The “Dangers” of Hypnotism?

Let’s go back to the horse’s mouth and see what the bloke who coined the term “hypnotism”, James Braid, the founder of hypnotherapy, said about the dangers it posed and the extent to which patients could be “controlled” and made to do objectionable things…

While under the hypnotic influence, the patients evince great docility, but there is, however, such a state of the perceptive faculties and judgement that they will be quite as fastidious of correct conduct as when in the natural state. So far as I know, there is no more, or not so much, chance of gaining a knowledge of the thoughts of others than might be attained by giving the patient a glass or two of wine. And I have no experience of any such irresistible influence over individuals for producing those malign effects you refer to. I strongly suspect they only exist in the imagination of the parties operating or operated on. At all events, no such effects result from my operations, although undoubtedly I have been able to produce the most wonderful effects in many instances where ordinary treatment had been unavailing.

This is from an unpublished letter in the archive of his follower, Dr. John Milne Bramwell, who goes on to comment,

[Braid] had never seen a hypnotised patient who did not strenuously resist any attempt at taking a liberty with her. Such patients could not be induced to take off their stockings, for example, or to give a kiss to a gentleman, even should he be a hallucinatory one. On the contrary, they would repel such suggestions with more energy than in the waking condition.

Victorian doctors were, it has to be said, in a better position to test behaviour which might be considered too dubious to propose in a modern psychological experiment, and wouldn’t get approval from a modern ethics committee. Braid recognised that people do sometimes do things they later regret in hypnotism but that this was more often due to other factors such as social compliance, peer pressure, deception, etc., and that it seemed to him more likely to be possible to manipulate people psychologically through the use of alcohol or intoxicating drugs rather than hypnotism.

What might be achieved by systematic and persevering attempts to corrupt a virtuous person during that state, I do not pretend to tell; I should never condescend to witness such attempts being systematically made; but my present convictions are that the same individual might be more readily demoralised when awake, than when in the second conscious state of nervous sleep, which evidently has a tendency with virtuous people to quicken their perceptions and heighten their notions of what would be immoral or highly indecorous, whilst at the same time it renders them most docile and obliging in all which is reasonable and seemly in their estimation. Thus, while they still indignantly repel the proposal to kiss an imaginary gentleman, they will be quite willing to do so to an imaginary child.

Modern research on hypnotism has, overall, supported Braid’s original view and failed to find credible evidence that hypnotic subjects were more complaint than non-hypnotised subjects. It has to be emphasised, in this context, that as Milgram’s famous experiment illustrates, people are surprisingly compliant to social pressure anyway and this is easily confused with the effects of hypnotism.

The 2001 report reviewing the scientific research on hypnotism, commissioned by the British Psychological Society (BPS), concludes,

Hypnotic procedures are not in themselves able to cause people to commit acts against their will. However, the demands of the context in which the procedures take place may exert pressure on the subject to comply with the hypnotist’s instructions. (BPS, 2001)

Essentially this confirms Braid’s original account of hypnotism, which he opposed to the misconception of “mind control” originating in the tendency to confuse hypnotism with Mesmerism.

Braid’s Nine Observations on Hypnotism

In concluding his primary text on hypnotism, Neurypnology (1843), James Braid, the founder of hypnotherapy, lists summarises the main points of his theory as follows. 

1. [Eye-fixation]  That the effect of a continued fixation of the mental and visual eye in the manner, and with the concomitant circumstances pointed out, is to throw the nervous system into a new condition, accompanied with a state of somnolence, and a tendency, according to the mode of management, of exciting a variety of phenomena, very different from those we obtain either in ordinary sleep, or during the waking condition.
2. [Hypnotic Stages]  That there is at first a state of high excitement of all the organs of special sense, sight excepted, and a great increase of muscular power; and that the senses afterwards become torpid in a much greater degree than what occurs in natural sleep.
3. [Nervous Excitation & Depression]  That in this condition we have the power of directing or concentrating nervous energy, raising or depressing it in a remarkable degree, at will, locally or generally.
4. [Heart Rate]  That in this state, we have the power of exciting or depressing the force and frequency of the heart’s action, and the state of the circulation, locally or generally, in a surprising degree.
5. [Muscular Tone]  That whilst in this peculiar condition, we have the power of regulating and controlling muscular tone and energy in a remarkable manner and degree.
6. [General Physiological Effects]  That we also thus acquire a power of producing rapid and important changes in the state of the capillary circulation, and of the whole of the secretions and excretions of the body, as proved by the application of chemical tests.
7. [Therapeutic Use]  That this power can be beneficially directed to the cure of a variety of diseases which were most intractable, or altogether incurable, by ordinary treatment.
8. [Pain Control]  That this agency may be rendered available in moderating or entirely preventing, the pain incident to patients whilst undergoing surgical operations.
9. [Muscular Suggestion]  That during hypnotism, by manipulating the cranium and face, we can excite certain mental and bodily manifestations, according to the parts touched.

That Hypnosis Never Meant Sleep

It is a common misconception that hypnotism involves a state resembling unconsciousness or sleep.  This can be partly attributed to the fact that the word “hypnotism” derives from hypnos, the Greek word for sleep.  However, few people realise that the word “hypnotism” is actually an abbreviation for the longer term “neuro-hypnotism”, meaning sleep of the nervous system, as opposed to normal sleep.  It was coined around 1841 by James Braid, the Scottish surgeon who many authorities consider to be the founder of hypnotherapy.  Braid simply meant that many hypnotic subjects would become physically relaxed and engrossed in a single idea to the exclusion of distraction.  Indeed, according to its founder, hypnotism was better characterised as a state of conscious concentration rather than unconsciousness.  Braid soon came to regret his use of the term “hypnotism” because of the misconceptions it encouraged, even during his own lifetime.  In Hypnotic Therapeutics (1853), Braid writes,

It is of great importance that it should be clearly understood by patients, that it is by no means generally requisite that they should lapse into the state of unconsciousness in order to ensure the salutary effects of the nervous sleep.  Many imagine, that unless they become torpid and insensible, no beneficial effect can ensue.  This is a complete misapprehension, for the happy results of innumerable cases treated with the greatest success by hypnotism, clearly prove, that cases which had resisted all ordinary treatment by the exhibition of medicines and external applications, have readily yielded to the impression made on the nervous system by this peculiar influence, even when they were perfectly conscious of all that was done, and could remember, after awaking, every circumstance that had happened during the nervous sleep.  This was strikingly verified in my own case, when I cured myself of a violent rheumatic attack by throwing myself into the nervous sleep [i.e., into self-hypnosis] for eight or nine minutes, from which I was aroused perfectly free from pain, although I had been perfectly conscious all the while.

