DCH Thesis (2006)

Hypnosis Study

On this page is my final thesis for the Doctor of Clinical Hypnotherapy (DCH), written in 2006. The American Institute of Hypnotherapy (AIH) Doctorate was approved by the California Bureau for private postsecondary & vocational education. The degree is ‘approved’ and not ‘accredited’ and is (as of the time of writing) the 2nd most in depth qualification in Hypnotherapy. The most in depth is the MSc in Clinical Hypnosis (The London College of Clinical Hypnosis/University of West London). The DCH from the AIH which I hold is not to be confused with other Doctor of Clinical Hypnotherapy qualifications offered on the internet.

There are practitioners in the UK, Australia, worldwide (especially America) that use the title ‘Dr.’ with this qualification in Hypnotherapy. I do not use this title.

I welcome any questions or comments re the content of this Hypnotherapy study.

Hypnosis in the Medical Field – a Historical Study

By

Count Kristian von Sponneck

– June 2006 –


INTRODUCTION

THE MYTHS AND REALITY OF HYPNOSIS

The word hypnosis is derived from the Greek word Hypnos, which means ‘sleep’. This word derivation is essential to understanding both the history of hypnosis and the controversies surrounding its current use within medicine. While hypnotized, patients are not ‘asleep’ in any conventional sense of the word, neither are they fully ‘awake’. They exist in a trance-like state that has enjoyed a somewhat occult reputation, but which is in fact no different in nature from the various other altered states of consciousness that the average human being goes through in a single day.

Thus when watching television, sitting in a car waiting for a red light to change or day-dreaming while sitting in the sun, a person will not be fully conscious. Consciousness, as hypnosis shows, is, in fact, a continuum, a line on which the human being’s state of awareness may be placed at any one time, rather than a simple dualism between “conscious” and “unconscious” (Bootizin, 1992). A person within a trance is “unusually responsive to an idea or image, but this does not mean that a hypnotist can control his or her mind or free will” (Hart, 2002).

The American and British Medical Associations recognized hypnotherapy as legitimate techniques in 1958 and in 1995 the National Institutes for Health (USA) recommended hypnosis as a treatment for chronic pain. These current uses for hypnotherapy will be discussed in the last part of this study, but in order to understand contemporary uses, it is important to place them in context.

Thus, Chapter 1 deals with the historical context of hypnosis, particularly the work of Mesmer and other 18th/19th century pioneers of the technique.

Chapter 2 explores Freud’s influence upon hypnosis, detailing his practice of it and subsequent abandonment within psychoanalysis. This discussion leads into a consideration of some of the more bizarre, but vital, explorations of hypnosis by various governments seeking to make a reality of popularized, movie notion of ‘mind control’ during the first 60 years of the twentieth century.

Chapter 3 describes and analyses the various techniques by which hypnotism may be carried out, while Chapter 4 discusses the modern use of hypnosis, with a delving into the controversy surrounding memory regression/recovered memories as well as less exotic, but more effective uses of hypnosis within modern medicine, particularly pain management.

Chapter 5, the Conclusion explores what has been discovered during the study and will suggest possible routes towards more effective use of hypnosis in the future.

CHAPTER 1
HYPNOSIS: THE HISTORICAL CONTEXT

It is clear that many of the popular notions of hypnosis are in fact untrue, and have given the technique a bad name which it does not deserve. Hypnosis appears to have been used in one form or another for much of recorded history and indeed, as the sleep temples in Ancient Greece and Egypt testify, even before that time (Waxman, 1984). Some have suggested that there may be mention of hypnosis in the Bible (Genesis 2:21, Acts 10:10) but within the context of hypnotism in general, and the hypnotherapy that is performed within medicine today, the practice starts with Mesmer(ism).

Franz Anton Mesmer was so influential within hypnotism, catching the public’s imagination so intensely, that his name became a word. To mesmerize is to hypnotize, both in a literal and metaphoric sense. People use the word ‘mesmerizing’ to describe experiences that have no relation to formal hypnosis. Any experience which seems to capture the attention and/or imagination of a person is commonly called mesmerizing.

Mesmer was born in Austria in 1734. He studied at various Jesuit (religious order) schools before entering the University of Vienna in 1759 to study medicine. In 1766 his doctoral dissertation, ‘De Planetarum influxu in corpus humanum’, was published; it dealt with the supposed influence that the planets and the moon have on human affairs. This was a serious study within what was called at the time ‘medical astrology’. The fact that Mesmer wrote his doctorate within a field that has since been shown to be based upon unfounded superstition rather than scientific fact has been unfortunately extended to cast aspersions on his work in other fields of medicine such as hypnosis. Added to this is the allegation that he plagiarized a large part of his dissertation from a book published by Richard Mead more than a hundred years before Mesmer himself was born(Darnton, 1968).

Mesmer became a centre of attention in Vienna after he married a wealthy widow, set up a medical practice and started to patronize the arts and sciences. His activities ranged from giving the first performance of the twelve year-old Mozart’s opera ‘Bastien and Bastienne’ to investigations into what he called the “artificial tides” that could be induced within people (Mesmer, 1814). He started to focus on the link between the physical and the mental within the human body when he gave a preparation of iron to a patient, followed by the attachment of magnets to various parts of her body.

Mesmer claimed that this produced the artificial tide’ within the patient: she reported feeling streams of a mysterious fluid running through her body, and her symptoms were supposedly relieved for several hours. Mesmer did not believe that the magnets had somehow cured her, but rather that they had contributed to what he termed the naturally occurring animal magnetism that occurred within all human beings. He stopped his research into magnets when it became clear that no rational evidence could be discovered for how they could cure disease.

Mesmer was thus using the scientific method within his studies, countering the allegation that he was a charlatan. In 1775 Mesmer gave his opinion to the Munich Academy of Sciences on the validity (or otherwise) of the ‘exorcisms’ carried out by Joseph Gassner, a priest and healer. Ironically, Mesmer argued that while Gassner was sincere, the exorcisms were in fact a result of his high concentration of animal magnetism rather than any religious or supernatural powers. Gassner was humiliated in the exchange and his career ended. The irony in this situation is that Mesmer was in fact using the ‘science’ of animal magnetism to disprove the ‘superstition’ of exorcism when in fact they were equally specious.

Mesmer moved from Vienna to Paris in 1777, after a farcical attempt to cure an eighteen year-old girl’s blindness with animal magnetism. It was in Paris that Mesmer developed what can now be seen as the beginnings of both hypnotism and hypnotherapy. In a 1779 book, Mesmer wrote what have now become his famous ‘27 Propositions’ regarding medical theory (Mesmer, 1779). Central to these propositions was Mesmer’s argument that health was the free flow of the process of life through thousands of channels. Illness was caused by obstacles to one or more of these flows. The more obstacles, the more ill the patient until the whole system broke down because of multiple blockages: death.

Mesmer argued that contact with someone who possessed a high degree of ‘animal magnetism’ (i.e. himself) could remove the obstacles and start a healthy flow again. Mesmer aimed to help what nature could do through accelerating the crisis of an illness without danger. Thus ‘curing’ an insane person would involve provoking an extreme fit of madness.

The ‘treatment’ that Mesmer instituted involved sitting in front of a patient with his knees touching their knees. He would press the patient’s thumbs in his hands and look fixedly into the patient’s eyes. He then made a number of ‘passes’, which involved moving his hands from the patient’s shoulders down their arms, and sometimes would press his fingers into the hypochondriac region below the diaphragm. Often this whole process would continue for a number of hours. The whole treatment process would be watched by patients waiting their turn or by other interested parties such as doctors (Danton, 1968).

Many patients claimed to feel strange sensations or had convulsions that were regarded as the ‘crises’ of their conditions, thus bringing about an acceleration of the obstacles, their removal, and thus the patient’s cure. It must be stated that any ‘strange sensations’ may have been more the result of sitting in the same position for hours having a man staring into their eyes and pressing his hands into their body than of any potential cure. It can also be seen that an element of ‘performance’ was developing within hypnosis that would, in the twentieth century, reduce it to the level of showmen and charlatans in many case (stage hypnosis).

Mesmer’s treatments became very popular, and he soon had more patients than he could individually treat. In order to meet demand, Mesmer established a collective treatment that he called a ‘baquet’. The ‘baquet’ was described as follows by a visiting English physician:

“In the middle of the room is placed a vessel of about a foot and a half high which is called here a ‘baquet”’. It is so large that twenty people can easily sit round it; near the edge of the lid which covers it, there are holes pierced corresponding to the number of persons who are to surround it; into these holes are introduced iron rods, bent at right angles outwards, and of different heights, so as to answer to the part of the body to which they are to be applied. Besides these rods, there is a rope which communicates between the baquet and one of the patients, and from him is carried to another, and so on the whole round. The most sensible effects are produced on the approach of Mesmer, who is said to convey the fluid by certain motions of his hands or eyes, without touching the person. I have talked with several who have witnessed these effects, who have convulsions occasioned and removed by a movement of the hands…”
(Danton 1968)

Mesmer’s work soon became a victim of its own success, as it attracted the attention of the French King, Louis XVI. He appointed a commission to investigate whether Mesmer had in fact discovered a new kind of fluid within the body. This Commission consisted of several distinguished doctors, the chemist Lavoisier and then American ambassador to France, Benjamin Franklin.

After witnessing the ‘baquet’ in person and investigating all of Mesmer’s claims, the commission concluded that there was no evidence of any new fluid, or even that any cure was occurring. Mesmer soon left Paris and spent the rest of his life in obscurity. The fact that he had perhaps accidentally discovered a new type of technique (what would eventually become known as hypnotism) was alluded to by Franklin within the report. He noted the very tangible effects that the stillness of the body and staring into the eyes seemed to have on the patient. The relief that the patients seemed to feel was undeniable, although Franklin could not identify its exact origin. Chertok (1981) has perhaps best described what was actually occurring.

“There was no talking during the treatment, so there were no direct verbal injunctions. However, these were implicit in the therapist’s attitude. The passes, the music, the setting; the atmosphere round the tub (baquet), were factors which were indirectly to increase the effect of suggestion, but also contributed in producing a kind of sensory deprivation which induced an alteration of the state of consciousness, gradually ending in the ‘crisis’. Mesmer’s patients did not all have attacks. Some showed, rather, a sort of lethargy, while still being able to walk, talk, etc. In other words, they were hypnotized”.
(Chertok, 1981) (My emphasis)

One of Mesmer’s disciples, Marquis de Puysegeur, studied closely what happened to people during what he called ‘magnetic somnambulism’, more commonly known today as ‘deep hypnosis’. He developed the following principles, all of which would be familiar to any practitioner who uses hypnotherapy today:

• Convulsions were not necessary; words were sufficient
• The magnetist had to listen to the person seeking relief
• Often the client had to re-experience painful feelings
• The sessions had to be of regular frequency and duration
• The magnetist had to be neutral and patient
• Symptoms might return temporarily.

