What is hypnosis?
What is hypnosis? Does it have to do with power and power of will? Is it a type of black magic? Is it a spectacle? Why is it off-putting? These are questions which you and I consider. In this article, I will try to formulate an answer to this.
Show hypnosis
Unfortunately, the common picture of hypnosis is strongly influenced by the world of show and spectacle. That which show hypnotists show you is often more show than hypnosis. Show hypnotists continue a tradition which was developed at the end of the last century, in the French, Parisian salons, where neurologists re-discovered the phenomenon of "hypnosis" and demonstrated it to charm aristocratic Parisian ladies, or simply to become popular.
The history of medical hypnosis
One must not forget that the model of society looked different in the last century than it does today. We now live in a world of democracy and communication, while the past century was ruled by hierarchy and power. The prestige and the power of the 19th century bourgeoise and the professions like physician and notary were larger than they are now. It is therefore not a surprise that, in that context, the first doctors who re-discovered hypnosis mainly built up the aspects which could impress, and which could give the illusion of power. One must not forget that hysterical paralysis and fainting spells were fashion in the last century, like we now have a fashion of hyperventilation, spasms, chronic fatigue syndrome, and so on. If you wanted to get attention of those close to you or affection of your family, the 19th century dictated that it would be useful to get a hysterical paralysis. In our busy society, you will instead develop a subconscious tension headache or other psychosomatic complaints. As the spectacular aspect of hypnosis and show offered the hypnotists a lot of prestige and money, it is not a surprise that this aspect is cultivated by the 20th century show hypnotist too, who earns a living by selling spectacles. Some research even shows that show hypnotists make use of tricks such as putting pressure on your carotid, which provides blood to the brain: tricks combined with some phenomena which have something - yet very little - to do with hypnosis, give the illusion that the hypnotist has power over the medium on the stage. What you cannot forget is that the people who have been picked for the demonstration are often selected in advance, and that from a group of volunteers, two or three of the most easily hypnotizable subjects are chosen. This makes it logical that spectacular shows can be given. And is it not logical that some subjects enjoy playing along in the show? Of course, the impression is hereby given that you can really have somebody do something against their will. However, it is so that someone who is given a suggestion which defies their values, they will never act accordingly and will awaken from their trance almost automatically Hypnotists can, however, dodge this problem by testing off-stage how far they can go and with whom. It is unfortunate that this image of hypnosis is so wrong that it scares away people who could be helped by hypnosis.
What is trance in hypnosis?
When people ask me what hypnosis is, I often ask them if they ever read a book or watched an exciting movie, while they did not hear that someone entered a room or that they were sitting in an uncomfortable or hard chair. Most people know this experience. That is something I would call a spontaneous, everyday trance. Trance is a situation of heightened concentration where your focus lies with one piece or one part of your experience of reality. Other parts which are not relevant at that moment, are not actively experienced. This does, however, not mean that this information is not processed subconsciously. So: trance is a narrowing of the consciousness. Stimuli which you do not pay attention to, will still enter your senses, get processed, but are kept in the background as subconscious information. During the trance, the brain makes it so that you can focus more intensively on the information which is important at that time. To show the difference between consciousness and subconsciousness, it might be useful to compare it to the learning process of a child, who is playing and too focused on their foot to notice that it is a foot. In the course of their life, the child will hardly ever consider that this is their foot, how it looks, and how it functions. subconsciously, the information is used until the child learns to stand up. Now, it focuses on the coordination of its muscles to keep its balance. As soon as the child learns to do this, they concentrate ono the movements and steps it takes. And once this is something they can do, they will no longer think of how they keep their balance or take steps for the rest of their lives, unless it loses these capabilities due to an illness or something similar. When you learn to drive a car, you are aware of having to press and let go of a pedal, and that you must push down another pedal to slow down. You focus on this new information until you are able to do it. An experienced driver does no longer thing about this. This illustrates the function of trance or heightened attention. Increased concentration is the mechanism which allows us to use only the information needed which is useful at that time, and focus on what we need to think of in order to learn new and important things. In that sense, trance is a vital and important part of our life and development: nothing spectacular or unusual.
Then, what is medical hypnosis?
Hypnosis is nothing more than stimulating this natural trance in a professional and systematic way. The doctor or hypnotherapist does this with the goal to teach a client with a problem something new. To build up a new experience which can help them to deal with the problem or to even solve the problem. The goal of a show hypnotist, however, is to pick the phenomena which impress the masses and earn them money.
Hypnosis: subconsciously learning to learn!
Hypnosis thus mainly has to do with learning processes. It is not so that you lose your will or are unconscious during hypnosis. You are fully conscious, you are only more focused on certain aspects of your own reality. One of the phenomena of deep trance is amnesia, or the forgetting of some things which happen during a trance. This makes it so that people sometimes get the impression that they were gone during a trance, but this is not the case. The advantage of this increased concentration is that you can work on certain things during hypnosis, while other things are put out of focused or are disregarded.
