Hypnotherapy

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Hypnotherapy

Definition

Hypnotherapy is the use of hypnosis as part of psychological or psychiatric treatment. Hypnotherapy may be used in short-term psychotherapy to help alleviate symptoms or as part of a long-term plan of psychotherapeutic intervention for personality change. Hypnotherapy may use any one or a combination of techniques administered by a trained professional who induces a hypnotic state in the patient and then presents therapeutic suggestions.

Purpose

Hypnosis, when used in conjunction with proven therapeutic procedures, can be a highly effective form of treatment for many mental, psychosomatic, and physical disorders. For example, through the use of regressive techniques, an adult patient may mentally travel back to a point in youth that was particularly troublesome, allowing the healing of old emotional wounds. Another patient can be led to understand that emotional pain has been converted to physical pain, and that the pain can be eliminated once the source has been addressed. Hypnotherapy can also be used to help persons with chronic pain to control the pain without use of medications. There are a number of techniques for correcting dysfunctional behaviors such as self-destructive habits, anxiety disorders , and even managing side effects of various medical treatments and procedures.

Hypnotherapy has been used to stop self-destructive and addictive habits like smoking. It has also been used to curb overeaters’ urge to eat, to stem the disruptive actions of tics, cure insomnia , stop bed-wetting, and minimize anxiety. Excessive stress can be generated from any number of sources and can be the springboard for anxiety. Some of the more prominent sources of anxiety and stress for which people seek hypnotherapy are: public speaking, test taking, and job stress. Hypnotherapy also works well for other anxiety disorders such as phobias and has proven to be an effective treatment for mild to moderate depression. In one study, hypnotherapy was used in conjunction with traditional cognitive therapy to assist persons who had severe aversion to needles. The treatment was necessary, because it was essential that each participant receive periodic medical injections. However, the participants would have become noncompliant without the adjunct intervention of hypnotherapy. In another case, involving care for terminally ill cancer patients, it was concluded that hypnotherapy was more effective at enhancing

MILTON ERICKSON (1901-1980)

Erickson rose to prominence during the 1940’s and 1950’s as a pioneer in the medical, dental, and psychotherapeutic uses of hypnosis. He was considered the world’s leading authority on the subject of hypnotherapy and was instrumental in establishing worldwide recognition and acceptance of hypnosis as a valid and effective therapeutic technique. He was frequently consulted by doctors and scientists, including anthropologist Margaret Mead, and during the 1950’s he collaborated with author Aldous Huxley on research on hypnosis and other states of consciousness.

Erickson practiced psychiatry in Massachusetts and Michigan before moving to Arizona in the late 1940’s. He was confined to a wheelchair following a bout with polio but continued to conduct teaching seminars from his Phoenix home. Erickson’s teaching style was similar to his psychotherapeutic method-distraction by verbal communication and other forms of indirection disrupted the conscious set, providing access to the subject’s unconscious mind. His orientation was eclectic, drawing on the widest range of schools of personality theory for the most useful elements of each. Erickson’s books on the subject of hypnotherapy are geared toward health professionals and are, according to a Psychology Today reviewer, “written in a style …as original and personal as [Erickson’s] technique.”

quality of life and relieving anxiety and depressive symptoms, when compared to others who received traditional care.

Precautions

Confusion can occur when one seeks a hypnotherapist as a result of the various titles, certifications, and licenses in the field. Many states do not regulate the title “hypnotist” or “hypnotherapist,” so care must be exercised when selecting someone to see. As a rule, it is best to consult a professional in the field of mental health or medicine, although alternative sources for hypnosis are available. Care must also be taken by the therapist to ensure adequate training and sufficient experience for rendering this specialized service. The therapist must be well-grounded in a psychotherapeutic approach before undertaking the use of hypnotherapy. Professionals should not attempt hypnotherapy with any disorder for which they would not use traditional therapeutic approaches. The patient seeking hypnotherapy is reminded that unskilled or amateur hypnotists can cause harm and should not be consulted for the purpose of implementing positive change in an individual’s life. The detrimental effects of being subjected to amateur or inadequately trained persons can be severe and long lasting.

Description

In order to understand hypnotherapy, it is necessary to understand the underlying concepts of hypnosis. A brief review of the history of hypnosis, description of hypnosis, and modern techniques follows.

