By Tracie O’Keefe. This research paper evolved out of the doctoral thesis material that the author worked on with the American Institute of Hypnotherapy, between 1995-1998. Tracie O’Keefe also wrote the book Investigating Stage Hypnosis, Extraordinary People Press 1998.
ABSTRACT
This paper reviews the circumstances and dynamics surrounding the death of Sharron Tarbarn, a young woman in her twenties, who died after being a volunteer in a stage hypnosis show.
The period that has passed since her death has given rise to considerable public debate over whether someone may be harmed or die as a result of post-hypnotic or intra-hypnotic suggestions. Whilst a great deal of academic evidence suggests that this may happen there have been prominent hypnosis intellectuals who have argued that this could not happen.
Finally the project considers what lessons that may be learnt from Sharron’s death and recommends possible changes to the way in which hypnosis may be used and regulated in Britain and possibly other countries further afield.
AIM
The aim of reviewing this case is to look again at the circumstances surrounding the death of a young woman who died five hours after being involved, as a volunteer, in a stage hypnosis show. At the time the death was recorded, by the coroner, as death by natural causes. As the case is reviewed it may be more accurate that this woman could have died as the result of post-hypnotic trauma brought about by suggestion. Therefore it may have been more appropriate to have recorded an open verdict, and even death through misadventure due to the misuse of hypnosis.
The coroner was guided by two expert witnesses whose evidence, on reflection, was later questioned by other members of their professions and the family of the deceased. This culminated in the case being brought back before the British High Court (Brown 1998). Much controversy has been attracted by this case. Both the media and professional hypnotists have been concerned whether someone may be harmed by hypnotic suggestion (O’Keefe 1998) Since there has been only one published opinion on this case I believe It is a worthy endeavour to look at the facts and theories surrounding Sharron’s death from a different perspective.
It is my proposal that because of certain factors, hypnosis, for Sharron, may have been dangerous in the hands of an incompetent hypnotist, therefore hypnosis could have played a role in contributing towards the cause of her death.
BACKGROUND
According to the kind of hypnosis that is taking place, different states of trance experience are identified. When discussing stage hypnosis I shall identify three such states:
1st state: hypnoidal or waking trance
2nd state: sleeping trance
3rd state: artificial somnambulism
Here I am considering stage hypnosis solely for entertainment, but when profiling other forms of hypnosis there may be a greater or lesser number of states to the trance experience. Hypnosis is the engagement of the unconscious processes used to guide an individual into a state of trance, thereby inducing an altered state of awareness, which is apart from normal waking conscious behaviour. A hypnotist learns the skill, art and science of hypnosis (O’Keefe 1998).
The hypnotist guides the individual from the first, hypnoidal waking state of trance, throughout the second sleeping state, eventually to the artificial somnambulist state where they appear to be awake, but are in actual fact, in a deep state of trance and very suggestible (McGill 1996).
In some forms of hypnosis an epileptic-like fit can be induced through suggestion, leading the individual into a convulsive state (Gauld 1992) (Grof 1988).
Sharron was a 24-year-old woman in good health as far as the evidence shows (Medical records, Sharron Tabarn, 1993). Her death occurred on 23rd September 1993 after Sharon had taken part as a volunteer in a stage hypnosis show at a public house in Leyland, Lancashire, UK (Death certificate, Sharron Tabarn, 1993).
At the inquest the coroner, Michael Howard McCann recorded a verdict of death by natural causes. Sharron’s family were not happy with that decision, claiming she had been a very healthy young woman who was rarely ill. McCann said at the time that he thought the verdict would be hard for the family to accept (McCann, 1993). Margaret Harper, the deceased mother, has stated that she feels that, at the time of the inquest, she did not properly understand the possible ramification stage hypnosis could have had on her daughter’s death (O’Keefe1998).
The death certificate states the cause of death as:
1. Pulmonary Oedema.
2. Inhalation of gastric contents.
Verdict: natural causes.
There was no definite evidence of natural disease, although histological changes in the heart suggested there may have been an underlying defect that might have produced acute cardiac failure (Tapp 1993).
Sharron was menstruating at the time. There was no evidence of any drugs having been taken but, alcohol levels of 78mg per 100ml were recorded, which, according to the post-mortem report, is not excessive. It was suggested by the pathologist, Dr Edmund Tapp, that allowing for metabolism this could have stood at over 100mg. Tapp informed the coroner at the inquest that this was the equivalent of three pints of beer. However, subsequently a member of the Central Scientific Laboratories, JP Wootten, reported that the figure, in fact, represented three half pints of beer. He concluded that Tapp’s statement was “ambiguous and may well have misled the coroner” into believing that Sharron’s body contained double the amount of alcohol than it actually did (JP Wootten’s letter to the Tabarn family’s solicitor).
Furthermore, there was no recorded history of any allergic reaction to alcohol (Medical records, Sharron Tabarn, 1993). Alcohol can increase the chances of an epileptic fit, but we must remember that Sharron had not consumed a great amount and it had never had an adverse effect on her before. Not only can epilepsy turn into sleep, but sleep can also turn into epilepsy (Chokroverty, MD, 1994).
Sharron had never undergone hypnosis before the incident at the show and according to Patricia Andrew, one of the group of three friends who accompanied Sharron that evening, the stage hypnotist had not asked any of the volunteers if they had any phobias (Patricia Andrew, witness statement 24.9.93).
It is necessary for any hypnotist to ask subjects about phobias, before they put them into deep trances, because suggestions may trigger a phobic reaction. If a hypnotist is in possession of that knowledge it enables them to avoid any provocative suggestions that may trigger such a reaction (Kroger 1977).
Tapp found that during the post-mortem a high level of Prolactyn was present in Sharron’s body, more than 14 times the normal level. He indicated that this may have meant that she had a fit before she died. There was, however, no personal family history of epilepsy, neurological or heart dysfunction. The current medical knowledge is that Prolactyn is released into the body in reaction to pain (Heap 1994).
Because Tapp had not seen any death before that might have been caused in connection with hypnosis, he consulted Michael Heap, a clinical psychologist who lectures on hypnosis at Sheffield University. They were unable to come up with the decision that Sharron had or had not died as the direct result of the stage hypnosis (Heap 1994).
