Comparative effects of hypnotic suggestion and imagery instruction on bodily awareness

Bodily awareness is informed by both sensory data and prior knowledge. Although misleading sensory signals have been repeatedly shown to affect bodily awareness, only scant attention has been given to the influence of cognitive variables. Hypnotic suggestion has recently been shown to impact visuospatial and sensorimotor representations of body-part size although the mechanisms subserving this effect are yet to be identified. Mental imagery might play a causal or facilitative role in this effect, as it has been shown to influence body awareness in previous studies. Nonetheless, current views ascribe only an epiphenomenal role to imagery in the implementation of hypnotic suggestions. This study compared the effects of hypnotic suggestion and imagery instruction for influencing the visuospatial and sensorimotor aspects of body-size representation. Both experimental manipulations produced significant increases (elongation) in both representations compared to baseline, although the effects were larger in the hypnotic suggestion condition. The effects of both manipulations were highly correlated across participants, suggesting overlapping mechanisms. Self-reports suggested that the use of voluntary imagery did not significantly contribute to the efficacy of either manipulation. Rather, top-down effects on body representations seem to be partly driven by response expectancies, spontaneous imagery, and hypnotic suggestibility in both conditions. These results are in line with current theories of suggestion and raise fundamental questions regarding the mechanisms driving the influence of cognition on body representations.