Hypnosis is way to alter conscious attention. It could be described as “attention being absorbed in the creative unconscious.” Yet hypnosis is so very subjective, differing from person to person. There is some debate as to whether trance and hypnosis are the same phenomenon. For now, I am going to assume they are.
Some trances feature marked increases in sensory perception and dynamism. Yet the most common experience of trance involves dissociation from sensory processes. That means increased focus on, and control of, the “internal world” and its processes. And usually the hypnotist’s influence with the subject increases along with that dissociation (still with some significant limitations).
These limitations reflect the relative level of rapport between hypnotist and subject. But they also reflect, rather more significantly, the subject’s “ecology.” Ecology is the term Gregory Bateson used for the system maintaining an individual’s personhood – including, but not limited to, beliefs, values and motivations.
Hypnosis directly challenging a subject’s ecology will run into significant difficulties. Hence, there are some important differences between clinical hypnosis and stage hypnosis.
A stage hypnotist has neither the time nor any stagecraft justification for handling ecology. Only the hypnotist's influence or the hypnotic subject's “suggestibility” usefully gauges trance on stage.
Thus, stage hypnotists must winnow-down their pool of subjects from maybe 40 or so, to between four and say, eight. Any subject refusing to follow suggestions or even too slow to do so is promptly ushered from the stage. Each new suggestion must demand increasing compliance quickly to make a “good show.”
Clinicians, by contrast, seek to work with their clients. Both to discover the nature of problems and how to solve them. Clinical hypnosis is used to bring about insights, yes, but also direct emotional or behavioural changes.
This kind of hypnotic encounter relies on client and clinician working together for the client’s good. This cooperative effort is often called the “therapeutic alliance.”
Deep clinician-client rapport characterizes the therapeutic alliance. And part of what brings this about is the clinician's accommodation of the client's ecology.
So then, what is hypnotherapy?
If hypnosis brings about a state of profoundly focused consciousness then hypnotherapy is the application of that focused consciousness. The application can be for healing, but it's often better to consider it learning of one type or another.
The state of absorption we call hypnosis is a learning state. So if we do consider that healing happens as a result of the hypnosis it is usually really as the result of learning. Learning a new behaviour, learning a new strategy of behaviours, or learning a new way of getting your neurology to act on other bodily systems. When you learn a new way to have an effect on the immune and endocrine systems, this is especially true. But your neurology can also affect the vascular system, the digestive system and even the skeletal system or the nervous system itself.
Inevitably, the nervous system controls the rest of the body. This means that you can be achieve quite a lot with hypnosis. Not that you can change anything however you want. Two important things have to considered. First, you need a sufficient level of responsiveness in the client. This is brought about through clinician and client having enough unconscious rapport between them. The second and more far reaching consideration is ecology. Ecology is not just about your moral system, beliefs or values. It's also about your physiological systems being able to do their jobs adequately. The more the hypnotic intervention can account for ecology, the more effective it will be.
Pain response can be controlled by acting on the nervous system directly, Joint inflammation and soft tissue damage can be reduced by giving suggestions reduce inflammation to the skeletal system. Many diseases can be improved with a more functional bowel. Migraine symptoms can be mitigated by controlling blood flow. Additionally, many other kinds of healing can be brought about by having the neurological and endocrine control systems improve immune response in appropriate ways.
In the same way, solutions to many cognitive or emotional issues can be elicited. New cognitive strategies may be broached with direct learning and insight. Alternatively solutions may be effected indirectly, for example, by using suggestion processes which elicit changes in neuro-chemistry.
Sufficient understanding of the physiological processes involved can allow the clinician to give direct instructions. Then the unconscious mind can produce certain effects. But far safer and more long lasting is establishing a truly generative process in trance. Thereby, the unconscious mind can compute an optimal solution strategy which takes all the nonlinear variables into account. Then that same strategy system can monitor, adjust or reevaluate aspects of its parts outside of consciousness.
Rarely is the salutary effect of clinical hypnosis total, but it can often get to the good end of partial.
There are many misconceptions in what I’ll call the Mythology of Hypnosis. Let’s single out 3 common “myths”:
– This sounds plausible, but since trance is a natural phase in the cycle of consciousness it’s false. Trance is difficult to maintain without help; one of a hypnotist’s functions is maintaining trance. Anyone left in a trance will spontaneously move towards either sleeping or full “beta” waking, (the easiest consciousness phases to maintain).
– The strongest minds are the ones with most ease at achieving hypnotic states. Even the ability to remain tense or unrelaxed is itself an altered state which can be utilized hypnotically. No one’s mind or will is too strong to be hypnotized.
