Recent Research in Psychology

P. Suedfeld J.W. Turner, Jr. T.R. Fine

Editors

Restricted
Environmental Stimulation
Theoretical and Empirical Developments in
Flotation REST

Springer-Verlag
New York Berlin Heidelberg
London Paris Tokyo Hong Kong
Peter Suedfeld, Ph.D.
Faculty of Graduate Studies
The University of British Columbia
Vancouver, BC, Canada V6T lZ3

John W. Thrner, Jr.

Department of Physiology
Medical College of Ohio
Toledo, OH 43699, USA

Thomas H. Fine
Department of Psychiatry
Medical College of Ohio
Toledo, OH 43699, USA

Library of Congress Cataloging-in-Publication Data

Restricted environmental stimulation : theoretical and empirical
developments in flotation REST / Peter Suedfeld, Thomas H. Fine &
John W. 'furner, Jr., editors.
p. cm. - (Recent research in psychology)
Selected papers from the 1st three international conferences on
REST.
Includes bibliographical references.
I. Sensory deprivation-Therapeutic use. 2. Sensory deprivation-
-Physiological effect. 3. Floating bodies. I. Suedfeld, Peter,
1935- . II. Fine, Thomas H. m. 'furner, John W. (John
Whitfield)" 1944- IV. Series.
RC489.S44R47 1990
616.89' 144-dc20 90-9944

Printed on acid-free paper

© 1990 Springer-Verlag New York Inc.

All rights reserved. This work may not be translated or copied in whole or in part without the
written permission of the publisher (Springer-Verlag New York, Inc., 175 Fifth Avenue, New
York, NY 10010, USA), except for brief excerpts in connection with reviews or scholarly
analysis. Use in connection with any form of information storage and retrieval, electronic
adaptation, computer software, or by similar or dissimilar methodology now known or hereaf-
ter developed is forbidden.
The use of general descriptive names, trade names, trademarks, etc., in this publication, even if
the former are not especially identified, is not to be taken as a sign that such names, as
understood by the Trade Marks and Merchandise Marks Act, may accordingly be used freely by
anyone.

Camera-ready copy provided by the editors.

9 8 7 6 5 4 3 2 1

ISBN-13: 978-0-387-97348-7 e-ISBN-13: 978-1-4613-9701-4

001:10.1007/978-1-4613-9701-4
 To the profound nature of the isolation
experience, which has persisted in man s self discovery
throughout history.
Contents

Dedication . ......................................................................................................... ... v

Contributors............. ............ .... .... .... .................... ........ ....................... ........... .... ... ix
Introduction. ........ .... .... .... .... .... .... .... .... ............ .... .... .... .... .... ... .... .... .... .................. xi

Section I Theoretical Formulations

1 Hemispheric Asymmetry and REST
Thomas H. Budzynski. ........ ........ ............................................ ................ ... 2
2 Distress, No Stress, Anti-Stress, Eustress:
Where Does REST Fit In?
Peter Suedfeld. .... .... .... .... ................ .... .... .... .... ........ .... .... .... ..... ........... ....... 22
3 A Cybernetic Model of Restricted Environmental
Stimulation Effects
Michael Bross ............................................................................................ 31
4 The Common Therapeutic Elements and Procedural Components
in Self-Hypnosis and Other Stress Reduction Techniques
Ian Wickramasekera .................................................................................. 42
5 Body-Centered Therapies: A Holographic Paradigm for
Understanding REST
Terry Hunt ......... .... ........ ........ .... ............ ................ ..................... .... ........ ... 56

Section II Experimental Studies

6 Hormonal Changes Associated with Restricted
Environmental Stimulation Therapy
John W. Turner, Jr. and Thomas H. Fine ................................................... 71
7 The Presence or Absence of Light in the REST Experience:
Effects on Plasma Cortisol, Blood Pressure and Mood
Gina Ewy, Peter Sershon and Thomas Freundlich ................................... 93
8 Effects of Restricted Environmental Stimulation
on Inversion Perception
Mary Frances Miller and Marianne Barabasz .. ....... ................................ 105
9 Flotation REST and Information Processing:
A Reaction Time Study
Daniel S. O'Leary and Robert L Heilbronner.......................................... 113
10 The Effects of Flotation Restricted Environmental
Stimulation Therapy on Learning: Subjective Evaluation and
EEG Measurements
Thomas Taylor .......................................................................................... 125
11 Effects of Flotation REST on Simulated Instrument
Flight Performance
Lori G. Melchiori and Arreed F. Barabasz ............................................... 135
12 Enhancing Hypnotizability: Differential Effects of Flotation
REST and Progressive Muscle Relaxation
Glenn M. Kaplan and Arreed F. Barabasz ............................................... 143
13 Enhancing the Creativity of Psychologists Through Flotation REST
Janet Metcalfe and Peter Suedfeld ........................................................... 159

Section III Clinical Studies and Applications

14 Flotation for the Management of Rheumatoid Arthritis
Clifton Mereday, Craig Lehmann and Roderick A. Borrie ...................... 169
15 REST for Muscle Contraction Headaches: A Comparison of
Two REST Environments Combined with Progressive Muscle
Relaxation Training
Randy Rzewnicki, Alistair B.C. Wallbaum, Howard Steele and
Peter Suedfeld.......... ... ........ .... .... ......... ... ........ .... .... .... .... .... ........... .... ....... 174
16 Effects of Biobehavioral1y Assisted Relaxation Training on
Blood Pressure and Hormone Levels and Their Variation
in Normotensives and Essential Hypertensives
John W. Turner, Jr., Thomas H. Fine, Angele McGrady and
James T. Higgins ...................................................................................... 184
17 Replication of a Oinical Outcome Study on a Hospital-BaSed
Stress Management and Behavioral Medicine Program Utilizing
Flotation REST and Biofeedback
Gilbert M. Koula, John C. Kemp, Keith M. Keane and
Allan D. Belden ....................................................................................... 202
18 Flotation Effect on Premenstrual Syndrome
Deborah D. Goldstein and Walter E. Jessen ........................................... 210
viii
Contributors

Arreed F. Barabasz, Department of Counseling Psychology, Washington State

University, Pullman, Washington 99164-2131, USA

Marianne Barabasz, Department of Counseling Psychology, Washington State

University, Pullman, Washington 99164-2131, USA

Allan D. Belden, Saint Elizabeth Hospital, Appleton, Wisconsin 54915, USA

Roderick A. Borrie, Sensorium REST Laboratory, State University of New York,

Stony Brook, New York 11794, USA

Michael Bross, Department of Psychology, Concordia University, Montreal, PO,

Canada

Thomas H. Budzynski, Saint Luke Medical Center, Bellevue, Washington 98004,

USA

Gina Ewy, Medical College of Ohio, Toledo, Ohio 43699, USA

Thomas H. Fine, Department of PSYChiatry, Medical College of Ohio, C.S. 10008,

Toledo, Ohio 43699, USA

Thomas Freundlich, Medical College of Ohio, Toledo, Ohio 43699, USA

Deborah D. Goldstein, Regeneration Institute, Los Gatos, California, USA

Robert L. Heilbronner, Department of Clinical Neuropsychology, HCA

Presbyterian Hospital, Oklahoma City, Oklahoma 73104, USA

James T. Higgins, Medical College of Ohio, Toledo, Ohio 43699, USA

Terry Hunt, Aqua Retreat Center, Brighton, Massachusetts, USA

Walter E. Jessen, Regeneration Institute, Los Gatos, California, USA

Glenn M. Kaplan, Woodland Park, Colorado 80866, USA

Keith M. Keane, Saint Elizabeth Hospital, Appleton, Wisconsin 54915, USA

John C. Kemp, Saint Elizabeth Hospital, Appleton, Wisconsin 54915, USA

Gilbert M. Koula, Saint Elizabeth Hospital, Appleton, Wisconsin 54915, USA

Craig Lehmann, Department of Medical Technology, State University of New

York, Stony Brook, New York 11794, USA

Angele McGrady, Department of Physiology, Medical College of Ohio,

C.S. 10008, Toledo, Ohio 43699, USA

Lori G. Melchiori, Olympia, Washington 98502, USA

Clifton Mereday, Department of Physical Therapy, State University of New York,

Stony Brook, New York 11794, USA

Janet Metcalfe, Department of Psychology, University of California at San Diego,

San Diego, California 92093, USA

Mary Frances Miller, Cheney, Washington 98004, USA

Daniel S. O'Leary, University of Health Sciences, The Chicago Medical School,

Chicago, Illinois, USA

Randy Rzewnicki, Department of Psychology, University of Vermont,

Burlington, Vermont 05405-0134, USA

Peter Sershon, Medical College of Ohio, Toledo, Ohio 43699, USA

Howard Steele, Department of Psychology, University College London,

London WC 1, United Kingdom

Peter Suedfeld, Department of Psychology, University of British Columbia,

Vancouver, BC V6T 1Y7, Canada

Thomas Taylor, Department of Chemistry, Texas A & M University, College Sta-

tion, Texas, USA

John W. Turner, Jr., Department of Physiology, Medical College of Ohio,

C.S 10008, Toledo, Ohio 43699, USA

Alistair B.C. Wallbaum, Department of Psychology, University of British Colum-

bia, Vancouver, BC V6T 1Y7, Canada

Ian Wickramasekera, Department of Psychiatry and Behavioral Sciences,

Eastern Virginia Medical School, Norfolk, Virginia 23501, USA
x
Introduction

A Brief History of REST and IRIS

The Restri cted Envi ronmental St i mul at ion Techni que or Therapy; in
either case, REST is a descendant of perceptual isolation, an experimental
method developed in the 1950's to study how human beings are affected by a
drastic reduction in aspects of stimulation from the environment. In the
original research, the factors being manipulated were variety and
meaningfulness: the subject lay on a bed, with translucent goggles, gloves,
and constant white noise. Thus, the absolute level of stimulation was not
dramatically changed from normal, but most of it was homogeneous,
unchanging, and meaningless.
Later versions of the procedure, then better known as sensory
deprivation, involved a reduction in the absolute level of stimulation, by
having the subject lying on a bed in a completely dark, soundproof chamber.
Some variants also restricted movement by confining the subject in an iron
lung or a small box-like structure. In still others, participants were
submerged in a tank of water, using a diving helmet or other breathing
apparatus. The helmet and the surrounding water blocked incoming light and
sound.
The reported results of these experiences were dramatic, generally
negative, and - to jump ahead of the story a little - ultimately unreliable.
Much of the evidence about aversive emotional reactions and disruptions of
normal psychological processes was contradicted when experimental artifacts
were el iminated, and many of the most widely publ icized phenomena turned
out to be extremely rare, obtained only under idiosyncratic conditions, or
completely unrepl icable (see, e.g., Solomon et al., 1960; Suedfeld, 1980;
Suedfeld & Coren, 1989; Zubek, 1969).
Some forty years after the introduction of the technique, both the
experimental methods and the foci of interest have changed. The mental set
for subjects in the early years of this research was one of aberration and
endurance. The methodology used now i nvo 1ves st i mul us reduct i on under
conditions of reassurance and comfort, either for prolonged periods (24 hrs.
or more) in a soundproof chamber or shorter lengths of time (1-2 hrs.) in a
specifically-designed flotation tank. Very few participants exhibit stress

xi
symptoms, strong negative emotions, hallucinations, or disruptions of
cognitive or motor abilities.
The flotation tank was invented by John C. Lilly (e.g., 1977), a
neurophysiologist who had worked with immersion since the 1950's. Subjects
in immersion experienced the stressful ness of being completely submerged in
water (being dependent on an air hose and pump for breathing, having to wear
diving apparatus on the head and face). In contrast, a person in the
flotation tank floats supinely in a skin-temperature aqueous solution of
saturated Epsom salts, which supports the body (in much the same way as the
Dead Sea and the Great Salt Lake) so that the face and chest are above the
surface and breathing can proceed normally.
Flotation REST is a relative newcomer to the repertoire of stimulus-
reducing environments (see Fig. 1). However, its dramatic ability to induce
deep relaxation, both physiologically and psychologically, has made it an

Fig. 1. Restricted stimulation environments: Taxonomy

NATURAL
(Polar regions,
deserts) EXPERIMENTAL
(Submarines, mines,
spacecraft, solitary
confi nement, i ntensi ve
care units, etc.)

}---.L----{]OQ:TBHIE~R (e.g. group

reclining chair, etc.)

xii
instant focus of attention. It was immediately reported to be extremely
pleasant, conducive to enjoyable alterations in the state of consciousness,
and useful as a tool in therapy and in performance enhancement of various
kinds. In the past ten years, commercial tank facilities have sprung up
worldwide, allowing the publ ic to explore the flotation REST experience.
While its popularity has helped in some ways to correct the erroneous image
of REST as stressful and bizarre, an overly zealous portrayal of REST as a
cure-all by some individuals has probably hindered its acceptance in
clinical therapeutics.
To bring together the growing community of researchers and therapists
who are interested in the technique, the International REST Investigators'
Society (IRIS) was formed in 1983. As of 1989, IRIS has held three
international conferences on REST, besides publishing a bulletin and
fostering the presentation of REST-related research in other conferences and
journals.
To date there has been relatively little controlled, systematic
research on the effects of flotation REST other than on psychophysiological
and emotional (mood) responses. For example, most of the scientific
experimentation on such topics as the effects of REST on thinking, memory,
motor skills, perception, and attitude change - areas that constitute the
salient components of psychological research - has been conducted in
chamber, rather than flotation, REST. Nor has the question of whether the
two techniques have equivalent effects been explored. We speculate that
flotation REST may have a greater impact on the autonomic nervous system and
that chamber REST may have greater impact on the central nervous system. In
therapeutic application, flotation REST may be more effective on conditions
that do not involve voluntary behavior (chronic pain, hypertension, stress
dysfunctions), and chamber REST may be better for treating vol itional
problems such as substance abuse. Because of the relative newness of
flotation, and the scarcity of rigorous research, the major review volumes
have said little about the flotation REST tank version of the REST
techn i que. As i de from the Proceed i ngs of the I RIS conference (Fi ne &
Turner, 1985; Turner &Fine, 1987, 1989), books discussing flotation and its
effects have been in the popular, not the scientific, genre: Lilly (1972,
1977), Smith (1975), Hutchinson (1984).

xiii
Origin and Contents of the Papers
The papers in this collection were chosen from those presented at the
first three international conferences on REST. The selection was made by
Peter Suedfeld, the first President of IRIS,and John W. Turner, Jr. and
Thomas H. Fine, early researchers in flotation REST, who contributed to all
of the conferences and served as editors of thei r Proceedi ngs. The
conference programs themselves ranged qu ite wi de ly across envi ronments
characterized by stimulus restriction - including not only papers describing
work with flotation and chamber REST, but also studies of solitary
confinement and polar living. For this book, however, we selected
contributions that explored the implications and effects primarily of
flotation. We feel this to be important because the REST tank is so widely
known and used, yet so little studied.
It shoul d be noted that - with a few exceptions - the papers are
reproduced as they were presented. Several have since been publ ished
elsewhere, in revised versions, but these original texts give a good
perspective on what was known and thought about flotation REST at a
particular time in the recent history of the technique.
The papers are divided into categories, although some of them do not
fit comfortably into anyone. Nevertheless, for the sake of coherence, the
three major areas with which REST researchers have concerned themselves are
separated. Within each category, the order of papers is roughly from those
dealing with the most basic, usually biological or psychobiological,
processes through increasing levels of complexity in sensation, perception,
affect, and cognition (and interactions among them). In each of these
again, we move from simpler to more complex issues; for example, from
learning to creativity within the general framework of cognitive processes.
The fi rst, and probably most important, major category is that of
theoretical formulations. Although the field was based on Donald O. Hebb's
des ire to test some of his theori es of "the conceptual nervous system"
(Hebb, 1955), much of the subsequent research has been atheoretical. More
recently, diverse explanations have been proposed for REST effects.
Unfortunately, each has tended to focus on only a segment of the findings
and most have ignored the crucial issue of putting REST in the context of
other environments. Many are not obviously testable, and even those that
are have seldom been tested empirically - much less tested against each
other (Suedfeld, 1980).

xiv
 Some of the theoretical explications included in this book can
contribute significantly to the progress of theory-driven research in REST.
The lead paper by Thomas H. Budzynski, presents a theory that ties REST into
a wi de range of neuropsycho log i ca 1 and neurophys i 01 og i ca 1 phenomena. It
also explains many of the known effects of REST, including the most reliable
ones, such as its positive impact on memory and its effectiveness in
facilitating habit modification.
A more cognitive/affective perspective is presented in the paper by
Suedfeld. It reviews sequential changes in how REST has been thought to fit
into the context of the stress concept. Beginning as a technique for
inducing stress, later studies showed - and several papers strongly argued -
that it is in fact not stressful. Later still, it was proposed as a
treatment for stress. The paper concludes by suggesting that REST actually
provides the experience of eustress (positive stress or challenge).
Experiments deal ing with arousal consequences of challenge, and assessing
techniques for coping with it, could test the validity of this view.
Bross' cybernetic model connects the sensory/perceptual aspects of REST
to general systems theory. The control loops which in this theory determine
how sensory signals are processed in the brain can hypothetically generate
sensitivity curves (which fit the empirical curves for threshold changes in
REST). On a more complex level, the theory also explains information
motivation, perceptual adaptation, and cognitive changes. Not only are
aspects of the theory testable; Bross actually describes some highly
feasible experiments to test it.
Moving toward more hol istic theories, Wickramasekera outl ines the
common ground among a number of stress-management techniques including REST.
Although his emphasis is on self-hypnosis, it is clear that stimulus
reduct ion is one component of most of the procedures. The presentat ion
raises a number of interesting questions, one of the most germane being the
degree to which REST may be necessary and/or sufficient to reach the maximal
potency of such treatments. Another is whether REST induces a hypnoid
state, which in turn mediates some of its other effects.
The 1ast of the theoret i cal presentat ions is Terry Hunt's "holograph i c"
paradigm. This is perhaps the least obviously testable of the group, and
its integration of REST into a range of body centered therapies has made
some of the more orthodox experimental scientists in IRIS somewhat
uncomfortable. Nevertheless, the hologram is an interesting metaphor,

xv
applied to general brain functioning by Karl Pribram. While the empirical
validity of metaphors is at best difficult to substantiate, they can lead to
novel conceptualizations of the phenomenon that in turn may be verifiable by
data.
The second section deals with experimental findings. The first paper,
by Turner and Fine, is a classic assessment of the effects of REST on the
secretion of a number of hormones related to stress and relaxation. It also
opens a new perspective, that some of the emotional consequences of REST may
be mediated by the secretion of endogenous opioids. Both of these sets of
data have important implications for the applications and theories of REST.
The paper by Ewy, Sershon, and Freundlich addresses the old issue of
disaggregating the various components of REST. In this case, they floated
subjects either in darkness or in 1 ight, and compared the physiological
(cortisol and blood pressure) and mood states of the subjects in the two
conditions. This study, which won the John P. Zubek Memorial Award in 1987,
tests the validity of one of the most pervasive assumptions about flotation
REST, that stimulus reduction in the normally most important modality -
vision - is a crucial component. In addressing this fundamental question,
it is a model of the kind of parametric research needed to establish the
facts about REST.
The other six papers in this section address different aspects of the
influence of flotation on perceptual/motor/cognitive performance. Miller
and M. Barabasz study a perceptual measure of regressed functioning; O'Leary
and Heilbronner measure reaction time (along with basic psychophysiological
processes and mood); Taylor looks at learning (and EEG); Melchiori and A.
Barabasz measure a complex psychomotor and cognitive task performance in
simulated instrument flight; Kaplan and A. Barabasz look at the effects of
flotation on hypnotizability, and report that it seems to be about the same
as the effect of progressive muscle relaxation, and less potent than chamber
REST - an important finding for the question of differential outcomes of the
two major REST procedures; and Metcalfe and Suedfeld provide prel iminary
evidence that flotation may have a positive effect on high-level creative
thinking.
The last section deals with clinical research. Because of the widely
publicized ability of flotation to induce relaxation, a relatively large
number of papers in the field deal with this kind of application. Most of
them, however, are best thought of as rudimentary pilot studies. They

xvi
report on one or two cases, with no control s of any sort, and sometimes
without very credi b1e outcome measures. The papers we have selected for
this collection are at least one step beyond such demonstrations: group
sizes are reasonable, there are comparative data from other treatments,
and/or the measures are quantified.
There are two major therapeutic areas omitted in this section. Chamber
REST has been demonstrably effective in habit modification, with many
controlled studies of such applications as smoking cessation and reduction
of alcohol intake. However, the only publ ished attempts to use the
flotation tank for this purpose have reported failure (again implying direct
relations between techniques and outcomes, and contradicting hypotheses that
REST effects are due merely to expectancy). The other omission is the use
of REST in traditional psychotherapy, where it has been said to improve
rapport, decrease defensiveness,and encourage a freer flow of information
from the client. However, no formal studies have verified these clinical
reports.
The papers included in the clinical section cover the management of
rheumatoid arthritis (Mereday, Lehmann, & Borrie), tension headache
(Rzewnicki et al.), high blood pressure (Turner et al.), general stress
symptomatology (Koula et al.), and premenstrual syndrome (Goldstein &
Jessen). Flotation REST appears to be effective in all of these contexts,
although its power and cost-effect i veness re 1at i ve to more wi de 1y used
treatments is less clear. Further research is needed to identify the
problems and patients who benefit maximally from REST, to develop parametric
studies of the clinical REST effect (e.g., "dose"/response relations), and
to examine the possibility - fairly well established in the use of chamber
REST as a smoking intervention - that REST may potentiate the effectiveness
of other treatment techniques.
As a careful reading of the entire collection will make clear, further
research is a crucial need in all three of the categories covered here. Now
that testable theories are being advanced, the tests should be conducted.
We anticipate that explanations of REST effects can be made validly at a
number of levels, from the neurological to the psychosocial: after all,
human beings are entities that operate on all of these levels, and the
substrates of their behavior are multi-level as well. Thus, adequate
theories can be physiological, biochemical, cognitive, affective, or social;
the goal is to identify the most adequate theory (or theories) at each of

XVII
these levels, and to make sure that they are consistent with each other.
Similarly, much experimental work is needed to establish the reliable
effects of fl otat i on on phenomena at all of the 1eve 1s ment i oned in the
previous paragraph. Both her and in clinical investigations, an improvement
in research design and methodology is particularly important. Adequate
numbers of subjects, control groups, elimination of artifacts, appropriate
statistical analyses - all of these must become axiomatic. The fact that
they are not so now reflects the newness of flotation REST as a research
tool, and the eagerness of its users to collect information quickly. As
workers in the area concentrate increasingly on establ ishing a sol id and
rep 1 i cab 1e data base, REST wi 11 fo 11 ow the route of most other novel
research areas, from daring exploration to systematic mapping. We hope that
this volume, and the continuing series of IRIS conferences and conference
publications, will be signposts along that route which will mark points of
accomplishment and encourage our colleagues to move onward.

REFERENCES
Fine, T.H. &Turner J.W. Jr. (Eds.) First International Conference on REST
and Self-Regulation: Proceedings. Toledo, OH: IRIS Publ., 1985, 219
pp.
Hebb, D.O. (1955). Drives and the CNS (conceptual nervous system).
Psychological Review, 1955, 62, 243-254.
Hutchinson, M. The Book of Floating. New York, NY: Morrow, 1984.
Lilly, J.C. The Center of the Cyclone. New York, NY: Julian, 1972.
Lilly, J.C. The Deep Self. New York, NY: Simon &Schuster, 1977.
Smith A. Powers of Mind. New York, NY: Random House, 1975.
Solomon, P., Kubzansky, P.E., Leiderman, P.H., Mendelson, J., & Wexler, D.
(Eds.) Sensory Deprivation. Cambridge, MA: Harvard Univ. Press.,
1961.
Suedfeld, P. Restricted Environmental Stimulation: Research and Clinical
Applications. New York, NY: Wiley, 1980.
Suedfeld, P. & Coren, S. Perceptual isolation, sensory deprivation, and
REST: Moving introductory psychology tests out of the 1950's.
Canadian Psychology, 1989, 30, 17-29.
Turner, J.W. Jr. & Fine, T.H. (Eds.) Second International Conference on
REST: Proceedings. Toledo, OH: IRIS, 1987, pp. 201.

xviii
Turner, J.W. Jr. & Fine, T.H. (Eds.) Restricted Environmental Stimulation:
Research and Commentary. Toledo, OH: Medical College of Ohio Press,
1990, in press, 273 pp.
Zubek, J.P. (Ed.) Sensory Deprivation: Fifteen Years of Research. New
York, NY: Appleton-Century-Crofts, 1969.

xix
Section I
Theoretical Formulations
1
Hemispheric Asymmetry and REST

Thomas H. Budzynski

Restricted Environmental Stimulation Technique (REST) has been found

to be somewhat difficult to classify in terms of anyone theoretical model
(Suedfeld, 1980). Yet the usefulness of a given procedure is enhanced by
its inclusion within the context of a model that fairly well describes the
phenomenon. In the last 15 or so years a model of the brain based in part
on the work of Roger Sperry and his associates has evolved to the point
where one might attempt to apply it to REST.
The Dynamic Hemispheric Asymmetry Model
The early studies of split-brain patients by the Sperry group at Cal
Tech showed that the nondominant (ND) cerebral cortical hemisphere possessed
functions significantly different than the dominant (D) side (Sperry, 1969).
These startling observations captured the imagination of scientists and lay
public alike. The left/right or hemispheric asymmetry model seemingly was
applied to every aspect of life by educators, social scientists,
psychologists, religious leaders, and salespeople, to mention but a few.
This widespread uncritical adoption of the "model" angered certain of the
scientific community who do not enjoy such creative leaps by laymen. The
scientists realized of course that the available data were not so
unambiguous as to permit these generalizations.
Perhaps too, there was some fear that the enthusiastic lay
pronouncements actually might prove to be reasonably accurate. In any case,
a great deal of peer di sapprova1 was 1evi ed at those sci ent i sts who
supported the left/right brain model. It is the writer's personal
impression however, that the basic model, with a few modifications, is of
considerable utility in general, and specifically with regard to the
phenomenon of REST.
Cortical Hemispheric Functional Differences
In the 70's there were many lists of D and ND hemisphere functional
characteristics based on the split-brain research. Table 1 is a partial
listing of the D and ND functions. It is presented here to emphasize the
surprising differences that have been uncovered. Perhaps, as some
researchers suggest, such a dichotomy, or degree of lateralization,
2
 Table 1
Cortical Hemispheric Functions

DOMINANT NONDOMINANT

Speech Voice intonation contours

Language comprehension Language comprehension
(Abstract/Concrete) (Concrete Only)
Words Images
Logic Intuit ion
Less emotional expression More emotional expression
Right side skeletal muscles Left side skeletal muscles
Time sense (past, present, future) Present oriented
Sequential Parallel
Deta il ori ented Gestalt (whole) oriented
Temporal Spatial
Rhythm Melody, pitch
Math, e.g., algebra Spatial aspects of math,
e.g., geometry
Convergent Divergent
Evolutionarily recent Evolutionarily older
Discrete Continuous
Objective Subjective
Focal Diffuse
Directed, plodding Spontaneous, creative
Secondary process Primary process
Narrow arousal level range Wide arousal level range
Known stimuli Novel, degraded stimuli
Verbal communication Nonverbal communication
Facts Faith
Facial recognition
Humor
PSI
NDE or OBE experiences
Conscious (primarily) Unconscious (primarily)

3
represents only the extreme found in the human speci es. However, the
backlash of "damnation by ambiguity", or "we just don't know enough yet",
should not preclude the offering of a brain model based on these
differences.
A very recent review by Joseph (1988) in fact, focused on the
difference in funct i on between 0 and NO hemi spheres. Th is revi ew is
authored by a clinician who maintains a private practice in neurobehavioral-
neuropsychological assessment. One might tend to believe that the view from
the trenches is reasonably accurate.
Joseph noted that the right or NO hemisphere appears to be dominant in
the perception and identification of environmental and nonverbal sounds; the
analysis of geometric and visual space; somesthesis; stereognosis; the
maintenance of body image; the production of dreams during REM sleep; the
perception of most aspects of musical stimuli; and the comprehension and
expression of prosopic, melodic, visual, facial, and verbal emotion. He
concluded that, " . . . it also appears that the right hemisphere maintains
a highly developed social-emotional mental system and can independently
perceive, recall, and act on certain memories and experiences without the
aid or active reflection of the left. This leads to situations in which the
right and left halves of the brain sometimes act in an uncooperative
fashion, which given rises to inter-manual and intrapsychic conflict" (1988,
p. 630).
We can now sample some other of the contemporary thinking on this
subject, such as, for example, that of the noted brain researcher Efram
Zaidel who notes that, ". . a surprising amount of cl inical data
demonstrates modularity in the cognitive-cerebral system, both functional
and structural. Hemi spheri c speci ali zat ion probably represents the most
general modular system in the brain. The LH and RH have sharp anatomical
boundaries and some apparently sharp functional demarcations as well" (1985,
p. 54).
Zaidel concludes by stating, "The anatomical connectionist models of
laterality effects in the normal brain are oversimplified, but heuristically
useful and theoretically illuminating" (1985, p. 60).
The language was a little stronger in 1974 when Nobel Laureate Sir John
Eccles boldly stated that the minor hemisphere could be regarded as, " .. a
very superior animal brain. It displays intelligent reactions and primitive
learning responses and it has a great many skills, particularly in the

4
spatial and auditory domains, but it gives no conscious experience to the
subject. Moreover, there is no evidence that this brain has some residual
consciousness of its own" (1974, p. 92).
Evidence for the Unconscious in the DHA Brain Model
The idea that the brain functions with both conscious and unconscious
processing appears to be making a comeback after being banished for almost
50 years by behaviorism. Notable quotes by two influential psychologists
illustrate this impression: First, Bryan Welch, chair of the APA Board of
Professional Affairs, "I think that the psychodynamic approach and
psychoanalysis will experience a resurgence" (1986, p. 5). Moreover, A.
Eugene Shapiro, a former member of the APA Board of Directors, stated, "I
think we are going to move back to more psychodynamic therapy. Behavioral
modification will always have a role, but it doesn't answer all the
problems" (1986, p. 5).
Another indicator of a changing attitude toward brain functioning in
general and the unconscious in particular is the fascinating book edited by
Bowers and Mei chenbaum ent it 1ed, The Unconsc i ous Recons i dered (1984) in
wh i ch the case for unconsc i ous process i ng is buttressed by, among other
phenomena, subliminal perception.
The dynamic hemispheric asymmetry (DHA) model, as it is defined here,
impl ies an unconscious factor which may operate on speeded and reversed
speech, speech absorpt ion duri ng general anesthes i a, and sub 1i mi na 1 or
preconscious process. It is suggested that the primary processor for these
phenomena is the ND hemisphere.
Implications from Split-Brain Research
The research of psychol ogi st Roger Sperry along with neurosurgeon
Joseph Bogen produced the most complete body of work ever on the functional
characteristics of both cerebral cortical hemispheres. Many other
scientists came along to continue the intriguing series of studies. One of
them, David Gal in, in an article entitled, "Impl ications for Psychiatry of
Left and Right Cerebral Specialization: A Neurophysiological Context for
Unconscious Process", looked at the hypothesis that the ND hemisphere was
indeed the site of the unconsc i ous as Freud descri bed it (1974). Hi s
provocative effort helped ignite a renewed interest in psychodynamic process
in the human brain.
Galin noted that certain aspects of right hemisphere functioning are
congruent with the mode of cognition psychoanalysts have termed primary

5
process, the form of thought that Freud originally called the unconscious:
1) The ND hemisphere primarily uses a nonverbal mode of
representation, presumably images: visual, tactile, kinesthetic,
as well as auditory.
2) The ND brain reasons by a nonlinear mode of association rather
than by syllogistic logic. Its solutions to problems are based
on multiple converging determinants rather than a single causal
chain. It is much superior to the D hemisphere in part-whole
relations (i.e., grasping the concept of the whole from just a
part).
3) The ND hemisphere is less involved with perception of time and
sequence than the D side.
4) Although it does possess vocabulary, words are not organized for
use in propositions. For example, a patient without a D
hemisphere may be able to sing a song but cannot use the same
words in a sentence.
5) Lesions affecting the D hemisphere result in problems of
emotionality and impulse control, an observation that supports
the i nterpretat i on that the D brain is important to normal
impulse control. Hall, Hall, and Lavoie (1968) suggested that
the D hemi sphere performs the role of censor in personal i ty,
controlling and inhibiting the more loosely structured ideation
of the ND side of the brain.
6) The ND hemisphere is more involved than the D in the mediation
of emotion. As Tucker (1981) noted in his extensive review:
"The importance of emotion of the right hemisphere's cognitive
functions suggests the possibility that the right cortical
regi ons may be part i cul arl y well connected with subcort i ca 1
process" (p. 22).
7) Ga 1ina 1so not iced the compe 11 i ng s i mil arity between certa i n
dissociative phenomena seen in the spl it-brain patients and
Freud's early model of the mind in which repressed mental
contents functioned in a separate realm that was inaccessible to
conscious recall or verbal interrogation, "functioning according
to its own rules, developing and pursuing its own goals,
affecting the viscera and insinuating itself in the stream of
ongoing behavior" (p. 574).

6
 8) Finally, Gal in felt that the two hemispheres might develop
conflicting programs under certain circumstances. In this event
the D hemisphere would probably inhibit the carrying out of the
ND brain's plan. Potential for conflict lies in the fact that
the D hemisphere uses syllogistic logic to solve problems,
whereas the ND side relies more on emotional programming as it
processes faci a1 express ion, body posture, gesture, tone of
voice, and past history of emotional experiences in arriving at
solutions.
Is Inter-Hemispheric Conflict Possible in the Intact Brain?
Because the D hemisphere is a different sort of computer than the ND
and because each operates on slightly different aspects of the incoming and
stored data, there exists the possibility that in a given situation the two
brains could arrive at two very diverse programs of action. The
neurosurgeon Joseph Bogen suggested that the possession of two independent
problem-solving organs increased the chance of a successful solution to a
novel situation, but it had the hazard of conflict in the event of different
solutions (Bogen and Bogen, 1969).
Researchers Dimond and Beaumont (1974) believe that each hemisphere is
an information processing system that works its own idiosyncratic way
through the information it receives. At this stage, no facility appears to
exist for passing unanalyzed information across to the opposite hemisphere.
Each therefore, appears to act independently of the other. The process of
integrating the products of the work of each hemisphere presumably occurs at
a late stage following the completion of visual analysis.
Michael Gazzaniga, who worked with Sperry in the investigation of the
first split-brain patients, feels that conflicts develop because our brains
are organized in terms of independent modules, each capable of carrying out
activities that test and re-test the beliefs that are maintained by our D
bra in's 1anguage and cognit i ve systems. The confl i ct is produced by a
mental module eliciting a behavior which conflicts with the behavioral
tendency of the D brain. Such a module can function independently from the
dominant, language-based system of the D half-brain (1985).
Gazzaniga also believes that the ND hemisphere is able to set-up the
D side and it does so in a way that leaves the D brain unconscious of the
process. Thus, the ND hemisphere at times carries out its program without
the knowledge of the more conscious brain.

7
 David Loye (1983) imagines a higher, governing intelligence constantly
examining the left and right brain "video screens". Agreement between
screens means that the information on the screens probably is accurate with
regard to what is happening "out there" and the muscles and organs act
accordingly. However, if the screens do not agree, there is no consensus on
the nature of what's there, the higher intelligence activates warning
signals and the organism backs away. Obviously, a non-match produces an
unpleasant state of the organism.
Cortical Arousal Level Effects
Cortical arousal level is sometimes thought of as the level of
activation or cortical excitation. It is signified electrically by changes
in frequency of the cortical electroencephalogram (EEG). High arousal is
signified by beta frequencies (14 Hz or higher) which are low amplitude
signals. As arousal decreases to a relaxed yet alert level the frequency
decreases to the alpha range (8-13 Hz) characterized by high amplitude,
sinusoidal waves. Still lower arousal levels, actually stage 1 sleep,
called the theta range, are characterized by 4-7 Hz waves smaller and less
sinusoidal than the alpha waves. A slightly lower arousal level, stage 2
sleep, produces theta frequencies mixed with sudden bursts of spindles or K
complexes. Finally, there are the delta waves (1-3 Hz) of stages 3 and 4 of
deeper sleep. Thus, as cortical arousal level changes from very alert,
focused-attention beta to deep sleep delta, the EEG changes accordingly in
both frequency and amplitude.
One might wonder if the two cortical hemispheres change together,
lockstep, or can they independently vary arousal level? Levy (1980)
explains that a structure called the massa intermedia is involved in the
regul at i on of the hemi spheri c arousal 1eve 1s. In 1ower animal s the massa
intermedia is relatively large while in man it is small and even nonexistent
in a substantial minority of the population, strongly suggesting that the
agenes is of the structure is a recent evo 1ut i onary adaptation to the
asymmetric brain of man. This agenesis, according to Levy, is more frequent
in males than females. A smaller massa intermedia allows a greater
variation in interhemispheric arousal level in males, which would allow a
given hemisphere to be activated more than the other for a given task. One
might think of it as a fine tuning of arousal or activation so that those
hemispheric functions best suited to a given task are activated while other,
not relevant, functions are inhibited by a lower activation.

8
 Ruben and Raquel Gur (1980) reviewed the area of cortical activation
and noted that small changes in the re 1at i ve alpha ampl itudes of the
left/right EEGs signalled hemispheric shifts in activation. Specifically,
a spatial task produces a decrease in ND alpha amplitude relative to the D
level of the alpha. The reverse is true for verbal tasks. A decrease in
the alpha ampl itude usually means that a shift toward more of the high
frequency, low ampl i tude beta signal is occurri ng and, therefore, th is
hemisphere is becoming more aroused. This type of measure has been used in
many studies because it does illustrate the change of hemispheric activation
with task. Similarly, the measurement of increasing blood flow documents
the areas of the brain being activated by the task at hand.
Functional Effects of a Changing Cortical Arousal Level
How does the brain funct i on as its arousal or act i vat i on 1eve 1 is
increased or decreased? Most people take it for granted that as we get
sleepy our brain slows down and stops processing external stimuli, as in the
case of the student who falls asleep in class. They probably also believe
that at very high excitement times the brain doesn't process stimuli very
accurately, as might be the case with this same student paralyzed with fear
on the final exam. Researchers have pondered these same questions and yet
their answers were essentially the same as the layman's until the split-
brain studies allowed a more precise determination of D and ND differences
with regard to changing arousal level.
Dimond and Beaumont (1974), following Sperry's lead with the spl it-
brain patients, examined separate hemispheric functioning in the paradigm of
a series of vigilance tasks. They found a way to assess the performance of
the D and the ND brains during long, boring vigilance experiments. Here is
what they concluded: "The left (hemisphere) is capable of sustaining high
levels of performance, but as intense activity to detect small and
infrequent signals from the environment is particularly demanding,
performance cannot be consistently maintained, and hence, decline sets in.
The ri ght hemi sphere however, whi 1e apparently not capable of such hi gh
levels of performance, unless sustained by the left, maintains its
performance steadily, beyond the point at which the performance of the left
hemisphere has deteriorated seriously. The right hemisphere appears
therefore to provide a skeleton service in vigilance, a minimum service
capab 1e of ma i nta i ni ng performance after decrement occurs in the 1eft
hemisphere" (p. 69).

9
 Together, anecdotal and scientific data support the hypothesis that,
when compared to the NO, the 0 hemisphere has a smaller arousal level range
over whi ch it can function normally. Furthermore, when cort i cal arousal
goes outside this range either on the high end or the low, the 0 brain loses
its abil ity to maintain critical defenses and to logical screen incoming
information. At these extremes, although eventually limited, the NO
hemisphere can still function in typical fashion. Because of the functional
abdication of the 0 brain, the NO side apparently assumes dominance by
default. As noted in Budzynski (1977), the general case seems to be that
any method that reduces or eliminates critical screening can permit access
to the NO processing. Altering cortical arousal level is one way of doing
this, but not the only one.
There is a relationship between cortical arousal level and relative
dominance change in 0 and NO hemispheres. Revival meetings, certain
primitive ceremonies, and extreme danger situations are examples of high
arousal incidents that can drive the left or 0 brain, out of its normal
funct i oni ng range and yet, the ri ght or NO hemi sphere, with its greater
range, can process the stimul i even though it does so with its 1imited
language comprehension (see Fig. 1.1).
Extreme danger can produce a highly suggestive state in some
individuals which explains why traumas, especially in childhood, are so
capable of affecting attitudes and behaviors throughout the rest of life.
Much of the new work with ACOAs (adult children of alcoholics) attempts to
bring to the surface and to integrate the troublesome memories.
At the other end of the stimulus continuum are a number of procedures
that incorporate or are associated with a decreased arousal.
Twilight learning involves the automated presentation of audio
information when the learner produces a theta (4-7 Hz) EEG pattern
signifying a hypnagogic, twil ight or stage 1 sleep. Since the audio
presentat i on of pos it i ve suggest ions is presented only when the user is
unconscious in stage 1 sleep, the conscription of conscious defenses does
not interfere with the absorption. Twilight learning has shown success with
a variety of difficult cases (Budzynski, 1972, 1976, 1977, 1979, 1986).
Subjective report data indicate that a hypnagogic state is often associated
with the REST experience.