Although some subjects entered a state of mind in which they experienced amnesia for the process, which the earlier Mesmerists had termed “artificial somnambulism”, Braid elsewhere makes it clear that only 5-10% of his subjects experienced this response to hypnotism.  As Braid implies, the whole notion of self-hypnosis conflicts with the assumption that hypnosis involves unconsciousness or sleep because one cannot very well be both asleep and consciously directing one’s own autosuggestions at the same time.  Self-hypnosis requires some degree of conscious concentration, or at least relaxed attention.

Braid’s Later Theories of Hypnotism

In his two books, Hypnotism: Its History, Practice & Theory (1903) and Hypnotism & Treatment by Suggestion (1909), Bramwell expands Braid’s later thoughts into a more generally suggestion-oriented  interpretation of hypnotism, which in many respects pre-empts modern “non-state”, or cognitive-behavioural, research on hypnosis.  There is a distinct shift in emphasis from the idea of a special physiological state of nervous sleep, to a range of (ideo-dynamic) psychological mechanisms and their social context, e.g., the role of expectation, habit, imagination, imitation, verbal suggestion, association, attention, etc., become increasingly central to Braid’s approach and the physiology of rigid catalepsy or nervous sleep becomes somewhat less significant.

However, neither Bramwell nor Braid concluded from this that the classical eye-fixation induction should be completely abandoned, because it may have psycho-physiological effects which are helpful, though non-essential.  It is also likely that most subjects expect to experience some kind of recognisable induction ritual, and so the eye-fixation technique, or a similar style of working, may itself be a kind of physical suggestion which facilitates subsequent suggestion by satisfying the client’s expectations about hypnotism.

 

Hypnotism: Its History, Practice & Theory (1903)

Braid’s theories changed as his knowledge increased, and he held in all three distinct and widely differing ones.  In the first, he explained hypnosis from an almost purely physical standpoint; in his second, he considered it to be a condition of involuntary monoideism and concentration of the attention.  His third theory differed from both of these.  In it he recognised that reason and volition were unimpaired, and that the attention could be simultaneously directed to more points than one.  The condition, therefore, was not one of involuntary monoideism.  Further, he recognised more and more clearly that the state was essentially a conscious one, and that the losses of memory which followed on awaking could always be restored in subsequent hypnoses.  Finally, he described as “double consciousness” the condition which he had first termed “hypnotic”, then “monoideistic”.  [Bramwell probably meant that Braid wished to reserve the terms “hypnotism” and “monoideism” for special states associated with the use of suggestion, but that he came to see neither as essential to suggestion therapy.]  As already noted, few students of hypnotism are acquainted with any of Braid’s theories except the earliest; and his third and latest one, which he promised to put before the public in a more complete form, never saw the light in the manner he intended.  [In The Physiology of Fascination (1855), for example, Braid had stated, ‘It is my intention shortly to publish a volume entitled “Psycho-Physiology: embracing Hypnotism, Monoideism, and Mesmerism.”’]  My account is drawn from little-known pamphlets, unpublished MS., etc.  [Bramwell had acquired most of Braid’s works, including several unpublished pieces.]

The following is a summary of Braid’s latest theories:-

1. Hypnosis could not be induced by physical means alone.
2. Hypnotic and so-called Mesmeric phenomena were subjective in origin, and both were excited by direct or by indirect suggestion.
3. Hypnosis was characterised by physical as well as by psychical changes.
4. The simultaneous appearance of several phenomena was recognised and much importance was attached to the intelligent action of a secondary consciousness.
5. Volition was unimpaired, moral sense increased, and suggested crime impossible.
6. Rapport was a purely artificial condition created by suggestion.
7. The importance of direct verbal suggestion was fully recognised, as also the mental influence of physical methods.
8. Suggestion was regarded as the device used for exciting the phenomena, and not considered as sufficient to explain them.
9. Important differences existed between hypnosis and normal sleep.
10. Hypnotic phenomena might be induced without the subject having passed through any condition resembling sleep.
11. The mentally healthy were the easiest, the hysterical the most difficult, to influence.

In this country, during Braid’s lifetime, his earlier views were largely adopted by certain well-known men of science, particularly Professors W.B. Carpenter and J. Hughes Bennett, but they appear to have known little or nothing of his latest theories.  [Bramwell, 1903: 293-294]

Hypnotism & Treatment by Suggestion (1909)

Before discussing hypnotic theories, I wish to draw attention to the cases and experiments just cited.  In some, the condition termed hypnosis was present.  This varied from slight drowsiness or lethargy to apparently profound sleep, followed by amnesia on waking, i.e., the subjects were unable to recall the events of the so-called hypnosis.  At first, both Braid and Liébault regarded this as artificially induced sleep, and believed that it must be evoked before patients would respond to suggestions, either curative or experimental.  The condition, however, might be more accurately described as “imitation sleep”.  The deeply hypnotised subject believed he had been asleep, because he could not afterwards recollect what had happened.  Various facts, however, show great dissimilarity between imitation and natural sleep [i.e., between so-called “hypnotic sleep” and natural sleep].  When the subject is re-hypnotised and questioned, he can relate all that took place in the previous hypnosis with the exception of any special sensations inhibited by suggestion.  Thus, my patients who had undergone painless hypnotic operations could afterwards describe them, and knew what had been said and done by those around them.  They were only unable to recall pain, as that sensation had never reached consciousness.  Further, in the so-called lethargic state [the deepest stage of hypnosis according to the Salpêtrière school] the subjects, who lie apparently asleep, hear and respond to the operator’s suggestions, even if these are whispered so softly that they could not have heard them in the normal condition. […] In every instance, where I questioned so-called hypnotic somnambules as to their mental condition in previous hypnoses, I found that they knew where they had been and what they had been doing or thinking about.  They felt that they were the same persons in the so-called hypnotic state as in the waking one, and were conscious that their reason and volition were unimpaired.  [It was not, therefore, an autonomous “unconscious”, “subconscious”, or “dissociated” mind, but their normal conscious mind, that was listening to the hypnotic suggestions and responding.]