Heap made a statement to the police stating that, in his opinion, if anyone has been under any form of stage hypnosis and later becomes ill or distressed, there should be no reason why they should not be able to seek help, even if that person had consumed alcohol. He also stated that in his opinion there is no connection between hypnosis and adverse side effects. Since this was the statement of someone brought in as an expert witness, the police relied upon his professional opinion (Heap, witness statement 28.9.93).
Kroger, one of America’s foremost teachers of hypnosis, with over four decades of teaching experience, warns against uncontrolled hypnosis by untrained individuals, including stage hypnotists. He states that such practices could cause psychological and physiological adverse reactions to occur with some subjects during hypnosis per se, including inducing a person to carry out antisocial acts of aggression1.
Waxman (1978) wrote to the British Medical Journal warning of the dangers of untrained hypnotists being allowed to use hypnosis in unregulated ways, such as stage hypnosis.
Erickson (edited by Rossi 1989) reported over a dozen cases of mysterious back complaints in subjects who had previously been involved in stage hypnosis2. These particular subjects had all performed catalepsy and been suspended in mid air between two chairs in unnatural positions for extended periods.
In subjects who suffer physical or mental illness, emotional distress, anxiety, phobias and a range of potential problems a hypnotist may be working in co-ordination with general practitioner of medicine or other professionals. They may also have carried out a detailed investigation into the person’s background and psychological state. This does not happen in stage hypnosis and the entertainer knows nothing about the person before they attempt to produce profound altered states of trance through hypnosis. Therefore they are unaware of potential dangers that may occur during or after the stage hypnosis situation (Crasilneck 1985).
Mahchovec (1986) writes that during and after stage hypnosis unpredictable symptoms can often be severe life threatening emergencies; personality changes, psychotic-like decompression, and transient unpleasant thoughts and feelings that fade within minutes but can still be unpleasant. He further states that frequently reported side effects are headaches anxiety irritability, fatigue, depression, unexplained weeping, dizziness, disturbed sleep or dreams, fear or panic attacks, lowered stress threshold, poor coping skills, depersonalisation, derealisation, disorientation, obsessive rumination, delusions, psychomotor retardation, impaired or distorted memory, attention deficiency disorder or concentration difficulties, sexual or antisocial acting out, and symptom exaggeration, post-traumatic stress disorder, and at the extreme, death.
Echterling & Emmerling (1987) published a study of university students, many of whom complained of feeling uncomfortable and unhappy with being volunteers or members of the audience. Their conclusions were that hypnosis was not a safe or suitable procedure to be used in the stage hypnosis context.
John Hartland (1995) talks about how he considers that stage hypnosis is abusive, and devalues and degrades the subjects. He further goes on to warn about classical cases reported on a variety of consequences suffered by volunteers, ranging from panic reactions, schizophrenia, psychosis to suicide3.
A paper appeared in the Australian Journal of Clinical Hypnosis by Rob O Stanley (1994) looking at the protection of the use of hypnosis. Its findings concluded that side effects did occur at times with hypnosis both in the clinical and other settings, ranging from mild disturbances to the bringing on of psychotic episodes. Regarding stage hypnosis he commented that it was a process that was imprecise and highly dangerous. He believed, as did the majority of his colleagues, including Wendy Louis-Walker PhD, that legal measures should be in place to prohibit such exhibition of hypnosis by untrained individuals.
In the American Society of Clinical Hypnosis publication (1995) entitled Hypnotic Induction and Suggestion, edited by D Corydon Hammond, PhD, there is a section of on stage hypnosis and complications of hypnosis. It advises against stage hypnosis, commenting that many of the complications reported are the result of the use of hypnosis for entertainment.
Derek Crussell in the European Journal of Clinical Hypnosis, Summer, 1996 profiled several cases who had suffered physical, mental and emotional damage after having been subjects in stage hypnosis shows. His patients include cases of broken limbs, headaches, dizziness and in the severest of cases what the volunteer believed was hypnotically triggered schizophrenia.
There is a considerable body of academic evidence that shows the use of hypnosis, of any kind, can be dangerous and life threatening when misused, not only in the hands of the untrained, but also when used with particular subjects who are contraindicated to a variety of suggestions and procedures. Stage hypnosis is cited as being an unsafe procedure in which to use hypnosis (Kroger 1977) (Waxman 1978) (Erickson, 1989) (Crasilneck 1985) (Machovec, 1986) (Echterling & Emmerling, 1987) (Hartland, 1995) (Stanley, 1994) (Hammond 1995) (Crussell, 1996).
In clinical or experimental hypnosis, which is often on a one-to-one basis, the attention of the hypnotist is focused on the subject and should any problems arise they can be noted and dealt with immediately. Professional hypnotists further take precautions to prevent the likelihood of adverse reactions occurring in their subjects. These include taking extensive case histories, prior to the induction of a profound state of hypnotic trance, in order to screen for any potential problems or contraindications (Kroger 1977).
Taking all the considerations into account,Sharron would have made a highly suggestible subject for hypnosis that evening as indicated by the following. She had told her girlfriend, even before she arrived at the venue, that she intended to volunteer. Sharron’s mother had also seen her before the show and said she was excited about going to see it. Such expectations are considered a constituent part of a good subject for stage hypnosis (McGill, 1996).
Some people are more susceptible to hypnosis than others. That means they are able to enter hypnosis easily and often very deeply, becoming unaware of their surroundings and absorbed in the hypnotic experience (Hilgard & Hilgard 1973).
Suggestible subjects are those who are able to react well to suggestions offered to them, performing the requested behaviour either in or out of hypnosis (McGill 1996). From the evidence presented about Sharron’s behavior it would be safe to assume that Sharron was both susceptible to hypnosis and very suggestible (Patricia Andrew, witness statement 24.9.93).
Spanos (1996) discussed the ability to disassociate as being an important part of the trance experience. He described it as being mentally some place other than in full conscious attention. He viewed this ability to be a major component of hypnosis, believing that it was a situation construct. Hilgard & Hilgard (1994) stated that the disassociation which took place, during trance induced by hypnosis, was a psychological state, as the conscious mind and its defence mechanisms became unaware of the person’s surrounding.