As Chertok puts it, a patient under de Puysegur’s care would experience the following:

“While he was in deep magnetic sleep, (the client)
was asked to establish his own diagnosis . . . and the form of his treatment . . . he was also asked to predict the development of his treatment: when he would recover, when the attacks would occur, etc. Thus was produced a kind of psychodrama in which the patient caused the magnetist to play a part in a series of successive catharses.”
(Chertok, 1981, p.121)

Thus the beginnings of hypnotherapy can be glimpsed, without the theatrics and supposed magnetism of Mesmer’s original vision. Indeed, some of the principles that de Puysegur discovered are applied within the wider field of psychotherapy and psychology in general. Thus, the fact that a therapist has ‘to listen to the person seeking relief’ while being ‘neutral and patient’ within sessions of ‘regular frequency and duration’ could be description of a wide variety of therapies, both physical and mental.

CHAPTER 2
FREUD, PSYCHOANALYSIS
, AND HYPNOSIS: THE HISTORY OF HYPNOSIS 1880-1958

The next major development within the history of hypnotherapy within medicine, as in psychology in general, was the contribution of Sigmund Freud, who championed and then abandoned the cause of hypnosis as a treatment. Freud became disenchanted with hypnotherapy, but the methods of psychoanalysis that he developed are actually closely linked, both historically and methodologically, to hypnosis. Thus the theories of hypnosis and its practice essentially anticipated much of what was to occur in psychoanalysis. Hypnosis was used by Freud and the psychoanalytical technique actually produces, whether by design or accident, a state of hypnosis when performed comprehensively and skillfully.

Freud rejected the use of hypnotism while continuing with techniques that often employed it:

Freud sought to escape the hypnotism label for his work. He began to use free association with no apparent awareness of that technique’s basic similarity, with its couch, relaxation, closed eyes, occasional touch on the client’s forehead, to the formal hypnosis he had renounced.
(hypnosis, 2006)

The technique might be in place, but the link to the subconscious that it seemed to enable went against what was Freud’s basic view of the subconscious: a violent place of primeval and often incestuous urges that needed to be understood in order to be conquered.

Modern psychology tends to view the subconscious as a neutral area where memories and emotions are stored. But to Freud, the very process of hypnosis was something akin to uncontrolled (and uncontrollable) experience of being in love:

“From being in love to hypnosis is evidently only a short step . . . There is the same humble subjection, the same compliance, the same absence of criticism toward the hypnotist just as toward the love object”.
(Freud, 1958)

While the ‘love object’ was not necessarily unhealthy in Freud’s estimation, it clearly did not belong in the relationship between the analyst and the patient. It was Freud’s view, passed through the simplistic lens of mass entertainment, which led to the countless movie portrayals of hypnotists as mad geniuses who held terrifying powers that allowed them to control people against their will. Whatever the reality, it is this myth that holds the public’s imagination vis-à-vis hypnotists, hypnotism and hypnotherapy.

Freud’s influence within psychoanalysis, as within society in general, was of course profound and it soon came to be the case that his views reflected those that are found today among many therapists. Thus, as Rossi (1988) suggests, “many traditional psychoanalysts respond with indignation when it is suggested that their patients are in continually varying states of trance as they free associate on the couch” (Rossi, 1988, p.49) The problem that both Freud and current psychoanalysts have with hypnosis stems from a basic misunderstanding of what the technique actually involves. Thus, ‘Freud failed to realize that the client, not the therapist, is in control of his or her use and ‘depth’ of hypnosis.’

The popular view of the hypnotized patient as being somehow a zombie that can be controlled at will, while well known to be false by both Freud and his later disciples, still influences their overall view of the technique. A degree of control is presupposed by them, in which the patient relinquishes a certain amount of autonomy in favour of the therapist. The nineteenth century ‘mesmerist’ (stage hypnotist) of the travelling circus and music hall still casts a long shadow over the supposedly rational and clinical atmospheres of modern psychologist’s offices.

A dispassionate view of what occurs in many psychological therapies, and indeed, within life in general, is that hypnotic states are often fallen into. Thus, it might be argued that any time a person is remembering a sequence of events, and is ‘taken out’ of ordinary consciousness they are at least partially in a state of hypnosis. There are different levels of hypnotic states, some of which require the instigation of a hypnotist, but many of which naturally occur.

A little before the time that Freud was experimenting with and then supposedly rejecting the techniques of hypnotism, it was used, at least for a short while, as a form of anaesthesia. Hypnotism could be used as a form of anaesthesia but when Queen Victoria gave birth to one of the children using the new chloroform, the practice became popular throughout the world and hypnotism as a form of anaesthesia fell out of fashion.

The conflict between psychoanalysis and hypnotism carried on during the twentieth century. In 1943, at the height of World War II, a doctor sounded the public alarm regarding what he claimed could be the massively damaging uses of the technique by enemy forces. Doctor Estabrooks suggested the hypothesis that an enemy country could plant a foreign agent as a doctor in an American hospital, and that he could place thousands of people under his power over a period of time. The doctor could hypnotize key officers and program them to follow his suggestions. This ‘masked manoeuvre’ could enable the lowest officer to take over the entire reins of the whole U.S. Army. Estabrooks continued with a bizarre scenario that was apparently taken seriously by many within the US government:

“Let us suppose that in a certain city there lives a
group of a given foreign extraction. They are loyal
Americans, but still have sentimental ties to the old
country. A neighbourhood doctor, working secretly for
a foreign power, hypnotises those of his patients
who have ties favourable to his plans. Having done
this he would, of course, remove from them all
knowledge of their ever having been hypnotized”.
(Estabrooks, 1943)

Estabrooks then suggested that these citizens, while appearing on the outside (and believing themselves to be) loyal and safe citizens, could actually be used to carry out the most terrible attacks against America.

Other medical professionals pointed out to Estabrooks that it was an accepted principle of genuine hypnosis (as opposed to movie myths and stage hypnotists) that no subject could be made to do what they would not normally do, or even more, to do an action that was against their own will. Estabrooks replied that “my experiments have shown this assumption to be poppycock . . . it depends not so much on the attitude of the subject as on that of the operator himself . . . in wartime the motivation for murder and under hypnosis doesn’t need to be very strong.” (Estabrooks, 1944) Estabrooks even stated, in a famous claim that he repeated numerous times:

“I can hypnotize a man – without his knowledge or
consent – into committing treason against the
United States”.

Easterbrook’s claim led to about twenty five years of serious research by the US government into the possible uses of hypnotism. In some of the most famous experiments, Dr. Bernard Gindes used several soldiers to test some of Estabrooks’ more outrageous claims. These centred around the complete lack of memory that a person might have that they ever had been hypnotized, which would be associated with apparently unbelievable feats of memory associated with recall. Grindes described his experiments as follows:

“A soldier with only grade school education was able to memorize an entire page of Shakespeare’s Hamlet after listening to the passages seven times. Upon awakening, he could not recall any of the lines, and even more startling was the fact that he had no remembrance of the hypnotic experience. A week later he was hypnotized again. In this state, he was able to repeat the entire page without a single error. In another experiment to test the validity of increased memory retention, five soldiers were hypnotized en masse and given a jumbled ‘code’ consisting of twenty-five words without phonetic consistency.

They were allowed sixty seconds to commit the list to memory. In the waking state, each man was asked to repeat the code; none of them could. One man hazily remembered having had some association with a code, but could not remember more than that. The other four soldiers were allowed to study the code consciously for another sixty seconds, but all denied previous acquaintance with it. During rehypnotization, they were individually able to recall the exact content of the coded message.

(Grindes, 1956)

These experiments were continued by other doctors, who moved into the realms of what today would be regarded as highly unethical or even criminal conduct on the part of the researchers. In one series of experiments, Dr. JD Watkins induced criminal behaviour in deeply hypnotized subjects through inducing suggestions, or what he called “hallucinations” that did not counter their normal moral standards. Thus one young soldier was deeply hypnotized and then told that the man sitting opposite him (an American officer he had seen before being hypnotized) was in fact a Japanese soldier, and that he needed to strangle him in order to stop being killed himself. The soldier immediately lunged across the table and tried to strange the officer, who was actually injured because the large assistants who had been placed in the room in case of emergency, found great difficulty in removing the soldier’s hands from what he though was his Japanese enemy.

It is interesting to note that the soldier exhibited a similar single-mindedness to that shown by patients/subject who are given memory tasks: utter concentration on the task at hand can bring positive or negative results that are difficult to stop once in motion. Watkins took his experiment one step further by taking a pair of very close friends and hypnotizing one, giving him the same suggestion regarding the Japanese soldier. The subject not only tried to strangle his friend, but also took out a concealed knife and tried to stab him. As Watkins put it, “only the quick action of one of the assistants, who was a judo expert, prevented a potentially fatal stabbing.”

The apparent contradiction between these experiments and the generally accepted principle that a subject cannot be induced into behaviour under hypnotism that he would not otherwise do is in fact satisfied on closer examination. Both the subjects in the Watkins experiments had been hypnotized into a state of suggestibility in which they genuinely believed there was a Japanese soldier sitting across the table from them. Once within this state their actions made sense: they were not ‘criminal’ or unethical in nature, but rather justifiable self-defence. It is the belief that the person opposite is someone other than who he really is which is the contentious issue here, not the act of violence perpetrated by the belief.

As the Cold War cast its shadow across many areas of American life, the Armed Forces continued with their interest in hypnotism, commissioning a report from the Rand Corporation in 1958. The author of this report, Seymour Fisher, suggested that research into hypnotism should be continued if for no other reason than the “enemy” (now Russia rather than Japan) was undoubtedly undertaking research itself. Forewarned is the best manner of being forearmed according to the report:

“To both the lay person and the behaviour scientist hypnosis has long been regarded as a potentially powerful instrument for controlling human behaviour. Undoubtedly, the intelligence divisions of many countries have given serious thought to this potential and have done classified research in various areas of hypnosis … it is conceivable … that these techniques could have been used and covered up so successfully that they might be impossible to recognize…”
(Fisher, 1958)

Fisher, in apparent seriousness, suggested ways in which America could advance in the mind-control field: developing drugs that would enable the easier induction of hypnotic states, drugs that would produce deep hypnosis almost instantly, and drugs that would ensure than amnesiac-suggestions were flawless.

It is interesting to note that Fisher was suggesting all of this research in the same year that the American and British Medical Associations were both accepting that hypnosis was a legitimate, if limited, technique within various forms of medical treatment. What the exact results of the experiments which logically sprang from this report were is not known as they were never released. The commonly held supposition that the experiments must have failed because the results were never made public seems naïve in the extreme. If they had worked it is likely that the US government (with all countries who indulged in similar research) would want the results kept secret.

CHAPTER 3
THE TECHNIQUES OF HYPNOSIS

There are many different techniques used to induce hypnosis, but they share a number of common characteristics. All of the following is assuming that the hypnotism experiments that were mentioned in the previous chapter were in some way misrepresented or that such a deep state of hypnosis was induced that the subject genuinely believed they were in an utterly different situation from reality.

The first characteristic of hypnotism is that the person to be hypnotized must be willing and cooperative; he must trust the hypnotist. This basic premise puts the lie to the idea that hypnotists can somehow hypnotize people against their will and then make them do things that they would not otherwise do. The patient must be completely trusting of the hypnotist in order to put herself into the necessary state of relaxation that is needed for hypnosis to occur (Rossi, 1988.) With this proviso in place, hypnosis normally takes the following course:

1) The subject is invited to relax in comfort and to fix his gaze on some subject.
2) The hypnotist continues to suggest, usually in a quiet and low voice that the subject’s relaxation will increase and his eyes will grow tired.
3) The subject’s eyes start to close, and the hypnotist suggests that they should close.
4) The eyes close, begins to show signs of profound relaxation (limpness and relaxation).
5) A state of hypnotic trance now exists.

