Context, Rapport, Expectation, Absorption, and Motivation: Revisiting C.R.E.A.M. After Five Years
Looking back at a five factor model of hypnotic response five years later. First published on reddit.com/r/hypnosis
It's been five years (to the day) since I first put the C.R.E.A.M. acronym out into the world and I thought I would revisit it with a retrospective.
Jensen, M. P., et al. (2014). Mechanisms of hypnosis: Toward the development of a biopsychosocial model. Int J Clin Exp Hypn, 62(4), 463-489. https://doi.org/10.1080/00207144.2014.961875
C.R.E.A.M. was carved out of a biopsychosocial model of the factors that influence hypnotic response. It principally focused on the factors of the model that we as hypnotists could reasonably control and narrowed it down to five:
Context
Rapport
Expectation
Absorption
Motivation
Five years later, I still quite like the framework as a pedagogical tool. I certainly could have done worse; I have had a few doubts along those years though. The first was on the construct of "rapport" and how I saw it used. A lot of the rapport building techniques prioritized being in sync, being congruent and matching the subject (you will like me, because I am like you!). And I think this kind of rapport that is imitative in nature is a perfectly fine way to do things, but I think there's also a complementary kind of rapport. This is the kind we see in more dominant and authoritative styles. The hypnotist doesn't try to mirror and match as much as they present themselves as a person of authority (look at the diplomas on the wall, my tuxedo, my stage, my camera man, my whips and floggers - I am a professional, don't you know?) and gives space for the subject to conform. I think this is also a fine thing to do. Both have their drawbacks, which become obvious when taken to comical extremes - the first lacks a sense of identity, boundaries, and is whatever the subject wants them to be while the other inspires fear, resistance, and is a bit of an asshole. Most people, I thought then, fall somewhere in that spectrum in their approach to the relationship they build with the subject. It feels weird to call the latter style rapport, so I thought I would call it connection and collapse rapport and motivation into it for the sake of parsimony. And I rephrased the acronym to be Expectation, Premise, Immersion, and Connection.
Which was E.P.I.C.
Thinking about connection made more room for emotion than motivation as a word could inspire in me. And the more I did things and thought things through, the emotional salience, the meaningfulness of what we were doing seemed to matter more and more, both in a philosophical sense and in a practical matter of results. At some point, I came across Kev Sheldrake and Anthony Jacquin's old Head Hacking material and one of their hypotheses stood out to me. Engaging people emotionally increased hypnotic response, and it wasn't just me, I wasn't seeing things or at least, I wasn't the only one seeing things.
And the more I thought of it, depth of engagement seemed more fundamental to depth of trance or absorption or immersion (depth is such a delightfully flexible word, isn't it?). The way people engaged with their emotions and expectations seemed to be more predictive and philosophically parsimonious. And so I took the carving knife back to the acronym to simplify it even further (the primary criticism about C.R.E.A.M. I remember getting, was it was too jargony) and got to the 3Es:
E – Emotion (Motivation+Rapport)
E – Expectation (Context+Expectation)
E – Engagement (Absorption+Rapport)
I folded in Context into Expectation to help reinforce the role of demand characteristics and the expectations implied by and inherent to contexts. I foresee that kind of sensemaking becoming more central in the way we think about suggestions and how to pre-suade them as Cialdini might say. Rapport, I cleaved into half, one half that described the feelings of alliance and power dynamic went along with Motivation to make Emotion. The other half, was the part of that related to attunement and interpersonal synchrony and that mixed with absorption and immersion, I could make up the factor of Engagement.
I think (as of writing this) the 3Es are the three fundamental pillars of the way I do hypnosis, and perhaps, the way everyone else does it too. I still think of things in terms of C.R.E.A.M. from time to time, when I am debugging some sort of a response, but I am much more aware of the importance of engaging people's emotions and expectations. This is also of course, not the only way of looking at things, for example, my first post on C.R.E.A.M. got riffed on beautifully by Binaural Histolog (/u/randomhypnosisacct) in his newbie guide as :
and that too is worth a read.
There's more to be written on how to approach each factor practically and philosophically, but that's for another year.
--- WW
Explore Deeper, Understand Better, Engage Fully. More coming soon -