Sharron had two children by natural childbirth (Medical records, Sharron Tabarn, 1993), without the aid of any form of anaesthetic, which, from a psychological point of view, demonstrates a natural ability to disassociate. Kroger (1977), a psychiatrist and anaesthesiologist, acknowledged that women who are able to bear children without chemical anaesthesia have a natural ability to enter profoundly into the trance-like state, either on their own or through training in disassociation techniques.
Further to this, Sharron’s mother has said that she was a very imaginative and artistic person. The older of two daughters, she had exhibited considerable fantasy oriented play as a child, being satisfied with making up games for herself, and not always seeking new toys, but being quite happy to use the ones she had. She was described as a happy-go-lucky child and known as a very sociable, trusting adult who mixed well (Conversations between O’Keefe and Mrs Margaret Harper 1997).
Sheehan (1979) wrote about people who have a good ability to use their imagination and who have trusting temperaments, making very good hypnotic subjects. They can also be very responsive to suggestion when in trance. The use of imagination is essential for the individual to create the kind of alternative realities that exist within the trance experience and those who can easily call to use those abilities can generally be highly susceptible to hypnosis. Trusting people have lower psychological levels of defensive strategies running therefore they are happier to accept a wider range of suggestions freely.
In her statement Patricia Andrews says that she attended the stage hypnosis show with Sharron, Sharron’s estranged husband Darren, and his friend John. Darren had also gone onto the stage to be hypnotised but had been rejected by the hypnotist as an unsuitable subject, while Sharron was accepted. Patricia goes on to describe how, having stepped up as a volunteer, Sharron was then hypnotised, going through the first two stages of trance and entering a deep somnambulistic state along with the other volunteers. Sharron was described as responding well to suggestion (Patricia Andrew, witness statement 24.9.93).
In short, taking hypnotic susceptibility, suggestibility, dissociation ability, capacity to use imagination and fantasy, being trusting and having great expectations about the hypnotic encounter, Sharron profiles as a stage hypnotist’s ideal subject (McGill 1996).
As stated earlier I shall consider the induction of the trance experience, through hypnosis, as consisting of three basic levels with regard to the stage hypnosis experience. Firstly waking trance or what Kroger (1977) describes as the hypnoidal state, when the individual appears to be awake but in the first state of trance. Secondly the sleeping trance when the individual appears to be in a soporific condition with their eyes closed and the hypnotist may refer to them being asleep (McGill 1996). Thirdly the somnambulist state when the individual is said to be in a waking sleep where they are in a deep state of trance, only having selective attention to the external world, and maybe very reactive to suggestions offered (0’Keefe 1998).
From reports of Sharron’s behaviour it seems that she was capable of entering into, utilising and experiencing all three of these states of stage hypnosis (Patricia Andrew, witness statement 24.9.93).
Sharron was put through several tasks during the stage hypnosis experience including imitating the pop singer Madonna, seeing the men in the audience with no clothes on (the X-ray specs routine (McGill 1996) and kissing a man in the audience. The suggestion given to her to terminate the trance experience was that when the hypnotist said “goodnight” the subjects would feel 10,000 volts of electricity through the seat of their chairs. As the hypnotist did this it seemed to onlookers that she flew off her chair (Patricia Andrew, witness statement, 24.9.93) (McCann, 1993).
When Sharron was 11 years old, according to her parents, she had received an electric shock from a wall switch in the family home and it had thrown her across the room. Her parents reported that from that moment on Sharron had been terrified of electricity and as an adult would not even change a light bulb or a plug. Three or four weeks before her death her father nearly died of an electric shock and was signed off work with burns for five weeks (Interviews between Mr and Mrs Harper (Sharron’s parents) & O’Keefe, 1996-97).
With people who suffer phobias the exposure to a specific stimuli can bring on an adverse reaction in response to that imagined stimuli as if it had been real (Bourne 1995) (Andreas & Andreas 1989).
After the stage hypnosis show Sharron said that she was not feeling well so the group went back to her home. Complaining of a bad headache and dizziness, she went to lie down and slept on the bottom of her youngest daughter’s bed, not even bothering to take off any of her clothes (McCann, 1993). Just after she went to bed, she was adminstered Paracetamol, something which Sharron’s mother said was very rare (Interviews with Mr and Mrs Harper and O’Keefe, 1996-97)
At 7.00am in the morning her estranged husband Darren, who had stayed over in the same room, heard the children making a noise and when he investigated he found Sharron dead at the bottom of the bed (McCann, 1993).
When considering the possibility that the hypnotic suggestion for feeling 10,000 volts of electricity going through Sharron’s body might have caused a post-hypnotic induced epileptic fit that eventually led to her death, we need to look at the possible correlation between certain forms of hypnosis and epilepsy.
In a book on hypnosis co-authored by Heap he talks about early mesmerism not being quite the same as hypnosis, saying that hypnosis today is more the purposeful induction of a state of trance through verbally conveyed ideas4. There are further references to mesmerism inducing a “crisis”, something like an epileptic fit. This seems to be only a partial understanding of modern-day hypnosis, for today’s hypnotists use all the sensory systems to induce the desired trance-like states (Bandler & Grinder 1981).
The psychodynamics involved in early mesmerism were generally different to modern-day hypnosis (Gauld 1992), but they can be much closer than Heap portrays. If mesmerism was not a form of hypnotism, why mention it at all in a book on clinical hypnosis?
Also, if mesmerism came out of exorcism, inducing epileptic-like seizures, why then is it not possible to make stronger associations between Sharron Tabarn’s stage hypnosis experience and the fit she may have suffered? (Tapp 1993) (McCann 1993) (Heap 1993) (Heap 1994).
Heaps contradicts himself. On the one hand in his police statement he says hypnosis cannot be harmful (Heap, witness statement 28.9.93), and on the other he relates it to the mesmeric induction of epileptic-like fits (Gibson & Heap 1991). As we have seen earlier, to imply that hypnosis is benign is, in fact, incorrect because its very induction is dependent upon suggestions changing the psychological and physical qualities of the subject.