            Further, subjects in whom hypnosis had been evoked would afterwards pass into the suggestible condition characteristic of it, at any signal to which they had been taught to respond, and without going through any intermediate state even superficially resembling sleep. […]

            In some of the cases nothing even superficially resembling sleep was induced: the patients simply rested in an armchair while suggestions were made.  Yet, in many instances, the curative results were as striking as those obtained after the induction of so-called hypnosis.

            In both groups increased suggestibility had been developed, and a control of the organism obtained far beyond the will-power of ordinary life.  Examples of this are found in the influence of suggestion upon menstruation, perspiration, the secretion of milk, the action of the bowels, etc.  [That is, despite the absence of anything remotely resembling a sleep-like “trance”, suggestions given in the waking state were found effective and capable of influencing bodily function usually classed as “involuntary”, by means of ideo-dynamic reflex action.]  (Bramwell, 1909: 133-135)

Braid’s method. – Braid took a bright object, generally his lancet case, held it in his right hand about a foot away from the patient’s eyes, and at such a distance above the forehead that it could not be seen without straining.  The patient was told to look steadily at it and to think of nothing else.  The operator then extended and separated the fore and middle fingers of the right hand, and carried them from the object towards the patient’s eyes.  The lids generally closed involuntarily; if this did not happen the process was repeated, and rarely failed.

Later, as Braid found that fixed gazing was frequently followed by slight conjunctivitis, he changed his methods: prolonged staring was abandoned, and the patient instructed to close his eyes at an early stage of the proceedings.  Hypnosis was induced as easily as before and without unpleasant symptoms.  If the body and mind were at rest, Braid found he could hypnotise as readily in the dark as in the light, and he also succeeded with the blind; these facts induced him to abandon his physical theory [of eye-fixation leading to nervous fatigue] and to conclude that the influence was exerted through the mind.  He observed that repeated hypnoses increased susceptibility; this arose from habit, association of ideas and imagination.  In such cases, if the patients believed something was being done which ought to produce hypnosis, the state appeared.  On the other hand, the most expert hypnotist would exert his influence in vain if the patient did not know what was expected and, at the same time, voluntarily yield to the demands of the operator.  Later, Braid asserted that direct verbal suggestion was the best method for inducing hypnosis and its phenomena; physical methods were simply indirect suggestions, their influence depending upon the mental states they excited.  [Braid had already emphasised that physical manipulation of the body posture and facial expression were likely to evoke corresponding ideas and feelings in the mind of the subject; rather than having a direct physical effect, eye-fixation might suggest the idea of focused attention and sleepiness by mental association.]  (Bramwell, 1909: 159-160)

Before describing my later methods, I wish again to draw attention to several points in connection with the so-called hypnotic state.  As we have seen, the subject may have his eyes open, and act like a normal individual who is awake.  In the lethargic condition, when he appears to be asleep, he still hears all that is said around him.  Further, all the phenomena of so-called hypnosis can be induced in the waking state, without the patient having preliminarily passed through any condition resembling sleep.  It is to Braid’s earlier work that we owe the theory that it was necessary to induce hypnosis before beginning treatment by suggestion.  At first he regarded the condition as an artificial sleep, but pointed out later that only one in ten of those he cured passed into a state even superficially resembling [normal] sleep.  He proposed, therefore, to abolish his entire terminology, as it misled the public, and made them believe they could not be cured by suggestion unless they had first been put to sleep.  With the majority of Braid’s patients there was not even an apparent loss of consciousness – they simply became slightly drowsy, and afterwards remembered all that had happened – while, with others, hypnotic phenomena were induced, without any previous stage in any way resembling sleep.  Further, in those cases where sleep had apparently been present, it could be proved that the condition was really a conscious one, as the recollection of all that had occurred could be evoked by suggestion.

            Braid’s later observations passed unnoticed, and, until recent times, nearly all operators proceeded on his earlier lines.  They suggested artificial sleep, lethargy or drowsiness, and then began treatment.  They did not recognise that the artificial or, more correctly speaking, imitation sleep was only one of the phenomena of increased suggestibility, due to suggestion.  Given increased suggestibility, any of the phenomena of hypnosis might be evoked as readily as imitation sleep, and the patient cured just as easily when that state had been omitted. 

            For many years, [the founder of the Nancy School] Liébault’s methods were similar to Braid’s earlier ones, and he always tried to induce what he called sommeil provoqué [“artificial sleep”].  Gradually the views of the Nancy School were modified till they resembled Braid’s later theories.  Now, Bernheim [the leader of the Nancy School] states that there is nothing in hypnotism but the name.  All is “suggestion”, and patients can be cured without the induction of artificial sleep.  Bernheim’s statement requires some modification: all the phenomena we have been accustomed to call hypnotic are undoubtedly the result of suggestion; but the suggestions must be accepted by the patient before the phenomena can be evoked.

            The essence of the whole condition, then, is an increased suggestibility; the production of a preliminary imitation sleep is not necessary, and is simply a waste of time.  In some instances, I tried to induce so-called hypnosis [i.e., “artificial sleep”] a hundred times before I succeeded.  Now, with the method I shall presently describe, I commence curative treatment at once, and obtain quicker results.

            Lest my readers may be confused by my asserting, on the one hand, that the hypnotic state – i.e., a condition of sleep – does not really exist, and, on the other, by my talking of inducing hypnosis, I will summarise my views.  Every stage of the so-called hypnotic condition is a conscious one.  In some instances the subjects have their eyes open and are obviously wide awake, in others their eyes are closed and they appear to be asleep; but, even in the most profound condition, the sleep is only apparent, not real, as the subjects retain consciousness, volition and intelligence.  The condition described as the hypnotic is essentially one of increased suggestibility.  The artificial or imitation sleep, suggested by the operator, is only one amongst the many phenomena which can be evoked by suggestion.  In what is described as the deepest stage – i.e., hypnotic somnambulism, followed by amnesia – when the state is terminated, the patients believe they have been asleep, because they do not remember what has happened.  This is equally true, whether they have been apparently asleep, or seemingly awake with their eyes open in the “alert” stage.  The lost memories of both stages can always be recalled in subsequent hypnosis.  Further, it is probable that the amnesia is an artificial one due to the suggestions of the operator.  When I use the word hypnosis – and it is almost impossible to avoid doing so until this fresh conception of the condition is accepted – I only mean that I have tried to induce increased suggestibility [as opposed to a sleep-like state] by methods which I shall presently describe.  The condition – i.e., increased suggestibility – is sometimes preceded by drowsiness, but this is often absent, and the patients are voluntarily thinking of some restful monotonous subject during the whole process.  Sometimes the patients’ minds are filled with the melancholy thoughts of neurasthenia, or obsessional fears; at others their attention is fixed on their hysterical convulsions or other uncontrollable muscular movements; but, despite this, increased suggestibility is frequently induced.  Here there has been neither imitation sleep nor restful monotonous thought, but, nevertheless, brilliant therapeutic results are often obtained in such cases. 

