About Hypnotherapy

What is Hypnotherapy?

Does Hypnotherapy work?

How do I choose a good Hypnotherapist?

Many people have misconceptions about hypnosis and hypnotherapy. Hypnotherapy is often more about therapy than it is about hypnosis - no one is going to make you stand up and cluck like a chicken! The only time I do that is when my teenage son is acting up, and he needs a little grounding. During a hypnotherapy session you will not loose any free will, you are not 'under anybodies power'.

Hypnosis is a process you should generally find enjoyable. It can be rewarding, relaxing and even a lot of fun. One way to experience it without laying out much money is to join one of my group sessions . This gives you a good taster for what it's like, and only costs $30. If you are a little skeptical, come on down anyway - and bring a friend. You'll surprise yourself.

My intention is to give as much information as you need to understand hypnosis. For those interested in a the technical aspects of hypnosis you may find this case study of interest.

What is Hypnotherapy?

Hypnosis happens when you are in a relaxed state, something like daydreaming, when your critical faculties are suspended and you are open to suggestion. The words 'hypnosis' and 'hypnotherapy' are derived from the Greek word hypnos, meaning 'sleep'.

Hypnotherapists induce a hypnotic trance in order to help you overcome addictions and phobias, such as fear of flying, or to relieve pain or stress contributing to illnesses like asthma. Some therapists who practise 'modern' or 'ericksonian' hypnotherapy (a style of psychotherapy called NLP) don't even induce the trance state, having found they can rely on 'everyday trance' — the mind's ability to wander and daydream — as a basis for making effective therapeutic suggestions.

In the 18th century, the Austrian doctor Franz Anton Mesmer practised a kind of hypnotism involving magnets ('mesmerism'). His patients claimed to feel no pain while in a trance and although Mesmer was dismissed as a charlatan, a Scottish doctor, James Braid, became interested in Mesmer's approach and investigated the possibilities of trance-like states of mind as a form of anaesthesia.

Early psychoanalysts like Sigmund Freud made use of hypnosis, but the American psychotherapist Milton H Erickson developed the form of hypnotherapy commonly used today. Many practitioners are counsellors, psychotherapists or psychologists, others are doctors and dentists.

What it's supposed to do?

Hypnosis bypasses the conscious mind, allowing direct communication with the unconscious. Most people can be hypnotised to a greater or lesser extent; the best subjects are those who are imaginative and easily absorbed in what they are doing.

Hypnotherapy is said to be particularly useful for habit problems like bedwetting in children, smoking, compulsive eating and nail biting; stress-related or psychosomatic conditions like skin problems, irritable bowel syndrome and migraine; pain relief, phobias, panic attacks, lack of confidence, inhibitions and sexual problems.

What happens?

Hypnotic states can be induced in several ways (whirling Dervishes use motion, for instance) but Western hypnotherapists tend to prefer quiet relaxation. You normally see a practitioner for a course of 30- to 60-minute sessions. At your first appointment, the therapist will ask about your physical and mental health, the nature of your problem and why you have chosen hypnotherapy. A hypnosis session often starts with a relaxation procedure, such as tensing and releasing different parts of your body, as you lie on a reclining chair or couch.

The video below shows me working with a client who acheives a good state of trance in quite literally seconds. This is a little unusual, but illustrates the fact that hypnosis can take place very rapidly if you know what you are doing. As you can see, this is a comfortable and relaxing experience. The ability to be hypnotized is generally an indication that the client has strong visualisation skills. The client gave permission for the use of the video.

This about sleep:

This is an instant induction:

Some therapists deepen this state into trance by suggesting you feel heavy and relaxed. Visualisation techniques might include imagining yourself going down in a lift or descending a flight of stairs. Once you are in a light to medium trance, the hypnotherapist will address your unconscious mind. People with arthritis may be told they can turn the pain down like the volume of a radio, or smokers that they will no longer find smoking pleasurable. You may be given a post-hypnotic suggestion that enables you to induce self-hypnosis after the treatment course is completed.

