An Overview of Clinical Hypnosis

An Overview ofAn Overview of
Clinical HypnosisClinical Hypnosis
Connie Lemmond, LCSWConnie Lemmond, LCSW
&&
Jay Yeomans, MDJay Yeomans, MD
Grand RoundsGrand Rounds
Behavioral Health Center,Behavioral Health Center,
CMC-RandolphCMC-Randolph
March 21March 21stst
20092009

An Overview of ClinicalAn Overview of Clinical
HypnosisHypnosis
DefinitionDefinition
State of inner absorption, concentration & focused attentionState of inner absorption, concentration & focused attention
‘‘using a magnifying glass to focus the rays of the sun’ … ultimateusing a magnifying glass to focus the rays of the sun’ … ultimate
act of self-controlact of self-control
Practitioners use clinical hypnosis in three ways.Practitioners use clinical hypnosis in three ways.
FirstFirst, they encourage the use of, they encourage the use of imaginationimagination.. Mental imagery is veryMental imagery is very
powerful, esp. in a focused state of attention. The mind seems capable ofpowerful, esp. in a focused state of attention. The mind seems capable of
using imagery, even if it is only symbolic, to assist us in bringing about theusing imagery, even if it is only symbolic, to assist us in bringing about the
things we are imagining. For example, a patient w/UC may be asked tothings we are imagining. For example, a patient w/UC may be asked to
imagine what his/her distressed colon looks like. If she imagines it as beingimagine what his/her distressed colon looks like. If she imagines it as being
like a tunnel, with very red, inflamed walls that are rough in texture, thelike a tunnel, with very red, inflamed walls that are rough in texture, the
patient may be encouraged in hypnosis (& self hypnosis) to imagine thispatient may be encouraged in hypnosis (& self hypnosis) to imagine this
image changing to a healthy one.image changing to a healthy one.
SecondSecond basic hypnotic method is to present ideas orbasic hypnotic method is to present ideas or suggestionssuggestions that arethat are
compatible with what the patient wants.compatible with what the patient wants.
ThirdlyThirdly, hypnosis may be used for, hypnosis may be used for unconscious explorationunconscious exploration, to better, to better
understand underlying motivations or identify whether past events orunderstand underlying motivations or identify whether past events or
experiences are associated with a problem, avoiding the critical censor ofexperiences are associated with a problem, avoiding the critical censor of
the conscious mind.the conscious mind.

HypnosisHypnosis
Franz Anton Mesmer (1734-1815)Franz Anton Mesmer (1734-1815)
Viennese physicianViennese physician
‘‘Mesmerism’Mesmerism’
Magnetic fluid in our bodyMagnetic fluid in our body
determines our healthdetermines our health
over the affected organs with magnets,over the affected organs with magnets,
Sick could be cured by passingSick could be cured by passing
contact with magnetized water or thecontact with magnetized water or the
magnetically gifted hands of the Mastermagnetically gifted hands of the Master
Patients would go into “a grand crisis”Patients would go into “a grand crisis”
(resembled an epileptic seizure)(resembled an epileptic seizure)
ParisParis …… 1780s1780s ‘marvel of the age’‘marvel of the age’
Large oaken tubs containing a layer ofLarge oaken tubs containing a layer of
supposedly magnetized water coveringsupposedly magnetized water covering
a layer of iron filings & powdered brokena layer of iron filings & powdered broken
glass bottles floated on top,glass bottles floated on top,
iron & glass rods projected from the lid –iron & glass rods projected from the lid –
sufferersgrasped the rods & held hands …sufferersgrasped the rods & held hands …
emanations from the rodsemanations from the rods
were supposed to stimulate the circulationwere supposed to stimulate the circulation
of theof the ‘magnetic fluid’‘magnetic fluid’ in the patientsin the patients

An Overview of Clinical HypnosisAn Overview of Clinical Hypnosis
Franz Anton MesmerFranz Anton Mesmer