For hypnosis to take place, suggestions are required to produce an altered state of awareness, regardless of which communication systems are being used for the induction (visual, auditory, kinaesthetic, olfactory or gustatory). That altered state will produce bodily changes. Erickson was famous for being able to induce trances using any of those systems and noted many physiological changes that took place during the process.(Erickson 1989).
Erickson observed that physiological reactions do take place as a result of suggestions, including alteration in breathing, heart rate, levels of alertness and awareness. A person’s subjective perceptions can, in reality, elicit physically those imagined reactions (Erickson 1989).
Therefore hypnosis equals the consequences of suggestions and a change in physiological as well as psychological processes cause the trance-like state. Not all inductions or trance-like states, however, are the same and not all produce a lessening of heart rate, lowering of blood pressure or a soporific state. If we consider the bodily changes that take place in profound states of trance, where activities can be energetic as well as soporific, then motivation induced through suggestion means that the hypnotic process can never be benign and are variable according to context
(O’Keefe 1998).
This begs the question of how wide the definition of hypnosis can be spread. I choose the expansionist model (Lynn & Rhune 1991) to spread the definition of hypnosis to all states of altered consciousness induced through suggestion.
Examining trance-like waking behaviours gives rise to a dilemma for some clinicians as they classifiy these behaviours as not being an altered states of awareness and choose to align themselves along with the social compliance theory (Spanos 1996). However, this brings us to Wolinsky’s (1991) point of view that people are permanently in trances, and that they simply move from one trance to another, with hypnosis being the influence by which suggestion alters the trance.
ANALYSIS
For Sharron Tabarn then, she may have gone home in a different trance state from the one in which she arrived at the venue in that evening. The new trance may have contained the post-hypnotic dangers of a massive abreaction to the suggestion that when she woke up she would feel 10,000 volts of electricity going through her body (O’Keefe 1998).
It is possible that Sharron may never have woken up from the trance on the stage, but went home in a somnabulistic trance, fell asleep, and then could have woke up reacting to the post-hypnotic suggestion of receiving 10,000 volts of electricity. This could have compounded with her phobia of electricity to cause the epileptic-like seizure, and in sheer terror she had a heart attack, vomited and choked to death on the contents of her stomach.
It is noteworthy here that her choke reflex did not work when her lungs filled with vomit, meaning one of two things; either she was already dead or for some reason her senses were impaired. Her husband and two children were in the room but no one heard her die (McCann, 1993).
Is pain registered at some unconscious level but ignored by the conscious mind?
If we consider the work of the respected researchers from Stanford University, the Hilgards (1994), who have studied hidden pain extensively, we can look at Sharron’s possible hidden pain.
Pain, and suffering derived from pain seems to be a neurological indicator of physical, mental, emotional, social, and even spiritual disturbance of the organism’s homeostasis. The registration of the pain sensory experience fluctuates from unconscious to conscious awareness eg hunger, blisters, toothache, psychological distress.
Since the unconscious mind runs the involuntary functions, it is logical to assume that all disturbance is registered at an unconscious level, but not necessarily at a conscious level. Pain reaches a threshold level, forcing it into conscious awareness, requiring the organism to have extra focuses of attention, in order to change the circumstances and alleviate the pain.
Overt pain is the open behavioural display of both conscious and unconscious awareness of discomfort from noxious external stimuli, internal disturbance or a hallucinated experience of either of the previous.
Covert pain is the unconscious registration of pain, without it being brought to conscious attention, ignored by consciousness or through the unconscious processes purposefully keeping it from consciousness.
Experimentally it is possible to demonstrate the existence of hidden or covert pain that is kept from consciousness (Hilgard & Hilgard1994). During hypnosis a hypnotist can tell a subject to consciously ignore the pain and they can do that. By monitoring the heartbeat, hormone levels and muscle tonality during this process it can be observed that the subject is displaying the physiological signs of the pain experience, without being consciously aware.
Therefore pain can be registered at an unconscious level without the conscious mind being aware of the distress, hidden for whatever reason the unconscious mind has for keeping it solely in a particular part of the unconscious.
Jung (1974) spoke of the differing egos that came to and from consciousness according to their need to function at the executive level. Virginia Satir (1988), the American therapist, talked of our psyche being composed of many different parts, and some of her work on internal conflict consists of getting one part to talk to another. The American hypnotist D Corydon Hammond (1995) referred to the Control Room Technique, where the therapist talks to the relevant control mechanism within the subject’s psyche. Erickson (1989) reported experiments with automatic writing where he communicated with separate personality aspects, in different sensory systems, at the same time.
This splitting of consciousness into many factions, far from being a pathology, is now considered a natural part of normal psychological processing. We have a part for running our heart, changing our blood, checking our state of happiness, and even doing the shopping. In fact we have parts for doing everything in our experiential existence.
One of those parts is a defence mechanism that sometimes wakes someone up out of hypnosis if a suggestion is made that is contrary to their wellbeing. However, in hypnosis this part does not work every time in some people. Suggestions can be made during hypnosis that are contrary to the subject’s well-being, but sometimes, due to organic or existing cognitive processes, that defensive part fails to activate (O’Keefe 1998).
Psychological defensive mechanisms are cognitive programs that are running in the mind in order to keep the individual safe from harm. Should the person perceive that they may be in danger, from anything, then that defensive mechanism will implement a series of procedures designed to withdraw that person from the perceived danger or minimise any harmful effects. All reactions to perceived danger are context bound and no two individuals will react in exactly the same way, although basic rules of safety may be applied to human behaviour in general.
When in a dangerous situation we exhibit what is referred to in psychology as the fight or flight response (Adcock 1964). Mentally if a person is given a possible harmful hypnotic suggestion then the fight response may cause their mind to reject that suggestion. The flight response may also activate in that they withdraw from fully paying attention to that suggestion, thereby disassociating themselves from the suggested reaction to that suggestion. This is what can happen most of the time when individuals are given hypnotic suggestions that they may be perceived as being harmful to their wellbeing.
However, if we look at people who have been subjected to an abusive childhood (Bass & Davis 1988) and who later turn up for therapy, it is plain to see that suggestions that were made to them can have had the effect of producing a negative self-image. Even though those suggestions will have been contrary to that person’s wellbeing, they may have accepted and incorporated such suggestions into their personality.