I will now describe my present methods.  In many respects they resemble those I have used for years; the difference between them, more apparent than real, being due to what I believe to be a clearer conception of the so-called hypnotic state. […]

The first suggestions refer to the conditions which I wish to create while the patient is in the armchair.  I tell him that each time he comes he will find it easier to rest, to turn his attention away from me and to concentrate it upon something restful [after simply closing his eyes normally].  I have previously explained that I do not wish him to go to sleep, but that, if he can get into the drowsy condition which precedes sleep, the suggestions are likely to be responded to more quickly. (Bramwell, 1909: 162-168)

Pavlov & Hypnotic Sleep Therapy

 Copyright (c) Donald Robertson 2008-2009.  www.UKhypnosis.com

The Nobel prize-winning Russian physiologist and psychologist, Ivan P. Pavlov, developed an influential theory of hypnosis based upon his experiments in animal conditioning.  Pavlov’s collection of lectures entitled Conditioned Reflexes (1927) culminates in ‘The experimental results obtained with animals in their application to man’ which summarises two conclusions of his research in relation to hypnotherapy, 

1. That the state of relaxation induced in human hypnosis resembles the physiological phenomenon of “animal hypnosis” and results from intense fatigue or inhibition of specific cells in the cerebral cortex (“cortical inhibition”) irradiating to other parts of the brain.
2. That hypnotic suggestions function by using words as stimuli to evoke conditioned responses which are intensified in nature because the general inhibition of the cortex leaves individual “rapport zones”, i.e., residual centres of attention and excitation in which conditioned reflex responses to words become greatly enhanced.

In contrast to much of the subsequent literature concerning his theories, Pavlov opens his own discussion of conditioning and hypnotherapy in terms which appeal to common sense observations from daily life.

It is obvious that the different kinds of habits based on training, education and discipline of any sort are nothing but a long chain of conditioned reflexes.  We all know how associations, once established and acquired between definite stimuli and our responses, are persistently and, so to speak, automatically reproduced, sometimes even although we fight against them.  For instance, in the case of games and various acts of skill, it is as difficult to abolish all sorts of superfluous movements as to acquire the necessary movements and it is equally difficult to overcome established negative reflexes, i.e., inhibitions.  Again, experience has taught us that a difficult task should be approached by gradual stages.  We know also how different extra stimuli inhibit and discoordinate a well-established routine of activity, and how a change in a pre-established order dislocates and renders difficult our movements, activities and the whole routine of life.  Again, we know how weak and monotonous stimuli render us languid and drowsy, and very often lead to sleep.  We are also well acquainted with different cases of partial alertness in the case of normal sleep, for example a sleeping mother next to her sick child.  All these [human] phenomena are analogous to those constantly met with in our animals and described in the preceding lectures […] (Pavlov, 1927, Lecture 23).

Regarding the method of inducing hypnosis employed and its relation to conditioning theory, Pavlov observed that a monotonous and weak stimulus, such as the sound of a metronome, or gentle stroking, could progressively induce relaxation and sleep in animals.

The method of inducing hypnosis in man involves conditions entirely analogous to those which produced it in our dogs.  The classical method consisted in the performance of so-called [Mesmeric] “passes” – weak, monotonously repeated tactile and visual stimuli, just as in our experiments upon animals.  At present the more usual method consist in the repetition of some form of words, describing sleep, articulated in a flat and monotonous tone of voice [i.e., direct verbal suggestions of relaxation and sleep].  Such words are, of course, conditioned stimuli which have become associated with the state of sleep.  In this manner any stimulus which has coincided several times with the development of sleep can now by itself initiate sleep or a hypnotic state. […] Most of the procedures producing hypnosis become more and more effective the more frequently they are repeated.  (Pavlov, 1927, Lecture 23)

Braid had emphasised the “law of sympathy and imitation” whereby hypnotic subjects seem to show an enhanced ability to imitate the behaviour of others.  Pavlov pre-empts later social theories of learning by acknowledging the role of this mechanism in hypnotherapy.

Obviously we deal with a certain degree of inhibition of some parts of the cortex – a state in which the more complicated forms of normal activity are excluded and replaced by responsiveness to immediate stimuli.  This partial inhibition allows of or even favours the establishment and reinforcement of the physiological connections between certain stimuli and certain activities, e.g., movements.  In this manner, in hypnosis all activities based on “imitation” are accentuated and we see revealed the long-submerged reflex which in all of us in childhood forms and develops the complicated individual and social behaviour. (Pavlov, 1927, Lecture 23)

Pavlov conceived of hypnotic suggestion as a complex example of a conditioned reflex, fundamental to human nature,

Among the various aspects of the hypnotic state in man attention may be drawn to “suggestion” so-called and its physiological interpretation.  Obviously for man speech provides conditioned stimuli which are just as real as any other stimuli.  At the same time speech provides stimuli which exceed in richness and many-sidedness any of the others, allowing comparison neither qualitatively nor quantitatively with any conditioned stimuli which are possible in animals.  Speech, on account of the whole preceding life of the adult, is connected up with all the internal and external stimuli which can reach the cortex, signalling all of them and replacing all of them, and therefore it can call forth all those reactions of the organism which are normally determined by the actual stimuli themselves.  We can, therefore, regard “suggestion” as the most simple form of a typical conditioned reflex in man.  The command of the hypnotist, in correspondence with the general law, concentrates the excitation in the cortex of the subject (which is in a condition of partial inhibition) in some definite narrow region, at the same time intensifying (by negative induction) the inhibition in the rest of the cortex and so abolishing all competing effects of contemporary stimuli and of traces left by previously received ones.  This accounts for the large and practically insurmountable influence of suggestion as a stimulus during hypnosis as well as shortly after it.  The command retains its effect after the termination of hypnosis, remaining independent of other stimuli, being impermeable to them, since at the time of primary introduction of the stimulus into the cortex it was prevented from establishing any connection with the rest of the cortex.  The great number of stimuli which speech can replace explains the fact that we can suggest to a hypnotized subject so many different activities, and influence and direct the activities of his brain. (Pavlov, 1927, Lecture 23)

Pavlov considers the question as to why hypnotic suggestions should be more effective stimuli than the imagery experienced in dreaming, a point which could be made in comparing hypnosis with ordinary daydreaming or reverie as well.