History of hypnosis

It appears that hypnosis, under other names, has been used since the beginning of time. In fact, it has been insinuated that the earliest description of hypnosis may be portrayed in the Old Testament and in the Talmud. There is also evidence of hypnosis in ancient Egypt, some 3,000 years ago. However, the man credited with the development of what has become modern hypnosis is Friedrich Anton Mesmer. An Austrian physician, Friedrich Anton Mesmer one day watched a magician on a street in Paris demonstrate that he could have spectators do his bidding by touching them with magnets. Fascinated by the demonstration, Mesmer believed the magnets had power of their own and from this belief developed his theory of “animal magnetism.” He also believed that good health depended on having correct magnetic flow and that the direction of one’s magnetic flow could easily be reversed. He further believed that he could direct this magnetic flow into inanimate objects, which could then be used for the good health of others. The term “mesmerism” came to be applied to his mystical workings. He experienced much success in helping the people of Paris as well as visitors who came from other countries, upon hearing of his powers. Later he was completely discredited by a special commission of the French Academy appointed by the king, resulting in Mesmer’s departure from France. Two of the more famous members of the French Academy at the time were chairman of the commission Benjamin Franklin, American ambassador to France, and Dr. Guillotine, the inventor of the execution device.

Later, around 1840, a patient in the office of Scottish physician James Braid accidentally entered a state of trance while waiting for an eye examination. Braid, aware of the disfavor of mesmerism and animal magnetism coined the term “hypnosis,” and thus began the serious study of this altered state of awareness.

What is hypnosis?

It is far easier to describe what hypnosis is not than to describe what it is. For example, it is not one person controlling the mind of another. The patient is not unconscious and does not lose control of his or her faculties. People will not do things under hypnosis that they would be unwilling to do otherwise. The person being hypnotized is always in control. The hypnotized person decides how deep the trance will be, what suggestions will be accepted, and when to awaken. Therefore, a hypnotized person cannot be forever “lost” if the therapist should fall dead during an induction or while the patient is deep in trance.

Hypnosis is first and foremost a self-accepted journey away from the reality of the moment. Although the trance state is often referred to as if the patient is asleep, nothing could be further from the truth. The patient is fully awake at all times. The hypnotic subject is simply in a heightened, more receptive state of mind. This fact is proven with inductions called open-eye techniques, where the patient keeps his/her eyes open during the hypnotherapy. Full and deep trance is still achievable.

Trance is commonplace. People fall into traces many times without even being aware that it has happened. Examples of this include reaching the destination of a morning commute, but not recalling the passing of familiar landmarks; daydreaming while sitting in a college classroom; or that anxiety-free state achieved just before going to sleep. The difference between these altered states and clinically used hypnotherapy is that a professionally trained person is involved in helping the patient achieve the trance, which can be done in many ways.

A typical hypnotherapy session has the patient seated comfortably with their feet on the floor and palms on their lap. Of course, the patient could choose to lie down if that option is available and if that will meet the patient’s expectation of hypnosis. The therapist can even set the stage for a favorable outcome by asking questions like, “Would you prefer to undergo hypnosis in this chair or on the sofa?” Once patients makes the choice, they are in effect agreeing to undergo hypnosis. Depending on the approach used by the therapist, the next events can vary, but generally will involve some form of relaxing the patient. Suggestions will lead the patient to an increasingly relaxed state. The therapist may wish to confirm the depth of trance by performing tests with the patient. For example, the therapist may suggest that when the eyes close that they will become locked and cannot be opened. The therapist then checks for this by having patients try to open their eyes. Following a successful trial showing the patient’s inability to open the eyes, the therapist might then further relax them by using deepening techniques. Deepening techniques will vary for each patient and depend largely on whether the patient represents information through auditory, visual, or kinesthetic means. If the patient is more affected by auditory suggestions, the therapist would use comments such as “You hear the gentle patter of rain on the roof;” or, “The sound of the ocean waves allow you to relax more and more.” For the visual person, the therapist might use statements such as, “You see the beautiful placid lake, with trees bending slightly with the breeze.” Finally, with the kinesthetic person phrases like, “You feel the warm sun and gentle breeze on your skin,” could be used. It is important for the therapist to know if the patient has difficulty with the idea of floating or descending because these sensations are sometimes used to enhance the experience for the patient. However, if the patient has a fear of heights or develops a feeling of oppression with the thought of traveling downward and going deeper and deeper, suggestions implying the unwanted or feared phenomenon will not be taken and can thwart the attempt.