Hypnosis to process emotions
If you have to work through an emotional process, it can be useful to be able to reduce the immense overwhelming feeling your emotions cause for a while so that you can focus on the core of the problem on which you want to work. This makes it so that, under hypnosis, you are able to do things which are much more difficult to do when you are not in this trance. You can 'zoom-in' on one aspect of your problem and focus on this while working on it, while you take a break from the other aspects. This makes it easier to break down your problems and look for a solution, step by step. While your conscious mind focuses on one thing, your subconscious makes it so that the whole is still respected. Because it is so that you cannot be given suggestions which fundamentally are against the subconsciousness. Respect therefore is key in medical hypnosis. Respect for both the consciousness and the subconsciousness. We here do not use subconsciousness in the Freudian sense of the word. When I use the word "subconsciousness", it is better to think back to the learning experiences of the child, where well-known, subconscious experiences are a tool to support new and conscious experiences. Another way to use the heightened concentration at one part of your experiences, is when treating a severe pain. If some part of your body hurts because of a process of illness, you can stop focus on the pain and focus on other positive experiences in your body's other parts instead, so you experience less pain or learn to handle the pain in a better way. That is how you can also develop anesthesia or numbness in deeper trance, where your sensing receptors sort of forget to send the painful information from your skin to your brain. Under hypnosis you can take suggestions because your heightened concentration responds better to suggestions than a normal conscious state of mind. Suggestions can have the goal to start psychological processes or learning experiences as well as influence bodily functions. For example, your blood pressure or heart rate can be influenced by suggestion, and even the time your blood takes to clot can be changed.
Scientific research on hypnosis
Research by a Swiss researcher shows that the amount of white blood cells in your blood changes during hypnosis or trance. The blood concentration of your own hormone cortisone changes and some physiological characteristics are altered. Several researchers such as Simonton, Rossi, Spiegel, and Auerbach in the United States suggest that your immunological protection against illnesses like the aids virus and cancer cells can be strengthened by hypnotic suggestion. Published results, which do not offer definite proof but clearly indicate something is at play, show that it is useful to complement normal treatment for illnesses like aids, cancer, rheum and asthma with hypnotherapy. They report a larger chance of healing and a better life quality. Headache, migraine, allergies, numerous skin diseases, and even some types of warts have been shown to be affected by hypnosis for many people. With all of this I do not want to make the allegation that hypnosis is a miracle cure which can do anything, but it does pose a good complement to all that already is available, and goes beyond the borders which are set by classic medicine. In recent years, hypnosis has become a more and more widespread practise among doctors, and one can even state that hypnosis has become a part of classic medicine, and is not just a type of alternative treatment.
Are there risks involved with hypnosis?
I want to consider the question of danger in hypnosis. Many people ask me "Is it dangerous? Will I get out of it again?" It is so that with professionally conducted hypnosis, there is no risk that you cannot get out of the trance. The worst thing that could ever happen is that your subconscious mind does not feel like getting out of trance immediately at the first suggestion, and that it must be repeated a few times before you get out of your trance. In very special cases, trance can even move on into a natural sleep. The trance is then broken once you wake up. However, there are several reasons as to why hypnosis is part of medicine and not of the alternative circuit. For example, I remember the story of a doctor who, during a hypnosis, suggested to his client that the client would imagine lying down relaxed and quietly in a field of grass. This client happened to be allergic to grass pollen, and got an asthma attack. If you are not a doctor or professional, such cases do risk you do create problematic situations. Another example was described by Milton H. Erickson, the biggest hypnotherapist in the 20th century, who once got a phone call of a client who asked him to hypnotize her to relieve her menstrual cramps. Half an hour later she called up again, to say the hypnosis did not work. He did the hypnosis again, after which he got another phone call after half an hour that the complaints did not disappear. He sent her to the hospital with a suspected diagnosis of appendicitis. In case he would have been careless in his formulation of the suggestions, and would have said that the pain would fully disappear, regardless of the cause of the pain, this client would have risked that the appendicitis would have painlessly evolved to a worse stage. Another risk is listening to a recording with a hypnosis while driving. In case a client hears this while driving a car, it is not impossible that they will enter a trance at that moment. In that sense it is important that you choose a hypnotherapist who you have researched, to make sure they are medically and technically apt, and have had a good education regarding hypnotherapy.
How does such a hypnotherapy work?