With many men who suffer from impotency, I have observed that it can often be the result of a single comment made to them that has instantly suppressed their sexual ego prowess. The same may be said of many human behaviours that have resulted from even the smallest of innuendoes. So when we enter into the hypnotic equation I propose that a subject can, indeed, be severely damaged by a hypnotist’s careless suggestions, and accept what would normally be considered a harmful suggestion.
Some theorists’ experiments have shown that subjects have overridden suggestions to steal or maim another person. However, such experiments are not a process of observation and can be corrupted by their very own design, since they are artificially constructed circumstances. Erickson (1989) carried out such experiments where the subject rejected suggestions contradictory to their normal moral code. He commented also later that there is the possibility that his results were part of the constructs of the experimental situation. The subject, at a deep unconscious level, might have known that it was an experiment and a part of their minds could still obey social rules in order to please the experimenter.
If hypnosis is some kind of behaviour regression back to infantile processing of information then there is the possibility that Sharron could have suffered night terrors in deep sleep, which are common to children (Fromm 1979) (Chokroverty, 1994). Let us also remember that she never made it to her own bed that night, but curiously went to sleep at the bottom of her daughter’s single bed, something her family said she had never done before.
Chokroverty (1994) tells us that Hippocrates described fears, rages, delirium and leaps out of bed that occur during sleep. Aristotle observed that many cases of epilepsy started in bed. Some people have described a sense of being locked into the stage hypnosis process unable to regain control over their situations (O’Keefe 1998).
It is common for subjects in states of trance to have an abreaction when faced with their worst fears or memories. For this reason the majority of hypnotherapists do not practice abreactive work, knowing that it can have unpredictable changes on the subject’s psychology and physiology. One of the problems with taking the subject into a traumatic mindset is that it can cause considerable dysfunction, from which the subject can suffer post-traumatic stress.
Woolger (1987) wrote about people, who during past-life regression, believed they remembered being choked to death, burned alive or suffered other physical injury. In trance these subjects literally do sometimes manifest physiological signs of incurring those injuries.
Raginsky (in Kroger 1977 p.193) revivified a state of cardiac arrest in a patient by post-hypnotic suggestion to relive an earlier heat attack. And stigmata is the perfect example of where the individual believes they are suffering the crucifixion of Christ and holes actually appear in their bodies (Early & Lifschutz, 1974) (Kroger 1977).
A possible argument against the considerations of Sharron Tabarn’s death is that much of what is proposed here may be termed to be pure speculation, however, the conclusions are based on deductive reasoning. A young healthy woman, who experienced no major illnesses, dies five hours after a stage hypnosis show, where she received the kind of suggestion that could be perceived as being life threatening. The pathologist can find no explicable cause of death, other than the kind of symptoms that may be present in someone who may have died of the results of a hypnotic abreaction.
Here I would like to suggest the application of the principle of Okham’s biographical razor5. That is when all non obvious reasons for Sharron’s death are stripped away we are then left with a simplest possible conclusion, which could be death as a result of hypnotic or post-hypnotic trauma.
To be fair to all involved, absolute, conclusive evidence may never have been offered the coroner in this case; however, circumstances surrounding the stage hypnosis and its possible effects were not reasonably looked into. Considering the facts in this case Sharron Tabarn would have more than likely been alive the next morning had she not undergone stage hypnosis.
Heap said in his paper A Case of Death Following Stage Hypnosis: Analysis and Implications (University of Sheffield 1994) that in all seriousness he found it hard to consider Sharron’s death to be a result of adverse affects of post-hypnotic suggestion. To explain this meaning he attempted to claim that all changes associated with hypnosis are derived from psychological, subjective experience and physiological changes tended to be comparatively unexceptional or even absent altogether. Firstly this ignores the function of the placebo effect and secondly the ability to achieve dramatic changes with some subjects.
Heap talks about the hypnotic subject’s experience being an “as if” frame where the individual is not really having physiological changes but is only imagining that they are. This sounds very much like a psychologist claiming hypnosis for psychology and has all the selective logic of the social compliance theory (Wagstaff 1979) (Spanos 1996). If it were so, why practise hypnosis with medicine at all?
Heap tries to comment that the effects of hypnosis are not dramatic, but how can he judge other people’s subjective experiences? It is surely a case of the theory preceding the experience, and the observer ignoring the facts concerning Sharron’s death, because they do not fit one specific theory.
Heap may be able to quote many theories and opinions to support his argument; however, it is naive to write as he does on the subjective interpretation of 10,000 volts of electricity experienced either in reality or in imagination. He says that “the circumstances of stage hypnosis call for a benign and humorous interpretation of an electric shock rather than one which entails the realistic enactment of a traumatic and fatal incident.” How could he possibly know what Sharron’s subjective interpretation of that suggestion was?
There is a contradiction in his argument when he also states that stage hypnosis may have some harmful effects in certain vulnerable individuals. He maintains that this is also true of many life situations which have stressing circumstances. It therefore becomes unreasonable to ignore that stage hypnosis can and sometimes appears to produce the harmful effects.
Heap’s partial redemption is that in his analysis he said he could not prove that the stage hypnosis was not responsible for Sharron’s death and that it was not a comfortable feeling for him to know this.
He also says that the ingredients in stage hypnosis have, in recent history, been over exploited by some entertainers, and participants may be coerced into behaving in a shameful and degrading manner in front of the audience. Along with that he comments that we should not be surprised if these people feel confused, distressed and humiliated when they try to make sense of their behaviour after the event. Here again he confounds his own previous view of hypnosis being benign. He seems confused and therefore does not appear to demonstrate a profound understanding of the relevant factors involved in stage hypnosis.
When Heap wrote an article called The Nature of Hypnosis in The Psychologist (November 1996) his views were received with much criticism. A letter to the journal in February 1997 cited the article as being misleading with the author largely ignoring other explanations of hypnosis except his own. We are all guilty of this kind of selective theorisation at times, but it is the kind of basis on which Heap seems to fail to connect Sharron Tabarn’s death and the stage hypnosis she underwent.