10
 BRAIN A OUSAL A 0 ALTERED
STATES OF CONSCIOUSNESS
HIGH

!tIGHT

REVIVAL MEET' GS
PRIWTlVE
CEREMONIES
EXTREME DANGER

HYPNOSIS
1 ~.aIOf\"""" 1

••
••
TWIUOHT LEARNING
REVERIE
SLEEP LIEAANING

•
SENSORY ISOLATION
(HONDOMI ANT)

..L
lOW

The Modular Brain

Earlier it was stated in a quote from Zaidel (1985) that a surprising
amount of the data on brain function suggests that the D and ND hemispheres
represent the most general modular system in the brain. No doubt modularity
of both structure and function exists and is manifested in smaller units as
well. In his book Mu7timind, Robert Ornstein states that, "It is illusory
to think that a person has one mind, good or bad. There is no single mind
but many; we are a coalition, not a single person" (1986, p. 21).
Ornstein believes that the mind consists of many functional units as
it selects the various components for the task at hand. He notes however,

11
 that the separate mental components have been developed over millions of
years. They have different priorities and are often at cross purposes with
each other and the present-day, fast-paced lifestyle.
Some of Ornstein's modules are unconscious and act automatically. He
feels that we often do not know which of the "small minds" is operating at
any time. Moreover, we frequently select the wrong "small mind" at the
. right time. Different modules may compete for the role of mediating the
act i ng out of behav i or. Some, such as the modul e for tyi ng a shoelace,
receive little or no competition for carrying out a task. In other words,
more compl ex and ambiguous situations, as for exampl e on accidentally
meeting an attractive member of the opposite sex in a bookstore, there may
be real confusion and conflict as more than one model vies for the output
circuits. Does the suave, seductive module win out, or is it the shy,
retiring, don't-take-a-chance module that takes over?
Ornstein's model is obviously more complex than the sum of the
individual modules. He admits that his approach is not complete but merely
a new perspective. He is even willing to consider the research of Kenneth
Ring (1980) and others who have examined people who have clinically died and
been revived. The reported NOEs, or "near death experiences," constitute
new and controversial data which support the belief that the mind may retain
a consciousness after death.
Ornstein, however, sees the major problem that of gaining more
conscious control over the selecting of the modules because he bel ieves
there are too many occasions when the wrong modules are called out.
Selectivity unfortunately may be somewhat at the mercy of cortical arousal
level and state dependent learning. Even these factors, however, can to
some degree, be brought under conscious control. Thus, the Ornstein
Multimind model, though complex because of such a large number of modules,
does not take into consideration the effects of arousal level (in responding
to a given situation, a different module may be selected depending on
whether the individual is emotional and to what extent).
Gazzaniga's "Social Brain"
Other scientists have reacted to the criticism that the left/right
model is too simplistic. Gazzaniga (1985) has generated the "Social Brain",
which features functional modules as does Ornstein's model. The "Social
Brain" modules are vast in number and capable of carrying out sophisticated
mental work. Moreover, says Gazzaniga, "These activities can go on outside

12
the awareness of our verbal conscious system" (p. 28).
The consciousness in Gazzaniga's model resides in a relatively large
verbal module located in the dominant hemisphere. This module, which he
calls the "interpreter," immediately interprets the behavior and constructs
a theory as to the meaning of the behavior generated by the nonverbal
"coconscious" module. Gazzaniga feel s that the nonverbal, coconscious
modu1 es are the equi va 1ent of what is known by other sci ent i sts as the
unconscious. As stated in 1985, "One can quickly adapt Freud to the theory
of modules by changing his concept of 'unconscious process' into the idea I
present here of 'coconscious but nonverbal mental modules'" (p. 117).
The Social Brain in Conflict
Earlier there was a quote from Gazzaniga in which it was noted that
conflicts develop because the independent nonverbal modules are each capable
of carrying out programs that test and retest the beliefs that are being
ma i nta i ned by our D bra in's 1anguage and cognit i ve systems. Gazzani ga
agrees with Festinger's concept (1957) that the mind drives to reduce
dissonance when there is conflict. Most often it is the verbal interpretive
module that uses rationalization to reduce dissonance by bringing order and
consistency to its conscious, nonverbal mental modules.
Gazzaniga's model places the conscious "interpreter" in the left or D
brain. The remaining nonverbal coconscious modules are, by default,
primarily in the right or ND side although it is possible that some are in
the D brain. Si nce Gazzani ga agrees that these nonverbal modu1 es are
equivalent to Freud's unconscious, we can assume that the ND is primarily
the site of the unconscious brain, or, if one prefers, the nonverbal
coconscious.
Is the Dynamic Hemispheric Asymmetry (DHAl Model Modular?
The DHA model is not a modular model in the sense of The Social Brain
or Mu1timind. It is assumed, however, that memories are stored in the DHA
mode 1 and certain of the traumat i cones, at 1east, may remain in the
unconscious, reasonably intact by virtue of a defensive encapsulation
process. It is possible that those memories which are accessible to
consciousness and therefore not so encapsu1 ated, are changed somewhat by
subsequent experience.
It may be important at this point to note that the modular concepts
represent attempts by scientists to update the simpler two module left/right
brain model. A model, of course, is only useful if it can generate testable

13
hypotheses. Gazzaniga's model certainly allows more of this than Ornstein's
Multimind. However, the DHA model takes into account arousal level factors
which, at certain high and low extremes, reduce or eliminate the critical
screening functions associated with the D brain. The DHA model incorporates
as well defense mechanisms, selective inhibition, language comprehension in
the ND brain, and subthreshold influences such as subliminal processing.
Thus, the DHA model predicts that REST will produce a decreasing arousal, a
decrease in D funct i oni ng, and an increase in re 1at i ve ND domi nance.
Hypotheses could be generated from the general premise that many of the ND
functions in Table 1 should be enhanced by REST.
Does the DHA Model Fit the REST Experience?
According to Suedfeld (1980), participants in REST studies experience
such effects as a progressive slowing of alpha EEG which may persist up to
4 days, and an increase in power in the theta frequency range.
Persuasibility is generally increased by REST and Suedfeld has stated that,
"There is no doubt by now that REST increases the susceptibil ity of most
subjects to influence from external sources" (p. 64).
Another finding in the REST literature that does argue for the DHA
model is the increase in creativity (Suedfeld, Metcalfe, and Bluck, 1987;
see this volume). In this study, faculty members produced more creative
novel ideas after tank REST than after the same amount of time sitting alone
in their offices. A content analysis of verbal izations in the study of
Shore (1971) concluded that the REST environment promoted access to pre-
conscious material related to the development and modification of scientific
concepts.
Taylor (1985; see this volume), as referenced in Suedfeld et al.
(1987), compared fl otat i on REST with 1yi ng on a couch to enhance the
learning of material related to a chemistry program. The students learned
the material better in the REST condition, especially if they used visual
imagery. The writer's personal experi ence with 24 hour chamber REST
included a significant increased in imagery. It was as though the imaged
scene could be examined in detail from every angle. The re-scripting of
childhood negative memories should be greatly enhanced by REST.
The REST experience is said to be somewhat less than pleasant for
conceptually complex individuals (Suedfeld, 1964). The control of the D
hemisphere is gradually eroded, and they are faced with the rare experience
of the ND brain assuming a more dominant role without the use of drugs,

14
alcohol or fever. Such a relinquishing of control is probably unpleasant at
the very 1east, and perhaps even fri ghteni ng for certa i n i ndi vi dual s who
have heavily invested through education and profession in the cultivated
dominance of the verbal hemisphere and who like to stay in control in all
situations. One would imagine that these people, in the REST environment,
would try, not necessarily consciously but simply habitually, to maintain
their fine logical, analytical thought processing, thus resisting the ND
hemisphere takeover as arousal level decreases.
Does "REST" Enhance Unconscious Accessibility?
The DHA model includes the provision that certain traumatic memories
are encapsulated by defense mechanisms and kept in unconscious memory
stores. These traumatic scripts, although not accessible to consciousness,
continue to plague the individual throughout life nonetheless. Dynamic
therapy attempts to recover these negative scripts and bring them into the
light of full, mature, adult comprehension so that an integration can take
place. The problem is the accessing of the traumas since they are protected
so well by unconscious forces.
It should be stated that the definition of a traumatic event is rather
broadly drawn. Such an event may be relatively innocuous in the objective
sense, but to a child it is horrendous. In adults, the absorption of
information during ND dominant states can result in the encapsulation of a
negative script. A case in point was a patient who suffered from a painful
stinging sensation in her forearms. The problem was traced to an occasion
when, in the hospital in a semi-conscious state after a fall from a horse,
a nurse was inserting an IV in the patient's arm and a visitor remarked,
"Gee, that must sting!". The ND brain, dominant that instant, apparently
absorbed the remark as a script to be carried out and did so. Re-scripting
under hypnos is cons i sted of havi ng the pat i ent re 1i ve the scene but the
addition of an authority figure, a white-coated older physician who said in
reply, "Oh it just stings for a second or two, and then it feels good as
new". The patient awoke with the sensation gone and a six month follow-up
indicated that it has not returned.
"Unfreezing" and Shifting Dominance
Hypnosis was used in the above case to access the repressed negative
script. Not every patient with this sort of problem can be or wants to be
hypnotized. Classical psychoanalysis, suggested as the therapy of choice by
Goleman (1985) based on the new dynamic model of the brain, accesses the

15
unconscious without changing arousal level or other state of consciousness.
It has the distinct disadvantage, however, of requiring a good deal of time
and expense. The therapist listens carefully for unconscious indications
that "leak through" to consciousness. A fully intact set of defense
mechanisms guard against the revelation of the unconscious material. How
much sooner could the work of therapy get down if these defenses could be
surmounted? The REST environment does appear to "unfreeze" attitudes
(Suedfeld, 1982) and lower defenses. Antista and Jones (1975) found that
university students undergoing as 1ittle as 45 minutes of REST showed a
significant reduction in the discrepancy between perception of their actual
selves and ideal selves. REST may facilitate the bringing to consciousness
of unconscious wishes, scripts, and feelings which can then be integrated
with conscious processing after REST, resulting in a decreased discrepancy
between selves.
Access to Early Memories
Suedfeld (1982) has also stated that, "Clinicians who proceed from a
psychodynamic theoretical standpoint have described the REST situation as
one in which childhood experiences are vividly relived" (p. 398). In the
DHA model, early childhood experiences, especially those of a traumatic
nature, are stored pri maril yin the ND hemi sphere. These unpl easant
memories are guarded by various defenses until the REST environment begins
to decrease D hemispheric dominance allowing greater access to ND early
scripts. REST participants who, for whatever reasons, are able to resist
the process of shifting dominance, will maintain defenses and
inaccessibility to these memories.
The psychodynamic model postulates that the root of many, if not most,
neuroses is built primarily on the negative experiences of childhood, and
the road to normalcy is paved with the rescription and proper integration of
these memori es, gi ven that the defenses can be pi erced. REST may be an
idea 1 med i urn for the 1oweri ng of the defenses and for the re- scri pt i ng
process as well. Supposedly, this process would proceed in three phases:
1) the facil itation of the accessing of the traumatic memories by the
installation of a set or expectancy for this sort of "early dredging"
operation just before the REST experience, 2) a discussion of the results of
the dredging with a clinician and the formulation of the re-scripting
procedure and 3) the actual re-scripting back of the REST environment.
The accessing of early, possibly repressed memories, although

16
facilitated in REST, could be somewhat difficult for those individuals whose
defenses against the revelation of this traumatic material are still
relatively strong. In the language of the psychoanalytic mode, REST is,
n • • • maximally pleasant for individuals who can adjust comfortably to

regression in the service of the ego" (Suedfeld, p. 243, 1980). What is

implied, however, is that there are those individuals who, because of the
defenses, cannot regress and thus cannot access the troublesome scripts.
For these people the REST situation may produce a minimum of therapeutic
change. Perhaps the majority of psychiatric clients, however, given the set
to access such material, would experience a somewhat unpleasant regression
in servi ce of the ego as defenses weakened and the anxi ety and other
negative feel ings came into consciousness. In these cases the proper
debriefing of the client after there REST session would be very important.
Duri ng th i s post-REST peri od the cl i ent and therapi st woul d effect an
integration of the recovered material. To further reduce residual anxiety
surrounding the recovered memories the therapist and client would design
new, more positive, adaptive outcomes for the childhood trauma situations.
The client would then return to the REST environment and, after a certain
amount of time, would be prompted to image as vividly as possible. The re-
scripting procedure would add positive outcome scripts in the same memory
storage location as the original trauma. Thereafter, whenever the brain
scans the memory stores for past experiences relevant to an ongoing process,
it will find not only the original traumatic memory but the positive outcome
re-scripts as well. The accompanying affect will not be the formerly
terrifying anxiety or dread but rather a more neutral response. Defense
mechanisms regarding this original trauma can now be dismantled, a process
that will tend to occur automatically over time.
REST, Addiction Treatment and the DHA Model
The treatment of smoking, obesity, and alcohol problems in the REST
environment is detailed in other chapters. A brief summary, however, will
serve to highlight the efficacy of the technique with these difficult
conditions. In a recent report on smoking, for example, Suedfeld and Baker-
Brown (1987) found that previous reports of therapeutic efficacy were
confi rmed by thei r study of chamber REST. The 3 and 12 month follow-ups
showed smoking reductions of 51% and 35%, and abstinence rates of 34% and
21% respectively.
In a study of weight loss, the 24 hour chamber REST plus messages

17
presented during the treatment resulted in a greater weight reduction than
just REST alone or control conditions (Borrie and Suedfeld, 1980). An
average weight loss of 5.9 kg was obtained at the 6 month follow-up. Borrie
later combined REST with post session counseling and behavioral and group
process to bring about an average loss of 13.4 kg over follow-ups ranging
from 1 to 7 months (Suedfeld and Kristeller, 1982).
Cooper, Adams, and Scott (1988) reported that only two and a half hours
of REST plus a message produced a mean reduction in alcoholic intake of 55%
after 2 weeks. This reduction persisted without decrement during follow-
up. At 3 months the mean a1coho 1i c intake was reduced 61% and after 6
months the reduction was still good at 59%. The authors concluded, "REST is
cl inically effective, simple, easy to apply in treatment and prevention
settings, and free of significant risks, hazards, and medical side effects"
(p. 68).
Why does REST seem to be a relatively effective technique for addiction
problems which are generally highly resistant to most therapy regimes?
Given that the research with REST typically involves only a few hours or at
most 24, it is quite surprising that the benefits are so long lasting. The
same messages, presented in a normal state of consciousness without REST, do
not appear to produce as great a result (59.3% alcoholic reduction in the
REST plus message group versus a 34.4% change in the message only group at
the 6 month follow-up) (Cooper et al., 1988).
As stated in Cooper et al. (1988), "The effectiveness of this one brief
procedure, with large changes in alcoholic consumption persisting without
decrement 6 months later, illustrates 'superlearning', which REST technology
makes possible" (Hutchison, 1984, p. 67).
Ostrander and Schroeder (1979) used the term "Superlearning" to mean
the unusual learning method first known as "Suggestology" as developed in
Bulgaria by Dr. Georgi Lozanov. Begun in 1966, Lozanov's Institute of
Suggestology explored a variety of techniques for faster learning. They
included mixing the learning material with classical music (students would
pay attention only to the music and yet score well on a multiple choice
comprehension test afterward), "infantilization" (acting like little
children as they learned), transcending self (the student would be given a
different identity which would be maintained during the lesson), and deep
relaxation while the teacher used special voice intonation to present the
lesson (Rose, 1985). One can easily recognize that, in terms of the DHA

18
model, all of these procedures have one thing in common - - they lure the 0
hemisphere out of dominance and allow the NO brain to absorb the lesson
without the usual learning blocks.
Inasmuch as REST can be considered to be a procedure that more often
than not results in a decrement in 0 hemisphere dominance, with results
coming quickly, it can be classified as a superlearning experience. Perhaps
one day the research with REST will explore more thoroughly the phenomenon
as a way of accelerating the learning of the more difficult and normally
mentally-blocked subjects. One might predict, however, that the
presentat i on of the materi a1 wi 11 need to be governed by the st imul us-
absorption characteristics of the NO hemisphere and by whatever learning is
possible in the decreased-arousal 0 brain.
Final Thoughts
The OHA model predicts that after some time in the REST situation the
individual is processing stimuli with the NO hemisphere ready for absorption
and relatively unimpeded by the usually dominant side. The full extent of
the NO hemisphere's learning ability under these circumstances is unknown.
Perhaps it is capable of comprehend i ng speeded, reversed and subl imi na 1
material, any or all of which may permit even greater cognitive and
attitudinal change because these information forms may further evade defense
mechanisms that might still be operative even in REST.
Perhaps the "RESTed" brain can even take in suggestions for physical
change and somehow implement them in the immune and autonomi c nervous
systems (can REST constitute a healing situation?). Could REST facilitate
out-of-body-experiences (OBEs)? Perhaps, the NO brain in the REST situation
may be able to funnel, receive, and act upon information of a psychic or
spiritual nature, given a set to allow this to happen.

REFERENCES
Ant i sta, B. & Jones, A. Some benefi cia 1 consequences of bri ef sensory
deprivation. Paper read at the meeting of the Western Psychological
Association, Sacramento, California, 1975.
Bogen, J. E. & Bogen, G. M. The other side of the brain II I: The corpus
callosum and creativity. Bulletin of the Los Angeles Neurological
Society, 1969, 34, 191-220.
Borrie, R.A. &Suedfeld, P. Restricted environmental stimulation therapy in
a weight reduction program. Journal of Behavioral Medicine, 19BO, ~,

19
 147 -161.
Bowers, K.S. &Meichenbaum, D. The Unconscious Reconsidered. New York, NY:
John Wiley &Sons, 1984.
Budzynski, T.H. Some applications of biofeedback-produced twilight states.
Fields Within Fields . . . Within Fields, 1972, ~, 105-114.
Budzynski, T.H. Biofeedback and the twilight states of consciousness. In:
Schwartz, G.E. &Shapiro, D. (Eds.) Consciousness and Self-Regulation.
Vol. 1, New York, NY: Plenum Press, 1976.
Budzynski, T.H. Tuning in on the twilight zone. Psychology Today, 1977,
August.
Budzynski, T.H. Brain lateralization and biofeedback. In: Shapin, B &
Coly, T. (Eds) Brain/Mind and Parapsychology. New York, NY:
Parapsychology Foundation, 1979.
Budzynski, T.H. Clinical applications of non-drug induced states. In:
Wolman, B.B. &Ullman, M. (Eds). Handbook in States of Consciousness.
New York, NY: Van Nostrand Reinhold, 1986.
Cooper, G.D., Adams, H.B., & Scott, J.C. Studies in REST I: Reduced
envi ronmental stimul at i on therapy (REST) and reduced alcohol
consumption. Journal of Substance Abuse Treatment, 1988, ~, 61-68.
Dimond, S.J. & Beaumont, J.G. On the nature of interhemispheric transfer of
fatigue in the human brain. Acta Psychologia, 1972, 36, 443-449.
Festinger, L. A Theory of Cognitive Dissonance. Stanford, CA: Stanford
University Press, 1957.
Galin, D. Implications for psychiatry of left and right cerebral
specialization. Archives of General Psychiatry, 1974, ~, 572-593.
Gazzaniga, M. The Social Brain. New York, NY: Basic Books, 1985.
Goleman, D. Vital Lies, Simple Truths. New York, NY: Simon & Schuster,
1985.
Gur, R.C. &Gur, R.E. Handedness and individual differences in hemispheric
activation. In: Herron, J. (Ed.) Neuropsychology of Left-Handedness.
New York, NY: Academic Press, 1980.
Hall, M.M., Hall, G.C., & Lavoie, P. Ideation in patients with unilateral
or bilateral midline brain lesions. Journal of Abnormal Psychology,
1968, 73, 526-531.
Hutchison, M. The Book of Floating. New York, NY: Morrow & Co., Inc.,
1984.
Joseph, R. The right cerebral hemisphere: Emotion, music, visual-spatial,

20
 body-image, dreams, and awareness. Journal of Clinical Psychology,
1988, 44, 630-673.
Levy, J. Cerebral asymmetry and the psychology of man. In: Wittrock, M.C.
(Ed.) The Brain and Psychology. New York, NY: Academic Press, 1980.
Loye, D. The Sphinx and the Rainbow. Boulder, co: Shambala Publications,
1983.
Ornstein, R. Multimind. Boston, MA: Houghton-Miflin, 1986.
Ostrander, S. & Schroeder, L. Superlearning. New York, NY: Delacorte
Press, 1979.
Rose, C. Accelerated Learning. New York, NY: Dell, 1985.
Shapiro, A.E. APA Monitor, January, 1986, p. 5.
Sperry, R.W. A modified concept of consciousness. Psychological Review,
1969, 76, 532-536.
Suedfeld, P. Birth order of volunteers for sensory deprivation. Journal of
Abnormal and Social Psychology, 1964, 68, 195-196.
Suedfeld, P. Restricted Environmental Stimulation. New York, NY: John
Wiley &Sons, 1980.
Suedfeld, P. Behavioral applications of the restricted environmental
stimulation technique. In: Eiser, J.R. (Ed.) Social Psychology and
Behavioral Medicine. New York, NY: John Wiley &Sons, 1982.
Suedfeld, P. &Baker Brown, G. Restricted environmental stimulation therapy
of smoking: A parametric study. Additive Behaviors, 1987, 11, 263-
267.
Suedfeld. P. &Kristeller, J.L. Stimulus reduction as a technique in health
psychology. Health Psychology, 1983, 1, 337-357.
Suedfeld, P., Metcalfe, J. &Bluck, S. Enhancement of scientific creativity
by flotation REST (Restricted Environmental Stimulation Therapy).
Journal of Environmental Psychology, 1987, I, 219-231.
Taylor, T. The effects of flotation restricted environmental stimulation
therapy on learning: Subjective evaluation and EEG measurements. In:
Fine, T.H. & Turner, J.W., Jr. (Eds.) Proceedings of the First
International Conference on REST and Self-Regulation. Toledo, OH:
Medical College of Ohio, 1985, 76-85.
Tucker, D.M. Lateral brain function, emotion, and conceptualization.
Psychological Bulletin, 1981, 89, 19-46.
Welch, B. APA Monitor. 1986, January, 5.
Zaidel, E. Language in the right hemisphere. In: Benson, D.F. & Zaidel,
E. (Eds.) The Dual Brain. New York, NY: The Guilford Press, 1985.
21
2
Distress, No Stress, Anti-Stress, Eustress:
Where Does REST Fit In?
Peter Suedfeld

As we all know, the early history of REST research centered around the
purported ability of the technique to arouse high levels of stress, in the
negative sense of that term. High levels of negative stress -- or, as Selye
called it, distress (1974) -- were indicated by just about all of the
measures administered by the McGill University team. The symptoms included,
above all, the unwillingness of subjects to continue in the experiment after
only about two days; and secondarily, such signs of mental aberration as
hallucinations, spontaneous emotional shifts, heightened suggestibility, and
deteri orat i on of performance on cogn i t i ve, perceptual, and motor tasks
(Bexton, Heron &Scott, 1954).
It is no wonder that, with such results, st imul us restri ct i on was
characterized as a supreme experimental stressor. In fact, it was thought
to generate a temporary psychos is, or at 1east a psychot i c- 1i ke state
(although it's hard to see the difference between those); and what could be
conceived of as more stressful than an experience that drove people crazy,
even temporarily (Solomon et al., 1961)?
Furthermore, the nonexperimental analogue environments to which
stimulus restriction was compared were also generally agreed to be sources
of distress. These included brainwashing, as practiced in the prisons of
the Soviet secret pol ice and/or Chinese prisoner-of-war camps in Korea;
monotonous prolonged effort, either primarily passive and perceptual, such
as mon i tori ng a radar screen, or both perceptual and motor, but st i 11
essentially with limited activity, such as long-distance truck driving; and
living and working for a long time in an unpleasant, boring, and possibly
dangerous environment, such as sol itary confinement cell, an Antarctic
station, a nuclear submarine, or a space capsule (Zubek, 1969).
The stimulus restriction laboratory was popularly viewed as furnishing
a controlled situation in which the forces at work in such field situations
could be studied. Consequently, an interesting cognitive schema was formed,
in which negative effects of REST were assumed as normative and a lack of
such effects -- much less a finding of positive effects -- was perceived as

22
an exception. It was thought to be axiomatic that people dislike and are
damaged by drastically lowered levels of stimulation. This is the way that
most people, including the lay public as well as medical and behavioral
sc i ent i sts, came to thi nk of the re 1at i onsh i p between people and the
stimulus environment. Heron's famous article, "The Pathology of Boredom"
(1957), said it all in the title.
As in many parallel situations, a counter-reaction eventually set in
as revisionist scholars got to work. It was discovered that the signs of
di stress might have been due to factors other than a reduced 1evel of
stimulus input. Some of these factors, such as anxiety-arousing
instruct ions and experi menter expectancy, had noth i ng to do with general
ambient stimulation at all (e.g., Orne & Scheibe, 1961; Suedfeld, 1969a);
others, such as moderate- to hi gh- 1eve 1 monotonous input, homogeneity,
reduction of meaningfulness and change, were environmental factors but were
different from those associated with darkness and silence (Suedfeld, 1980).
Furthermore, many of the negative stress symptoms were unreliable.
Some studies found them, others not; some tests showed them, others failed
to do so. Whether hallucinations occurred, for example, depended on how
clearly and rigorously the experimenter defined what a hallucination is. An
eminent expert in the field eventually concluded that many of them had been
generated by a tangle of variables that could not be untangled post hoc
(Zubek, 1973).
Then we started th i nki ng crit i ca 11 y about the supposedl y analogous
field environments, and concluded that they were not all that analogous
after all. Brainwashing, it turned out, was usually a matter of prolonged
and severe overstimulation, both social and physical. Sometimes it involved
rapid and unpredictable leaps from one level of input to its opposite; but
stimulus restriction per se was not one of its hallmarks (Suedfeld, 1980).
Pro longed vi gil ance in monotonous circumstances generally requ ired
concentration, a cramped and unnatural physical position, and readiness for
instant response. Its psychological and social meaning was very different
from that of part i c i pat i on in an experi ment, and the people who found
themselves in such situations were very different from the university
students who usually inhabited the REST chamber. Thus, the psychological
experiments that people lived through in the two settings had little if any
commonality.
In another aspect of the debunking of the distress myth, researchers

23
began to discover what has been called salutogenic, rather than pathogenic,
consequences of REST (cf. Antonovsky &Bernstein, 1986). It turned out that
the experimental reduction of stimulation could lead to improvements, not
just impairments, of performance on cognitive and perceptual tasks; that
subjects emerged from the chamber feel ing not only that they had had a
pleasant and interesting experience, but that it had helped them to
understand and sol ve personal probl ems. St imul us reducti on was shown to
lead to improved learning, memory and problem-solving, and to be an
effective tool in smoking cessation and other behavior modification
contexts. With improved methodology, we found that rather than being
intolerable, REST was quite acceptable to 90% or more of our volunteer
participants (Suedfeld, 1980).
Some of these findings were compatible with earlier ones that had been
largely ignored as being atypical of the "normal" -- i.e., distressful --
results of REST. Several pioneers in the field had always maintained that
the experience was pleasant unless expectancy and other artifacts intervened
(e.g., Li lly & Shurl ey, 1961). Cognitive and perceptual improvements had
always been found on some tasks (Suedfeld, 1969b). The increase in fantasy
and primary process thought associated with creativity had been noted within
the first few years of research (Goldberger & Holt, 1958). Increased
acceptance of new ideas and reduced attitude rigidity had been among the
very first data reported (Bexton et al., 1954; Myers et al., 1966); but now,
instead of viewing them as signs of mental deterioration and susceptibility
to propaganda, we thought of them as the prerequisite to greater insight,
habit modification, and beneficial self-directed behavior change. We began
to argue that the stimulus-reduced environment imposed minimal if any stress
on most subjects, and that positive effects were the rule and negative ones
the exception. To counter "The Pathology of Boredom", I wrote "The Benefits
of Boredom" (1975).
When the flotation tank was introduced, we moved from the no-stress to
the anti-stress position (Lilly, 1977). REST was not only innocent of
causing distress, it could be used to counter distress caused by other
sources. Both psychological and psychophysiological measures consistently
indicated that floating led to deep states of pleasant relaxation. It could
logically be used to treat adverse conditions related to tension:
headaches, high blood pressure, insomnia, muscle aches, and the like (Fine
&Turner, 1985; Hutchinson, 1985; Turner &Tine, 1987). Obviously, REST was

24
a promising technique in stress management. To bury the distress hypothesis
once and for all, people allover the world were actually willing to pay
good money for time in the tank. Un 1ess a11 of these customers were
masochists (not a very likely proposition), both the pleasantness and the at
least perceived positive outcome of REST were established.
I think I can fairly number myself among the ranks of the revisionists.
But now I would like to raise a different possibility, to voice what may be
called a neo-revisionist position. Remember that Selye, that grand old man
of stress research (and the man who fi rst used the word in its current
medical and psychological sense) described not only distress, but also
eustress (1974). Eustress is positive stress, stress that is good for you.
How can this be?
It can be because the word "stress" in science is not synonymous with
its common pop psych meaning. The latter is focused on negative aspects and
outcomes; but the former views stress as being essentially equivalent to
challenge. In fact, I would much prefer the use of that word. A challenge
is an event or condition that motivates the organism to cope, to respond
adaptively and perhaps even creatively. Dictionary definitions include such
phrases as "a demanding and stimulating situation".
Demanding and stimulating? It seems paradoxical to apply such terms
to an environment that by definition reduces both demands and stimulation to
a practicable minimum. But I have argued before that in our thinking we
should differentiate between environments (that is, physical conditions) and
experiences (the meaning of those conditions to the individual). And yes,
I think REST is both demanding and stimulating.
A paper by Shelley Taylor (1983), which deals with threatening events,
is relevant here. According to Taylor, in the face of such events one must
search for meaning in the experience, try to assert mastery over the event
and one's life in general, and establish self-esteem by self-enhancing
evaluations of how one dealt with the event. Taylor's analysis is set in
the context of a very negative event that occurred in the past (being
diagnosed as having cancer), but I think it appl ies to both positive and
negat i ve cha 11 engi ng events and to events occurri ng in the present and
ant i c i pated to occur in the future as we 11 as those that have already
happened. In the rest of this paper, I shall treat each component as a
characteristic of one temporal phase of the experience.
The challenge spans all three tenses. The expectation that one will

25
be going into a flotation tank for an hour, or into a completely dark,
s 11 ent chamber for up to a day, is a prospect that arouses a number of
emotions in most volunteers. I'm sure that anxiety is one of these
emotions, at least for most naive participants. But others may involve the
desire for novelty, a chance to test oneself in a strange setting, a hope
for unusual or even bizarre experiences. People may expect to gain new and
deeper knowledge of themselves or of others, and perhaps to attain new
heights of fantasy, concentration, or general well-being.
These are challenges that go beyond the obvious one of "Will I be able
to endure the situation?" Even in the absence of experimental artifacts,
subjects to try to give meaning to the experience in advance. Perhaps one
cause of distress symptoms was that the meaning attached to the experience
was of an ordeal to be borne; but if REST is viewed as an opportunity to be
used fully, the challenge -- though positive -- is not less.
In the tank or chamber itself, the attempt to gain mastery over the
situation is the salient direct challenge, and unquestionably a stimulating
problem. The participant explores the environment and tries to establish
ways to meet the demand for spending what seems like empty time. How to
fill that time, how to re-direct one's attention from the normal flow of
ambient information and stimulation to the usually evanescent, faint, and
sometimes uncomfortable signals from one's own body and mind, how to meet
the expectations one has set in advance -- these are problems that the
individual must solve by a variety of methods.
Some of these may be paradoxical; the challenge of maintaining focused
concentration without relying on external cues is perhaps the opposite of
the challenge to open the accustomed boundaries of one's thought and "go
with the flow". In the latter case, control is establ ished by abandoning
control, a truly Zen-like requirement. I'm not sure whether anyone person
is 1ikely to have such confl icting goals, or whether the difficulty is
avoided by different people having different aims (or one person pursuing
them sequentially). In any case, the REST subject must establish mastery
over his or her own mental and physical· processes; and this, in an
environment where those processes represent the dominant part of what is
happening, is equivalent to mastery over the event.
Afterwards, the experience must be integrated into one's total life.
Taylor proposes that one must "restore self-esteem through self-enhancing
evaluations". The word "restore" is not appropriate here, or at least not

26
always. But self-esteem is maintained, and I bel ieve in a very high
proportion of participants improved, by how they remember their REST
experience. Viewed as a period of challenge -- demanding and stimulating,
remember -- an opportunity for self-chosen and self-directed exploration and
growth, it is indeed ego-strengthening. In cases where the experience led
to hoped -for changes such as personal problems solved, undes i red habits
abandoned, health improved, creative work accomplished, this memory persists
for a long time and imbues the REST experience with meaning, a feeling of
mastery, and improved self-esteem.
I may point out that some of the analogue environments stipulated in
the early days, whose similarity to REST is now once again beginning to be
thought about, may be subjected to the same kind of analysis. If they are,
we may come to conclude that while the revisionists were correct -- that is,
the environments are not all that analogous -- so are the neo-revisionists
(actually, at this point I guess I should say "so is the neo-revisionist");
the experiences may be more analogous than we have assumed. Although I am
not sure about the truck driver and the radar operator, I believe that the
same three challenges face the political prisoner, the polar crew member,
and the astronaut. So the REST researcher may have something to say about
these situations after all.
Where else does this lead us? Well, it says that we should not
consider REST to be an environment to which people react passively,
stresslessly. It is challenging, in prospect, actuality and recall; but the
challenge and the process of meeting it are positive, eustress. REST does
demand coping responses. And it is, in one interpretation of Zuckerman's
old phrase, a walk-in inkblot; what it is for you depends on what you make
of it for yourself (Suedfeld, 1987a,b).
Our chall enge as researchers is to understand that process, and to
study intensively what the experience does mean to subjects. What
characteristics of the environment, of the individual, and of the
interaction affect this meaning? How does the meaning in turn relate to
responses on dependent measures -- and to other behavioral consequences?
When and how is mastery achieved, or felt to have been achieved? How do all
of these factors relate to the later role of the experience in the subject's
1ife?
I am intrigued, for example, by what we have been calling "beneficial
side-effects" in our studies on smoking cessation and blood pressure

27
reduction. We have fortuitously discovered that some participants seem to
have re-organized their whole 1ives, or at least significant portions
thereof, and show major changes in personality, work achievement, and close
personal interactions after REST (Roy, 1987; Suedfeld & Best, 1977). It
seems silly to call this a "side-effect"; the meaning of REST to these
people is obviously not what we have expected it to be, and perhaps not what
it is to others in the same studies. But these meanings remain to be
examined.
The challenge to the applied REST scientist is to take the
understanding of the three eustressful components of the experience and to
guide our clients so that the effects are most beneficial and long-lasting.
This may call for helping the client structure the experience, to guide him
or her toward or away from the some part i cul ar i nterpretat ion - - for
example, we have found it advisable to teach smokers to view REST as a tool
that helps them regain control over their own behavior, not as a magic
bullet that will kill the smoking habit. It may also require post-REST
work, to help the client give a proper place to the experience in the total
pattern of life.
In case I have not made it obvious, I greatly favor eustress (the
concept, al though not the word). Researchers and therapi sts have always
known that they themselves thrive on challenge, not on passively receiving
inputs. A transitive approach to psychology demands that we recognize the
same characteri st i c of our subjects or cl i ents. Members of IRIS can be
thankful that their field of study and application provides that challenge
to all of the players in the game, very transitively indeed.

REFERENCES
Antonovsky, A. & Bernstein, J. Pathogenesis and Salutogenesis in War and
Other Crises: Who Studies the Successful Copers? In: Milgram, N.
(Ed.), Stress and Coping in the Time of War: Generalization from the
Israeli Experience. New York, NY: Brunner/Mazel, 1986, p. 52-64.
Bexton, W.H., Heron, W. &Scott, T.H. Effects of De~reased Variation in the
Sensory Environment. Canadian Journal of Psychology, 1954, ~, 70-76.
Fine, T.H. &Turner, J.W., Jr. (Eds.). First International Conference on Rest
and Self-Regulation. Proceedings. Toledo, OH: Iris, 1985.
Goldberger, L. & Holt, R.R. Experimental Interference with Reality Contact
(Perceptual Isolation): Method and Group Results. Journal of Nervous

28
 and Mental Disease, 1958, 127, 99-112.
Heron, W. The Pathology of Boredom. Scientific American, 1957, 196, 52-56.
Lilly, L.C. The Deep Self. New York, NY: Simon &Schuster, 1977.
Lilly, J.C. &Shurley, J.T. Experiments in Solitude, In Maximum Achievable
Physical Isolation with Water Suspension, of Intact Healthy Persons.
In: Flaherty, B.E. (Ed.) Psychophysiological Aspects of Space Flight.
New York, NY: Columbia University, 1961, 238-247.
Myers, T.I., Murphy, D.B., Smith, S. & Goffard, S. Experimental Studies of
Sensory Deprivation and Social Isolation In: HumRRO Tech. Rept. 66-
~, Washington, D.C.: George Washington University, 1966.
Roy, C. Life Changes After Restricted Environmental Stimulation Therapy:
Observations of a Psychiatrist. In preparation, 1989.
Selye, H. Stress Without Distress. New York, NY: Signet, 1974.
Solomon, P., Kubzansky, P.E., Leiderman, P.H., Mendelson, J., & Wexler, D.
(Eds.) Sensory Deprivation. Cambridge, MA: Harvard, 1961.
Suedfeld, P. Theoretical Formulations: II. In: Zubek, J.P. (Ed.) Sensory
Deprivation: Fifteen Years of Research. New York, NY: Appleton-
Century-Crofts, 1969, 433-448.
Suedfe 1d, P. Changes in Inte 11 ectua 1 Performance and in Suscept i bil i ty to
Influence. In: Zubek, J.P. (Ed.) Sensory Deprivation: Fifteen years
of Research. New York, NY: Appleton-Century-Crofts, 1969, 126-156.
Suedfeld, P. The Benefits of Boredom: Sensory Deprivation Reconsidered.
American Sc1entist, 1975, 63, 60-69.
Suedfeld, P. Restricted Environmental Stimulation: Research and Clinical
Applications. New York, NY: Wiley, 1980.
Suedfeld, P. Extreme and Unusual Environments. In: Stokols, D. &Altman,
I. (Eds.) Handbook of Environmental Psychology. New York, NY: Wiley,
1987, Vol. I, 863-887. (a)
Suedfeld, P. Groups in Isolation and Confinement: Environments and
Experiments. Paper presented at the Conference on The Human Experience
in Antarctica: Applications to Life in Space. Sunnyvale, CA, 1987.
(b)
Suedfeld, P. & Best, A.J. Satiation and Sensory Deprivation Combined in
Smoking Therapy: Some Case Studies and Unexpected Side-Effects.
International Journal of the Addictions, 1977, 1Z 337-359.
Taylor, S. E. Adjustments to Threateni ng Events: A Theory of Cognitive
Adaptation. American Psychologist, 1983, 38 1161-1173.

29
Turner, J.W., Jr. & Fine, T.H. (Eds.) Proceedings of the Second
International Conference on REST. Toledo, OH: IRIS, 1987.
Zubek, J. P. (Ed.) Sensory Depri vat ion: Fi fteen Years of Research. New
York, NY: Appleton-Century-Crofts, 1969.
Zubek, J.P. Behavioral and Physiological Effects of Prolonged Sensory and
Perceptual Deprivation: A Review. In: Rasmussen, J.E. (Ed.) Man in
Isolation and Confinement. Chicago, IL: Aldine, 1973, 9-83.

30
3
A Cybernetic Model of Restricted
Environmental Stimulation Effects
Michael Bross

In the relatively short history of sensory restriction research the

field has progressed from the 1ament of "Many facts and few theories"
(Vernon, 1963) to a plethora of diverse theoretical models which attempt to
account for the variety of phenomena produced by restricted environmental
stimulation techniques (REST). One early attempt to impose a theoretical
framework was Schultz's (1965) neurophysiologically based concept of
sensoristasis, and the first major review of the area (Zubek, 1969) included
two important chapters on theoret i ca 1 developments, one emphas i zing the
neurophysiological perspective (Zuckerman, 1969), the other concentrating on
cognitively based explanations (Suedfeld, 1969) a dichotomy also retained in
Suedfeld's (1980) review of the field. A recent monograph which focusses on
REST phenomena as brought about by floatation (Hutchison, 1984) contains
thirteen chapters on different theoretical explanations; and while most of
these can also be classified into physiological and cognitive categories,
some also draw on evolutionary principles to explain certain REST effects.
Given th is abundance of theoret i ca 1 models, why look to general system
theory to propose an additional model? Firstly, and most importantly, it
would be desirable to have a theoretical orientation that is, at least in
principle, capable of not only explaining the great variety of REST effects
obtained, but also able to accommodate the broad range of the more specific
theoret i ca 1 approaches whi ch have been proposed. Secondl y, it is my
content i on that a cybernet i c model i ng approach as deri ved from general
system theory is ideally suited to force investigators to carefully analyze
what the adjustment of an organism exposed to REST actually is in terms of
what it is designed to accomplish from the organism's point of view, an
approach that looks beyond the empirical data and the identification of
structural components involved in producing REST effects. Finally, there is
a fundamental philosophical reason for suggesting a cybernetic perspective
to understand REST effects, a reason that derives from the assumption that
our experience and understanding of the world is based on an internal model
of reality which is built up and derived from the information we obtain from

31
the world via our sensory experience.
While this is not the place to elaborate on this proposition, briefly,
it derives from the philosophies of Berkeley, Hume, and Kant and has also
been championed by Helmholtz who arrived at this position not from a
philosophical basis, but from the empirical consideration that we are never
aware of objects or events per se but only know about them indirectly
through the activities of our nervous system. For both the philosophical
and the empirical arguments the conclusion is identical, namely that we
construct in our minds (from a philosophical - cognitive perspective) or in
our central nervous system (from an empirical - physiological perspective)
a model of the worl d whi ch is ut il i zed by us to ori ent, respond, and
interact with the world. What makes REST relevant to this approach (and
vice versa), is that REST effectively reduces or alters the normal flow of
sensory input wh i ch is used, in the fi rst place, to construct our worl d
model and, also, serves the function of continually monitoring and/or
adjusting this model to achieve a close correspondence between the model and
the world.
The most basic type of cybernetic model was proposed by Wiener (1948)
in the form of a single loop control system that contained five variables
(Figure 1).

+ e K

Xo
~--------------~----------~

Idealised single-loop control system

Where: Xi a reference or command signal
Xo a feedback or input signal
e an error or output signal
~ a comparator (of Xi and Xo)
K a controlled quantity
The objective of such a control system is to keep the variable K at a

32
given value, a value which is determined by the reference signal Xi. Thus,
in an ideal situation where Xi = Xo (i.e., Xi - Xo = 0) the system produces
no error signal and is said to be stable. The equation Xi - Xo is
constantly monitored by the comparator and whenever Xi - Xo = 0, e takes on
a positive or negative value and acts on the controlled quantity K in such
a way as to reduce or increase the feedback signal to approximate it again
to the value of the reference signal. By rearranging the layout of Wiener's
basic model and substituting terms more congenial to living organisms, the
cybernetic control system in Figure 2 results.
Referenca
Signal, r

. -_ _ _ _-lCompara- t-----~
lor (p.,.,

Perceplual Error
SIgnal, p Signal, a

Input Output
FUliction System Function

SYS1U1'S

W
ACTlurl (I' K

Proximal Results

PhysIcal
Laws Physical
Laws
comruIi1 amtTY (I:)

r I
Cause of I
L------lIOislurbanccl

Fi9ure 2. Cybernetic Control SYltem and its interaction

with an environment. Adapted from Power •• 1973.

The nature of the p and e signals are readil y ascertai ned inmost
cybernetic systems whereas the source and value of the reference signal (r
or Xi) is somewhat obscure. In mechanical systems r is normally set at a
given value, e.g., a thermostat in a climate controlled room. In living

33
systems we can, in general, distinguish three types of reference signals,
arranged hierarchically:
a) Genetic:generated by DNA, RNA
b) Intrinsic:generated by neuro-chemical reactions e.g., hormones
c) Acquired:generated by experience
All three types generate r values which are appropriate for specific
objectives at a given time and for a given state of the organism. The
genetic r signals must be regarded as more or less fixed, i.e., only subject
to alteration under highly unusual (abnormal) conditions (e.g., X-ray
radiation), the intrinsic r signals are flexible within certain limits, and
acquired r-values have the greatest flexibility. From the perspective of
REST effects, the intrinsic and acquired r signals have the greatest
flexibility since the efforts of the organism in response to reduced levels
of stimulation can readily be regarded as attempts to reinstate the equation
p = r by some means.

t:mIl'AMA1'OR
\'
(wttll .odel of UK")

'l CotU'ARAl'OR

_................_--._---_.-_..._-_..._.
\,

Fiqure 1. A control System wi th an illlt!l'lIal

model of the controlled qUilfllity K.

Before going into a specific example, two additional points must be

considered. For one, the view of the organism as a single cybernetic control

34
system is in general too simp 1i st i c. Rather we deal with a hi erarchy of
horizontally as well as vertically interconnecting subcontrol systems where
the e signals from one such subcontrol system become the p or r signals of
other sUbsystems. Secondly, the most efficient type of control systems are
those wh i ch have a model of the controlled quant ity K as part of thei r
system, an arrangement that leads to the optimal performance of such systems.
Figure 3 is an example of such a system.
Another important feature of incorporating a model of K into the system
is that the model can take on different parameters as a function of other
control systems, i.e., it can be a flexible component. Most control systems
operate on the principle of negative feedback where the objective is to
stabilize the system at a given, constant value. Indeed, these types of
systems are inherently unable to deal with positive feedback, i.e., where
the e signal produces (via K) greater and greater values of the p signal.
Some types of control loops, however, are susceptible to positive feedback
in that this type of feedback leads to adjustments in the control loop and
here one can point to the model within the system as that component which
will respond to the positive feedback by altering its parameters.
The above considerations are drawn from systems engineering, and while
similar or analogous control loops do exist in organisms with nervous
systems, an interesting case of the present discussion arises where the
mode 1 is not only a model of the controlled quant ity, but also a second
comparator that mon i tors, integrates and regul ates some other important
functions of the system itself. One specific example that would fall into
this category is the regulation of sensory thresholds by an organism exposed
to sensory restriction. By assigning to the concept of "optimal level of
stimulation" a reference signal "rD" set at a certain value, the following
relationships can be diagramed:
The following interactions arise out of the relationships given
in Figure 4.
a) Sensory signals (P) go to both cortical and subcortical regions
in this case the reticular formation.
b) The controlled quantity (~) is the amount of afferent neural
excitation that is passed on to higher order neurons from lower
order neurons. Normally this amount is held below maximum
channel capacity by tonic inhibition (sensory gating) exerted by
efferent neural signals.

35
 OrTlllAl. I.EVEI. OF STltlUl.ATIOH

CARAS)

I' (Nt.)

________ 1 . - _ , . - " , . -...

-----_.... .... ...-...._.-
_ _

K2 SUlsnMY .t-:STlllCTlnN

Figure 4 _ 1\ cyl>ernetic Klodel of se'l"0ry qatinq_

c) The amount of afferent signals not subject to tonic inhibition

is regulated by the arousal states (needs) of relevant cortical
processes (ro)'
d) Any inequality of p~ or r M leads to a change in the reference
signal r RF for the reticular formation which results in:
1) a change in the value of the error signal el normally (in
the case of sensory restriction) a negative value which in
turn would lower the amount of tonic inhibition in the
sensory gate, and,
2) a change in the value of e(a)' whose pathways can be regarded
as belonging to the ARAS, will lead to an increase in
arousal signals to cortical areas to compensate for the
input usually received via classical sensory pathways (p).
These relationships can be stated in a formal manner and cast in mathematical
form.

36
Assuming linear approximations, one can derive the following set of
equations:
1. e=r-p
2. p Ke
3. p = K(r - p)
4. p k..
=

1+ K
For systems with more than one controlled quantity, equation '(4) expands to
incorporate the different values of K.
In the case of 2 k variables of interest, equation (4) can be written
(in simplified form) as:
5. P = K,_r_
1 + K"
If K2 represents a given un it of time, the value of p wi 11 represent the
loop gain of the system per unit time, and equation (5) will generate a
negatively accelerated curve that after a given time stabil izes at an
asymptotic level.
Now, this function fits quite well with empirical findings on the
effect of sensory restriction on changes in sensory sensitivity. Taking some
data from Bross and Zubek (1975) on the effect of 14 days of auditory
restriction (silence) on the critical flicker frequency (CFF) of the eye and
letting K2 being equal to days of auditory restriction, K, set at optimum
efficiency for transduction (i .e., a value of 1.0), and r as an ad hoc
approximation of 2.0, the fit between the observed and predicted function is
shown in Figure 5.
In principle, one can move from specific subsystems which comprise the
multitude of functions a living organism carries out to a perspective which
regards the organism as a single cybernetic system by focussing on major
control functions the organism carries out. For example, a major control
loop must be the organism's attempt to generate and maintain a stable model
of the world where the collective perceptual signals are constantly utilized
to test the correctness or validity of that model. As briefly alluded to in
the introduction, given the way we process information about the world a
strong case can be made that we experience the world in this inductive
manner. For this case a cybernetic approach to REST effects can make some
interesting, testable predictions. Given that the role of sensory/perceptual
signals is critical to the maintenance of such a model, the controlled

37
 5
H.S -

~~.O -
o
Z
o 3

~ "J.5 p
z
~ ,(3.0 _
:c

~
b~2.5 -
o

Changes in the CFF during 14 days of auditory depIivation

FiSUTI! 5_ EmpiricAl and theoretic~l curves of the loop

gain in the CFF. After Bross and Zubek, 1975.

quantity r would not only consist of the total amount of p that can be
obtained by the individual, but also the type of information that will be
preferred (utilized) to other types of information. Moreover, one should
expect that certain types of information normally disregarded or only
peri ph era 11 y drawn upon wi 11 now be ut i 1i zed to a greater extent. The
following two predictions can be made on the basis of these considerations:
Given two types of information, both normally valuable to the
individual about the world, an individual exposed to sensory restriction will
prefer to obtain that type of information which contributes towards the
maintenance of a stable model about the world.
For instance, an individual who is a devoted baseball fan and will go
to great 1engths to obtain i nformat i on about the weekend results and
statistics of baseball games should prefer other types of information if
exposed to severe sensory restriction, e.g., verbal directions about the
layout of his/her immediate physical environment, weather reports, general
and local newscasts.
This example is somewhat general and in need of greater specification

38
of the variables involved such as length of SR, type of SR and so on, but it
could easily be applied to specific situations.
A second instance where an interesting and also unique prediction can
be generated from the cybernetic model of REST is in the area of adaptation
to novel perceptual environments. Given that sensory reduction entails a
significant decrease in the individual's ability to monitor the validity or
correctness of his/her world model via sensory feedback, it should follow
that there is also a decrease in the probabil ity of the i ndi vi dua l' s
expectation that the model which is operational at the state of a sensory
restriction period will have the same degree of validity after it ceases.
Assuming that the testing and adjustments of the world model has a high
priority in the hierarchy of control system, a reasonable prediction would
be that any experimentally induced mismatch of sensory feedback and the model
following sensory restriction would lead to a more rapid adaptation (and
adjustment of the model) by the individual than for someone who has not been
exposed to sensory restriction since the latter has not had the probabilities
concerning the correctness of his/her world model reduced. A direct way to
eva 1uate th is pred i ct ion woul d be to test it by means of an opt i ca 1
rearrangement procedure (Held and Hein, 1958; Kohlers, 1964; Welch, 1978).
By shifting the visual field through distorting prisms and assessing the
speed by which an individual adapts his/her visu-motor behavior, it would be
predicted that individuals exposed to sensory restriction adapt much more
quickly than individuals who have not.
In addition to generating predictions, a cybernetic approach to REST
as drawn from general systems theory is well suited to incorporate or
complement a great number of the variety of theoretical explanations that
have been offered for REST effects. Thus the concepts of sensoristasis,
optimal level of stimulation and stimulus hunger can readily be incorporated
into the approach outlined in this paper. Explanations such as Maclean's
(1973) triune brain and Budzynski's (1983; see this volume) hemispheric
1ateral ization model would represent the case where specific structural brain
areas are assigned to the location of control systems with different
functional objectives. Cognitive model s of REST effects, too, can be
accommodated from a cybernet i c perspect i ve, for example, the concept of
unfreezing (Suedfeld, 1980) would represent an instance where the reference
Signal for a particular control system is significantly altered. One feature
of cognitive models that is of particular interest is that they are more

39
likely to represent "software" rather than "hardware" control systems, a
feature that makes them readily amendable to alterations and adjustments.
The considerable evidence on the facil itatory effect of REST on attitude
change, changes in self image etc., can be drawn upon in support of this
contention.
The arguments presented in this paper do not, of course, present an
exhaustive analysis of the viabil ity of cybernetic theory to REST. The
specific implications of such an approach will have to be worked out in much
greater detail and subjected to empirical tests. The promise this approach
holds, in addition to presenting a more unified view of REST phenomena, is
that it will lead to a perspective that will enable investigators to identify
the reference signals, levels of control, and the controlled quantities by
which we maintain our everyday behavior and expectations about the world, as
well as our attempts to change these behaviors and expectations.

REFERENCES
Bross, M. &Zubek, J.P. Progressive increase in the CFF of the non-occluded
eye during prolonged monocular deprivation. Canadian Journal of
Psychology, 1972, 29, 340-347.
Budzynski, T.H. Biofeedback and the twilight states of consciousness. In:
Schwartz, G.E. &Shapiro, D. (Eds.) Consciousness and Self-Regulation:
Advances in Research, IV New York, NY: Plenum, 1976.
Held, R. & Hein, A. Adaptation of disarranged hand-eye coordination
contingent upon reafferent stimulation. Perceptual and Motor Skills,
1958, ft, 87-90.
Hutchison, M. The Book of Floating. New York, NY: Morrow &Co., Inc., 1984.
Kohler, I. The formation and transformation of the perceptual world.
Psychological Issues, 1964, J.
Maclean, P.O. The triune brain, emotion, and scientific bias. In: Schmitt,
F.O. (Ed.) The Neurosciences. New York, NY: Rockefeller University,
1970, 336-348.
Powers, W.T. Behavior: The Control of Perception. Chicago, Il: Aldine,
1973.
Schultz, D.P. Sensory Restriction. New York, NY: Academic Press, 1965.
Suedfeld, P. Theoretical formulations: II. In: Zubek, J.P. (Ed.) Sensory
Deprivation: Fifteen Years of Research. New York, NY: Appleton-
Century-Crofts, 1969, 433-448.

40
Suedfeld, P. Restricted Environmental Stimulation: Research and Clinical
Applications. New York, NY: John Wiley and Sons, 1980.
Vernon, J. Inside the 8lack Room. New York, NY: Clarkson, 1963.
We 1ch, R. B. Perceptua 1 Modifi cat ion: Adapt i n9 to Altered Sensory
Environments. New York, NY: Academic Press, 1978.
Wiener, N. Cybernetics. New York, NY: Wiley &Sons, 1948.
Zubek, J.P. (Ed.) Sensory Deprivation: Fifteen Years of Research. New
York, NY: Appleton-Century-Crofts, 1969.
Zuckerman, M. Theoretical formulations: I. In: Zubek, J.P. (Ed.) Sensory
Deprivation: Fifteen Years of Research. New York, NY: Appleton-
Century-Crofts, 1969.

