History, types and myths of hypnotherapy
When the term ‘hypnosis’ is used, often people think straight to stage shows they’ve seen that includes audience members being on stage, uncontrollably clucking like a chicken. Fortunately though, hypnosis has had the spotlight shone on it in more recent times, and its shifting from an entertainment gimmick to a very powerful and well respected form of therapy in clinical practise. Although hypnosis is not a new thing, more people are turning to this type of therapy for a multitude of reasons including breaking free from addictions, overcoming anxiety and depression, shifting behaviours, breaking old habits, decreasing and eliminating pain in the body, plus much more. The difference between hypnosis and hypnotherapy is that hypnosis is defined as the trace state of mind, and hypnotherapy is the therapeutic modality in which hypnosis is used.
So what is hypnosis? As stated by Dr Michael Yapko, a clinical psychologist and author of many books on the topic of hypnotherapy, “hypnosis has no single agreed upon definition simply because something so abstract that also varies greatly with circumstances and suggested qualities of subjective experience.” (Extract from Essentials of Hypnosis, Yapko). A broad definition from the American Psychological Associations hypnosis division states ‘hypnosis is a procedure during which a health professional or researcher suggests that a client, patient, or subject experiences changes in sensations, perceptions, thoughts or behaviour.” Being under hypnosis is being in a trance-induced state of deep relaxation, with the therapist being able to access the clients subconscious in order to create positive change. By being in this natural altered state of conscious awareness, the client has an enhanced capacity to respond to suggestion that can facilitate therapeutic changes in behaviours, mood and perception.
It is difficult to tell when hypnosis was first developed or named, but we know it dates back in history in practically all ancient cultures in some form, including Persian, Indian, Greek, Roman, and Egyptian. Early accounts of the phenomena that is hypnosis can be found in the Bible, and evidence from the Egyptian Ebers Papyrus dating to 1550BC suggest a hypnotic-like healing practice described as laying hands on the patient and eye-fixation. In a tradition called ‘temple-sleep’, ailing patients would journey to the sleep temple in search of a cure, and engaged in a ritual including the ingestion of herbs and hours of rhythmic recitation of prayers, followed by entering a darkened chamber to ‘sleep’ and await a dream in the hope of revealing a cure. This practice eventually spread to Greece where physical and emotional healing took place due to treatments such as direct suggestion (hypnosis). During the sixteenth century in Europe, there was attempts made to provide scientific explanations, as until then it was accepted and explainable only in supernatural and metaphysical ways.
It wasn’t until around the 1700s that hypnotism became more a scientific-based practice, and away from mysticism. In 1841, James Braid, a medical doctor and respected surgeon from Scotland, observed his first mesmerist show performed by a Swiss Mesmerist, which intrigued him to study it further. At first a sceptic, he experimented with trance-state on friends and relatives by having the subject fix their eyes on a bright object such as his lancet case. At first, he researched trance as being physiological but concluded there was a number of contributing factors involved, such as expectation, imagination and fixed attention, and it was then that he termed it ‘hypnotism’, as he disliked the term ‘mesmerism’. Although criticized for his work by the British Medical Association, and other mesmerists, he continued to use hypnosis for anaesthesia during surgery and self-hypnosis for his arthritic pain. During his research, he concluded that hypnotic phenomena are the result of suggestion, and the power of hypnosis resides in each individual person.
Although Braid is often referred to as the father of modern hypnosis, due to his research around the science behind it, two Frenchmen working around the same time are considered the founders of modern psychotherapy. Ambroise-Auguste Liebeault (1823-1904) treated his patients at no charge if they accepted hypnotic treatment over conventional approaches. Although he published a book in 1889 which received little credit, his work came to the attend of a professor of medicine and famous neurologist, Hippolyte Bernheim (1840-1919), when Liebeault cured a chronic case of sciatica in one of Bernheim’s patients. With the intention of exposing Leibeault and his clinic as fraudulent, Berheim was genuinely amazed when he visited, and went on to become an authority on the subject of hypnosis, due to being known and well respected in the medical profession in Europe, his theories could not easily be dismissed. Berheim’s work had eventually established the therapeutic possibilities of hypnosis, and experiments began for treatment of an assortment of ailments with success claimed for problems such as depression, epilepsy, skin diseases, agoraphobia as well as incontinence, nail-biting and untruthfulness in children.
Around 1885 Sigmund Freud took an interest in studying therapeutic methods of hypnosis, and at first he was strongly opposed to the effectiveness of this type of therapy. With a deep level of scepticism at first, Freud and a fellow researcher, Josef Breuer, watched Liebeault and Bernheim perform ‘astonishing experiments’ with Freud later writing that he’d received “the profoundest impression of the possibility that there could be powerful mental processes which nevertheless remained hidden from the consciousness of men” (Freud, 1925/1953-1966, p17).
Hypnosis was revolutionised around 1930 by Milton Erickson, an American psychiatrist whose career spanned more than 50 years. After contracting polio at age 17 and becoming severely paralysed, he was told by doctors he would die, as he’d become entirely lame and unable to speak. During his bed-ridden days, Erickson became strongly aware of the significance of nonverbal communication such a body language and voice tone, and the way these expressions often directly contradicted the verbal ones. He also started having ‘body memories’ of muscular activity in his body, and found that by concentrating on these memories, he slowly but surely began to regain control to parts of his body, to the point of being able to talk and use his arms again, and eventually walking again with the assistance of a cane. This lead him to extensive research on suggestion and hypnosis initially as an undergraduate at the University of Wisconsin then later during medical training in Massachusetts and Michigan. By the late 1930’s, Dr Erickson had become renowned for his work in hypnosis, and in the 1950’s and 60’s he published many articles, travelled extensively and lectured both domestically and abroad. He died in 1980 at the age of 78, leaving behind a written legacy of more than 140 scholarly articles and five co-authored books on hypnosis. His technique, known as the Ericksonian technique, were once considered extreme are now incorporated into the mainstream of contemporary practice.