Modern techniques

In order for a hypnotherapist to convey positive suggestions for change, the patient must be in a receptive state. The state is called trance and the method of achieving a trance is through induction. Induction techniques are many and varied and involve the therapist offering suggestions that the patient follows. The formerly common “your eyes are getting heavy” suggestion may still exist, but other more reliable and acceptable (to the patient) forms of induction have come to the forefront. The artful hypnotherapist is always aware of the present condition of the patient and uses this information to lead him/her down the path of induction. In its lighter stages, trance can be noted by the relaxation of muscles. At this point, hands can levitate when given the suggestion, and paresthesia, a feeling of numbness, can be induced. In a medium trance, a patient can be led to experience partial or complete amnesia , or failure to recall events of the induction after the fact. A deep trance opens the patient to powerful auditory, visual, or kinesthetic experiences. The phenomenon of time distortion is experienced most profoundly at this level. Patients may believe they have been away briefly, and may react with disbelief when told they were away much longer. Although some work can be done in lighter states of trance, the best circumstance for implementing change is when the patient reaches a deep trance state. At this level, the patient is focused inwardly and is more receptive to positive suggestions for change. This is also the point at which the therapist can invoke posthypnotic suggestions, or instructions given to the patient so he/she will perform some act or experience some particular sensation following awakening from the trance. These suggestions, if accepted by the patient, can be formed to make foods or cigarettes taste bad, or to delay impulses, curb hunger, or eliminate pain, for example. However, it should be noted that posthypnotic suggestions given to a person which run counter to the person’s value system, or are not something they are likely to do under ordinary circumstances, will not be accepted and therefore not implemented.

Neuro-Linguistic Programming (NLP) is the name given to a series of models and techniques used to enhance the therapist’s ability to do hypnotherapy. NLP consists of a number of models, with a series of techniques based on those models. Sensory acuity and physiology is one model whose premise is that a person’s thought processes change their physiological state. People recognize such a physiological change when startled. The body receives a great dose of adrenaline , the heart beats faster, the scare may be verbalized by shouting, and the startled person may sweat. Sensory acuity (i.e., being attuned to changes occurring in another person) will strengthen communication to a person in ways over and above simple verbal cues, therefore making the therapist more effective. A second model of NLP deals with representational systems. The idea behind this model is that different people represent knowledge in different sensory styles. In other words, an individual’s language reveals that person’s mode of representation. There are three basic modes of representation: auditory, visual, and kinesthetic. The same information will be expressed differently by each type. For example, the auditory person might say, “That sounds good to me,” the visual person might offer, “I see it the same way,” and the kinesthetic person would say, “I’m comfortable with it too.”

Preparation

Before people subject themselves to hypnotherapy they are advised to learn as much about the process and about the chosen therapist as is necessary to feel comfortable. Rapport and trust are two key factors. Therapists should be open and willing to answer all questions regarding qualifications, expertise, and methods used. A well-qualified professional will not undertake the use of hypnosis without interviewing the patient to ascertain their level of understanding of the process. This is very important for two reasons. First, it allows the patient the opportunity to have questions answered and to develop some rapport with the therapist. Second, it is important for the therapist to know the patient’s expectations since meeting these expectations will enhance the likelihood of success.

Aftercare

Depending on the purpose of the hypnotherapy (i.e., smoking cessation , weight loss, improvement in public speaking, or addressing some deep emotional turmoil), follow-up may be advisable. When trying to eradicate unwanted habits, it is good practice to revisit the therapist, based upon a date prearranged between the therapist and the patient, to report progress and, if necessary, to obtain secondary hypnotherapy to reinforce progress made.