A person’s responsiveness to being hypnotized is probably greatest when she believes she can be hypnotized, that the hypnotist is competent/trustworthy and that the process of hypnotism is safe, appropriate and congruent with her wishes. Thus a degree of rapport must exist between the patient and the hypnotist before the hypnosis session starts to occur.

It is at this point that induction starts to occur. Hypnotic inductions almost always begin with simple suggestions that are almost always accepted by the subject. At this point is it not clear to either the subject or the hypnotist whether the subject’s behaviour constitutes a hypnotic response or mere cooperation. After this initial stage suggestions are given that demand increasingly distorted perceptions or memory. Thus, the hypnotist may tell the patient that he cannot open his eyes even if he tries to. This stage of induction can be achieved in a few seconds or may take many hours.

It must be stated that the state of hypnosis differs from one patient to another and indeed, from session to session with the same patient. There are degrees of hypnotic trance, from light to profound. There is no fixed stability to these however, and a single subject may move from light to profound and then back to light etc. within the same session. This has led some critics of hypnosis (foremost among them was Freud) to suggest that the state of hypnosis is in fact dependant upon purely subjective matters such as whether the patient ‘believes’ they are hypnotized. In other words, a degree of acting or outright lying occurs. This is however, an attempt to force a scientific certainty and concrete methodology onto a technique that is essentially difficult to define within such limitations.

The state of hypnotic trance normally displays the following characteristics. There is “a simplicity, a directness, and a literalness of understanding, action and emotional response that are suggestive of childhood”. (Britannica, 1998) The fact that some hypnotized patients display unusual abilities that they may not normally possess in everyday life seems to stem from the restriction of their attention to the task at hand. They are able to avoid the normal distractions of life and so concentrate absolutely on what they have been asked to do. Suggest ability which may be defined as a state of greatly enhanced receptiveness to suggestions and stimuli presented by the hypnotist constitutes the central phenomenon of hypnosis.

The skilful hypnotist can bring about a greater range of psychological, sensory, and motor responses from the patient through suggestion. By both accepting and responding to suggestion, a patient can seem to become they all ranges of states including being deaf, blind, paralyzed, read and suffering from hallucinations. While the movie image of the hypnotist and control someone against their own will is, as has already been stated, grotesquely exaggerated, it is true that posthypnotic suggestion and behaviour can occur. This involves patient doing something at a later date which has been suggested by the hypnotist, and the patient when of no idea why she has carried out the action. This post hypnotic behaviour depends upon the degree of amnesia within the patient that is unusual. This type of behaviour and suggestion is far less powerful than behaviour that is voluntary on the part of the patient.

In contrast to this amnesia is a state called hypermnesia, in which the patient exhibits greater powers of memory than they would normally enjoy. This is the subject of a great deal of controversy, as well be discussed later, within this supposed exposure of memories that have been suppressed by the patient because of the emotional difficulty of dealing with them in a conscious manner. Memory is of child abuse are supposedly uncovered in this manner. As one scholar puts it, “in the trance state the patient, by virtue of an uncritical willingness to make the effort and a freedom from inhibitions to deriving from preformed judgments, can vividly remember long forgotten, even deeply repressed experiences, recount them in extensive detail and still maintain an amnesia for them at the ordinary level of consciousness” (Britannica, 1998). It was this seemingly magical ability of recovering apparently hidden memories that enabled Freud to start upon his explorations all the patients subconscious. Freud may not have realized this, or even if he did realize it he could not admit it, but hypnosis was occurring during these times.

Various hypnotic states have also been associated with the altered states of consciousness that can occur through various drugs, states of meditation and even mental disease. Here we run across the problem of exact definition, as the altered states of being made in fact be merely symptoms of the disease rather than of any hypnotic state. The shamanistic practices of various indigenous peoples throughout the world seem to suggest that hypnosis can in fact be self administered. In a sense the person has put himself into a state of trance.

Hypnosis does not seem to require any particular kind of training nor does it involve any particular talent or skill that might be inherited or developed. However, it must be said that due to some of the more negative occurrences which have occasionally been seen among patients without undergone deep hypnosis, some degree of medical training should at least be available to the hypnotist, even if he does not possess it himself. Some medical authorities, as we shall see, wish to see bans on the use of hypnosis within entertainment or even by untrained personnel. Such a ban would be very difficult to enforce, because of the uncertainty of the definition of what hypnosis actually is.

CHAPTER 4
CURRENT MEDICAL USES OF HYPNOSIS

As this study has already briefly explored, the use of hypnosis within the medical field has been the subject of some controversy for many centuries. Various medical associations have conflicting and even sometimes contradictory attitudes towards the technique. These range from disdain for its apparent claims to acceptance of it as a legitimate technique. The American Medical Association recognized hypnosis as an approved science in 1958. Since then it can be argued that hypnosis has become a rapidly growing field.
Unfortunately, hypnosis like any other ill-defined and thus vulnerable medical technique is open to abuse and to outlandish claims. Thus, the official sounding National Board of Professional and Ethical Standards, which essentially sells diplomas for which one needs no previous academic experience of qualifications (the educational value of any courses they offer is void of substance), gives the following rather impressive statistics on its website:

Psychoanalysis 38% Recovery after 600 sessions
Behaviour Therapy 72% Recover after 22 sessions
Hypnotherapy 93% Recovery after 6 sessions
(National, 2006)

Unfortunately, it does not inform the prospective student what the patients were recovering from. It gives the source for these statistics as an American holistic health magazine. Looking at the claims, it would seem as though just two weeks of hypnotherapy sessions are three times as likely to lead to “recovery” as eleven years of weekly sessions of psychoanalysis. If this were true, one might wonder why hypnotherapy is not the only form of psychological counselling allowed. The fact (discussed in an earlier chapter), that psychoanalysis is often just a form of hypnosis by another name places these statistics in an even more problematic light. What differentiation between “psychoanalysis” and “hypnotherapy” is being made here? The claims continue, with one Dr. Weil of Dr Weil’s Self Healing Newsletter stating, “in general, I believe that no condition is out of bounds for trying hypnotherapy on” (National, 2006).

These kinds of claims diminish the serious therapeutic value that hypnosis can offer, but they must be regarded as part of the spectrum of how hypnotherapy is used within medicine.

One of the most commonly used, and yet one of the most controversial uses of hypnotism, is within the criminal justice system. This can be regarded as a “medical” because many of the people involved are in fact being treated for traumatic experiences (in which they were the victims of crimes) when “evidence”, in the form of so-called ‘suppressed memories’ occurs which is then used in court.

The first time that hypnotically-induced evidence was used in court was in 1968 (Harding, 1968), when the Maryland Supreme Court allowed the introduction into evidence of “hypnotically refreshed” eyewitness testimony, despite the scientific controversy about its reliability. The Court ordered the Judge and Jury to consider this controversy in determining the weight to give such testimony. This ruling held for about twenty years, but in the last couple of decades increasing number of courts have disallowed the use of such evidence for a number of reasons:

First, there is little reason to believe that recollections under hypnosis are more accurate than unhypnotized recollections.

Second, hypnotized persons are highly suggestible and often provide inaccurate information in response to subtle and unintended cues given by the hypnotist.

Third, evidence obtained from hypnotized persons may often include confabulations — false memories that the hypnotized subject creates to fill in gaps in his recollections, which the subject later believes, and may testify to as true memories.

Fourth, while hypnosis may cause hypnotized persons to provide a greater amount of accurate detailed recollections, it also induces a greater number of false recollections.
(Orne, 1995)

There are also other problems, such as the fact that a hypnotized person may become surer of the exact details of an incident than he reality he would be without the hypnotic process.

Within psychoanalysis the recovery of memories that the patient ordinarily finds too painful or disturbing to actually recall may be an essential part of the process of healing. This technique is commonly called hypnotic age-regression, and has become a commonly used although controversial method. Within this technique the hypnotized person is given a suggestion that they are reliving an earlier age. The major question involved within hypnotic age-regression is whether the age-regressed individual is actually reliving past events or just role-playing the particular age that has been suggested to her.

The fact that the person most easily hypnotized is the also the person who believes in hypnotism and in its positive effects to the greatest extent may be important here. Because “the hypnotic suggestion to relive a past event, particularly when accompanied by questions about specific details, puts pressure on the subject to provide information for which few, if any, actual memories are available.” (Orne, 1995) The patient may then fill in the large blanks within their memory by plausible sounding imagined occurrences or events later in life that they do remember. This is particularly important when a doctor is exploring the possibility that some kind of child abuse has occurred in a patient’s past. If the patient has been hypnotized with the express intent of “recovering” those memories of being abused as a child that have been “lost” or “suppressed”, the patient is under a great deal of pressure to find those memories, whether they actually exist or not.

In recent years it has become clear that some psychiatrists, for mysterious reasons, have taken it on themselves to deliberately implant false memories of child abuse within patients. One of the most disturbing cases included Nadean Cool, a nurse’s aid who sought psychiatric help “to cope with her reaction to a traumatic event experienced by her daughter.” (Loftus, 1997) While the therapy was meant to discover coping methods for the mother to deal with her daughter’s trauma, the psychiatrist turned it around and used hypnosis to “reveal” memories of abuse that Cool had supposedly suffered from as a child. The list of traumas and mental conditions that Cool was supposedly suffering from reads somewhat like a satire of mal-practice, but when reading it, one should constantly remind oneself that it is what a real psychiatrist actually did.

Cool became convinced that she had repressed memories of having been in a satanic cult, of eating babies, of being raped, of having sex with animals and of being forced to watch the murder of her eight-year-old friend. She came to believe that she had more than 120 personalities-children, adults, angels and even a duck-all because, Cool was told, she had experienced severe childhood sexual and physical abuse. The psychiatrist also performed exorcisms on her, one of which lasted for five hours and included the sprinkling of holy water and screams for Satan to leave Cool’s body.
(Loftus, 1997)

One other case serves to show how the repressed memory technique can be abused by medical practitioners, adding once again to the bad reputation that genuine hypnosis undeservedly enjoys. In 1992, the daughter of a Minnesota clergyman “recovered” childhood memories of having been raped by her father (while her mother held her down) and that he had also forced her to abort the fetus herself, without anaesthetic, with a coat-hanger.

The patient’s father resigned from his clergy position, the family broke up and then it was discovered, after a medical examination, that the woman was still a virgin and had never been pregnant. In both these cases the women were awarded large sums of money against the psychiatrist, but the question remains as to what is actually happening within this hypnotic therapy. Is the psychiatrist deliberately placing false memories within the patient under suggestion or is it a case of the patient filling in empty parts of her early childhood memories with her macabre imagination? Both scenarios bring about the conclusion that hypnosis is a very powerful technique that should only, perhaps, be used under exceptional circumstances to perform regressive memory. No psychiatrist involved in the legal cases that have resulted from false-memories has ever admitted to deliberately planting the memories within the patient. Of course, it is unlikely that any of them would, even if they had, considered the possible effects upon their medical license and even criminal charges that might result.

