Hypnotherapy

Graphics courtesy of Therapy tribeOpens in new window Hypnotherapy is a treatment modality utilizing specific techniques while the patient is in a state of hypnosis.

The term hypnosis comes from the Greek root hypnos (sleep). Self-hypnosis is a technique an individual can learn to reinforce desired emotional or behavioral changes.

Hypnosis is a therapeutic tool, not a therapy in itself; it is often used in conjunction with other types of therapy (e.g., cognitive-behavioral therapyOpens in new window).

Hypnotherapy has been used to treat a variety of conditions, including anxiety disorders (e.g., panic disordersOpens in new window, general phobiasOpens in new window, social phobiaOpens in new window, generalized anxiety disorderOpens in new window), posttraumatic stress disorder (PTSD)Opens in new window, obsessive-compulsive disorderOpens in new window, Tourette’s syndromeOpens in new window, depressionOpens in new window, eating disordersOpens in new window, attention-deficit hyperactivity disorderOpens in new window, chronic painOpens in new window, asthmaOpens in new window, and irritable bowel syndromeOpens in new window.

Hypnosis has been used as anesthesiaOpens in new window, in both surgical and dental procedures. German physician and astrologer Franz Anton MesmerOpens in new window (1734 – 1815) utilized a force he called animal magnetismOpens in new window to heal people. It was thought that all elements in the universe, including the human body, were interconnected through a magnetic fluid. Disease resulted from an imbalance of this fluid. The physician served as a conduit to channel animal magnetism from the universe into the patient’s body.

The process, known as mesmerismOpens in new window, was initially popular. In 1784, French King Lous XVIOpens in new window appointed commissioners from the Faculty of Medicine and the Royal Academy of Sciences to investigate animal magnetism. The commission concluded that any healing effects of mesmerism were due to imagination.

Scottish neurosurgeon James BraidOpens in new window (1795 – 1860) is considered the father of hypnotherapy. Braid was influenced by the demonstrations of Mesmer. The term hypnotism (short for neurohypnotism)—as used in the sense of inducing a trance—was coined by Braid in 1843.

French neurologist Jean-Martin CharcotOpens in new window (1825 – 1893) believed that hysteriaOpens in new window (a neurosis of the brain or emotional disorder) was a neurological disorder. He performed experiments using hypnosis to induce a state of hysteria in patients. Charcot described the somatic (physical) effects of hypnosis as occurring in successive stages and claimed that somatic manifestations could be transferred from one side of the body to the other utilizing magnets.

French physician Hippolyte BernheimOpens in new window (1840 – 1919) disagreed with Charcot’s explanations. Bernheim conceived of hypnosis as a normal state of mind in which suggestion plays an essential role (Wozniak, 1995). While Charcot focused on the physical and neurological aspects of hypnosis, Bernheim emphasized the power of suggestion.

Mesmer believed that a force within the hypnotist was responsible for the effects of hypnotism; however, Bernheim posited that the power of suggestion and expectation within both the patient and the hypnotist was responsible for hypnotic effects.

In the 1840s, hypnosis was used as surgical anesthesia in England and India. However, with the advent of chemical anesthesia, hypnosis fell out of favor with the medical establishment (James, 2008). As a psychiatric treatment, hypnosis was used in World Wars I and II to treat battle fatigue (now known as PTSD) so that soldiers could return to battle (Zahourek, 2002).

American psychiatrist Milton EricksonOpens in new window (1901 – 1980) practiced a unique form of hypnotherapy. Ericksonian hypnosisOpens in new window was based on three approaches he referred to as naturalistic, utilization, and indirect. His approach incorporated the waking trance.

The naturalistic approach accepts and appreciates the client where he is. The client may be as receptive to suggestion in a waking trance as in a deep trance state.

The indirect approach is less authoritarian or directives as traditional forms of hypnosis. Using a directive approach, a hypnotherapist misht suggest to a client “relax,” “stop smoking now,” or “remember a time when you felt in control.”

An indirect approach is framed positively and is less specific, allowing room for interpretation. For example, “you may find you are increasingly comfortable.” Ericksonian hypnotherapyOpens in new window influenced the development of many other therapeutic modalities and techniques, including family therapyOpens in new window and group therapyOpens in new window. Neurolinguistic programming (NLP)Opens in new window, which emerged in the 1970s, was an approach utilizing Erickson’s ideas. NLP, which was loosely based on Ericksonian hypnotherapy, has been used in employee training (Maron, 1979).

While similar in some ways to relaxationOpens in new window, imageryOpens in new window, and biofeedbackOpens in new window techniques, hypnosis differs in the timing and manner with which suggestions are introduced (Zahourek, 2002).

Myths about hypnosis include a fear of loss of control, doing or revealing embarrassing things under hypnosis, or being under the control of the hypnotist. These are common misperceptions that are perpetuated by stage hypnosis, which tends to be sensationalist and is performed for entertainment. Being in a hypnotic trance cannot cause someone to violate her values, morals, or ethical code or to reveal information against her will (Appel, 2002).

In hypnotherapy, the therapist learns about the client’s background, culture, learning style, strengths, goals, and desires. A diagnostic assessment is performed to determine which therapeutic techniques (including hypnosis) will be most effective. If the client is motivated to try hypnosis, the process is explained to the client.

During hypnotic induction, the therapist observes the client’s attention, focus, and breathing to assess the depth of the client’s trance state. The therapist may introduce direct or indirect suggestions that are in line with the client’s stated goals and values.

Suggestions generally reinforce the client’s internal resources, drawing on examples of past successes and positive interactions.

Posthypnotic suggestions form a bridge so that the client can transfer feelings and states experienced during the trance state into future behaviors, thoughts, and feelings. The therapists’s tone of voiceOpens in new window, rhythm of speechOpens in new window, and body languageOpens in new window can reinforce suggestions given during hypnosis (Zahourek, 2002).

Research, often based on small samples sizes or case studies, has made it difficult to establish the effectiveness of hypnotherapy for mental health issues. There has been more research establishing effectiveness of hypnosis for treatment of physical issues such as pain and irritable bowel syndrome. Children seem to respond more readily to hypnosis than adults (Huynh, Vandvik, & Diseth, 2008).

As hypnotherapy seems to demonstrate beneficial effects in a shorter period of time (fewer sessions) than traditional psychotherapy, incorporating hypnotherapy into a treatment plan can save time and money—both for the patient and in the context of managed care (or limited health care resources).

Many different types of professionals can be trained to utiize hypnotherapy, including psychotherapists, psychiatrists, clinical social workers, nurses, physicians, surgeons, and dentists.