If you have a problem, physical or psychological, and you think hypnosis can help you, the first phase is a discussion with the doctor or therapist. The doctor then tries to map out your problem, and forms some hypotheses for themselves. These hypotheses are discussed with the client, and often the first conversation already makes it clear whether the complain can be eased with the help of hypnotherapy treatment, or if other types of therapy are more useful. In the discussion, you look for a vision which both the therapist and client are comfortable with. An important question in the first discussion is if the complaint only affects the client negatively, or if it also has positive aspects. It often happens that a client finds it difficult to give up a complaint because they have something to lose. This process is sometimes conscious, sometimes subconscious. It can be discussed with the client and possibly, if the answer remains unclear, be further explored under hypnosis. There namely are several techniques which let the therapist or client ask questions to the subconscious, or even to negotiate with the subconscious. When the strategy has been decided upon to some extent, the next session is planned, so that both the client and the therapist get a chance to process the discussion. If hypnotherapy is chose, the second session will teach the client the experience of going into trance. It is important that this phase of learning to experience trance is focused on before continuing on to work on the actual problem. After a short conversation, the client places themselves in a relaxed position, can eventually ask any final questions, and then follows the induction phase. The induction phase is the first phase of hypnosis, which will be repeated in every hypnosis, while it will generally go more quickly and more easily for every session that is done. The therapist and client together pick an induction technique which suits the client. There are tens to hundreds of induction techniques to be found in literature, and it does not really happen that one certain technique suits all clients. The client follows the suggestions and lets themselves be lead to a state of deep relaxation while the trance is slowly induced. The therapist follows the signs of trance and can eventually ask the client questions about their experience. While the trance is induced, a second phase follows: the deepening phase. The therapist gives suggestions which allow the client to sink deeper into a trance until it is at a depth at which the subconscious mind decides that the problem can be worked on. In the third phase, the therapeutic work starts. Direct or indirect suggestions are given or the therapist can ask questions to the client, if this is the strategy which is used. During this phase, the client will still be aware of what is happening. Depending on the depth of the trance, the consciousness will be focused on a broad or small level. At the end, some adapted suggestions are often built-in which allow the subconsciousness to keep working on the problem during the following days or weeks, to look for an own creative solution. At the end of the session, the therapist gives several suggestions which allow one to return from this trance with a fresh and clear feeling. Afterward, there is a short discussion in which the client talks about their experiences, and where the therapist can answer eventual questions which the client might have. Depending on the problem, the therapist might ask the client to start practising self-hypnosis at home, and eventually to do other tasks in the context of the therapy. Depending on the problem, more sessions are needed and it is often chosen to combine talking with hypnotherapy, so that the client gets a chance to work through issues on a conscious as well as a subconscious level.
Medical indications for hypnosis
As mentioned earlier, hypnosis is used as a complementing treatment to a medical treatment of numerous normal illnesses where the internal immune system plays a large role: cancer, aids, rheum, allergies, eczema, psoriasis, or other skin diseases. Hypnosis helps here to strengthen one's own immunity and to improve the healing process or chance of healing. Hypnosis can be a useful tool in the treatment of many psychological problems, such as stress, anxiety, hyperventilation, exhaustion, depression, addiction, burnout, performance anxiety, exam anxiety, phobia, fatigue, sleeping disorders, psychosomatic problems, eating disorders, relationship problems, ... In these cases, hypnosis nowadays also often is successfully combine with the online self-help program which also works on the same stress mechanisms. Other problems in which hypnosis can help are acute or chronic pain, high blood pressure or hypertension, muscle cramps, back ache, torticollis, ... Hypnosis can also be a good tool to develop yourself as a person and to reach personal goals such as motivation, concentration abilities, exam preparation, improved sports performance, metal training, meditation, creativity, making decisions, analyzing problems, removing subconscious blockages, ... Furthermore, hypnotic techniques are often used in normal conversational therapy by hypnotherapists, without hypnosis. Good results with this can be seen in, among other things, addiction, anxiety, hyperventilation, ...
Medical hypnosis: summary
Hypnosis does not work miracles, but it is a useful tool to complement all other techniques which medicine has to offer. Not one remedy solves all problems, each remedy has its own indication. However, hypnosis is a relatively harmless and very specific type of treatment if it is used well. If one combines it with classic medicine, it can be a useful complement, especially in situations where there are very few alternatives.
Who is competent for using hypnosis?
Only doctors or psychologists with a decent training in medical hypnosis are competent in medical hypnosis to help you solve a medical or psychological problem. So make sure to ask what type of education your health care provider has had to make sure you can trust them with this. In my own practise as a physician and hypnotherapist in Antwerp I often see how people are mistreated by quacks without a diploma nor education. When I train doctors and psychologists myself, I take the time to teach them the tools, limits, and possibilities of every medical hypnosis technique. So make sure to be well-informed when choosing a hypnotherapist. Feel free to e-mail via the contact form if you have any questions.
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Paul Koeck, MD