41
4
The Common Therapeutic Elements and Procedural
Components in Self-Hypnosis and Other Stress
Reduction Techniques

Ian Wickramasekera
ABSTRACT
Se If- hypnos is appears to be a prototype of fi ve other techni ques
currently marketed to control psychological stress. These techniques like
self-hypnosis, are self initiated, self regulated, and follow an educational
model. All these techniques appear to enable the trainee to access at least
one or more of three useful conditions (hypersuggestibility, "allocentric
mode of perception", cognitive control of autonomic functions) for
psychophysiological and behavioral change. The probabil ity of accessing
these three therapeutic elements is increased by four procedural variables
(sensory restriction, relaxation, credibility enhancing packaging, and
therapeutic expectations) built into self-hypnosis and the other five
psychophysiological stress reduction techniques.

INTRODUCTION
Psychological stress (Lazarus, 1966; Appley &Trumbull, 1967) has been
imp 1 i cated in the exacerbat i on or et i 01 ogy of several psycho log i ca 1 and
medical disorders (e.g., headaches, peptic ulcers, essential hypertension,
alcohol, drug and tobacco abuse). Analyses of psychological stress emphasize
the critical role of cognition (e.g., appraisal and labelling) in the
sequence of events that comprise psychological stress (Arnold, 1960;
Schachter, 1966; Mandler, 1975) and suggest that it is unl ikely that
physiological arousal alone, without aversive cognitive labelling of the
arousal, is a sufficient condition for the acquisition and maintenance of
chronic stress-related clinical conditions.
The stressors that impinge on these patients seldom involve tissue
damage or treat of ti ssue damage. Frequently, they present in vague
ambiguous forms that elicit cumulative physiological arousal and/or
ambivalent feelings in these patients. These "psycho-social" stressors may
include an unhappy marriage, a problem child, a hypercritical boss, an
unrealistic performance standard, rejection, or loneliness. These complex
psycho-social problems cannot be adequately remedied by primitive "fight or

42
flight" methods of coping, or alternatively by modern drugs and surgery.
Surveys done in the last fifteen years indicate that approximately 60
percent of the patients in a general practitioner's waiting room present with
physical complaints without physical findings (Cummings, 1977; Hilkevitch,
1965). This statistic is supported by the fact (Blackwell, 1975) that minor
tranquilizers like librium are the most frequently prescribed medications in
general practice and that stress-related disorders are replacing infectious
di seases as the maj or cause of death and cri pp 1i ng in i ndustri ali zed
societies (U.S. Department of H.E.W., 1973). It appears that there is a real
need for an effective, reliable and cheap psychological method to cope with
psycho-social stressors. Self-hypnosis may fit such a need.
Self-Hypnosis
There are, of course, a variety of techniques for inducing altered
states of consciousness that may involve elements of self-hypnosis (e.g.
rel igious dances, prayers). But more conventionally self-hypnosis is a
procedure practiced quietly, inwardly, and in a relatively immobile state.
Self-hypnosis is at least a psychophysiological technique to self induce an
altered state of consciousness characterized by hypersuggestibil ity and
increased cognitive control of autonomic functions. But three is probably
another characteristic of this state, increased creativity, which is even
more important to problem solving but difficult to document (Bowers, 1978;
Raikov, 1976).
The importance of enhanced creativity lies in the simple fact that most
psychological stress is initiated and maintained not by tissue damage, but
by rigid appraisals, anticipations, and the fixed meanings we assign to
psycho-social and other events over which we have 1ittle or no control.
Habits of cognitive (Ellis, 1962; Beck, 1976) appraisal can transduce into
"stressors," the inevitable psycho-social events (failure, delays,
uncertainty, rejection, etc.) of life. When appraised rigidly as "stressors"
these events can lead to chronic and excessive physiological arousal (causing
muscular or vascular pain), negative cognitive ruminations (depression),
neurotic avoidance (phobias) or self-medication (e.g., substance abuse).
There appears to occur in self-hypnosis an alteration in the mode of
appraisal of everyday events and problems (Fromm, Brown, Hurt, Oberlander,
Joab, Boxer & Pfeifer, 1981). This alteration is a function of certain
components (sensory restriction, reduced physiological arousal, and positive
expectanc i es) that are common to self -hypnos is and certain other

43
psychophysiological stress reduction techniques 1ike autogenic training,
symbolic desensitization, biofeedback for relaxation, transcendental
meditation, and progressive muscular relaxation. Various aspects of this
alteration in the perception of everyday events have previously been
described by poets like William Blake and numerous religious mystics. But
more recently, this alteration in perception that becomes more probable in
self-hypnosis, has been psychologically described by Kris (1951), Schachtel
(l959), and others. Percept ion is altered ina way that increases the
probability that events and problems in living (Szasz, 1960) will be looked
at freshly. Schachtel (1959) called this the "allocentric mode of
perception" and described it thus: "this openness means that the
sensibil ities of the person, his mind, and his senses, are more freely
receptive, less tied to fixed anticipations and sets, and that the object is
approached in different ways, from different angles, and not with any fixed
purpose to use it for the satisfaction of a particular need, or the testing
of a particular expectation or possibility".
Five other techniques like self-hypnosis have recently been proposed
to combat psychological stress. The best known of these methods are
Transcendental Meditation (TM), Autogenic Training, Progressive Relaxation,
Symbolic Desensitization (Bandura, 1969) and Frontal EMG Biofeedback. There
are reports that at 1east some of these techn i ques will also enhance
suggestibility, creativity, and the cognitive control of autonomic functions
(Green, Green &Walters, 1971; Budzynski, 1976; Wickramasekera, 1971, 1973;
Schubot, 1966; Ferguson & Gowen, 1974). There is also evidence of the
clinical utility of these techniques for many patients with certain stress
related problems (Budzynski, Stoyva, Adler & Mullaney, 1973; Wolpe, 1973;
Schultz & Luthe, 1959; Jacobson, 1970; Wallace & Benson, 1972).
Common Therapeutic Elements
Hypersuggestibility, the "allocentric mode of perception" and enhanced
cognitive control of autonomic functions are hypothesized to be the essential
and sufficient conditions for positive cl inical outcome with these six
psychological techniques of stress reduction. The hypersuggestibility
produced by self-hypnosis and the other five techniques may enable a person
to attend to and absorb for his use in problem solving, factual information
which he might ignore or consider irrelevant in the alert waking state. For
example, Spiegel's (1970) self-hypnotic procedure for smoking controls draws
the patients attention to important but ignored information. For example,

44
he says, "You cannot live without your body . . . This is your way of
acknowledging the fragile, precious nature of your body . (Spiegel,
1976) .
The increased cognitive control of autonomic functions that a patient
often experiences with self-hypnosis or the other five techniques can add
considerably to the patients conviction of "self efficacy" (Bandura, 1977)
apart from actually reducing the frequency or intensity of a specific symptom
(e.g., tension or migraine headache pain). "An efficacy expectation is the
conviction that one can successfully execute the behavior required to produce
an outcome" (Bandura, 1977). Self-efficacy is postulated by Bandura (1977)
to be the primary determinant of the intensity and duration of coping
behaviors, assuming the patient has the relevant skills and incentives.
The "allocentric mode of perception" increases the probabil ity of
creatively approaching old problems in 1iving, finding "meaning" in what
seemed meaningless, looking freshly at everyday events, and noticing
alternat i ves where none seemed to exi st before. These att itud i na 1 and
perceptual changes can have far reaching positive behavioral and biological
consequences, which can feed back to reinforce the perceptual changes. The
patient may become more willing to take risks, acquire new skills, explore
his environment, and persist in adaptive behavior in the face of uncertainty
or non-reinforcement. The absence of an adaptive mental attitude can be at
least as crippling to self actualization as the loss of an arm or leg.
Simil arit ies
There are many differences between symbo 1i c desens it i zat ion,
transcendental meditation, frontal EMG feedback, autogenic training,
progressive relaxation and self-hypnosis. In spite of the differences
between these six techniques at a historical, cultural, and philosophical
level, they appear at a procedural level to have some similarities. First,
the most obvious way in which five of these techniques are alike is in their
similarity to self-hypnosis. As in self-hypnosis, patients or trainees are
introduced to these methods by a therapist, guru or trainer who implicitly
uses an educational model. As in self-hypnosis, there is emphasis on active
patient participation, on self-regulation of the process, on the
responsibility of the patient for the success of therapy, a graduated
approach to difficult therapeutic tasks, homework assignments, emphasis on
repeated practice at home or work, guidel ines, and periodic review or
supervision with the trainer. All these techniques appear to use a graduated

45
educational model that makes the trainee an active participant in his own
rehabilitation.
All the techniques appear to have four additional similarities. 1) All
six techniques encourage or require the trainee to restrict sensory
stimulation during the exercises. For example, 1) subjects are asked to
close their eyes, 1ie or sit still, and/or to concentrate attention on a
repetitive stimulus of phrase. 2) All six procedures encourage the patient
to relax his muscles, let go, and to reduce his level of physiological
arousal. 3) All six techniques explicitly or implicitly engage the patient's
belief system. The technique's credibility may be boosted by its association
with bel i ef systems (e. g., sc i ence, medi ci ne, human potent i a1 movement
(Barber, 1976), the mysterious and esoteric, etc.) that already have high
credibility for the patient. 4) All six techniques explicitly or implicitly
structure therapeutic expectations. All techniques are presented as
therapeutic procedures. Their claims to cl inical effectiveness are supported
by the display of empirical data in the form of charts and graphs, clinical
anecdotes, and at least plausible and logical rationales.
Where data are available, careful study demonstrates that a) there are
large and significant individual differences in response to these six
psychological stress reduction techniques, b) the effective components are
not clear in these superfi cia lly very different procedures, and c) the
mechanism of change in clinical status and physiological response is no clear
in these studies.
Sensory Restriction and Hypnotizability
It appears that sensory restriction procedures can be used to increase
human suggestibility and to potentiate therapeutic expectations (Azima, Vispo
& Cramer-Azima, 1961; Adams, Robertson & Cooper, 1963; Suedfeld, 1969;
Lindsley, 1957). These reports have been critically and exhaustively
reviewed in at least two authoritative tests (Zubek, 1969; Rasmussen, 1973)
and will not be elaborated on further.
The studies to be reviewed here, however, constitute the first
controlled empirical demonstrations that sensory restriction procedures
reliably and at least temporarily increase primary suggestibility (Eysenck
& Furneaux, 1945) or hypnotizabil ity. Previous studies focused mainly on
secondary suggestibility or persuasibility and did not incorporate pre-post
measures of hypnotizability of known reliability and validity. Increased
patient sensitivity to expectational manipulations is not appropriately

46
indexed by changes in primary suggestibility or hypnotizability.
Several controlled and independently repl icated studies demonstrate
that sensory restriction procedures increase primary suggestibility or
hypnotizability at least temporarily (Pena, 1963; Wickramasekera, 1969, 1970,
1971, 1973; Sanders & Reyher, 1969). Th is increased hypnot i zabil ity, in
turn, could make patients (in stress reduction therapies) more responsive to
any expl icit therapeutic expectations and the impl icit demand characteristics
(Orne, 1962) of all clinical situations. The sensory restriction component
built into these stress reduction procedures may potentiate the credibility
of the therapeutic milieu, and the belief systems on which these clinical
interventions are base.
Recent reviews (Adams, 1964; Suedfeld, 1977) support the thesis that
in a clinical situation subjects show a positive therapeutic response to even
a single session of mild to moderate sensory restriction. But these studies
do not illuminate the mechanism of change. The therapeutic regimens of self-
hypnosis, autogenic training, progressive muscular relaxation, transcendental
meditation, clinical biofeedback, and symbolic systematic desensitization
increase the probability of numerous brief consecutive periods of sensory
restriction, which may have cumulative therapeutic effects through
potentiated primary suggestibility and subsequently increased acceptance of
associated positive expectancies.
Muscle Relaxation and Hypnotizability
Relaxation instructions are one of the independent variables that
increase suggestibility (Barber, 1969). It would seem that increasing the
precision of relaxation training with EMG feedback may increase
suggestibil ity even more significantly. In a prel iminary study
(Wickramasekera, 1971) with twelve white male volunteers between the ages of
18 and 22, we found that the EMG feedback training significantly increased
hypnotic susceptibility (p < .001). The control procedure was an auditory
tape of the first six sessions of a psychiatric patient in feedback training.
The feedback tone declined over time but noncontingently.
Encouraged by these preliminary observations, we attempted replication,
again using twelve white vol unteer subjects and an experimental. design
i dent i ca 1 to the prev i ous study. The only differences were that in the
second (Wickramasekera, 1973) study, 1) there were ten 3D-minute feedback
training sessions; 2) the post-testing for hypnotic susceptibility was done
by a research assistant who was blind to the nature (true or false) of the

47
feedback training the subjects received. We again found that response-
contingent (true) feedback training increased hypnotic susceptibility
significantly (p ; .001).
In both of the above studies, all groups were equated on predetermined
hypnotizability, and verbal instructions to the subjects were limited to the
subjects were limited to taped verbal instructions that told them they were
to be trained to relax and that feedback training could increase their
ability to relax. These studies do need independent replication, but within
the constraints of both our experimental studies and our clinical procedures
with tension-headache patients, we have often observed that those who succeed
in learning to reliably drop (approximately 3 uV. P-P) EMG levels appear more
responsive to hypnosis on post-testing on the SHSS: B (Wickramasekera,
1976). These observations are also consistent with the systematic studies
of Engstrom (1976) and the clinical study of Malzack and Perry (1975) who
used EEG feedback for re 1ax at ion, although there may be some problems in
interpreting the EEG studies (Evans, 1972; Dumas & Spitzer, 1978).
Engagement of the Patient's Belief System and/or Cognitive Motivation
Credibility appears to be at least a function of selective experiences
and effective events (Wickramasekera, 1979). The variety of high credibil ity
belief systems (science, medicine, human potential and mystery) that
rationalize these techniques permit an accommodation somewhere on this brief
spectrum, of the bulk of individual differences in needs and beliefs, that
people in stress bring to professional and lay healers. We are introduced
as children to exaggerate images of the power and mystery of hypnosis by the
mass media (movies, TV, popular books, newspapers). Cognitive motivation for
participation in hypnosis or self-hypnosis may be latent long before the
patient enters the waiting room. Recently, heroic efforts (Hilgard, 1965;
Barber, 1979) have been made with some success to package hypnosis in the
trappings of science and even to marry it to the human potential movement
(Barber, 1976).
TM training, for example, is introduced with a display of charts and
graphs and a lecture on the scientific val idation of TM. Progressive
relaxation (Jacobson, 1970) stresses its roots in the muscle physiology
laboratory and EMG measurement. Desensitization (Wolpe, 1958) is introduced
to a patient in clinical practice with reference to its roots in the
conditioning laboratory and its presumed origins in experimental-scientific
psychology (Buchwald & Young, 1969). Clinical biofeedback uses impressive

48
scientific medical instruments, and in fact, appears to have such high face
validity that it requires no explicit presentation of credentials. Autogenic
training is preceded by a serious ritualistic medical measurement of vital
functions (pulse, blood pressure, etc.), which can create the impression that
grave and healing events are at hand. The scientific and medical packaging
of these six procedures may increase their credibility and attractiveness for
many people in distress.
These bel i ef systems provi de the ki nd of durable (Res i stance to
disconfirmation by scientific negative instances) and cross-situationally
consistent cognitive motivation to mobilize "hope" (Frank, 1965) and to
minimize the major problems with non-compliance (Failure to do "homework")
to which all psychological (Even more than medical treatments) treatments are
vulnerable. Med i ca 1 i ntervent ions have shown that the most effect i ve
treatment program (primary prevention) is that which requires the least
personal effort (Saward & Sorensen, 1978), for example, interventions like
the pub 1i c health management of water, sewage, and fl uori dat ion, etc.
Psychological, unlike medical interventions (injections, surgery, pills,
etc.) require much personal effort and time, and also intrude on the
patient's priorities and life style. Hence, a complex comprehensive and
cross-situationally consistent bel ief system that is resistant to
disconfirmation by specific negative instances is essential to motivate
compliance in the face of slow progress, uncertainty, conflict, and episodic
clinical relapse. The dogmas of older and more complex religions once
provided this motivational component. But today, the marketability of a
belief is in direct proportion to the extent to which it is packaged in
science, medicine, humanism, or mystery, in that order. The credibility of
a procedure is a determinant of the potency of the expectations it generates.
Therapeutic Expectations and Clinical Outcome
There is a good consensus in both the psychotherapy and the medical
literatures, that patient expectations can powerfully influence clinical
outcome with both psychological and biological disorders (Frank, 1965;
Shapiro, 1971; Beecher, 1959; Goldstein, 1962). The medical literature shows
that the effects of an active drug can be attenuated, potentiated, or
reversed by expectational manipulations (Shapiro, 1971). Beecher (1959) and
Evans (1974) reviewed in all 36 double blind studies and found that a placebo
reduced organic pain by half its original intensity in 36 percent of
patients.

49
 There are currently at least three models of the placebo effect. The
suggestion hypothesis (Shapiro, 1971; Barber, 1969), the anxiety reduction
hypothesis (Orne, 1974) and recently, I have proposed (Wickramasekera, 1977)
a conditioned response model. All three models regard patient expectations
as a critical component. Therapeutic expectations have also been shown to
powerfully influence the outcome of psychotherapy (Goldstein, 1962; Strupp
&Bergin, 1972) and two recent independent reviews of the massive literature
on desensitization (Kazdin &Wilcoxin, 1976; Lick &Bootzin, 1975) have also
reached the same conclusion.

SUMMARY
Self hypnosis and the five other psychophysiological stress reduction
techniques are all based on an educational model of self-regulation. Despite
varied cultural, philosophical, and historical roots these six techniques are
alike with respect to four procedural variables (sensory restriction,
relaxation, packaging to potentiate credibility, and therapeutic
expectations) which induce an altered state of consciousness in the trainee.
This altered state of consciousness appears to include three therapeutically
effect i ve elements. These elements are hypersuggest i bil ity, the" all ocentri c
mode of perception" (Sachachtel, 1959) and enhanced cognitive control of
autonomic functions.

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55
5
Body-Centered Therapies: A Holographic Paradigm for
Understanding REST
Terry Hunt

The recent theoretical developments and research on the

interplay between psyche and soma in the healing process must not
go unnoticed in the therapeutic use of REST. In particular, the
ho 1ograph i c parad i gm is presented here as a model for
understanding the homogeneous benefits of a variety of body-
centered therapies, including: massage, rolfing, Feldenkrais,
biofeedback, colonic irrigation, chiropractic, acupuncture,
osteopathy, and body-centered psychotherapi es. A "theory of
cellular consciousness" is suggested as an implication of this
paradigm and as a way to fully comprehend the val ue of these
therapies in maintaining a homeostatic equilibrium in the body.
Particular focus is paid to the author's own work with
bioenergetic analysis developed by Alexander Lowen. The
principles of charging and discharging, grounding, psychic
contactlessness, and the orgasm reflex are each defined and
discussed with respect to the therapeutic issues that are involved
and the possible value of REST in the treatment of these problems.

Since the earliest research on REST, the problems addressed by the

various research methods have consistently stretched the validity of these
methods in order to come up with any answers at all. As seems almost
inevitable in science, the most interesting problems are just a bit out of
reach. The application of the holographic paradigm to the field of REST
continues this pattern of stretching the imagination, including the mystical
overtones that have so often been problematic and closer approximations of
reality in our search and that the limits of rationality stretch rather than
rupture as we approach the ineffable.
A few examples are in order. As Suedfeld pointed out in his 1975
paper, "The Benefits of Boredom", the original interest in sensory
deprivation was to discover a resolution - the problem, "How are people
motivated internally or externally?" The answer - both ways, with individual

56
differences - is accurate but disappointing. When Orne (1964) and Rosenthal
(1975) later came to the scene and offered quite convincing evidence that
methodology was producing as much effect as treatment, interest in REST
waned almost completely among experimental psychologists, its early
champions. The recent treatment - outcome research is the best theology yet
devised for the field, but still we are left wondering if REST was actually
the cause or if the follow-up was long enough. My own doctoral research
(Hunt, 1980) was then an attempt to understand from a phenomenological point
of view how this history could be reconciled with the current condition where
the public is now willing and eager to pay to have the REST experience and
are delighted with the results!
The holographic paradigm, a metaphor drawn from the physics of light
and applied as a model of consciousness, provides both a reasonable and a
parsimonious way of looking at our current frontier. The idea was first
suggested by Stanford Uni versity neurosurgeon Karl Pri bram in hi s book
Languages of the Brain when he concluded from his research on memory and
brain functioning that it seemed to simulate the physics of this optical
storage system. Simultaneously, physicist David Bohm was developing similar
theories from his work on relativity.
The Holographic Model

The hologram can be more easily understood by the use of the above
diagram as an example. As you can see, one can take a section out of a
holographic picture, in this case the robot's midsection, and what you get
when you blow the picture back up again is a picture with the whole robot,
complete with three-dimensional aspects but with less resolution as if one

57
had used grainier film. Thus, quoting Ken Wilber in the introduction to the
Ho7ographic Paradigm and Other Paradoxes (1982).
"Each individual part of the picture contains the whole picture
in condensed form. The part is in the whole and the whole is in
each part -- a type of unity-in-diversity and diversity-in-unity.
The key point is simply that the part has access to the whole."
"Thus, if the brain did function like a hologram, then it
might have access to a large whole, a field domain or "holistic
frequency realm" that transcended spatial and temporal boundaries.
And this domain, reasoned Pribram, might very likely be the same
domain of transcendental unity-in-diversity described (and
experienced) by the world's great mystics and sages." (1982, p.2)
When I first uncovered this 1ine of thinking, my excitement led my
imagination to a rather startling possibility. What if the brain is not the
seat of the self after all? Perhaps consciousness is a characteristic of a
single cell, the brain being a holographically organized locus of
communi cat i on between cells where memori es are di sp 1ayed and act i on is
orchestrated. Perhaps consciousness does not have matter associated with its
existence at all but manifests through living cells and organisms by a method
David Bohm calls "enfolding-unfolding universe" (1982).
I suggest that this model be called "the cellular consciousness
theory". The nervous system would then be a vast communication system
carrying votes (feedback) to the brain and plans of action back to the
various cells of the body. Perhaps there is an even more sophisticated, as
yet undocumented, message system such as the aura that carries this
communication.
Body-Centered Therapies in the Paradigm
These imaginings, while outlandish in some ways, have become a
focalizing agent to synthesize into one model the variety of therapies that
are essentially body-centered. While the ideas can also invoke science
fiction fantasies of cloning a person from a finger cell, the more useful
implications point to a greater focus on a homeostatic equilibrium in healthy
human functioning. People who are too much in their heads or who vote only
with their feet are out of balance. A well functioning senate needs a
democratically organized body.
A few examples: one can imagine few places where one can find one's
own equilibrium more effectively than in a REST environment. In addition,

58
floating, by taking the body out of gravity, invites the organism to go on
idle far more completely than in any other condition yet devised for the
general public. The mind can process any backed up images that are left over
from the day while the body is able to, in parallel form, let go of any
tensions that are directly related to the mind's productions. Perhaps this
is only prophylactic rather than therapeutic. However, a homeostatic system
that daily maintains its own equilibrium is certainly in better condition
to function in a stressful world, having addressed "dis-ease", rather than
awaiting disease.
Massage and therapeut i c touch rank up there as one of the oldest
professions and can be strongly recommended for anyone on a regular basis.
While on one hand, the muscles are carefully being relaxed by the experienced
practitioner, the therapeutic value of simply having loving hands contact a
patient may only be accurately estimated through this alternative paradigm.
Osteopathy and chiropractic have consistently offered over the last century
an alternative point of view to allopathic medicine. Treat the whole person,
not just the whole in the person. While the spine is a primary focus of
these pract it i oners, the context is the body's organi zat i on and
interdependence. Acupuncture and colon i cirri gat ion, controvers i a1
techniques developed by healers millennia ago, have documented effectiveness
through helping the body release stagnated natural functions and activated
positive energetic flow. Rolfing and Feldenkrais, although quite different
in practice, both seek to ore-educate" the body to move in a more integrated
way in a gravity-affected environment. Biofeedback directly tells the ego
what the body has been communicating too subtly all along. Using this
information, the individual is immediately more integrated. Finally, body-
centered psychotherapy, in general, and bio-energetic analysis in particular,
suggest that more direct and therapeutic access to the real self is available
through the emot i ona 1 1i fe of the body, rather than solely through the
labyrinthian rationalization, attitudes, and motivating factors that seem to
originate in the intellect.
Ego-Centered Vs. Body-Centered in a Holographic World
The ego mi ght even be thought of as the seat of the false self,
grasping at images of who one would like to be or is supposed to be. The ego
forms and serves its defensive functions against the anxiety that must follow
from a child's earliest realization that the universe is often non-linear,
non-causal, non-rational, in fact, indeterminant. In other words, the

59
child's world is often terrifying and intolerable in some ways, and simple
and wonderful in others. In fact the worl d appears much more 1i ke a
meaningless pattern to a child. Unfortunately, children are generally told
the opposite: the world is meaningful and all the information is available
if you are just smart (or good, or patient, etc.) enough to find it. This
meaningless pattern may in fact be holographic in nature.
The way a hologram works can be described simply but is often quite
difficult to grasp conceptually. First, it is lenseless photography, the
image appears as if in midair, with three dimensional perspective. Second,
what appears on a holographic photograph is a seemingly meaningless pattern
that is made up of the interactions of two initially identical laser (single
frequency light) light sources. One laser goes directly to the film, the
other comes to the film having been disturbed (i.e., its frequency changed
into many other frequencies) by the object being photographed. Then the
photograph is created into the form of an interference pattern of the
original laser light and the diffused laser light. It is analogous to the
pattern one sees in a still pond when one throws a number of rocks into the
water at the same time.
Seemingly Meaningless Holographic Photograph

~
6ser l i ~ht disturbed
by object

undIsturbed
,': , t~~r

'?L "',
~ . ';""';)")
loser / oblect to be
li9h~ \ ...'''::':~:-''':~~''<~' photogr6phed

losee light
source

The photograph can then be decoded and the pi cture projected for
viewing with the original 1aser 1ight shined through the film. The
holographic theory is that the brain may function this same way. The brain's
parallel processing capability combines with the holographic theory to show
how a specific memory does not have a location but is scattered throughout
the brain. New impulses manifest in slow waves with the potential to carry
out the mathematic perception. The magic laser in that case is the old

60
nemesis of phenomenological psychology, our capacity for attention.
The Implications and the Criticism of the Theory
Without going into a very complex theory too much further, suffice it
to say that the implications of this theory extend to every aspect of human
life. The suggestion that it invites a paradigm shift is not an
understatement. If in fact the nature of reality is itself holographic and
the brain functions holographically then we must ponder with the particle
physicists whether there can be matter without sUbstance. That is then what
the Eastern religions have said, maya; a magic show of illusion.
Needless to say, there are critics of this theory from both the secular
and sacred sides. One must not rule out that what appears as illusion in
part i c1e phys i cs now wi 11 eventua 11 y have a more concrete phys i cal and
biochemical basis. On the other side, pop mystics have taken the extremely
elaborated hierarchical system of spiritual awakening to enlightenment and
reduced it to what Ken Wilber has identified as mere "Pantheism" without a
transcendent component. As he pointed out "Brahman is in the world as the
whole world, it is true, but the whole world in and by itself is not
exclusively Brahman, because you can theoretically destroy the whole world,
but that wouldn't destroy Brahman or Buddha nature or Tao . . . . . An
eternity dependent for its existence on a temporal structure, tape (recorded)
or brain, is a strange eternity." (p 251-253, 1982) Indeed!
Wilber's point of view is convincing. The usefulness and accuracy of
the paradigm remains in limbo while there are necessary research and
theoret i ca 1 developments that a11 ow for a ho 1ographi c concept without
obviously erroneous reductionism. Wilber offers an alternative which is not
unlike Polanyi's system of personal knowledge (1956) as it was applied to the
field of REST by the author (Hunt, 1980). Wilber suggests that we can learn
about the universe from the laws of physics as long as we are careful to
remember that the "higher principle comes through the lower, then rests on
the lower but does not come from the lower". God, therefore, transcends the
secondary conditions defined by lower levels of operation (i.e., physics and
chemistry) but does not violate those laws. Similarly, the absolute bliss
of nirvana will have its analog in the sexual thrill and oceanic feelings
associated with orgasm.
As Wilber points out, both Pribram and Bohm are careful not to make
these reductionist mistakes, they simply say they don't know. They are
searching for a paradigm that incorporates the transcendent with the

61
historical and physical.
The Importance of Emotion and Style of Attending
There are two key points for purposes of this discussion. First, the
concept of the access of the part through the whole and visa versa points to
the need for a deepened understanding of the interrel ationships of the
various homeostatic systems (e.g., physiological, ego-centered/cognitive-
mastery, transpersonal (Hunt, 1980) or matter, mind, spirit (Wilber, 1982).
In other words, how do these levels interpenetrate? It is the body-centered
perspective that the mechanism of interpenetration is associated with human
feeling.
The second point is that in this paradigm a person's capacity and style
of attention directly affect the manifestation of the holographic universe.
We actually live in different worlds. One's capacity and style of attending
and making contact must now take a central role in the understand i ng of
individual differences. For example: anxiety and stress in a holographic
model can be reformulated as "static" rather than as "dust on the lens". It
is not that one's vision is inaccurate or blurred, but that one is out of
contact, "not really there".
The Paradigm Shift from Doing to Being
The impl ications of this simple idea are indeed paradigmatic and
directly infer the value of body-centered therapies and REST. We are now
challenged by this paradigm in very important new ways for Western people:
"Don't just do someth i ng, be there!" When confronted with an unusual
percept ion, Contact it, dwell in it, empath i ze with it fi rst. In REST,
since there is nothing else to do, one learns to release the static rather
than to activate the fight/flight system that rushes to fit the perceptual
information through a previously constructed lens. In this new model, a
well-formed homeostasis is as valuable as a sharp intellect for healthy adult
functioning in a stressful world.
The therapeutic value of the integration of the body, mind and spirit
was first articulated in Western psychology by Wilhelm Reich in the Function
of the Orgasm (1940), a book that has been insufficiently read and greatly
misunderstood because of its controversial subject matter and hostility that
Reich had personally engendered from his colleagues by the time of its
publication. His perspective was that the organism has an energy economy as
its primary determinant of functioning. The body becomes excited and must
find a way to discharge that excitement. Aggression, often in the form of

62
eating and sexual expression, is therefore a natural movement of the
organism. Reich went on further to suggest that an orgasm is essential to
stable adult equilibrium, since orgasm is the most complete system that the
body has to discharge energy. The levels of mind and spirit must have their
own forms of satisfactory expression as well.
But Reich and Alexander Lowen, who elaborated on these theories,
maintain that the foundation of healthy adult homeostasis cannot be in these
higher levels of operation unless the body is functioning properly. In other
words, physical reality is the primary access point for healthy human
functioning because it is the sine qua non. Without the body, there is not
life to theorize about.
The Dialectical Relation of Mind and Body
It is from this formulation, the primacy of body, that body-centered
therapy takes its theoretical cue. The holographic paradigm merely supports
it by pointing to the interpenetration of the various levels of the hierarchy
without negating the principle that the higher order must not violate the
laws that apply to the lower. In simple fact, the body must live, and live
fully, if the mind is to be fully sane and the spirit is to soar to its
fullest potential.
Reich, however, also theorized that the conflict between mind and body
should be seen as an unfolding dialectic rather than as a battle between id
and superego for ego's allegiance. The thesis, or primary force, of the
dialectic was the functional identity of the mind and body in their mutual
drive toward pleasure. As the body feels good, the mind also feels good.
Darwin's discovery that evolution is driven by the survival of the species
laid the foundation for Freund's discovery of (and Reich's emphasis on) the
sexual basis of personality development. This logic is appropriately named
"The Pleasure Principle".
The antithesis of the dialectic between the mind and body is that the
ego must surrender to the involuntary processes of the body and give up ego
control in a healthy sexual encounter. The ego is at its best in dealing
with problems and solving them. It is not formed with respect to pleasure,
wonder, or love. Tragically, the ego rejects this primacy of the body
because of, 1) the terror of the involuntary and, 2) the fact that the ego's
self-esteem, more or less developed through interactions with parents and
society, is dependent on its ability to control and suppress the organismic
impulses, especially the sexual ones. Character formation is the habitually

63
developed solution to this ongoing mind-body dialectic.
Reich, then, empirically discovered that the synthesis of the dialectic
was that character formation and chronic muscular tension in the body were
both caused by real and imagined trauma in childhood and were functionally
identical. They didn't look alike since they operated on different levels,
but they functioned in the same way, constricting the original impulses of
the organism towards basic pleasures.
Reich also noticed that no amount of interpretation of the unconscious
neurosis was ultimately of positive therapeutic value without the parallel
release of muscle tension. In the same way a neurotic ego chronically
repeats self-destructive behavior, muscular tension is similarly blocking the
flow of energy and excitement, both pa i nful and p1easurab 1e, that was
ori gi na 11 y experi enced as overwhe 1mi ng and into 1erab 1e by the deve 1opi ng
child. As a result, the neurotic adult is withdrawn from full contactfulness
with reality and has replaced reality with an image of reality that more or
less corresponds with the reality of others.
As we all know, the search for satisfaction is inevitably at odds with
one's environment. The particular constellation of blocks to satisfaction
from parents and other loved ones forms the basis of individual character
structures. Ego development is the compensating factor in what would
otherwise appear to the child to be an overwhelming scary dog-eat-dog world.
Less body-centered formul at ions have consi stently argued that the
essence of cure is in intellectual self-understanding and self acceptance.
The fact that this contrasts so dramatically with the most basic needs for
human contact of all kinds never ceases to baffle me. Instead of pursuing
the goal of experi enci ng the rare phenomena of a healthy orgasm wh i ch
produces deep abiding affection, gratitude, and fidelity toward one's
partner, our society reacts with a conflict knee-jerk repulsion toward the
priority of one's sexual life.
Image vs. Reality
At the same time, we seem to have become a society preoccupied with
fantasy, sexual and otherwise. One's image has become the important
priority. Reality has been forced to take a second place. The point I'm
trying to make here is that while the ego is the champion of image, the body
is the halcyon of reality. So many people are trying to fit their bodies
into the i mage that they hold for themselves. Any witness to these
obsessions must see the task is one of chasing the carrot that belongs to the

64
young, the perfect, and those who appear never to suffer.
In contrast, the therapeutic work of body-centered therapies as well
as REST sometimes involves pain. The reality is that the body is and has
been in some measure of pain since its first impulse towards pleasure was
welcomed like a cut whose irritation draws our attention. Healthy organisms
embrace reality, however pleasurable or tragic at the moment.
An example: when someone enters a float tank, they become aware of
tensions that they have not experienced in years, and might never experience
otherwise. From the body-centered point of view, pain can be defined quite
simply: If it hurts, pay attention to it. While our society is inviting us
to numb ourselves to anxiety with alcohol, cigarettes and portable
headphones, the principle of the primacy of the body is trampled on in the
glorious quest for an image or a self that is false. Even meditation and
jogging can be misused in this way.
Transformation Through the Body
The principle of the primacy of the body can provide a liberation that
the ego in its defensive functions can never provide. In the float tank, the
body usually develops an euphori a after even a bri ef peri od. Persona 1
satisfaction should be the result; unfortunately, this is not always so. The
body has also developed its own defense reactions so that reality can be
equally inaccessible through the body, particularly when one has avoided the
emotional life of the body for an extended period of time. A floater will
experience relief for a brief period of time (i.e., "get high on floating")
but eventually they will return (i .e., "crash") to the chronic muscular
pattern if some transformation doesn't take place. The therapeutic premise
of REST and body-centered therapies, however, is that the more a person
inhabits his/her own body (not the perfect body), the more in reality he or
she becomes. The more in real i ty one is, the more sanely a person can
function in ways that result in personal satisfaction, sexual and otherwise.
A Cellular Theory of Transformation
Bioenergetic analysis (Lowen, 1975) offers three general areas where
the body can be addressed in ways that promote this movement toward personal
satisfaction: psychic contactfulness, charging and discharging, and
groundedness. Following the holographic paradigm, we can consider cell
functioning as a simple example. Bodily expression is modeled as an
aggress i ve movement from the center (nucl eus) to the peri phery (semi-
permeable membrane). This expression (the arrow in the diagram) can be

65
construed as self-protective or as a mechanism to absorb nutrients from the
environment.
At the boundary is another cell with which to communicate. In the
float tank, we can theorize that a primary cellular communication is in the
"letting go" of the muscular organization that is developed in response to
gravity and other external stimulation. The body goes through a
disorganization that is either resisted by the ego or allowed in the form of
"regression in the service of the ego" (Kris, 1952) or "ego diffusion"
(Kammerman, 1977). In this state, Suedfeld (1980) has suggested that an
"unfreezing" of the habit-attitude-behavior-belief structure takes place
through inspiration, suggestion or self-hypnosis. In bioenergetics, we
similarly talk of a body armor being frozen in such postures as in fright,
as victims, in defiance, or in needy, burdened, rigid or dominant positions.
Psychic Contactlessness
Bioenergetic analysis emphasizes the importance of the need for healthy
contact at boundaries where one is neither psychically withdrawn nor
unbounded and engulfing. The neurotic can be obstructed from fully
contacting his or her environment at almost every orifice (especially the
eyes, lips, genitals and anus) as well as on the skin in general. When one
touches the body, or looks at a patient's eyes with expertise, one can easily
tell the dimensions of contactlessness in an individual. In a REST
environment, the practice of mindfulness, "continuous uncapitulating
alertness" (Krishnamurti, 1969), can deepen one's abil ity to be aware of this
dimension; but generally, one is much more aware of how one loses contact
when one is in a stressful condition.
Charging and Discharging
Being highly charged is an example of such a stressful condition.
Healthy individuals are able to build and maintain a charge of excitement,
even one that is not necessarily pleasurable. For example, in the upper
body, one might reach out with aggression and not be immediately gratified.

66
"Giving up" and rigid determination are opposite examples of the same
problem: diminished charging ability. In the lower part of the body, one
must be able to charge and discharge throughout the entire body, particularly
into the heart, where the flow of excitement activates profound "heart-felt"
emotions for one's partner.
The most basic way to change a body is to breathe deeply without losing
contact with reality. Too much oxygen can make one "spaced out" or
hyperventilate. The technique can be practiced with caution in a REST tank.
Allow sufficient time for discharge which may include spontaneous expression
of feelings, especially anger and sadness. One caution: to the extent that
a body is integrated among its various parts, that is the extent that the ego
is able to surrender to the involuntary (i.e., discharge) functions of the
body without losing self esteem.
Grounding
Breathing is an organismic expression of self-extension and self-
contraction. It builds a genuine sense of self as the body charges without
strain. One then discharges by spontaneously releasing muscles that have
become too taut with the charge. Unfortunately, one can easily "space out"
into euphoric states if "one does not keep one's feet on the ground". This
is the great danger of floating; the over valued ideas that come to one in
this state are just one example. By "grounded" homeostatic equilibrium, as
one Sufi teacher suggested to me, the enlightened seeker may have his or her
head in the clouds, but his or her feet are on the ground.
Being grounded results in feeling, not always pleasant feelings. Real
feeling is an expression of an integrated cellular organization. Impulse
inhibited characters have little feeling at all. Narcissistic characters,
epidemic in our culture, have feelings associated with false idealized images
of self, therefore have 1ittle real feel ing either. In the narcissistic
character sexuality is under the control of the self-esteem and never the
heart. In bioenergetic analysis, the healthy individual is one who is strong
enough to face disappointment with real feelings of pain in the heart.

SUMMARY
A healthy floater can be described similarly. He or she is able to be
alone with his or her body in a state of energetic disorganization, perhaps
painful at times, without withdrawing from contact with reality. Within the
framework of the holographic model, the floater's mind may soar to ecstatic

67
heights or crash into intolerable pain while the body progressively lets go
of tension that had previously inhibited the natural impulse toward
satisfaction. The sense of satisfaction may be derived simply from a good
meal for the body, or an insight for the questioning mind.
The tool of attention is also different in a holographic "lenseless"
universe. In order to have accurate perception, the task of alertness must
not be only one of simply focused concentration, but also one of tuning into
reality as it unfolds. This tuning in optimally occurs with every cell of
one's body. Thus, a theory of cellular consciousness is the ultimate
implication of this line of thinking.
Finally, tuning in must be the context of the accuracy of the organism.
Contactlessness, the ability to charge and discharge, and groundedness are
unqualifiable and usually depend on the circumstances. We can be more finely
tuned after a float, massage, or a profound di scharge. We wi 11 fi nd
ourselves out of psychic contact at another time. In any case, perfectionism
is a principle of the mind and spirit. It is an image one strives for. It
has very little to do with the life of the body. Body, mind and spirit may
interpenetrate as we search for meaning in loss and pain. At the body level,
pain simply just hurts. Premature attempts to rationalize the pain can lead
to a block of energetic discharge and reinforcement of chronic muscular
patterns.
Pleasure is also the body's birthright. Maintaining a healthy
homeostasis is not only dealing with "dis-ease" and stress, but focusing for
the body's sake on pleasures as well. Egos are good at deal i ng with the
prob1ems, that's what they are des i gned for. The body is home. In a
holographic universe it may be an illusion; but a healthy person keeps his
or her feet on the ground and his or her house in order.

REFERENCES
Bohm, D. The enfolding-unfolding universe: A conversation with David Bohm,
with Renee Weber. In: Wilber, K. (Ed.) The Holographic Paradigm and
Other Paradoxes. Boulder, CO: Shambhala, 1982, 44-104.
Hunt, R. (Terry) Naming an unknown world: The transformation of perceived
meaning by voluntary subjects after repeated use of the "isolated tank"
floatation environment (unpublished doctoral dissertation, Boston
University) 1980.
Kammerman, M. Personality changes resulting form water suspension sensory

68
 isolation. In: Kammerman, M. (Ed.) Sensory Isolation and Personality
Change. Springfield, IL: Charles C. Thomas, 1977.
Kris, E. Psychoanalytic Explorations in Art. New York, NY, 1952.
Lowen, A. Bioenergetics. New York, NY: Penguin Books, 1975.
Orne, M. On the social psychology of the psychological experiment with
particular reference to the demand characteristics and other
implications. American Physiologist, 1962, 776-783.
Polanyi, M. Personal Knowledge: Towards a Post-Critical Philosophy.
Chicago, IL: University of Chicago Press, 1958.
Pribram, K. What the fuss is all about. In: Wilber, K. (Ed.) The
Holographic Paradigm and Other Paradoxes. Boulder, CO: Shambhala,
1982, 24-34.
Rosenthal, R. Experimenter Effects in Behavioral Research. New York, NY:
Appleton-Century-Crofts, 1966.
Suedfeld, P. The benefits of boredom. Sensory deprivation reconsidered.
American Scientist, 1975, 63, 60-69.
Suedfeld, P. Restricted Environmental Stimulation. New York, NY: Wiley-
Interscience, 1975.
Wil ber, K. The Ho 1ographi c Parad i gm and Other Paradoxes: Exp 1ori ng the
Leading Edge of Science. Boulder, CO: Shambhala, 1982.

69
Section II
Experimental Studies
6
Hormonal Changes Associated with Restricted Environmental
Stimulation Therapy
John W. Turner, Jr. and Thomas H. Fine

ABSTRACT
Restricted Environmental Stimulation Therapy (REST), which involves
placing an individual into an environment of severely reduced stimulation for
brief periods, has been subjectively reported to produce deep relaxation.
The present studies determine the effects of REST-assisted relaxation in the
plasma levels of several hormones including cortisol, ACTH, luteinizing
hormone (LH) and testosterone and urinary levels of cortisol. The possible
role of endogenous opioids in the mild euphoria which is frequently
associated with REST-assisted relaxation was also examined in a preliminary
study using an opiate antagonist, naloxone. Varied protocols in these
studies with different groups of subjects included from 4 to 20 REST sessions
in frequencies ranging from bi-weekly to daily. The direct hormone
measurement studies utilized a baseline-treatment-follow-up design, whereas
the naloxone study employed a single subject double-blind crossover design.
Pl asma and uri nary cort i so 1 and plasma ACTH showed s i gnifi cant decreases
associated with REST. Testosterone and HL levels in plasma did not change.
All subjects reported that the REST experience was deeply relaxing. Naloxone
treatment cons i stent 1y prevented the mil d euphori a associ ated with REST.
These data suggest that REST-assisted relaxation is associated with REST.
These data suggest that REST-assisted relaxation is associated with specific
decreases in the activity of the pituitary-adrenal axis, and that the mild
euphoria occurring in REST may be mediated by release of altered sensitivity
to endogenous opioids.

INTRODUCTION
During the 1950's, there was a push to new frontiers in many areas of
science and technology. Space flight was coming of age, extensive underwater
exploration was undertaken and the field of psychology was probing areas such
as motivation, social development and the neurological basis of behavior.
A common aspect of these investigations was the need to know. how isolation
and sensory deprivation would affect physical and mental states. Since the

71
early studies with sensory deprivation attempted to define response limits,
conditions of severe isolation for prolonged periods were used (reviewed in
Suedfeld, 1980; Zubek, 1969). In essence the mind set was one of
"endurance". It is not surprising, therefore, that subjects invariably
exhibited stress responses such as increased sympathetic nervous system
activity and adrenal activation. Since the focus was on long-term isolation,
it is also not surprising that the data on short-term isolation (less that
2 hrs) were largely ignored. Interestingly, these data showed changes in
measured endpoints which suggested that in most subjects rel axation was
occurring in the first two-hours of isolation. When we viewed this
information in light of the experimental reports of deep relaxation achieved
during brief flotation isolation which were published by John Lilly in 1977,
we were convi nced of the meri t of invest i gat i ng the psychophys i 01 ogy of
sensory deprivation. The recently adopted terminology for this re-emerging
field is Restricted Environmental Stimulation Therapy (REST).
One of our early goals in this work was to find reliable physiological
indicators of the effects of REST. The endocrine systems of the body are
perhaps the most refined examples of biological homeostasis, and the
endocrine feedback loops are exquisitely sensitive. We hypothesized that by
combining the reportedly profound relaxation experienced in REST with the
high sensitivity of hormonal feedback regulation, we would maximize the
opportunity to observe the physiological effects of REST.
The choice of hormonal endpoints was not difficult. Since activation
of the pituitary-adrenal axis is well known to be part of the response to
both acute and chronic stress, we hypothesized that the deep relaxation of
REST would be associated with a decrease in the activity of the pituitarv-
adrenal axis. We also hypothesized that REST-assisted relaxation may be
associated with the release of endogenous opioids. Exogenous administration
of p-endorphin has been shown to produce transient analgesia and various
degrees of euphoria (Toyama &Heyder, 1981; Malizia et al., 1978) and in our
laboratory eighty percent of more than 200 people using our REST facility had
reported a mild euphoria associated with the REST experience. Furthermore,
in a clinical study of chronic pain patients we observed consistent decreases
in reported pain levels during REST (Fine &Turner, 1984).
On the basi s of the above background, the present studies were
undertaken to exami ne hormonal responses to re 1ax at i on associ ated wi th
flotation REST. Specifically these studies examine (1) the effects of REST

72
on the activity of the pituitary-adrenal axis and (2) the effects of
naloxone, an opiate antagonist, on the REST experience.

METHODS
REST Chamber
Purchased from Samadhi Tank Company (Los Angeles), the chamber (06) was
a rectangular box 8' long, 4' wide, and 42" high, constructed of styrofoam
backed with bl ack pl astic. Twenty-gauge vinyl (simil ar to that in a
waterbed) lined the box and contained saturated epsom salts solution (sp. gr.
1.3). Temperature control of the solution (94.0 ± .S'F) was maintained
through the use of a water bed heater with a solid-state thermoregulator. The
REST chamber was completely enclosed, eli mi nat i ng 1i ght. Marked sound
attenuation (levels < 10 dB) occurred since the ears were submerged in the
solution during flotation. Subjects floated nude in supine position with
arms at their side (Figure 1).

' - - - - ' PUMP & FILTER f----f------+----"

B.