““Mesmerism”Mesmerism” persisted in various incarnations into the mid 19persisted in various incarnations into the mid 19thth
century - it’s creator faded into disrepute when a royalcentury - it’s creator faded into disrepute when a royal
commission which includedcommission which included Benjamin FranklinBenjamin Franklin & the chemist& the chemist
AntoineAntoine LavoisierLavoisier decreed that there was nothing to Mesmer’sdecreed that there was nothing to Mesmer’s
magnetism except “excitement of the imagination”magnetism except “excitement of the imagination”
Hindu-Portuguese priest,Hindu-Portuguese priest, AbbeAbbe‫׳‬‫׳‬FariaFaria wrote in 1819 that thewrote in 1819 that the
stimulus for ‘lucid sleep’ of mesmerism was not magnetism butstimulus for ‘lucid sleep’ of mesmerism was not magnetism but
concentration – clients relax, lean back, empty their minds &concentration – clients relax, lean back, empty their minds &
concentrate on falling asleepconcentrate on falling asleep

““Mesmerism”Mesmerism”
James BraidJames Braid: (British surgeon - 1795-1860) via experimentation: (British surgeon - 1795-1860) via experimentation
that “nervous sleep” was a condition brought about by athat “nervous sleep” was a condition brought about by a
suggestion … coined the terms “hypnosis” and “hypnotism”suggestion … coined the terms “hypnosis” and “hypnotism”
(Greek(Greek hypnoshypnos = sleep) – misnomer= sleep) – misnomer
used it frequently in his medical practice in the 1840s & 1850sused it frequently in his medical practice in the 1840s & 1850s
James EsdaileJames Esdaile: (British surgeon) performed > 300 major: (British surgeon) performed > 300 major
operations in India the 1840s using “mesmerism” as anesthesiaoperations in India the 1840s using “mesmerism” as anesthesia

QuestQuest was to understand what happens inwas to understand what happens in
hypnosis - what mechanisms are at work, arehypnosis - what mechanisms are at work, are
they physical, psychological or both?they physical, psychological or both?
Late 19Late 19thth
century - bitter rivalry between twocentury - bitter rivalry between two
French neurologistFrench neurologist
Jean Martin CharcotJean Martin Charcot (1825-1893)(1825-1893)
&&
HippolyteHippolyte BernheimBernheim (1840-1919)(1840-1919)

CharcotCharcot:: susceptibility to hypnosis was a pathological state –susceptibility to hypnosis was a pathological state –
““Morbid condition”Morbid condition” of hypnosis was closely related toof hypnosis was closely related to hysteriahysteria
BernheimBernheim: susceptibility to hypnosis came through suggestions from: susceptibility to hypnosis came through suggestions from
either the hypnotist or the subject himself –either the hypnotist or the subject himself –
phenomenon is driven by the force of ‘phenomenon is driven by the force of ‘suggestion’suggestion’, defined as, defined as
““the amplitude to transform an idea into an act”the amplitude to transform an idea into an act”
Charcot attributed hysteria to organic diseaseCharcot attributed hysteria to organic disease
Bernheim explained hysteria & hypnosis entirely onBernheim explained hysteria & hypnosis entirely on
psychological groundspsychological grounds
Freud:Freud: studied under both Charcot & Bernheim - used hypnosis earlystudied under both Charcot & Bernheim - used hypnosis early
in his career but eventually abandoned it, however, in favor of freein his career but eventually abandoned it, however, in favor of free
association and the interpretation of dreams, which became theassociation and the interpretation of dreams, which became the
basis of psychoanalysis.basis of psychoanalysis.