It was in 1955 that the British Medical Associated recognised hypnosis as a useful therapeutic tool, then a few years later in 1958 The American Medical Association approved hypnosis for medical use. 2 years following the AMA approval, The American Psychological Association endorsed hypnosis as a branch of psychology. Since then, it has continued to grow and become a popular therapeutic treatment for an array of ailments, illnesses and addictions.
Two types of hypnosis are clinical hypnosis and stage hypnosis. Although stage hypnosis is quite light-hearted and entertaining to the audience, it really serves no therapeutic benefit. It involves seeking willing participants to engage in fun but silly, sometimes humiliating behaviours to amuse the audience, but this in turn has lead to people undermining the credibility and therapeutic benefits of clinic hypnosis when its seen for just its entertainment value.
Clinical hypnosis on the other hand, is done in a safe and private setting, lead by a trained hypnotherapist and involves a harmless altered trance state of the client. The hypnotherapist is able to speak directly to the subconscious of the client to create positive change within the client’s life.
Most people can be hypnotised, but the depth people can reach in hypnosis varies between individuals. If a client is committed to wanting hypnosis to work for them, then it’s very likely they will enter a trance state with ease, under the right conditions. It doesn’t necessarily have to be a deep state of trance to have effective results. Generally speaking, anyone of average intelligence, who has a good imagination and is capable of concentrating can be hypnotised. Some people may feel they’re too strong minded or strong willed to be hypnotised, and as all hypnosis is in fact self-hypnosis, they’re correct. It’s up to them if they wish to enter a trance state or not. A study done at Stanford University School of Medicine found that some patients in a clinical trial cannot be hypnotised, and although it’s not linked to any specific personality trait, are still exploring why. Some people fear being in a trance state, or that they may be out of control and don’t allow themselves to relax enough to be hypnotised. People on certain prescription or recreational drugs, or with a severe mental disorder or psychiatric conditions may not be susceptible to being hypnotised.
There has been a lot of research done around hypnotisability and the relationship between dimensions of personality and responsiveness to hypnosis. Recently, a “Five Factor” model was studied, which included openness, conscientiousness, neuroticism, agreeableness and extraversion, however no meaningful relationship was found between these characteristics and hypnotic responsiveness. Other factors of hypnotisability that have been explored include gender, age, self-esteem, and mental status, however all research into these factors were unsuccessful in attempting to relate each single factor to an exact outcome, however some hypnosis experts argue quite convincingly that some factors (other than gender and age) are modifiable.
As more and more people hear about the incredible results that hypnotherapy can offer, the myths surrounding it are being debunked as it has been so successful for so many people.
Some of the most common myths are hypnosis are that someone can get stuck in a trance, that you’re just asleep when in a trance and that you can be hypnotised into doing something against your will. Luckily, these are just that; myths! It’s not possible to get stuck in a trance, and a person in a trance has the ability to come out of it at any stage, as it’s a natural occurring state and the client is likely to still be aware of their surroundings. During hypnosis, the brainwaves vacillate through the Alpha to Theta ranges and the client is able to open their eyes and become fully alert at any time. If a client does end up in a Delta or sleep state, it’s because they have naturally fallen asleep, not because they were forced asleep. The client, at all times, has full control over their thoughts, body, and actions. Hypnosis is purely a guide to reprogramming the subconscious, in which the client can choose to go along with, or not.
There are 3 main models of clinic hypnosis, each offering a similar approach however each have their strength and their weaknesses.
The original model of hypnosis is Traditional Hypnosis, also known as authoritarian hypnosis, is very directive and tells the client what to do by instructing the unconscious mind with the assumption it will follow willingly. In some cases this works, however studies have shown it rarely achieves more than a 30% success rate and also has a higher relapse rate. It generally only works on people who easily follow order or command.
The second model is scripted hypnosis. This very generic model however can be quite effective for some clients and can be great for very general issues the client is coming in with. The client is still put into a trance state and the therapist generally reads directly from a script, however if part of the script doesn’t resonate with the client during the session, the client may feel it’s not working for them.
The third model is Modern Ericksonian/Indirective hypnosis, which was developed by American Psychiatrist Milton Erickson, and as mentioned earlier, he really paved the way for a new style of hypnosis in a clinical setting. By skillfully using language patterns to create a relaxed and trance state, it involves talking, at times, quite candidly to clients using metaphors, antidotes and contradictions to influence behaviour. It doesn’t involve ‘pushing’ the client to be in a trance state as it doesn’t involve direct commands, which can make the client much more relaxed and open. The possible downside to this particular model is if a client went to see a therapist that used this technique but had only had a scripted session in the past which included a more direct entry into trance, it may seem that it’s not working at the time, as they go into a trance state in a different and more relaxed way.
Hypnotherapy is becoming very popular in the medical and dental fields. An example of this is more and more expectant mothers are turning to hypno-birthing to avoid to the use of pain relief drugs during labour, with many recorded cases of mothers feeling far less pain than a non-hypnotic and drug-free labour. Mothers attend classes in the weeks leading up to birth and focus on different techniques for self-hypnosis to encourage a calm, peaceful and natural birth. Another popular field for hypnosis is for clients with a phobia of going to the dentist, and even in place of requiring anaesthesia for treatment. It has been proven to be effective in relieving pain for not only procedures such as extractions and fillings, but also reduced bleeding and faster recovering afterwards.
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