The APA Division 30 definition of hypnosis is laudable in some respects. For instance, the committee rightly defines the "induction" as nothing more or less than the first suggestion after the introduction. However, the definition stumbles over its nonposition on whether the word hypnosis must be uttered during the procedure. This equivocation invites research designs that preemptively define a hypnotic group and a control group in terms of whether or not the word hypnosis is used in the protocol. These designs represent a backslide into naive operationism; they reveal little new about human nature or hypnosis. The field deserves an optimally heuristic definition that preserves pluralism and is relatively resistant to the teflon shield of preemptive definition. Researchers and practioners require a definition that recognizes the incompleteness of our concepts, generates a level epistemological playing field, and enables hypnosis theories to "reach."

Psychology Department, University of Tennessee, Knoxville 37996-0900, USA. mnash@utk.edu

Psychological comorbidity with medical illness is associated with poor health status, complicated medical management, and increased utilization and greater costs of medical services. Hypnosis practitioners in specialty psychological or psychiatric treatment settings infrequently treat such patients, since there is a greater likelihood of patients' psychological problems being treated solely in primary medical care. Referring patients from primary care to the mental health system will most likely not result in patients initiating psychological or hypnotic treatment. At the same time, integrated provision of medical and psychological treatment in the medical office has demonstrated much higher rates of initiation of treatment and improved medical outcomes. Although hypnosis has been found to be an empirically effective treatment for many medical problems, when hypnosis practitioners do not practice in these medical sites then patients do not have access to effective hypnotic interventions for cotreatment of medical problems.

Berlin Family Health and Central Vermont Medical Center, Berlin, Vermont, USA. rodger.kessler@hitchcock.org

Whereas early studies have found moderately high agreement between self- and observer-rated scores on the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A), these studies shared a common confound in that participants were aware of being directly observed. In the present study, confederates made surreptitious observations of group participants' hypnotic responding. Following the hypnotic procedure, participants indicated whether or not they remembered each item and provided self-reports of their hypnotic response. The study assesses the accuracy of participant self-report for hypnosis items when individuals are unaware of being observed. Thirty-two percent of participants failed to recognize at least one item from the hypnosis session, suggesting that the inability to remember items is a common phenomenon. When participants reported not remembering an item, the accuracy of their self-reported response was no better than chance.

Arizona State University, Tempe, USA. Jarred.Younger@asu.edu