Understanding Hypnosis

Definition - Brain Wave Frequencies - Research

Definition

Hypnosis is:

"A state or condition in which the subject becomes highly responsive to suggestions. The hypnotized individual seems to follow instructions in an uncritical, automatic fashion and attends closely only to those aspects of the environment made relevant by the hypnotist. If the subject is profoundly responsive, he or she hears, sees, feels, smells, and tastes in accordance with the suggestions given, even though these may be in direct contradiction to the actual stimuli that impinge upon the subject. Furthermore memory and awareness of self can be altered by suggestions. All these effects may be extended post hypnotically into the individual's subsequent waking activity. It is as if suggestions given during hypnosis come to define the individual's perception of the real world. In this sense, the phenomenon has been described as a "believed in fantasy." (1990 Grolier Electronic Publishing, Inc.)

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Deep Relaxation
Focused Concentration
Daydreaming

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Brain Wave Frequencies - As they relate to hypnosis

Through hypnosis we are able to relax the physical body, bypass the critical factor or the mind, and utilize the other levels of consciousness. Levels of conciousness are measured through the frequency of electrical brain wave activity (Hertz or HZ), a unit of frequency equal to one cycle per second.

Beta 13-30 + Hertz Awake and Alert

The beta state is a state of alertness and awareness in which (theoreticaly) we spend most of our waking time. We are able to experience our invironment, thoughts, and feeling.
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Alpha 8-12 Hertz Relaxed

The Alpha state is a state of alertness and awareness is redirected. It is often accompanied by a sense of drowsiness and compliance. We slip into alpha in that transitional state of being half awake and half asleep; when we are "day dreaming"; distracted by a motion  process; driving; or when we are simply engrossed in a fire, a book or a movie.
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Theta 3-7 Hertz Reverie, Imagery, Near Sleep

Theta is the state thata occurs between the light drowsiness and relaxation of alpha and the more profound heavy sleep in delta.
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Delta 0.5 - 2 Hertz Sleep
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The delta state is associated with the deepest stages of sleep.

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Research

Understanding Hypnosis:

A Journey Through Time To A New Psychological Paradigm

John J. Moore

 Abstract

This is an overview of some of the key factors that have detracted from the therapeutic uses of hypnosis while at the same time sighting the many positive outcomes it has produced.  It is a perplexing topic that seems fraught with contradictions.  If it can be such a useful tool to help clients find relief from pain, relax, lose weight, stop smoking or cope with fears why is there such confusion about its’ use or value?

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History

By looking at some of the roots or beginnings of the uses of hypnosis it becomes apparent why there is such a shadow hanging over it’s current application. Shamans and medicine men used suggestive healing for centuries before Dr. Anton Mesmer began studying it’s potential in the late 18th century. His focus on “animal magnetism” that was discredited around 1780 by The French Academy of Science was still culturally accepted among the masses (Gauld A. A History of Hypnotism. Cambridge, England: Cambridge University Press; 1992).  On top of this the fact that many nonprofessionals were using hypnosis as pure entertainment made it quite difficult for doctors to use it even though the evidence strongly indicated its usefulness.

Methods of inducing a hypnotic trance borrowed many of the same techniques used to induce mesmeric trances. So much so that as late as 1890 William James, the influential Harvard philosopher and psychologist, used "hypnotic," "mesmeric," and "magnetic" trances synonymously (Charcot JM. Clinical Lectures on Diseases of the Nervous System Delivered at the Infirmary of La Salpariere, III. London, England: New Sydenham Society; 1889).  By maintaining this close association between the basic thinking of the supposed uncontrollable influences of mesmerism and the more scientific uses of hypnotism a perpetuated unrealistic conceptualization of what really took place in hypnotism was maintained.

Sigmund Freud practiced hypnotism enthusiastically between 1887 and 1892 only to abandon it for his free association psychoanalytic technique of subsequent years, in part because he decided that "it conceals from us all insight into the play of mental forces”. (Freud S. On psychotherapy. In: Jones E, ed; Bernays J, trans (1904). Collected Papers. London, England: Hogarth Press; 1950:249-263).