– A statement like that makes hypnosis sound intoxicatingly dangerous, doesn't it? Yet the truth here is that the hypnotic subject acquires greater control of (through greater access to) their own unconscious processes while in trance. Any control the hypnotist has is that granted by the subject. And this can be withdrawn any time (and I have seen precisely this happen).
All people pass through a short trance on their way to sleep, so they access the trance state every day, and with the right hypnotic approach, practically everyone can enter and maintain therapeutic trance. Yet, while everyone can be hypnotized, not everyone will be.
Sometimes a clinician’s skills are insufficient to build the necessary rapport. Sometimes the client is simply unwilling. Both ethics and effectiveness would then mean abandoning hypnosis for another therapeutic vehicle.
However, everyone is capable of going into trance because everyone does already enter trance without realizing it over and over again in daily life. Daydreaming is a kind of trance, as is watching television – in fact, any set of unconscious processes provide avenues for falling into trance easily without knowing it, including reading.
So what approach is best?
Traditional, authoritarian hypnosis has benefits: a hypnotic subject enjoys a very powerful experience and the hypnotist’s therapeutic credibility increases because of their “control” of the subject.
The hypnotist can make impressive changes fast, particularly around outcomes like pain control and other symptom-based phenomena.
Unfortunately, only a fraction of the population responds well to this style of hypnosis. Additionally, therapy arising from the hypnotist’s authority takes little account of ecology so changes may be impermanent.
It also fosters client misconceptions as changes may become associated with the hypnotist, working against any context where increased personal power and freedom for the client is an expected outcome.
Scripted hypnosis also has strengths, among which are that the hypnotist has a ready supply of “tried and true” materials so preparation is fast and make for a confident hypnotist. If combined with an authoritarian approach the hypnotist may be able to use personal credibility to overcome whatever the script lacks in tailoring, especially in a medical setting. Or perhaps some other situation where the problem can be treated rather than the person.
However, personal credibility is usually not enough in any setting to achieve high quality therapeutic ends. Even though people can and do go deeply into trance, suggestions often fail. My friend once went to three hypnotists for smoking cessation who all used scripts, two in Australia and one in France and while the French hypnotist induced a very deep trance the post-hypnotic benefit lasted just two weeks!
Ericksonian hypnosis and its relatives (eg. NLP) rely greatly on three things: unconscious rapport, facilitation of client based soltions and utilization of client motivations.
This is both a strength and a weakness. It makes the hypnosis very effective when trance intervention is achieved but the rapport and understanding of motivation may be difficult to acquire.
The client does benefit from a measure of reassurance in the understanding and competence of their clinical hypnotist. Ericksonian-type interventions are long lasting due to the high degree of sensitivity to client subjective structures (values, beliefs, motivations, interests,...). Because the hypnotist taps into them wherever appropriate they can account for ecology better than other methodologies.
However, some have called it “manipulative” as the client may be consciously unaware of even being in trance; Ericksonian trance sometimes does not seem like “trance” to the client.
Yet it has broadly extended hypnotherapy’s effective range: allowing successful interventions in many behavioural, emotional, cognitive, learning and symptom-only conditions. Command of metaphor, use of hypnotic language and a permissive approach to suggestion are its hallmarks.
Over all, the Ericksonian approach requires the greatest skill to practise and is the most sensitive to clients; it is therefore usually the most effective for the client in a therapeutic context.
The most common calls are for ending “bad habits” (like smoking, drinking, etc.) And then treatment of certain cognitive-behavioural disorders like anxiety and primary insomnia. Treatments for weight-loss, obsessive-compulsions, pain (chronic, dental, post-operative healing) are not far behind.
Often, direct suggestion and symptom substitution is used, although more often than not (particularly in a Strategic Psychotherapeutic practice like mine), hypnosis also involves indirect suggestion, story-telling and a more permissive “cognitive restructuring” than is found in talk-therapies like CBT.
I have particular interest in remission of sleep issues. But this involves quite a few other areas. Discomfort, hypertension, weight-loss, anxiety, depression, stress, work-life balance, drinking, smoking, inflamation/immune response and even skin conditions can be casually related to sleeping disturbance. So in fact this one speciality leads to a lot of general expertise. I am fortunate because some of those related conditions were the issues my first clients had.
But in my practice, I also address a range of psychological issues including addictions, anxiety, anger, procrastination and many others. I am also happy to treat some physiological pathologies too (allergies, migraine,...) if the client has tried the alternative without success.
Yet the most interesting hypnotherapy to me is in the pursuit of excellence. What is the mystery behind achieving high performance in sports or sales? Can anyone learn to be a charismatic public speaker, a successful negotiator, develop accelerated learning in any area, better relationships and more creativity? All these are areas where modern hypnosis can – and should – take its place as a methodology for helping people create better more satisfying lives. Modern hypnosis is one of the best tools in existence for allowing people to design their own lives to be the best they can be.