Orne, M.T. The why and how of a contribution to the literature: A brief communication. International Journal of Clinical and Experimental Hypnosis, 1981, 29, 1-4.

The International Journal of Clinical and Experimental Hypnosis 1981, Vol. XXIX, No. 1, 1-4



The Institute of Pennsylvania Hospital and University of Pennsylvania

Abstract: The purpose of writing a journal paper is discussed, emphasizing that it is intended to communicate a meaningful observation as simply and effectively as possible, that it is necessary to place the contribution in the context of the existing literature, if only to avoid reinventing the wheel. The function of a scientific journal as well as the personal benefits derived from contributing to the literature of the field are outlined.

All too often colleagues have a profoundly ambivalent attitude toward journal publication. On the one hand, it is considered a good thing to publish. We take pride in the quality of our Journal and the prestige it brings to the field as a whole and to our Society in particular. On the other hand, journal papers are often difficult to read and many colleagues are confused about what makes a paper publishable, erroneously believing that it is a matter of fancy statistics, large samples, or worse yet, pretentious writing. Instead of attempting to describe the specifics of a paper, it seems to me to make more sense to first consider what a paper is supposed to do.

Just as contributions to scientific meetings are designed to share one's experience with one's peers, so is the scientific paper intended to communicate something novel to others. If we assume a fool learns only by his own mistakes, whereas a wise man learns by the mistakes of others, one has gone far in specifying the goals of publication. In the final analysis, a paper should communicate in clear, simple, expository English some important, novel observation, study, or insight. It matters not whether it is based on historical research, on clinical observation, on questionnaire information, or on the outcome of a systematic research study. The important issue is that the observation be interesting, novel, and justified by the evidence that is presented.

Editor's Note- The succeeding two papers and the present one were part of a panel discussion entitled "Haw to share your ideas with your colleagues; Suggestions to assist publication." Because of repeated requests for the material covered in that panel discussion, it is presented here. The three presentations--by the I]CEH Editor. the Clinical Editor, and the Medical Editor--were seen as complementing each other and were conceived in the hope of encouraging a larger proportion of our readers to become active contributors to the literature of our field.

Manuscript submitted November 8, 1978; final revision received May 27, 1980.

1 An earlier version of this paper was presented in, How to share your ideas with your colleagues: Suggestions to assist publication. Panel discussion presented at the 30th annual meeting of the Society for Clinical and Experimental Hypnosis, Asheville, North Carolina, October 1978.

2 Reprint requests should be addressed to Martin T. Orne, M.D., Ph.D., Unit for Experimental Psychiatry, The Institute of Pennsylvania Hospital, 111 North 49th Street, Philadelphia, Pennsylvania 19139.



2 Brief Communications

Before going into detail of how one meets these criteria, let us consider the more basic question of the purpose for scientific journals- -indeed, the purpose for a scientific and clinical literature. Since each of us has a finite experience, the literature of a field is intended to represent the accumulated knowledge of the field. For example, having been impressed with how well a patient can concentrate under hypnosis, one might well feel that hypnosis ought to be used in education to facilitate learning. Discussing the matter with a few colleagues, such an idea may engender considerable interest. The purpose of the literature, however, is to obviate the need for reinventing the wheel more often than necessary. A brief review will show that there have been a number of efforts to use hypnosis to facilitate learning, and while the early studies reported very good results, they also were not well controlled, and as one examines more carefully controlled studies, it turns out that hypnosis is not a useful technique to assure more effective learning. To have been able to make this statement, however, involved a tremendous amount of work by a number of different investigators, whose work was reviewed by a number of different scientists, until it ultimately was published and became a part of the literature. In a true sense, then, the purpose of the literature is highly practical--it communicates the successes and the failures of those who went before us. It makes it less likely that we will go up blind alleys and makes it possible to utilize a limited amount of time in the most useful fashion.

If one has an idea that seems novel and wishes to explore it, given the opportunity, one might well want to try it out. If one is serious about it, however, the most efficient and effective way of learning more about the idea is to do a search of the literature to discover what others have done in relation to it. A few hours in the library will generally yield a number of papers in which other colleagues have addressed the issue that concerns us. Often this will be discouraging because we will find that what we had assumed to be novel had been elegantly discussed before the turn of the century. Such a result should not dim our enthusiasm because it is likely that the review of what has been done will allow us to advance knowledge further. The obvious fact which must be faced, however, is that it is impossible for anyone to know whether an idea is novel without having carefully reviewed what others have said before. Unfortunately, from the point of view of the field, it does not matter whether one gets an idea from reading about it or whether one laboriously reinvents it--in neither instance is it considered novel. On the other hand, if we do go to the trouble of reviewing what others have said and thought, it is likely that we will gain entirely new perspectives on our own ideas and ultimately make a contribution, which while perhaps somewhat smaller than we had originally thought, does entail something important and novel for the field as a whole, and that of course is the enterprise of developing either science or a clinical art.

I emphasize these points because one is asked all too often why it is necessary to have a review of the literature. The answer is simple: without knowing what has gone before, how can we put our own ideas into perspective? Is it not incredibly presumptuous to assume that my ideas are sufficiently important to have them become a part of the permanent record of the field without bothering to see what others before me have thought about the same matter?