It could be questioned why does suggestion carry in itself such a commanding influence as compared with dreams, which are usually forgotten and only have a very small vital significance?  But dreams are due to traces, generally of very old stimuli, while suggestion is a powerful and immediate stimulus.  Moreover, hypnosis depends upon a smaller intensity of inhibition than sleep.  Suggestion, therefore, is doubly effective.  Still further, suggestion as a stimulus is brief, isolated and complete, and therefore vigorous, while dreams are generally linked up into chains of various, sometimes inconsistent or antagonistic, traces of stimuli. (Pavlov, 1927, Lecture 23)

Soviet Hypnotherapy (Platonov)

Following Pavlov’s seminal physiological research, which concluded that hypnosis was a form of artificial (conditioned) sleep, Platonov and other Soviet researchers began employing hypnotherapy on a massive scale.  They developed a form of hypnotherapy which employed extended periods of “suggested sleep” in a manner resembling Victorian Mesmerism but based on laboratory research on conditioning.  Indeed, Platonov subtitled his book on hypnotherapy “The Theory and Practice of Psychotherapy according to I.P. Pavlov.” (1959).

            In the Soviet approach, subjects were left to sleep for around an hour following a hypnotic induction without any further suggestions, i.e., in total silence so that they could rest without any disturbance whatsoever.

We have always used long-continued suggested sleep as an auxiliary therapeutic method.  It is usually employed in more or less grave conditions as a concluding method after a course of psychotherapy and serves the purpose of restoring the function of the cortical cells and consolidating the therapeutic effect obtained.

                Even short suggested sleep not infrequently exerts a positive influence on the patient’s nervous system.  This is indicated by very numerous observations of many authors, as well as our own and those of our associates.  In a number of cases even a state of light suggested sleep produces a certain therapeutic effect of itself, without any special suggestions.  Thus, upon awakening from the very first suggested sleep some of our patients frequently report the disappearance of pain or unpleasant sensations.  (Platonov, 1959: 234)

Sleep induced by suggestion often seems considerably more restful and recuperative than normal, nocturnal sleep.  Platonov cites research by Petrova, one of Pavlov’s research team, supporting this observation experimentally (Platonov, 1959: 234).  Platonov applied this method to the prevention of hypertension, treatment of ulcers, and other physical conditions, but also in the treatment of neuroses.

Platonov found physiological evidence that the recuperative function of hypnosis was significantly deepened when explicit suggestions of a “state of absolute rest”, e.g., were used instead of the normal procedure, merely suggesting that the subject was “sleeping deeper”, etc.  (Platonov, 1959: 77-78).

These studies have led us to the recognition of the extraordinarily great importance of a special physiological state of deep rest specially created by verbal suggestion.

                It must be especially emphasised that natural sleep does not always put all the organs and systems of man into a state of complete rest. […]  It is precisely for this reason that it is necessary to exert special influence on the subject’s cerebral cortex by a verbal suggestion that his organism “is in a state of complete rest” during which “all of the experienced emotions have been fully eliminated,” while his brain and all organs and tissues are rapidly regaining their functions.  Thus the first step in the verbal suggestion [“sleep”, “sleep deeper”, etc.] puts the person from his usual waking state into a state of suggested sleep, while the second step in the suggestion [“rest completely”] creates special conditions for deep rest during this suggested sleep.  (Platonov, 1959: 78).

He goes so far as to claim that this special method succeeds by inducing “a maximal activation of the restorative function of the cerebral cortex.” (1959: 235, his italics). 

            In the vast majority of cases, Platonov’s clinic employed short sessions of direct hypnotic suggestion, followed by around an hour of deep hypnotic rest in silence, for about 5-6 sessions.  This approach would be considered unusual today.  However, deep rest of this kind clearly has considerable therapeutic potential.

Experience has shown that one hour of this state, in most cases, provided maximum rest for the entire organism.  This prolonged state of suggested deep rest is extraordinarily beneficial not only to the cortical dynamics and the entire higher nervous activity as a whole, but also to the functional state of all tissues and organs and the entire vegetative and endocrine system.  (Platonov, 1959: 79).

Platonov seemed to believe that any suggestions given during this state might disturb the state of rest, a fact consistent with a number of empirical observations, e.g., Clark L. Hull’s (1933) findings on the phenomenon of initial negative reaction in response to direct suggestion.  He also argued that continued rapport with the hypnotist required the retention of a certain level of awareness, and therefore stimulation of the cerebral cortex.  Whereas, in these periods of silent relaxation, with no disturbing suggestions from outside or need for continued attention, the subject was free to enter an even more profound level of relaxation.  After a while, the subjects receiving “suggested sleep” appear to become unresponsive to suggestion.  Indeed, the subject becomes progressively detached from their whole environment for a while, including the hypnotist as the following report from one of Platonov’s patients illustrates.

“When I am in a state of hypnosis,” writes a woman patient, “I experience different sensations at each session.  Thus during the first session I continued to feel my entire body but was unable to move a single member and though I clearly heard the voice of the hypnotist and was conscious of everything my thoughts were in a sort of muddle.  This was what I should call bodily sleep.  At each successive session my body grew increasingly heavier, I no longer felt it, though I continued to hear all that was going on and it seemed to me it was all happening somewhere far away, I was not quite conscious of it, and it was all absolutely immaterial to me.

                “During the last, fifth, session I no longer felt my body at all, as if I had none.  Nor could I think of anything.  I had no thoughts at all.  I heard various external sounds which did not concern me in the least.  During suggestions I heard everything clearly, but my mind failed to work, and the words of suggestion relating to my former experiences in no way affected me.