It seems likely that a kind of folie a deux occurs within the therapist’s room at this point. The session starts in a conventional manner with a legitimate attempt to discover the source of some psychological or emotional trauma that is creating some kind of condition within the patient in the present day. Once the session progresses however, the eagerness to please the operator within the subject (tendency that has been constantly observed since the time of Mesmer) starts to take over and, with the suggestion of the psychiatrist as a catalyst; stories are invented which then become memories.

As the session continues, the subject wishes to make the operator even more pleased than they already are with their performance, and so the story becomes even more elaborate and extreme. The hypnotist in turn is satisfied at the “positive” outcome of the session, i.e. some cause for the psychological condition has been discovered, and so encourages (but in fact suggests) further revelations. It is this vicious cycle of suggestion -> invention -> encouragement -> suggestion . . . that leads to some of the more outlandish claims regarding the “memories” that have been uncovered.

Part of the problem with this use of hypnosis is some of the questions that the therapists tend to ask the patients, both before and during the session. Thus 11% of clinical psychologists instruct their patients to “let the imagination run wild”, while 22% tell them to “give free reign to the imagination” (Loftus, 1997). The therapist Wendy Maltz, who is written an influential and popular book on childhood sexual abuse, advocates the following type of questioning:

“Spend time imaging that you were sexually abused, without worrying about accuracy proving anything, or having your ideas make sense …. Ask yourself … these questions: What time of day is it? Where are you? Indoors or outdoors? What kind of things are happening? Is there one or more person with you?”
(Maltz, 1986)

Further and perhaps even more disturbing, she suggests dwelling upon the following:

“Who would have been likely perpetrators?
When were you most vulnerable to sexual abuse in your life?”
(Maltz, 1986)

Not surprisingly a remarkable number of patients tend to “recover” memories of childhood sexual abuse through these methods, often by their parents. Eventually, any study of repressed memories falls back on the intuitive understanding of memory possessed by the vast majority of human beings: long-term memories tend to be of important events rather than of insignificant ones. The more traumatic an experience the more likely it is that a patient will be able to recall it, not the less likely. When a patient cannot recall childhood abuse, even though such abuse seems to fit within a therapist’s theory of the causation of a present condition, it is probably because such abuse never occurred.

Hypnosis can be very effectively used by a therapist however within a more limited, but often more powerfully therapeutic sense. Thus hypnosis can be utilized in a whole series of situations including those involving weight loss, smoking cessation, stress management and insomnia. These are more common, less controversial (and thus less publicly known) uses for hypnosis that can actually succeed.

Many of these uses involve strengthening a patient’s “will-power” to stop potentially harmful behaviour. Thus the cessation of smoking is, because of the very addictive qualities of nicotine and other substances put in cigarettes, a very difficult prospect for most people. The conscious mind may seek to stop the person from smoking, but subconscious pressures and the physically addictive properties of the substance may be impossible to avoid. Within smoking cessation the hypnotist will put the patient into a hypnotic state (varying in depth according to the wishes of operator/subject) and then suggest that the patient will stop smoking. The therapist may list various situations in which the patient will be tempted to smoke and then suggest to them possible ways of avoiding lighting up a cigarette. This type of hypnosis succeeds because the subject has a great vested interest in wanting the suggestion that will occur while in the hypnotic state to succeed.

An example of why hypnosis can succeed in such cases is to be found within a description of what occurs for a patient who is invested within the process that is taking place. It is the belief in the effectiveness of the treatment that may be its most effective tool:
Somewhere between wakefulness and sleep is the state of consciousness that hypnotherapists use. That trance like state is similar to the one that occurs spontaneously in sleepwalking or daydreaming. Most people will experience hypnosis as a state in which they become more aware of their inner being, their emotions and state of mind so as to make it possible to work and transform those emotions and states which may have become a problem. You will not lose consciousness or awareness, but become able to gain a different perspective on what has been troubling you.

Most people talk and act as if the conscious mind is the prime mover behind our behavior and regard the unconscious mind as something vague, that they are not really aware of. In fact, the unconscious mind is always working, monitoring and affecting all the physical and psychological functions of the mind and the body, from blood pressure and hormone levels to states of hunger and fatigue, even when we are asleep. The sum of what we have learned and experienced is also stored within the unconscious mind, and our memory holds far more than we can usually remember at a conscious level

Through accessing that unconscious mind, hypnotherapy can help you learn how to react differently to certain situations and help you to understand better the development mechanism of your mind. For example, if you have to prepare for an exam and feel nervous about it, you can learn how to access and strengthen your ability to relax and apply that to the situation of passing an exam. Once you know how to do that, then it becomes easier to “decide” how you would like to feel and react in a given situation.
(CHIS, 2006)

Note the fact that this description is written in simple language that the person of average intelligence and education can understand. Hypnosis, unlike other medical techniques which tend to lose the patient within a morass of technical language and scientific terms, is most effective when it is most fully comprehended by the subject. The pre-hypnosis education as to what the technique is (and what it is not) is vital to the overall efficacy and success of the hypnosis which is to occur.

Hypnotism can also be used within pain management, especially that caused by operations, in giving birth and within particularly painful conditions such as shingles. Other studies on pain reduction conclude that hypnosis can be very effective. Thus, a 1989 study by a University of Milan researcher, Dr. Giuseppe Benedttis showed that hypnosis could relieve the pain associated with ischemic heart disease. In 1991, a study showed that hypnotized patients undergoing the often agonizing procedure of angioplasty could keep the balloon used in the procedure inflated for 25% longer than nonhypnotized patients. This reduced the need for surgery among the hypnotized patients. Two studies by Dr. David Spiegel of Stanford University Medical School offer both ends of the claims for hypnosis: the explicable and the mysterious. Thus in a 1993 study, Spiegel found that hypnosis could bring about a 23% success rate in the cessation of smoking. A few years earlier his 1989 study had concluded that hypnosis therapy appeared to double the survival time for women with metastatic breast cancer.

What the curative linkage between hypnosis and the metastasis of cancer could possibly be is completely unclear. It seems as though some kind of false correlation may have been occurring here: another variable, untested within the study, may have been at work. However, if hypnotherapy sticks to what it appears to have a certain (and explicable) effect upon, the list of conditions is still very impressive:
• inflammatory bowel diseases (namely, Crohn’s disease and ulcerative colitis)
• sleep disorders, including insomnia
• addictions
• warts
• bedwetting
• fibromyalgia
• irritable bowel syndrome
• phobias
• labor and delivery
• fractures
• skin disorders (such as acne, psoriasis, and eczema [atopic dermatitis])
• migraine headaches
• stress
• tinnitus (ringing in the ears)
• cancer related pain
• weight loss
• eating disorders, namely anorexia and bulimia
• indigestion (dyspepsia)

This is a list of diseases and conditions collected from the American Medical Association, a group that is notoriously sceptical regarding medical practices that do not clearly belong to the “mainstream” of modern medicine. As this study has shown, hypnotherapy has resided in a fascinating area on the edge of medicine for a number of centuries. At times being held within it, at others firmly outside of it, but much of the time inhabiting a no-man’s-land where it may be pushed in one direction by dubious practices (memory regression is a recent example) or towards that of legitimacy through proven applications such as pain management.

Part of the legitimization of hypnotherapy has come through the standardization of its licensing. Most hypnotherapists are licensed medical doctors, registered nurses, social workers, or family counsellors who have received additional training in hypnotherapy. For example, members of the American Society of Clinical Hypnosis (ASCH) must hold a doctorate in medicine, dentistry, podiatry, or psychology, or a master’s level degree in nursing, social work, psychology, or marital/family therapy with at least 20 hours of ASCH-approved training in hypnotherapy. Similarly, the American Psychotherapy and Medical Hypnosis Association provide certificates for licensed medical and mental health professionals who complete a six to eight week course.

CHAPTER 5
CONCLUSIONS AND THE FUTURE OF HYPNOSIS

This study has shown that hypnosis has had a long and fascinating association with medicine. The origins of hypnotherapy appear to stem to prehistory and the various religions such as shamanism and other beliefs that have existed since those times. The idea that both mental and physical healing can occur at a time of altered states of consciousness has stemmed from an intuitive belief held by different cultures over a wide span of historical periods that such states offer a route into both understanding and change that ordinary consciousness cannot.

The exact “medical” nature of these beliefs is somewhat difficult to define, as they rely upon instinct and intuition rather than the scientific method. Mesmer is perhaps the ideal example and metaphor of the constant struggle between innate belief and scientific rationality within the field of hypnotherapy. Mesmer debunked the idea of “exorcism”, but continued to believe that he himself could cure blindness through his magnets and special powers. The paradoxes and contradictions presented by a figure such as Mesmer have continued to the present day. The idea that a Hypnotherapist needs no special “powers” in order to perform hypnosis is countered by the idea that some hypnotists clearly do have greater success rates than others. It is generally accepted in other branches of medicine, as within human activities in general, that some people are more innately skilled in certain techniques and acts than others, but when it comes to hypnotherapy the principle is discarded. This reluctance to concede that one individual may be a better Hypnotherapist than another probably stems from the stage performer “mesmerist” who claims to have almost supernatural powers. In this case the charlatans have made an indelible impression on what a hypnotist is and what he is not.

As with much of medicine in particular, and human life in general, the future of hypnosis may lie within technological advances. First, increased understanding of both the structure and the processes at work within the human brain will inevitably lead to greater knowledge of what actually occurs to a person within a hypnotic state. This knowledge may lead to a number of developments. Perhaps a depth scale of hypnotic trances can be set up in which the hazy, qualitative distinction between “light” and “deep” hypnotic states will be replaced by a quantitative scale. This scale may be used to correlate different states of hypnotic trance with the kinds of therapies that can be used with them. Thus the current understanding that light hypnosis can be used for pain management, whereas deeper hypnosis can be used for alleviating compulsive habits such as smoking can be expanded upon (Baumgaertel,1999).

The use of digital sound and light devices (perhaps as simple as an MP3 player or a laser light pen) might be developed than can induce different levels of hypnotic state within a standard period of time. Hypnotic treatments could thus become standardized in the way that many medical techniques are currently standardized today. The use of technology to induce hypnotic states would, once-and-for-all, place the image of the hypnotist as some sinister person with virtually supernatural powers into the pleasant fictional mythology to which it probably belongs. Hypnotherapy should endeavor to standardize, quantify and legitimize itself within the pantheon of medical practices.

Bibliography

Baumgaertel A. Alternative and controversial treatments for attention-deficit/hyperactivity disorder. Pediatr Clin North Am. 1999;46:977-992.
Bootzin, RR. Perlils, ML. Nonpharmacologic treatments of insomnia. Journal of Clinical Psychiatry. 1992; 53: 37-41.

Chertok, Leon. Sense and Nonsense in Psychotherapy. Permagon, Oxford: 1981.

Darnton, Robert. Mesmerism and the End of the Enlightenment in France. Harvard UP, New York: 1968.

Encyclopedia Britannica, Vol. 6, p. 203. 1998.

Estabrooks, George. Quoted in Bowart, George. Operation Mind Control. Dell, New York: 1978.

Fisher, Seymour. “Rand Corporation Report on Hypnotism”, US Air Force, 1949.

Freud, Sigmund. Comment on Hypnosis quoted in Kline, Milton. Freud and Hypnosis. Julian Press, New York: 1958.

Harding v. State, 5 Md App. 230, 246 A.2d 302 (1968)

Hart, Jacqueline. “Hypnotherapy”. University of Maryland Medical Centre. 2006.