Hypnotherapists may use trance to explore the root of a problem and help you change deep-seated attitudes or feelings. At the end of the session, the hypnotherapist suggests that you return to normal consciousness.

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Does Hypnotherapy work?

There is good evidence from controlled trials that hypnosis can reduce anxiety (especially when related to medical procedures like chemotherapy), relieve acute and chronic pain and skin irritation, and benefit asthma and irritable bowel syndrome. When used with cognitive behavioural therapy, hypnosis was shown to help panic attacks, insomnia, phobia and obesity.

Is hypnotherapy just some form of mumbo jumbo, or is there evidence of success?

Yes - there is plenty of evidence of success. I have many clients who came to me with a problem - and now no longer suffer with that issue. I stop people killing themselves with tobacco virtually everyday.

However, in North America the medical profession is sadly still far behind the United Kingdom in their acceptance of Hypnotherapy. Fortunately many individuals go out and research the subject for themselves and find examples of hypnotherapy helping others with the same disorders they suffer from. Below is an extract from Wikipedia that gives some details of the systematic evalutation of Hypnotherapy in the United Kingdom - and the service it can provide within a healthcare system. It's results and implications are undeniable. RH

Evidence from Systematic Reviews

In 1892, the British Medical Association (BMA) commissioned a team of doctors to undertake an extensive evaluation of the nature and effects of hypnotherapy, they reported,

The Committee, having completed such investigation of hypnotism as time permitted, have to report that they have satisfied themselves of the genuineness of the hypnotic state. (British Medical Journal, 1892)

Adding,

The Committee are of opinion that as a therapeutic agent hypnotism is frequently effective in relieving pain, procuring sleep, and alleviating many functional ailments [i.e., psycho-somatic complaints and anxiety disorders]. (Ibid.)

This report was approved by the general council of the BMA, thereby forming BMA policy and rendering hypnotherapy a form of "orthodox", as opposed to complementary or alternative, medicine.

Subsequent research on hypnotherapy has tended to highlight three main areas in which it's efficacy as a treatment has been demonstrated,

1. Anxiety.
2. Insomnia.
3. Pain management.
4. Psycho-somatic disorder, i.e., stress-related illness.

Hypnotherapy has many other applications but efficacy research has tended to focus upon these issues. More mixed results have been obtained for its efficacy in relation to the treatment of addictions, an area where high relapse is common with most treatments.

In 1955, the Psychological Medicine Group of the BMA commissioned a Subcommittee, led by Prof. T. Ferguson Rodger, to deliver a second, and more comprehensive, report on hypnosis. The Subcommittee consulted several experts on hypnosis from various fields, including the eminent neurologist Prof. W. Russell Brain, and the psychoanalyst Wilfred Bion. After two years of study and research, its final report was published in the British Medical Journal (BMJ), under the title ‘Medical use of Hypnotism’. The terms of reference were:

To consider the uses of hypnotism, its relation to medical practice in the present day, the advisability of giving encouragement to research into its nature and application, and the lines upon which such research might be organized. (BMA, 1955)

This is a much more thorough and extensive report, and constitutes one of the most significant documents in the history of hypnotherapy research. With regard to efficacy, it concludes from a systematic review of available research that,

The Subcommittee is satisfied after consideration of the available evidence that hypnotism is of value and may be the treatment of choice in some cases of so-called psycho-somatic disorder and psychoneurosis. It may also be of value for revealing unrecognized motives and conflicts in such conditions. As a treatment, in the opinion of the Subcommittee it has proved its ability to remove symptoms and to alter morbid habits of thought and behavior. […]

In addition to the treatment of psychiatric disabilities, there is a place for hypnotism in the production of anesthesia or analgesia for surgical and dental operations, and in suitable subjects it is an effective method of relieving pain in childbirth without altering the normal course of labor. ('Medical use of hypnosis', BMJ, April, 1955)

According to a statement of proceedings published elsewhere in the same edition of the BMJ, the report was officially ‘approved at last week’s Council meeting of the British Medical Association.’ (BMA Council Proceedings, BMJ, April 23rd, 1955:1019). In other words, it was approved as official BMA policy. This statement goes on to say that,

For the past hundred years there has been an abundance of evidence that psychological and physiological changes could be produced by hypnotism which were worth study on their own account, and also that such changes might be of great service in the treatment of patients.
(Loc. cit.)