                “At the words of awakening, I begin to awaken at first from the head, as it were: thoughts rise in my mind, I begin to think about how to move, to get up; I understand everything that takes place around me, but begin to feel my body somewhat later; as my consciousness clear up, I begin to feel a heaviness throughout my body, which subsequently dissipates upon complete awakening.”  (Platonov, 1959: 73)

This approach is obviously impractical for modern clinical practice.  Clients may resent paying for a session in which they are merely left to relax in silence.  However, a similar technique might be used in different settings, e.g., during group workshops or between sessions with the aid of a self-hypnosis CD.

Advertising Smoking Cessation Hypnotherapy

Sole copyright © Donald Robertson, 2007

[The text of this article was checked and approved by Donna Mitchell of the ASA Communications Team (31/1/07) before publication by the NCH journal and GHR newsletter.]

What advertising claims can you make about hypnotherapy to quit smoking?  There are three main restrictions which bind UK hypnotherapists, 

1. The UK law insofar as it restricts certain forms of advertising.
2. Having made an agreement to abide by their (NCH) code of ethics, they are bound to abide by any restrictions imposed by their professional body, failure to do so might be construed as a breach of contract.
3. The Advertising Standards Authority (ASA) administer self-regulatory codes of practice for the advertising sector.  Written advertisements are regulated by the CAP Code (the British Code of Advertising, Sales Promotion and Direct Marketing – www.asa.org.uk or www.cap.org.uk)

The ASA have the power to investigate complaints about specific advertisements and to impose sanctions on advertisers who break their codes.  They publish a very useful database of adjudications online.

            I should mention in passing that, unfortunately, the ASA database shows that a number of therapists, including hypnotherapists, have made advertising claims in the past which they have been unable to substantiate when evidence was requested by the ASA Council.  The adjudications make very interesting reading. 

            All hypnotherapists should be aware that the Committee of Advertising Practice (CAP), which is responsible for writing the CAP Code that is administered by the ASA, publishes a number of very valuable articles in their AdviceOnline database available from their main website.  In particular, hypnotherapists should be familiar with, 

1. Ailments, Treatments and Therapies: General

2. Ailments, Treatments and Therapies: Hypnotherapy

3. Smoking, Stopping

CAP also provide a very useful service through the CAP Copy Advice team who will inspect your proposed advertising copy and make recommendations on wording to help ensure it complies with the codes.  Several of our students have found this service very helpful.  In fact, the Copy Advice team have not only helped us avoid transgressions but actually, on a more positive note, came up with some good ideas for new advertising headlines!

            One important requirement of the CAP Code is that specific claims should be supported by appropriate evidence.  We spotted that an adjudication relating to Nicotine Replacement Therapy (NRT) had made use of the important meta-analysis by Viswesvaran and Schmidt (1992) of the University of Iowa.  This study compares many different pieces of individual research to compare the efficacy of different methods of stopping smoking.  The evidence shows that NRT is more effective than willpower alone.  (A finding, incidentally, which many researchers now consider a research artefact due to the dubious research design used with NRT.)  However, we were aware from our own research that this study also authoritatively shows hypnotherapy to be more effective than NRT for smoking cessation.

            I believe that there are strong grounds for concluding that meta-analysis tends to substantially underestimate the efficacy of treatments like hypnotherapy which can evolve significantly in response to research findings, unlike chemical therapies including NRT and Zyban, which are pretty fixed in their nature and therefore do not improve much over time.  If you take the statistical average of old studies using clumsy hypnotherapy methods and new ones using sophisticated multi-component cognitive-behavioural hypnotherapy strategies you necessarily negate the benefits of progress that has been made over time.  Nevertheless, even in these unfavourable conditions, research consistently shows hypnotherapy to be more effective than NRT and other treatments.  It is therefore something of a scandal that anti-smoking charities and the NHS continue to recommend NRT as the treatment of choice for smoking and resist calls to endorse hypnotherapy.  Most therapists suspect that this has something to do with the David versus Goliath problem, the voice of the hypnotherapy profession is inherently feeble, indeed virtually non-existent, compared to the “Big Pharm” lobby who have the ears of the decision makers and media.

            It is my personal belief, based on the research, that NRT will be conclusively shown to be of negligible efficacy within the next ten years or so.  It’s not much better than placebos, i.e., dummy patches.  As my students know, I believe that the key to smoking cessation lies in evidence-based client selection procedures derived from other research studies.  We provide training in our own approach on our “Smoking Cessation Masterclass” available in central London.  Most private hypnotherapists will not undertake treatment with clients who they feel are unmotivated or only coming for treatment because someone else wants them to stop smoking.  That’s just common sense.  There are much more sophisticated and empirically-based ways of assessing clients’ suitability for treatment, though.

            We attempted to take a proactive stance on advertising smoking cessation by submitting our own advertising copy to the copy advice team for approval, and supporting specific claims by reference to independent research.  The copy advice team exchanged several emails with us during which we carefully revised our wording until we arrived at agreement upon the following wording,

Obviously, this is a template and individual advertisers would need to add their details and modify the wording to suit their requirements.  However, we would recommend that any changes to wording which might change the meaning or even connotation should be cleared with the CAP Copy Advice team on an individual basis.  In particular, the Copy Advice team were insistent that the wording make it clear that the evidence relates to hypnotherapy in general and not the outcome rates for the specific practice being advertised.  We eventually agreed that the wording above satisfied this requirement. 

* Clarification.  Since publication of this article, several professional organisations have emphasised that they think the guarantee should be time-limited.  This wording was only meant to demonstrate the kind of claims that could be acceptable, we never intended hypnotherapists to use it as it stands without further elaboration.  As you can see from our manual, we have ourselves always recommended that satisfaction guarantees are time-limited.

Advanced Certificate in
Cognitive-Behavioural Hypnotherapy

Stage 2 of the UK College Diploma Programme

The next stage 2 advanced certificate course in cognitive-behavioural hypnotherapy will be starting this Sunday (15th) in Croydon, London. See the page below to book online or call our office on 0800 195 9809.

Click here to book online

This course is only available to students who have previously attended the first stage of our diploma training programme. However, see our website for details of our conversion course route for accredited hypnotherapists.

www.UKcognitive.com

Did Hypnotism Originate as a Form of Meditation?