The ideation’s that being hypnotized somehow took away free will conjures up all kinds of unsavory thoughts. Many perceived hypnotic suggestion and chronic substance abuse as diminishing, even robbing, a person of free will. Neither physicians nor polite society wanted patients, even "degenerate alcoholics,” on whom hypnotism was known to work, to become automatons by hypnotic suggestion.  On top of this in the religious community the thought of being hypnotized suggested that somehow you were opening up yourself to demons or some other power beyond your control. 

Many people have seen cartoons or movies in which a wizard or someone of dubious character takes a watch or a spinning wheel and places a person into a trance.  This person walks around like a mindless zombie carrying out commands beyond their control.  No matter how hard one might try to explain a more rational understanding of what does and does not happen under hypnosis these mental pictures remain etched into many peoples minds.

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Paradigm Shift

Before anyone who wants to truly get a clear understanding of hypnosis potential, all previously held preconceptions must be put aside and  while strictly looking at this phenomenon from a purely clinical perspective.  In so doing it will be discovered that hypnosis does not look, or "behave," as you thought it would.  The way it does work establishes it as a valuable tool that must not be overlooked.  The challenge remains in the difficulty of escaping from faulty thinking that hinders a clear objective rendering about what is observed

In the face of a scientific community that desperately wants an empirical means to explain all psychopathology the tendency to reject otherwise potentially valid information must be addressed. Richard S. Cowles suggests the need to establish an alternative existential psychological paradigm (The Journal of Psychology, July 1998 v132 n4 p357(10)). This existential-phenomenological model emphasizes the individual's experience over any preconceived notions or diagnoses.  He sights specifically that children are a perfect illustration of how perception proceeds experience. (Cowles 1998)

He argues that children are able to experience certain phenomenon differently because they have not entered the stage of adulthood where there is the mind-body split. Piaget has shown that children do not have fully developed cognitive processes and that they reach the formal operational thinking stage at about the age of 11 or 12.  This mind-body split impacts perception and thus makes the way the child views the world as being significantly different than that of an adult.  Specifically applied to hypnosis, children are more able to receive maximum benefit and enter into a trance state more readily because of there greater suggestibility that is uninhibited by excessive reasoning.

The fact that clinicians don’t know why hypnosis works coupled with their already pre-defined schema inhibits full openness to new experiences. The overtone of misunderstanding from previous inaccurate knowledge predisposes these individuals to erroneous conclusions.   Research shows that hypnosis does change therapeutic outcomes (e.g., complete anesthesia without chemical adjunct and the total recall of events never consciously retained; Elman, D. (1964). Hypnotherapy. Glendale, CA: Westwood)

Thus in children versus adults, phenomena is reported as it is experienced rather than being filtered through what is expected.  Children are not burdened with the same theories and facts about how the world works and more importantly how it should operate in our day-to-day lives.  This is a critical point in understanding how hypnosis is able to have the impact that is does as will be shown in the course of this paper.

It is precisely this tendency to hold to our own schemata that gives shape to our perceived world that can hinder our ability to assimilate new ways of viewing what goes on around us.  Because we are not personally familiar with or able to believe in another individuals sense of reality does not preclude its validity.

Hypnotism Framework

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David Spiegel explains that the hypnotic state is one in which highly focused attention (absorption) is coupled, usually, with physical relaxation, heightened responsiveness to social cues (suggestibility), and an increased capacity to cut off from awareness certain perceptions, memories, and other aspects of consciousness (dissociation) (Harvard Mental Health Letter, Sept 1998 v15 n3 p5(2)).

