Dr Robert London

Hypnosis: Underused Technique

Clinical Psychiatry News - Volume 31, Issue 10, Page 8 (October 2003)

Lots of patients are seeking out medical hypnosis regularly to help them stop smoking, lose weight, sleep better, or function better sexually. They're also interested in hypnosis  for other reasons, including pain, phobias, and obsessive thinking. Hypnosis can be an effective aid in treating these problems. But not enough psychiatrists understand hypnosis and what it can and cannot do.

For many patients and mental health professionals, hypnosis brings to mind mental weakness, mind control, sleep, or loss of consciousness. Women are often considered more hypnotizable than men. Those are myths. Hypnosis is neither mind control nor a strategy for the weak-willed. Clearly, women are not more hypnotizable than men, and finally, the old wives' tale that people go to sleep or lose consciousness when they are hypnotized is just that—an old wives' tale. On the contrary, a hypnotized person enters a highly alert state in which the person's focus of concentration is heightened.

The word hypnotism was first introduced in 1843 by James Braid, a Scottish surgeon, who was attempting to use hypnoanesthesia. Soon after, in India, James Esdaile performed several surgical procedures using hypnosis alone as the method of anesthesia. As the use of hypnosis has developed over the last 150 years, many of the great names of medicine and science—Freud, Pavlov, Janet, and Charcot, to name a few—have tried to define hypnosis. No clear definition yet exists.

In the mid 1950s, the British Medical Association and the American Medical Association recognized hypnosis in a policy statement as a legitimate treatment in medicine and dentistry.

Smoking cessation is an area in which hypnosis has been particularly effective. A study by Dr. Joseph Barber of the University of Washington, Seattle, for example, found that hypnotic intervention can be integrated into a treatment protocol for smoking cessation. Of 43 patients who were undergoing the protocol, 39 reported staying abstinent at follow-up, which was 6 months to 3 years after the treatment ended (Int. J. Clin. Exp. Hypn. 49[3]:257-66, 2001).

Certainly, hypnosis does not cure anything. But in the hands of a trained and competent practitioner, hypnosis is a tool that can be used once the patient has made a commitment to alter a detrimental behavior pattern.

There are many different types of hypnotic induction techniques: eye fixation, hand levitation, coin technique, Lewis Wolberg's theater technique, Simon Chiasson's method, and multiple relaxation techniques. My view is that the shorter the hypnotic induction technique the better, therefore allowing you to teach the patient what to do to enter the hypnotic state—and then launch into the treatment strategy for the specific problem being addressed. It is important for hypnosis not to be used alone, but as an adjunct to a basic treatment strategy.

Unfortunately, many people who claim to be hypnotists do not have the requisite medical or psychological training. They have the patient come back for repeated sessions, when many times a few sessions will suffice.

In my experience, if hypnotic strategies are going to work, they will be effective within a few sessions. If they do not work for a problem, it might be time to move on to other approaches.

There's no need for gadgets or drugs when hypnosis is used. If the patient is hypnotizable—and many medical practitioners can conduct a simple test or tests to determine this—all that's needed is the patient's willingness and the practitioner's skill in guiding the patients into their own hypnotic state.

More psychiatrists should be trained in hypnotic techniques. Hypnosis should be part of general psychiatric education, because these strategies add a valuable dimension to the psychiatric toolbox.

PII: S0270-6644(01)70008-2

© 2003 International Medical News Group. Published by Elsevier Inc. All rights reserved.