Loftus, Elizabeth. “Creating False Memories”. Scientific American. Sept, 1997, vol. 277 #3, pp.70-75.

Maltz, Wendy. The Sexual Healing Journey: A Guide for Survivors of Sexual Abuse. Crown, New York: 1988.

Mesmer, Franz. De Planetarum influxu in corpus humanum. University of Vienna, 1766.

Mesmerismus oder System der Wechsel-beziehungen. Private Publication, 1814.

Memoire sur le decouverte du magnetisme animal. Paris, 1779.

Orne, Martin. Hypnotically Refreshed Memory: Enhanced Memory or Tampering with Evidence. UPenn, Philadelphia: 1995.
Rossi, Ernest., and Cheek, David. Mind-Body Therapy: Ideodynamic Healing in Hypnosis. Norton, New York: 1988.

www.chisuk.org.uk/bodymind/whatis/hypnotherapy

www.hypnosis.org

Waxman, David. Hypnosis: A Guide for Patients and Practitioners. Unwin, London: 1984.

 
For more about Kristian von Sponneck, click here for his about page or for a more visual perspective of the Hypnosis demonstrations he undertakes, click here.

DCH Thesis (2006)

Hypnosis Study

On this page is my final thesis for the Doctor of Clinical Hypnotherapy (DCH), written in 2006. The American Institute of Hypnotherapy (AIH) Doctorate was approved by the California Bureau for private postsecondary & vocational education. The degree is ‘approved’ and not ‘accredited’ and is (as of the time of writing) the 2nd most in depth qualification in Hypnotherapy. The most in depth is the MSc in Clinical Hypnosis (The London College of Clinical Hypnosis/University of West London). The DCH from the AIH which I hold is not to be confused with other Doctor of Clinical Hypnotherapy qualifications offered on the internet.

There are practitioners in the UK, Australia, worldwide (especially America) that use the title ‘Dr.’ with this qualification in Hypnotherapy. I do not use this title.

I welcome any questions or comments re the content of this Hypnotherapy study.

Hypnosis in the Medical Field – a Historical Study

By

Count Kristian von Sponneck

– June 2006 –


INTRODUCTION

THE MYTHS AND REALITY OF HYPNOSIS

The word hypnosis is derived from the Greek word Hypnos, which means ‘sleep’. This word derivation is essential to understanding both the history of hypnosis and the controversies surrounding its current use within medicine. While hypnotized, patients are not ‘asleep’ in any conventional sense of the word, neither are they fully ‘awake’. They exist in a trance-like state that has enjoyed a somewhat occult reputation, but which is in fact no different in nature from the various other altered states of consciousness that the average human being goes through in a single day.

Thus when watching television, sitting in a car waiting for a red light to change or day-dreaming while sitting in the sun, a person will not be fully conscious. Consciousness, as hypnosis shows, is, in fact, a continuum, a line on which the human being’s state of awareness may be placed at any one time, rather than a simple dualism between “conscious” and “unconscious” (Bootizin, 1992). A person within a trance is “unusually responsive to an idea or image, but this does not mean that a hypnotist can control his or her mind or free will” (Hart, 2002).

The American and British Medical Associations recognized hypnotherapy as legitimate techniques in 1958 and in 1995 the National Institutes for Health (USA) recommended hypnosis as a treatment for chronic pain. These current uses for hypnotherapy will be discussed in the last part of this study, but in order to understand contemporary uses, it is important to place them in context.

Thus, Chapter 1 deals with the historical context of hypnosis, particularly the work of Mesmer and other 18th/19th century pioneers of the technique.

Chapter 2 explores Freud’s influence upon hypnosis, detailing his practice of it and subsequent abandonment within psychoanalysis. This discussion leads into a consideration of some of the more bizarre, but vital, explorations of hypnosis by various governments seeking to make a reality of popularized, movie notion of ‘mind control’ during the first 60 years of the twentieth century.

Chapter 3 describes and analyses the various techniques by which hypnotism may be carried out, while Chapter 4 discusses the modern use of hypnosis, with a delving into the controversy surrounding memory regression/recovered memories as well as less exotic, but more effective uses of hypnosis within modern medicine, particularly pain management.

Chapter 5, the Conclusion explores what has been discovered during the study and will suggest possible routes towards more effective use of hypnosis in the future.

CHAPTER 1
HYPNOSIS: THE HISTORICAL CONTEXT

It is clear that many of the popular notions of hypnosis are in fact untrue, and have given the technique a bad name which it does not deserve. Hypnosis appears to have been used in one form or another for much of recorded history and indeed, as the sleep temples in Ancient Greece and Egypt testify, even before that time (Waxman, 1984). Some have suggested that there may be mention of hypnosis in the Bible (Genesis 2:21, Acts 10:10) but within the context of hypnotism in general, and the hypnotherapy that is performed within medicine today, the practice starts with Mesmer(ism).

Franz Anton Mesmer was so influential within hypnotism, catching the public’s imagination so intensely, that his name became a word. To mesmerize is to hypnotize, both in a literal and metaphoric sense. People use the word ‘mesmerizing’ to describe experiences that have no relation to formal hypnosis. Any experience which seems to capture the attention and/or imagination of a person is commonly called mesmerizing.

Mesmer was born in Austria in 1734. He studied at various Jesuit (religious order) schools before entering the University of Vienna in 1759 to study medicine. In 1766 his doctoral dissertation, ‘De Planetarum influxu in corpus humanum’, was published; it dealt with the supposed influence that the planets and the moon have on human affairs. This was a serious study within what was called at the time ‘medical astrology’. The fact that Mesmer wrote his doctorate within a field that has since been shown to be based upon unfounded superstition rather than scientific fact has been unfortunately extended to cast aspersions on his work in other fields of medicine such as hypnosis. Added to this is the allegation that he plagiarized a large part of his dissertation from a book published by Richard Mead more than a hundred years before Mesmer himself was born(Darnton, 1968).

Mesmer became a centre of attention in Vienna after he married a wealthy widow, set up a medical practice and started to patronize the arts and sciences. His activities ranged from giving the first performance of the twelve year-old Mozart’s opera ‘Bastien and Bastienne’ to investigations into what he called the “artificial tides” that could be induced within people (Mesmer, 1814). He started to focus on the link between the physical and the mental within the human body when he gave a preparation of iron to a patient, followed by the attachment of magnets to various parts of her body.

Mesmer claimed that this produced the artificial tide’ within the patient: she reported feeling streams of a mysterious fluid running through her body, and her symptoms were supposedly relieved for several hours. Mesmer did not believe that the magnets had somehow cured her, but rather that they had contributed to what he termed the naturally occurring animal magnetism that occurred within all human beings. He stopped his research into magnets when it became clear that no rational evidence could be discovered for how they could cure disease.

Mesmer was thus using the scientific method within his studies, countering the allegation that he was a charlatan. In 1775 Mesmer gave his opinion to the Munich Academy of Sciences on the validity (or otherwise) of the ‘exorcisms’ carried out by Joseph Gassner, a priest and healer. Ironically, Mesmer argued that while Gassner was sincere, the exorcisms were in fact a result of his high concentration of animal magnetism rather than any religious or supernatural powers. Gassner was humiliated in the exchange and his career ended. The irony in this situation is that Mesmer was in fact using the ‘science’ of animal magnetism to disprove the ‘superstition’ of exorcism when in fact they were equally specious.

Mesmer moved from Vienna to Paris in 1777, after a farcical attempt to cure an eighteen year-old girl’s blindness with animal magnetism. It was in Paris that Mesmer developed what can now be seen as the beginnings of both hypnotism and hypnotherapy. In a 1779 book, Mesmer wrote what have now become his famous ‘27 Propositions’ regarding medical theory (Mesmer, 1779). Central to these propositions was Mesmer’s argument that health was the free flow of the process of life through thousands of channels. Illness was caused by obstacles to one or more of these flows. The more obstacles, the more ill the patient until the whole system broke down because of multiple blockages: death.

Mesmer argued that contact with someone who possessed a high degree of ‘animal magnetism’ (i.e. himself) could remove the obstacles and start a healthy flow again. Mesmer aimed to help what nature could do through accelerating the crisis of an illness without danger. Thus ‘curing’ an insane person would involve provoking an extreme fit of madness.

The ‘treatment’ that Mesmer instituted involved sitting in front of a patient with his knees touching their knees. He would press the patient’s thumbs in his hands and look fixedly into the patient’s eyes. He then made a number of ‘passes’, which involved moving his hands from the patient’s shoulders down their arms, and sometimes would press his fingers into the hypochondriac region below the diaphragm. Often this whole process would continue for a number of hours. The whole treatment process would be watched by patients waiting their turn or by other interested parties such as doctors (Danton, 1968).

Many patients claimed to feel strange sensations or had convulsions that were regarded as the ‘crises’ of their conditions, thus bringing about an acceleration of the obstacles, their removal, and thus the patient’s cure. It must be stated that any ‘strange sensations’ may have been more the result of sitting in the same position for hours having a man staring into their eyes and pressing his hands into their body than of any potential cure. It can also be seen that an element of ‘performance’ was developing within hypnosis that would, in the twentieth century, reduce it to the level of showmen and charlatans in many case (stage hypnosis).

Mesmer’s treatments became very popular, and he soon had more patients than he could individually treat. In order to meet demand, Mesmer established a collective treatment that he called a ‘baquet’. The ‘baquet’ was described as follows by a visiting English physician:

“In the middle of the room is placed a vessel of about a foot and a half high which is called here a ‘baquet”’. It is so large that twenty people can easily sit round it; near the edge of the lid which covers it, there are holes pierced corresponding to the number of persons who are to surround it; into these holes are introduced iron rods, bent at right angles outwards, and of different heights, so as to answer to the part of the body to which they are to be applied. Besides these rods, there is a rope which communicates between the baquet and one of the patients, and from him is carried to another, and so on the whole round. The most sensible effects are produced on the approach of Mesmer, who is said to convey the fluid by certain motions of his hands or eyes, without touching the person. I have talked with several who have witnessed these effects, who have convulsions occasioned and removed by a movement of the hands…”
(Danton 1968)

Mesmer’s work soon became a victim of its own success, as it attracted the attention of the French King, Louis XVI. He appointed a commission to investigate whether Mesmer had in fact discovered a new kind of fluid within the body. This Commission consisted of several distinguished doctors, the chemist Lavoisier and then American ambassador to France, Benjamin Franklin.

After witnessing the ‘baquet’ in person and investigating all of Mesmer’s claims, the commission concluded that there was no evidence of any new fluid, or even that any cure was occurring. Mesmer soon left Paris and spent the rest of his life in obscurity. The fact that he had perhaps accidentally discovered a new type of technique (what would eventually become known as hypnotism) was alluded to by Franklin within the report. He noted the very tangible effects that the stillness of the body and staring into the eyes seemed to have on the patient. The relief that the patients seemed to feel was undeniable, although Franklin could not identify its exact origin. Chertok (1981) has perhaps best described what was actually occurring.