As well as all the above if we consider the effects of belief upon the emotional, mental and physical body this would also add weight to the effects of belief in Sharron’s case (whether real or imagined). There have been many recorded cases of death through inexplicable causes, with people who have died, believing they have a Voodoo curse upon them (Rigaud 1985). Many of the early explorers into Africa noted and documented such cases.
Belief is a very strong motivator in our actions and reactions as human beings. Our beliefs form one of the basic frameworks by which we negotiate our inner and outer worlds. They drive us to preserve our safety, provide nutrition for our intellectual, spiritual, emotional and social growth, motivate us within the criteria of our philosophical paradigms, drive us to war, lead us towards excellence and bear relevance upon physical compliance and competence. Change our belief and the efficacy of our life or death circumstances changes too.
In Haitian culture priests do convince some people, with the aid of poisons and expansionist hypnosis, that they are zombies and they have been brought back from the dead6. In fact many of these priests have been tried and convicted for this perceived sorcery.
Among the half-castes of Guatemala, magical procedures can kill. Susto or Aspanto occurs when victims fall stone dead and are later revived by ritualistic ceremonies of the magician (Kroger 1977).
Stanislav Grof (1988), the former chief of psychiatric research at Maryland Psychiatric research Centre, discusses in his book The Adventure of Self-discovery, the human ability to psychologically alter the body via thought, a concept which is now accepted by Western science. For thousands of years the yogis have practised extraordinary physiological feats of changing their heart rates, slowing and reducing their capacity of breathing, varying body temperature and surviving without food or water for long periods (Kroger 1977).
The following case I experienced was with the parents of very close friend of mine. In the mid 1970s his father developed cancer and was simply lying in bed waiting to die. His mother, who was devoted to her husband, tended to his father’s every need. One day his father died at 5.00pm and his mother went over to the dressing table, brushed her hair, then laid down next to her husband’s body and also died. At his mother’s inquest no cause of death could be found (O’Keefe 1998).
Existent in Native American cultures is the tradition of death by intent of the mind. If a husband died the old wife would go out into the snow, just sit there and wait to die. Life for them was hard and the old women believed they had outgrown their usefulness and would be a burden to their relatives (O’Keefe 1998).
These examples may not be the same as the post-hypnotic trauma that Sharron may have suffered, but they do demonstrate the principle of death by belief. For her there may have existed a belief that electricity was a thing to be much feared. Due to her past learning experiences, she developed a phobia against it, even as far as being unable to change a plug. More than that she may have associated electricity with the possibility of a terrible death. It does not take a great leap of faith here to assume she could have been terrified by the post-hypnotic or intra-hypnotic suggestion she received to feel 10,000 volts going through her body.
Our belief systems are part of the drivers of our behaviours that not only influence our psychology but also help create our physiology (Dilts, Holbourn & Smith 1990). It is commonly accepted that the psychological mindsets that exist bear upon a patient’s conditions, and can determine who will recover well from an illness and who will not.
Working in reverse, positive imaging and beliefs are reported to have altered bodily functions and performance through hypnotic suggestion. Hypnosis is now used in cases of cancer to improve the prognosis and change the physiology of the patient. In Texas the Simontons have documented many cases, some terminally ill, who have changed the diagnosis using techniques of hypnotic creative visualisation (Simonton, Matthews-Simonton & Creighton 1978).
Ernest Rossi PhD (1986), a psychologist and hypnotherapist, has published works on changes to the body’s immune system and chemistry through the power of hypnosis and mind control techniques. Far from being just theory based suppositions, he has shown that microbiological examination of tissue and blood samples shows a marked difference, in controlled studies, after a person was hypnotised and healing suggestions were made to them.
Hirshberg & Barasch (1995) profiled many cases of people who change their physical destinies due to their belief of whether they would live or die after their diagnosed illnesses.
Undoubtedly psychology changes physiology and for Heap to say that these effects are simply psychological perceptions seems like selective blindness, and an attempt to validate only psychology as the real viewpoint. The evidence presented in this project suggests that neither hypnosis nor the suggestions delivered by hypnosis can be completely benign. Whether at an organ functionality or molecular level there is sufficient evidence to prove, beyond reasonable doubt, that hypnosis has a profound effect on the human condition.
People do die of fright, throughout different cultures, even though it can be an unexplainable pathology when trying to determine the cause of death during an autopsy. “Died of fright” is not something that a pathologist wants to put on a death certificate because it may be perceived as being unscientific and indecisive. It is here proposed that “Died of natural causes” was an incorrect deductive reasoning to put on Sharron Tabarn’s death certificate because, through a process of logical deduction, the hypnosis was the extraordinary fact that preceded death.
DISCUSSION
I propose that several things could have happened to Sharron Tabarn that night:
1. Sharron was capable of being a very good hypnotic subject and was also a very suggestible person.
2. She was very responsive to the hypnotist’s suggestions and performed for the greater part according to his instructions.
3. There was a profound expectation present in her that what the hypnotist suggested, she believed would come true.
4. There had been no warning that the absolute trust she had probably placed in the hypnotist was going to be betrayed by the suggestion of one her worst fears, an electric shock.
5. When that happened a part of her reacted to the post-hypnotic suggestion, a defensive part protected her from it and another part suspended the full reaction from taking place at that time. She experienced covert pain, but little overt pain.
6. The waking suggestion of feeling 10,000 volts of electricity did not, in fact, bring her out of trance – she remained somnabulistic. Instead it acted as a time delayed post-hypnotic or even intra-hypnotic (a suggestion-reaction that takes place within the hypnotic context) suggestion.
7. At some unconscious level this suggestion waited to be activated to its fullest potential until she woke up.
8. Having gone to sleep she dreamed and her unconscious processed that concealed post-hypnotic/intra-hypnotic suggestion, which activated as she slept or began to wake.
9. Experiencing the full terror of an abreaction that the suggestion produced, she had an epileptic fit, which induced a heart attack, causing her to vomit and she was unable to seek help before she choked to death.
Other difficulties arise if the conclusion is ever changed at a later date and the cause of her death is accredited to the stage hypnosis. Heap asks in his paper why there is an urge by both professionals and lay people to convict the stage hypnotist, “on the basis of the most indeterminate set of ideas and evidence”. But what of Sharron Tabarn’s family?