HypnosisHypnosis
Charles DickensCharles Dickens practiced it oftenpracticed it often
& contemplated a career as a& contemplated a career as a
mesmeristmesmerist
Edgar Allen Poe’sEdgar Allen Poe’s, “The Facts in, “The Facts in
the Case of M. Valdemar” - manthe Case of M. Valdemar” - man
suspended in a mesmericsuspended in a mesmeric
trance between life & deathtrance between life & death
H.G. WellsH.G. Wells && Sir Arthur ConanSir Arthur Conan
DoyleDoyle wrote stories built aroundwrote stories built around
hypnosishypnosis
*Hypno-novel*Hypno-novel TrilbyTrilby ((George DuGeorge Du
MaurierMaurier - 1894) – diabolical- 1894) – diabolical
Svengali exerts total dominationSvengali exerts total domination
over the winsome & helplessover the winsome & helpless
TrilbyTrilby
- publication led to demands to- publication led to demands to
outlaw hypnosisoutlaw hypnosis
Svengali (1931) - John Barrymore1931) - John Barrymore

HypnosisHypnosis
““Traveling mesmerizers’Traveling mesmerizers’
Stage hypnosisStage hypnosis
““human plank” trickhuman plank” trick
Danish hypnotist Carl Hanson &Danish hypnotist Carl Hanson &
“The Amazing Kreskin”“The Amazing Kreskin”
5-10% of the population that was5-10% of the population that was
characterized as “fantasy-prone”characterized as “fantasy-prone”
Some people, by nature, are highlySome people, by nature, are highly
susceptible & can experience thesusceptible & can experience the
effects of suggestion whethereffects of suggestion whether
they have been hypnotized or notthey have been hypnotized or not
AmjPsych ’92: dissociative disorderAmjPsych ’92: dissociative disorder
patients had higherpatients had higher
hypnotizability scoreshypnotizability scores
DSM-IV: Histrionic PersonalityDSM-IV: Histrionic Personality
(criteria 7/8: highly suggestible)(criteria 7/8: highly suggestible)

Stanford Hypnotic Susceptibility Scale (’50s)Stanford Hypnotic Susceptibility Scale (’50s)
12 activities: Score range from 0 – 1212 activities: Score range from 0 – 12
0=id who do not respond to any of the hypnotic suggestions0=id who do not respond to any of the hypnotic suggestions
(most people score 5-7)(most people score 5-7)
Ability to respond is remarkably stable during adulthoodAbility to respond is remarkably stable during adulthood
New Science:New Science: Mass Gen Hosp …Mass Gen Hosp … increased blood flow inincreased blood flow in
susceptible parts of the brain of hypnotized subjectssusceptible parts of the brain of hypnotized subjects
1969 – Thomas H. McGlashan1969 – Thomas H. McGlashan (U of Penn)(U of Penn)……for poorly hypnotizablefor poorly hypnotizable
people, hypnosis was as effective in reducing pain as a sugar pill thatpeople, hypnosis was as effective in reducing pain as a sugar pill that
the subjects had been told was a powerful painkiller. But highlythe subjects had been told was a powerful painkiller. But highly
hypnotizable subjects benefited three times more from hypnosis thanhypnotizable subjects benefited three times more from hypnosis than
placeboplacebo

Hypnosis & MemoryHypnosis & Memory
””recovered” (‘false’) memory …recovered” (‘false’) memory …
Actual or imagined eventsActual or imagined events
cuecue that humans use in making the distinction between reality &that humans use in making the distinction between reality &
imagination is the experience ofimagination is the experience of efforteffort … at the time of encoding a… at the time of encoding a
memory, a “tag” cues us as to the amount of effort we expend … if thememory, a “tag” cues us as to the amount of effort we expend … if the
event is tagged as having involved a good deal of mental effort, weevent is tagged as having involved a good deal of mental effort, we
interpret it as something weinterpret it as something we imaginedimagined – if it’s tagged as having little– if it’s tagged as having little
mental effort then we interpret as something that actuallymental effort then we interpret as something that actually happenedhappened
Calling card of hypnosis is the feeling of effortlessness – can see whyCalling card of hypnosis is the feeling of effortlessness – can see why
hypnotized people can easily mistake an imagined past event forhypnotized people can easily mistake an imagined past event for
something that actually happened long agosomething that actually happened long ago
especially in highly hypnotizable subjectsespecially in highly hypnotizable subjects
1950s LAPD – ‘Svengali Squad’ - hypnotically induced statements1950s LAPD – ‘Svengali Squad’ - hypnotically induced statements