Research studies show that children tend to be more easily induced into the trance state (Gardner, G., & Olness, K. (1981). Hypnosis and hypnotherapy with children. New York: Grune & Stratton).  This finding gives us insight into how hypnosis is able to produce the results that it does.  If you think of a group of children sitting in a circle listening to a fairy tale the point becomes perfectly clear.  While listening to the tale the children will cover their eyes or shriek with fear in response to the details of the story they are hearing.  In their minds eye they actually become involved with the events of the tale.  They do not question the merits of possibility or unlikelyness of a given detail they just experience it.  Similarly adults who are able to receive maximum benefit from hypnosis are those who are able to suspend disbelief. Thus if an individual has some of the correlates of hypnotizeability such as absorption, creativity, vividness of imagery, social desirability, a dissociative capacity, and others (Plotnick, A., Payne, P., & O'Grady, D. (1991) they will be able to enter a hypnotic trance that is much the same as that of a child.  The foregoing comments do not suggest that those who do not have these traits can not be hypnotized it just suggests a greater or lesser degree of skill required by the therapist to induce the client into the desired state. Many practitioners believe motivation is as important as innate capacity for those who desire to be hypnotized. 

That brings us to another mental block for those who are not current with what they know about hypnosis.  Can someone be forced to do what he or she would not ordinarily do while in a hypnotic trance? To this issue an understanding of critical faculty is helpful. This is when the impossible becomes possible.  In a trance a subject will accept a suggestion despite the fact that under ordinary circumstances he might consider it an impossible idea. (Elman, 1964, pp. X-XI) Kihlstrom et al. (1989) describing Shor's work (1959, 1962, 1979) states there is no critical appraisal of this new subjective experience without the general reality orientation. This allows for "unrealistic" psychological moments to occur and be sustained. Shor emphasized that this process is voluntary and motivated by the subject's projects and intentions. The hypnotist is a "hypnotic operator" (Elman, 1964) who teaches the subject to achieve the trance state and then, if the subject is willing, stimulates his or her imagination. Consent is imperative to the process. "Nonviolation is always an illusion," according to Shor (1970, p.95), as no suggestion will be accepted by a subject who does not want that particular suggestion.

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It Works

As was mentioned earlier history is full of the efficacy of hypnosis.   For example, in 1898, C. Lloyd Tuckey reported that he had hypnotized 93 patients with alcoholism. Twentyfive  remained sober during a 2-year follow-up.  He also suggested to his patients,  while they where under trance, that they would vomit if they drank alcohol subsequently, a cue that other practitioners adopted and found favorable in limiting recidivist drinking (Tuckey CL. Treatment by Hypnotism and Suggestion in Psychotherapeutics. 4th ed. London, England: Balliere Tindall and Cox; 1900). No hypnotist came close to the results of  M. Tokarsky, MD, from Moscow, who reported that after hypnotizing 700 patients with alcoholism 80% remained sober for at least a year.

In 1996 a 12 member panel gathered information from 23 experts and reviewed extesive medical literature and concluded that there is strong evidence supporting the effectiveness of hypnosis in alleviating chronic pain associated with cancer (JAMA, The Journal of the American Medical Association, July 24, 1996 v276 n4 p313(6)..) 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, emporomandibular disorders, and tension headaches.

Marcia Greenleaf, assistant clinical professor of psychology at Albert Einstein College of Medicine in New York. has seen many patients in the cardiac intensive care unit with heart rates as high as 190 beats per minute. "With hypnosis, they're often able to stabilize their condition within minutes, without using medication." (Health, May-June 1997 v11 n4 p52(3).)

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Physiological Explanations

Hypnosis has been hypothesized to block pain from entering consciousness by activating the frontal-limbic attention system to inhibit pain impulse transmission from thalamic to cortical structures, JAMA 1996.  Helen Crawford, a psychology professor at Virginia Polytechnic Institute and State University in Blacksburg, says the sensation of pain is like any other mental process that can be controlled to some degree.  Her tests of people experiencing hypnosis -- she's been mapping brain waves and measuring cerebral blood flow -- have shown increased activity in the brain's frontal region, which is known to inhibit sensory information. The pain still registers in other areas of the brain, but the hyped-up frontal cortex blocks its ascent into consciousness.

Crawford has observed that electronic tracings of the brain waves of people undergoing hypnosis have a surge of theta waves, which are associated with enhanced attention.  In two recent studies, measurements of blood flow and metabolic activity by positron emission tomography (PET) have shown that hypnosis activates a part of the brain involved in focusing attention, the anterior cingulate gyms. There is also evidence that it enhances the activity of dopamine, a neurotransmitter involved in planning, memory, and movement. Thus hypnosis is a neurophysiological reality as well as a psychological and social one, David Spiegel 1998.