Soon afterwards, in 1958, the American Medical Association (AMA) commissioned a similar (though more terse) report which endorses the 1955 BMA report and concludes,

That the use of hypnosis has a recognized place in the medical armamentarium and is a useful technique in the treatment of certain illnesses when employed by qualified medical and dental personnel. ('Medical use of hypnosis', JAMA, 1958).

Again, the AMA council approved this report rendering hypnotherapy an orthodox treatment,

The Reference Committee on Hygiene, Public Health, and Industrial Health approved the report and commended the Council on Mental Health for its work. The House of Delegates adopted the Reference Committee report […]. (AMA Proceedings, JAMA, Sep. 1958: 57, my italics)

In 1995, the National Institute for Health (NIH), in the US, established a Technology Assessment Conference that compiled an official statement entitled ‘Integration of Behavioral & Relaxation Approaches into the Treatment of Chronic Pain & Insomnia.’ This is an extensive report that includes a statement on the existing research in relation to hypnotherapy for chronic pain. It concludes that:

The evidence supporting the effectiveness of hypnosis in alleviating chronic pain associated with cancer seems strong. In addition, the panel was presented with other data suggesting the effectiveness of hypnosis in other chronic pain conditions, which include irritable bowel syndrome, oral mucositis [pain and swelling of the mucus membrane], temporomandibular disorders [jaw pain], and tension headaches. (NIH, 1995)

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In 1999, the British Medical Journal (BMJ) published a Clinical Review of current medical research on hypnotherapy and relaxation therapies, it concludes,

• 'There is good evidence from randomized controlled trials that both hypnosis and relaxation techniques can reduce anxiety, particularly that related to stressful situations such as receiving chemotherapy.

• 'They are also effective for panic disorders and insomnia, particularly when integrated into a package of cognitive therapy (including, for example, sleep hygiene).

• 'A systematic review has found that hypnosis enhances the effects of cognitive behavioural therapy for conditions such as phobia, obesity, and anxiety.

• 'Randomized controlled trials support the use of various relaxation techniques for treating both acute and chronic pain, […].

• 'Randomized trials have shown hypnosis to be of value in asthma and in irritable bowel syndrome […].

• 'Relaxation and hypnosis are often used in cancer patients. There is strong evidence from randomized trials of the effectiveness of hypnosis and relaxation for cancer related anxiety, pain, nausea, and vomiting, particularly in children.' (Vickers & Zollman, 'Clinical Review: Hypnosis & Relaxation Therapies', BMJ, 1999)

In 2001, the Professional Affairs Board of the British Psychological Society (BPS) commissioned a working party of expert psychologists to publish a report entitled The Nature of Hypnosis. Its remit was 'to provide a considered statement about hypnosis and important issues concerning its application and practice in a range of contexts, notably for clinical purposes, forensic investigation, academic research, entertainment and training.' The report provides a concise (c. 20 pages) summary of the current scientific research on hypnosis. It opens with the following introductory remark:

Hypnosis is a valid subject for scientific study and research and a proven therapeutic medium. (BPS, 2001)

With regard to the therapeutic uses of hypnosis, the BPS arrive at much more positive conclusions.

Enough studies have now accumulated to suggest that the inclusion of hypnotic procedures may be beneficial in the management and treatment of a wide range of conditions and problems encountered in the practice of medicine, psychiatry and psychotherapy. (BPS, 2001)

The working party then provide an overview of some of the most important contemporary research on the efficacy of clinical hypnotherapy, which I summarize as follows (omitting their detailed references).

• 'There is convincing evidence that hypnotic procedures are effective in the management and relief of both acute and chronic pain and in assisting in the alleviation of pain, discomfort and distress due to medical and dental procedures and childbirth.