“There was no talking during the treatment, so there were no direct verbal injunctions. However, these were implicit in the therapist’s attitude. The passes, the music, the setting; the atmosphere round the tub (baquet), were factors which were indirectly to increase the effect of suggestion, but also contributed in producing a kind of sensory deprivation which induced an alteration of the state of consciousness, gradually ending in the ‘crisis’. Mesmer’s patients did not all have attacks. Some showed, rather, a sort of lethargy, while still being able to walk, talk, etc. In other words, they were hypnotized”.
(Chertok, 1981) (My emphasis)

One of Mesmer’s disciples, Marquis de Puysegeur, studied closely what happened to people during what he called ‘magnetic somnambulism’, more commonly known today as ‘deep hypnosis’. He developed the following principles, all of which would be familiar to any practitioner who uses hypnotherapy today:

• Convulsions were not necessary; words were sufficient
• The magnetist had to listen to the person seeking relief
• Often the client had to re-experience painful feelings
• The sessions had to be of regular frequency and duration
• The magnetist had to be neutral and patient
• Symptoms might return temporarily.

As Chertok puts it, a patient under de Puysegur’s care would experience the following:

“While he was in deep magnetic sleep, (the client)
was asked to establish his own diagnosis . . . and the form of his treatment . . . he was also asked to predict the development of his treatment: when he would recover, when the attacks would occur, etc. Thus was produced a kind of psychodrama in which the patient caused the magnetist to play a part in a series of successive catharses.”
(Chertok, 1981, p.121)

Thus the beginnings of hypnotherapy can be glimpsed, without the theatrics and supposed magnetism of Mesmer’s original vision. Indeed, some of the principles that de Puysegur discovered are applied within the wider field of psychotherapy and psychology in general. Thus, the fact that a therapist has ‘to listen to the person seeking relief’ while being ‘neutral and patient’ within sessions of ‘regular frequency and duration’ could be description of a wide variety of therapies, both physical and mental.

CHAPTER 2
FREUD, PSYCHOANALYSIS
, AND HYPNOSIS: THE HISTORY OF HYPNOSIS 1880-1958

The next major development within the history of hypnotherapy within medicine, as in psychology in general, was the contribution of Sigmund Freud, who championed and then abandoned the cause of hypnosis as a treatment. Freud became disenchanted with hypnotherapy, but the methods of psychoanalysis that he developed are actually closely linked, both historically and methodologically, to hypnosis. Thus the theories of hypnosis and its practice essentially anticipated much of what was to occur in psychoanalysis. Hypnosis was used by Freud and the psychoanalytical technique actually produces, whether by design or accident, a state of hypnosis when performed comprehensively and skillfully.

Freud rejected the use of hypnotism while continuing with techniques that often employed it:

Freud sought to escape the hypnotism label for his work. He began to use free association with no apparent awareness of that technique’s basic similarity, with its couch, relaxation, closed eyes, occasional touch on the client’s forehead, to the formal hypnosis he had renounced.
(hypnosis, 2006)

The technique might be in place, but the link to the subconscious that it seemed to enable went against what was Freud’s basic view of the subconscious: a violent place of primeval and often incestuous urges that needed to be understood in order to be conquered.

Modern psychology tends to view the subconscious as a neutral area where memories and emotions are stored. But to Freud, the very process of hypnosis was something akin to uncontrolled (and uncontrollable) experience of being in love:

“From being in love to hypnosis is evidently only a short step . . . There is the same humble subjection, the same compliance, the same absence of criticism toward the hypnotist just as toward the love object”.
(Freud, 1958)

While the ‘love object’ was not necessarily unhealthy in Freud’s estimation, it clearly did not belong in the relationship between the analyst and the patient. It was Freud’s view, passed through the simplistic lens of mass entertainment, which led to the countless movie portrayals of hypnotists as mad geniuses who held terrifying powers that allowed them to control people against their will. Whatever the reality, it is this myth that holds the public’s imagination vis-à-vis hypnotists, hypnotism and hypnotherapy.

Freud’s influence within psychoanalysis, as within society in general, was of course profound and it soon came to be the case that his views reflected those that are found today among many therapists. Thus, as Rossi (1988) suggests, “many traditional psychoanalysts respond with indignation when it is suggested that their patients are in continually varying states of trance as they free associate on the couch” (Rossi, 1988, p.49) The problem that both Freud and current psychoanalysts have with hypnosis stems from a basic misunderstanding of what the technique actually involves. Thus, ‘Freud failed to realize that the client, not the therapist, is in control of his or her use and ‘depth’ of hypnosis.’

The popular view of the hypnotized patient as being somehow a zombie that can be controlled at will, while well known to be false by both Freud and his later disciples, still influences their overall view of the technique. A degree of control is presupposed by them, in which the patient relinquishes a certain amount of autonomy in favour of the therapist. The nineteenth century ‘mesmerist’ (stage hypnotist) of the travelling circus and music hall still casts a long shadow over the supposedly rational and clinical atmospheres of modern psychologist’s offices.

A dispassionate view of what occurs in many psychological therapies, and indeed, within life in general, is that hypnotic states are often fallen into. Thus, it might be argued that any time a person is remembering a sequence of events, and is ‘taken out’ of ordinary consciousness they are at least partially in a state of hypnosis. There are different levels of hypnotic states, some of which require the instigation of a hypnotist, but many of which naturally occur.

A little before the time that Freud was experimenting with and then supposedly rejecting the techniques of hypnotism, it was used, at least for a short while, as a form of anaesthesia. Hypnotism could be used as a form of anaesthesia but when Queen Victoria gave birth to one of the children using the new chloroform, the practice became popular throughout the world and hypnotism as a form of anaesthesia fell out of fashion.

The conflict between psychoanalysis and hypnotism carried on during the twentieth century. In 1943, at the height of World War II, a doctor sounded the public alarm regarding what he claimed could be the massively damaging uses of the technique by enemy forces. Doctor Estabrooks suggested the hypothesis that an enemy country could plant a foreign agent as a doctor in an American hospital, and that he could place thousands of people under his power over a period of time. The doctor could hypnotize key officers and program them to follow his suggestions. This ‘masked manoeuvre’ could enable the lowest officer to take over the entire reins of the whole U.S. Army. Estabrooks continued with a bizarre scenario that was apparently taken seriously by many within the US government:

“Let us suppose that in a certain city there lives a
group of a given foreign extraction. They are loyal
Americans, but still have sentimental ties to the old
country. A neighbourhood doctor, working secretly for
a foreign power, hypnotises those of his patients
who have ties favourable to his plans. Having done
this he would, of course, remove from them all
knowledge of their ever having been hypnotized”.
(Estabrooks, 1943)

Estabrooks then suggested that these citizens, while appearing on the outside (and believing themselves to be) loyal and safe citizens, could actually be used to carry out the most terrible attacks against America.

Other medical professionals pointed out to Estabrooks that it was an accepted principle of genuine hypnosis (as opposed to movie myths and stage hypnotists) that no subject could be made to do what they would not normally do, or even more, to do an action that was against their own will. Estabrooks replied that “my experiments have shown this assumption to be poppycock . . . it depends not so much on the attitude of the subject as on that of the operator himself . . . in wartime the motivation for murder and under hypnosis doesn’t need to be very strong.” (Estabrooks, 1944) Estabrooks even stated, in a famous claim that he repeated numerous times:

“I can hypnotize a man – without his knowledge or
consent – into committing treason against the
United States”.

Easterbrook’s claim led to about twenty five years of serious research by the US government into the possible uses of hypnotism. In some of the most famous experiments, Dr. Bernard Gindes used several soldiers to test some of Estabrooks’ more outrageous claims. These centred around the complete lack of memory that a person might have that they ever had been hypnotized, which would be associated with apparently unbelievable feats of memory associated with recall. Grindes described his experiments as follows:

“A soldier with only grade school education was able to memorize an entire page of Shakespeare’s Hamlet after listening to the passages seven times. Upon awakening, he could not recall any of the lines, and even more startling was the fact that he had no remembrance of the hypnotic experience. A week later he was hypnotized again. In this state, he was able to repeat the entire page without a single error. In another experiment to test the validity of increased memory retention, five soldiers were hypnotized en masse and given a jumbled ‘code’ consisting of twenty-five words without phonetic consistency.

They were allowed sixty seconds to commit the list to memory. In the waking state, each man was asked to repeat the code; none of them could. One man hazily remembered having had some association with a code, but could not remember more than that. The other four soldiers were allowed to study the code consciously for another sixty seconds, but all denied previous acquaintance with it. During rehypnotization, they were individually able to recall the exact content of the coded message.

(Grindes, 1956)

These experiments were continued by other doctors, who moved into the realms of what today would be regarded as highly unethical or even criminal conduct on the part of the researchers. In one series of experiments, Dr. JD Watkins induced criminal behaviour in deeply hypnotized subjects through inducing suggestions, or what he called “hallucinations” that did not counter their normal moral standards. Thus one young soldier was deeply hypnotized and then told that the man sitting opposite him (an American officer he had seen before being hypnotized) was in fact a Japanese soldier, and that he needed to strangle him in order to stop being killed himself. The soldier immediately lunged across the table and tried to strange the officer, who was actually injured because the large assistants who had been placed in the room in case of emergency, found great difficulty in removing the soldier’s hands from what he though was his Japanese enemy.

It is interesting to note that the soldier exhibited a similar single-mindedness to that shown by patients/subject who are given memory tasks: utter concentration on the task at hand can bring positive or negative results that are difficult to stop once in motion. Watkins took his experiment one step further by taking a pair of very close friends and hypnotizing one, giving him the same suggestion regarding the Japanese soldier. The subject not only tried to strangle his friend, but also took out a concealed knife and tried to stab him. As Watkins put it, “only the quick action of one of the assistants, who was a judo expert, prevented a potentially fatal stabbing.”

The apparent contradiction between these experiments and the generally accepted principle that a subject cannot be induced into behaviour under hypnotism that he would not otherwise do is in fact satisfied on closer examination. Both the subjects in the Watkins experiments had been hypnotized into a state of suggestibility in which they genuinely believed there was a Japanese soldier sitting across the table from them. Once within this state their actions made sense: they were not ‘criminal’ or unethical in nature, but rather justifiable self-defence. It is the belief that the person opposite is someone other than who he really is which is the contentious issue here, not the act of violence perpetrated by the belief.

As the Cold War cast its shadow across many areas of American life, the Armed Forces continued with their interest in hypnotism, commissioning a report from the Rand Corporation in 1958. The author of this report, Seymour Fisher, suggested that research into hypnotism should be continued if for no other reason than the “enemy” (now Russia rather than Japan) was undoubtedly undertaking research itself. Forewarned is the best manner of being forearmed according to the report:

“To both the lay person and the behaviour scientist hypnosis has long been regarded as a potentially powerful instrument for controlling human behaviour. Undoubtedly, the intelligence divisions of many countries have given serious thought to this potential and have done classified research in various areas of hypnosis … it is conceivable … that these techniques could have been used and covered up so successfully that they might be impossible to recognize…”
(Fisher, 1958)

Fisher, in apparent seriousness, suggested ways in which America could advance in the mind-control field: developing drugs that would enable the easier induction of hypnotic states, drugs that would produce deep hypnosis almost instantly, and drugs that would ensure than amnesiac-suggestions were flawless.

It is interesting to note that Fisher was suggesting all of this research in the same year that the American and British Medical Associations were both accepting that hypnosis was a legitimate, if limited, technique within various forms of medical treatment. What the exact results of the experiments which logically sprang from this report were is not known as they were never released. The commonly held supposition that the experiments must have failed because the results were never made public seems naïve in the extreme. If they had worked it is likely that the US government (with all countries who indulged in similar research) would want the results kept secret.