Risks

One obvious risk to patients is the insufficiently trained therapist. The inadequately trained therapist can cause harm and distort the normally pleasant experience of hypnotherapy. A second risk for patients is the unscrupulous practitioner who may be both inadequately trained and may have some hidden agenda. These rare individuals are capable of causing great harm to the patient and to the profession. As mentioned above, the patient should carefully scrutinize their chosen therapist before submitting themselves to this dynamic form of therapy.

Normal results

The result of hypnotherapy is overwhelmingly positive and effective. Countless success stories exist attesting to the benefits of this technique. Many people have stopped smoking, lost weight, managed pain, remembered forgotten information, stopped other addictions, or improved their health and well-being through its use.

Abnormal results

Abnormal results can occur in instances where amateurs, who know the fundamentals of hypnosis, entice friends to become their experimental subjects. Their lack of full understanding can lead to immediate consequences, which can linger for some time after the event. If, for example, the amateur plants the suggestion that the subject is being bitten by mosquitoes, the subject would naturally scratch where the bites were perceived. When awakened from the trance, if the amateur forgets to remove the suggestion, the subject will continue the behavior. Left unchecked, the behavior could land the subject in a physician’s office in an attempt to stop the itching and scratching cycle. If the physician is astute enough to question the genesis of the behavior and hypnosis is used to remove the suggestion, the subjects may experience long-term negative emotional distress and anger once they understand exactly what happened. The lack of full understanding, complete training, and supervised experience on the part of the amateur places the subject at risk.

Resources

BOOKS

Barabasz, Arreed, and John G. Watkins. Hypnotherapeutic Techniques, 2nd ed. New York: Brunner-Routledge, 2004.

Flemons, Douglas. Of One Mind: The Logic of Hypnosis, the Practice of Therapy. New York: W. W. Norton, 2002.

Hawkins, Peter J. Hypnosis and Stress: A Guide for Clinicians. New York: Wiley, 2006.

Lynn, Steven Jay, and Irving Kirsch. Essentials of Clinical Hypnosis: An Evidence-Based Approach. Washington, D.C.: American Psychological Association, 2006.

Spiegel, Herbert, and David Spiegel. Trance and Treatment: Clinical Uses of Hypnosis, 2nd ed. Washington, D.C.: American Psychiatric Publishing, 2004.

Yapko, M.D, ed. Hypnosis and Treating Depression. New York: Routledge, 2006.

Zarren, Jordan I., and Bruce N. Eimer. Brief Cognitive Hypnosis: Facilitating the Change of Dysfunctional Behavior. New York: Springer Publishing, 2002.

PERIODICALS

Bamford, Candy. “A Multifaceted Approach to the Treatment of Phantom Limb Pain Using Hypnosis.” Contemporary Hypnosis 23.3 (Sept. 2006): 115–26.

Bryant, Richard A., Michelle L. Moulds, Reginald D. V. Nixon, Julie Mastrodomenico, Kim Felmingham, and Sally Hopwood. “Hypnotherapy and Cognitive Behaviour Therapy of Acute Stress Disorder: A 3-Year Follow-Up.” Behaviour Research and Therapy 44.9 (Sept. 2006): 1331–35.

Gay, Marie-Claire. “Effectiveness of Hypnosis in Reducing Mild Essential Hypertension: A One-Year Follow-Up.” International Journal of Clinical and Experimental Hypnosis 55.1 (Jan. 2007): 67–83.

Kihslinger, Daun, and Marty Sapp. “Hypnosis and Diabetes: Applications for Children, Adolescents, and Adults.” Australian Journal of Clinical Hypnotherapy and Hypnosis 27.1 (Fall 2006): 19–27.

Kraft, Tom, and David Kraft. “The Place of Hypnosis in Psychiatry: Its Applications in Treating Anxiety Disorders and Sleep Disturbances.” Australian Journal of Clinical and Experimental Hypnosis 34.2 (Nov. 2006): 187–203.

Mende, Matthias. “The Special Effects of Hypnosis and Hypnotherapy: A Contribution to an Ecological Model of Therapeutic Change.” International Journal of Clinical and Experimental Hypnosis 54.2 (Apr. 2006): 167–85.

Uccheddu, Ornella Manca, and Antonello Viola. “Descriptive Survey of Therapeutic Alliance in Hypnotherapy.” European Journal of Clinical Hypnosis 7.1 (2006): 10–25.