A. The loss they have suffered by her premature death has been devastating to them. Two small children were left without a mother. The father of those children was left with the burden of bringing them up as a single parent. Her parents and sister also suffered a great loss and continue to feel cheated because they believe that her death was not sufficiently investigated.
B. The family felt they need what they believe is the real cause of her death to be recognised so they can complete their grieving process. Sharron’s mother believes this process is not able to come to its full conclusion because of the verdict of death by natural causes.
C. There is also the consideration of compensation for the hardships her family and children have and will suffer from Sharron not being around, and for their sense of loss. Why should stage hypnosis be exempt of blame? If Sharron had been knocked down by a car, that would have been duly investigated beyond the boundaries of reasonable doubt.
Here, however, we hit another barrier, because suppose, just for one moment, that the verdict was changed to death through hypnosis. The legal situation is unclear as there is no law to specifically prosecute the hypnotist.
Sorcery or witchcraft is about the only thing in British law that comes close to the kind of charges that could be levelled at him. A claim that insurance companies would no doubt dismiss.
Perhaps death by mental cruelty or grevious bodily harm might be the nearest justice possible, but certainly not death by natural causes. If the stage hypnotist was ignorant of the kind of devastating effects that his suggestions could have on people who are in deep hypnotic trances, then steps need be taken to protect the public against such practitioners. As the law stands the stage hypnotist involved was able to go straight out and hypnotise another audience the very next night.
Ignorance here can be no excuse.
Sharron’s death once again portrays that stage hypnosis is a dangerous, imprecise and unpredictable procedure. Compound this with the lack of training of most stage hypnotists and the result can often be serious damage to some of the unsuspecting public.
Hypnosis is never benign because it changes the psychological and physiological constituents of experience. To some people suggestions that are contrary to wellbeing are not harmful, since they may have the kind of psychological defence mechanisms that can reject such suggestions. For others those mechanisms may be partially inoperative for psychological or organic reasons.
Dr Prem Misra, a consultant psychiatrist and chairperson of the academic committee of the British Society of Medical and Dental hypnosis, wrote to Margaret Harper, Sharron’s mother. The letter said that he was sorry to hear about her daughter’s death and explained that the society had long campaigned for the banning of stage hypnosis.
It is hoped by the family of Sharron’s family, myself and the majority of professionals in the field of hypnosis that stage hypnosis will be eventually be banned as a form of entertainment, as it is in many other countries such as Israel, France, Germany, Sweden, Norway and certain states of America. However, without the full and active support of the hypnotherapy community there is unlikely to be sufficient pressure on the British government to amend the legal situation and cause this to happen.
In regard to any threats to the validity of this paper I will mention that I am an active member of the Campaign Against Stage Hypnosis. This organisation not only seeks to help those people who have identified as victims of the process of stage hypnosis, but also attempts to bring political pressure to bear on licensing authorities, politicians and legislators to seek to have stage hypnosis banned.
Secondly I have completed a 60,000-word dissertation on the complications that can arise due to the stage hypnosis process and therefore may be prejudiced in my findings in this paper.
Thirdly I have published the thesis in a book format, and it is well known in the public arena that even though my findings are in line with the opinions of the majority of clinical and experimental hypnotists, there are other hypnotists who may disagree with my conclusion.
Fourthly I am a member of various professional caring organisations which specifically have clauses in the codes of ethics that prohibit hypnotists to be involved with stage hypnosis.
Fifthly I was involved in legal action with the stage hypnotist Paul McKenna who attempted to sue me because I commented on his activities in a journal of clinical hypnosis and said that I did not consider stage hypnotists to be sufficiently qualified to teach clinical hypnosis. Later he withdrew his suit and a few months later I sued him for libellous comments made about the outcome of the first case. In December 2000 the High Court in the Strand, London found McKenna and the company McKenna Breen guilty of ‘very serious libel’ and I was awarded several thousand pounds in damages plus costs.
In conclusion considerations of the Sharron Tarbarn case can lead to different viewpoints from those drawn by Michael Heap. In his paper on the case he stated that he was unable to conclusively determine that Sharron Tabarn died due to post-hypnotic trauma and perhaps from an evidence point of view he was right. However, since the theories, applications and outcomes of hypnosis differ considerably, from school to school, and opinions vary widely amongst those who write and lecture about hypnosis, it is possible that the proposed theory presented in this paper is as valid as his.
It is likely that the hypnosis that Sharron underwent, hours before her death, may well have contributed greatly to her death. Calling into play Okham’s razor again, the only extraordinary evident antecedent to her death was stage hypnosis itself and the suggestions she received.
Twenty years before in the north of England Sonia Cunningham, a young woman, died in similar circumstances. Her death occured less than 24 hours after being involved in stage hypnosis. In that district an immediate ban on stage hypnosis was taken up by the local authority and is still in force today (O’Keefe 1998).
Margaret Harper applied for Sharron Tarbarn’s case to be brought before the British High Court in front of Lord Justice Simon Brown on 19 January 1998. The application was for the case to be reopened again and the petition claimed that the verdict of death by natural causes was an incorrect verdict. The applicant proposed that death by misadventure should be the very least that is recorded in so far as Mrs Harper’s belief that hypnosis may have played a considerable role in her daughters death (Harper 1997).
Justice Brown refused the application saying that even though some experts in the field of hypnosis may have come to that conclusion he did not wish for the case to be played out as one set of theories versus another. He further stated that even if the hypnosis had been a contributory factor in Sharron’s death the coroner was still entitled to bring in a verdict of death by natural causes (Brown 1998)
It is my opinion that Justice Brown failed to comprehend the gravity of his decision in that it now gives the impression that stage hypnotists are allowed carte blanche to practice their art, and should someone be injured, the stage hypnotist may not necessarily be held accountable.