Copyright (c) Donald Robertson, 2009.  All rights reserved.  www.UKhypnosis.com

For more information see my longer article on this subject,

James Braid on Hypnotic Meditation

Most scholars assume that hypnotism originated in 1841, in the work of James Braid, as a psychological and physiological system contrasted with the more “occult” or supernatural theories of Franz Mesmer and his followers, the “animal mangetists”.  Braid originally saw Mesmerism as the predecessor and closest analogy to his method of hypnotism.  However, within three years of his discovery, the similarities between hypnotism and various Oriental meditation practices was brought to Braid’s attention.  At this time, in the 1840s, knowledge of Oriental meditation was very limited in England.  However, Victorian soldiers and officials of the East India company sent word back from the further reaches of the empire.  Braid explains, in his final essay, On Hypnotism (1860), written as a summary of his life’s work for the French Academy of Sciences,

I had already worked for three years to define hypnotism, the process which consists in fixing the eyes on a point and concentrating the attention, and I had demonstrated that it was an influence of a subjective nature which caused the sleep, when, in 1844, by carrying out research for a history of magic and witchcraft, as well as Mesmerism and hypnotism, I discovered in The History of Hindoos by [William] Ward and in the Dubistan (History of the religious sects in India) [Dabistān-i Mazāhib, a 17^th century Persian religious text] developments which, through the practices of Fakirs and Yogins [Sufi and Hindu mystics], wholly confirmed my subjective theory.

Braid contrasted his “subjective” theory of hypnotism with the older “objective” theory of the Mesmerists.  By this he simply meant that whereas the Mesmerists believed that they were putting their subjects into a trance by channeling an invisible force, “animal magnetism”, into their bodies, Braid and other sceptics disputed the objective reality of this force and argued instead that hypnotism was mainly the result of the psychological (subjective) activity of the hypnotic subject themselves.  In other words, as many hypnotists put it today, “All hypnosis is self-hypnosis.”

Indeed, it is notable that there was no such concept or even expression as “self-magnetism” or “self-mesmerism”.  Braid, as well as introducing the concept of hypnotism, also coined the term “self-hypnotism” to refer to the fact that one could hypnotise oneself, and he recounts, in a memorable passage, how he used self-hypnotism to manage his own severe attacks of rheumatic pain.  Indeed, as Braid defined hypnotism as a state of focused attention upon a single dominant idea or mental image, accompanied by expectation of a response, hypnotism and self-hypnotism were never really two distinct activities.  Hypnotism was seen by Braid as a process whereby someone, the hypnotist, assists someone else, the hypnotic subject, to focus their attention for a prolonged period on a single train of thought with a sense of growing confidence in some response occuring.  Hypnotism is really just assisted or guided self-hypnosis according to this, the original theory.  The analogy with yogic meditation soon became obvious to Braid,

The Fakirs and Yogins have caused ecstatic trance in themselves for 2,400 years, for religious purpose, by a process quite similar to that which I taught my patients so they could hypnotise themselves using, i.e., continual fixation upon the end of the nose or another part of the body or an imaginary object, and with intense attention and while holding or slowing down their breath. 

Indeed, Braid usually helped people to focus their attention, inducing hypnotism, by asking them to stare patiently at a single point, e.g., the tip of his silver lancet case, or the top of a bottle, or a chandalier in one case.  However, he felt the object of concentration, in this initial (induction) stage, was irrelevant, so long as it was relatively “unexciting”, simple and bland enough for one to focus upon without distraction, to the exclusion of other things.  Braid observed that when this was done for a few minutes, the eyes would close and people would often report very vivid and spontaneous bodily sensations of an unusual nature, especially if their attention was drawn to their body and their awareness and expectation heightened.  However, he also observed that this “diamond glare” of attention, as one of his followers put it, could be transposed onto some positively therapeutic idea suggested by the hypnotist, or chosen by the subject, such as the idea or image of the body healing some disease or simply a general sense of confidence and wellbeing.

Moreover, even in his earliest writings, Braid refers to hypnotism being induced by means of focusing the gaze on the tip of one’s own finger, or some other part of the body, including the centre of the forehead.  He was struck by the similarity between this method and the Oriental practice of focusing attention upon the tip of one’s nose or the centre of the forehead in meditation that he soon came to see Oriental meditation as the true precursor of hypnotism, and a closer analogy to it than Mesmerism.  Both hypnotism and meditation could be practised by oneself, and were understood as psychological and physiological activities inter-acting, mind-body techniques, whereas animal magnetism was (falsely) assumed to require the presence of a skilled Mesmerist.  Hence, the analogy with meditation provided Braid with unlikely support for his debunking of Mesmerism.

I did not know of the practices of Fakirs and Yogins, when I published my method of hypnotising; they confirm, in the most satisfactory manner, my subjective theory, at the expense of the objective theory of the magnetisers. 

From the point at which he discovered these books on meditation and began writing articles about them, Braid was undoubtedly encouraged to define hypnotism more and more as a form of “mental abstraction” or “monoideism”, as he later called it, meaning focused attention upon a single idea, image, or train of thought.

Many hypnotherapists today, and their clients, have been exposed to yogic or Buddhist meditation techniques, etc., and immediately intuit some similarity between the theory and practice of hypnotism and those of meditation.  It should further reinforce that observation for them to realise that the founder of hypnotherapy, almost from the outset, was aware of this connection and that hypnotism itself evolved, in part, under the influence of Oriental meditation techniques.

The Discovery of Hypnosis:

The Complete Writings of James Braid, the Father of Hypnotherapy

Foreword by Dr. Michael Heap
Edited with detailed prefatory essays by Donald Robertson
Published by the National Council for Hypnotherapy (NCH)

From the author: This is a major new publication which every hypnotherapist should possess. Just as you’d expect every psychoanalyst to have read Freud, every hypnotist should be familiar with the writings of James Braid, the founder of hypnotherapy. Braid’s writings are particularly relevant today with the growing emphasis upon evidence-based practice in psychological therapies. Contrary to popular misconception, which tends to confuse hypnotism with mesmerism, hypnotism actually originated as an early scientific critique of pseudoscientific Victorian therapies such as animal magnetism. Braid, as these writings clearly demonstrate, was an arch-sceptic and passionate empiricist, seeking a rational and common sense explanation for the phenomena of hypnotism.

Braid’s views help to powerfully counteract some of the most common misconceptions which undermine the confidence of clients and other professionals in hypnotherapy. Braid’s common sense approach makes hypnotism understandable and accessible, cutting through the confusion which followed in later decades. His ideas are surprisingly consistent with modern research on hypnosis and pre-empt certain aspects of contemporary cognitive-behavioural therapies (CBT). Braid’s writings even contain “forgotten” hypnotherapy strategies and techniques, which deserve to be revisited in modern times.