HypnosisHypnosis
Hypnosis & PainHypnosis & Pain
1969 - NIH panel judged hypnosis to be an effective1969 - NIH panel judged hypnosis to be an effective
intervention for alleviating pain from cancer & otherintervention for alleviating pain from cancer & other
chronic conditions -chronic conditions -
e.g. reduced acute pain experienced by patientse.g. reduced acute pain experienced by patients
undergoing burn-wound debridement, children enduringundergoing burn-wound debridement, children enduring
bone marrow aspirations & women in laborbone marrow aspirations & women in labor
Meta-analysisMeta-analysis (International Journal of Clinical & Experimental Hypnosis)(International Journal of Clinical & Experimental Hypnosis)
…… hypnotic suggestion relieved pain in 75% of 933 subjectshypnotic suggestion relieved pain in 75% of 933 subjects
participating in 27 different studies …pain relief wasparticipating in 27 different studies …pain relief was
substantial & in some cases matched or exceededsubstantial & in some cases matched or exceeded
morphinemorphine

An overview of clinicalAn overview of clinical
hypnosishypnosis
Hypnosis & PainHypnosis & Pain
Alleviates pain by decreasing theAlleviates pain by decreasing the
activity of brain areas involved inactivity of brain areas involved in
the experience of suffering – PETthe experience of suffering – PET
scan – while hands of ascan – while hands of a
hypnotized subject where dunkedhypnotized subject where dunked
into painfully hot water – act of theinto painfully hot water – act of the
somatosensory cortexsomatosensory cortex
(processes physical stimuli) did(processes physical stimuli) did
not differ whether the subject wasnot differ whether the subject was
given hypnotic suggestion that thegiven hypnotic suggestion that the
sensation would besensation would be painfully hotpainfully hot
(L)(L) or that it would beor that it would be minimallyminimally
unpleasant (R)unpleasant (R) … in contrast,… in contrast,
anterior cingulate cortexanterior cingulate cortex
(involved in mediating pain) was(involved in mediating pain) was
much less active when subjectsmuch less active when subjects
were told that the pain would bewere told that the pain would be
minimally unpleasantminimally unpleasant

Uses of Hypnosis in MedicineUses of Hypnosis in Medicine
Gastrointestional DisordersGastrointestional Disorders (PUD,(PUD, IBSIBS, Crohn’s), Crohn’s)
Dermatological DisordersDermatological Disorders (Eczema, Herpes, Neurodermatitis, etc.)(Eczema, Herpes, Neurodermatitis, etc.)
Surgery / AnesthesiologySurgery / Anesthesiology
Acute & Chronic PainAcute & Chronic Pain
BurnsBurns
NauseaNausea & Vomiting, esp. assoc. w/chemo& Vomiting, esp. assoc. w/chemo
ChildbirthChildbirth
HemophiliaHemophilia
Allergies /Allergies / AsthmaAsthma
High Blood PressureHigh Blood Pressure
Raynaud’s DiseaseRaynaud’s Disease

Uses of Hypnosis in DentistryUses of Hypnosis in Dentistry
Behavior ModificationBehavior Modification
Relaxation / Anxiety ControlRelaxation / Anxiety Control
Fear EliminationFear Elimination
Quelling Undesirable Habits (Bruxism, Clenching)Quelling Undesirable Habits (Bruxism, Clenching)
AmnesiaAmnesia
Analgesia / Anesthesia / Pain ControlAnalgesia / Anesthesia / Pain Control
Prevention of Gagging & NauseaPrevention of Gagging & Nausea
Control of Saliva & BleedingControl of Saliva & Bleeding
Creative visualization for healingCreative visualization for healing
Restorative Appliance Tolerance / Pretx DesensitizationRestorative Appliance Tolerance / Pretx Desensitization
Self-image / Self-esteem and ConfidenceSelf-image / Self-esteem and Confidence