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Discussion

It is unfortunate that hypnotherapy has had such a shaded past.  With all the documented examples of its proven usefulness it becomes apparent that those who have not taken its therapeutic value seriously need to look again at their reasoning.  Do clients have to miss out on receiving any potential therapeutic approach because of a practitioner’s unwillingness to use better and more efficient ways of addressing a given condition?  

It's easy to imagine the advantages. Once a client becomes proficient at hypnotizing themselves, they can do it anywhere and anytime. There are no side effects and it doesn't cost a dime. Such control is a powerful tonic for many recipients, even when hypnosis is used as an adjunct to conventional approaches. With the current trends toward more eclectic interventions it seems clear that hypnosis needs to be given appropriate consideration.

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REFERENCES

Source:  JAMA, The Journal of the American Medical Association, July 24, 1996 v276 n4 p313(6).

Title:  Integration of behavioral and relaxation approaches into the treatment of chronic pain and insomnia.
Source:  Health, May-June 1997 v11 n4 p52(3).

Title:  Hypnosis: trick or treatment? You'd be amazed at what modern doctors are tackling with an 18th century gimmick.
Author:  Jean Callahan

Source:  JAMA, The Journal of the American Medical Association, Feb 26, 1997 v277 n8 p611(1).                                                                             

Title:  Hypnotism's medical heyday.(JAMA 100 Years Ago...In Perspective)
Author:  Robert L. Martensen

Gauld A. A History of Hypnotism. Cambridge, England: Cambridge University Press; 1992.

Charcot JM. Clinical Lectures on Diseases of the Nervous System Delivered at the Infirmary of La Salpariere, III. London, England: New Sydenham Society; 1889.

Freud S. On psychotherapy. In: Jones E, ed; Bernays J, trans (1904). Collected Papers. London, England: Hogarth Press; 1950:249-263.

Tuckey CL. Treatment by Hypnotism and Suggestion in Psychotherapeutics. 4th ed. London, England: Balliere Tindall and Cox; 1900.

Source:  The Journal of Psychology, July 1998 v132 n4 p357(10).                                                                

Title:  The magic of hypnosis: is it child's play?
Author:  Richard S. Cowles

Elman, D. (1964). Hypnotherapy. Glendale, CA: Westwood.

Gardner, G., & Olness, K. (1981). Hypnosis and hypnotherapy with children. New York: Grune & Stratton.

Kihlstrom, J., Register, P., Hoyt, I., Albright, J., Grigorian, E., Heindel, W., & Morrison, C. (1989). Dispositional correlates of hypnosis: A phenomenological approach. International Journal of Clinical Experimental Hypnosis, 37(3), 249-263.

Plotnick, A., Payne, P., & O'Grady, D. (1991). Correlates of hypnotizability in children: Absorption, vividness of imagery, fantasy play, and social desirability. American Journal of Clinical Hypnosis, 34(1), 51-58.

Shor, R. E. (1959). Hypnosis and the concept of the generalized reality-orientation. American Journal of Psychotherapy, 13, 582-602.

Shor, R. E. (1962). Three dimensions of hypnotic depth. International Journal of Clinical Hypnosis, 10, 23-38.

Shor, R. E. (1970). The three-factor theory of hypnosis as applied to book-reading fantasy and to the concept of suggestion. International Journal of Clinical and Experimental Hypnosis, 18, 89-98.

Shor, R. E. (1979). A phenomenological method for the measurement of variables important to an understanding of the nature of hypnosis. In E. Fromm & R. E.

Shor (Eds.), Hypnosis: Developments in research and new perspective (rev. ed., pp. 105-135). New York: Aldine.

Hypnosis - Harvard Mental Health Letter

Source:  Harvard Mental Health Letter, Sept 1998 v15 n3 p5(2).

Title:  Hypnosis.
Author: David Spiegel

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