Available now from Amazon UK and Amazon.com

You can also browse the whole text online free-of-charge through Google books or visit our website and blog www.James-Braid.com

Some Reviews from Readers on Amazon

An Important Book for All Hypnotherapists – Paul Howard, hypnotherapist

This should be essential reading for all hypnotherapists, and for anyone with an interest in the history of psychology or psychotherapy. Most of Braid’s writings have been pretty much unavailable until now. 150 years on many of Braid’s ideas are still relevant. Braid’s writings show that hypnotism began as a thoroughly scientific therapy, based on criticisms of Victorian quack remedies.

Obligatory Reading – John O’Flynn, hypnotherapist

This quintessential work should be obligatory study for anyone in the field of Hypnotherapy. Donald Robertson unfolds the history of this most powerful therapy, through the words and works, the experiments and demonstrations, of Dr. James Braid, in a straightforward, deeply educational and most enlightening fashion. Excellently researched, it recounts the journey of a highly respected doctor who set out to debunk the follies of Mesmerism and found the jewel of Hypnosis. If you wish to simply understand hypnosis, or study the subject in depth, this is most certainly the book to have. I would go so far as to say, shame on anyone in the field of Cognitive Behavioural Hypnotherapy, who remains ignorant of what this book contains.

Fascinating – Tom Butler-Bowdon, self-help author

Braid was the first to put hypnotherapy on a scientific, rational footing, so today’s hypnotherapists have a lot to thank him for.

A Manchester surgeon, Braid discovered hypnotism reasonably late and like most doctors of his time considered stage hypnotists charlatans. It was only his physical examination of a hypnotised subject that convinced him an actual bodily change had taken place with non-mystical causes.

The Discovery of Hypnosis puts together Braid’s key writings and provides succinct commentary and historical context. This is an exhaustive survey and the editor has obviously mastered the material, revealing an underrated figure in the history of psychology and psychotherapy.

One of Robertson’s fascinating ideas is that Braid should not be considered simply the father of hypnotherapy, but the father of psychotherapy, given his early work into what is now called cognitive behavioural therapy.

Robertson’s clear writing style and to-the-point comments enliven the historical material, and the book itself is large and well laid out. Any hypnotherapist serious about their subject should have this book in their library. It is also a intriguing read for the layman.

Available now from Amazon UK and Amazon.com

You can also browse the whole text online free-of-charge through Google books or visit our website and blog www.James-Braid.com

Diploma in Cognitive-Behavioural Hypnotherapy

In my opinion, Don is one of the leading authority figures in the art of hypnotherapy and self hypnosis of his time. I would have no reservations at all in recommending him to whoever wishes to broaden their understanding of these fascinating disciplines.  (Frank Forster, Chair of AICH)

Do you want to become a professional hypnotherapist? Call the UK College now on freephone 0800 195 9809 to order a prospectus. Save 10% on the total cost of training, when paying in full before 31st October, and receive a free copy of our new book The Discovery of Hypnosis.* You can also book online on our payment page. You can reserve your place by paying a deposit and fees can easily be split over ten, monthly, interest-free payments.

The UK College of Hypnosis & Hypnotherapy is one of the country’s leading accredited hypnosis training schools. We have been established since 2003 and specialise in evidence-based and cognitive-behavioural approaches to clinical hypnotherapy.

This course can’t be improved; Donald, you are pure perfection.  I loved it! Thank you.  (Itai, Psychologist, London)

External Accreditation

People who wish to practice as hypnotherapists normally complete a diploma training approved by one of several independent professional bodies. Our diploma in cognitive-behavioural hypnotherapy is externally accredited by the National Council for Hypnotherapy (NCH) and the General Hypnotherapy Register (GHR), the two largest independent bodies in the field. Unlike most other courses, this diploma is also externally accredited by multiple professional bodies, including the Hypnotherapy Society, Hypnotherapy Association, and Register for Evidence-Based Hypnotherapy and Psychotherapy (REBHP).

The diploma is a Level 4 award issued by NCFE, a leading Government-recognised national awarding body who provide external quality assurance to verify that students are trained and assessed to adequate standards and in accord with the official National Occupational Standards (NOS) for hypnotherapy.

I thoroughly recommend this training, it’s excellent. (Vanessa, Hypnotherapist, Surrey)

Course Syllabus & Assessment

The diploma training is based upon a standard one-year diploma training which has been condensed into divided into three seven-day intensive stages. These can be spread out or close together, depending upon the needs of individual students. There are many dates to choose from, the first stage usually runs about six times each year. The total number of classroom hours, however, remains the same as a typical one-year diploma course.

Training focuses on practical face-to-face classroom exercises and group learning with rigorous online assessment following completion of the classroom training. Stage one focuses on the core skills of a hypnotherapist whereas stage 2 deals with behavioural psychology and interventions in hypnotherapy and stage 3 addresses cognitive concepts and techniques. The whole training provides a thorough grounding in modern cognitive-behavioural hypnotherapy.

Full details of the diploma training, including prices, dates, locations, and course syllabus, can be found on these pages.

I liked the relaxed, peaceful, gentle atmosphere, and sense of humour.  Don, you know your thing very well!  (Gosia, Intuitive Coach & Trainer, London)

Diploma Trainers

We have a variety of associate trainers who specialise in areas such as sports hypnosis, medical hypnosis, applied relaxation, and deliver components of the diploma training.

The main trainer on the diploma course is Donald Robertson, the College principal and founder. Donald is well-known as a proponent of cognitive-behavioural hypnotherapy through his talks and writings. He is also a published authority on the origins of hypnotherapy and the editor of The Discovery of Hypnosis, the Complete Writings of James Braid (2009). Braid coined the term “hypnotism” and was the founder of hypnotherapy as it’s known today. Donald is also the author of the forthcoming books The Philosophy of CBT and The Practice of Cognitive-Behavioural Hypnotherapy, due for publication by Karnac in 2010. Donald is an accredited Senior Clinician Hypnotherapist (NCH) and registered psychotherapst (UKCP/EAP).

* Terms and condition apply. The advertised discount applies to payment received in full for all three stages of training before October 31st 2009. This offer applies to bookings for course dates before 31/12/2010. This offer cannot be combined with any other discount or special offer.