• 'Hypnosis and the practice of self-hypnosis may significantly reduce general anxiety, tension and stress in a manner similar to other relaxation and self-regulation procedures.

• 'Likewise, hypnotic treatment may assist in insomnia in the same way as other relaxation methods.

• 'There is encouraging evidence demonstrating the beneficial effects of hypnotherapeutic procedures in alleviating the symptoms of a range of complaints that fall under the heading 'psychosomatic illness.' These include tension headaches and migraine; asthma; gastro-intestinal complaints such as irritable bowel syndrome; warts; and possibly other skin complaints such as eczema, psoriasis and urticaria [hives].

• 'There is evidence from several studies that its [hypnosis'] inclusion in a weight reduction program may significantly enhance outcome.' (BPS, 'The Nature of Hypnosis', 2001)

Meta-analysis of Success Rates

In 2003, perhaps the most recent meta-analysis of the efficacy of hypnotherapy was published by two researchers from the university of Konstanze in Germany (Flammer & Bongartz). The study examined data on the efficacy of hypnotherapy across the board, though studies included mainly related to psychosomatic illness, test anxiety, smoking cessation and pain control during orthodox medical treatment. Most of the better research studies used traditional-style hypnosis, only a minority (19%) employed Ericksonian hypnosis.

The authors considered a total of 444 studies on hypnotherapy published prior to 2002. By selecting the best quality and most suitable research designs for meta-analysis they narrowed their focus down to 57 controlled trials. These showed that on average hypnotherapy achieved at least 64% success compared to 37% improvement among untreated control groups. (Based on the figures produced by binomial effect size display or BESD.)

According to the authors, however, this was meant as a deliberate underestimate. Their professed aim was to discover whether, even under the most skeptical weighing of the evidence, hypnotherapy was still proven effective. They showed conclusively that it was. In fact, their analysis of treatment designs concluded that expansion of the meta-analysis to include non-randomized trials for this data base would also produce reliable results. When all 133 studies deemed suitable in light of this consideration were re-analyzed, providing data for over 6,000 patients, the findings suggest an average improvement in 27% of untreated patients over the term of the studies compared with a 74% success rate among those receiving hypnotherapy. This is a high success rate given the fact that many of the studies measured included the treatment of addictions and medical conditions. The outcome rates for anxiety disorders alone, traditionally hypnotherapy's strongest application, were higher still (though a precise figure is not cited). (Flammer & Bongartz, 'On the efficacy of hypnosis: a meta-analytic study', Contemporary Hypnosis (2003), 179 – 197.)

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How do I choose a good Hypnotherapist?

• Do you prefer talking to a man or a woman?

• Is this a problem you have difficulty discussing with someone younger than you?

These are all questions you might want to think about before choosing a hypnotherapist. There are some extremely good hypnotherapists in BC, and several good training establishments.

If you are unable to locate a hypnotherapist that suits you, and if I am unable to assist, please don't hesitate to ask me to recommend someone. I may well know a hypnotherapist that will work well for you.

The article that follows is available at no charge for use in any publication - however please let me know you are using it and please credit me with it. Many thanks,

Rob Hadley MH. CHt.

“How can I find a good hypnotherapist?”

First you need to understand what hypnotherapy is.

Hypnotherapy is the process of identifying a problem, addiction or issue, and then using hypnosis finding solutions to it. There are several techniques for doing this. The most effective techniques have results that become evident very swiftly. It is quite normal for a small number of sessions to solve a problem that would otherwise take years or decades to resolve.

One striking example of this is stuttering. If the cause can be found, and the correct therapy applied, it is not uncommon for stuttering to quite simply cease. Other therapies may take many months to show improvement.

Another good example is found in addictions. When someone enters a hypnotherapists office a smoker, and leaves a non smoker, a damaging habit has been broken. This happens all the time.

There are many troubling afflictions hypnotherapy can help. These span depression, self confidence issues, pain management, erectile dysfunction – the list is quite literally endless. Behaviors and addictions are another area hypnotherapy is proven effective.

The key thing to keep in mind is that good hypnotherapy produces lasting results quickly.