Fig. 1 Diagram of Restricted Environment Stimulation Therapy (REST)

flotation chamber. Enclosed light-free sound-free environment
is regulated by (A) temperature control system to ±.soF, (B) air
circulation system, and (C) pump and filter system for saturated
aqueous epsom salts.
Experiment 1 - Short-term effects of brief, repeated REST on plasma
adrenocorticotropic hormone (ACTH), luteinizing hormone (LH) and cortisol.
Subjects:
Twelve normal white male volunteer subjects, aged 22-30, were studied.
The subjects were recruited from a medical school class and were told that
they were participating in a study of physiological changes associated with

73
relaxation. All subjects were on a normal diet with normal mealtimes and
normal sleep-wake cycles. Subjects were divided equally and randomly into
two groups, one experiencing REST-assisted relaxation and one experiencing
a similar relaxation procedure but without REST.
Procedure:
The REST procedure began with subjects in dim light in the chamber.
The lights were decreased to complete darkness and the taped audio message
"my arms and legs are heavy and warm" was played quietly for 90 seconds.
Lights were then returned to basel ine for 60 seconds while the subject
allowed thoughts to flow without special focus (as per instruction). This
procedure was repeated for 10 full cycles. Non-REST relaxation subjects were
reclined in a reclining chair in a room with dim lights «1 ftcd) and little
room noise « 30 dB). These subjects received the same light-dark and
message procedure as the REST group for 10 full cycles. The experiment was
divided into three phases: baseline, REST or non-REST relaxation, and
follow-up. Baseline was two sessions lasting 35 minutes each, with 1 day
between the sessions. During baseline all subjects reclined quietly for 30
minutes in a recl ining chair. Four days later REST sessions were begun.
REST (or non-REST) relaxation consisted of one 35-minute session per day as
described above for 4 consecutive days. Four or 5 days later each subject
had two 35-minute follow-up sessions in which he util ized the relaxation
phrases in the same environment as for baseline. At the end of follow-up
each subject was asked to fill out a brief questionnaire evaluating the
relaxation experience. All sessions took place between 1200 and 1400 hr and
all sessions for a given subject started within 1 hour of the same time each
day. Blood samples were collected in heparinized vacutainers from the
forearm, with subjects in a sitting position, before and after sessions 1,
2, 5, and 8. Samples were centrifuged immediately and plasma was frozen.
Cortisol was measured by radioimmunoassay (RIA) kit (Code KCOD2, Diagnostic
Products, Los Angeles). ACTH was measured by RIA kit (CODE IM66, Amersham
Corporation, Chicago). Luteinizing hormone (LH) was measured by RIA kid
(Code LM7011, Nichols Institute Diagnostics, San Pedro). Quality-control
measures for each assay were withi n respective 1 imi ts of acceptabil ity.
Assays were carried out in bl ind fashion. (Because several post-session
blood samples were inadvertently destroyed, the n is less than 6 in tables
with pre-post measures). The results section is divided as follows: (I)
cortisol, (2) (2) ACTH and LH, and (3) attitudes of subjects. The hormone

74
subsections are further subdivided according to the comparisons that were
considered: (a) presession versus postsession for a given session (acute
effects), (b) across sessions (long-term effects), i.e., baseline (sessions
1 and 2) versus treatment (session 5) versus follow-up (session 8), and (c)
REST versus non-REST.
Experiment 2 - Long-term effects of brief, repeated REST on plasma and
urinary cortisol.
Subjects:
Three previously diagnosed borderl ine essential hypertensives were
recrui ted as volunteers from the general popul at i on as part of a blood
pressure study. DJ was a 25-year-old white male, TB was a 52-year-old white
male and GM was a 50-year-old white female. All subjects had been on
diuretic medication which was withdrawn prior to the study and were otherwise
healthy.
Procedure:
The single subject experimental design included 5-week baseline, a 10-
week REST treatment (2 sessions per week, 20 min. each) and a 12-week follow-
up. Twenty-four hr. urine samples and blood samples were obtained in weeks
3 and 5 of baseline, weeks 8 and 10 of REST treatment and weeks 6 and 12 of
follow-up. All blood samples were taken as presession samples. For each
blood sampling, two samples were obtained 20 minutes apart between noon and
1400 hr. via forearm venipuncture into heparinized vacutainers. After sample
configuration, plasma was stored at -20·C. Cortisol was measured by
radioimmunoassay (Kit KCOD2, Diagnostic Products, Los Angeles). Blood
pressure was measured in these subjects twice before each session. During
baseline and follow-up, all subjects reclined quietly in a reclining chair
in a room with dim lights « 1 ftcd) and little room noise « 30 dB). The
first four REST sessions served as orientation to the procedure. In the
fifth and subsequent sessions, each treatment included 40 min. REST plus 10
mi n. of autogen i c re 1axat i on at he end of the sess i on. Subjects were
instructed to provide their relaxation phrases daily at home. All sessions
took place between 1000 and 1800 hrs. and those sessions which included blood
sampling took place between noon and 1500 hr.
Experiment 3: - Effect of 13 consecutive daily REST sessions on plasma
cortisol and testosterone.
Subjects:
A 24-year-old white male medical student served as the subject in this

75
study. He had participated in a previous REST study. The study was
performed during a relatively non-stressful period, with no pending exams or
major personal problems. His normal daily activities were no interrupted by
the study.
Procedure:
The REST sessions began Monday, March 23 and finished Sunday, AprilS.
There were 13 consecutive daily 1 hr. REST sessions and one follow-up session
9 days after. A relaxation tape was played during the first 5 min. of each
sess ion. Blood samples were taken on the fi rst 2 days and thereafter on
alternate days via forearm venipuncture prior to each session and between
noon and 1400 hr. On non-sampling days the onset time of sessions ranged
from 1000 to 1800 hrs. A follow-up blood sample was taken 9 days after
cessation of REST sessions. Plasma cortisol and testosterone were measured
by radioimmunoassay (Kit KCOD2 for cortisol, Diagnostic Products; Testokit
for testosterone, Serono). The subject also provi ded a bri ef, written
subjective report after each session.
Experiment 4 - Effect of naloxone, an opiate antagonist, on the REST
experience.
Subjects:
Four white mal es between 25 and 38 years of age were used in th is
pre 1imi nary study . All subjects had more than 2 years of fl otat i on REST
experience, and they had consistently reported that these experiences were
associated with mild euphoria.
Procedure:
All subjects were informed that the study was examining the potential
effect of naloxone, an opiate antagonist, on the euphoria associated with
flotation REST. A trial study demonstrated that subjects in a routine daily
activity setting could not differentiate between saline placebo and naloxone
injections. Each subject experienced 4 REST sessions: two naloxone and two
saline placebo. All injections were intramuscular in 1 ml volume. The does
of naloxone was 0.8 mg (NARCAN), which has been shown to reverse the effects
of opiate overdose in addicts (Malizia et al, 1978) and to nullify mood
changes induced by acupuncture (Toyama &Heyden, 1981). The period of peak
effect was from 30 to 90 min. Treatment was in random order and in double
bl ind format. At the end of each session the subject (1) guessed which
treatment he had received, and (2) completed the Zuckerman Multiple Affect
Adjective Check List.

76
 RESULTS
Experiment 1 -
Cortisol:
Both pre-and postsession data are available for sessions 1, 5, and 8.
Only presession data are available for session 2. Cortisol data were
subjected to a repeated-measures ANOVA (2 X 2 X 3). The independent factors
were as described above (a) pre/post (within), (b) sessions (within), and (3)
treatment (between). Significance for specific differences was determined
by a Newman-Keuls multiple-range test.
Pre/Post. In the REST -ass i sted group average postsess i on plasma
cortisol levels were significantly (p < .05) lower than the presession levels
in session 5 (treatment). Levels were not different in sessions 1 (baseline)
or 8 (follow-up) (Table 1). In the non-REST group, average pre- and
postsession plasma cortisol levels were not different for any session. In
session 5 the REST -assisted group averaged 20.3% pre-to postsession decrease,
while the non-REST group averaged 7.3% decrease.

Table 1

Plasma Cortisol Before and After REST-Assisted

Relaxation and Non-REST Relaxation

CONOlTlONS' GROUP (n) PLASMA CORTISOL (mg/d1) !. SE

Pre-Sess i on Post-Session

Basel ine. REST 12.9 + 1.0 13.6+1.1

(Session 1) Non-REST 12.8 I2.2 13.4 I 1.6

Treat"'ent REST 11.9 + 0.7 9.3 + 0.5**

(Session 5) Non-REST 13.3 I loB 11.8 I 1.8

Follow-Up REST 12.1 + 1.5 11.1 + 1.2

(Session 8) Non-REST 14.6 I2.0 13.8 I2.3

* Experiment consisted of Baseline (Sessions 1 and 2), Treatment

(Sessions 3, 4, 5 and 6) and Follow-Up {Sessions 7 and 8}. REST
relaxation was used only during Treatment sessions in REST group.
All other sessions for both REST and non-REST groups employed
non-REST relaxation. Post-session data were not available for
Sesssion 2.
Values significantly different (p <0.05, multiple range test.)

77
 Across Session. Results presented in Figure 2 reflect pooled pre- and
postsession values, since pre- and postsession measures showed significant
interaction with across-session measures in ANOVA and the average values most
effect i ve 1y represent the long term. In the REST group plasma cort i so 1
levels in sessions 5 and 8 were significantly (p < .05) lower than in
sessions 1 and 2, which were not different from each other (Figure 2).
'6

.~

..J
o
UJ
~ 13
o
<.l
«
~
UJ
«
..J
0.. .2

11

.0

8~SEl1NE
t TREATMENT
t
POST -TREAT M ENT

SESSION

Fig. 2. Effect of repeated brief REST on plasma cortisol. Data re-

present pooled pre- and postsession values. Shaded areas are 95% con-
fidence intervals. Values for REST treatment and REST follow-up were
significantly different from all others (p<.OI, multiple-range test).
REST II---tI (N=6), non-REST 0-----0 (N=6).

78
In the non -REST group there was no difference in plasma cort i so 1 across
sessions.
Rest versus non-REST. As shown in Figure 2, plasma cortisol levels in
the REST group were not different from levels in the non-REST group in
sessions 1 and 2 but were lower than non-REST group levels in sessions 5 and
8 (p < .05).
ACTH and LH:
Due to variation in absolute ACTH and LH values among individuals,
these data are presented in the form of postsession value as percent of
presession value, which reflect pre to post changes. These data also did not
meet bas i c criteri a for paramet ri c stat i st i cal anal ys is and therefore
significance of specific differences was evaluated by non-parametric tests.
Friedman test, Wilcoxon signed-rank test, and Mann-Whitney U test were
appropriately employed.
Pre/Post. No significant pre/post differences in plasma LH occurred
in any sessions, and no trends were apparent (Table 2). Regarding plasma
ACTH, a 39.3% decrease was observed in session 5 in the REST group. This
decrease was significantly (p <. 05, Wilcoxon test) greater than the decrease
in sess i on 1 in the rest group. No other s i gnifi cant pre/post changes
occurred in any sessions in either the REST or non-REST group (Table 2).
Four of five subjects in the REST group showed a decrease in plasma ACTH in
session 5, while four of five non-REST subjects showed no change or a slight
increase in plasma ACTH in session 5.
Across Sessions. Plasma LH and ACTH levels in both the REST-assisted
and non-REST relaxation group showed no differences across sessions (Figure
3). No trend was observed in plasma LH across sessions in either group.
Average plasma ACTH levels showed a decreasing trend across sessions in the
REST group but not in the non-REST group.
REST versus non-REST. Regarding plasma LH, no differences between REST and
non-REST groups were observed in either pre/post or across-session measures.
For ACTH, the amount of change from pre- to postsessions in the REST group
was not different from that in the non-REST group in sessions 1 and 8.
However, in sess i on 5 the pre/post ACTH change in the REST group (39.3%
decrease) was significantly (p < .05, Mann-Whitney U test) greater than in
the non-REST group (3.9% decrease). As stated previously, in the REST group
the pre/post differences in session 5 were significantly greater (p <.05,
Wilcoxon test) than the respective pre/post differences in session 1. This

79
 Table 2. Effect of REST on Plasma ACTH and LH:
Comparison of Pre- and Post-session Values

CONDlTIOS' Post-Session Value as Percent of fMean.:. S8

Pre-Session Value (100%) ! Sf L(median)J
REST (n) NON-REST (n)

Basel ;r.e ACTH 96.8 + 10.3 (5) 92.0 + 13.1 (5)

(98.6)- (107.5)-

Treatment ACTH 60.7 + l1.9**t (5) 107.8 + 10.4 (5)

(63.1)- (99.2)-

Fa 11 ow-up ACTH 98.4 + 16.0 (4) 101.9 + 29.2 (5)

(97.4)- (95.2)-

Basel ine LH 104.1 + 22.1 (5) 93.4 + 36.2 (4)

(83.4)- (82.9)-

TreatITEnt LH 110.5 + 16.7 (5) 99.2 + 16.0 (5)

(104.5)- (86.6)-

Fa 11 ow-up lH 87.8 + 20.7 (5) 78.4 + 15.5 (5)

(79.3)- (87.5)-

* Non pararretric Friedman test showed significant (p <0.05) difference

across sessions for ACTH in REST group_ This test, when applied to
non-REST ACTH~ REST LH or non-REST lH Showed no differences across
sessions.
Value significantly (p <0.05, Wilcoxon signed rank. test) different
from basel i ne.
t Value significantly (p <0.05. Mann-Whitney-U test) different from
value in comparable non-REST group.

comparison in the non-REST group showed no significant difference.

Summary:
Pl asma corti sol and ACTH, but not pl asma LH, showed significant
changes. Both cortisol and ACTH decreased only in the REST group and only
in session 5 in that group. Plasma cortisol, but not ACTH or LH showed a
decrease across sess ions in the REST group only, bei ng lower in both
treatment and follow-up than in basel ine. ACTH, but not LH, showed a
decreasing trend across sessions.
Attitudes of Subjects:
At the end of follow-up, all subjects were asked to rate the following
questions on a O-to-5 scale: (a) Do you believe you learned a relaxation
technique? (b) Did you experience physical relaxation during the procedure?
(c) Di d you experi ence mental re 1ax at ion duri ng the procedure? All REST
subjects and all except one non-REST subject responded to question (a) at a
4 or 5 rating and to question (b) at a 5 rating. The average rating for
Question (c) was slightly higher for REST (4.8) than for non-REST (4.0)

80
 e= REST
0= CONTROL

40

PLASMA
LH
(ng/mil
30 .. ····1
20

.·-1
40

PLASMA
ACTH
(pg/ml)
30
. . . . . . . . . .+. .
20

BASELINE TREATMENT FOLLOW-UP

SESSIONS

Fig. 3. Effect of repeated brief REST-assisted or non-REST relaxation on

plasma ACTH and LH. Data represent pooled pre- and postsession
values. Values were not different across sessions for either
hormone in either group. REST (n=6), non-REST control (n=6).

subject, and this difference was significant (p <.05, t-test). Note:

Portions of Experiment 1 have been previously reported (Turner and Fine,
1983).
Experiment 2 -
Results are presented in Figure 4. Subject OJ showed a 22% decrease
in plasma cortisol from baseline to end of treatment, with a return to
basel i ne during foll ow-up. In subject TB, pl asma cortisol decreased 36%
across treatment and was still 27% below baseline at the twelfth week of
follow-up. Plasma cortisol values in subject GM were in the low-normal range
during baseline and did not change more than 10% across treatment and follow-
up.
Urinary cortisol levels decreased from baseline to end of treatment in

81
all subjects (average reduction of 18.7%). This decrease continued in all
subjects through follow-up, with an average difference of 48.7% between
baseline and follow-up.

1~0 T8

120 .

100 .
URINARY

CORTISOL
80 . DJ
(MG/GM CREATININE) GM

60 .

20
DJ

T8
15 .
PLASMA

CORTISOL GM
10
(~G/DL)

BASELINE TREATMENT FOLLOIof-UP

Fig. 4. Pl asma and uri nary cort i so 1 changes in three essent i a1

hypertensives experiencing flotation REST. Protocol included 6
week baseline, 10 week REST treatment (biweekly sessions, 40 min.
each) and 12 week follow-up.
Experiment 3 -
The average value for plasma cortisol in the first two session was 14.7

82
and 14.1 ug/dl, respectively. Cortisol levels decreased gradually with some
variation to a value of B.6 and 10.4 on the last two sampling days (Figure
5). The cortisol level in the blood sample taken 9 days after cessation of
REST was B.9 ng/ml. Plasma testosterone values were 6.60 and 7.00 ng/ml for
the first two samplings and 6.60 and 7.10 for the last two samplings,
respectively, with no consistent changes across sessions. The same taken 9
days after cessation of REST revealed 7.35 ng/ml. Subjective reports
i nd i cated that all sess ions were good to excellent with the except i on of
session 4, which "ended a very angering day".

15

12.5
PLAS~lA

CORTISOL
10
(pGJ'DL)

7.5

8.0
PLASMA
TESTOSTERONE 6.0
(NG/ML)

4.0

2.0

I----DAILY REST SESSIONS -----1

, I

5 6 7 8 9 10 11 12 13 14 23

DAYS

Fig. 5. Plasma cortisol and testosterone in a single subject experiencing

daily 40 min. flotation REST sessions for two weeks. A follow-
up sample was taken 9 days after cessation of REST.

B3
Experiment 4 -
In all trials for all subjects (4 X 4) the accuracy of guessed
treatment was 100% (Table 3). All subjects reported being confident in their
guesses. Analys is of mean scores across tri al s for anxi ety-depress ion-
hostil ity in the Zuckerman Check List revealed for each subject a more
negative score for placebo than for naloxone (Table 3). Note that a more
negative score means less negative affect). The combined mean scores across
trials averaged for all subjects revealed a -2 for naloxone and a -74 for
placebo, indicating significantly more negative affect (or less positive
affect) with naloxone than with placebo (Fig. 6).

Table 3. Subject's Accuracy in Guessing Type of Treatment

After Each REST Session

SUBJECT SESSION TREATMENT> ACCURACY**

GUESSED ACTUAL

JT 100%

JR 100~

TF 100%

JB 100%

SALlNE PLACEBO
NALOXONE (0.8 mg)

TREATMENT WAS GIVEN AT ONSET OF 60 MIN SESSION.

ASSUMING INDEPENDENCE OF EVENTS, PROBABILITY OF THIS OCCURR;~G RANDOMLY
IS 1.53 X 10- 5 (l IN 65,536).

DISCUSSION
Cortisol
Despite differences in subject populations and treatment protocols, the
repeated REST-assisted relaxation session in this study were consistently

84
associated with a decrease in plasma cortisol across sessions. This
suggestion of decreased adrenal axis activity is consistent with the verbal
reports of the REST subjects, each of whom found the experi ence "very
relaxing".

PLACEBO NALOXONE
PRE POST PRE POST
+16 +16

~
x
*
w "U

~
+8 0 +8 3::
0:
0 0
(fJ
-1
~ 0
0
0
()
0
(J)
-8
x < -8
0
m (fJ

0 -16 »
"T1
-16
0
0
0 "T1 :IJ
:2: -24 m - 24m
PRE- 0 *
-32 -1 -32
POST PRE-POST
-40 AVE. 0
-19.2 + 7.1
• AVE.
2.0+1.0**
-40

*Mean score across sessions for anxiety,

depression and hostility as measured by the
Zuckerman multiple affect adjective check
list. A positive score indicates more negative
affect.
** Significantly different from placebo
( P <.01, t - TEST)

Fig. 6. Naloxone Affects Pre to Post Session Measures of Mood.

Although the number of subjects in these studies is small, the fact that the
decrease in cortisol was observed in REST protocols ranging in number from
4 to 20 sessions, in frequency from biweekly to daily and in time from 1 to
27 weeks lends credence to the idea that this is a consistent and
reproduc i b1e response to REST. Furthermore, the REST effect on plasma
cortisol appears to be due to more than a general response to a relaxation
procedure, since control subjects in experiment 1 who were exposed to a
similar relaxation paradigm, but without REST, showed no change in plasma
cortisol. Although one subject showed no change in plasma cortisol across
REST sessions, the cortisol values in this subject (GM, experiment 2) were
already low-normal during baseline, and further decreases in the range of

85
normal physiology may not have been possible.
Urinary cortisol, which was measured in 3 subjects (experiment 2), was
decreased across treatment and through follow-up in all cases. Since each
urine sample was a 24 hr. collection, these data confirmed on a more chronic
scale what the acute plasma cortisol data indicated. It is noteworthy that
subject GM, the only one who showed no decrease in plasma cortisol across
sessions, did show a decrease in urinary cortisol across sessions.
A surprising finding in the cortisol studies (experiments 1, 2 and 3)
was that plasma cortisol levels remained below baseline or starting levels
during the follow-up periods in all subjects except one. This was true for
both the brief follow-up periods of 4-9 days in experiment 1 and 3 and for
the extended follow-up of 12 weeks in experiment 2. Although the reason for
this phenomenon is unknown, it is possible that REST-assisted relaxation may
exert a carry-over effect on the regulation of plasma cortisol, perhaps
through the establishment of a new, lower-activity reference point for the
cortisol feedback loop. It has been demonstrated that biofeedback-assisted
relaxation training can lead to a physiological change such as blood pressure
reduction that is maintained well beyond the training sessions (Patel, 1975;
Patel & North, 1975).
ACTH and LH
Although the data for ACTH are less clear than for cortisol, it appears
that less ACTH was released during session 5 (treatment) in the REST group
than in the non-REST group. In addition, it appears that relatively less
ACTH was secreted in session 5 than in basel ine. As with cortisol data,
these data are consistent with the concept of decreased adrenal-axis activity
associated with REST. The fact that plasma ACTH did change and plasma LH did
not change duri ng REST -assi sted rel axat i on suggests that the endocri ne
response to REST-assisted relaxation at the pituitary level may represent a
specific action of the adrenal axis rather than a general decrease in
pituitary activity.
Both LH and ACTH values varied considerably within and among subjects.
In viewing the reasonably short circulating half-life of ACTH (Besser, Orth,
Nicholson, Byyny, Abe & Woodham, 1971) and LH (Schalch, Parlow, Boon &
Reichlin, 1968) and the pulsatile release patterns that have been
demonstrated for these hormones (Boyar, Perlow, Hellman, Kapen & Weitzman,
1972; Gallagher, Yoshida, Roffwarg, Fukushima, Weitzman & Hellman, 1973;
Filicori, Bolelli, Franceschetti & Lafisca, 1979), it is probable that

86
consistent values cannot be obtained using single samples. It appears that
long-term single-subject studies would be advantageous, and for protein
hormone measurement at least, three closely spaced blood samples per data
point should be used. This approach would minimize variability that might
mask the relatively small changes in basal hormone levels associated with
relaxation.
Testosterone
The repeated alternate-day blood sampl ing over two weeks showed no
trend in plasma testosterone levels. This is in contrast to the decreasing
trend in plasma cortisol measured in the same blood samples. Although no
fi rm concl us i on can be drawn from the data from a s i ngl e subject, thi s
situation parallels the ACTH vs. LH situation described above, supporting the
suggest i on that REST -assi sted rel axat i on does not produce a general i zed
decrease in hormone release.
Naloxone Effects
The results of this preliminary study suggest that the specific opiate
antagoni st, naloxone, blocks the mil d euphori a assoc i ated with fl otat ion
REST. While the euphoria associated with REST may be the result of increased
production of endogenous opioids, the data do not rule out the possibility
that the REST experience simply heightened the subject's sensitivity to
existing levels of endogenous opioids by attenuating other input. Although
the results of this study consist of subjective data and are based on a small
number of subjects, the differences between naloxone and placebo effects are
clear and dramatic. If flotation REST is associated with increased release
of endogenous opioids, then we have a relaxation state in which there is
potentially both decreased ACTH release and increased opioid release. Most
previous studies have shown concomitant release of ACTH and fl-endorphin (an
endogenous opioid) from the pituitary (Guillerman, Vargo et al., 1977). This
seems reasonable, since they are both part of the same precursor storage
molecule, pro-opiomelanocortin, present in pituitary and certain brain areas
(Ganong, 1983). However, there are studies which indirectly suggest that
ACTH and endogenous opioids can be released separately (Risch et al., 1980;
Kalin et al., 1980), especially under non-stress, non-pharmacological
conditions (Pomerleau, 1983). Studies of REST effects on ACTH and endogenous
opioid levels in the same subject will be necessary before conclusions can
be drawn in this regard.

87
General
The 20% decrease in plasma cortisol during a 35-minute REST session in
experiment 1 is similar to the 26% decrease in plasma cortisol in 30 minutes
of transcendental meditation (TH) reported by Jevning et al. (1978). It is
noteworthy that the present study employed naive subjects, while the TM study
used regularly practicing meditators with 3-5 years experience. Michaels et
al. (1979) found no decrease in plasma cortisol associated with experience.
Similarly conflicting results have been obtained in across-session studies
of EMG biofeedback-assisted relaxation and cortisol in hypertensive subjects.
McGrady, et al. (1979) found no effect of 16 3D-minute biofeedback sessions
on plasma cortisol, but they observed decreased urinary cortisol in a
separate study (McGrady, et al., 1981) using a similar protocol.
In experiment 1 of the present report, naive subjects reported
experiencing deep relaxation and showed statistically significant decreases
in adrenal-axis activity after only three REST sessions. In most forms of
relaxation, such as transcendental meditation or biofeedback-assisted
relaxation, the individual must elicit relaxation by utilizing some internal
strategy. In contrast, REST-assisted relaxation utilizes the environment to
induce relaxation with the individual passively experiencing the process.
The effortless passive relaxation of REST may provide advantages over methods
requiring a trial-and-error approach to the deep relaxation state. One
possible benefit is the achievement of a deeper state of relaxation, which
may increase the degree of change in measured endpoints and lessen the chance
of missing real differences.
All the changes observed in the hormone level s in these experiments
were within the limits of what is routinely accepted in radioimmunoassay as
"normal". However, cortisol has a number of target tissues and has
demonstrable effects on physiological functions such as metabol ism, the
immune response, and neural homeostasis. The possible long-term effects of
small persistent changes in plasma cortisol levels within this "normal" range
are unknown, at both the tissue and the whole individual level. Furthermore,
although the ability of behavior to modify physiology is well documented in
bi ofeedback, the poss i b1e med i at i on of such phenomena by hormones has
received little attention. It is interesting to consider, for example, that
the conditioned learning of immunosuppression in rats demonstrated by Ader
and Cohen (1975) may in part be mediated by small, long-term changes in
plasma ACTH and cortisol within the "normal" range. From a different

88
perspective, but equally interesting, is the possibility that passive deep
relaxation can elicit a hormonally mediated change in psychological state
(augmenting the sense of well-being), which may improve coping ability and
1i festyl e.

ACKNOWLEDGEMENT
The authors wish to express appreciation to James G. Roby, M.D. for
med i ca 1 advi sement and ass i stance to Jeffrey Bruno for ass i stance in the
na 1oxone study. We also wi sh to thank Carol Carbonell for techn i ca 1
assistance in the other studies.

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Psychosomatic Medicine, 1975, 37, 333-340.
Besser, G.M., Orth, D.N., Nicholson, W.E., Byyny, R.L., Abe, K. & Woodham,
J. P. Di ssoc i at i on of the disappearance of bi oact i ve and
radioimmunoactive ACTH from plasma in man. Journal of Clinical
Endocrinology and Metabolism, 1971, 32, 595-603.
Boyar, R., Perlow, M., Hellman, L., Kapen, S. & Weitzman, E. Twenty-four
hour pattern of luteinizing hormone secretion in normal men with sleep
stage recording. Journal of Clinical Endocrinology and Metabolism,
1972, 35, 72-81.
Cohen, S.I., Silverman, A.J. &Shmavonian, B.M. Psychophysiological studies
in altered sensory environments. Journal of Psychosomatic Research,
1962, Q, 259-281.
Davidson, D.M., Winchester, M.A., Taylor, C.B., Alderman, E.A. & Ingels, N.B.
Effects of relaxation therapy on cardiac performance and sympathetic
activity in patients with organic heart disease. Psychosomatic
Medicine, 1979, il, 303-309.
Filicori, M., Bolelli, G., Franceschetti, F. & Lafisca, S. The ultraradian
pulsatile release of gonadotropins in normal female subjects. ACTA
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Fine, T.H. &Turner, J. W., Jr. Rest-assisted relaxation and chronic pain.
Proceedings of the III International Congress on Psychology. Acapulco,
Mex., Elsevier-North-Holland, 1984, in press.
Fine, T.H. &Turner, J.W., Jr. The effect of brief restricted environmental
stimulation therapy in the treatment of essential hypertension.
Behavioral Therapist, 1982, 250, 567-570.
Gallagher, T.F., Yoshida, K., Roffwarg, H., Fukushima, D., Weitzman, E. &
Hellman, L. ACTH and cortisol secretory patterns in man. Journal of
Clinical Endocrinology and Metabolism, 1973, 36, 1058-1068.
Ganong, W.F. Review of Medical Physiology, 11th ed., Los Altos, CA: Lange
Medical Publications, 1983.
Guillemin, R., Vargo, T., Rossier, J., Minich, S., Long, N., Rivier, C.,
Vale, W. &Bloom, F. B-endorphin and adrenocorticotropin are secreted
concomitantly by the pituitary gland. Science, 1977, 197, 1367-1370.
Hanna, T.D., Burns, N.M. & Tiller, P.R. Behavioral and physiological
response to varying periods of sensory deprivation. Air Crew Equipment
Laboratory, U.S. Naval Air Material Center, Philadelphia, Bureau of
Medicine Subtask, 1963, MR005, 13-066.6.
Jevning, R., Wilson, A. & Davidson, J.M. Adrenocortical activity during
meditation. Hormones and Behavior, 1978, lQ, 54-60.
Jevning, R., Wilson, A., Vanderlaan, E. & Levine, S. Plasma prolactin and
cortisol during transcendental meditation. Proceedings of the
Endocrine Society, 1975, p. 257.
Kalin, N., Risch, S., Cohen, R., Insel, T. &Murphy, D. Dexamethasone fails
to suppress B-endorphi n pl asma con cent rat ions in humans and rhesus
monkeys. Science, 1980, 209, 827-828.
Lilly, J.C. The Deep Self. New York, NY: Simon &Schuster, 1977.
Malizia, E., Andreucci, G., Cerbo, R. & Colombo, G. Effect of naloxone on
the acupuncture-elicited analgesia in addict. Advances in Biochemistry
and Psychopharmacology, 1978, la, 361-366.
McGrady, A.V., Tran, S.V., Crane, R., Fine, T. & Yonker, R. Biochemical
correlates of biofeedback in essential hypertension. Biofeedback and
Self-Regulation, 1979, i, 258.
McGrady, A.V., Yonker, R., Tan, S.Y., Fine, T.H. & Woerner, M. The effect
of biofeedback-assisted relaxation training on blood pressure and
selected biochemical parameters in patients with essential
hypertension. Biofeedback and Self-Regulation, 1981, Q, 343-353.

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Mendelson, J., Jubzansky, P.E., Liederman, P.H., Wexler, D., Dutoit, D. &
So 1omon, P. Catecho 1ami ne excret i on and behavi or duri ng sensory
deprivation. Archives of General Psychiatry, 1960, llQ, 883-888.
Michaels, R.R., Huber, M.J. & McCann, D.S. Evaluation of transcendental
meditation as a method of reducing stress. Science, 1976, 192, 1242-
1244.
Michaels, R.R., Parra, J., McCann, D.S. & Vander, A.J. Renin, cortisol and
aldosterone during transcendental meditation. Psychosomatic Medicine,
1979, ii, 50-54.
Miyabo, S., Hisada, T., Asato, T., Mizushima, N. & Ueno, K. Growth hormone
and cortisol response to psychological stress: Comparison of normal
nd neurotic subjects. Journal of Clinical Endocrinology and
Metabolism, 1976, 42 1116-1120.
Patel, C. Twelve-month follow-up of yoga and biofeedback in the management
of hypertension. Lancet, 1975, 1, 62-65.
Patel, C.H. & North, W.R.S. Randomized controlled trial of yoga and
biofeedback in management of hypertension. Lancet, 1975, l, 93-95.
Pomerleau, O.F., Fertig, J.B., Seyler, L.E. & Jaffe, J. Neuroendocrine
reactivity to nicotine in smokers. Psychopharmacol, 1983, 81, 61-67.
Risch, S.C., Cohen, R.M., Janowsky, D.S., Kalin, N.H. & Murphy, D.L. Mood
and behavioral effects of physostigmine on humans are accompanied by
elevations in plasma /l-endorphin and cortisol. Science, 1980, 209,
1545-1546.
Schalch, D.S., Parlow, A.F., Boon, R.C. & Reichlin, S.J. Measurement of
human luteinizing hormone in plasma radioimmunoassay. Journal of
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Selye, H. Stress in Health and Disease. Boston, MA: Butterworths, 1976,
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Suedfeld, P. Restricted Environmental Stimulation: Research and Clinical
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Toyama, P.M. & Heyder, C. Acupuncture induced mood changes reversed by the
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Turner, J. W., Jr. &Fine, T.H. Effects of relaxation associated with brief
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91
Zubek, J.P. (Ed.) Sensory Deprivation: Fifteen Years of Research.
Englewood Cliffs, NY: Appleton-Century-Crofts, 1969, p. 254-289.
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92
7
The Presence or Absence of Light in the REST Experience:
Effects on Plasma Cortisol, Blood Pressure and Mood
Gina Ewy, Peter Sershon and Thomas Freundlich

ABSTRACT
This study examined the effect of light on relaxation associated with
flotation restricted environmental stimulation therapy (REST), as measured
by plasma cort i so 1, mean arteri a1 pressure, and psychometri c parameters.
Twenty subjects were paired by baseline cortisol levels into two groups; one
experiencing flotation REST in the presence of 1ight (REST -L) and one
experiencing flotation REST in the absence of light (REST-D). Subjects were
fifteen male and six female students aged 22-28 in normal health and naive
to REST. Repeated flotation REST (8 sessions) either with light or without
light was associated with a decrease in plasma cortisol and a decrease in
mean arterial pressure, with no differences in effectiveness between groups.
The psychometric assessment of mood using the POMS scale, before and after
sessions 1 and 8 revealed mood state improvement in both REST-L and REST-D
groups. These data suggest that the presence of light did not compromise the
flotation REST experience, as evidenced by the lack of difference between
REST-L and REST-D groups.

INTRODUCTION
It is well known that the body's response to various stressors is
mediated by important and complex homeostatic mechanisms. Although these
mechanisms are primarily beneficial, chronic stress can lead to disruption
of the regulatory processes governing them. Such disregulation may result
in harmful physiological and psychological manifestations. Chronic
elicitation of the stress response has been associated with a number of
disease states (Basmajian, 1985), including gastrointestinal ulcerations,
migraine headaches, hypertension, and coronary artery disease. Therefore,
procedures potentially evoking a state of relaxation and stress attenuation
deserve investigation.
The importance of stress management relative to the prevention of
disease and overall well-being has lead to the development of non-
pharmacological (biobehavioral) relaxation techniques. The benefit of

93
biobehavioral treatment over pharmacological treatment is two-fold. First,
with the former treatment the system reregulates internally, to correct the
problems rather than masking the problem or its symptoms with an external
agent. Secondly, biobehavioral treatment avoids the issue of drug side-
effects. Procedures reported to induce deep relaxation include biofeedback
(Basmajian, 1985), transcendental meditation (Wallace and Benson, 1972), and
short-term REST (Restricted Environmental Stimulation Therapy) (Fine and
Turner, 1985).
Early studies with restricted environment concentrated on behavioral
and physiological effects of long-term sensory deprivation and were endurance
ori ented. Subjects reported high stress states and exhi bited increased
sympathetic nervous system stimulation and elevated adrenocortical activity
(Zubek, 1969). However, data collected in these studies indicated a
relaxation effect associated with short-term (less than 1 hour) sensory
deprivation. Lilly (1977) and others (Suedfeld et al., 1983; Turner &Fine,
1983; Green et al., 1980) reported a deep relaxation effect in subjects using
brief, repeated flotation isolation.
Previous data have demonstrated that relaxation is associated with a
decrease in activity of the adrenal axis (Davidson et al., 1979; Michaels et
al., 1979; Jevning et al., 1978; McGrady et al., 1981). Plasma cortisol can
be measured as an indicator of this axis, and levels have been shown to
decrease during REST (Turner & Fine, 1983; Turner & Fine, 1987). In
addition, a decrease in blood pressure has been a common finding in previous
studies (Jacobs et al., 1985; Fine &Turner, 1985; Kristeller et al., 1982;
Suedfeld et al., 1982), indicating that, along with plasma cortisol, blood
pressure can be a rel iable effective index of the REST effect. Other
measurements that have been used to assess relaxation associated with REST
include heart rate, muscle tension, plasma ACTH, galvanic skin response, and
subjective reports (reviewed, Turner & Fine, 1985).
Some studies have been concerned with applications of REST treatment,
examining the clinical effectiveness of this technique in treating
hypertension (Fine & Turner, 1982), pain (Fine & Turner, 1985), autism
(Suedfeld &Schwartz, 1983), and in some addictions (Suedfeld &Baker-Brown,
1986; Adams et al., 1987). Results concerning the use of REST therapy in
stress management have been encouraging, yet the underlying mechanism is
unknown, and no studies to date have addressed the question of which
parameters of the flotation REST condition are necessary for the deep

94
relaxation response to occur. The present study begins a series of
experiments to investigate the mechanism of the flotation REST effect.
This study examines the effect of light on the REST experience. We
hypothesized that the presence of light, by compromising the sensory
restriction, would diminish the relaxation associated with REST as measured
by plasma cortisol, mean arterial pressure and psychometric data. This was
tested by comparing the across-treatment effects of repeated, brief REST in
subjects exposed to REST with light and subjects exposed to REST without
light.

MATERIALS AND METHODS

Subjects
Twenty-one healthy volunteers, ages 22-28, were recruited from a class
of medical school students. Fifteen subjects were male, and six were female.
None of the subjects had experienced relaxation training previously. All
subjects were told they were participating in a study of physiological
changes associated with relaxation. Subjects were paired by basel ine
cortisol levels into two groups - one experiencing relaxation in a flotation
REST environment in the presence of light (REST-L) and one experiencing the
same relaxation procedure using flotation REST in the absence of light (REST-
O). There were no drop-outs during the study.
Design
The study cons i sted of three phases: a two-week peri od of basel i ne
with blood samples taken biweekly for cortisol measurement, a two-week
treatment period of two REST sessions per week, and a two-week treatment
period of two REST sessions per week with blood samples for cortisol
measurement taken on each of four non-session days.
Psychometric measures included the Taylor Manifest Anxiety Scale and
Marlowe-Crowne Social Desirability Scale administered at orientation, and the
Profile of Mood States (POMS) which was filled out before and after the first
and last treatment sessions.
Blood Sampling Procedure
Subjects were oriented regarding the blood drawing procedure which
consisted of two venipunctures from the forearm spaced twenty minutes apart
during each of eight visits. Subjects sat quietly between samplings. Heart
rate and blood pressure measurements were taken before the first blood sample
and blood pressure was again measured five minutes after the second draw.

95
All blood samp 1i ng occurred between 1200 and 1400 hours. Samples were
centrifuged at 3000 x g for ten minutes, and pl asma was separated and
refrigerated. Cortisol levels were determined by radioimmunoassay kit (Code
KCOD2, Diagnostic Products, Los Angeles, CA).
Tank Procedure
The flotation tank (Enrichment Enterprises Inc., Huntington, NY) was
an ovoid fiberglass chamber, 8 feet long, 4 feet wide and 42 inches high.
Subjects floated in a saturated epsom salt solution, specific gravity 1.28.
The tank temperature was rna i nta i ned at 94.0 ± 0.5' F. The chamber was
completely enclosed, eliminating light. For REST-L subjects a subdued light
(15 watt incandescent bulb) at the bottom of the tank illuminated the
interior and could be switched on from inside the chamber. Subjects floated
nude in a supine position. In this position the ears were submerged,
resulting in marked reduction of sound perception.
Two flotation tanks of similar design were used, one for REST-L
subjects and the other for REST-D subjects. Orientation to tank flotation
was the same for all volunteers and cons i sted of fl otat i on techni que
information and a tour of the facility. A trained monitor was available at
all times and subjects were told they were welcome to terminate the sessions
any time they did not feel comfortable in continuing. Each tank session
consisted of: blood pressure measurement, a shower, a forty minute flotation
session, another shower, and blood pressure measurement.
Data Analysis
Data were subjected to 2 levels of analysis. Two-way repeated measures
ANOVA was used to determine differences across sessions (among weeks 1, 2,
5, and 6). Specific differences were determined by Turkey test and by t-
test (Zar, 1984).

RESULTS
Cortisol
Cortisol data were subjected to repeated measures analysis of variance,
and data are presented in Figure 1.
Baseline: ANOVA established no significant difference between REST-L and
REST-D before treatment sessions began. Since no difference was found prior
to treatment sessions this allowed further measures across sessions.
Across sess ions: Repeated measures anal ys is showed no sign i fi cant difference
between REST-L and REST-D groups during post-treatment sessions.

96
 171I BASEUNE II TREATMENT

,J
::>
'!<
J I
~
.., 141
1J
0
';:::"
'0tJ"
~
....,'" ,J
,,1
,JI
WEEKS

Figure 1. Effect of REST with and without light on plasma cortisol.

Treatment values are significantly different from baseline
(light p < 0.01, dark p < 0.05). REST-L 0 - - - - - 0 (N=II),
REST-D ----- (N=10).

Treatment: Average plasma cortisol levels were significantly lower than pre-
session levels in both REST-L and REST-D groups (light p<O.OI, dark p<0.05).
The REST-L group plasma cortisol decreased from 14.95 ± 0.57 ug/dl in
baseline to 11.72 ± ug/dl in treatment while the REST-D group plasma cortisol
decreased from 16.58 ± 0.54 ug/dl in baseline to 13.78 ± 0.51 ug/dl in
treatment.
Mean Arterial Pressure
Mean arterial pressure data were subjected to similar statistical
analysis and data are presented in Fig. 2.
Baseline: ANOVA established no significant difference between REST-L and
REST-D groups during baseline.
Across session: ANOVA showed no significant different between light and dark
REST groups during post-treatment sessions.
Treatment: Mean arterial pressures were significantly lower than baseline
in both REST-L and REST-D groups (light p <0.005, dark p <0.0003). The REST-

97
L group decreased from a mean arteri a1 pressure of 89.4 ± 1.76 mmHg in
baseline to 81.11 ± 1.89 mmHg in treatment while the REST-D group decreased
from a mean arterial pressure of 90.44 ± 1.64 mmHg in baseline to 80.54 ±
1.26 mmHg in treatment.

BASELINE II TREATMENT

90

~ 89
e 88
e
~ 87

"
~ 86
g: 85

~ 84

"
~ 83

":z:<: 82
<:
~ 81

80

79

78

WEEKS

Figure 2. Effect of REST with and without light on mean arterial pressure.
Treatment values are significantly different from baseline (light
p < 0.005, dark p < 0.0003). REST-L 0 - - - - - 0 (N=II), REST-D
(N=10).

Psychometric Measures
The Taylor Manifest Anxiety Scale (TMAS) and the Marlowe-Crowne Social
Desirability Scale (MCSDS) were filled out by subjects to predict repressive
coping styles. The criterion for repressive coping style is a score below
13 on the TMAS and a score greater than 18 on the MCSDS (Weinberger et al.,
1979). No subjects showed repressive coping strategies.
Profile of Mood States Scales were given before and after treatment
sessions one and eight, to assess effect of treatment on mood across session.
Summing all six factors in the scale (weighing tension-anxiety, depression-
dejection, anger-hostility, fatigue-inertia and confusion-bewilderment
positively and vigor-activity negatively) provides a rel iable single estimate

98
of affective state (McNair et al., 1971). POMS scores showed improvement of
mood state in all sessions for both REST -L and REST -D groups (Table 1).
REST-D subjects showed a significantly greater improvement of mood state
across session one than REST-L subjects (p <0.05). There was no difference
between light and dark REST groups across the last session.

TABLE 1.
PROFILE OF MOOD STATES* FOR REST SUBJECT WITH AND WITHOUT LIGHT
POMS score**

Session 1 Session 8
REST-L - 7.64 ± 2.35 -11.0 ± 3.47
REST-D -21.25 ± 6.79*** -16.0 ± 8.68

* each value is the mean change ± SE across a given session for all
subjects in respective groups.
** POMS score is inversely proportional to Mood State
*** REST-L vs. REST-D was significantly different across session 1 (p<0.05,
t-test)

DISCUSSION
Repeated flotation REST with or without restriction of 1ight was
associated with decrease in plasma cortisol and mean arterial blood pressure
across sessions. This decrease in adrenal axis activity was consistent with
psychometric measures of mood state in these subjects as assessed by the POMS
scale. These data were also consistent with subjects' verbal reports of deep
re 1ax at ion in REST. The results of th is study and previ ous stud i es of
flotation REST (Turner & Fine, 1983; Turner & Fine, 1987; Turner & Fine,
1985) were similar in suggesting a decrease in the activity of the adrenal
axis. Blood pressure decreases in association with REST have been reported
for both hypertensive (Fine &Turner, 1982) and normotensive (Jacobs et al.,
1985) subjects, although there are two reports of no change in blood pressure
with normotensive subjects (Turner & Fine, 1987; Francis &Stanley, 1985).
However, the present study was different from previous studies in that
two REST conditions rather than a REST versus control condition were
compared. This was done in order to examine mechanisms of flotation REST
which produce the observed psychophysiological responses. We hypothesized

99
that the presence of light would disrupt the homeostatic effect of sensory
isolation, and thus diminish the relaxation associated with REST, as measured
by plasma cortisol, mean arterial blood pressure, and psychometric
parameters. The presence of light did not compromise the flotation REST
experience as evidenced by the lack of difference between REST-L and REST-
O groups.
One possible explanation for these results is that the light in the
tank was serving as a monotonous stimulation, or at least insufficient
stimulation to interfere with the REST effect. Studies examining the effects
of monotonous stimulation (perceptual deprivation by continuous unpatterned
1i ght and constant "whi te" noi se) have reported effects s imil ar to studi es
using restricted environmental stimulation. However, it is unlikely that the
light condition in the present study satisfies criteria of perceptual
deprivation, since REST-L subjects reported having their eyes open
intermittently and were able to see varied and well-defined images such as
the tank ceiling, condensation droplets and well defined shadows.
An additional consideration in concluding that the presence of light
did not compromise the flotation REST experience lies in the POMS data. POMS
scores indicated an improvement of mood states for all evaluated sessions in
both REST-L and REST-D groups. Care was taken not to bias subjects toward
one condition being more powerful than the other for relaxation, and the
terms "control" and "experimental" were avoided. However, most subjects had
previously heard about REST and knew that it involved flotation in darkness.
The greater improvement of mood during session one for REST-D subjects as
compared to REST-L subjects may reflect their initial expectations (Delmonte,
1984). Since this difference did not maintain itself across sessions, the
bias may have washed out.
It is noteworthy that none of the subjects in the present study showed
repress i ve copi ng styl es as defi ned by the TMAS and the MCSDS. Previ ous
studies with a similar population of medical students (Turner &Fine, 1985)
and other studies (Schwartz, 1983) have reported that 11-25% of subjects
exhibited repressive coping style. Thus the population of the present study
may be unusually homogenous in this regard. The reason for the lack of
repressors is unknown.
The results of this study do not reveal why light did not interfere
with the REST experience. The simplest explanation would be that the
restri ct i on of 1i ght is not a crit i ca 1 component of the fl otat i on REST

100
environment. Since only one type of light at a given intensity was used, it
is possible that light of a higher intensity may affect the REST experience.
Several other model s could be considered to expl ain the underlying
mechanisms of flotation REST. Since the REST environment greatly attenuates
light, sound, temperature-awareness and kinesthetic-awareness, it is possible
that one or a combination of these conditions is responsible for the observed
phys i 01 ogi ca 1 effects. One of these models suggests the exi stence of a
threshold of sensory input which, if exceeded, will result in a compromise
of the REST effect. It may be helpful to develop a scenario to explain this
model. This scenario will assign hypothetical percentage values to those
conditions believed to be factors important to the REST experience. The
inputs to consider are 1ight, sound, temperature and flotation. For
illustrative purposes, light will be assigned a value of 30%; sound a value
of 10%; temperature a value of 10%; and flotation a value of 50%. Thus, if
all inputs were eliminated, 100% sensory deprivation would occur. Let it
further be supposed that a threshold of 40% exists. This threshold implies
that the addition of sensory input totalling more than 40% would result in
a compromi se of the fl otat i on REST experi ence. For example, if the
restriction of light were eliminated no compromise in the REST effect would
occur because 1ight only contributes 30% to the REST experience. If
temperature (10%) or sound (10%) were al so added, then hypothetically a
compromise in the REST experience would occur. Likewise, el iminating
flotation alone, (with a value of 50%) from the REST environment would
compromise the REST experience, regardless of whether light was present or
absent.
Within this model of a threshold effect, two possibilities concerning
the compromise of the REST experience must also be considered. First, if too
much sensory input is added, an "all or none" response may occur. Exceeding
the sensory input threshold would then result in a substantial compromise of
the REST effect. Second, when the threshold of sensory input is reached, it
is possible that the compromise in the REST experience would be gradual, and
proportional to the intensity and nature of the sensory input.
Another possibility which is consistent with the results of the present
study is that not all the elements of sensory deprivation are needed to have
a complete REST experience. In other words, the REST condition is not
similar to a chain which is only as strong as its weakest link. If the
weakest link model was valid, the REST subjects experiencing flotation in

101
light would have shown a compromise in their REST experience. A final model
of flotation REST suggests that REST-assisted relaxation is like a
holographic experience in which each part of sensory attenuation contributes
to the experience, but the experience is more than the sum of the parts.
Persistent activation of the stress response is known to playa role
in the process of disease. Since REST can be an effective tool in stress
management, efforts should be made to elucidate the underlying mechanisms.
The present study has shown that the presence of light does not compromise
psychophysiological measures of relaxation associated with REST and further
demonstrates the need to define in functional terms the meaning of
"restricted environment".

