes about the latter abound. Often cited is a formal experiment where credible wine experts characterized white wine, convincingly colored red with a flavourless food dye, as red wine (Morrot, Brochet, & Dubourdieu, 2001), leading to derisive headlines in the popular media such as … ‘The legendary study that embarrassed wine experts across the globe’ … and rather harsh generalisations about the credibility of supposed wine ‘experts’. A rather more sympathetic interpretation might be that the experts’ brains would have produced an avalanche of predictions about the nature and meaning of the stimulus and due to the influence of the accompanying sensory inputs (i.e., the context of the experiment), the brain created a representation which some experts perceived as red wine. Before castigating these experts as frauds or dunces, it’s important to recognize just how influential and dominant visual sensory inputs are in the predictions made and the representations created by the brain (McGurk & MacDonald, 1976). Presumably, the sensory inputs received via smell and taste that might have caused the brain to predict white wine, were ignored in the face of the more persuasive visual inputs.

Most people believe that their perceptions of the outside world are driven by objects people and events in the outside world. However, as described above, it transpires that perceptions are actually predictions that are ‘tested’ against incoming sensory inputs. Through continuous prediction, correction and remodeling, we experience a world of our own creation, moderated by sensory inputs from the outside world.

Spontaneous thought, hypnosis, and suggestion in the clinical context

In a clinical context, perceived automaticity and the fluidity of mental processes, alongside the diversity of potential therapeutic suggestions, can be a boon, as mental disorders often are marked by rigidity and inflexibility, and suggestions can be individually tailored to inculcate new patterns of thoughts, feelings, and actions that can be stitched together in novel or more malleable associational matrices and reinforced by the clinical practitioner. The hypnotic context thus provides virtually unlimited opportunities to deautomatize habitual and overlearned self-defeating thoughts, feelings, and behaviors.

In their now classic study that monitored mind wandering in the daily life of 2250 adults, Killingsworth and Gilbert (2010) found that participants were less happy when their minds wandered; further analyses clarified that mind wandering was generally the cause rather than the consequence of unhappiness and that participants' thoughts while mind wandering better predicted their happiness than their activities (see also Hobbiss et al., 2019; Smallwood, Fitzgerald, Miles, & Phillips, 2009). Spontaneous, automatic, and intrusive negative thoughts are associated with much psychopathology and many problematic conditions (e.g., obsessive compulsive disorder, Salkovskis, 1989; anxiety and depression, Calvete & Connor-Smith, 2005; self-injurious behavior, Cha, Wilson, Tezanos, DiVasto, & Tolchin, 2018; perfectionism, Flett, Nepon, Hewitt, & Fitzgerald, 2016) and have been observed on a cross-cultural basis in cognitions representing negative self-concept, “inability to cope,” negative self-talk, and “dissatisfaction” (Calvete & Connor-Smith, 2005). Marchetti et al. (2016) suggest that spontaneous thoughts can confer cognitive vulnerability (e.g., hopelessness, rumination, low self-esteem) on individuals at risk for mood disorders, as it “mostly focuses on unattained goals and evaluates the discrepancy between current and desired status” (p. 216). Hypnotic suggestions can dramatically modify the form and content of negative spontaneous thoughts. Lynn and Kirsch (2006) contend that spontaneous or automatic thoughts, which are pivotal to a cognitive and behavioral conceptualization of anxiety and depression (Beck, 1976; Beck, 1988), can be viewed as self-suggestions. In depression, the focus of negative self-suggestions is often on themes of inadequacy and low self-esteem (e.g., “I'm worthless.” “I'm stupid.”), pessimism (e.g., “Nothing I do ever works out right and never will.”), and guilt (“I am a terrible person because I have done terrible things.”). In anxiety, the focus of negative self-suggestions is on anticipated threat (e.g., “I will surely fail the test”. “I will make a fool of myself when I give my presentation.”).

According to this view, the task of therapy is to identify the maladaptive self-suggestions, challenge them, and replace them with more functional self-suggestions. Hypnotic suggestions can be used to identify and be mindful of incipient negative or counterproductive spontaneous thoughts; interrupt them when they occur; orient participants to the present moment as well as to their goals; and, in general, constrain, direct, and redirect endogenous mental activity to more productive, healthy, creative, and rewarding patterns of associations, imaginings, and future forecasting (Lynn et al., 2019). The hypnotist can also present posthypnotic suggestions for participants to carry suggestions forward on an everyday basis, apart from the context of hypnosis. Suggestions can be reinforced via repetition and developed collaboratively with the participant to act as a counterweight to harmful thought patterns by (1) developing new perspectives on the self and others; (2) creating and rehearsing imaginative scenarios to practice behaviors and emotional responses in anticipated future situations; (3) reinterpreting and distracting oneself from painful sensations, promoting relaxation, and modifying counterproductive “self-talk”; and (4) individualizing suggestions to treat specific mental and physical disorders and conditions. As attention is focused on what is suggested, rather than on negative, demotivating thought patterns, in the presence of hope and optimism, the hypnotic context affords unique and rich opportunities for modifying entrenched spontaneous and intrusive negatively valenced cognitive activities.

Lynn et al. (2019) have summarized qualitative and quantitative metaanalytic reviews that have documented support, to varying degrees, for hypnosis in alleviating symptoms or behaviors associated with depression, anxiety, acute and chronic pain, obesity, irritable bowel syndrome, and smoking. Moreover, hypnosis has shown promise as an adjunct to surgical interventions and in mitigating needle-related pain and has been widely used to promote relaxation and replace negative with positive self-talk among healthy participants (see Lynn & Kirsch, 2006). Additionally, meta-analyses have revealed that hypnosis can augment the effects of psychodynamic and cognitive-behavioral psychotherapies (Kirsch, 1990; Kirsch, Montgomery, & Sapirstein, 1995). Still, efforts to isolate the role of both suggestions, independent of hypnosis and of placebo effects, are necessary to determine the importance of the hypnotic context and expectancies in determining treatment success. Clear advantages of hypnosis over some other psychotherapeutic approaches include that it is typically brief and cost-effective, can be easily learned, and can be combined readily to advantage with empirically supported interventions (e.g., cognitive-behavior therapy) for a variety of disorders and used to catalyze mindfulness-based approaches to counteract tendencies to mind-wander (see Lynn, Green, Elinoff, Baltman, & Maxwell, 2016; Lynn & Kirsch, 2006; Yapko, 2018).

Overview

In this second session, the focus is on the behaviors and mental processes that can block control. The awareness technique is revisited and it is suggested that this can be used to manage problematic thinking. We also include a range of other techniques.

What is the awareness of one's own mental processes and the mental processes of others?

What are mental processes explain?

Is the awareness and controlling of mental process?

How can I be aware of my mental process?