“How do I know if my hypnotherapist is competent?”

A hypnotherapist should make you feel comfortable, and safe. Your relationship with your hypnotherapist should be one which you enjoy. The therapy should be at times relaxing, sometimes exciting. There may be times when therapy can be troubling – but nonetheless the issues have to be resolved. Throughout you should feel in control of the situation. The rapport you build up with your therapist will dictate how effective the therapy will be.

You may find that when in trance you remember everything – this is quite normal. At times you may remember nothing at all. What you will experience is a general slowing down of your mind and body, to a state where your subconscious is able to take on board direct suggestions. These suggestions remain with you long after the end of the session – sometimes for a lifetime.

Because your memory is extremely accurate in hypnosis, your hypnotherapist may use regression in your therapy. This is the mark of solid hypnotherapy. Surprisingly a relatively small number (about 10%) of therapists use hypnotic regression. Training in regression is time consuming and complicated, however it is one of the cornerstones of effective hypnotherapy. Coastal Academy in White Rock and some other training centers provide training in regression. When looking for a hypnotherapist you should ask if your therapist uses regression techniques. If they do not, they likely will not be able to locate the source of issues. In this case they will be working using just positive reinforcement techniques, which may have a band aid effect, but will not provide lasting help.

Unless the situation is extremely complex (a cocaine addiction for example) you should expect to solve simple issues in one or two visits, and more complex ones in five or six. If you are told to expect ten or more sessions, you should be very wary. The exception to this is cocaine addiction. Because of the nature of the addiction it’s quite possible a client may see their hypnotherapist a dozen times to overcome the effects of cravings, reduce frequency of use, and eventually eradicate usage entirely.

Most clinical hypnotherapists receive extensive training. This goes far beyond the ability to hypnotize.

You should not expect a Woody Allen type scenario – 25 years in therapy and beginning to show signs of improvement.

“What is supposed to happen in hypnotherapy?”

Specifically, you are put through a series of exercises that relax you and allow communication with your subconscious. This communication allows the identification of issues and the modification of basic values around those issues.

Trance is achieved quite easily in most cases. It is not a mystical experience, it’s really very normal. Light trance may not be particularly noticeable to the client – however the therapist will see evidence of trance in the form of slight flushing, a redness in the eyes, eyelid flutter, slight easing of breathing and a few other signs. At this point the client is effectively suggestible and can be worked with. You will likely remember everything said and experienced in trance. From time to time a client moves very deeply into hypnosis and is unable to remember the content of the therapy, or part of it – however their subsequent response to the therapy is evidence of its efficacy.

“Can a hypnotherapist be incompetent without me realizing it?”

Yes.

Poorly executed therapies have little effect. Some work for a brief time, but have no lasting benefit. A client may feel the process has worked and experience relief for a time – only to find that the issues return later. In this case not all the triggering events around the issue have been worked on. Just like most things, a skilled craftsman is needed to do the job well. This really comes down to training and experience.

There are some brief two or three day hypnosis courses available. This is a very basic introduction to the concepts of hypnosis and has little to do with the distinctly different practice of clinical hypnotherapy. Clients should always look for a hypnotherapist that is certified with the IMDHA. All Coastal Academy graduates join IMDHA.

“Is a hypnotherapist the best therapist?”

Psychotherapy is the diagnosis and conversational therapy of mental illness. Talk therapy, play therapy, cognitive behavior therapy are all forms of psychotherapy. Clients generally expect results after 15 or 20 sessions and in many cases an ongoing situation, sometimes extending over many months, results. Hypnotherapy is not only more flexible, it deals with issues very swiftly. Two to three sessions may achieve the same or more effective results. However, the benefits of a regular support process with psychotherapy can provide a safety net in their own right in some cases.

Realistically, the answer is probably ‘not necessarily’. It’s really all down to the individual therapists. If you have a good rapport with your psychotherapist, you should maintain that structure in your life. If, on the other hand, you find a good hypnotherapist – you may sort your issues out very much more quickly than you had come to expect.

Rob Hadley MH. CHt.

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