REFERENCES
Adams, H.B., Cooper, G.D. & Scott, J.C. REST and Reduced Alcohol
Consumption. In: REST and Self Regulation: Proceedings of the 2nd
International Conference. (Turner and Fine, Eds.) Toledo, OH: IRIS
Publ., In Press, 1987.
Basmajian, J.V. Biofeedback Principles and Practice for Clinicians. 2nd
Ed., Baltimore, MD: Williams and Wilkins Co., 1985.
Davidson, D.M., Winchester, M.A., Taylor, C.B., Alderman, E.A. &Ingles, N.B.
Effects of Relaxation Therapy on Cardiac-Performance and Sympathetic
Activity in Patients with Organic Heart Disease. Psychosomatic
Medicine, 1979, ii, 303-309.
Delmonte, M.M. Physiological Responses During Meditation and REST.
Biofeedback and Self-Regulation, 1984, 2i£l, 181-200.
Fine, T.H. &Turner, J.W., Jr. The Effect of Brief Restricted Environmental
Stimulation Therapy in the Treatment of Essential Hypertension.
Behaviour Research and Therapy, 1982, 20, 567-570.
Fine, T.H. &Turner, J.W., Jr. (eds.). REST and Self-Regulation: Proceedings
of the 1st International Conference. Toledo, OH: IRIS Publ., 1985.
Fine, T.H. & Turner, J.W., Jr. The Use of Restricted Environmental
Stimulation Therapy (REST) in the Treatment of Essential Hypertension.
In: REST and Self-Regulation: Proceedings of the 1st International
Conference. (Turner and Fine, Eds.) Toledo, OH: IRIS Publ., 136-142,
1985.
Fine, T.H. & J.W. Turner, Jr. REST-Assisted Relaxation and Chronic Pain.
IN: Health and Clinical Psychology. (Sanchez-Sosa, Ed.) New York, NY:

102
 Elsevier Science Publ. Co., 1985, 511-520.
Francis, W.D. & Stanley, J.M. The Effects of Restricted Environmental
Stimulation on Physiological and Cognitive Indices. In: REST and
Self-Regulation: Proceedings of the 1st International Conference.
(Turner and Fine, Eds.) Toledo, OH: IRIS Publ., 1985, 40-49.
Green, E.E., Green, A.M. &Norris, P.A. Preliminary Report on a New Non-Drug
Method for Control of Hypertension. Journal of South Carolina Medical
Association, 1980, §i1l, 126-137.
Jacobs, G.D., Heilbronner, R.L. & Stanley, J.M. The Effects of Short Term
Floatation REST on Relaxation: A Controlled Study. In: REST and Self-
Regulation: Proceedings of the 1st International Conference. (Turner
and Fine, Eds.) Toledo, OH: IRIS Publ., 1985, 179-185.
Jevning, R., Wilson, A. & Davidson, J.M. Adrenocortical Activity During
Meditation. Hormones and Behavior, 1978, 10, 54-60.
Kristeller, J., Schwartz, G.E. & Black, H. The Use of Restricted
Environmental Stimulation Therapy in Treatment of Essential
Hypertension: Two Case Studies. Behaviour Research and Therapy, 1982,
20, 561-566.
Lilly, J. The Deep Self. New York, NY: Simon and Schuster, 1977.
McGrady, A.V., Yonker, R., Tan, S.Y., Fine, T. &Woerner, M. The Effect of
Biofeedback-Assisted Relaxation Training on Blood Pressure and Selected
Biochemical Parameters in Patients with Essential Hypertension.
Biofeedback and Self-Regulation, 1981, §i1l, 343-353.
McNa i r, D., Lorr, M. & Dropp 1eman, L. EITS Manual for Profi 1e of Mood
States. San Diego, CA: Education and Industrial Testing Service, 1971.
Michaels, R.R., Huber, M.J. & McCann, D.S. Evaluation of Transcendental
Meditation as a Method of Reducing Stress. Science, 1976, 192, 1242-
1244.
Schwartz, G. Disregulation Theory and Disease: Applications to the
Repression/Cerebral Disconnection/Cardiovascular Disorder Hypothesis.
International Review of Applied Psychology, 1983, 32, 95-118.
Suedfeld, P., Roy, C. & Landon, B.P. Restricted Environmental Stimulation
Therapy in the Treatment of Essential Hypertension. Behaviour Research
&Therapy, 1982, 20, 567-570.
Suedfe 1d, P. & Schwartz, G. REST as a Treatment for Aut i st i c Chil dren.
Journal of Developmental and Behavioral Pediatrics, 1983, i, 196-201.
Suedfeld, P., Ballard, E.J. &Murphy, M. Water Immersion and Flotation: From

103
 Stress Experiment to Stress Treatment. Journal of Environmental
Psychology, 1983, 1, 147-155.
Suedfeld, P. & Baker-Brown, G. Chamber REST and Aversive Conditioning in
Smoking Cessation: Active and Placebo Effects. Behaviour Research and
Therapy, 1986, £iiil, 421-428.
Turner, J.W., Jr. & Fine, T.H. Effects of Relaxation Associated with Brief
Restricted Environmental Stimulation Therapy (REST) on Plasma Cortisol,
ACTH and LH. Biofeedback and Self-Regulation, 1983, ~, 115-126.
Turner, J.W., Jr. & Fine, T.H. Hormonal Changes Associated with Restricted
Envi ronmental St imul at i on Therapy. IN: REST and Self-Regul at ion:
Proceedi ngs of the 1st Internati onal Conference. (Turner and Fi ne,
Eds.) Toledo, OH: IRIS Publ., 1985, 17-39.
Turner, J.W., Jr. & Fine, T.H. Effects of Restricted Environmental
Stimulation Therapy (REST) on Self-Control of Heart Rate. In: Health
and Clinical Psychology. (Sanchez-Sosa, Ed.) New York, NY: Elsevier
Science Publ. Co. Inc., 1985, 477-490.
Turner, J.W., Jr. & Fine, T.H. Effects of Biobehaviorally-Assisted
Re 1ax at ion Tra i ni ng on Blood Pressure and Hormone Levels, and Thei r
Variation in Normotensives and Essential Hypertensives. In: REST and
Self-Regul at ion: Proceedi ngs of the 2nd International Conference on
REST. (Turner and Fine, Eds.) Toledo, OH: IRIS Publ., In Press, 1987.
Wallace, R. &Benson, H. The Physiology of Meditation. Scientific American,
1972, 225, 84-90.
Weinberger, D., Schwartz, G. &Davidson, R. Low-Anxious, High-Anxious, and
Repressive Coping Styles: Psychometric Patterns and Behavioral and
Physiological Responses to Stress. Journal of Abnormal Psychology,
1979, 88, 369-380.
Zubek, J.B. Sensory Deprivation: 15 Years of Research. New York, NY:
Appleton-Century-Crofts, 1969.

104
8
Effects of Restricted Environmental
Stimulation on Inversion Perception
Mary Frances Miller and Marianne Barabasz

ABSTRACT
Severa 1 cogn i t i ve and psychophys i 01 og i ca 1 adaptations to Restri cted
Environmental Stimulation (REST) (Suedfeld, 1980) have been demonstrated.
The study investigated the effect of short term flotation Restricted
Environmental Stimulation Therapy on inversion perception conformity.
Experimental subjects (N=15) were exposed to two hours of flotation REST.
Control subjects (N=12) spent two hours in one of the laboratory suites.
Immediately prior to, immediately following and two months after their two
hour experimental or control participation, all subjects viewed twelve
abstract figure pairs and indicated which figure of each pair appeared upside
down. Subjects exposed to REST demonstrated a tendency toward a significant
increase in focal point dependency following exposure to flotation REST.
Control subjects' scores decreased from pretest to follow up testing. These
findings are consistent with the changes in inversion perception demonstrated
by A. Barabasz & M. Barabasz in subjects exposed to Antarctic isolation.

I NTRODUCTI ON
Recent studies have demonstrated several cognitive and
psychophysiological adaptations to Restricted Environmental Stimulation
(REST) (Suedfeld, 1980). These adaptations have been demonstrated in both
laboratory and field settings. These include increases in hypnotizability
(Barabasz, 1980; 1982), EEG alpha states (Barabasz, 1980), experimental
absorption (Barabasz &Mullin, 1983), and imaginative involvement (Barabasz,
1984) . Alternat i ve mechan isms have been hypothes i zed to exp 1a i n these
adaptations including regression to primary process thinking (Bexton, Heron
&Scott, 1954; Gill &Brenman, 1959; Reyher, 1964) and learned dissociation
(Barabasz, 1982). Reyher (1964) suggested that regression is functionally
associated with a lower level of neuro-cortical integration. When
individuals are functioning at this lower level, their subjective experiences
and behaviors are characteristic of those associated with regression. Reyher
(1964) further suggested that there is a relationship between the degree

105
and/or type of environmental stimulation and level of cognitive processing.
In order to maintain normal adaptive behavior, continually varied sensory
input has been vi ewed as essent i a1 (Bexton et a1, 1954). Bexton et a1 .
(1954) concluded that the restriction of sensory inflow may result in
behavior that is indicative"of regression. The regressive behavior, however,
is only present when individuals are in a sensory restricted environment.
Barabasz and Barabasz (1986) invest i gated regress i on phenomena in
Antarct i c i so 1ates. Based on Gi 11 and Brenman (1959) and Reyher' s (1964)
hypotheses concern i ng the re 1at i onshi p between REST and regressi on, they
predicted Ss would demonstrate increased focal point dependency responses in
the process of identifying abstract figure pairs as inverted, immediately
following Antarctic isolation. Focal point dependency refers to the degree
to which subjects consistently use focal point location as the basis for
identifying abstract figures as inverted (Strang, 1967). Pre-primary age
children demonstrate greater focal point dependency when compared to adults
and primary age children (Dodd &Strang, 1966; Strang, 1967). If regression
effects occur, subjects would be expected to demonstrate greater focal point
dependency immediately following sensory isolation.
In subjects experienced long term isolation, Barabasz and Barabasz,
(1986) found that there was a significant increase in focal point dependency
scores immediately following Antarctic winter isolation. Immediately after
short term summer Antarctic isolation subjects demonstrated a tendency
(p>.106) toward increased focal point dependency. This interesting
adaptation was maintained two months after subjects returned to the United
States (p>.109).
The purpose of the present study was to determi ne whether or not
subjects who experi ence short-term 1aboratory fl otat i on REST demonstrate
increased focal point dependency.

METHOD
Subjects consisted of upper undergraduate, graduate and post doctoral
level volunteers (N=30) at Washington State University. At the time of
recruitment, subjects were randomly divided into an experimental group and
control group. Three subjects who were randomly assigned to the control
group withdrew from the study, thus reducing the total number of subjects to
twenty seven. The experimental group consisted of fifteen subjects (X age
= 28.3 years; X education level = 18.5 years; males = 7; females = 8). The

106
control group consisted of twelve subjects (X age = 27.7 years; X education
level = 18.6 years; males = 6; females = 6.
Experimental subjects were asked to spend up to one orientation hour
and two experi menta 1 hours ina Fl oatari urn brand fl otat i on tank. The
dimensions of the tank are: Length = 266 centimeters; Widest width = 170
centimeters; Narrowest width = 135 centimeters; Height = 235 centimeters.
The tank was filled with a twenty percent solution of water and epsom salts
(M9 2 S0 4 ) (depth = 25 cent imeters) . The temperature of the sol ut i on was
maintained at 34.2 degrees centigrade plus or minus 0.1 degree centigrade.
pH factor was maintained between 7.4 and 7.6. Specific gravity was held
between 1.26 and 1.28. The Floatarium flotation tank was equipped with a two
way communication system, which was used to provide instructions and to
monitor subjects during isolation periods.
Experimental subjects were monitored for signs of sensory restriction
while in the flotation tank (Sanders, 1967). Subjects were told that if they
wanted to discontinue the experiment they could terminate at any time by
simply leaving the tank. If the subjects had any questions they could simply
ask the experimenter, who monitored all sessions continuously. None of the
subjects terminated early or initiated contact with the experimenter during
isolation.
The control subjects were told that the experiment was investigating
the "famil iarity of surroundings on the perception of abstract figures."
Control subjects were asked to spend up to two hours in one of the rooms of
the laboratory suite. They could read, study, or listen to music during this
time period. They were also told they could end the experiment at any time.
None of the control subjects terminated the experiment early.
Procedure: Consistent with previous investigations (Barabasz, 1984;
Barabasz & Barabasz, 1986) all testing was completed on an individualized
basis. Experimental subjects spent one orientation hour in the flotation
tank and returned within twenty four to thirty six hours for the two hour
experi menta 1 sess i on. The purpose of the fi rst ori entat i on hour was to
familiarize experimental subjects with the flotation tank in a calm,
reassuring atmosphere (Suedfeld, 1980).
I n order to measure focal poi nt dependency, subjects vi ewed twelve
s 1ides, each conta in i ng two fi gure pa irs. The s1 i des were presented
separately in an established sequential progression. The figures were the
same as used by Dodd and Strang (1966), Strang (1967) and Barabasz and

107
Barabasz (1986). The pairs were identical figures, but one figure was
rotated 180 degrees in relation to the other. Figures were represented as
white lines on a blue background. Subjects were asked to indicate verbally
which figure was upside down. The first two figures portrayed real objects
in order to establish task orientation. Experimental subjects' focal-point
dependency was assessed prior to the two experimental hours while subjects
sat upright in the flotation tank and immediately after the two hours of
flotation REST. Follow-up testing was completed two months later.
Contro 1 subjects ' focal poi nt dependency was assessed i mmed i ate 1y
before and immediately after the two hour control condition, and at a two
month follow-up.

RESULTS
Pre, post and follow-up focal point dependency scores were analyzed by
analysi s of vari ance (ANOVA). Overall ANOVA resul ts for experimental
subjects showed a significant difference existed among the testing periods
(F = 19.6, P <.001). Between group ANOVA's indicated a significant increase
in focal point dependency between post-test and follow-up (F = 7.6, P <.01).
Increases in focal point dependency from pre- to post-test showed a tendency
toward significance (F = 3.9, P <.06).
The results fail to support the regression to primary process thinking
exp 1anat i on of Bexton et a1., (1954), Gi 11 & Brenmen (1959), and Reyher
(1964) as the adaptation to REST, but are consistent with the findings of
Barabasz (1986).
Overall ANOVA results for control subjects indicated a significant
difference existed among the testing periods (F = 19.6, P <.001). Between
group ANOVA's indicated a significant decrease in focal point dependency
scores and between pre-test and follow up (F = 5.0, P <.04) and between post-
test and follow-up (F = 9.0, P <.01). No significant difference was found
between pre-test and post-test scores (F = 2.2, N.S.).
One way analyses of variance were performed upon the pre-test, post-
test, and follow-up focal point dependency scores of the experimental and
control subjects. Control subjects demonstrated higher focal point
dependency scores than experimental subjects on the pretest measure at a
level approaching significance (F = 3.6, P <.06). No significant difference
between experimental and control groups were found on post-test F = 1.8,
N.S.) or follow-up scores (F = 1.7, N.S.).

108
 FIGURE 1
FOCAL POINT Dt:Po.'OENC'i RESULTS

F
o

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DISCUSSION
Barabasz and Barabasz (1986) demonstrated that individuals who
experienced short term isolation in Antarctica showed a tendency toward
increased focal point dependency immediately following isolation. The same
subjects who experienced short-term isolation in Antarctica maintained
similar levels of focal point dependency at follow-up testing two months
later. Barabasz and Barabasz (1986) also demonstrated that subjects who
experienced long term isolation in Antarctica showed significantly increased
focal point dependency following isolation. Due to logistical problems,
follow-up testing was not performed on subjects who experienced long term
isolation in Antarctica.
In regard to short term isolation, in both the field study (Barabasz
& Barabasz, 1986) and the present study, there was a tendency toward
increased focal point dependency from the pre-test to the post-test. At the
follow-up testing, two months after isolation, the focal point dependency
results of subjects who experienced short term Antarctic isolation were

109
rna i nta i ned at the post-test 1eve 1s, however, the focal poi nt dependency
results of subjects exposed to short term fl otat i on REST sign i fi cant 1y
increased from the post-test.
The results of this preliminary study on short term flotation REST fail
to support the regress i on hypothes is of sensory restri ct ion descri bed by
Reyher (1964). Based on the regression hypothesis proposed by Sanders and
Reyher (1969), individuals who experience sensory restriction would be
expected to regress to primary process thinking while in isolation, but
return to normal levels after sensory restriction. Barabasz (1982) proposed
learned dissociation as an alternative mechanism to explain the effects of
sensory restriction. The learned dissociation hypothesis (Barabasz, 1982)
predicts the maintenance of capacities developed in adapting to isolation.
While the present preliminary study focused only on focal point dependency
effects, the tendency toward significant effects from the pretest to the
post-test and the continuation of these effects to significant increase in
focal point dependency from the post-test to the follow-up test are
consistent with Barabasz's (1982) learned dissociation hypothesis.
Speculations based on observations made by the investigators might
offer some explanations for the findings and aid in further research on this
topic. In the present study, the increase in focal point dependency scores
from the pre-test to the post-test may have been attenuated by short term
memory effects. Many subjects stated to the experimenter following flotation
REST, that they had attempted to remember the stimuli from the pretest to the
post-test. Attempts by the experimental subjects to remember the stimuli may
have attenuated increases in focal point dependency. The results of follow-
up testing of experimental subjects showed that the focal point dependency
scores increased significantly from the post-test scores. It is possible
that at follow-up testing, the increases in focal point dependency were fully
demonstrated because the subjects could not remember the stimuli after two
months. A suggestion for further research would be to employ parallel forms
of the focal point dependency test or to administer the pre-test several days
prior to the post-test.
Subject self selection might have also affected the results obtained
in this study. All subjects volunteered for the study with the understanding
that they would be randomly placed into one of the two groups; either the
group that would be exposed to flotation REST or the group that would test
familiarity of surroundings on the perception of abstract figures. Dumas

110
(1977) concluded that subject self selection was an important variable.
Three subjects refused to participate in the study when they learned that
they would not be exposed to flotation REST. This may have contributed to
the nearly significant difference between the pre-test focal point dependency
scores of the experimental and control groups. Control subjects' focal point
dependency scores changed significantly from the pretest to the follow-up
test. An examination of the mean focal point dependency scores, however,
demonstrates that there was a decrease in focal point dependency from the
pre-test to the follow-up test. Subject self selection variables may have
impacted these results as well. At this point it is not possible to draw any
firm conclusions.
Subjects who experienced short term flotation REST stated informally
to the investigators that they found the experience quite pleasant. This is
consistent with previous research involving REST (Barabasz &Barabasz, 1986,
Suedfeld, 1980). None of the subjects had to leave the flotation tank due
to clinical signs or symptoms of sensory restriction.
Further research is needed to further understand individuals'
adaptations to sensorially restricted environments. Additional research
might lead to specific recommendations for environmental designs.

REFERENCES
Barabasz, A.F. EEG alpha, skin conductance and hypnotizability in
Antarctica. International Journal of Clinical and Experimental
Hypnosis, 1980, 28, 63-74.
Barabasz, A.F. Restricted environmental stimulation and the enhancement of
hypnotizabil ity: Pain, EEG alpha, skin conductance and temperature
responses. International Journal of Clinical and Experimental
Hypnosis, 1982, 30, 147-166.
Barabasz, A.F. Antarctic isolation and imaginative involvement: Preliminary
findings. International Journal of Clinical and Experimental Hypnosis,
1984, 32, 296-300.
Barabasz, A.F. & Barabasz, M. Antarctic isolation and inversion perception:
Regression phenomena. Environment and Behavior, 1986, 18, 285-292.
Barabasz, M., Barabasz, A.F. & Mullin, C.S. Effects of brief Antarctic
i sol at i on on absorption and hypnotic suscept i bil ity. International
Journal of Clinical and Experimental Hypnosis, 1983, 31, 235-238.
Bexton, W.H., Heron, W. &Scott, T.H. Effects of decreased variation in the

111
 sensory environment. Canadian Journal of Psychology, 1954, ~, 70-76.
Dodd, J.M. & Strang, H. Conformity of perception of figure inversion in
children. Perceptual and Motor Skills, 1966, 22, 703-706.
Dumas, R.A. EEG alpha hypnotizability correlations: A review.
Psychophysiology, 1977, Ii, 431-438.
Gill, M.M. & Brenman, M. Hypnosis and Related States. New York, NY:
International Universities Press, 1959.
Reyher, J. Brain mechanisms, intrapsychic processes and behavior: A theory
of hypnos is and psychopathology. The Ameri can Journal of Cl in i ca 1
Hypnosis, 1964, I, 107-119.
Sanders, R.S. The utilization of sensory deprivation procedures for
increasing hypnotic susceptibil ity. Unpubl ished Doctoral Dissertation,
Michigan State University, Ann Arbor, 1967.
Sanders, R. S. & Reyher, J. Sensory depri vat i on and the enhancement of
hypnotic susceptibility. Journal of Abnormal Psychology, 1969, J, 375-
381.
Strang, H.R. Relationship between focal point location and inversion
perception at three age levels. Journal of Genetic Psychology, 1967,
ill, 3-8.
Suedfeld, P. Restricted Environmental Stimulation. New York, NY: Wiley,
1980.

112
9
Flotation REST and Information Processing:
A Reaction Time Study

Daniel S. O'Leary and Robert L. Heilbronner

ABSTRACT
There has historically been much debate on the effects of sensory
isolation on cognitive functioning and state of arousal. This preliminary
study examines the effects of flotation REST on arousal and attention. The
speed of manual response to a simple visual stimulus and a more complex two-
choice reaction time task were used to assess cognitive alertness and
attention. Physiological measures of the relaxation response, heart and
blood pressure and mood state were recorded also. Twelve subjects
experienced two REST and two control sessions (one per day, 45 min) in
alternating sequence (REST-control-REST-control or vice versa). The results
revealed significant decreases in heart rate and blood pressure in REST but
not in control conditions. The reaction time tasks were performed equally
well in REST and control, suggesting that neither cognitive disorganization
nor enhancement of attention occurred in REST. Reported mood changes in REST
included decreased anxiety and tension and increased energy. No changes in
mood occurred in the control condition. Although the results of this study
do not rule out the possibility that cognitive disorganization can occur in
REST, it appears that REST is associated with relaxation leading to lowered
anxiety and increased feelings of energy with no change in cognitive
performance.

INTRODUCTION
The first studies in the field of sensory deprivation were initiated
to address a particular problem: the lapses of attention that occur when one
must give prolonged attention to some aspect of the environment in which
little is happening, or in which changes are regular and monotonous (Bexton,
Heron &Scott, 1954; Heron, Bexton &Hebb, 1953). Subjects in these studies
reported difficulties in concentration, disorganized thinking, and frequent
ha 11 uc i nat ions after peri ods spent in reduced sensory envi ronments (Suedfe 1d,
1975). These results suggested that a reduction in sensory input can have
disorganizing effects upon an individual's thought process. Although these

113
early findings appeared unequivocal, more recent studies investigating the
effects of restricted environmental stimulation on cognitive processes have
had contradi ctory results. The most frequent fi ndi ng has been that of
cognitive disorganization, as subjects reported that they were unable to
concentrate, or 0 effectively carry out certain cognitive tasks (Goldberger
&Holt, 1958; Cohen, Silverman, Bressler &Shmavonian, 1961). However, other
studies reported no decrements on tests of verbal and numerical problem
solving (Wexler, Mendelson, Leiderman & Solomon, 1958; Zuckerman, Albright,
Marks &Miller, 1961); and some even suggested that sensory deprivation can
improve cogn it i ve funct i oni ng (Vernon & Hoffman, 1956; Zubek, Sansom &
Prysiaznuik, 1960). Because of the contradictory nature of the data,
Brownfield, in a 1964 review of the literature, suggested that more
investigation was necessary before definitive conclusions could be drawn
(Brownfield, 1964). Parameters such as length of confinement, type of tasks
used, and the type of sensory deprivation environment employed, need to be
accounted for in any study investigating the cognitive effects of reduced
stimulation.
Close ly all i ed to the research on cogn i t i ve processes were studi es
which investigated the effects of sensory deprivation upon levels of arousal.
As with the cognitive literature, there are conflicting findings. There is
evidence to indicate that subjects in sensory deprived environments show slow
wave EEG patterns (Saunders &Zubek, 1967; Stern, 1980). This implies that
sensory deprivation results in lower levels of arousal or activation which
would in turn, lead to poor cognitive performance. Others have postulated
that stimulus reduction leads to an arousal increase and an increase in
motivation due to "stimulus action hunger" (Lilly, 1956) or an information
need (Jones, 1969). Suedfe 1d (1969) has argued that since arousal and
performance are frequently related by an inverted U shape curve (Yerkes &
Dodson, 1908) performance deficits on cognitive tasks could be due to an
over-arousal rather than under-arousal. Suedfeld also suggests that
differences in task complexity are critical to this U-shaped relationship.
He found that performance on simple tasks, such as memorization or a word
list, could be improved by sensory deprivation, while performance on complex
tasks, such as making up a story, was impaired. As with the cognitive
findings, there is basic disagreement in the literature as to the effects of
sensory deprivation upon arousal.
After a hiatus in research, the field of sensory deprivation has

114
entered into a new era in which it has emerged as an adjunct to certain
therapeutic procedures. Tetlock and Suedfeld (1976) have suggested that the
clinical utility of REST is due to an increased susceptibility to a
therapist's suggestions, which may be the result of the cognitive
d i sorgan i zat i on induced by sensory depri vat ion. Others have focused on
possible changes in the brain stem reticular formation, whereby the
attentional shifts and changes in arousal lead to a decreased rigidity of
habitual cognitive and behavioral patterns (Lindsley, 1961). Water immersion
or "flotation" tanks are increasingly being integrated into clinical
settings, and decisions relating to their therapeutic use are being made
based on their presumed effects upon arousal and cognitive functions. It is
important, therefore, to determi ne just how th is techni que affects these
functions.
The study we will report represents our initial attempt to explore the
effects of flotation REST upon arousal and attention. Because the results
of earlier studies were so contradictory, we decided to start with a fairly
straightforward measure - visual reaction time. The speed of a manual
response to a simple vi sua 1 st i mul us was used to provi de a measure of
cognitive alertness, while a two-choice visual reaction time task provided
a measure of slightly more complex cognitive processes.
There has been a relative dearth in the literature on reaction time and
sensory deprivation. The few studies that have been conducted showed
di screpant results due presumably to differences in the length of the
experimental session, the subjects' endurance capacities, and in the time of
test administration. Liederman (cited in Zubek, 1969) observed no
significant changes in simple and choice reaction time after 2 to 6 hours of
sensory deprivation; this was when the test was administered after a 20
minute delay. Kamchatnov (cited in Zubek, 1969) reported a significant
slowing of simple reaction time administered immediately after 8 hours of
darkness, but with normal auditory stimulation. To our knowledge, no studies
to date have explored the effects of flotation REST upon visual reaction
time.
While the research on flotation tanks, as a whole, is in its infancy,
there is evidence to suggest that this means of inducing sensory reduction
can provide subjectively pleasant results. This is in marked contrast to the
disorganization and subjective stress which subjects experienced in the water
immersion chambers of the 1950's and 60's. If the future of REST is to

115
involve application in health care settings, and this certainly seems to be
the case, then it is important for researchers to also consider the
subjective experiences of their subjects. Therefore, in addition to
investigating the effects of REST on information processing, it was also our
objective to determine both the immediate and delayed impact of the
experimental sessions upon individual's subjective experiences.
Finally, we also thought it important to determine whether the REST
experience might result in changes in autonomic nervous system arousal which
could be related to changes in cognitive alertness and the subjective states;
we therefore measured changes in heart rate and blood pressure.

MATERIALS AND METHODS

The design of the study involved comparing the effects of flotation
REST with a control condition which consisted of lying on a cot in a quiet,
dimly lit room. Each subject served as their own control and on alternative
days, either floated for 45 minutes in a REST chamber or spent 45 minutes
lying on a cot. THere were 12 subjects (7 males and 5 females) all of whom
participated in 4 sessions, with approximately half of the subjects starting
on day 1 with the tank condition and the other half starting with the control
condition. All measurements were taken on three separate occasions on each
day: immediately prior to entering the tank or the control environment,
after the subject emerged from the environment and again one hour later.
Thus each subject had pre, post and 1 hour retest data collected on each of
four days with the tank or control condition alternating across days.
The pre, post and one hour retest testing was always the same. It
consisted of the subjects filling out a self-report mood scale - the Profile
of Mood States (POMS); having their HR and BP measured, and then having 32
trials each of simple and then 2-choice visual reaction time recorded.
On each day the subject would enter the room, have the measures taken
and then either shower and enter the tank, or enter the control environment
(in both cases, for 45 minutes). We decided not to have the subjects shower
on control days, and we also decided not to test the subjects in the tank
condition until after they had emerged from the tank, showered and dressed.
While this produced a delay between the tank experience and the post-test and
may have introduced confounds, we decided in this initial study to
investigate the effects of the flotation experience as it might normally be
used in clinical practice or in a commercial flotation establishment.

116
Therefore, we expected to see differences between the tank and control
conditions only if changes were fairly robust and persisted well beyond the
tank experience.
The data we will present are from day 3 and 4 of the experiment only.
This is because reaction-time tasks typically show practice effects which
should have stabilized by the third day and because we also anticipated that
there would be "novelty" effects on the first tank day.

RESULTS AND DISCUSSION

Figure 1 shows the results for simple visual reaction time. What are
plotted are mean scores for the pre-test session, the post-test and the one-
hour retest. The dotted line is the REST condition, the solid line is the
control. The 2 means at each session are for the same subjects, but on
alternate days. As can be seen, there is very 1ittle difference between
the 2 conditions, and not much change across the three sessions. The
statistics support the lack of effect--there were no significant differences
between any of the mean scores. The means were on the order of 170
milliseconds with a standard deviation of around 20 milliseconds.

190
(j)
o 180
z
o
o 170
w ------ .........................
(j)
.-J
---
LEGEND
.-J 160
~ -CONTROL
- - EXPERIMENTAL
150~-------.--------~
PRE POST HOUR
TEST ADMINISTRATION
Fig. 1. Simple Visual Reaction Time in Milliseconds
for PRE-TEST, POST-TEST and ONE-HOUR RETEST.

117
 380
LEGEND
-CONTROL
~ 360 - - EXPERIMENTAL
z
o
o 340 ------- --
w
(/)
-.J 320
-- .........

--
-.J
~
300~--------~------~
PRE POST HOUR
TEST ADMINISTRATION
Fig. 2. Two-Choice Reaction Time in Milliseconds for
PRE-TEST, POST-TEST and ONE-HOUR RETEST.

Although we had only 12 subjects in the study and therefore not a lot
of statistical power, we feel that the results indicate fairly strongly that
45 minutes of flotation REST do not affect simple visual reaction either
negatively or positively when it is measured soon after the person comes out
of the environment, or one hour later. While simple visual reaction time
requires a fairly low level of information processing, it does require
considerable attention and concentration to maintain performance throughout
the test i ng sess ion. Thus, the results show no evi dence that cogn it i ve
disorganization is produced by flotation REST, at least in the cognitive
realm of attention and concentration. Conversely, there is no evidence for
an enhancement of attention and concentration as some anecdotal evidence
might suggest. It is possible, however, that there were ceiling effects--
with subjects performing at near maximal levels during the pre-test so that
increases in cognitive efficiency would not show upon this task.
Figure 2 displays the means for the 2 choice visual reaction time task
with the REST condition connected by dotted lines as before. The means are
in the range of 325 to 350 milliseconds with standard deviations around 39

118
 w 85 HEART RATE
I-
~
z 80
~
a:: 75
w
a..
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"- ,, ",
"..'"
/'

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(J)
70 ....................... LEGEND
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(l)
65
PRE POST HOUR
TEST ADMINISTRATION
Fig. 3. Heart Rate at PRE-TEST, POST-TEST and ONE-
HOUR RETEST.

milliseconds. The stimulus and response requirements of this task were the
same as for the simple reaction time task - a manual key press when a light
appeared. The fact that it took the subjects longer to respond reflects the
fact that a decision had to be made concerning whether the light was yellow
or red and the proper response accessed - either an right or a left hand key
press. Again, the task does not require a very high level of information
processing, but it does require attention and concentration and is more
cognitively complex than simple reaction time--as is indicated by the fact
that the choice reactions times are approximately twice as large as the
simple reaction times. As can be seen for the tank condition the means are
slightly lower after flotation REST than in the pretest session and are lower
again one hour later. However, these differences were not significant. The
means for the control condition show an opposite effect with a significant
increase in reaction times occurring after 45 minutes reclining on a cot.
At the one hour retest there was a decrease in reaction times so that there
was no significant difference between the pre-session and the one hour
retest.
These data again show no indication of cognitive disorganization

119
following flotation REST. The decrements in performance seen after the
control experience are important in that they demonstrate the sensitivity of
the choice reaction measure to changes in cognitive efficiency. Many of the
subjects fell asleep during the control condition and we think that the
increase in choi ce react ion time refl ects drows i ness, and consequently,
slowed decision processes. The fact that this effect was not seen following
flotation REST suggests that this experience is affecting cognitive
performance in a different wan than is the superficially similar experience
of spending an equal amount of time lying on a cot. The decrease in choice
reaction time at the one hour retest in the flotation REST condition, while
not significant, is interesting. It suggests that it may be worthwhile to
further examine long term changes in cognitive efficiency which may result
from flotation REST.

SYSTOLIC BLOOD PRESSURE

120

115

---
0)
I
E 110 ~-
~- ~........,;; .......... ------
E
105 LEGEND
-CONTROL
- - EXPERIMENTAL
100+--------.--------~
PRE POST HOUR
TEST ADMINISTRATION

Fig. 4. Systolic Blood Pressure (in millimeters

of mercury) at PRE-TEST, POST-TEST and
ONE-HOUR RETEST.

120
 Immediately prior to the reaction time tasks, we measured heart rate
and blood pressure and administered a self-report mood inventory. This
figure illustrates the changes in heart rate seen in two conditions across
the three testing sessions. Heart rate showed a significant drop from about
75 beats per mi nute to about 69 beats per mi nute in the fl otat i on REST
condit ion. The control condition showed only a very sl ight and non-
significant decrease from pre to post.
Systolic blood pressure shows a very similar pattern, dropping
significantly from pre to post in the flotation REST condition and dropping
slightly but non-significantly in the control condition. For both heart rate
and blood pressure the values were increased again at the one-hour retest,
so that there were no significant differences between the pre-measures and
the one-hour retest measures in either the REST or the control conditions.
These data indicate that autonomic nervous system arousal, as measured
by heart rate and blood pressure, is significantly decreased by flotation
REST. Thi s decrease in autonomi c arousal is independent of changes in
cognitive efficiency as measured by simple and choice reaction time. Along
with the changes in autonomic arousal are associated changes in subjective
state. Two of the six subscales from the Profile of Mood States showed
significant changes following flotation REST. The Tension-Anxiety subscale
dropped significantly (which indicates a drop in subjectively - perceived
musculoskeletal tension and anxiety) and the Vigor-Activity scale increased
significantly, which indicates an increase in energy. None of the subscales
showed statistically significant changes following the control condition.
The POMS scales which showed no significant change following flotation REST
were: Anger-Hostility, Confusion-Bewilderment, Fatigue-Inertia and
Depression-Dejection.
To summarize the findings, we found to change in attention-
concentration, or cognitive efficiency following flotation REST but did find
a decrease in autonomic nervous system arousal and an associated change in
mood, namely, a decrease in anxiety and tension and an increase in energy.
The only significant change which followed the control condition was an
increase in choice-reaction time, which probably reflected the fact that the
subjects were drowsy.

121
 These findings do not rule out the possibility that flotation REST may
cause cognitive disorganization. We only looked at one-time interval - 45
mi nutes - and tested only after the subject emerged from the tank and
showered. It is possible that more complex tasks would show different
effects, as would increasing the duration of the session or testing while the
subject is in the tank. From our results, however, it appears that the
standardly used duration of flotation REST induces a state of lowered anxiety
and increased feelings of energy while not significantly affecting cognitive
performance.

122
 REFERENCES
Bexton, W.H., Heron, W. &Scott, T.H. Effects of decreased variations in the
sensory environment. Canadian Journal of Psychology, 1954, ~, 70-76.
Brownfield, C.A. Deterioration and facilitation hypothesis in sensory
deprivation research. Psychological Bulletin, 1964, 61, 304-313.
Cohen, S.1., Silverman, A.J., Bressler, B. & Shmavonian, B. Problems in
isolation studies. In: Solomon, P. et al., (Eds.). Sensory
Deprivation. Cambridge, MA: Harvard University Press, 1961.
Goldberger, L. & Holt, R.R. Experimental interference with reality contact
(perceptual isolation). Journal of Nervous and Mental Disease, 1958,
ill, 99-112.
Goldstein, L., Stoltzfus, N.W. &Gardogki, J.F. Changes in interhemispheric
ampl itude relationships in the EEG during sleep. Physiology and
Behavior, 1972, ~, 811-815.
Heron, W., Bexton, W.H. & Hebb, D.O. Cogn it i ve effects of decreased
variation in the sensory environment. American Psychologist, 1953, ~,
366.
Jones, A. Stimulus-seeking behavior. In: Zubek, J.P. (Ed.), Sensory
Depri vat ion: Fi fteen Years of Research. New York, NY: App 1eton-
Century-Crofts, 1969.
Lilly, J.C. Mental effects of reduction of ordinary levels of physical
st i mul i on intact, healthy persons. Psych i atri c Research Reports,
1956, ~, 1-9.
Lilly, J.C. The Deep Self. New York, NY: Simon &Schuster, 1977.
Lindsley, D.B. Common factors in sensory deprivation, sensory distortion and
sensory overload. In: Solomon, P., et al. (Eds.), Sensory
Deprivation. Cambridge, MA: Harvard University Press, 1961.
Saunders, M.G. & Zubek, J.P. EEG changes in perceptual and sensory
deprivation. Electroencephalography and Cl inical Neurophysiology,
1967, 25(Suppl.l, 246.
Stern, G. Physiological and mood effects of salt water flotation.
Unpublished manuscript, University of Colorado, Denver, 1980.
Suedfeld, P. Changes in intellectual performance and in susceptibility to
influence. In: Zubek, J.P. (Ed.), Sensory Deprivation: Fifteen Years
of Research. New York, NY: Appleton-Century-Crofts, 1969.
Suedfe 1d, P. The benefits of boredom: Sensory depri vat ion recons i dered.
American Scientist, 1975, 63, 60-69.

123
Suedfeld, P. Restricted environmental stimulation: Research and clinical
applications. New York, NY: John Wiley and Sons, 1980.
Tetlock, P.E. & Suedfeld, P. Inducing belief instability without a
persuasive message: The role of attitude central ity, individual
cognitive differences and sensory deprivation. Canadian Journal of
Behavioral Sciences. 1976,~, 324-333.
Vernon, J. &Hoffman, J. Effects of sensory deprivation on learning rate in
human beings. Science, 1956, ll1, 1074-1075.
Wexler, D., Mendelson, J., Leiderman, P.H. & Solomon, P. Sensory
deprivation: A technique for studying psychiatric aspects of stress.
AMA Archives of Neurology and Psychiatry, 1958, 79, 225-233.
Yerkes, R.M. &Dodson, J.D. The relation of strength of stimulus to rapidity
of habit formation. Journal of Comparative Neurology and Psychology,
1908, 18, 459-482.
Zubek, J.P. (Ed.), Sensory deprivation: Fifteen years of research. New
York, NY: Appleton-Century-Crofts, 1969.
Zubek, J.P., Sansom, W. & Prysiaznuik, A. Intellectual changes during
perceptua 1 i so 1at i on (darkness and silence). Canadi an Journal of
Psychology, 1960, l!, 223-243.
Zuckerman, M., Albright, R.J., Marks, C.S. & Miller, G.L. Stress and
hallucinatory effects of perceptual isolation and confinement.
American Psychologist, 1961, lQ, 427, (abstract).

124
10
The Effects of Flotation Restricted Environmental
Stimulation Therapy on Learning: Subjective Evaluation
and EEG Measurements
Thomas Taylor
ABSTRACT
Th i s study exami nes the effects of fl otat i on REST on 1earn i ng and
attempts to correlate changes in EEG patterns with the learning experience.
One important question which is addressed is whether the amount of material
learned was different during flotation REST than during non-REST relaxation.
This study also demonstrates the capability for doing EEG recordings during
flotation REST.
A total of 20 volunteers aged 18-22 who were of average height, truly
right-handed, and in the preluteal stage of the menstrual cycle (days 5
through 12) were used as subjects in the study. Subjects were initially
screened to establish the level of artifacts in the EEG patterns.
They were then tested for initial level of knowledge on a graded series
of questions while EEG recordings were being made. Following controlled
learning in the flotation tank (experimental group) or while relaxing on a
couch (control group), final EEG recordings were made while the subjects were
thinking about each of the questions in the series.
Within the statistical parameters stated, more learning occurred in
subjects who had floated and were instructed while floating, than in subjects
who lay quietly in a darkened room on a couch and were similarly instructed
for the same period of time. In addition, the most pronounced increases in
learning rates of floaters vs. controls were found in the more difficult
questions. A visual inspection of raw EEG tracings revealed pattern changes
which seemed to be consistent with gaining a higher level of understanding.
These patterns were more pronounced in the floating group than in the non-
floating control group.
An EEG recording during the chance moment in which a difficult
technical concept suddenly "made sense" to a floating subject, showed an
abrupt change in brain wave patterns.
When the floating group and the control group were divided into
primarily visual vs. predominately conceptual thinkers, the amount of
learning was greater for the visualizers.

125
 MATERIALS AND METHODS
Facilities and Equipment
The screening EEG's were recorded on a Grass Mode 6
Electroencephalograph, on loan from Bryan Hospital, courtesy of the
administrator, Mr. Bobby Morgan. This machine is located in a classroom
buil di ng and does no have a Faraday cage. Pre- instruct i on and post-
instruction EEG's were recorded from a Faraday room on a Grass Model 8
Electroencephalograph and simultaneously on an eight channel analog tape
recorder provided by Dr. William R. Klemm, TAMU Veterinary Anatomy
Department. The analog recording level was monitored on an oscilloscope for
signal level. The flotation (sensory isolation) tank used was provided by
Aggieland Float-to-Relax. All orientation and data floats were done in one
tank of a six tank commercial operation. The relaxing environment for the
control subjects was set up in a classroom building. The room was dark and
quiet. The subjects relaxed while lying on a comfortable sofa. The question
set and instruction tapes were recorded on 60 minute cassettes by Mr. Jeff
Cowan, of TAMU Educational Media Production Center.
The analog data from the previous studies were converted to digital on
a PDP 11 Analog to Digital conversion. The Fast Fourier spectral analyses
were run on TAMU Data Processing Center Amdahl computer by Dr. Glen Williams,
Industrial Engineer, and Dr. Joe Newton, TAMU Institute of Statistics. These
facilities are available for similar analysis of the data collected in this
study.
Learning Material
Three series of technical question sets were generated. Each series
ranged from a knowledge-rote/recall task to a synthesis level task. The
subject matter was related to content from the first-year collage chemistry
program in which the majority of the subjects were enrolled. A portion of
the subject matter chosen was material that had been previously covered in
the course and the remainder was an extension of that same material into
cognitive levels not required for the course. No content matter was used
that was currently being emphasized in the subject's chemistry classes.
Question Set One was deemed to best meet the requirements of the study and
that set was used exclusively in the learning sessions. A cassette tape
recording of 12 different voices was made to select the one to be used for
introducing the technical question-set and for the instruction tapes.
JUdgements on clarity of these voices were then made by project workers while

126
they were floating in the tank. Tapes of both the question-set and the same
questions with complete explanations were then recorded with the voice deemed
most appropriate.
Subjects
To obtain volunteer subjects, announcements were made in second
semester Chemistry classes, and signs were posted in the TAMU General Science
and Laboratories Building. A total of 453 students responded; 109 possible
subjects were chosen from this group. Participants met the basic criterion
of being female, 18-22 years of age, Caucasian, truly right-handed,
monolingual, average weight, average physical activity level, not recently
or currently pregnant, no history of a serious head injury or clinically
abnormal EEG, no previous experience with the flotation tanks, a willingness
to sign the human subject consent form, and a schedule which allowed them to
provide the six hour time blocks required for the study.
Screening EEG's
Data sheets and consent forms were completed for each subject and the
electrodes placed in pos i t ion. The same montage was used for all EEG
recordings. This montage was Fpp Fp2 ' C3 , C., 0" and O2, each to tied-ears.
In addition, an EKG channel was included to detect any heartbeat artifact in
the EEG channels and to measure any heartbeat rate changes that might occur
during the study. Baseline screening EEG's were run on the 109 volunteers
to select those subjects that would be more likely to provide EEG's with
useful artifact-free segments. During the screening EEG recordings, these
subjects were asked to perform a series of mental exercises. The subjects
were then rated according to their level of artifact products (eyes open and
eyes closed) during the processing of a difficult mental task. The 40 best
subjects were chosen after three independent opinions of artifact ratings had
been made. These 40 students were randomly divided into the experimental
(floating) and control (non-floating) groups.
Subject Introduction to Floating
The floating subjects were acclimated to the sensory isolation
envi ronment through a general verbal ori entat i on by Mr. John Moran of
Aggieland Float-to-Relax and by two silent, one-hour and ten-minute floats.
In order to remove the novelty of sound in the tank, an additional pre-
instruction sound float was experienced using an environmental thunderstorm
tape. After the three prel iminary floats, the subjects were questioned
concerning their reactions to the experience. Since the resting experience

127
for the control group was not in a novel environment, parallel introductory
relaxation sessions were not conducted for these subjects.
Data Collect ion
Complete data were collected in the preluteal phase (Days 5-12) of the
menstrual cycle on a total of twenty subjects. Due to time constraints in
the school semester, twenty of our original subjects could no longer schedule
six hour data sess ions and/or complete pre 1i mi nary floats. For the data
sessions, personal data sheets were completed and blood pressures taken prior
to the pre-learning EEG recording.
The pre-learning EEG recordings were conducted with the subjects in a
reclining chair in a lighted Faraday cage room. Communication with the
subject during each recording session was done via a Faraday screened speaker
from a microphone and/or cassette recorder in an adjoining recording room.
The subject was observed by a worker 1ooki ng through a Faraday screened
window and any physical movements of the subject were noted with an event
marker on the EEG recording. The same event marker was also used to mark the
time of all communication with the subject. During the pre-learning EEG
recording session, the subjects encountered the technical questions for the
first time. These technical questions were played directly from the cassette
tape and the "relax", "open/close your eyes" and "visual ize _______
commands were given by an operator using a microphone.
The technical questions were presented to each subject in pairs. A
lower level knowledge-rote/recall question was asked and the subject given
time to consider her response. This was followed by a "relax" period. Then
the next higher level (appl ication) question was asked and an additional
"relax" period followed. There were four total repetitions of these two
questions. After each pair of technical questions, the recording was
interrupted while an operator entered the Faraday room and asked the subject
what she had been thinking in response to each technical question and each
vi sua 1i zat ion. These i ntervi ews were recorded on cassette tape and the
subjects were encouraged to give as detailed an answer as possible. This
procedure was followed in both the eyes open and eyes closed modes prior to
moving to the next pair of questions.
The second pair of technical questions began with the application level
questions, repeated from the first set, and introduced the third level,
synthesis level, question. Otherwise, the recording mode was the same as for
the first set. During the taping of the interview sessions, no responses

128
were made regarding either the correctness or the errors in the subjects'
verbalized responses to any of the technical questions.
The rationale behind using pairs of questions was that the asking of
the synthesis level question could affect the response received for the
application level question.
At this point, the electrodes were removed (but the electrode placement
marks were preserved) and the subject was taken to the learning session (tank
for experimental subjects and the couch for the controls).
Each learning session began with a 15 minute relaxation period allowing
adjustment to the environment. This was followed by the Playing of the
cassette tape wi th the lower 1eve 1 (knowl edge/rote) question and answer
(explanation) to that question. After a brief pause, the explanation to the
same question was repeated. Following ten minutes of silence, the procedure
was repeated for the next level (application) question. Another ten minutes
of silence followed before the third level (synthesis) question and its
exp 1anat i on were played. A fi na 1 20 mi nute silent peri od concluded the
learning/ relaxation phase. A soft knock on the tank or door to the room
signaled to the subject that this phase of the program was over.
The subjects were then returned to the Faraday room, the electrodes
were placed using the same placement marks and the post-learning recordings
were made using the same procedure as in the pre-learning recording session.
The oral quest ions, however, covered all these 1eve 1s of quest ions ina
single interview session.
To avoid extraneous input, all sessions involved continuous monitoring
of the subjects from the beginning of the pre-learning session through the
final post-learning recordings.