Regardless of the nature of the paper, it is essential for the writer to have familiarized himself with what others have said, thought, and written about the topic. It is not necessary to exhaustively review everything that others have done, but it is essential to give a perspective, and to cite the most important con-


3 Brief Communication

tributions. If, indeed, there is nothing in the literature that has dealt with the precise problem, that can be stated--hopefully only after a careful literature search--but then one would generally want to know the closest others have come to dealing with the problem at hand. Just as it is not possible for a clinician to make a diagnosis without having seen a large number of different kinds of patients, it is not possible to contribute to the field without having read the relevant literature.

It takes only one or two experiences in tracing through some particular question and reviewing what has been said about it to learn that contributions to the literature vary widely. Some are carefully reasoned, well documented papers which are not only easy to follow but where the conclusions flow from the observations that are reported. Other papers not only make implausible statements but also undocumented assertions. Clearly, to get a proper perspective does not merely involve counting how many people agree with a particular point of view but it also requires examining the evidence upon which these views are based.

In our field in particular, we have all heard speakers present essentially self- serving ego trips rather than meaningful observations. Not only are such so-called contributions annoying, but at times they actually confuse the unsuspecting listener. Journals will vary greatly in their willingness to accept manuscripts of this type. In every field of science there are a few journals which take the position "let a thousand flowers bloom" and will publish a very high proportion of manuscripts submitted without requiring any clarification or changes. To publish in such journals requires the author only to go to the trouble of putting pen to paper. Such journals do not feel constrained to be concerned about technical deficiencies in the manuscripts, the accuracy of the literature cited, or, for that matter, whether any literature is cited. The now defunct British Journal of Medical Hypnosis had a policy much along this line. Occasionally a worthwhile manuscript will nonetheless appear in such a journal, and also not infrequently there are some interesting ideas which find their way into print, particularly since there is little effort required of the author in order to publish. The disadvantage, on the other hand, is that the reader must seek to find the little wheat among much chaff and, most importantly, if the technical issues involved are outside of the reader's competence, it is very likely that there will be gross errors which the reader is not in a position to recognize and he may erroneously assume that because the paper is published its information is likely to be correct.

At the other end of the continuum, there are the so-called refereed journals. There a paper that is submitted is reviewed by independent reviewers who are recognized authorities in the relevant disciplines. The purpose of these journals is quite different. They are intended to be journals of record; that is, authoritative sources of information in their field. Typically there will be a considerable publication lag because it takes time to review the papers submitted to such journals, and it is the rule rather than the exception that the reviewers will insist upon some matters being clarified, perhaps that more data be provided, and that the various technical details are carefully attended to. Such journals typically check references and strive to make certain that if statistical tests have been carried out that they are appropriate tests and that the conclusions follow from the tests. This is particularly important if a proportion of the readership lacks sophistication in areas such as statistics.

The International Journal of Clinical and Experimental Hypnosis is, of course, this kind of journal. This means that if someone submits a paper on the treatment of dermatological lesions with hypnosis, the manuscript will be


4 Brief Communications

reviewed not only by someone who knows something about clinical applications of hypnosis but also by at least one reviewer who is an authority in dermatology. Since we are an evolving field, the International Journal has been able to serve an important role in providing feedback to authors where two, or possibly three, highly competent colleagues will have gone over the manuscript in depth and would be in a position to indicate what needs to be done to have the paper make an optimal impact.

It does require effort to write a paper, but for a paper to appear in a journal such as ours means that it has reasonably met basic technical requirements, that it has tried to put the problem in perspective with what others have done before, and that it has dealt fairly with the observations, drawing conclusions which can be justified. What does this require of the author? The author should be clear as to the problem he wishes to write about, he should have reviewed the work of others, and then presented his observations--whether they be clinical, historical, experimental, or naturalistic does not matter. What matters is that these observations be presented clearly and lucidly. If one is dealing with data from groups, a simple statistical analysis may well be needed. While some technical help may be required, it is rarely this issue that presents a problem. More often the need is for clarity, for thinking through a study.

Perhaps the most important thing to recognize about writing any paper is that some aspects are tedious and involve hard work. All too often colleagues assume that one can write a good manuscript in one or two evenings. There are few people indeed capable of writing this quickly. Usually those of us who seem to write most fluently do so most painfully. For example, it is the rule rather than the exception for my own work to go through ten or twelve revisions. In the case of experimental studies which are carefully designed and executed, I have learned that roughly one-third of the total time is ultimately taken up in the writing. Thus, all of the planning, running, and data analysis involve only two-thirds of the work. The rest is the necessary thinking through and polishing which ultimately communicates to one's colleagues a close approximation of what we think we have learned.

While this is difficult, it is also satisfying. I would urge you to write, not because it is a good thing, not because it is nice to see your name in print, not even because it is relevant to full membership in our Society, but rather because you will get to really know a field only if you become sufficiently involved to contribute to it. Most of us will choose to read in depth what others before us have done only as we begin to write about our own work, and finally we will get to truly understand our own ideas only as we seek to communicate them to others. Writing ultimately becomes important, not only because of what it does for others but also for what it does for oneself, and that, in the final analysis, is the only real justification for going through the tedium and the sheer frustration that are inevitably involved in many stages of the enterprise.

The preceding paper is a reproduction of the following article (Orne, M.T. The why and how of a contribution to the literature: A brief communication. International Journal of Clinical and Experimental Hypnosis, 1981, 29, 1-4.). It is reproduced here with the kind permission of the Editor-in-Chief of The International Journal of Clinical and Experimental Hypnosis.