CHAPTER 3
THE TECHNIQUES OF HYPNOSIS

There are many different techniques used to induce hypnosis, but they share a number of common characteristics. All of the following is assuming that the hypnotism experiments that were mentioned in the previous chapter were in some way misrepresented or that such a deep state of hypnosis was induced that the subject genuinely believed they were in an utterly different situation from reality.

The first characteristic of hypnotism is that the person to be hypnotized must be willing and cooperative; he must trust the hypnotist. This basic premise puts the lie to the idea that hypnotists can somehow hypnotize people against their will and then make them do things that they would not otherwise do. The patient must be completely trusting of the hypnotist in order to put herself into the necessary state of relaxation that is needed for hypnosis to occur (Rossi, 1988.) With this proviso in place, hypnosis normally takes the following course:

1) The subject is invited to relax in comfort and to fix his gaze on some subject.
2) The hypnotist continues to suggest, usually in a quiet and low voice that the subject’s relaxation will increase and his eyes will grow tired.
3) The subject’s eyes start to close, and the hypnotist suggests that they should close.
4) The eyes close, begins to show signs of profound relaxation (limpness and relaxation).
5) A state of hypnotic trance now exists.

A person’s responsiveness to being hypnotized is probably greatest when she believes she can be hypnotized, that the hypnotist is competent/trustworthy and that the process of hypnotism is safe, appropriate and congruent with her wishes. Thus a degree of rapport must exist between the patient and the hypnotist before the hypnosis session starts to occur.

It is at this point that induction starts to occur. Hypnotic inductions almost always begin with simple suggestions that are almost always accepted by the subject. At this point is it not clear to either the subject or the hypnotist whether the subject’s behaviour constitutes a hypnotic response or mere cooperation. After this initial stage suggestions are given that demand increasingly distorted perceptions or memory. Thus, the hypnotist may tell the patient that he cannot open his eyes even if he tries to. This stage of induction can be achieved in a few seconds or may take many hours.

It must be stated that the state of hypnosis differs from one patient to another and indeed, from session to session with the same patient. There are degrees of hypnotic trance, from light to profound. There is no fixed stability to these however, and a single subject may move from light to profound and then back to light etc. within the same session. This has led some critics of hypnosis (foremost among them was Freud) to suggest that the state of hypnosis is in fact dependant upon purely subjective matters such as whether the patient ‘believes’ they are hypnotized. In other words, a degree of acting or outright lying occurs. This is however, an attempt to force a scientific certainty and concrete methodology onto a technique that is essentially difficult to define within such limitations.

The state of hypnotic trance normally displays the following characteristics. There is “a simplicity, a directness, and a literalness of understanding, action and emotional response that are suggestive of childhood”. (Britannica, 1998) The fact that some hypnotized patients display unusual abilities that they may not normally possess in everyday life seems to stem from the restriction of their attention to the task at hand. They are able to avoid the normal distractions of life and so concentrate absolutely on what they have been asked to do. Suggest ability which may be defined as a state of greatly enhanced receptiveness to suggestions and stimuli presented by the hypnotist constitutes the central phenomenon of hypnosis.

The skilful hypnotist can bring about a greater range of psychological, sensory, and motor responses from the patient through suggestion. By both accepting and responding to suggestion, a patient can seem to become they all ranges of states including being deaf, blind, paralyzed, read and suffering from hallucinations. While the movie image of the hypnotist and control someone against their own will is, as has already been stated, grotesquely exaggerated, it is true that posthypnotic suggestion and behaviour can occur. This involves patient doing something at a later date which has been suggested by the hypnotist, and the patient when of no idea why she has carried out the action. This post hypnotic behaviour depends upon the degree of amnesia within the patient that is unusual. This type of behaviour and suggestion is far less powerful than behaviour that is voluntary on the part of the patient.

In contrast to this amnesia is a state called hypermnesia, in which the patient exhibits greater powers of memory than they would normally enjoy. This is the subject of a great deal of controversy, as well be discussed later, within this supposed exposure of memories that have been suppressed by the patient because of the emotional difficulty of dealing with them in a conscious manner. Memory is of child abuse are supposedly uncovered in this manner. As one scholar puts it, “in the trance state the patient, by virtue of an uncritical willingness to make the effort and a freedom from inhibitions to deriving from preformed judgments, can vividly remember long forgotten, even deeply repressed experiences, recount them in extensive detail and still maintain an amnesia for them at the ordinary level of consciousness” (Britannica, 1998). It was this seemingly magical ability of recovering apparently hidden memories that enabled Freud to start upon his explorations all the patients subconscious. Freud may not have realized this, or even if he did realize it he could not admit it, but hypnosis was occurring during these times.

Various hypnotic states have also been associated with the altered states of consciousness that can occur through various drugs, states of meditation and even mental disease. Here we run across the problem of exact definition, as the altered states of being made in fact be merely symptoms of the disease rather than of any hypnotic state. The shamanistic practices of various indigenous peoples throughout the world seem to suggest that hypnosis can in fact be self administered. In a sense the person has put himself into a state of trance.

Hypnosis does not seem to require any particular kind of training nor does it involve any particular talent or skill that might be inherited or developed. However, it must be said that due to some of the more negative occurrences which have occasionally been seen among patients without undergone deep hypnosis, some degree of medical training should at least be available to the hypnotist, even if he does not possess it himself. Some medical authorities, as we shall see, wish to see bans on the use of hypnosis within entertainment or even by untrained personnel. Such a ban would be very difficult to enforce, because of the uncertainty of the definition of what hypnosis actually is.

CHAPTER 4
CURRENT MEDICAL USES OF HYPNOSIS

As this study has already briefly explored, the use of hypnosis within the medical field has been the subject of some controversy for many centuries. Various medical associations have conflicting and even sometimes contradictory attitudes towards the technique. These range from disdain for its apparent claims to acceptance of it as a legitimate technique. The American Medical Association recognized hypnosis as an approved science in 1958. Since then it can be argued that hypnosis has become a rapidly growing field.
Unfortunately, hypnosis like any other ill-defined and thus vulnerable medical technique is open to abuse and to outlandish claims. Thus, the official sounding National Board of Professional and Ethical Standards, which essentially sells diplomas for which one needs no previous academic experience of qualifications (the educational value of any courses they offer is void of substance), gives the following rather impressive statistics on its website:

Psychoanalysis 38% Recovery after 600 sessions
Behaviour Therapy 72% Recover after 22 sessions
Hypnotherapy 93% Recovery after 6 sessions
(National, 2006)

Unfortunately, it does not inform the prospective student what the patients were recovering from. It gives the source for these statistics as an American holistic health magazine. Looking at the claims, it would seem as though just two weeks of hypnotherapy sessions are three times as likely to lead to “recovery” as eleven years of weekly sessions of psychoanalysis. If this were true, one might wonder why hypnotherapy is not the only form of psychological counselling allowed. The fact (discussed in an earlier chapter), that psychoanalysis is often just a form of hypnosis by another name places these statistics in an even more problematic light. What differentiation between “psychoanalysis” and “hypnotherapy” is being made here? The claims continue, with one Dr. Weil of Dr Weil’s Self Healing Newsletter stating, “in general, I believe that no condition is out of bounds for trying hypnotherapy on” (National, 2006).

These kinds of claims diminish the serious therapeutic value that hypnosis can offer, but they must be regarded as part of the spectrum of how hypnotherapy is used within medicine.

One of the most commonly used, and yet one of the most controversial uses of hypnotism, is within the criminal justice system. This can be regarded as a “medical” because many of the people involved are in fact being treated for traumatic experiences (in which they were the victims of crimes) when “evidence”, in the form of so-called ‘suppressed memories’ occurs which is then used in court.

The first time that hypnotically-induced evidence was used in court was in 1968 (Harding, 1968), when the Maryland Supreme Court allowed the introduction into evidence of “hypnotically refreshed” eyewitness testimony, despite the scientific controversy about its reliability. The Court ordered the Judge and Jury to consider this controversy in determining the weight to give such testimony. This ruling held for about twenty years, but in the last couple of decades increasing number of courts have disallowed the use of such evidence for a number of reasons:

First, there is little reason to believe that recollections under hypnosis are more accurate than unhypnotized recollections.

Second, hypnotized persons are highly suggestible and often provide inaccurate information in response to subtle and unintended cues given by the hypnotist.

Third, evidence obtained from hypnotized persons may often include confabulations — false memories that the hypnotized subject creates to fill in gaps in his recollections, which the subject later believes, and may testify to as true memories.

Fourth, while hypnosis may cause hypnotized persons to provide a greater amount of accurate detailed recollections, it also induces a greater number of false recollections.
(Orne, 1995)

There are also other problems, such as the fact that a hypnotized person may become surer of the exact details of an incident than he reality he would be without the hypnotic process.

Within psychoanalysis the recovery of memories that the patient ordinarily finds too painful or disturbing to actually recall may be an essential part of the process of healing. This technique is commonly called hypnotic age-regression, and has become a commonly used although controversial method. Within this technique the hypnotized person is given a suggestion that they are reliving an earlier age. The major question involved within hypnotic age-regression is whether the age-regressed individual is actually reliving past events or just role-playing the particular age that has been suggested to her.

The fact that the person most easily hypnotized is the also the person who believes in hypnotism and in its positive effects to the greatest extent may be important here. Because “the hypnotic suggestion to relive a past event, particularly when accompanied by questions about specific details, puts pressure on the subject to provide information for which few, if any, actual memories are available.” (Orne, 1995) The patient may then fill in the large blanks within their memory by plausible sounding imagined occurrences or events later in life that they do remember. This is particularly important when a doctor is exploring the possibility that some kind of child abuse has occurred in a patient’s past. If the patient has been hypnotized with the express intent of “recovering” those memories of being abused as a child that have been “lost” or “suppressed”, the patient is under a great deal of pressure to find those memories, whether they actually exist or not.

In recent years it has become clear that some psychiatrists, for mysterious reasons, have taken it on themselves to deliberately implant false memories of child abuse within patients. One of the most disturbing cases included Nadean Cool, a nurse’s aid who sought psychiatric help “to cope with her reaction to a traumatic event experienced by her daughter.” (Loftus, 1997) While the therapy was meant to discover coping methods for the mother to deal with her daughter’s trauma, the psychiatrist turned it around and used hypnosis to “reveal” memories of abuse that Cool had supposedly suffered from as a child. The list of traumas and mental conditions that Cool was supposedly suffering from reads somewhat like a satire of mal-practice, but when reading it, one should constantly remind oneself that it is what a real psychiatrist actually did.

Cool became convinced that she had repressed memories of having been in a satanic cult, of eating babies, of being raped, of having sex with animals and of being forced to watch the murder of her eight-year-old friend. She came to believe that she had more than 120 personalities-children, adults, angels and even a duck-all because, Cool was told, she had experienced severe childhood sexual and physical abuse. The psychiatrist also performed exorcisms on her, one of which lasted for five hours and included the sprinkling of holy water and screams for Satan to leave Cool’s body.
(Loftus, 1997)

One other case serves to show how the repressed memory technique can be abused by medical practitioners, adding once again to the bad reputation that genuine hypnosis undeservedly enjoys. In 1992, the daughter of a Minnesota clergyman “recovered” childhood memories of having been raped by her father (while her mother held her down) and that he had also forced her to abort the fetus herself, without anaesthetic, with a coat-hanger.