RESULTS AND DISCUSSION

The collected data include:
a) subject history
b) screening EEG recordings
c) Pre- and post-learning EEG tracings and the same data recorded
on analog tape
d) cassette recordings of the subjects' verbalized responses for
both the pre-and post-learning sessions
Each subject was rated as to knowledge of all technical questions both
prior to and following instruction. The subject responses were reviewed by

129
a minimum of three workers in an attempt to obtain a more objective rating
of the subjects' grasp of each technical question. Amount of learning (if
any) was judged for each question.
By reviewing the voice recordings from the pre- and post-learning
sessions, together with the notes taken by the operator, the subjects were
classified as predominantly visualizers or primarily conceptual thinkers.
Those subjects for whom such a distinction was unclear were rated as unknown
and not used in the visual vs. non-visual comparisons.
Finally, all pre- vs. post-learning EEG segments were compared for the
same subject considering the same technical question in the eyes-open mode
and similarly for the eyes-closed mode. The four criteria listed under
discussion of results were used for each of these comparisons.
The rated increases in knowledge, following instruction and the
comparisons of pre- vs. post-learning EEG tracings, were statistically
analyzed using ANOVA tables. A standard X2 -test was used for the highest
level question.
No work has yet been done with the EEG recordi ngs on analog tape.
These recordings all contain calibration signals and are thus suitable for
computer power-spectra analysis.
The i nit i a1 phases of th is project, before the i nvo 1vement of the
Float-to-Relax Corp., had indicated the possibility that various changes in
EEG patterns could be related to a corresponding increase in the cognitive
level at which the subject was mentally processing a given concept. In the
first stage, no correlates of cognitive level increase were discovered in the
viewing of raw EEG's. The following spectral analysis (Fast-Fourier-
Transform Program), however, a series of such changes were found and, with
these as guides, distinctions could then be seen in the more complex case of
the raw data. It was with these comparisons in mind that we undertook the
current project with the support of Float-to-Relax, Inc. The controls for
this work were tightened extensively as a result of the experiences with the
prior studies. First, all the presentation of questions and the subsequent
instruction of the subjects to raise their cognitive levels was done with
identical tape recordings. This avoided any unintentional changes in mode,
in rate, in i nfl ect ion, in durat i on, and in completeness of presentat ion.
Secondly, tape recordings ere made of both the pre- and post-instruction
interview sessions. These tapes, and transcripts made from the tapes,
a11 owed more of the workers to analyze the degree of 1earn i ng that had

130
actually occurred and also facilitated the repeat reviewing of these
conclusions. Thirdly, total contact time was controlled for all subjects in
quest i oni ng, in pre- 1earn i ng recordi ng, in re 1axat ion (both floaters and
control), in instruction, and in post-instruction recording sessions.
The previously observed EEG pattern changes which accompanied an
increase in cognitive levels were used as guides to review the raw EEG data
from the current study. The characteristics examined were:
1. An overall increase in power in the pre-frontal
position. (The reverse seemed to appear in the power
spectra generated in the prior study).
2. A diminution in left-central power relative to right-
central (a characteri st i c wh i ch may be un i que to
female subjects).
3. An increase in occipital power particularly in the
right hemisphere and most pronounced in the dominant
alpha frequencies. This is accompanied by a
broadening of the alpha peak (mixed frequencies, which
diminishes with time.
4. An increase in low frequency waves.
These were examined separately in the eyes-open and eyes-closed EEG
recordings of all pre-learning vs. post-instruction cases in which
significant learning had occurred. An average of 22 such segment
(comparisons were made per subject (this number varies, of course, with the
amount of learning that occurred). Definitive statements regarding these
changes should be made from spectral analysis rather than the examination of
raw EEG data. Nonetheless, in those cases where the changes were observed
directly from the raw data, the direction of change was consistent for all
of the above cond it ions for all the subjects except the fi rst compari son
(pre-frontal activity) for a single subject. In general, more of these
changes were observable in the eyes-open than in the eyes-closed (17 vs. 10)
recordings. Secondly, the incidence of consistently observable changes was
much greater for the floating than for the control subjects (20 vs. 7).
Within the necessary large uncertainty that is a part of visually analyzing
raw EEG data, it would appear that the brain wave change that accompanied
learning in the floating group was more pronounced than in the controls.
This result is seen in both the predominantly visual and the primarily non-
visual thinkers. At the same time, changes in the first comparison

131
predominate for the non-visual subjects while conditions three and four are
more consistent for the visualizing group. For all of these comparisons, a
confirmation by spectral analysis should be made.
The total amount of learning per subject was greater among the floating
group than among the non-floating control group. Quite unexpectedly, the
differences in degree of learning, between the floating subjects and the
non-floating controls in this study, were much greater as the degree of
difficulty on the concept increased (Fig. 1).

ALL SUBJECTS
z . - - EXPERIMENTAL IfioatinglGROUP
~ ~n-floatingIGROUP
00
zw
::':::z
Za: ,,
::::)« ,
>-w "-
(f)--1 "-
::::)(f) "X
0«
>~ SUBJECTS WITH SAME TECHNICAL BACKGROUND
wI- . - - EXPERIMENTALlfloatinglGROUP
a:«
D..I -~------x
X--X CONTROLlnon-fioatingIGROUP
LLI-
0--1
1-« -- ---
ziI " ,,
::::)w
01-
, '\
2« '\
«2 'x
DIFFICULTY OF QUESTION

Fig. 1. Comparison of learning efficiency in floating

and non-floating subjects.

A statistical analysis of these results indicates that the probability

of-ihis result being significant is > 99.5%. Indeed this indicates that
within the limits of probability mentioned, the increased learning rate that
Float-to-Relax, Inc. has reported for the acquisition of foreign language (a
lower cognitive level task) is very small compared to the possible
improvement of learning rates for more complex records.
When the same learning records (pooled floaters and non-floaters) are
analyzed on the basis of persons who are basically "visual izers" versus
those who are primarily "conceptualizers" (non-visual thinkers), a greater
degree of learning occurred in the visual than in the non-visual group (Fig.

132
2). The large divergence of the curves with degree of difficulty seen in
Fig. 1 (floaters vs. non-floaters), however, was not noted here. In
addition, the successful learning of the visualizers at the highest degree
of difficulty was noted only within the floating group. These data suggest
that the float i ng experi ence may be of most benefi t to the vi sua1 i zer
subgroup. At a minimum, it suggests that a visual component of instruction
versus the strictly auditory used in this study needs to be tested.

v-v VISUALIZERS
n--n NON-VISUALIZERS

DIFFICULTY OF QUESTION

Fig. 2. Comparison of learning efficiency in

visualizers (V) and non-visualizers eN).
Data for floaters and non-floaters
were pooled.

Late in this study, a chance event occurred during the post-instruction

EEG recording of one of our visualizing-floating subjects which we refer to
as the EUREKA event. While the recording was in progress, the explanation
of the more difficult (synthesis level) technical question suddenly
"cl icked" for this subject. The EEG recording for that interval (eyes were
open) are shown in Figure 3. If similar changes occur when any concept
suddenly "makes sense" to the learner, it suggests that recordings need to
be made during the instruction in spite of the experimental difficulties
involved.

133
Fig. 3. EEG recording prior to and during "EUREKA" event (see
bottom sequence) Montage (top to bottom) if Fpi, Fp 2,
C3, C4, 01, 02. Each to tied ears.

134
11
Effects of Flotation REST on Stimulated
Instrument Flight Performance
Lori G. Melchiori and Arreed F. Barabasz

ABSTRACT
Research on the,effects of restricted environmental stimulation (REST)
suggests that various psycho-motor abilities are impaired, while others are
enhanced.
Many early studies employed anxiety provoking instructions which may
have confounded the results and led investigators to incorrectly attribute
their negative findings to REST. This study emphasized procedures designed
to be low in anxiety arousal potential.
Twenty instrument flight rules rated pilots participated individually
in a four hour experimental session, after having earl ier had a general
orientation and practice simulator flight. Each flew an initial half hour
fl ight while the instrument panel was videotaped. Subjects spent the
following two hours in either a well lit office (10 control) or a flotation
REST environment (10 treatment). Each pilot again flew the same half hour
flight as the instrument panel was videotaped. The videotapes were scored
by two raters blind to subjects' assigned conditions.
The results suggested that REST had a positive effect, significantly
improving mean instrument fl ight performance from pretest to post test
(t=2.05, p<.05) in the flotation group.

INTRODUCTION
Research on the effects of REST on psychomotor performance has
generated conflicting findings. Early REST investigations, then erroneously
termed "sensory deprivation" (Suedfeld, 1980), appeared to demonstrate
decrements in performance while recent research appears to support
performance enhancement following REST.
Examples of studies showing impairment after REST include fine eye-hand
coordination represented by tests of cancellation and dexterity (Zubek et
al., 1960), handwriting speed and qual ity (Bexton et al., 1954; Scott et
al., 1959), complex measures of coordination such as rail walking, rotary-
pursuit and mirror tracing (Vernon et al., 1961) and visual vigilance (Zubek

135
et al., 1961; Barabasz, 1980). Zubek (1969) concluded that a slowing of
visual reaction time and decrease in visual alertness were definite
consequences of REST. Suedfeld (1980) suggested that an activity that
demands vigilance, such as driving a car, may be disrupted after experiencing
long periods of REST.
Results of the early REST studies were confounded by the use of anxiety
provoking instructions and anxiety producing situational cues such as "panic
buttons", "medical trays" and inadequate introductions to the experimental
settings (M. Barabasz, &A. Barabasz, 1985; A. Barabasz &M. Barabasz, 1985;
Suedfeld, 1980; Suedfeld et al., 1971; Lilly, 1977). In contrast, recent
research (0' Leary & He il bronner, 1985) found no evi dence REST produced
organization, attention or concentration deficits using an orientation
designed to minimize anxiety.
The present study was conducted to determine the effects of two hours
of flotation REST on a complex psycho-motor performance task using modern
REST orientation (Suedfeld, 1980) procedures.

METHOD
Subject
Twenty (3 female, 17 male) Instrument Flight Rules (IFR) rated pilots
ranging in age from 21 to 63 years (X=36.7) participated in this study. Ss
were randomly assigned to treatment and control groups. Approximate total
flight experience ranged from 240 to 9,700 hours (median=863). Approximate
IFR fl ight time ranged from 40 to 4,000 hours (median=83 hours). All
subjects cited the opportun i ty to fl y the s i mul ator as thei r reason for
volunteering.
Apparatus
Ss were exposed to REST using a Floatarium Brand fiberglass tank (267
cm long x 170 cm wide x 135 cm high). The tank contained a 20% solution of
Epsom salt and tap water. The sol ut i on was ma i nta i ned at a constant
temperature of 34.2 (± .3) degrees C. Vent il at i on to the 1i ght free and
sound attenuated REST environment was provided by a positive pressure system.
The flying task was performed on an Analog Training Computer flight
simulator (ATC-610J). The computer, with a complete instrument panel, yoke,
throttle, propeller, rudder and landing gear controls, was programmed by
selection of communication and navigation codes during the flight. The
commands of the air traffic controller were provided to Ss from a pre-

136
recorded tape pl ayed on a standard cassette recorder. The tape used was
number 27 of the ATC Aviation Cassette Library (1977) IFR rating program
series. The 28 minute flight was consistent in length with previous research
(Davies &Tune, 1969) that identified 30 minutes as an approximate optimum
length for a vigilance task.
A random turbulence factor of level one (selected from a range of zero
- completely smooth, through five - highly erratic flight conditions) was
programmed into the ATC-610J on all flights. This required the pilot to
constantly scan the instrument panel and make frequent small corrections to
the aircraft controls to maintain a consistent flight path. Pilot
performance was monitored in pre and post conditions by videotaping the
instruments showing altitude, airspeed, course deviation, landing gear
position, navigation and communication radio frequencies.
Procedure
Consistent with modern anti-anxiety REST procedures (Suedfeld, 1980)
all subjects viewed the flotation tank and had general questions answered
prior to the experimental session. The 90 minute orientation also included
a practice flight session on the ATC-610J within a week of their experimental
participation.
During the experimental session, each pilot was provided with a
standard instrument fl i ght rul es chart detail i ng the route of fl i ght, an
approach plate with landing information specific to the destination airport
and pencil and paper for writing down the controller's instructions. At two
minute intervals throughout the flight, a video camera was focused on the
specific instruments to be rated for that portion of the flight.
After the initial flight, control group subjects remained active
(reading or writing material of their choice) in a normally lighted office.
Experimental group subjects were exposed to two hours of flotation REST.
After subjects settled into the tank, the following instructions
derived from an earlier investigation (Barabasz, 1982) were read over the
intercom and heard through underwater transducers embedded in the body of
the tank:
The intercom will be on the whole time. Feel free to
tell me whatever you want about your reactions while
you are in the tank. These will help us to better
understand the resul ts of the study. Whatever you say
will be kept confidential. Try not to sleep but don't

137
 worry if you do doze off. I wi 11 not talk to you
again until the session is over when I shall ask you
to get out and shower.
After two hours in their assigned condition, the subjects returned to
the flight lab and again flew tape 27. At the completion of the second
flight, brief questionnaires asking background information and their
impressions of the flight and flotation or control conditions were filled
out.

RESULTS
The videotapes of the fl ights were scored by two independent bl ind
raters. They compared the pilot's actual performance to a score sheet that
had been compiled by the experimenter after transcribing tape 27. Precise
timing made it possible to determine exactly what instrument readings could
be expected at two minute intervals throughout the flight. If the reading
on the instrument was within a specified range a plus was awarded for that
instrument for that data point (Barabasz, 1985). If it was not, a minus was
recorded. The total number of pluses on the score sheet became the flight
score.
Ss who spent two hours between flights in the flotation tank
si gni fi cantl y improved thei r simul ator performance on the second fl ight.
The results appear in Table 1. The pilots who remained active showed no
significant improvement in their performance.
Post-Hoc Questions and Analyses
After assess i ng the i nformat i on on the quest i onna ires, it was noted
that a possible source of variability in the data was the diverse level of
past flight experience among the 20 pilots. Regardless of assigned
experimental condition, the flight scores were divided into two groups -
those with 100 hours or more of IFR fl ight time (8 total; 4 control & 4
flotation) and those with less than 100 hours of IFR experience (12 total;
6 control & 6 flotation). An AN CO VA util izing prefl ight scores as the
covariate detected a significant difference between the scores of the
experienced and least experienced pilots on the second flight (F(1,17) =
7.8, P <.01).
A t-test for correlated samples showed that the mean score of the
second flight of the less experienced pilots had significantly improved over
the first flight (t(11) = 3.78, P <.002).

138
 Table 1
T-TEST RESULTS

N X SD t P
Flotation
Prefl ight 10 23.10 5.07
Postfl ight 10 25.20 3.85 2.05 <.05
Control
Preflight 10 21.60 5.44
Postfl ight 10 23.70 4.62 1.47 >.05

DISCUSSION
The major results of the study appear to demonstrate significant
enhancement of IFR flight performance following exposure to two hours of
flotation REST. These findings are in contrast to early studies reviewed by
Zubek (1969) and Suedfeld (1980), showing a decrease on several measures of
psycho-motor funct i on i ng after exposure to REST wi th anxi ety produci ng
orientation cues. IFR simulator performance appeared to be a function of
both assigned condition (flotation tank or control) and past flight
experience possessed by each pilot. A considerable variability of
experience was revealed in post experimental interviews.
Ceiling effect was not a factor as all flight performance scores had
room to improve. The flight and navigation performance required by the task
might have placed greater demands on the less experienced pilots (Kail &
Pellegrino, 1985). Because task complexity is known to be a significant
factor in the direction of the effect REST will have on performance, future
research should assure that pilots with a similar skill/experience level are
present in each group and/or a less demanding flight task might be used to
help insure that the results would not be confounded by this factor (Landon
& Suedfeld, 1972; 5uedfeld, 1969; 5uedfeld, 1968).
Flying style also appeared to vary greatly among 5s. 5s in the study
were told to "fly as you normally do". Perhaps the more experienced pilots,
due to their rigorous military and/or occupational flight training tolerated
less deviation from the flight controller instructions than those with fewer
hours who may have viewed flying as a less stringent task. This factor does
not necessarily reflect skill level. Had the instructions been to "fly as

139
prec i se 1y as you can" the 1ess experi enced pilots mi ght have had 1ess
variation as a group in their flight scores.
Reactions to the REST experience varied greatly. Most Ss felt that
approximately the first 90 minutes were "comfortable" and "enjoyable" but
during the last 30 minutes they were "bored". Although flight performance
did not appear to be systematically related to their subjective feelings,
perhaps those who became irritated prior to leaving the REST environment
lost potential benefits that relaxation may have produced in their flying
ability. In future studies the investigators may wish to limit the maximum
REST exposure to 90 minutes (Barabasz, 1980).
The results of this study support Suedfeld's (1980) view that non-
anxiety provoking instructions provided to the subject prior to experiencing
the REST environment are important. The chances of confounding true REST
phenomena with those changes precipitated by anxiety, fear or stress can be
essentially el iminated. The results of this study add strong support for
the argument that many of the early investigators incorrectly attributed
many of the psycho-motor impairments they found to REST. A direct
comparison of the results of this study and previous research should be done
with caution. Although stimulus reduction had been accomplished to varying
degrees, different procedures were used. Furthermore, the early studies
emphas i zed 1aboratory tests of psycho-motor performance rather than the
complex flight simulator task employed in the present study.
Based on the results of this study, the authors feel investigators
should continue to re-evaluate the early negative findings of the effect of
REST on psycho-motor performance, using non-anxiety provoking instructions,
a duration of REST in common use and meaningful psycho-motor tasks.

ACKNOWLEDGEMENTS
Thanks are expressed to Enrichment Enterprises Corp. The Floatarium
tank was provided to the second author as part of a research grant.

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Suedfeld, P. Restricted environmental stimulation: Research and clinical
applications. New York, NY: John Wiley & Sons, 1980.
Suedfeld, P., Landon, P.B., Epstein, Y.M. & Pargament, R. The role of
experimenter and subject expectations in sensory deprivation.
Representative Research in Social Psychology, 1971, £ill, 21-27.
Vernon, J., McGi 11, T., Gul i ck, W. & Candl and, D. The effect of human
isolation upon some perceptual and motor skills. In: Sensory
deprivation: A symposium held at Harvard Medical School. Cambridge,
MA: Harvard University Press, 1961, 41-57.
Zubek, J.P. (Ed.). Sensory deprivation: Fifteen years of research. New
York, NY: Appleton-CenturY-Crofts, 1969.
Zubek, J.P., Pushkar, D., Sansom, W. &Gowing, J. Perceptual changes after
prolonged sensory isolation (darkness and silence). Canadian Journal
of Psychology, 1961, ~ 83-100.
Zubek, J.P., Sansom, W. & Prysiazniuk, A. Intellectual changes during
prolonged perceptual isolation (darkness and silence). Canadian
Journal of Psychology, 1960, l!iil, 233-243.

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12
Enhancing Hypnotizability: Differential Effects of Flotation
REST and Progressive Muscle Relaxation

Glenn M. Kaplan and Arreed F. Barabasz

ABSTRACT
The purpose of th is study was to determi ne the effect i veness of
flotation Restricted Environmental Stimulation Technique (REST) for
enhancing hypnotizability. Thirty subjects randomly assigned to a)
flotation REST (N=10), b)Progressive Muscle Relaxation (PMR) (N=10), or c)
no treatment Control (N=10), were pretested with the Stanford Hypnotic
Susceptibility Scale, form C (SHSS:C), and re-administered the SHSS:C after
treatment and at follow-up. PMR enhanced hypnotizabil ity more than no
treatment Control. Contrary to previous studies using chamber method REST,
flotation REST did not enhance hypnotizability more than PMR as predicted.
Both REST and PMR subjects significantly increased hypnotizability over time
while Control subjects did not. The role of relaxation in hypnosis was
discussed.

I NTRODUCTI ON
Hypnotizability has been defined as the ability to become hypnotized
and is thus conceptual ized by some researchers as a stable trait of an
individual (As, Hilgard, &Weitzenhoffer, 1963). An operational definition
of hypnotic susceptibility which permits behavioral measurement is given as
"the number of times the subject acts like a hypnotized person when hypnosis
is induced by a standard procedure" (Weitzenhoffer &Hilgard, 1959, p. 5).
In contrast to viewing hypnosis as a stable trait, evidence has
accumulated supporting the notion that hypnotizability can be learned and is
therefore modifiable. In an early study, Pascal and Salzberg (1959), found
significant increases in hypnotic susceptibility as a function of a
systematic training procedure. Since this 1959 study, research has been

143
directed toward the modification of hypnotic susceptibility with a range of
techniques, including chamber restricted environmental stimulation technique
(REST) (Barabasz, 1982; 1984; Leva, 1974; Sanders & Reyher, 1969; Zubek,
1969), perceptual isolation (Pena, 1963), behavioral modeling cues (Cooper
et al., 1967, observational learning (DeVoge & Sachs, 1973), written
instructions (Diamond et al, 1975), successive approximation and verbal
reinforcement (Sachs &Anderson, 1967), dream deepening suggestions (Wiseman
& Reyher, 1962), rel axation training (Edmonston, 1977), rel axing music
(Talone, Steadman & Diamond, 1973), EMG feedback training (Wickramasekera,
1971) and encounter group experiences (Shapiro & Diamond, 1972).
The discrepancy in explaining hypnotizability either as a stable trait
or a learned skill may be due to methodological inconsistencies in earlier
studies that did not have subjects brought up to their 'plateau' level of
hypnotizability prior to their being pretested. The concept of plateau
hypnotizability or plateau susceptibility (Shor, Orne & O'Connell, 1966) has
led investigators to report that most subjects will reach a plateau of
hypnotic performance once a number of hypnotic sessions have occurred.
The usual research practice of modifying hypnotizability has been to
obtain a basel ine score on an accepted measuring instrument such as the
Stanford Hypnotic Susceptibility Scale: Forms A (SHSS:A), B (SHSS:B)
(Weitzenhoffer & Hilgard, 1959), or C (SHSS:C) (Weitzenhoffer & Hilgard,
1962), the Harvard Group Scale of Hypnotic Susceptibility: Form A (HGSHS:A)
(Shor & E. Orne, 1962), or the Stanford Hypnotic Clinical Scale (SHCS)
(Morgan & Hilgard, 1975). Following this measure, some training procedure
is utilized to increase hypnotizability after which the subject is re-
evaluated either using the initial measuring instrument or a different
hypnotic scale in order to establish generalization of the effect. Control
subjects are usually evaluated on the pretest and post test measures but are
not subjected to the training procedures.
Barabasz (1982) has shown that one way to effectively enhance
hypnotizability is to have subjects participate in restricted environmental
stimulation technique (REST). The chamber REST procedure involves exposure
to a reduced stimulation environment involving attenuation of auditory
input, reduction of tactile stimulation and elimination of visual
stimulation. According to Suedfeld (1980) the subject is asked to reduce
motor activity to the minimum required to maintain comfort, communicating
only with the therapist or experimenter. who controls the situation to some

144
extent; that is, she/he indicates when the subject is to perform certain
tasks and when the session is over.
The achievement of a state of relaxation is usually the major goal of
REST in formal cl inical practice. This is different from studies which
emp 1oyed 'sensory reduct ion' or 'sensory depri vat ion' whi ch was used to
increase the susceptibility of the subject to persuasion and major
personality change (Suedfeld, 1980). The current use of the REST procedure
involves stimulation from the environment that is in some way restricted and
kept to a minimum.
In comparison to other training procedures, namely, progressive muscle
relaxation, REST does not require continued practice and it can be used for
individuals who might otherwise stop practicing. What it does require is
some special facility, for example, a chamber environment or flotation tank.
The isolation environment minimizes interactions with external reality and
provides an opportunity to fully explore one's inner domain. It has been
postulated that while in the tank one is allowed to separate the mind and
body and to become aware of "hundreds if not thousands of other states of
being in which one's consciousness is unimpaired and apparently disconnected
from the brain and the body" (Lilly, 1977, p. 104).
Modern investigators and practitioners rely, almost exclusively, on
induct i on procedures i nvo 1vi ng the concept of re 1axat ion. As. noted by
Edmonston (1972, p. 227-228), "It has been evident for two centuries that
relaxation is an inseparable part of what is traditionally known as hypnotic
procedures". However, as presented in a study by Banyai and Hilgard (1976),
a relaxed state is not necessary for hypnosis, which may be induced via an
act i ve- alert induct ion. In a recent study, Mi tche 11 and Lundy (1986)
examined induction procedures in which relaxation and imagery were isolated
in terms of their relative effect on hypnotic responsivity. Regardless of
hypnotizability levels, a combined induction (relaxation plus imagery) led
to a greater subjective report of hypnotic response than did either the
relaxation or the imagery inductions. It may follow that the subjective
experience of hypnosis is facilitated by inductions which include
relaxation.
While findings from previous studies support the efficacy of chamber
REST in enhancing hypnotizability, published studies using flotation REST
for this purpose are non-existent. In addition, it is important to examine
the potent i a1 effect of muscl e relaxation on the enhancement of

145
hypnotizability. Since the Stanford scales utilize an hypnotic induction
involving relaxation prior to hypnosis, it is important to examine whether
it is muscl e re 1axat i on brought about vi a the fl otat i on REST tank or PMR
that accounts for the potential enhancement of hypnotizability. Thus, the
purpose of this study was to compare the differential effects of flotation
REST and Progressive Muscle Relaxation (PMR) for increasing hypnotizability.
It was predicted that, (1) subjects exposed to flotation REST will
significantly increase their hypnotizabil ity more than subjects in the
control group, (2) subjects trained in Progressive Muscle Relaxation (PMR)
will significantly increase their hypnotizability more than subjects in the
control group, (3) subjects exposed to flotation REST will significantly
increase their hypnotizability more than subjects trained in PMR, and (4)
subjects in both the flotation REST and PMR groups will show significant
increases in hypnotizability test scores from pretest to post test, while
control subjects will not.

METHOD
Subjects
Subjects consisted of Washington State University graduate and
undergraduate students who volunteered for a study on hypnos is. Th i rty
subjects were randomly assigned to the two treatment groups and the control
group. Ages ranged from 17 to 44 years with a mean age of 23.1 years. The
flotation REST tank group had 7 females and 3 males with a mean age of 23.6
years, the PMR group had 5 females and 5 males wi th a mean age of 24.1
years, and the Control group had 5 females and 5 males with a mean age of
21.7 years.
Apparatus
The 'Floatarium' REST tank is essentially an enclosed fiberglass tub
that contains a dense solution of water and epsom salts. The density of the
solution is so great that the subject floats effortlessly on top of the
water. The experience is usually described as 'weightlessness'. The
solution, 13"-15" (33 cm - 38 cm) deep is maintained at average skin
temperature of 93.5 degrees Fahrenheit (34'C) so the subject does not feel
the water. The tank is sound attenuated and once the door is closed, is
1ight free. The floatarium is ventilated by a positive pressure system.
Underwater transducers allow transmission of messages to the subject. The
subject may also talk with the experimenter at any time via the built in

146
communications system. The large overhead door has spring-assisted hinges
to allow easy entrance and exit at any time by the subject. The system
includes a complete water filtration and purification system. The maximum
dimensions of the tank are: L-I0l" (2.56 m), W-60" (1.5 m), H-54" (1.37 mI.
A shower facility installed in the lab was used by subjects before and after
each session in the tank.
Instrument
The Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) of
Weitzenhoffer and Hilgard (1962), consists of an hypnotic induction,
followed by 12 items on the SHSS:C utilized in determining hypnotizability
levels of the subjects. The hypnotic induction employed in this study was
taken from the Stanford Hypnotic Clinical Scale (SHCS) of Morgan and Hilgard
(1975). This induction utilizes relaxation techniques.
Procedure
The purpose of this study (i.e., "to test for any changes in
hypnotizabil ity") was explained to all subjects during the initial group
meeting. Subjects were then randomly assigned to their specific groups and
instructed to move to different rooms where they were ori ented to thei r
part i cul ar treatment. Each subject was then instructed to fi 11 out a
personal questionnaire with demographic information and to sign a consent
form containing a description of their specific treatment. Confidentiality
was assured, both verbally and in writing on the consent form. The
following procedure was then used to help maximize each subject's plateau
level of hypnotizability. After the brief meeting with the three individual
groups, all subjects re-united in a large classroom. At this time they were
admi ni stered the Harvard Group Scale of Hypnotic Suscept i bil ity [HGSHS]
(Shor & Orne, 1962), to famil i ari ze subjects with the procedures and
experiences of an hypnotic induction and hypnosis test items. The HGSHS was
not scored. This procedure lasted approximately 60 minutes.
Subjects in the two treatment groups and the control group met one week
later for their second session. The procedures in this session were again
used to help maximize each subject's plateau level of hypnotizability.
During this second session, subjects spent approximately 60 minutes
undergoing hypnosis experiences similar to the HGSHS procedure. This
session, conducted by a psychologist experienced in clinical and
experimental hypnosis, involved question and answer time, demonstrations,
and brief hypnotic inductions. Subjects in each group were then scheduled

147
on an individual basis for their pretest, subsequent treatments, and post
test. Procedures for the individual groups were as follows:
Subjects in the REST group were administered the pretest of the SHSS:C on an
individual basis, and were then scheduled for flotation REST tank sessions.
Subjects were assured of the safety of floating and told that while they
were permitted to leave the tank at any time, they were encouraged to remain
for the full session. Once in the tank, subjects were read the following
message (based on instructions from Barabasz, 1982, and Sanders & Reyher,
1969):
Listen carefully to what I say ... Please tell me
whatever you can about your reactions to this session.
Your experiences will be helpful in understanding the
results of the study. Whatever you choose to talk
about will of course be kept confidential. Also, try
not to sleep during the session, but if you should
doze off, don't feel guilty about it. At no time will
I respond to what you say or answer any questions you
may ask, or communicate with you in any way until the
experiment is over. However, I shalla 1ways be in the
adjacent room listening to what you say. Do you have
any questions? Very good. Have a nice float and I'll
let you know when your time is up.

Subjects were mon i tored throughout the sess i on by the Experi menter
using the intercommunications system. Subjects floated for two 90 minute
sessions scheduled one week apart (total time = 180 minutes). Upon
completion of the second float they were again administered the SHSS:C.
Each subject was asked to return in three weeks for a follow-up test of the
SHSS:C. Progressive Muscle Relaxation (PMR): Subjects in the PMR group were
administered the pretest of the SHSS:C on an individual basis and then met
as a group for three 60 minute sessions of Progressive Muscle Relaxation
(PMR) within a one-week period (total time + 180 minutes). While PMR is
usually performed in a dimly lit room with little extraneous sound and with
subjects' eyes closed, this procedure may function as a form of sensory
restriction (Pena, 1963; Wickramasekera, 1970). To reduce the possibility
of such sensory restriction, PMR sessions were conducted in a normally
lighted room and subjects were instructed to perform the steps of PMR with

148
their eyes open. Rel axation training, based on the model presented by
Bernstein and Borkovec (1973), was introduced to the group during the first
session. In each session the PMR techniques were demonstrated by the
experimenter. Paul and Trimble (1970), and Beiman, Graham and Ciminero
(1978), have found live training to be superior to audiotaped versions of
the standard relaxation procedure.
Upon completion of the third PMR session subjects were re-administered
the SHSS:C on an individual basis. Each subject was instructed to return in
three weeks for a follow up test of the SHSS:C.
Control: Subjects in the control group were pretested on an individual
basis with the SHSS:C. Subjects then returned to spend three hours together
as a group in a large classroom one evening (total time=180 minutes).
Subjects were instructed to study or read material of their own choosing,
but were not allowed to talk or interact with the others. They were
permitted to use the restroom or to get a drink of water at any time. The
purpose of the control group was to allow subjects to think they were being
administered a treatment, thereby maintaining subject interest in the study.
Upon completion of this session subjects returned after a 24 hour period and
were re-administered the SHSS:C on an individual basis. Each subject was
instructed to return in three weeks for a follow-up test of the SHSS:C.

RESULTS
A one-way Analysis of Variance (ANOVA) indicated the three groups did
not differ in pretest SHSS:C scores, F(2,27) = 1.38, R = ns, thus suggesting
successful randomization. Pretest means and Standard Deviations (SO) for
the flotation REST, PMR and Control groups were: 5.50 (3.06), 4.00 (2.98),
and 6.50 (4.00), respectively.
In order to determi ne overall changes in SHSS: C scores, AN OVA was
performed on the difference scores resulting when pretest scores were
subtracted from post test scores. Results indicated a trend, F(2,27 = 2.72,
R <.08, in the predicted direction for treatment subjects to increase in
hypnotizability compared to control subjects. Means and Standard Deviations
(SO) for the REST, PMR, and Control groups were: 1.10 (1.52), 1.70 (1.77),
and .20 (.92), respectively. Post hoc analyses were subsequently conducted
to test the a priori predictions in Hypotheses 1 through 4.
Dunnet IS (1955) mult i p1e compari son procedure for compari ng several
treatments with a control group resulted in no significant difference

149
between subjects in the flotation REST tank group and the Control group.
The results of this test did not support Hypothesis 1. Pretest Means and
Standard Deviations (SO) for the REST and Control groups were: 5.50 (3.06),
and 6.50 (4.00), respectively. Means and Standard Deviations (SO) for the
REST and Control group on Post test scores were: 6.60 (3.13), and 6.70
(3.77), respectively.
Ounnet's (1955) multiple comparison procedure resulted in statistical
s i gnifi cance between the PMR group and the Control group, 11<.05, thus,
results of thi s test supported Hypothesi s 2. Pretest Means and Standard
Deviations (SO) for the PMR and Control groups were: 4.00 (2.98), and 6.50
(4.00), respectively. Means and Standard Deviations (SO) for the PMR and
Control groups on Post test scores were: 5.50 (3.20), and 6.70 (3.77)
respectively.
In order to determine changes in SHSS:C scores, a one-way Analysis of
Variance was performed on the difference scores resulting when pretest scores
were subtracted from post test scores. The results of this test,
F(1,18)=.66, 11=ns, did not support Hypothesis 3. The Difference score Means
and Standard Deviations (SO) for the REST and PMR groups were: 1.10 (1.52),
and 1.70 (1.77), respectively. To determine support for Hypothesis 4, t-
tests for correlated samples using pretest and post test scores for each
group were performed. The REST group, t=2. 28, 11<.05, and the PMR group,
t=3.04, 11<.02, showed a significant difference between pretest and post test
scores, while no significant difference was found between pretest and post
test scores for the Control group (t=.68,11=ns).
To test for follow-up changes in hypnotizability, a Repeated Measures
ANOVA for three groups (flotation REST tank, PMR, Control) across three time
periods (pretest, post test, follow-up) was performed. The Repeated Measures
AN OVA indicated a significant Group X Time interaction, F(4,36)=3.19, 11<.05.
Follow-Up Means and Standard Deviations (SO) for the REST, PMR, and Control
groups were: 6.40 (2.84), 5.60 (3.27), and 6.40 (4.03), respectively.
Results of this test indicated significant increases in means from pretest
to post test and from pretest to follow-up within each of the two treatment
groups (REST and PMR), but no significant increases from pretest to post
test, or pretest to follow-up for the Control group. An examination of mean
scores for each test period (pretest, post test, and follow-up) between each
group (REST, PMR, and Control) indicated no significant differences.
Within Group Changes

150
 A Repeated Measures ANOVA for the flotation REST Tank and PMR groups
indicated significant differences over the three time periods (pretest, post
test, follow-up). Results of this measure for the REST group were:
F(2,lS)=4.47, Q<.05, and for the PMR group were F(2,lS)=7.0S, Q <.01.
A Repeated Measures ANOVA for the Control group indicated no
significant difference over the three time periods (pretest, post test,
follow-up), F(2,lS)=.67,Q=ns.
ANOVA was performed on the difference scores that resulted when pretest
scores were subtracted from follow-up scores for the three groups. Results
of this test indicate a significant increase across time (pretest to follow-
up) F(2,27)=3.7S, Q<.05. Means and Standard Deviations (SO) for the REST,
PMR, and Control groups were: .90 (1.37),1.60 (1.S4), and -.10 (.74),
respectively.
To test the differences between groups, a Student Newman-Keuls test was
performed to determine which of the three group means differed significantly
from each other. Results of this test indicated that the PMR group differed
significantly from the Control group (Q <.05). The REST and Control group
means did not differ significantly from each other. In addition, the REST
and the PMR group means did not differ significantly from each other.

DISCUSSION
In contrast to the view that hypnotizability is a stable and enduring
feature of an individual, evidence has accumulated supporting the notion
that hypnotizability can be modified. Results of this investigation provide
further support for the notion that hypnotic susceptibility can be increased
as a function of appropriate training techniques. Present results support
Hilgard's (1965) conclusion that,
"without special intrusion, hypnotic susceptibility
is reasonably stable; with intrusions of various
kinds, with repeated inductions running upward of a
dozen or so, some dramatic changes may occur,
including loss of susceptibility as well as increase"
(p.ll).
Hypothesis 1 may not have been supported due to a ceiling effect
occurring in the Control group, as four subjects in this group scored over
10 on the pretest SHSS:C compared to only one subject in the flotation REST
group. While pretest SHSS:C scores among the three groups did not differ

151
significantly, the Control group mean was the highest of the three.
Repeated test i ng i nd i cated that Control subjects' scores did not change
across the three measurement periods, while scores for the REST group showed
a significant increase. However, even though there was a significant change
in the flotation REST tank group mean from pretest to follow-up, it was not
a substant i a1 improvement over the Control group's mean to support th is
hypothesis. That Hypothesis 1 was not supported may suggest the 1imited
effect i veness of fl otat i on REST compared to chamber REST for enhanc i ng
hypnotizability. Further research is needed before such a conclusion can be
made.
The results were in support of Hypothesis 2. This hypothesis stated
that subjects exposed to Progressive Muscle relaxation (PMR) would
significantly increase their hypnotizabil ity more than subjects in the
Control group on pretest to post test measures. This hypothesis was based
on previous studies which found that relaxation training would improve
hypnotizability (Edmonston, 1977; Ham & Edmonston, 1971; Springer, Sachs, &
Morrow, 1977; Talone, Diamond, &Steadman, 1975; Wickramasekera, 1973, 1983;
see this volume).
Results did not support Hypothesis 3, as PMR and flotation REST
subjects had comparable increases in thei r hypnot i zabi 1i ty scores. One
major difference in comparing the two experimental treatment groups is that
PMR involves an active role on the part of the subject while flotation REST
emphasizes a passive role. It is possible that the state of relaxation
brought about by the active role of subjects in PMR may have accounted for
s i gnifi cant increases over the Control group (Hypothes is 2) whil e the
pass i ve role of subjects in the fl otat i on tank did not account for any
significant difference over Controls (Hypothesis 1). One implication for
future study may be to compare active versus passive roles of subjects
within the flotation REST tank.
Results were in support of Hypothesis 4. This hypothesis stated that
subjects in both the flotation REST tank group and the PMR group would show
significant increases in hypnotizability test scores from pretest to post
test, while subjects in the Control group would not. This hypothesis was
based on previous studies which found that hypnotic susceptibility can be
enhanced through REST (Barabasz, 1980, 1982, 1983; A. Barabasz et al., 1984;
Diamond, 1974; Gill & Brenman, 1961; Leva, 1974; Pena, 1963; Sanders &
Reyher, 1969; Shor & Cobb, 1968; Wickramasekera, 1970; Zubek, 1969, 1973),

152
and relaxation training (Edmonston, 1977; Ham & Edmonston, 1971; Springer,
Sachs &Morrow, 1977; Talone, et al., 1975; Wickramasekera, 1973, 1983; see
this volume).
Subjects in all three groups were involved in procedures used to help
maximize their plateau level of hypnotizability. In addition to subjects
being plateaued, the hypnotic inductions and administration of the SHSS:C
were performed by the same person. Other researchers have noted that
hypnotizability may result if the subjects' fears abate through some
tra in i ng techn i que or through increased mot i vat i on and rapport wi th the
hypnotist (Blatt, Goodman & Wallington, 1969; Kramer, 1969). Therefore,
since only the experimental treatment groups showed significant increases
across post test and follow-up, it may be concluded that these increases in
hypnotizability may be a result of the specific treatment.
Conclusions and Implications
While previous studies have found chamber REST to effectively enhance
hypnotizability, present findings do not support the efficacy of flotation
REST for such purposes. One reason for the ineffectiveness of flotation
REST may be the short fl otat ion sess i on used in the study. Previ ous
research using chamber REST has employed longer treatment durations. For
example, Barabasz (1982) used 6 hours of chamber REST and found significant
increases in hypnotizabil ity (all REST subjects more than doubled their
hypnosis scores). To explore the variable of session length, future studies
may have subjects, (a) spend a longer amount of time in the flotation tank,
(b) spread the time out over a number of sessions, or (c) increase the
length of time subjects would spend floating in the tank in any given
sess i on. Present results suggest that the re 1at i ve 1y short sess ions of
flotation REST may not significantly enhance hypnotizability.
Another reason flotation REST may not have effectively enhanced
hypnot i zabi 1i ty scores is that subjects may not have experi enced sensory
restriction phenomena. In previous successful chamber studies (Barabasz,
1982; Barabasz et al., 1984) subjects reached a point where sensory
restri ct ion signs were evi dent, us i ng the criteri a of Sanders and Reyher
(1969). Thus, future studies using the flotation REST tank might have
subjects float until these sensory restriction signs become evident. For
example, the subject could communicate this experience to the experimenter
via the build-in communications system.
Previous studies employing chamber REST (Suedfeld et al., 1982;

153
Kristeller et al., 1982) and flotation REST (Jacobs et al., 1984) have had
subjects actively practice relaxation techniques while in the REST
environment. Such a procedure serves to enhance the subject's active
involvement, which appears to make the subject more sensitive to internal
stimuli. In the present study, subjects were instructed to simply relax
while in the tank. To enhance this internal focus, future studies may
instruct subjects to practice such relaxation techniques while floating.

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Ham, M.W. & Edmonston, W.E., Jr. Hypnosis, relaxation, and motor
retardation. Journal of Abnormal Psychology, 1971, 77, 329-331.
Hilgard, E.R. Hypnotic Susceptibil ity. New York, NY: Harcourt, Brace &
World, 1965.
Jacobs, G.D., Heilbronner, R.L. & Stanley, J.M. The effects of short term
flotation REST on relaxation: A controlled study. Health Psychology,
1984, J, 99-112.
Kramer, E. Hypnotic susceptibil ity and previous relationship with the
hypnotist. American Journal of Clinical Hypnosis, 1969, 11, 175-177.

155
Kri ste 11 er, J. , Schwartz, G. L Bl ack, H. The use of Restri cted
Environmental Stimulation Therapy (REST) in the treatment of essential
hypertension: Two case studies. Behavior Research and Therapy, 1982,
20, 561-566.
Leva, R.A. Performance of low susceptibility subjects on Stanford Profile
Scales after sensory deprivation. Psychological Reports, 1974, 34,
835-838.
Lilly, J.C. The Deep Self. New York, NY: Simon and Schuster, 1977.
Mitchell, G.P., Jr. & Lundy, R.M. The effects of relaxation and imagery
induct ions on responses to suggest ions. Internat i ona 1 Journal of
Clinical and Experimental Hypnosis, 1986, 34, 98-108.
Morgan, A.H. & Hilgard, J.R. Stanford Hypnotic Clinical Scale (SHCS). In:
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13
Enhancing the Creativity of Psychologists Through
Flotation REST
Janet Metcalfe and Peter Suedfeld

Many retrospective reports of highly creative scientists, artists, and

poets suggest that a hypnogogic state of consciousness may be especially
fruitful for the initial stages of creative scientific research or new works
of art. Perhaps the most famous of these reports is the often cited
discovery of the Fuchsian functions in mathematics, by Poincare, who
discovered the existence of these functions during a state of light sleep.
"For fifteen days I strove to prove that there could not be any functions
1ike those I have since call ed Fuchs ian funct ions. I was then very
ignorant; every day I seated myself at my work table, stayed an hour or two,
tried a great number of combinations and reached no results. One evening,
contrary to my custom, I drank black coffee and could not sleep. Ideas rose
in crowds; I felt them collide until pairs interlocked, so to speak, making
a stable combination. By the morning I had established the existence of a
class of Fuchsian functions, those which come from the hypergeometric
seri es; I had only to write out the results, wh i ch took but a few hours"
(Vernon, 1970, p. 81). Kekule, too, is reported to have discovered the
structure of benzine during a dream in which he viewed an image of a snake
biting its own tail, which provoked the insight of the ringlike structure of
benzine. More recently, Shepard (Shepard and Cooper, 1987, p. 7) described
the discovery of the phenomenon of mental rotation, a field study that has
had great impact upon our thinking about representation and mental
operat ions wi th i n cogn it i ve psychology. "The very 1i ne of chronometri c
studies of the transformation of mental images assembled in this volume has
its origin in a state of hypnopompic suspension between sleep and wakening,
in the early morning of November 16, 1968. Just before 6:00 A.M. of that
morning and in the absence of any noticed precursors, one of us experienced
a spontaneous kinetic image and three-dimensional structures majestically
turning in space.. Within moments and before full emergence from sleep, the
basic design of the first of the chronometric experiments on "mental
rotation of three dimensional objects,", as it later appeared in the journal

159
Science (Shepard &Metzler, 1971), took essentially complete--though as yet
completely unverbalized--shape." Shepard notes a number of other creative
acts that have evidently been spurred by free play with images and concepts
that is apparently facilitated by an hypnotic state of consciousness. This
free play of ideas, unimpeded by restrictive judgmental processes, is said
to be of the greatest importance for discovery and understanding. Bruner
(1979, p. 102) notes that "Intuition implies the act of grasping the meaning
or significance or structure of a problem without explicit reliance on the
analytic apparatus of one's craft. It is the intuitive mode that yields
hypotheses quickly, that produces interesting combinations of ideas before
their worth is known. It precedes proof; indeed, it is what the techniques
of analysis and proof are designed to test and check. It is founded on a
kind of combinatorial playfulness that is only possible when the
consequences of error are not overpowering or sinful." Rather than being
specifically taught responses, or even logically deduced conclusions,
creative discoveries appear to involve the playful self-organization of
mental constructs into new structures. Bowers (1976) has noted the
correlation between standard tests of creativity and hypnotic
susceptibility. One salient aspect of hypnotizability is the highly
hypnotizable person's ability to temporarily suspend judgmental processes.
Bowers (1987) has also found that highly hypnotizable subjects generated the
correct hunch on a task that involved the convergence or intuitive synthesis
of remote associations on a target more quickly than did unhypnotizable
subjects. This factor was unrelated to verbal intelligence (which also had
an effect on the synthesis task). Self organizing behavior--which appears
to be of great importance for human creativity--may be facil itated by a
state of consciousness that relaxes the usually strong hold of our
preconceived structures and organizations, and analytical judgmental
processes, and for this reason, the hypnogogic state may facilitate the free
play of ideas that is apparently of the greatest importance in mathematical
intuition and creative discovery. In systems-theoretic terms (Haken, 1983;
Kelso & Scholz, 1985; and Pattee, 1974), it may be of importance for
creative restructuring to alter the normal state of consciousness, or to
introduce "noise" into the system (noise, what we mean here is just a state
of control that is different from and less restrictive than the normal state
of consciousness).
There may be a number of methods to induce a state of consciousness

160
that would facilitate the free play of ideas critical to creativity. In the
present experiment, we investigated the method of restricted environmental
stimulation (REST) by means of flotation. Restricted environmental
stimulation has been intentionally used by a number of creative individuals
to foster their creative abil ities. Shore (1971), observing reports of
three graduate students in chemi stry who underwent sensory depri vat ion,
reached the conclusion that "the sensory deprivation procedure can
participate in the formation and modification of scientific concepts"
(Suedfe1d, 1980). However, no control groups or alternative environments
were used, and so the reported enhancement of creativity cannot be assessed
from Shore's study. Taylor (1985; see this volume) has found that subjects
under flotation REST learned material related to their chemistry studies
better and tended to use more visual imagery. The REST subjects performed
especially well on questions requiring conceptual synthesis. Suedfe1d
(1980) has pointed out that "There is no scarcity of self-reported creative
thinking while under conditions of isolation and reduced stimulation.
Examples range from Descartes laying the groundwork of his philosophy while
stayi ng in one i so 1ated room "und i sturbed by any cares or pass ions" and
building upon it afterwards "as sol itary and as retired as in the midst of
the most remote deserts" to Raymond B. Cattell citing the solitude needed
for intellectual incubation, which he found among the lonely moors of his
chil dhood and 1ater in" an eyri e" in the Rocky Mountains. To the extent
that creativity is a function or consequence of a relaxed and free flow of
i mages and ideas, one wou1 d expect it to be fac ili tated accordi ng1y.
Clearly, the usefulness of REST in facilitating the productivity of artists,
scientists, and other creative individuals deserves careful exploration.