HypnosisHypnosis
Hypnosis & PsychotherapyHypnosis & Psychotherapy
Meta-analysisMeta-analysis (International Journal of Clinical & Experimental Hypnosis)(International Journal of Clinical & Experimental Hypnosis)
…… examined the outcome of subjects in 18 studies & foundexamined the outcome of subjects in 18 studies & found
that patients that received CBT plus hypnosis for obesity,that patients that received CBT plus hypnosis for obesity,
insomnia, anxiety and HTN showed greater improvementinsomnia, anxiety and HTN showed greater improvement
than 70% of patients who received psychotherapy alone.than 70% of patients who received psychotherapy alone.
APA task force validated hypnosis as a adjunct procedureAPA task force validated hypnosis as a adjunct procedure
for the treatment of obesity.for the treatment of obesity.
Drug addiction & EtOHism do not respond well.Drug addiction & EtOHism do not respond well.
Smoking cessation results are equivocal.Smoking cessation results are equivocal.

Uses of Hypnosis in Psychotherapy & Behavioral HealthUses of Hypnosis in Psychotherapy & Behavioral Health
Trauma (physical & emotional abuse, etc.)Trauma (physical & emotional abuse, etc.)
Anxiety & stress management (phobias)Anxiety & stress management (phobias)
DepressionDepression
EnuresisEnuresis
Sports & Athletic PerformanceSports & Athletic Performance
Smoking CessationSmoking Cessation
Obesity & weight controlObesity & weight control
Sexual dysfunctionSexual dysfunction
Sleep disordersSleep disorders
Concentration difficulties / test anxiety, etc.Concentration difficulties / test anxiety, etc.

HypnosisHypnosis
Selecting a qualified HypnotherapistSelecting a qualified Hypnotherapist
Hypnosis & Hypnotherapy are not regulated in mostHypnosis & Hypnotherapy are not regulated in most
statesstates
Lay hypnosis training programs vary widely in theirLay hypnosis training programs vary widely in their
depth & length – some lay hypnotherapist maydepth & length – some lay hypnotherapist may
have only attended a brief W/E workshop with littlehave only attended a brief W/E workshop with little
to no supervised learningto no supervised learning
Major Distinction between the two is thatMajor Distinction between the two is that
professionalsprofessionals have received specific training inhave received specific training in
medicine, psychology, dentistry, social work ormedicine, psychology, dentistry, social work or
counselingcounseling

HypnosisHypnosis
Selecting a qualified HypnotherapistSelecting a qualified Hypnotherapist
Recommend:Recommend: professionally-trainedprofessionally-trained
practitionerpractitioner
Questions to ask
Licensed?Licensed? (not certified)(not certified)
Degree?Degree? (hypnosis or hypnotherapy – lay hypnotist)(hypnosis or hypnotherapy – lay hypnotist)
Membership?Membership?
 American Society of Clinical HypnosisAmerican Society of Clinical Hypnosis
 Society for Clinical and Experimental HypnosisSociety for Clinical and Experimental Hypnosis
(only nationally recognized organizations for licensed(only nationally recognized organizations for licensed
health care professionals using hypnosis)health care professionals using hypnosis)
 AMA,APA,NASW,ANAAMA,APA,NASW,ANA

HypnosisHypnosis
“you are getting sleepy”“you are getting sleepy”
-Demonstration--Demonstration-
Quiet PleaseQuiet Please

An Overview of Clinical Hypnosis

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (16)

Similar to An Overview of Clinical Hypnosis

Similar to An Overview of Clinical Hypnosis (20)

An Overview of Clinical Hypnosis