By Mickey Skidmore, ACSW
Despite increasing acceptance of hypnosis in health care delivery, many people continue to hold significant myths and misconceptions about its use. As a Clinical Social Worker specializing in Ericksonian Approaches to Hypnosis & Psychotherapy, my work frequently entails dispelling the many untruths which persist regarding this powerful, yet highly misunderstood clinical tool. This month’s “perspective” then will attempt to educate the reader about hypnosis in general and some of its applications.
In general, hypnosis has become familiar to many through more than 200 years of use as entertainment, self-help, and therapy; however for many, clinical hypnosis remains remarkably elusive and even mysterious. While many profess to know what hypnosis is, few could say if asked. It may even be difficult to pin down the experts on how to define it, however, most would usually acknowledge three related features: absorption or selected attention, suggestibility, and dissociation.
The term “hypnosis” emerged in the 19th century and is derived from the Greek word for sleep. Hypnotized persons sometimes walk and talk as though asleep or show amnesia afterwards as though awakening from a dream. The resemblance to sleep however, is superficial, as EEG studies reveal that hypnotized persons are fully awake and alert (consistent with a heightened focused attention).
Individuals in a trance tend to focus their attention narrowly; they perceive certain things clearly and vividly while excluding other stimuli from awareness and ignoring context. As a result, they may suspend critical judgment and become highly suggestible. They often have blank faces, speak softly, and move slowly; they can express their feelings and thoughts easily and may lose awareness of time and place. They sometimes have a sense of tingling, numbness or lightness, and some may experience catalepsy (muscular rigidity and unresponsiveness). Some individuals in trance can even produce such vivid and unusual effects as: automatic writing, negative hallucinations (not seeing something that is obviously present), and age regression (which may include talking and acting like a much younger person, even a child).
A competent mental health or medical professional can induce a trance in many ways. While there is disagreement among the experts regarding hypnotic susceptibility, it is reasonable to assume some individuals are more susceptible that others. Hypnosis is not mind control. While there is still some controversy on this issue, research has generally found that it is not really possible to consistently manipulate another person’s behavior against their will. In other words, people can not ordinarily be hypnotized against their will or forced to do anything they find truly objectionable. While persons in a trance may feel as if their actions are involuntary, and their suggestibility may also make them highly responsive to guidance and particularly inclined to comply with instructions and requests from the therapist facilitating the trance, the facilitator of the trance (hopefully a therapist) has no unique powers, and need not be flamboyant or charismatic. The main concern of hypnosis is the potential for emotional exploitation or deception inherent in all forms of psychotherapy and all forms of human influence. Thus, we should be both mindful and vigilant against the dark potential and unethical use of hypnosis by the wrong people who are not trained ethically and professionally.
Given the recent controversies surrounding False-Memory Syndrome, is should also be clearly stated that hypnosis is not a truth serum either. Persons in a trance cannot be forced to make unwanted self-revelations, and they are quite capable of lying deliberately and/or unconsciously. Furthermore, memories brought to light via hypnotic age regression are not necessarily more accurate or reliable than any other memories.
The use of therapeutic hypnosis declined in the early 20th century, after developing an aura of charlatantry and seeming incompatibility with scientific medicine. The interest in hypnosis however began to revive about 50 years ago in large part due to the efforts of Milton Erickson, MD, who is considered a transition figure in the history of hypnosis and influential in founding The American Society of Clinical Hypnosis in 1957. In large part due to his contributions, hypnosis today is predominantly used as a way to assist clients take control of their own lives rather than depend on an authoritarian healer. Therapeutic trance is used to help establish a therapeutic alliance wherein there is a greater focus on each individual finding their own talents for problem solving and healing in their own unique manner. Ericksonian hypnotherapy generally emphasizes the client’s own creative process.
The following general overview is provided for those considering hypnotherapy:
Hypnosis is generally agreed to be an altered state of consciousness, utilizing an increased concentration and focus, during which memory and/or motor capacities can be altered in order to initiate more appropriate or desired behavior. The resultant state of hyper-awareness or hyper-acuity we define as “trance”.
We should recognize also, what hypnosis is NOT! It is not a state of unconsciousness, accompanied by loss of control and amnesia. Neither is it something that someone does “to” another person; all hypnosis is self-hypnosis. Hypnosis does not resemble a sleep state, and the EEG more closely resembles the waking than the sleeping EEG. An individual in a trance knows what is occurring, so s/he will not reveal secrets. One is not weak-minded or gullible to be able to enter trance; in fact, intelligence and ability to concentrate are essential. There is no concern about ending the trance, since the person is aware and functional and may choose the appropriate time to terminate the experience.
Some “mechanics” help to develop the hypnotic situation (as with therapy in general). These involve: the ability to concentrate; the ability to believe that something beneficial can result, and of course the motivation for change.
Principles which should be recognized and utilized include: the recognition that when one’s attention is concentrated on any one idea, it makes the ideas easier to realize (sometimes call “positive thinking”); emotion, when combined with imagination, is a powerful tool; direct and indirect suggestions can be effective; verbal & non-verbal communications should be the same.
Hypnosis is not a treatment in itself. It is used as an adjunct to treatment that is already with the field of competence of the practitioner. It must also be recognized that induction of the trance state accomplishes nothing by itself: utilization of the trance is what offers the opportunity for change.
In clinical situations, hypnosis becomes an extension of the existing relationship between the practitioner and client. Formalized, structured techniques for hypnosis are useful, although not essential, since they give both the practitioner and the client the opportunity to realize that something different is happening. This makes it simpler to establish and utilize the clinical trance state.
Once trance has been established, additional suggestions may be given to encourage a more profound trance, with the development of some of the more dramatic phenomena of hypnosis such as regression and increased physiological control. At this point the utilization of the trance begins, whit suggestions appropriate to the client’s needs.
Hypnosis then, is not a panacea, nor a substitute for good practice. But it can be a useful adjunct in all health professions by reducing stress and increasing comfort for everyone.
“Hypnosis”, The Harvard Mental Health Letter, April 1991, Vol. 7, No. 10, (p. 3-4).
Rossi, Ernest. Ericksonian Hypnotherapy, Stress and Healing, Interview with German publication Esotera: Neues Denken und Handlen, February 1995, (p. 18-25).
Thompson, Kaye. “The Languages of Trance: Communication To Enhance Hypnosis Utilization” a professional training workshop Co-Sponsered by: The NC Society of Clinical Hypnosis (NCSCH) and the American Society of Clinical Hypnosis (ASCH), May 1991, Raleigh, NC