METHOD
Subjects
The participants were seven full-time faculty members of the Department
of Psychology at the University of British Columbia, including the first two
authors on thi s paper. Data were analyzed inc 1udi ng and exc 1udi ng the
authors (who had di vergent opi ni ons about the expected results of the
experiment) and the trends in the data were unaffected by their inclusion or
exc 1us i on. The part i c i pants were a11 act i ve researchers in the areas of
psychobiology, cognition, perception, social psychology, and measurement
theory. All participants except J.M. were male. Ages ranged from early

161
30's to late 40's. Only one participant (P.S.) had previous experience with
flotation REST.
Procedure
Multiple sessions in each of two environments were used with each
subject ina counterbalanced order. The control environment was the
subject's own desk. For the control sessions subjects were instructed to
sit at their desk, with the door to the office closed, and dictate ideas
related to their research continuously into a microphone for 90 minutes.
Only data from the first 30 minutes were used because the number of ideas
decreased dramatically after about fifteen minutes of dictation. Subjects
were somewhat restricted in the control environment insofar as they were
disallowed telephone calls, office visits from students, chatting with
friends or colleagues, or leaving the office.
The experimental envi ronment was fl otat i on REST. These sess ions
consisted of 60 minutes of flotation in a dark, quiet flotation tank
containing approximately 30 cm. of dense Epsom salts solution in 92 degree
water. The surrounding air was also controlled to approximately 92 degrees.
The dense Epsom salts solution allowed the subjects to float without undue
muscular stress with the face and ventral body surface out of the water, and
with normal breathing. Subjects were monitored continuously by means of an
intercom in the tank connected to an adjoining room. Subjects were able to
1eave the tank eas il y by merely openi ng a hatch, or by request i ng the
monitor's help. The end of the sixty minute REST session was signalled by
soft piped-in music that slowly increased in volume. The subject then
showered (to remove the salts) and proceeded to a semi-dark, quiet room next
to the flotation room, where the next half hour was spent dictating research
ideas into a tape recorder. Before beginning dictation, in both the REST
sessions and the Control sessions, subjects completed a Profile of Mood
Scale (POMS; McNair, Lorr & Droppleman, 1971) that allowed assessment of
various aspects of their mood states.
Subjects participated in sessions at approximately one-week intervals,
with the sessions in each condition being blocked within subjects and
counterbalanced across subjects. Most subjects participated in six sessions
in each condition, but, because of scheduling difficulties, some
participants went through fewer than the projected twelve sessions. The
first session results were not analyzed. Because most of the participants
were unfamiliar with flotation, it was thought that this session might have

162
effects different from the later sessions (Forgays & Belinson, 1986). In
addition, none of the subjects had practice in free dictation over extended
periods, so the first session also familiarized them with that procedure.
Scoring
The tape recordings generated from each session were transcribed and
returned to subjects approximately three months following their last
session. They were asked (1) to demarcate idea units in the transcripts,
(2) to i nd i cate whether the idea was a new one, or one that they had
previously thought about, (3) to rate on a 1 to 10 scale the quality of each
idea. The four middle sessions, in each condition, were used for the
analyses reported below (since not all subjects had a sixth session in both
conditions). As well as the subjects' own ratings, an integrative
complexity analysis on the idea rated as most creative in each session was
conducted. A count of the number of words spoken within the half hour
interval was also made. In addition, subjects participated in a post-float
interview.
Finally, about 15 months after the initial sessions, subjects were
asked to identify ideas that had led to new research, publications, grant
proposals, etc., to which six of the seven responded.

RESULTS
The data of primary interest are shown in Table 1. An analysis of
variance revealed that the quality of new ideas generated under REST was
rated as being higher than those generated under control conditions, £(1,4)
= 8.97, 11.<.05. The value of the most creative new idea was also higher
under REST than in the control condition, £(1,4) = 7.67, 11.<.05. There was
a decrease in quality of the most creative old ideas over sessions, £(3,16)
= 4.32, 11.<.05, but otherwise sessions had no effect. No other main effects
or interactions based on the subjects' ratings of ideas were significant in
this experiment. In addition, there were no differences in the scored
integrative complexity, as a function of environments or sessions. Overall
complexity was about the same as that shown by eminent diplomats of the 19th
and 20th centuries (Wallace & Suedfeld, 1986), but was lower than that of
presidential addresses delivered to the American Psychological Association
(Suedfeld, 1985). Although we had expected that speech rate might be slower
in the REST conditions, there were no differences on this measure.
Overall, the Profile of Moods Scale did not show differences across

163
conditions; however, a number of subscales of the test did indicate
differences in affect as a function of REST. The data consistently showed
less tension, anger, depression, fatigue, and confusion following REST,

Table 1
Mean Results on Ideas (5 subjects)
REST CONTROL
Measure M s.d. M s.d.

Number of old ideas 4.35 4.38 4.60 4.60

Number of new ideas 5.90 2.77 4.65 3.47
Quality of old ideas 5.03 2.51 5.17 2.24
Quality of new ideas 5.91 1.01 4.83 1.43
Best old idea 6.60 2.11 6.70 2.18
Best new idea 7.65 1.31 6.00 1. 91

although these scores, with our subject population, were all quite low even
under control conditions. Slightly higher vigor was reported in the REST
cond it i on than in the control cond it ion. In short the POMS indicated
somewhat more positive moods were attained after REST than in the control
condition. The post-float interviews also indicated that subjects had
enjoyed the flotation sessions, and that many had experiences approximating
what Budzynski (1976; see this volume) termed a "twilight" state of
consciousness. Such a state is not tapped by the mood questions in the
POMS. The major reported characteristics of the flotation experience in
this study were (a) disorientation in time and space, (b) suspension of
critical, analytical or judgmental thinking, (c) vivid imagery and short
dreams, and (d) a nonverbal experiential state. One subject differed from
the other six in not reporting such states, however, and mentioned that he
found it difficult to change topics and that he continued to think in a
linear manner. His protocols revealed that he had considered primarily
methodol ogi cal issues rather than theoret i ca 1 and metatheoret i cal issues
following both the REST and the control creativity sessions.
The assessment of ideas produced from the sessions that resulted in
experiments, grant proposals, etc. revealed that there were over 30 such

164
items in progress from the session, 12 to 15 months following the
experi ment, based on six subjects. However, many of these i terns were
discussed, in part, in both flotation and control sessions, so we were
unable to pinpoint their locus to particular environments in the study.

DISCUSSION
The results of this study indicate that creativity may be enhanced by
fl otat i on REST. However, we hasten to poi nt out the 1i mitat ions of the
study. The sample size was small, and was restricted to academic
psychologists. It would be of great interest to investigate the usefulness
of REST for artists, poets, musicians, and other scientists. The assessment
of creativity was based on self-rating of ideas. In future studies it would
be worthwhile having independent assessment of the goodness of creative
ideas. One might certainly argue that the self rating is not objective. It
may be the case, however, that such assessments determine those ideas to
which scientists and artists will devote their attention and efforts (and so
may nevertheless be important). Perhaps the enhancement of creativity
emanating from an hypnogogic state, as is often reported by creative
individuals, results only because those particular ideas made an intense
impression on the individual, and subsequently were accorded special
consideration. While we cannot refute this idea, we do not think our
results are attributable to simple demand characteristics. Subjects'
expectations about the efficacy of REST, as indicated by their post-
flotation interviews, were generally contrary to the findings of the study.
Five of the seven subjects reported that they believed that flotation had
either no effect or a deleterious effect on the creativity of their ideas.
The failure to find increased ratings on old ideas also obviates a simple
demand characteristics interpretation.
Finally, in assessing the efficacy of REST on enhancing creativity, as
based on the present study, it is important to note that our subjects were
highly involved and well-prepared creative individuals. In his classic
work, Wallace (1928) suggested that there may be several stages involved in
the creative process. The first of these is preparation, or intensive and
often extended conscious work on the problem of concern. Given that our
subjects were all active researchers, it is reasonable to suppose that they
were well prepared. The second stage indicated by Wall ace is one of
incubation, and it is this stage that presumably is enhanced by relaxation,

165
isolation and a hypnogogic state as appears to be facilitated by flotation
REST. It seems unlikely to us that a hypnogogic state, without intensive
preparation and involvement, will of itself facilitate creativity. Indeed,
studies of naive subjects who were tested under REST conditions for
original ity with the Alternate Uses Test (Suedfeld, 1969) showed poorer
performance than did control subjects. The involvement and preparation of
these subjects may have been quite different from that of our subjects and
those of Taylor (1985) who showed enhanced creativity with REST. The
results of the present research are consistent with the self reports of
discovery experiences by creative individuals and also with the reports of
individual subjects who have used REST in efforts to enhance their
creativity. However, the conditions under which such enhancement is to be
found are not yet clearly specified and further investigation of the
incubation stage of creativity as well as the precursors to that state, and
the generality of the enhancement of creativity under REST, remain to be
explored.

ACKNOWLEDGEMENTS
This research was facilitated by two grants from the Natural Sciences
and Engineering Research Council of Canada: A0505 to J.M. and A9589 P.S.
We thank Susan Bluck, Leslie Kiss, Paula Ryan, and our five colleagues who
participated in the study.

REFERENCES
Bowers, K.S. Hypnosis for the seriously curious. New York, NY: W.W. Norton
& Company, 1976.
Bowers, K.S. Memory, intuition, and Meno's paradox. Presented at the
American Psychological Association, August 1987, New York.
Bruner, J. On knowing. Cambridge, MA: Belknap Press of Harvard University
Press, 1979.
Budzynski, T.H. Biofeedback and the twilight states of consciousness. In:
G.E. Schwartz & D. Shapiro (Eds.) Consciousness and self-regulation:
Advances in research. New York, NY: Plenum, 1976, Vol. 1, 361-385.
Forgays, D.G. & Belinson, M.V. Is flotation isolation a relaxing
environment? Journal of Environmental Psychology, 1986, §, 19-34.
Haken, H. Synergetics: An introduction to noneguilibrium phase transitions
and self-regulation in physics, chemistry, and biology. Berlin:

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 Springer-Verlag, 1983.
Kelso, J.A.S. & Scholz, J. Cooperative phenomena in biological motion. In
H. Haken (Ed.) Computer systems Ooerational approaches in
neurobi 01 ogy, phys i ca 1 systems, and computers. Berl in: Spri nger-
Verlag, 1985, 124-149.
McNair, D.M., Lorr, M. & Droppleman, L.F. Profile of Mood States (Manual).
San Diego, CA: Educational and Testing Services, 1971.
Pattee, H.H. Discrete and continuous process in computers and brains. In:
M. Conrad, W. Guttenger & M. Dal Cin (Eds.) Physics and mathematics
of the nervous system. Berlin: Springer-Verlag, 1974.
Poincare, H. Mathematical creation. In P.E. Vernon (Ed.) Creativity.
Markham, Canada: Penguin, 1970, 77-88.
Shepard, R.N. & Cooper, L.A. Mental images and their transformations.
Cambridge, MA: MIT Press, 1986.
Shepard, R.N. & Metzler, J. Mental rotation of three-dimensional objects.
Science, 1971, lll, 701-703.
Shore, E. Sensory deprivation, preconscious processes and scientific
thinking. American Journal of Orthopsychiatry, 1971, 41 574-580.
Suedfe 1d, P. Changes in i nte 11 ectua 1 performance and suscept i bil i ty to
influence. In J.P. Zubek (Ed.) Sensory deprivation: Fifteen years of
research. New York, NY: Appleton-Century-Crofts, 1969, 126-166.
Suedfeld, P. Restricted environmental stimulation: Research and clinical
applications. New York: Wiley &Sons, 1980.
Suedfeld, P. APA presidential addresses: The relation of integrative
complexity to historical, professional and personal factors. Journal
of Personality and Social Psychology, 1985, 49 1643-1651.
Taylor, J.W. The effects of flotation restricted environmental stimulation
therapy on learning subjective evaluation and EEG measurements. In
T.H. Fine &J.W. Turner, Jr. (Eds.) Proceedings of the First Interna-
tional Conference on REST and Self-Regulation. Toledo, OH: IRIS Publ.,
1985, 76-85.
Wallace, M.D. & Suedfeld, P. Leadership performance in crisis: The
longevity-complexity link. Unpublished MS, Univ. of British Columbia,
Vancouver, 1986.

167
Section III
Clinical Studies and Applications
14
Flotation for the Management of Rheumatoid Arthritis
Clifton Mereday, Craig Lehmann and Roderick A. Borrie

INTRODUCTION
The overall goal of this presentation is to demonstrate the
interdisciplinary approach of health professionals and how we are
investigating the benefits of using a flotation tank in the treatment of
patients with rheumatoid arthritis. Rheumatoid arthritis is one of a large
group of diseases in which inflammatory changes and pain are the major
features. The effects of these changes on patient mobility and function are
so profound that they cause significant changes in the patient's ability to
earn a living, as well as his/her social status.
Treatment of rheumatoid and osteoarthritis continues to present major
probl ems to health care profess i ona 1s. The phys i ca 1 therapy goal s of
treatment are:
1) to relieve pain
2) to maintain and restore muscle power
3) to maintain and restore joint range of motion and mobility
4) to prevent deformities
5) to maintain optimum function
6) to educate the patient concerning his/her disability.
In order to achieve these goals, therapeutic exercises are given together
with a variety of physical agents. The specific needs of each patient
dictate the variations of the treatment procedures:
Several authors report that pool therapy can be helpful in the
treatment of rheumatoid arthritis. Tindall (1976) reported that patients
with decreased joint range, muscle weakness, and muscle pain derive
sign ifi cant benefit from pool therapy. The pa in may be reduced by warm
water wh i ch helps in muscle re 1axat ion. The buoyancy of the water also
supports the body in part, thus decreasing strain on the joints. Functional
abil ity may be improved since muscles can be better exerc i sed through
graduated activities.
Washburn (1981) stated that a hot bath at approximately 40 degrees
centigrade may reduce pain and the duration of "morning stiffness".

169
 Moll (1983) reported that active exercises in a warm pool are
particularly beneficial in the treatment of stiff and painful joints in
patients with osteoarthritis, capsulitis, ankylosing spondylitis, and
generalized arthritides.
We at Stony Brook read of a pilot study of salt water flotation in the
treatment of nine patients with rheumatoi d and osteoarthrit is that was
conducted in Australia by Dr. Dale Thomas. Three patients were diagnosed as
having rheumatoid arthritis and six had diagnoses of osteoarthritis. Visual
analogue scores of pain, tenderness, pulse and blood pressure measurements
were made before and after treatments. The results of that study suggested
patients with rheumatoid arthritis may benefit from the use of salt water
flotation. This report stimulated our interest. Professor Craig Lehmann of
the Department of Medi ca 1 Technology had already completed some stud i es
which showed flotation causing an immediate reduction in blood pressure. It
was hypothesized that through flotation, patients with arthritis would be
able to function better because of blood pressure and stress reduction. It
was also our bel i ef that the general phys i ca 1 therapy management of the
rheumatoid arthritic patient could be greatly enhanced through the use of
flotation.
Our preliminary findings at Stony Brook, using ten subjects, supported
the findings of the Australian group. We found flotation offered
significant benefits to the majority of those patients.
Some short term effects of flotation are:
1) blood pressure reduction
2) heart rate reduction
3) pain relief
It was hypothesized that long term effects would be:
1) stress reduction
2) pain reduction
3) improved functional ability
Initially, a pain questionnaire was used. This gave us subjective data
concerning the patient's perception of his/her pain and functional ability.
We used excerpts from the McGill Pain questionnaire. The questionnaire has
three major classes of descriptive words: sensory, affective and
evaluative, that patients use to describe subjective pain experiences. The
questionnaire was also designed to provide quantitative measures of clinical
pain that could be treated by statistical means. Types of data obtained

170
from the questionnaire included:
1) Pain rating index based on the rank values of the words. In this
system, the word implying the least pain is given a value of 1,
the next word a value of 2, and so forth. The values of the
words chosen are then added up to obtain a score.
2) The Present Pain Intensity scale (PPI), the number-word
combination chosen as representative of the overall intensity of
the pain at the time of administering the questionnaire. The
questionnaire is used before, as well as at the completion, of
all treatments. The differences can then be expressed
numeri ca 11 y.
As mentioned, ten subjects participated in the initial pilot study.
All of these patients had a diagnosis of rheumatoid arthritis. Of the ten,
six showed significant reduction of pain, with resultant increased ability
to move about as determined by the pre-float and post-float pain
questionnaire. The four subjects who showed no improvement did not follow
through with appointments as scheduled; hence, had to be discontinued as
participants in the study.

Patient Pre-float Pain Score Post-Float PPI A

CS 0 0 -2
JM 20 7 same
MH 26 5 -3
RE 22 11 same
LA 41 33 same
MS 17 0 -2

As a result of these very positive findings, the research team decided to

open the study to patients with "chronic pain syndrome" which included
patients with total hip replacements, herniated discs, cracked vertebrae,
and other debilitating problems. Our success with these patients, without
other psychological intervention, was not nearly as great. It became
obvious to us that many of these patients, with histories of pain of ten to
fifteen years durat ion, needed psycho log i ca 1 counsel i ng, in addit i on to
floating. As a result of a small paragraph in a local newspaper, we have
been swamped with phone requests for treatment. We are now attempting to
formulate a schedule to handle the more than 100 requests for treatment,

171
with calls coming in every day.
A review of the literature reveals that flotation or bathing in mineral
spri ngs call ed "spa therapy" has been known to exi st since the ninth
century. The earliest spas were located in Turnbridge, Wells, Scarborough,
Epsom (where the water is undoubtedly saturated with MgS02), and several
other cities in Wales and Scotland. The United States also has several
springs located around the country.
The value of the treatment at each spa in Europe and America seems to
be dependent upon the chemical content of the water. Some waters are rich
in iron, some contain sol ub 1e ch 1ori des, magnes i urn sulfate, calc i urn and
sodium. The White Sulphur Springs located in West Virginia has an abundance
of hydrogen sulphate.
Since the very beginning of the use of flotation and "Spa Therapy", no
objective data have existed that would enable researchers to specifically
quantify the reasons why so many arthritic patients report improvement in
function, with reduction of pain following "float therapy."
We at the State University of New York at Stony Brook are attempting
to do this. Two separate studies are being conducted. The first one
involves patients with "pure" diagnoses of rheumatoid arthritis. The
evaluative mechanism has become more sophisticated. In addition to the
pre/post questionnaire, we now have the participation of a physician, Paul
Tchau, who provides the medical direction for the drawing of blood which is
done at three intervals: 1) prior to the first float, 2) at midway point
during treatment, and 3) at completion of treatment. The purpose of this is
to conduct a biochemical profile on each patient. If the patient reports
improvement in functional ability or pain reduction after floating, we are
interested in knowing~. In addition to investigating rheumatoid factors,
we are hopeful of finding ways to measure the production of endorphins and
enkephalins produced by the nervous system. Endorphins are defined as "one
of a family of opioid-like polypeptides originally isolated from the brain
but now found in many parts of the body".
Enkephalins are pentapeptides found in many parts of the brain which
bind to specific receptor sites, some of which may be pain-related opiate
receptors.

172
 REFERENCES
Moll, J. Management of Rheumatoid Disorders New York, NY: Raven Press,
1983.
Tindall, A. Exercise in Water Duffild, M.H. (Ed), Baltimore, MD: Williams
& Wilkins, 1976.
Washburn, K. Physical Medicine and Rehabilitation 2nd Ed., Medical
Examination Publ. Co., Inc. 1981.

173
15
REST for Muscle Contraction Headaches: A Comparison of
Two REST Environments Combined with Progressive Muscle
Relaxation Training

Randy Rzewnicki, Alistair B.C. Wallbaum, Howard Steele and Peter Suedfeld

ABSTRACT
Restricted Environmental Stimulation Therapy (REST) has been used for
many years by researchers and members of the public to produce relaxation
and related benefits. Since flotation REST reportedly enhances attainment
of a relaxed yet focused state, it was hypothesized that in combination with
Progressive Muscle Relaxation (PMR) training, flotation REST would have a
beneficial effect on chronic muscle contraction headache sufferers. Six men
and twenty-five women who experienced at least three muscle contraction or
tension headaches per week were randomly assigned to one of 4 conditions in
the 4 week program: soundproof room, flotation tank and room, tank plus
PMR, or room plus PMR. Mean reductions from the baseline headache index
(measure of frequency, intensity and duration) across groups were 32% at end
of treatment, 15% at 2 months, 31% at 4 months, and 57% at 6 months. The
flotation TANK + PMR Training group reported the greatest reduction (74%) at
6 months. No si gnifi cant di fferences were found between i ntervent ion
conditions. There was a significant difference within subjects across time.

INTRODUCTION
Each year about 80% of all people experi ence some headache pa i n
(Caviness & O'Brien, 1980; Diamond, 1979; Friedman, 1979; Morell, 1972;
Newland et al., 1978; Phillips, 1977). Virtually all levels of social
class, race, education and intell igence are affected. Forty to fifty
million Americans, about one fifth of the population, have chronic head pain
and 157 million work days each year are lost to headaches (West, 1987).
Fifty percent of college students report having one or more headaches per
week (Andrasik et al., 1979). Such a high prevalence rate suggests that
headache pain may be the most common type of chronic pain.

174
 Muscle contraction headaches (also known as tension headaches) are in
turn the most common type of headache, accounting for approximately 80% of
headaches reported on surveys (Phillips, 1977). Physicians routinely treat
them with muscle relaxant, analgesic and anti-depressant drugs. Such
pharmacological treatments usually have one or more serious disadvantages,
including abuse potential, tolerance, addiction and undesirable side
effects. In addition, headache sufferers spend more than $400 million each
year on non-prescription pain killers (West, 1987). It is likely that both
prescription and non-prescription pain relievers can lead to suppression of
the body's production of natural pain relievers (West, 1987). In severe
cases, patients may remain on medication for the rest of their lives unless
alternatives can be found.
Relaxation training and biofeedback are the non-drug interventions of
choi ce for muscl e contraction headaches, in part because research and
clinical interventions have shown them to be very effective.
Many reports have been publ ished comparing biofeedback training to
Progressive Muscle Relaxation (PMR) training, often with mixed results.
Such comparisons have shown that PMR training is at least as effective as
biofeedback and at times more effective. A clear advantage of PMR training
is that it does not require the expensive electronic equipment of
biofeedback training.
Engstrom (1976) argues that relaxation is an important part of
biofeedback training because of the degree of physical and mental passivity
requi red by bi ofeedback tra i ni ng and tasks. He thus accounts for the
similarity in intervention effects for biofeedback and relaxation programs.
A review of these interventions reported improvements of muscle
contraction headaches by up to 80%; average improvements at end of treatment
were 59% for relaxation training in nine studies, and 60% for twelve studies
using frontal EMG biofeedback (Blanchard et al., 1980). The reviewers noted
a need for long-term follow-up, since little is known about the duration of
improvements produced by these interventions. The six frontal EMG
biofeedback studies that reported any follow-up data saw a 58% improvement
and the 4 relaxation training interventions reported a 70% improvement at
follow-up (Blanchard et al., 1980).
Though these behavioral interventions focus on muscle relaxation as an
intervention for tension headaches, the relationship between muscle
contractions and headache pain has not been clearly demonstrated. EMG

175
biofeedback programs designed to reduce muscle contractions of the neck,
shoulders or head show that sometimes muscle contractions are not reduced
but headaches are relieved. At other times muscle contraction is reduced
yet the pain persists. Though the relationship between muscle contractions
and headache pain has not been demonstrated, one distinction is consistent:
chronic muscle contraction headaches are usually successfully treated with
relaxation training techniques (Pikoff, 1984).
Given the success of relaxation as an intervention for muscle
contract i on headaches, the poss i bil i ty that other types of re 1ax at ion
interventions might be effective adjuncts or alternatives should be
investigated. One alternative intervention allows relaxation by placing an
individual in a quiet, dark environment such as that provided by a flotation
tank or a sound-proof room. Restricted Environmental Stimulation Therapy
(REST) has been used for many years by researchers and members of the public
to produce relaxation and related benefits.
The major application potential of chamber REST is in the area of
health-related changes in life-style patterns and improvements in stress
management such as smoking cessation, weight loss and the treatment of
hypertension (Suedfeld & Kristeller, 1982). For example, Suedfeld, Roy &
Landon (1982) have reported some success in treating essential hypertension
with 24 hours in the soundproof room. They report long-term reductions in
blood pressure, reduced need for medication and improved coping with
stressful life events (Kristeller et al., 1982).
Lilly (1977) described the flotation tank, which he invented, as useful
for expanding consciousness, restoring bodily energy, providing rest and
improving problem solving activities. Flotation REST has been employed by
researchers for guided relaxation and as an intervention for hypertension
(Fine & Turner, 1982). Systematic research is beginning to show that
fl otat i on REST is effect i ve in ass i st i ng i nd i vi dua 1s to experi ence deep
relaxation, psychological calm, and decreases in heart rate (Forgays &
Belinson, 1986; Turner & Fine, 1982; Jacobs et al., 1984; see this volume).
In the current study, the normal procedures for chamber REST were
modified so as to use the soundproof room as a minimal REST condition for
comparison purposes., We hypothesized that both the flotation tank and PMR
would be associated with reductions in the frequency, duration, and
intensity of muscle contraction headache and that the tank combined with PMR
would provide the greatest relief.

176
 METHOD
Muscle contraction headache sufferers were recruited through press
releases to the popular press and medical journals, radio talk shows and
letters to physicians. Thus cl ients were either self-referred or were
referred by a physici an. They were screened to sel ect vol unteers whose
headaches had been diagnosed as muscle contraction or tension headache by a
physician. Selected volunteers experienced at least three headaches per
week, but were not experiencing constant headache pain.
Physicians were notified of the following criteria we used to describe
muscle contraction/tension headaches: 1) headache usually described as
bilateral, and beginning in the occipital, sub-occipital or back of the neck
regions, 2) headache described as tightness or external pressure on the head
and/or like a cap or band around the head, and 3) headache usually described
as a continuing, dull ache. Se lf -reports by volunteers confi rmed the
physicians' diagnoses.
Over 200 callers requested information about the intervention program.
Forty-six were offered the program and forty accepted. Nine withdrew before
the end of the 4-week program. Six men and twenty-five women between the
ages of 22 and 65 years completed the intervention phase of the program.

PROCEDURE
To obtain a basel ine measure of headache activity, each headache
sufferer recorded headache frequency, i ntens i ty and durat i on, as well as
location, for two weeks preceding intervention. These reports were made on
a scale wh i ch has become the standard for daily rat i ngs of headaches
(Epstein & Abel, 1977). These self-reports were the basis from which the
dependent variable, a headache index, was calculated.
Volunteers were interviewed in the laboratory three times during this
baseline period about their headache pain and previous treatment programs.
They were given feedback and instructions for keeping a meaningful headache
diary. They also completed several personality indices and provided written
informed consent to participate.
There were four conditions, to which volunteers were randomly assigned
in the 4-week program. They were not informed about any condition other
than the one to which they were assigned. In all REST groups, volunteers
vi sited the 1ab twi ce each week for a sess ion wh i ch 1asted about ninety
minutes. Relaxation training sessions were about sixty minutes long. The

l77
four conditions were as follows:
ROOM 1 hour sessions in the soundproof room, 2 per week.
ROOM + TANK 1 hour in the flotation tank and 1 hour in the SPR
each week.
ROOM + PMR 1 hour in the SPR and approximately 1 hour of PMR
training each week.
TANK + PMR 1 hour in the tank and approximately 1 hour of PMR
training each week.
At the first intervention session, volunteers were familiarized with
the procedures and the relevant REST environment(s). They were instructed
to complete two state anxiety measures, the Spielberger STAI (1979) and the
Profil e Of Moods Scale (McNair et a1 ., 1971) , before and after each
intervention session. They were shown how to communicate with the monitor
who would be in the next room at al times, and shown how to open the door to
1et themselves out of the room or tank. They were instructed to 1i e as
still as possible for the hour in the REST environment and to refrain from
moving, talking, or making any kind of noise. Subjects in the tank
conditions were also required to shower both before and after all floats.
The flotation tank is located in a quiet dark room. The saturated
solution of Epsom salts is 32 degrees C and approximately 27 cm deep. When
one is floating in the tank, the face and ventral surface of the body are
above the water. Inside the tank there is no light and very little sound,
and volunteers are instructed to wear earplugs.
The soundproof room is an Industrial Acoustics Corp. sound-reducing
chamber. In REST research, the soundproof room is usually used for 6-24
hours at a time, without any lighting, and furnished with a bed. A chemical
toilet, water, and liquid diet food are also usually available ad lib for
the longer sessions. In this study, however, the soundproof room was used
as a mi nima 1 REST cond it i on for compari son purposes. Therefore sess ions
were scheduled for only 1 hour and with a dim light on.
The PMR technique was taught in groups of 3 or 4 by one of two Ph.D.
students in Clinical Psychology at UBC, according to the procedures outlined
by Bernstein and Borkovec (1973). These sessions were conducted in a quiet,
dimly 1it, carpeted room. Participants were instructed to practice this
technique twice per day for 20-25 minutes each time. Participants who
received PMR training were instructed not to practice these techniques
during their REST sessions. To control for time spent trying to relax

178
outside of the research lab, participants in all conditions were instructed
to find time in their daily schedule to relax twice per day for 20-25
minutes each time.
Participants continued to make daily records of their headache activity
throughout the intervention period. The last week of treatment was used as
a measure of end of treatment success. At the end of the program each
volunteer was given three one-week headache diaries and asked for follow-up
reports at the end of 2, 4 and 6 months.

RESULTS
Nine participants, 5 in the ROOM and 4 in the ROOM + TANK group,
dropped out, leaving 31 who completed the program. There was no significant
difference between groups on the headache index at basel ine (£<1). Our
follow-up procedure obtained data from 24 volunteers at 2 months, 22 at 4
months, and 20 at 6 months following intervention.
Table 1 shows the end of treatment results, as measured by percent
reduction from basel ine, for all subjects who completed the four week
program. The greatest reduction is seen with the 10 volunteers in the TANK
+ PMR group (53%) and the smallest reduction is in the ROOM + PMR group
(5%) .
All groups reported reductions in headaches at the 6 month follow-up.
Repeated measures analysis of variance of the 20 subjects reporting at all
the measurement periods (i .e., baseline, end of treatment, 2, 4 and 6 month
follow-ups) revealed a significant difference within subjects across time
[E( 4,19) =5.09, Q<. 001] . No s i gnifi cant differences were found between
intervention conditions.
Paired t-tests compared the baseline, end of treatment, and 2, 4 and
6 month fo 11 ow- up data across groups for the 20 complete cases. Us i ng
Dunn's t-values for the 10 comparisons, there were significant reductions
from baseline at end of treatment and the 6 month follow-up measures across
all groups (baseline:end of treatment 1(19)=4.98, Q<.05; baseline:6 mo.
1(19)=3.35, Q<.05). There was a significant increase in reported headaches
between end of treatment and the 2 month follow-up [1(19)=3.44, Q<.05].
Of the 22 participants providing 4 month follow-up data, 4 reported
having no headaches during the seven day measurement period. Two of the 20
volunteers who completed all follow-ups reported no headaches during the 6-
month follow-up period.

179
 TABLE 1
Results by Condition

GROUP END OF TREATMENT 2 MONTHS 4 MONTHS 6 MONTHS

ROOM 50% (50%) -21% 18% 26%

N=5(5)

PMR + TANK 70% (53%) 16% -5% 74%

N=5(10)

ROOM + TANK 41% (26%) 36% 28% 58%

N=4(6)

PMR + ROOM 54% (5%) 24% 55% 69%

N=6(10)

The percentage figures outside the parentheses are the average reductions
from the baseline obtained for the participants who provided follow-up data
at 2, 4 and 6 months. The figures within parentheses refer to all subjects
who completed treatment. Negative percentages refer to increases in
reported headache activity for the period indicated.

DISCUSSION
The results of this pilot investigation show that significant
reductions in the self-report of tension headaches can be produced with an
intervention program that includes Restricted Environmental Stimulation
Therapy (REST). An opt i ma 1 procedure was not i dent ifi ed. The average
reduction in headache index at the 6 month follow-up, regardless of
intervention, was 57%.
In this study, the most successful groups were the two REST-PMR
combinations: TANK + PMR, 74% at 6 months and the other ROOM + PMR, 69% at
6 months. The 74% decrease in reported headaches for the 5 participants in
the TANK + PMR group at the 6 month foll ow-up compares favorably with
reductions reported for the interventions reviewed in Bl anchard et al.,
(1980). Their meta-analysis revealed an average 59% reduction on the
headache index at end of treatment for fifteen studies that used either

180
re 1ax at i on alone or re 1ax at i on and bi ofeedback combi ned. Of the seven
studies that provided a follow-up measure, the average reduction at follow-
up was 70% for the four re 1ax at ion i ntervent ions, and 57% for the three
re 1axat i on/bi ofeedback combi nat ions. Thus, the effect of REST + PMR is
better than biofeedback + PMR and about the same as PMR alone.
The differential attrition rate might be regarded as further support
for the perceived effectiveness of the combination conditions. Five out of
the 10 original volunteers in the ROOM condition and 4 of 10 in the TANK +
ROOM group chose not to complete the four-week program. There was no
similar attrition in the REST + PMR combinations. Those who dropped out
during treatment often cited a lack of perceived effectiveness of the room
or tank as their reason for discontinuing participation.
Since all intervention procedures included repeated exposure to REST
environments, however minimized, this protocol was not a satisfactory test
of the REST interventions. Control conditions for REST and for contact with
a professional, which was much greater in the PMR conditions, were not
included. Further, the initial small size of the groups and subsequent loss
of contact with some participants during the follow-up may have provided
insufficient data for an accurate test among the interventions.
One of the effects of being in this intervention program which included
REST was a decrease in reported headaches. The robust effects of an
intervention program including REST allows the suggestion that future
research should examine it further. Such research could focus on the
differences between REST and non-REST interventions and compare them
directly while including appropriate control or placebo conditions.

ACKNOWLEDGEMENTS
Special thanks to the following individuals for their contributions and
support of this research program. Research assistants: Jeffrey Soo, Les
Leader, Jim Frankish, Linda Cousins, and Glenn Wong; Susan Bluck, Elizabeth
Ballard, and everyone at the UBC REST Lab for their unfailing, invaluable
advice; Mark Stephens for statistical support; and Dr. Donald Forgays for
his instrumental help in the editing and revision of this manuscript.

REFERENCES
Andrasik, F., Holroyd, K.A. & Abell, T. Prevalence of headache within a
college student population: A preliminary analysis. Headache, 1980,

181
 19, 384-387.
Blanchard, E.B. & Andrasik, F. Psychological assessment and treatment of
headache: Recent developments and emerg i ng issues. Journa 1 of
Consulting and Clinical Psychology, 1982, 50, 859-879.
Blanchard, LB., Andrasik, F., Ahles, T.A., Teders, S.J. & O'Keefe, D.M.
Migraine and Tension Headache: A meta-analytic review. Behavior Therapy
1980, 11, 613-631.
Caviness, V.S. &O'Brien, P. Current concept: Headache. New England Journal
of Medicine, 1980, 302(8), 446-450.
Diamond, S. Headache: Its di agnos is and measurement. Headache, 1979,
lilli, 113.
Engstrom, D.R. Hypnotic Susceptibility, EEG-Alpha and Self-Regulation. In
Consciousness and Self-Regulation, Vol. 1 (G.E. Schwartz & D. Shapiro
(Eds.), New York, NY: Plenum, 1976.
Epstein, L.H. &Abel, G.C. An analysis of biofeedback training effects for
tension headache patients. Behavior Therapy, 1977, ~, 37-47.
Fine, T.H. &Turner, J.W., Jr. The effect of brief Restricted Environmental
Stimulation Therapy in the treatment of essential hypertension.
Behavior Research and Therapy, 1982, 20, 567-570.
Forgays, D.G. & Belinson, M.J. Is flotation isolation a relaxing
environment? Journal of Environmental Psychology, 1986, §, 19-34.
Friedman, A.P. Nature of headache. Headache, 1979, lilli, 163-167.
Jacobs, G.D., Heilbronner, R.L. & Stanley, J.M. The effects of short term
flotation REST on relaxation: A controlled study. Health Psychology,
1984, ~, 99-111.
Kristeller, J.L., Schwartz, G.E. & Black, H. The use of Restricted
Environmental Stimulation Therapy (REST) in the treatment of essential
hypertension: two case studies. Behavior Research and Therapy, 1982,
20, 561-566.
Lilly, J.C. The Deep Self. New York: Simon and Schuster, 1977.
McNair, D.M., Lorr, M. & Droppleman, L.F. EITS Manual for the Profile of
Mood States, (POMS). San Diego, CA: Educational and Industrial Testing
Service.
Morell, D.C. Symptom interpretation in general practice. Journal of Royal
College of General Practice, 1972, 22, 297-309.
Newland; C.A., Illis, L.S., Robinson, P.K., Batchelor, B.G. & Waters, W.E.
A survey of headaches in an English city. Headache, 1978, ~, 1-20.

182
Phillips, C.A. A psychological analysis of tension headache. In S. Rachman
(Ed.) Contributions to Medical Psychology. Vol. 1, New York, NY:
Pergamon Press, 1977.
Pikoff, H. Is the muscular model of headache still viable? A review of
conflicting data. Headache, 1984, 24, 186-198.
Spielberger, C.D., Gorsuch, R.L. & Lushene, R.E. Manual for State-Trait
Anxiety Inventory (STAll. Palo Alto, CA: Consulting Psychologist
Press, 1979.
Suedfeld, P. Restricted Environmental Stimulation: Research and Clinical
Applications. New York: Wiley, 1980.
Suedfeld, P., Roy, C. & Landon, P.B. Restricted Environmental Stimulation
Therapy in the treatment of essential hypertension. Behaviour Research
and Therapy, 1982, 20, 553-559.
Turner, J.W., Jr. &Fine, T.H. Use of a Restricted Environmental Stimulation
Technique (REST) for induction of rel axation: Effects on plasma
cortisol, ACTH and LH. Presented at the Society for Behavioral
Medicine, 3rd Annual Meeting, March, 1982.
West, S. The hell in my head. Hippocrates, 1987, 1, 33-45.

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16
Effects of Biobehaviorally Assisted Relaxation Training on
Blood Pressure and Hormone Levels and Their Variation in
Normotensives and Essential Hypertensives

John W. Turner, Jr., Thomas H. Fine, Angele McGrady and James T. Higgins

ABSTRACT
Th is paper reports on the effect of two re 1axat i on -based treatment
modal ities, biofeedback-assisted (BF) relaxation and restricted
envi ronmenta 1 st i mul at i on therapy (REST) on the absolute 1eve 1s and the
variation of blood pressure, cortisol, aldosterone and plasma renin activity
in 18 hypertensives and 13 normotensives. Sixty-seven percent of both
hypertensive groups achieved cl inically significant blood pressure
reductions across treatment. Decreases were also observed in the average
level s of each hormone in all subgroups except normotensive BF. In some
individuals the blood pressure changes were not associated with changes in
hormone levels. Variation, reported as standard deviation, decreased across
treatment for blood pressure, cortisol and aldosterone in both hypertensive
and normotensi ve REST subgroups. The BF subgroups showed no consi stent
changes. These results are di scussed in the context of adrenocort i cal
activity, volume regulation of blood pressure and cybernetic theory.

INTRODUCTION
REST is the acronym for Restricted Environmental Stimulation Therapy.
In September of 1978, when we began our REST research, our goal was to
examine the physiological and psychological effects of the REST experience.
In our early studies we found that there were cl inically significant
decreases in blood pressure (BP) which occurred in hypertensive subjects.
These decreases in BP were maintained over several months.
These findings were consistent with other studies demonstrating that
patients with essential hypertension exhibit long-term decreases in blood
pressure via behavioral treatments involving various forms of relaxation
(Patel &North, 1975; Patel, 1977; Patel, 1975).
In 1979, Schwartz (1983) proposed a theory to address the etiology of
stress-related disorders in a cybernetic framework. This theory, termed

184
"disregulation theory", proposed that physiological feedback loops can be
forced out of regulation, or disregulated, by chronic psychological and/or
physiological stressors. Thus in some individuals, disregulation may be
expressed as essential hypertension, and relaxation training may reduce the
hypertension by eliminating a disregulated system or disregulated state,
i.e., by facilitating the process of regulation.
In the present study we attempted to establish, using a more rigorous
procedure than in earlier studies, whether the BP effects which we had
reported previously (Fine & Turner, 1982; Fine & Turner, 1985; see this
volume) were reproducible and what the mechanism of these effects might be.
Toward this end we designed an experiment which examined REST effects in:
1) a larger number of subjects, 2) normotensive as well as hypertensive
subjects, and 3) comparison to an established BP-reducing therapeutic
modality, EMG biofeedback-assisted relaxation training (Basmajian, 1985).
Specifically, BP and levels of plasma aldosterone and renin, and plasma
and urinary cortisol will be measured. These hormones have been implicated
in both the pathogenesis of hypertension and in the stress response (Selye,
1976) and previous studies have shown decreased plasma and urinary cortisol
levels and in association with REST (Turner & Fine, 1983) and EMG
biofeedback (McGrady et al., 1981), respectively. In addition, since one
characteristic indicator of the degree of regulation in a system is the
amount of variation of individual values around a mean value, across-
treatment changes in standard deviation of BP and measured hormone levels
will be examined.
It is hypothesized that REST-assisted relaxation training (REST) and
biofeedback-assisted relaxation training (BF) will be associated across-
treatment with: 1) decreased systolic, diastolic and mean arterial blood
pressure and their standard deviations, 2) decreased levels of plasma
aldosterone, renin and plasma and urinary cortisol and their standard
deviations and 3) correlation of BP and hormonal measures.

MATERIALS AND METHODS

Subjects
Twenty-one hypertensives (HT) were recruited through the Behavioral
Medicine Clinic at the Medical College of Ohio. They were accepted into the
study if thei r history and phys i ca 1 exami nat ion i nd i cated that they had
essential hypertension, and no clinical evidence of secondary complications.

185
Seven were on antihypertensive medications and were asked to withdraw
medication with their physician's permission, for the duration of the study.
There were 8 white females, 9 white males and one black male. Their average
age was 45 years (range 30 to 64). Starting BP (mm Hg ± S.E.) for the group
was 143 ± 3.8 systolic, 91 ± 1.5 diastolic, 108 ± 3.0 mean arterial pressure
(MAP). Thirteen normotensives (NT) were recruited through the Medical
College community. There were 5 white males and eight white females. Their
average age was 30 years (range 20 to 49). Starting BP for the NT group was
188 ± 3.0 systolic, 72 ± 1.2 diastolic, 87 ± 2.3 MAP.
Design and Treatment
At the first session all the participants were interviewed. A general
data base comprised of demographic variables was obtained. Blood pressures
were measured and the details of the study were explained. All participants
signed an informed consent form. A staff physician (J.H.) conducted a
cardiovascular examination on each participant and reviewed their medical
history.
The baseline period continued for six weeks after the initial
interview. Blood pressures were measured in the clinic with a mercury
baumanometer. Three measurements two minutes apart were taken once a week
from pat i ents in the s itt i ng pos i t i on after a ten mi nute rest. Subjects
were provided with a Marshall 114 self monitoring sphygmomanometer which was
calibrated against the mercury baumanometer. All subjects were taught to
measure their own blood pressure and were asked to record it three times a
day for the duration of the study. The measurement techni que of each
subject was verified by one of the investigators. Logs were collected
weekly. Home and clinic pressures were not different under any condition,
and clinic pressures alone were used in data analysis. Mean arterial
pressure (MAP) was calculated from the systolic (S) and diastolic (D) values
from the equation MAP = 1/3 (S-D)+D. Three measurements of muscle tension
levels, plasma and urinary cortisol levels, plasma aldosterone and plasma
renin activity were made during baseline for both HT and NT in REST and in
BF. One of the plasma renin activity determinations during baseline was
made under furosemide (Lasix) stimulated conditions. This permitted
classification of the low-renin hypertensives' who have been reported to be
less likely to respond to biobehavioral interventions than normal- or high-
renin hypertension (McGrady et al., 1986).
The 13 NT subjects were randomly assigned to two treatment groups BF

186
(n=7) and REST (n=6). The subjects were al so randomly assigned to two
treatment groups, SF (n=12) and REST (n=10). Four subjects dropped out of
the HT REST group during the early weeks of treatment for various personal
reasons unrelated to treatment. The HT group then consisted of 11 subjects
in SF and 6 subjects in REST.
All subjects underwent 20 sessions of 50-60 minutes duration over a 10-
week period. Twelve HT and seven NT subjects underwent 20 EMG
(electromyograph) SF-assisted relaxation sessions and 6 HT and 6 NT subjects
experienced 20 REST-assisted relaxation sessions. Each SP session included:
10 minutes sitting quietly; 3 SP measurements 2 minutes apart; 5 minute EMG
basel ine; 25 minutes EMG feedback from forehead muscles; 5-10 minutes
debriefing. All subjects were taught autogenic type relaxation exercises
(McGrady et al., 1986). They listened to a tape of these exercises during
their SF or REST sessions and were asked to practice the exercises twice
da il y for fifteen mi nutes. Comp 1i ance wi th these instructions was not
formally monitored.
Instruments and Measurement Techniques
Muscle tension levels were measured from the forehead with gold surface
el ectrodes by an Autogen 1700 el ectromyograph. Data were coll ected and
printed as an integral average every 5 minutes by a Texas Instruments TI-59
data acquisitions system. The REST chamber was purchased from Samadhi Tank
Company (Los Angeles). The chamber is a rectangular box 8' long, 4' wide
and 42" high, constructed of styrofoam backed with black plastic. The box
is lined with 20 gauge vinyl and contains saturated epsom salt solution of
specific gravity, 1.3. Temperature control of the solution was maintained
at 94.0 ± 0.5°F through the use of a waterbed heater with a solid state
thermoregulator. The chamber is completely enclosed, eliminating light and
attenuating sound to less than 10 decibels. The subjects float in a supine
position with their arms at their sides. Subjective reports from previous
studies have described the experience as deeply relaxing (Green et al.,
1980; Suedfeld et al., 1983).
The blood sampling protocol was structured for control of the diurnal
variation in cortisol levels and for its episodic secretion (Weitzman et
al., 1971). The blood samples were drawn by an experienced phlebotomist
between the hours of 12 noon and 2 PM; two samples were drawn twenty minutes
apart. The samples were centrifuged immediately to separate cellular and

187
plasma components, snap frozen in liquid nitrogen and stored at -60·C until
assay.
On one occasion during baseline, 80 mg of Lasix was administered to the
HT subjects in a divided dose (one dose late evening and one dose early
morning). One blood sample was drawn at 10 AM from the fasting subject for
determination of Lasix stimulated renin. Twenty-four-hour urine collections
were used as source for urinary cortisol. The cortisol value was divided by
the creatinine concentration to control for individual variations in
collections. Urinary, plasma levels of cortisol, urinary creatinine were
measured by the Department of Pathology, cortisol by competitive radioassay,
and creat in i ne by fl uorimetry. Pl asma 1eve 1s of aldosterone and ren in
activity were measured by radioimmunoassay: cortisol: RIA kit code KCOD 2 ,
Diagnostic Products, Los Angeles; aldosterone: RIA kit code KALd 2 ,
Diagnostic Products, Los Angeles; PRA: RIA kit code NEA026, New England
Nuclear, Boston, now E.I. DuPont DeNemours.
Statistical Analysis
Values used for statistical analysis were averages of data obtained
during weeks two through six (baseline) and averages of data obtained during
the 1ast week of treatment and the fi rst month after treatment (post-
treatment). Home BPs were not used in the statistical analysis. At the end
of the post-treatment interval, HT subjects were classified as succeeders if
they had sustained a decrease in systolic or diastolic BP of 10 mm Hg or
more between baseline and post-treatment. They were classified as tre~tment
failures if they did not decrease their systolic or diastolic BP at least 10
mm Hg. Statistical analysis included 2-way ANOVA with repeated measures, 1-
way ANOVA with repeated measures and Pearson correlation.