RECOMMENDATIONS
The British government’s review of the dangers involved in stage hypnosis (1996) needs to be reopened to include issues relating to:
1. More rigorous investigation into possible damages incurred to persons due to stage hypnosis.
2. Investigation into hypnotists practising without qualifications.
3. A British government register also needs to be set up to register hypnotists so that the general public can be assured that someone is sufficiently qualified and experienced to be using such intense psychophysiological techniques
Unfortunately the previous review, held in 1996, carried out by two psychologists and two psychiatrists, was not well received by professional hypnotists (0’Keefe 1998). The reasons behind that thinking were such persons were not qualified in hypnosis. It was inappropriate for a government review on hypnosis to be carried out by clinicians who were specifically requested not to have an in-depth knowledge of hypnosis.
The Home Office stated that the idea behind their thinking was that those persons should have an impartial viewpoint and that they should be experts in evaluating research. However, what appeared to happen at that review seems to indicate that the committee was quite out of touch with the general consensus of opinions in the caring professions, who use hypnosis, that stage hypnosis is dangerous and many casualities do occur.
My research has concluded that when asked, the majority of the clinical and experimental hypnosis professionals would like to see stage hypnosis made illegal in order to safeguard the public (O’Keefe 1998).
ADDENDUM
Since the case of Sharron Tarbarn has attracted so much attention in the public arena, both in the press and amongst academics themselves, the reviewing of it has been not only been productive but intellectually and scientifically necessary.
Due to the present climate of the issuing of many lawsuits in the hypnosis community I am required to mention that the intentions of this paper are simply scientific and no libel, either professional or personal, is intended to any person or organisation.
This paper was finished in 1998 but has been unable to be published until this date due to the fact that no publication would accept it as they stated they feared they would be involved in lawsuits. It is only now in 2001 the HypnosisAustralia Online Journal has published it.
REFERENCES
1. Kroger, William S, MD (1977), Clinical and Experimental Hypnosis: Second Edition pp 99-101.
2. Erickson, Milton H, MD (1980), Collected Works vol. 1, p. 533.
3. Hartland, John (1989) Medical & Dental Hypnosis Third Edition pp.446-486
4. Heap, Michael, Hypnosis in Therapy (Gibson & Heap 1991) p.18
5. Chamber’s Dictionary (1981) p.954.
6. The Serpent and the Rainbow, Universal 1987; To The Ends of The Earth: Interview with A Zombie, Channel Four, 1997.
BIBLIOGRAPHY
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BROWN, LORDS JUSTICE SIMON, SUMMING UP OF THE APPEAL TO REOPEN THE SHARRON TARBARN CASE. BRITSH HIGH COURT.19.1.1998
CRUSSELL, DEREK, CAUGHT IN THE ACT: THE VICTIMS OF STAGE HYPNOSIS, EUROPEAN JOURNAL OF CLINICAL HYPNOSIS, ISSUE 10, VOL 3 NO 2, ISSN 1351-1297, 1996.
COE, W C, KOBAYASHI, K, & HOWARD, M L., EXPERIMENTAL AND ETHICAL PROBLEMS OF EVALUATING THE INFLUENCE OF HYPNOSIS IN ANTI-SOCIAL CONDUCT, JOURNAL OF ABNORMAL PSYCHOLOGY 82, PP 476-482, 1973.
EARLY, L F & LIFSCHUTZ, J E, A CASE OF STIGMATA, ARCHIVES OF GENERAL PSYCHIATRY, 30, 197-200, 1974.
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HEAP, MICHAEL, FOUR VICTIMS, BRITISH JOURNAL OF EXPERIMENTAL AND CLINICAL HYPNOSIS, 2, 60-62, 1984.
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KEBBEL, MARK, PHD, ALTERNATIVE THEORIES OF HYPNOSIS, THE PSYCHOLOGIST, VOL 10 NO 2, FEBRUARY 1997.
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STAGE HYPNOSIS CAN HAVE DEVASTATING EFFECTS, THE 10TH INTERNATIONAL CONGRESS OF HYPNOSIS AND PSYCHOSOMATIC MEDICINE, 1985.
STANLEY, ROBB O., THE PROTECTION OF THE PROFESSIONAL USE OF HYPNOSIS: THE NEED FOR LEGAL CONTROLS, AUSTRALIAN JOURNAL OF CLINICAL & EXPERIMENTAL HYPNOSIS, VOL 22, 39-51, 1994.
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DOCUMENTS AND LETTERS
ANDREW NEE JOHNSON, PATRICIA, WITNESS STATEMENT. 24/9/1993.
BRIGGS, HELEN, MY DAUGHTER DIED AFTER BEING HYPNOTISED, THE BIG ISSUE, AUGUST 19-25TH NO 195, LONDON, 1996.
DEATH CERTIFICATE, SHARON TABARN, 1993.
HARPER, MARGARET, AFFADAVIT, 27.6.97.
HEAP, MICHAEL, WITNESS STATEMENT. 28/9/1993.
HEAP, MICHAEL, DEATH OF SHARRON TABARN (LETTER TO MARGARET HARPER, 23.6.94).
McCANN, CAMERON HOWARD, CORONER’S REPORT ON THE DEATH OF SHARRON TABARN. LANCASHIRE, 1993
MEDICAL RECORDS, SHARRON TABARN, 1993
MISRA, PREM C, DR, LETTER TO MARGARET HARPER & FAMILY. 20.1.1994.
TAP, EDMUND, AUTOPSY REPORT ON THE DEATH OF SHARRON TARBARN. LANCASHIRE, 1993
WOOTTEN, J P., STATEMENT TO MARTIN SMITH & CO, 12.9.97 (HARPER FAMILY’S SOLICITOR).
INTERVIEWS
INTERVIEWS BETWEEN MR & MRS HARPER (PARENTS OF SHARRON TARBARN) AND TRACIE O’KEEFE, 1996-97.
CONVERSATIONS BETWEEN MRS HARPER & TRACIE O’KEEFE 1997.
VIDEOS
THE SERPENT AND THE RAINBOW, UNIVERSAL, 1987.
TO THE ENDS OF THE EARTH: INTERVIEW WITH A ZOMBIE, CHANNEL FOUR, 1997.
Dr Tracie O’Keefe DCH, BHSc, ND, Clinical Hypnotherapist, Psychotherapist. Counsellor, PACFA registered Mental Health Professional and Naturopath In Sydney. You can get help by booking an appointment with her at Australian Health & Education Centre.
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