I see hypnosis as a catalyst rather than a cause. When you're hypnotized you're still you -- but with the added suggestion that you are hypnotized. If you happen to have an "Alice-in-Wonderland" imagination, then you can do things with your imagination that we normally regard as beyond our abilities as illustrated in the foregoing picture. When it comes to bringing about more permanent changes, if the necessary ingredients for change are there, then accepting this suggestion allows these ingredient's to combine more easily; but if they are not, then nothing will happen.
For example, a nurse I used to work with in a screening center asked me to hypnotize her to stop smoking, which I was happy to do. She mentioned that one of her high school teachers used to hypnotize her regularly (apparently as a demonstration subject in his classes), so it was clear that she was going to be a high responder. We didn't have time for the usual stop-smoking program that I use, with three visits and all the rest. But, knowing her as I did, it was clear that if she was ready to stop she was going to do so, with hypnosis providing the necessary catalyst, regardless of the time and format which were available to us -- so I just gave her the usual stop-smoking suggestions, with the usual repetition and elaboration. As I recall I told her that her desire to smoke would vanish, that the cues which would normally awaken a desire to smoke would no longer be effective in doing so; that she could not be suddenly surprised by taking a cigarette without thinking of it; and that she would feel strong feelings of pride, achievement, and accomplishment at the fact that she had become a non-smoker,
To my consternation, the next day, when I asked her how she had done, and she told me that she had gone home and smoked an entire pack of cigarettes! But six months later, when I casually mentioned something about her smoking, she told me, "Oh, I haven't smoked since the time you hypnotized me."
"But didn't you go home and smoke up a whole pack?" I asked her.
"Yes," she replied. "And then I stopped."
Having worked side by side on the same unit with her for quite some time, I realized why she had responded the way she did. Her approach to authority was basically confrontational. In her everyday work environment, she made it obvious to everyone around her that, "Nobody's going to tell ME what to do!" So, when I gave her suggestions under hypnosis that she was going to stop smoking, her life narrative required that she had to first go home and deliberately smoke up a whole pack just to prove that I wasn't telling HER what to do. Then, once she had made the point to her own satisfaction, she could comply with my suggestions. Once she had accepted them, she was able to comply because she was ready to change.
As Steve Lynn so eloquently put it in his summary of our induction chapter in the American Psychological Association's Handbook of Clinical Hypnosis:
. . .how clients respond to suggestions depends less on the nature and success of a particular induction than on the following variables: (a) clients' prehypnotic attitudes, beliefs, intentions, and expectations about hypnosis; (b) their ability to think, fantasize, and absorb themselves in suggestions; (c) their ability to form a trusting relationship with the hypnotist; (d) their ability to interpret suggestions appropriately and view their responses as successful; (e) their ability to discern task demands and cues; (f) their ongoing interaction with the hypnotist; and (g) the appropriateness of the therapeutic methods and suggestions to treating the presenting problem. . . . Accordingly, clinicians should devise inductions and suggestions with these variables in mind and tailor their approach to the unique personal characteristics and agenda of each client they encounter."