The patient’s father resigned from his clergy position, the family broke up and then it was discovered, after a medical examination, that the woman was still a virgin and had never been pregnant. In both these cases the women were awarded large sums of money against the psychiatrist, but the question remains as to what is actually happening within this hypnotic therapy. Is the psychiatrist deliberately placing false memories within the patient under suggestion or is it a case of the patient filling in empty parts of her early childhood memories with her macabre imagination? Both scenarios bring about the conclusion that hypnosis is a very powerful technique that should only, perhaps, be used under exceptional circumstances to perform regressive memory. No psychiatrist involved in the legal cases that have resulted from false-memories has ever admitted to deliberately planting the memories within the patient. Of course, it is unlikely that any of them would, even if they had, considered the possible effects upon their medical license and even criminal charges that might result.

It seems likely that a kind of folie a deux occurs within the therapist’s room at this point. The session starts in a conventional manner with a legitimate attempt to discover the source of some psychological or emotional trauma that is creating some kind of condition within the patient in the present day. Once the session progresses however, the eagerness to please the operator within the subject (tendency that has been constantly observed since the time of Mesmer) starts to take over and, with the suggestion of the psychiatrist as a catalyst; stories are invented which then become memories.

As the session continues, the subject wishes to make the operator even more pleased than they already are with their performance, and so the story becomes even more elaborate and extreme. The hypnotist in turn is satisfied at the “positive” outcome of the session, i.e. some cause for the psychological condition has been discovered, and so encourages (but in fact suggests) further revelations. It is this vicious cycle of suggestion -> invention -> encouragement -> suggestion . . . that leads to some of the more outlandish claims regarding the “memories” that have been uncovered.

Part of the problem with this use of hypnosis is some of the questions that the therapists tend to ask the patients, both before and during the session. Thus 11% of clinical psychologists instruct their patients to “let the imagination run wild”, while 22% tell them to “give free reign to the imagination” (Loftus, 1997). The therapist Wendy Maltz, who is written an influential and popular book on childhood sexual abuse, advocates the following type of questioning:

“Spend time imaging that you were sexually abused, without worrying about accuracy proving anything, or having your ideas make sense …. Ask yourself … these questions: What time of day is it? Where are you? Indoors or outdoors? What kind of things are happening? Is there one or more person with you?”
(Maltz, 1986)

Further and perhaps even more disturbing, she suggests dwelling upon the following:

“Who would have been likely perpetrators?
When were you most vulnerable to sexual abuse in your life?”
(Maltz, 1986)

Not surprisingly a remarkable number of patients tend to “recover” memories of childhood sexual abuse through these methods, often by their parents. Eventually, any study of repressed memories falls back on the intuitive understanding of memory possessed by the vast majority of human beings: long-term memories tend to be of important events rather than of insignificant ones. The more traumatic an experience the more likely it is that a patient will be able to recall it, not the less likely. When a patient cannot recall childhood abuse, even though such abuse seems to fit within a therapist’s theory of the causation of a present condition, it is probably because such abuse never occurred.

Hypnosis can be very effectively used by a therapist however within a more limited, but often more powerfully therapeutic sense. Thus hypnosis can be utilized in a whole series of situations including those involving weight loss, smoking cessation, stress management and insomnia. These are more common, less controversial (and thus less publicly known) uses for hypnosis that can actually succeed.

Many of these uses involve strengthening a patient’s “will-power” to stop potentially harmful behaviour. Thus the cessation of smoking is, because of the very addictive qualities of nicotine and other substances put in cigarettes, a very difficult prospect for most people. The conscious mind may seek to stop the person from smoking, but subconscious pressures and the physically addictive properties of the substance may be impossible to avoid. Within smoking cessation the hypnotist will put the patient into a hypnotic state (varying in depth according to the wishes of operator/subject) and then suggest that the patient will stop smoking. The therapist may list various situations in which the patient will be tempted to smoke and then suggest to them possible ways of avoiding lighting up a cigarette. This type of hypnosis succeeds because the subject has a great vested interest in wanting the suggestion that will occur while in the hypnotic state to succeed.

An example of why hypnosis can succeed in such cases is to be found within a description of what occurs for a patient who is invested within the process that is taking place. It is the belief in the effectiveness of the treatment that may be its most effective tool:
Somewhere between wakefulness and sleep is the state of consciousness that hypnotherapists use. That trance like state is similar to the one that occurs spontaneously in sleepwalking or daydreaming. Most people will experience hypnosis as a state in which they become more aware of their inner being, their emotions and state of mind so as to make it possible to work and transform those emotions and states which may have become a problem. You will not lose consciousness or awareness, but become able to gain a different perspective on what has been troubling you.

Most people talk and act as if the conscious mind is the prime mover behind our behavior and regard the unconscious mind as something vague, that they are not really aware of. In fact, the unconscious mind is always working, monitoring and affecting all the physical and psychological functions of the mind and the body, from blood pressure and hormone levels to states of hunger and fatigue, even when we are asleep. The sum of what we have learned and experienced is also stored within the unconscious mind, and our memory holds far more than we can usually remember at a conscious level

Through accessing that unconscious mind, hypnotherapy can help you learn how to react differently to certain situations and help you to understand better the development mechanism of your mind. For example, if you have to prepare for an exam and feel nervous about it, you can learn how to access and strengthen your ability to relax and apply that to the situation of passing an exam. Once you know how to do that, then it becomes easier to “decide” how you would like to feel and react in a given situation.
(CHIS, 2006)

Note the fact that this description is written in simple language that the person of average intelligence and education can understand. Hypnosis, unlike other medical techniques which tend to lose the patient within a morass of technical language and scientific terms, is most effective when it is most fully comprehended by the subject. The pre-hypnosis education as to what the technique is (and what it is not) is vital to the overall efficacy and success of the hypnosis which is to occur.

Hypnotism can also be used within pain management, especially that caused by operations, in giving birth and within particularly painful conditions such as shingles. Other studies on pain reduction conclude that hypnosis can be very effective. Thus, a 1989 study by a University of Milan researcher, Dr. Giuseppe Benedttis showed that hypnosis could relieve the pain associated with ischemic heart disease. In 1991, a study showed that hypnotized patients undergoing the often agonizing procedure of angioplasty could keep the balloon used in the procedure inflated for 25% longer than nonhypnotized patients. This reduced the need for surgery among the hypnotized patients. Two studies by Dr. David Spiegel of Stanford University Medical School offer both ends of the claims for hypnosis: the explicable and the mysterious. Thus in a 1993 study, Spiegel found that hypnosis could bring about a 23% success rate in the cessation of smoking. A few years earlier his 1989 study had concluded that hypnosis therapy appeared to double the survival time for women with metastatic breast cancer.

What the curative linkage between hypnosis and the metastasis of cancer could possibly be is completely unclear. It seems as though some kind of false correlation may have been occurring here: another variable, untested within the study, may have been at work. However, if hypnotherapy sticks to what it appears to have a certain (and explicable) effect upon, the list of conditions is still very impressive:
• inflammatory bowel diseases (namely, Crohn’s disease and ulcerative colitis)
• sleep disorders, including insomnia
• addictions
• warts
• bedwetting
• fibromyalgia
• irritable bowel syndrome
• phobias
• labor and delivery
• fractures
• skin disorders (such as acne, psoriasis, and eczema [atopic dermatitis])
• migraine headaches
• stress
• tinnitus (ringing in the ears)
• cancer related pain
• weight loss
• eating disorders, namely anorexia and bulimia
• indigestion (dyspepsia)

This is a list of diseases and conditions collected from the American Medical Association, a group that is notoriously sceptical regarding medical practices that do not clearly belong to the “mainstream” of modern medicine. As this study has shown, hypnotherapy has resided in a fascinating area on the edge of medicine for a number of centuries. At times being held within it, at others firmly outside of it, but much of the time inhabiting a no-man’s-land where it may be pushed in one direction by dubious practices (memory regression is a recent example) or towards that of legitimacy through proven applications such as pain management.

Part of the legitimization of hypnotherapy has come through the standardization of its licensing. Most hypnotherapists are licensed medical doctors, registered nurses, social workers, or family counsellors who have received additional training in hypnotherapy. For example, members of the American Society of Clinical Hypnosis (ASCH) must hold a doctorate in medicine, dentistry, podiatry, or psychology, or a master’s level degree in nursing, social work, psychology, or marital/family therapy with at least 20 hours of ASCH-approved training in hypnotherapy. Similarly, the American Psychotherapy and Medical Hypnosis Association provide certificates for licensed medical and mental health professionals who complete a six to eight week course.

CHAPTER 5
CONCLUSIONS AND THE FUTURE OF HYPNOSIS

This study has shown that hypnosis has had a long and fascinating association with medicine. The origins of hypnotherapy appear to stem to prehistory and the various religions such as shamanism and other beliefs that have existed since those times. The idea that both mental and physical healing can occur at a time of altered states of consciousness has stemmed from an intuitive belief held by different cultures over a wide span of historical periods that such states offer a route into both understanding and change that ordinary consciousness cannot.

The exact “medical” nature of these beliefs is somewhat difficult to define, as they rely upon instinct and intuition rather than the scientific method. Mesmer is perhaps the ideal example and metaphor of the constant struggle between innate belief and scientific rationality within the field of hypnotherapy. Mesmer debunked the idea of “exorcism”, but continued to believe that he himself could cure blindness through his magnets and special powers. The paradoxes and contradictions presented by a figure such as Mesmer have continued to the present day. The idea that a Hypnotherapist needs no special “powers” in order to perform hypnosis is countered by the idea that some hypnotists clearly do have greater success rates than others. It is generally accepted in other branches of medicine, as within human activities in general, that some people are more innately skilled in certain techniques and acts than others, but when it comes to hypnotherapy the principle is discarded. This reluctance to concede that one individual may be a better Hypnotherapist than another probably stems from the stage performer “mesmerist” who claims to have almost supernatural powers. In this case the charlatans have made an indelible impression on what a hypnotist is and what he is not.

As with much of medicine in particular, and human life in general, the future of hypnosis may lie within technological advances. First, increased understanding of both the structure and the processes at work within the human brain will inevitably lead to greater knowledge of what actually occurs to a person within a hypnotic state. This knowledge may lead to a number of developments. Perhaps a depth scale of hypnotic trances can be set up in which the hazy, qualitative distinction between “light” and “deep” hypnotic states will be replaced by a quantitative scale. This scale may be used to correlate different states of hypnotic trance with the kinds of therapies that can be used with them. Thus the current understanding that light hypnosis can be used for pain management, whereas deeper hypnosis can be used for alleviating compulsive habits such as smoking can be expanded upon (Baumgaertel,1999).

The use of digital sound and light devices (perhaps as simple as an MP3 player or a laser light pen) might be developed than can induce different levels of hypnotic state within a standard period of time. Hypnotic treatments could thus become standardized in the way that many medical techniques are currently standardized today. The use of technology to induce hypnotic states would, once-and-for-all, place the image of the hypnotist as some sinister person with virtually supernatural powers into the pleasant fictional mythology to which it probably belongs. Hypnotherapy should endeavor to standardize, quantify and legitimize itself within the pantheon of medical practices.

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