RESULTS
I. Genera 1
REST and BF were associated with clinically significant and equivalent
reductions in BP in HT subjects (Fig. 1, a-c). NT subjects showed no BP
change across these treatments. Comparison of across-treatment changes in
the level s of each hormone for all REST subjects and all BF subjects
revealed consistently greater hormone level decreases in REST (Fig. 2).
Furthermore, REST was associated with significant decreases for all hormones
in both HT and NT, while BP was associated with significant decreases (renin
and cortisol) only in HT subjects (Figs. 3,4,5). The standard deviations of
mean values both for BP and for hormones decreased significantly across
188
 Rest
155 8FD8K

!~
150
g 145
...J
g 140
-10- rJl

"""'-f~
_rJl
>- 135
'"E
:I: 130
.5 125
w
a:
::;)
rJl
rJl
W
a:
a..
Cl 100
0
0 95
...J

t~
m u
-}b- ::J 90

------11
0
I-
rJl 85
<
is 80
75

114

Ik,
'0
:I:
E 110
.5
w
a:
::;)
- le- 106
,,
rJl
rJl
W
a:
"', ,
a..
..J 102
<
a:w "-
"' "'

"'I
I-
a:
< 98
Z
"'
<
w
:::;
94

90
8ASELINE POST-TREATMENT

Fig. la,b,c: Systolic BP (Ia), Diastolic BP (Ib) and MAP (Ie) in baseline
and post-treatment for HT in the REST and BP groups. Yalues
are means ~ S.E.M. of 15 determinations averaged over 5
sessi ons in baseli ne and 3-5 sessi ons post-treatment.
Differences between baseline and post-treatment were sig-
nificant: SBP F = 9.5 df 1.16 P < 0.01 DBP F = 39.5 df 1,16
P < .01 MAP F = 10.7 1,16 P < .01. Two way analysis of
vari ance with repeated measures.

189
 •• IIOruClUU (It)
II - .Ul (1'1
11»-

flo"""",
lEVELS·
(POST· TREATMENT
VALUES AS
PERCEHT OF
BASELINE)

II
PLASIIA
1Il"1~
URIIWI'I'
COItTl~
ACTIVITY (..c;/G. ca:UTlJIIIH[)
(oNG/ulol.'
EACH VALUE WAS THE /EM OF 2 (U'INARY) OR q (PLAS"") I£ASURElENTS PER SUBJECT
AVERAGED ACROSS (.) SUBJECTS.

Fig. 2 Effect of Blofeedback- or REST-assisted relaxation training

on plasma levels of several honnones. Values for hyperten-
sive and nonnotensive subjects are pooled.

Fig. 3: Effect of biofeedback or REST-assisted relaxation training

on p1 asma a1 dosterone In I\ypertens Ives and normotens Ives;
REST HT = 6 and NT • 6. BF HT = 12 and NT • 7.

190
 IESf IIIfID80CI

1.5- .. 1,,,,,,,

>
•• ....TlISIVE

"'-

...,.
2.S-
"'-
""'....,
b,.,,"
2.a-

\
1.5-

1.0-

••5 -

'.1-

MSD.llE PUSI MSElII( I'IISI

lllAUOr TUIlEI'

Fig. 4: Effect of biofeedback or REST-assisted relaxation training

on plasma renin acthity in hypertensives and normotenshes;
REST HT = 6 and NT = 6, SF HT = 12 and NT • 7 •

U ...
lOT
.- .-
lEST

I\'P£IRtISIW
.-
•. ...,.M
e.

..."...
IUW

.,,-
~
II _

""""
.-
c.,...

\
""•• alAT1.,.J

50 -

.-
><
.... ....'E _'E ....... """'".... _'E """'"....
""-
POll POll
",11IOt

Fig. Sa,b: Effect of biofeedback or REST-assisted relaxation training

on plasma and urinary cortisol in t1Ypertensives and normo-
tenshes; REST HT • 6 and NT • 6, SF HT = 12 and NT • 7.

191
 •• BIOF[EDBACK (It)
1I'd. REST (12)
100 -

75 -
STANDARD
DEVIATION
o~ THE MEAN-
(PoST·TREATKEHT 50 -
VALUE AS
PERCENT OF
BASELINE)

SYSTOLIC UIASTOLIC PlJ\SIIA PLASI1II

BLOOD BLOOD ALDOSTERONE CORTISOL
PRESSURE PRESSURE eNG/DC,.) ""'G/od
(1YIiIo) (lYIiio)

ElICH VALUE WAS TilE STANDARD DEVIATION OF ~ (HoRHONAL) OR 15 (BP) MEASUREI1ENTI

PER SUIlJECT AVERAGED ACROSS (N) SUIlJECTS.

Fig. 6: Effect of relaxation training on variation around mean

values.

treatment (Fig. 6) for REST (combined HT and NT) but not for BF (combined HT
and NT). Thi s difference between REST and BF was due primarily to
differences in the NT subset. Specific values and variance results were
presented below.
I!. Measured Values
A. Blood Pressure
Figure 1 shows the effect of REST and BF on clinic BP (systolic (Ia),
diastol ic (Ib) and MAP (Ic). Sixty-seven percent of both groups were
classified as succeeders, that is, they decreased their systolic or
diastolic pressures by 10 mm Hg or more. The decreases in systolic,
diastolic and MAP that occurred in both groups were statistically
significant. No significant changes occurred across treatment in NT
subjects.

192
 B. Hormones
All mean values for all hormones in both baseline and post-treatment
were within the clinically established respective ranges of "normal".
Figures 3, 4 and 5 illustrate respectively the effects of BF and REST on
plasma aldosterone, plasma renin activity and plasma cortisol and urinary
cort i so 1 . Sign i fi cant decreases were found in the REST group for each
hormone tested in both HT and NT. In the BF group, significant decreases
were observed for HT but not for NT in plasma and urinary cortisol levels,
and in plasma renin activity. There was no significant decrease in plasma
aldosterone levels for HT or NT in BF.
C. Interrelationship of Blood Pressure and Hormones
A Pearson correlation was calculated between the percent change in MAP
and the percent change in each of the hormones for both REST and BF groups
for HT (Table 1). For the combined REST and BF groups, significant

TABLE 1 Pearson Correlations Among Percent Change Across Treatm.nt in Blood

Pressure and Hormones for Hypertens f yes
(Combined Rest and BF)

MAP PC PRA ALOO SINS BF IREST

Mean Arterial Pressure 0.46* 0.43* 0.22 0.23 O.BO* -0.20

(MAP)

Plasma Cortisol 0.21 0.14 0.36 o. 27

0.14
(PC)

Urinary Cortisol 0.71* 0.56* o . 37

0.52*
(UC)

Plasma en1n
Activity 0.66* 0.18 0.35
(PRA)

Plasma Aldosterone 0.31 0.50*

(Aldo)

Succeeders/non-succeeders -0.09
(SINS)

*Correlation coefficient significant (P > 0.05 for values ~'0.46. OF = 16)

for BF and REST groups combi ned

193
 REST <0-6) BIOFEEDBACK <..l2l
9.0,--.--------,-----------,;,-

8.0

7.0
AVERAGE
INDIVIDUAL
VARIATlOft •
(STAHDARD
DEVIATIONS)
6.0

5.0

~.O

BASELINE POST BASELINE POST

TREATl'{)(T TREATHEHT
• EACH POINT REPRESENTS THE S.D. OF 15 MEASUREMENTS
PER SUBJECT.

Fig. 7: Effect of relaxation training on variation in mean arterial

pressure in essential hypertensives.

correlations were found between percent change in mean blood pressure and
percent change in plasma and urinary cortisol. Change in urinary cortisol
was correlated with change in plasma aldosterone and plasma renin activity.
Change in plasma aldosterone was correl ated wi th changes in uri nary and
plasma cortisol. Change in plasma renin was correlated with change in
plasma aldosterone. However, all subjects who lowered BP (succeeders) did
not show decreased hormone levels and vice versa, i.e., the changes in
hormone levels were not dependent on whether the subjects lowered their BP
(Table I, succeed/nonsucceed). A difference between treatment groups was
observed in the change in urinary cortisol and plasma aldosterone with the
REST group showing a larger response than the BF group (I-way ANOVA p < 0.05
(F=5.91, df=16, and F=5.39 df = 16, respectively).
II 1. Vari at i on
The measure of vari at i on for thi s study was the standard devi at ion
(sd). Each value reported is the standard deviation of 4 (hormonal) or 15

194
(BP) measurements per subject averaged across On" subjects. Results are
presented in the format of post-treatment value as percent of baseline.
In the REST group (combined HT and NT) sd decreased significantly (p
< .01 paired t-test) across treatment for systolic and diastolic BP and for
all measured hormones. Representative data are presented in Figs. 6 and 7.
In the BF group (combined HT and NT) sd did not show a significant change
across treatment although a decreas i ng trend was observed for BP and all
measured hormones. Subdivision of treatment groups data into HT and NT
showed significant (p < .01 paired t-test) decrease in sd for all parameters
in the REST group for both HT and NT wi th the except i on of reni n in HT
(Table 2). Changes for the BP group for any measure. In HT of the BF
group, . the sd was decreased for aldosterone, but showed no significant
change for any other measure (Table 2).
TABLE 2. Standard Deyiation Changes Across Treatment For HypertenslYes
and Normotensiyes in REST and Biofeedback

Subject Para- Standard DeYlation (sd)"

meter REST Biofeedback (BF)
Base- Post- Post- Base- Post- Post-
line treat- treat- line treat- treat-
ment ment as ment ment as

I
1 of
I
" of
J baseline baseline
Hyper-
tens1 'ie >lAP 8.7
I
6.6
I 76 10.1 I 8.3 82
(Hf) P A1 dost. 6.0 2.8' 47 5.5 2.6+ 47
P Reni n 0.35 0.30 86 1.22 0.90 73
P Cortisol 3.3 1.5' 45 6.7 5.6 B4
U Corti sol 21.8 9.9' 45 16.1 19.1 119

Hormo-
tens I ye >lAP 10.4 7.0 67 10.7 9.3 B7
(NT) P A1dost. 7.2 2.4' 33 7.3 9.3 127
P Reni n 0.30 0.15' 50 1.20 1. 51 125
P Cortisol 9.0 5.2' 57 6.1 6.1 100
U Cortisol 3~. 3 29.0' 76 13.B 15.0 109

P = plasma. U = urinary. MAP = mean arterial preSSl1re.

··rlean sd for baseline and for post-treatlnent based on 15 (8P), 4 (plasma)

or 2 (urinary) measurements per subject, ayeraged across "n" subjects. n
= 6 REST HT, 6 REST NT, 12 BFHT and 7 BFNT.

·Slgnlfi cant1y different from basel I ne, p < • ai, pai red t-test.

195
 DISCUSSION
Our objective was to compare the effects of REST-assisted relaxation
training and BF-assisted relaxation training on BP and its variation and
several hormones and their variation in essential hypertensives and
normotens i ves. The present study di d not address the issue of wh i ch
component of the treatments was effective. The six-week baseline allowed
each subject to serve as their own control since previous studies have shown
that monitori ng BP alone wi 11 decrease BP to a plateau over a four week
period (Engel et al., 1981). In terms of BP the results support the initial
hypothesis and confirm previous reports that REST-assisted (Fine &Turner,
1982) and BF-assisted relaxation (McGrady et al., 1981; Engel et al., 1981;
Glasgow et al., 1982) were associated with cl inically and statistically
significant decreases in BP across treatments in hypertensives. A
previously unreported finding was the demonstration of equivalent
effectiveness of the two treatment modalities in lowering BP. In contrast
the equivalence hypothesis for REST and BF effects on hormonal patterns was
not confi rmed. In fact, subjects in the REST group exh i bi ted hormonal
changes more consistently, showing decreases in all measured hormones in 83%
of subjects compared to 33% of biofeedback subjects showing this response.
Other studies of adrenal hormone changes associated with relaxation
methodologies such as transcendental meditation (Michael s et al., 1976;
Jevning et al., 1975), deep muscle relaxation (Davidson et al., 1979) and
BF-assisted relaxation (McGrady et al., 1981) have also revealed
inconsistent hormonal responses, i.e., similar to the BF treatment group in
the present study. Jevning et al. (1975) reported a 26% decrease in plasma
cortisol in 30 minutes of transcendental meditation in regularly practicing
mediators with 3-5 years of experience, while Michaels et al. (1976) found
no decrease in plasma cortisol after 20-30 minutes of TM using mediators
with 2 years of experience. In across session studies of EMG biofeedback-
assisted relaxation and cortisol after 20-30 minutes of TM using mediators
with 2 years of experience. In across session studies of EMG biofeedback-
assisted relaxation and cortisol in hypertensives, McGrady et al. (1981)
found no effect of 16 30-min biofeedback sessions on plasma cortisol, but
they observed decreased urinary cortisol.
Assuming that the decrease in plasma levels of the measured hormones
are part of the relaxation response, one possible explanation for the
difference in the present study is that REST may be more potent than

196
bi ofeedback as a medi ator of the rel axation response, producing deeper
relaxation. In a previous study reported from this laboratory (Turner &
Fine, 1983) subjects with no prior REST experience showed an average 20%
decrease in plasma cortisol during 35-minute REST sessions. If decreased
plasma cortisol is a part of the relaxation response, then naive REST
subjects appear to have experienced equal or greater relaxation than
meditation with 2-5 years TM experience. Another possibility is that the
differences in hormonal responses reflect a difference in the process of
REST-assisted and BF-assisted relaxation. Certainly the procedures of REST
and BF are different. Biofeedback is an active learning process which
util izes outside stimul i (Basmajian, 1985). Although REST may include
active learning, the REST process is mediated only through internal stimuli
(Suedfeld, 1980; Lilly, 1977). Since both treatments included autogenic
relaxation, the hormonal results cannot be attributable to autogenic
relaxation alone. A complicating factor in the present study is the drop
out of several subjects in the REST group, which may suggest that the final
REST group was more self-selected than random. If the remaining REST
subjects were more committed to the study, this may have contributed to the
observed greater effects of REST treatment.
In designing this study cortisol was chosen as an adrenocortical index
of the relaxation response, and renin and aldosterone were designated as
indices of the volume regulation of BP. Although these designations were
admittedly somewhat arbitrary, it is interesting that in both treatment
groups, there was a significant correlation between BP changes and plasma
and urinary cortisol changes while there was no correlation between the
changes in BP and renin or between the changes in BP and aldosterone. This
was true for renin whether low-renin subjects were included or excluded in
data analysis, a result which was not surprising since only 2 of the 17
subjects were classified as low-renin. The variable and inconsistent
relationship among changes in BP, renin and aldosterone suggests that over
the long term, relaxation affects BP via complex, interactive pathways. It
is therefore unlikely that this relationship can be accurately assessed or
monitored simply through these neuroendocrine measurements.
One reasonable conclusion which can be made from the present
correlation data is that the BP response and hormonal response to relaxation
training can be independent, with responsiveness varying from subject to
subject. Thi sis consi stent with other studi es which have demonstrated

197
variation among individuals in diurnal hormone release rhythms (Cugini et
al., 1982), BP and hormonal responsiveness to various stressors (Stephenson,
1984) and BP response consistency (Fredrikson et al., 1985). These studies
suggest that single-subject, repeated-measures experimental design may offer
the best opportunity to probe possible relationships between BP and hormones
and to elucidate the mechanism(s) by which relaxation-based treatments lower
BP in hypertensives.
In the present study of hypertensives, the average starting levels of
all hormones were within the clinically defined range of normal. However,
the fact that beginning hormone levels and the changes due to treatment were
within the range of "normal" does not mean the BP effects are not hormonally
mediated. It is possible that even a small change in the setpoint of a
hormonal feedback loop may produce significant long-term phYSiological
reorganization, with one consequence being lowered BP.
The standard deviation (sd) data in the present study suggest that, at
least in the REST condition, some physiological reorganization has occurred.
If, as Schwartz has theorized (1983), decreased variation in a function
represents enhanced or improved regulation of that function, then REST is
associated with enhanced regulation of BP, plasma aldosterone, plasma renin
(NT only), plasma cortisol and urinary cortisol. The fact that BF was
generally not associated with reduced variation in measured parameters but
was as effective as REST in decreasing BP across treatment further supports
the concept that REST and BF achieve the reduction of BP by different
mechanisms.
Furthermore, while enhanced regulation may occur with REST treatment,
larger variance was not characteristic of hypertension in this study and
reduct i on of vari ance did not necessarily 1ead to reduced BP. Th is is
evidenced by the fact that: 1) it was possible to reduce BP across
treatment without reducing sd, as the BF group hypertensives, and 2) it was
possible to reduce sd across treatment without reducing BP, as in the REST
group normotensives. The relationship of variation in the BP loop to
hypertension may be examined from a different perspective by noting that HT
and NT subjects in REST exhibited similar decreases in sd for BP. In other
words, both HT and NT exhibited similar enhancement of BP regulation. Thus,
HT and NT individuals may have different set points for the absolute BP and
still have a similar degree of regulation of the BP loop at each set point.
According to Schwartz (1983) BP regulation is an integrated phenomenon

198
involving participation of a number of feedback loops in a hierarchical
fashion. The loop specifically regulating BP variation would be low in the
overall hierarchy. If REST can enhance regulation at the BP variation level
in the hypertensive individual, then it may also enhance regulation of loops
further up in the hierarchy. Eventual reorganization of overall BP
regulation (involving many loops) thus may occur, and the individual may
become normotensive again. Unfortunately, this concept cannot be refuted or
confirmed by the present study. It nonetheless deserves serious attention
in the design of future research in this area.

REFERENCES
Basmajian, J.V. Biofeedback Principles and Practice for Clinicians. (2nd
Ed.). Baltimore, MD: Williams and Wilkins Company, 1985.
Cugini, P., Piernatale, L., Tomassini, R., Centanni, M., Salandi, E. &Scavo,
D. Circadian Rhythms of Plasma Renin, Aldosterone and Cortisol.
Effect of Beta-Adrenergi c Blockade of Proprano 101 in Patients with
Recent, Advanced and Comp 1 i cated Forms of Essent ia 1 Hypertens i on.
Chronobiologia, 1982, 2, 229.
Davidson, D.M., Winchester, M.A., Taylor, C.B., Alderman, E.A. &Ingels, N.B.
Effects of Relaxation Therapy on Cardiac-Performance and Sympathetic
Activity in Patients with Organic Heart Disease. Psychomatic Medicine,
1979, 41, 303-309.
Engel, B.T., Gaardner, K.R. & Glasgow, M.S. Behavioral Treatment of High
Blood Pressure I. Analyses of Intra- and Interdaily Variations of
Blood Pressure During A One Month Baseline Period. Psychomatic
Medicine, 1981, 43, 255-270.
Fine, T.H. &Turner, J.W., Jr. The Effect of Brief Restricted Environmental
Stimulation Therapy in the Treatment of Essential Hypertension.
Behaviour Research and Therapy, 1982, 20, 567-570.
Fine, T.H. & Turner, J.W., Jr. The Use of Restricted Environmental
Stimulation Therapy (REST) in the Treatment of Essential Hypertension.
In: Turner, J.W., Jr. & Fine, T.H. (Eds.) REST and Self-Regulation:
Proceedings of the 1st International Conference. Toledo, OH: IRIS
Publ., 1985, 136-143.
Fredrikson, M., Danielssons, T., Engel, B.T., Frisk-Holmberg, M., Strom, G.
& Sundin, o. Autonomic Nervous System Function and Essential
Hypertension: Individual Response Specificity With and Without Beta-

199
 Adrenergic Blockade. Psychophysiology, 1985, l£i£l.
Glasgow, M.S., Gaardner, K.R. & Engel, B.T. Behavioral Treatment of High
Blood Pressure II. Acute and Sustained Effects of Relaxation and
Systol ic Blood Pressure Biofeedback. Psychosomatic Medicine, 1982,
llill·
Green, E.E., Green, A.M. &Norris, P.A. Preliminary Report on a New Non-Drug
Method for Control of Hypertension. Journal of South Carolina Medical
Association, 1980, ~, 126-137.
Jevning, R., Wilson, A., VanDerlaan, E. & levine, S. Plasma Prolactin and
Cortisol During Transcendental Mediation. Proceedings of the Endocrine
Society, 1975, 275.
lilly, J. The Deep Self. New York, NY: Simon & Schuster, 1977.
McGrady, A.V., Yonker, R., Tan, S.Y., Fine, T. & Woerner, M. The Effect of
Biofeedback-Assisted Relaxation Training on Blood Pressure and Selected
Biochemical Parameters in Patients with Essential Hypertension.
Biofeedback and Self-Regulation, 1981, ~, 343-353.
McGrady, A.V., Turner, J.W., Jr., Woerner, M., Higgins, J.T. &Custodio, D.
Predictors of Success in Hypertensives Treated with Biofeedback
Assi sted Rel ax at ion. Paper presented at the Bi ofeedback Soci ety of
American Annual Meeting, 1986.
Michaels, R.R., Huber, M.J & McCann, D.S. Evaluation of Transcendental
Meditation as a Method of Reducing Stress. Science, 1976, 192, 1242-
1244.
Patel, C.H. Twelve-Month Follow-Up of Yoga and Biofeedback in the Management
of Hypertension. lancet, 1975, 1, 62-65, 1975.
Patel, C.H. Biofeedback Aided Relaxation and Meditation in the Management
of Hypertension. Biofeedback and Self-Regulation, 1977, Zill, 1-41.
Patel, C.H. & North, W.R.S. Randomized Controlled Trial of Yoga and
Biofeedback in Management of Hypertension. lancet, 1975, Z, 93-95.
Schwartz, G.E. Disregulation Theory and Disease: Applications to the
Repression/Cerebral Disconnection/Cardiovascular Disorder Hypothesis.
Behaviour Research and Therapy, 1983, 32, 95-118.
Selye, H. Stress in Health and Disease. Boston, MA: Butterworth, 1976.
Stephenson, R.B.; Modification of Reflex Regulation of Blood Pressure by
Behavior. Annual Review of Physiology, 1984, 46, 133-143.
Suedfeld, P. Restricted Environmental Stimulation: Research and Clinical
Applications. New York, NY: Wiley, 1980.

200
Suedfe 1d, P., Ballard, E. J. & Murphy, M. Water Immers i on and Fl otat ion:
From Stress Experiment to Stress Treatment. Journal of Environmental
Psychology, 1983, 1, 147-155.
Turner, J.W., Jr. & Fine, T.H. Effects of Relaxation Associated with Brief
Restricted Environmental Stimulation Therapy (REST) on Plasma Cortisol,
ACTH and LH. Biofeedback and Self-Regulation, 1983, ~, 115-126.
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He 11 man, L. Twenty Four Hour Pattern of the Epi sod i c Secret i on of
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201
17
Replication of a Clinical Outcome Study on a Hospital-Based
Stress Management and Behavioral Medicine Program
Utilizing Flotation REST and Biofeedback
Gilbert M. Koula, John C. Kemp, Keith M. Keane and Allan D. Belden

ABSTRACT
Psychosocial stress is accepted as a known contributor to emotional and
somatic illness. This study is a replication of pre-post clinical
effectiveness of a medically supervised treatment program for stress
disorders. The program is hospital-based and employs bi ofeedback as an
introductory self-regulation, stress reduction method and flotation REST as
a primary self-regulation, stress reduction method.
Eighty respondents of 154 out-patients are reviewed statistically
assessing change in symptom severity and frequency and secondary symptoms.
The results are reviewed with comparison to an initial clinical outcome
study on a simil ar out-patient group treated in the same program. The
results continue to be strongly suggestive of health benefits with the use
of this treatment model.

INTRODUCTION
An initial cl inical outcome study on a group of 71 out-patients
receiving treatment in the Stress Management and Behavioral Medicine
Laboratory at St. Elizabeth Hospital (Jacobs et al., 1985) revealed
statistical results highly suggestive that a program utilizing biofeedback
as an introductory, self-regulation, stress reduction technique and
flotation REST as primary self-regulation, stress reduction technique is
effective in reduction of psychophysiologic symptoms.
This study reviews the ability of the treatment model as presently
applied to maintain consistent therapeutic gains.
Overactivation of the sympathetically mediated fight or flight response
has been impl icated in the development of several modern stress rel ated
health disorders including certain cardiovascular disorders (Friedman and
Rosenman, 1974; Pelletier, 1977; Guttman and Benson, 1971; Patel, 1973);
anxiety disorders (Gatchel, 1982; Selye, 1956; Pelletier, 1977; Basowitz et

202
al., 1954); migraine headaches (Pelletier, 1977; Selye, 1956);
musculoskeletal headaches (Budzynski et al., 1970) and gastrointestinal
disorders (Pelletier, 1977; Selye, 1956). It is hypothesized that these
disorders may be prevented or alleviated by either reducing sympathetic
activation or increasing parasympathetic activation.
Biofeedback and other self-regulatory techniques are being employed to
teach control over sympathetic and parasympathetic functioning.
The Stress Management and Behavioral Medicine Program at St. Elizabeth
Hospital received both in-patient and out-patient referrals for a variety of
stress-related health disorders. These include generalized anxiety, chronic
pain syndromes, muscle tension and migraine headaches, selected
gastrointestinal and cardiovascular disorders and other stress-related
disorders. Approximately 80% of our patients are physician referred. Prior
to self-regulation training, patients complete a detailed lifestyle
assessment questionnaire followed by a psychiatry behavioral medicine
evaluation and traditional biofeedback stress profile. Patients then
participate in a comprehensive self-regulation training protocol including
EMG-assisted (J & J model M-53) relaxation training as an introductory
method and then flotation REST -assisted relaxation training as a primary
form of relaxation training. Training sessions involve point-to-point
muscle relaxation, breathing techniques and guided as well as passive visual
imagery techniques. The program is a bio-behavioral treatment package
utilizing biofeedback and REST which also includes a discussion of symptoms
and stressors and instructions for integrating the relaxation skills into
the home and work environment.

METHOD
The replication study included 154 out-patients who received treatment
utilizing EMG assisted relaxation training as an introductory self-
regulation method and flotation REST assisted relaxation training as a
primary method between August of 1982 and October of 1984. Ten key
quantifiable variables from a pre-treatment questionnaire containing the
same 10 variables. The variables included: severity and frequency of the
chief complaint and secondary symptoms, cigarettes, alcohol, and medication
usage; type A behavioral traits, sleep time, ratings on daily life pressures
and the ability to relax along with a subjective rating of improvement by
the patient. All measures involved interval scales except symptom frequency

203
(ordinal scale) and medications (change in daily medication usage).
Differences in the pre-post means for the measured variables were examined
statistically. Variables with interval scales were examined using a one-
tailed Student t-test. Frequency of symptoms was examined using the non-
parametric one-tailed Wilcoxon T-test because of the ordinal scale used in
its measurement. Medication usage was not examined statistically due to the
complexity in evaluating the diversity of medication being used.

RESULTS
Eighty patients returned the follow-up questionnaire, representing 52%
of the sample. No significant differences were noted between respondents

TABLE I
CLINICAL OUTCOME STUDY (SECOND SAMPLE)
N=80 - PRESENTING PROBLEMS

PROBLEM PEOPLE
Generalized Anxiety 23
Musculoskeletal Headaches 22
Pain 11
Migraine Headaches 5
Depression 6
Hypertension 4
GI Disorders 2
Tort i coll i s 2
Blepharospasm
Chronic Musculoskeletal Tension
Stuttering 1
Type A Behavior/Obsessive Compulsive _1
TOTAL N=80

and nonrespondents in terms of improvement during therapy, age, sex or

number of sessions. The mean number of sessions was 11.1 represented by 3.7
biofeedback assisted relaxation sessions and 7.4 flotation REST-assisted
relaxation sessions. The mean follow-up time was 7 months. The treatment

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 TABLE II
PRE/POST MEANS AND STATISTICAL RESULTS FOR
MAJOR DIAGNOSTIC CATEGORIES

VARIABLE PRE POST T-VALUE DF

1. Generalized Anxiety: Wilcoxon

A. Symptom Frequency 6.97 3.35 0* 22
Student T
B. Symptom Severity 2.76 1.65 7.52* 22
C. Secondary Complaints 2.54 2.96 -4.28* 22
D. Relaxation Ability 4.26 2.95 6.06* 22

2. Tension Headaches: Wilcoxon

A. Symptom Frequency 6.82 4.05 7.4 19
Student T
B. Symptom Severity 2.95 1. 92 4.32* 21
C. Secondary Complaints 2.85 3.11 -1. 62** 19
D. Relaxation Ability 3.75 2.57 3.94* 19

3. Chronic Pain: Wilcoxon

A. Symptom Frequency 9.4 8.5 10* 9
Student T
B. Symptom Severity 3.18 2.5 2.09* 10
C. Secondary Complaints 2.94 3.09 -7.04* 9
D. Relaxation Ability 3.66 3.00 1.41* 8

4. Migraine Headaches: Wilcoxon

A. Symptom Frequency 3 1.2 0* 4
Student T
B. Symptom Severity 2.9 1.6 2.98* 4
C. Secondary Complaints 2.86 3.18 -1. 65** 4
D. Relaxation Ability 3.8 2.7 1.97** 4

* Significant p < .05

** Significant p < .10

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 TABLE III
GROUP #1
71 OUTPATIENTS - 54 RESPONDENTS, JUNE 1981 - JULY 1982

MEANS

VARIABLE PRE POST T VALUE* DF

Wilcoxon
Symptom Frequency 7.08 3.77 44* 49

Student T
Symptom Frequency 3.01 1. 63 9.71* 48
Secondary Complaints 2.55 3.02 -5.42* 47
Type A Traits 2.6 2.79 -1.80* 47
Sleep Hours 7.16 7.38 -1.84* 51
Life Pressures**
Work 3.06 2.58 2.92* 36
No Work 2.88 2.42 1.92* 11
Al cohol 2.92 2.38 4.25* 38
Relaxation Ability 4.13 2.82 7.21* 51
EMG 1-4*** 7.43 6.25 3.02* 34
EMG 16-20 5.74 4.78 2.43* 34
Cigarettes 4.0 4.0 0 10

206
 TABLE III - continued
GROUP #2
154 OUTPATIENTS - 80 RESPONDENTS, AUGUST 1982 - OCTOBER 1984

MEANS

VARIABLE PRE POST T VALUE* DF

Wil coxon
Symptom Frequency 7.078 4.08 108.5* 66

Student T
Symptom Frequency 2.90 1.83 10.02* 77
Secondary Complaints 2.75 3.08 -4.67* 76
Type A Traits 2.6 2.9 -2.61* 74
Sleep Hours 7.16 7.38 -1. 84* 51
Life Pressures**
Work 2.78 2.38 4.01* 58
No Work 2.97 2.50 1.72* 10
Al cohol 2.57 2.30 2.73* 57
Relaxation Ability 3.98 2.82 8.80* 74
EMG 1-4*** 3.57 2.56 2.75* 39
EMG 16-20 3.23 2.02 2.41* 39
Cigarettes 3.80 3.52 .90 20

* All values significant at p < .05

** Since the mean for life pressures represented an average of 3 areas
(work, home, personal functioning) and some patients did not work, this
variable divided into two groups: work and no work
*** For EMG, two values were calculated: 1) EMG 1-4, representing an
average of the first four minutes of each 25 minute baseline session;
2) EMG 16- 20, represent i ng the 1ast four mi nutes of each 25 mi nute
baseline session.

207
results were highly similar to the initial clinical outcome study (Jacobs
et al., 1985) Four percent of the patients rated their condition as
completely alleviated, 43% greatly improved, 25% moderately improved, 24%
slightly improved and 4% no change. In summary, 96% rated their condition
as improved. Statistical analyses of the pre-post measures revealed
significant changes for all variables except cigarettes and sleep. The
majority of patients fell into four major diagnostic treatment categories:
generalized anxiety disorders, tension headaches, chronic pain and migraine
headaches. Table II and Table III compare the initial study and replication
statistical data.
In each of the four major diagnostic categories, generalized anxiety,
chronic pain, migraines and muscle tension headaches, significant changes
from pre-test to post-test (P <.05) were observed on all four outcome
measures (symptom frequency, symptom severity, secondary compl a i nts and
subjective ratings in abil ity to relax). Additionally, 68% showed a
decrease in medication usage, 13% increased and 19% showed no change.

DISCUSSION
The results of this repl ication study show continued support for
positive treatment effects for the treatment model in use. This study in
conjunction with the initial outcome study strongly suggests that a
hospital-based Stress Management and Behavioral Medicine Program which
employs biofeedback as an introductory self-regulation technique and
flotation REST as a primary self-regulation technique may be effective as a
primary or adjunctive treatment modality in the treatment of a variety of
stress-related health disorders. This is evident as patients showed
significant change from pre-test to post-test on a variety of cognitive and
behavioral indicators of stress management, reported a high degree of
subject i ve improvement and showed s ignifi cant symptom reduct i on in four
major diagnostic treatment categories (general anxiety, tension headaches,
migraine headaches and chronic pain). The authors acknowledge limitations
in this study in that it is not a controlled study, the return rate of
questionnaires is low and longitudinal data are not yet available. Even
with these 1 imitations, the treatment program is highly suggestive of
clinical effectiveness. In order to assess the role of all the variables
contributing to positive outcome, a more formal investigative study with
appropriate controls and longitudinal follow-up components is necessary.

208
 REFERENCES
Basowitz, H., Persky, H., Horchin, S.J. &Grinker, R.R. Anxiety and Stress.
New York, Toronto, London: McGraw-Hill Book Company, Inc., 1954.
Budzynski, T.H., Stoyva, J.M. & Adler, C. Feedback-induced muscle
relaxation: Appl ication to tension headache. Journal of Behavior
Therapy and Experimental Psychiatry, 1970, 1205-1211.
Friedman, M. &Rosenman, R.H. Type A Behavior and Your Heart. New York, NY:
Alfred A. Knopf, 1974.
Gatchel, R.J. EMB, biofeedback, and anxiety reduction. In: White, L. &
Tursky, B. (Eds.) Clinical Biofeedback: Efficacy of Mechanisms. New
York, NY: Guilford Press, 1982.
Guttman, M.C. &Benson, H. Interaction of environmental factors in systemic
arterial blood pressure: A review. Medicine, 1971, 50, 543-553.
Jacobs, G.D., Heilbronner, R.L. &Stanley, J.M. The effects of short term
flotation REST on relaxation: A controlled study. In: Fine, T.H &
Turner, J.W., Jr. (Eds). First International Conference on REST and
Self-Regulation. Toledo, OH: Medical College of Ohio, 1985, 86-102.
Patel, C.H. Yoga and biofeedback in the management of hypertension. Lancet,
1973, ii, 1053-1055.
Pelletier, K.R. Mind as Healer/Mind as Slayer. New York, NY: Dell
Publishing Company, 1977.
Selye, H. The Stress of Life. New York, NY: McGraw-Hill, 1956.

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18
Flotation Effect on Premenstrual Syndrome

Deborah D. Goldstein and Walter E. Jessen

ABSTRACT
Three groups of women having premenstrual syndrome (PMS) completed
checklists for number and severity of symptoms at prescribed intervals, for
the assessment of symptoms over the last eighteen months and symptoms before
and subsequent to experimental conditions. They were divided into two
experimental float groups and a control group. The two-float group floated
in a flotation tank once during a non PMS interval and once during a PMS
interval. The one-float group floated only during a non PMS interval. The
control group did not float. An analysis of variance using repeated
measures revealed several outcomes. There were no significant group
differences in overall number or severity of symptoms. When only checklists
performed during treatment were assessed, the one-float group showed
significantly greater overall symptom severity than the other groups. PMS
symptoms vary significantly over all time intervals, and flotation results
in immediate reduction of symptoms and severity to very low levels.
Subsequent to the onset of PMS symptoms after the non PMS float, symptoms
and severity sign i fi cantl y increased beyond what was expected and were
significantly decreased only by a second float during the PMS interval.
Those who had the second float remained at low levels for both symptom
number and severity wh 11 e the other groups showed sign i fi cant 1y higher
values.

INTRODUCTION
Premenstrual syndrome is a plethora of symptoms running the range of
emotional anomal ies such as attempted suicide and panic states, physical
dysfunctions of migraine and epilepsy to increased sex drive and creativity.
It has been frustrating to both the medical profession and women. Some
physicians perceive PMS as something women have to accept as part of being
a woman, wh 11 e other phys i c i ans seek to treat it with a wi de range of
medical and non medical procedures. Just as mystifying as the onset of
symptoms is their disappearance, creating a bizarre Jekyll and Hyde

210
transition for many women. Bender (1987), Flowers (1979) and others have
indicated that these transformations are in large measure due to hormonal
disregulation. Turner and Fine (1987 and 1985) have shown that flotation
can regulate hormonal functioning. Thus, if flotation can normalize
hormonal activity, then PMS symptoms and their severity may diminish. It is
hypothesized that: a. there will be a significant reduction in number and
severity of symptoms with women who float over those women who do not float;
b. women who float twice in the same premenstrual cycle will report a
greater reduction in number and severity of symptoms than those women who
float once.

SUBJECTS
All volunteers in the study were women. The mean age was 32.8 and the
mean interval of PMS symptoms lasted 6.05 days; there was no statistical
difference between experimental groups on these characteristics. Each float
group had a subject who had one or more children, while one float group and
the non float group (control) each had one subject who had a tubal ligation.
Both of these factors are reported to increase the 1 i kel i hood of PMS
symptoms.
Subject Selection
All women were referred by a local cl inic or two psychotherapists.
Each woman called the experimenter and was interviewed on the telephone.
Those that were willing to be available for six weeks agreed not to change
their daily routine in regard to exercise, vitamins, yoga, medication, and
diet. None had floated before and all agreed to limit their floats during
the project to the experiment. They were sent an information packet in the
mail including an article about flotation, layout of the flotation room,
tanking procedure and the Premenstrual History Questionnaire (PHQ). Final
subject selection was based on completion of PHQ.
Subject/Group Assignment
Eighteen subj ects were ass i gned to each of three groups. Due to
attrition, six completed the two-float group, five completed the one float
group and four completed the no float/control group.

PROCEDURE
Apparatus
The Premenstrual History Questionnaire is a self report instrument that

211
asks questions about each woman's PMS symptoms, timing of her cycle, etc.
This was used to determine when the subject should float and when to take
the symptom checklist. The Daniel-Goldstein Premenstrual Symptom Checklist
(DGPSC) is a self report instrument that measures the frequency of severity
of sixty one (61) PMS symptoms. This was administered six separate times
for each subject. All subjects floated in a Samadhi I tank at the
Regeneration Institute. An interview room, adjacent to the flotation room,
was used to greet subjects and to administer the DGPSC at flotation
sessions.
Two-Float Group Procedure
The first DGPSC was self administered in the interview room, between
the end of menstruation and ovulation, a non PMS interval. The subject was
asked to rate all the PMS symptoms she experienced over the last twelve to
eighteen cycles. Upon completion, the subject floated for one hour. After
the float, or 1 1/2 hours after completing DGPSC 1, the subject completed
DGPSC 2 by rating only the PMS symptoms present at that time. DGPSC 3 was
self administered at the mid point of the first half of the PMS cycle, in
the interview room and just prior to her second float. Completing the
float, or 1 1/2 hours after administering DGPSC 3, the subject took DGPSC 4
in the interview room. This was also during her PMS cycle. DGPSC 5 was
administered six to twelve hours after DGPSC 4, at home during the subjects'
PMS cycle. Six to twelve hours after the onset of menstruation, DGPSC 6 was
rated from the vantage point of assessing the PMS symptoms twenty four hours
prior to this period. Upon completion of each checklist, it was sealed in
an envelope and either sent or given to the experimenter to insure relative
"independence" of measures.
One-Float Group Procedure
This group floated once between DGPSC 1 and 2. All other checklists
were self administered at home at the same intervals as the two float group.
Each was mailed to the experimenter upon completion.
Control Group Procedure
This group self administered all DGPSC at home and were naive that the
experimental groups were floating. All checklists were administered at the
prescri bed i nterva 1s used for the experimental groups and each completed
checklist was mailed to the experimenter.
Statistical Design
A three by six analysis of variance (ANOVA) of unequal group size with

212
repeated measures on one variable was used to analyze the data (Winer,
1962).

RESULTS
Number of Symptoms ANOVA
Significant differences P<.OOl were found on the repeated measure B
indicating that there are significant changes in number of PMS symptoms
during the cycle (Table I). A significant interaction P<.OOl AB was found
suggesting that the experimental groups varied in the number of symptoms
reported over treatments. There were no overall experimental group
differences suggest i ng that all three groups had a statist i ca lly equal
number of reported PMS symptoms. Individual comparisons were performed on
A and AB factors. All B comparisons were significant P<.OOl. AB
comparisons showed that: AB1, historical checklists were significantly
different; AB2, the control group, reported a significantly higher number of
symptoms than the float groups; AB3, the float groups reversed themselves
and had a significantly higher number of symptoms than the control group;
AB4 and 5, the two-float group reported a significantly lower number of

Tabl e 1
Number of Symptoms

Source of Variation S5 df M.S. F

Between Ss li
A 126.26 2 63.13
~s within groups 2,444.72 12 203.73

Within ~s 75
B 3,955.68 5 791.14 26.63***
AB 4,462.77 10 446.28 16.15***
Bx ~s within groups 1,657.58 60 27.63

*** P<.OOl
symptoms than the other groups; and AB6, all groups were statistically
different with the two-float group showing the fewest symptoms, the one-
float group reporting a moderate number of symptoms and the control group

213
reporting the most.
Severity of Symptoms ANOVA
There are strong para 11 e1s between the results of the number of
symptoms and severity of symptoms with some important differences. There
were significant B (treatment) effects P<.OOl, and significant AB (group by
treatment) effects P<.10 (Table 2). There were no significant A (group)
effects. However, when DGPSC 1 was deleted from the data (historical check
list) so that only treatment main effects were measured, the one-float group
reported significantly greater overall symptom severity than either of the
other groups F=16.19, P<.OO1. Individual comparisons showed significant
differences among all treatment intervals and some AB intervals: AB1 all
groups were different with the two-float group lowest and the control group
highest; AB2 float groups showed significantly lower severity; AB3 float

Table 2
Severity of Symptoms

Source of Variation SS df M.S. F

Between Ss II
A 3,489.98 2 1,744.99 1. 22
Ss within groups 17,148.58 12 1,429.05

Within Ss
B 51,196.94 5 10,239.29 2.33***
AB 4,459.96 10 446.00 1.84*
B x Ss within groups 14,513.54 60 241.89

* P< .10
*** P<.OOl

groups report significantly higher severity than the control group; AB4 the
two-float group reported significantly lower symptom severity than the
control group whil e the one-float group reported signifi cantly greater
severity than the other groups; AB5 and AB6 the two float group continued to
report lower symptom severity than the other groups.

214
 DISCUSSION
Hypothesis 1, predicted that PMS women who float would report
significantly fewer symptoms and symptom severity PMS than those women who
do not float. This was rejected. It was demonstrated that flotation
results in all subjects reporting a low number and severity of symptoms
immediately after the float. However, if the onset of PMS follows the
float, both the number and severity of symptoms greatly increase. It is as
though the non-PMS float enhances the onset of PMS symptoms and the subject
feels worse than if she didn't float. Further, the subject's sensitivity to
her symptoms is inflated. The control group subjects showed no such
inflation throughout most of the PMS cycle. This suggests that non floaters
appear to be able to regulate the severity of their symptoms most of the
time, despite the increase in number of symptoms. While this mechanism may
be disturbed in a non-PMS cycle, the one-float group slowly takes on the
characteristics of the control group.
The second hypothesis predicted that PMS women who float twice in the
same premenstrual cycle will report a greater reduction in number and
severity of symptoms than those that float once. This was partially
accepted. The second float was during the PMS cycle and resulted in: a)
immediate reduction of number and symptom severity to near non-PMS post
float levels, and b) greater stabilization of the number and severity of
symptoms than reported by the other groups. What is not clear is whether a
single float during the PMS cycle, timed at B4 would have the same effect as
a non PMS and a PMS float.
Two other surpri sing outcomes bear ment ion i ng. Not only do PMS
symptoms significantly fluctuate during their normal cycle, some PMS
symptoms are present during the non-PMS interval. These are not all stress
related. Symptom combinations such as low and high self esteem, panic and
high sexual energy can all co-exist in the same woman in a given interval.
The second interesting finding is that as the woman closely approaches
menstruation, which signals the end of most of her PMS symptoms, she reports
a significant increase in number and severity of symptoms. Whether this is
once again due to the onset of a biological change that disrupts control
mechanism or a paradoxical psychological anticipation of relief, the two-
float group handles this transformation better than the other group.
It is recommended that longitudinal studies be performed to determine
if additional floats are necessary to sustain symptom reduction from one PMS

215
cycl e to another, how often a person shoul d fl oat and when. Lastly,
hormonal flotation studies need to be done, to val idate the hormonal
hypothesis and to eliminate self report as the sole dependent variable.

REFERENCES
Bender, S.D. PMS, a positive program to gain control. The Body Press. New
York: NY: Division of H.P. Books, Inc., 1986.
Fine, T.H. & Turner, J.W., Jr. The effect of flotation REST on EMG
biofeedback and plasma cortisol. Second International Conference on
REST Proceedings. Toledo, OH: Iris Publ., 1987.
Flowers, C.E. & Abrams, M. A woman talks with her doctor. New York, NY:
William Morrow &Co. Inc., 1979.
Turner, J.W., Jr. &Fine, T.H. Hormonal changes associated with REST. First
Internat i onal Conference on REST and Self Regul at i on Proceedi ngs,
Toledo, OH: Iris Publ., 1985.
Turner, J.W., Jr., Fine, T.H., McGrady, A. & Higgins, J.T. Effects of
biobehaviorally assisted relation training on blood pressure and
hormone levels and their variation in normotensives and essential
hypertensives. Second International Conference on REST Proceedings,
Toledo, OH: Iris Publ., 1987.
Winer, B.F. Statistical principles in experimental design. New York, NY:
McGraw Hill, 1962.

216