A Manual for Evidence-Based Clinical Hypnosis

Copyright © Donald Robertson, 2012.  All rights reserved.

ISBN: 9781855755307

Due for publication in 2012.  Available for pre-order now.

The Practice of Cognitive-Behavioural Hypnotherapy is a major new clinical textbook on evidence-based practice in clinical hypnosis, written by psychotherapist and hypnotherapist Donald Robertson and published by Karnac, the UK’s leading specialist psychotherapy publishing house.  Based on extensive background research, it contains references to almost 250 different scientific journal articles and clinical textbooks on hypnosis and CBT.

About the Book

Hypnotherapy is arguably the oldest modality of psychological therapy, at least in the modern sense.  Psychologists have long attempted to conceptualize hypnosis in terms of cognitive and behavioural processes and the term cognitive-behavioural approach to hypnosis was first coined in 1974 by Theodore Barber, and his colleagues, one of the most prolific and influential researchers in the field of hypnosis.  Since then cognitive research on hypnosis has continued to evolve alongside the assimilation of modern cognitive-behavioral therapy (CBT) techniques within the framework of hypnotherapy and vice versa.  This book explores the historical and conceptual relationship between hypnotherapy and cognitive-behavioral therapies (CBT).

It proceeds to offer a modern cognitive conceptualization of hypnosis, based on the writings of James Braid the founder of hypnotherapy and drawing upon modern cognitive-behavioral research on hypnosis.  The author carefully explores the combination of hypnosis with both cognitive and behavioural interventions and ways in which methods can be adapted in the light of therapeutic principles derived from both fields.  The book aims to provide a comprehensive core text for the practice of cognitive-behavioural hypnotherapy and to facilitate further dialogue between practitioners of hypnosis and CBT.

Available for Pre-order Online

• Karnac, the publisher
• Amazon UK
• The Book Depository
• Google Books
• Waterstone’s
• Blackwell

Table of Contents

Part I: The Cognitive-Behavioural Approach to Hypnosis
Chapter 1: Introduction to Cognitive-Behavioural Hypnotherapy
Chapter 2: James Braid & the Original Hypnotherapy
Chapter 3: Cognitive-Behavioural Theories of Hypnosis

Part II: Assessment, Conceptualisation, & Hypnotic Skills
Chapter 4: Assessment in Cognitive-Behavioural Hypnotherapy
Chapter 5: Case Formulation in Cognitive-Behavioural Hypnotherapy
Chapter 6: Socialisation & Hypnotic Skills Training

Part III: Cognitive-Behavioural Hypnotherapy
Chapter 7: Applied Self-Hypnosis & Coping Skills
Chapter 8: Affect: Hypnotic Exposure Therapy
Chapter 9: Behaviour: Problem-Solving Hypnotherapy (PSH)
Chapter 10: Cognition: Cognitive Hypnotherapy
Chapter 11: Conclusion & Summary

Copyright © Donald Robertson, 2010.  All rights reserved.

In 2006, Steven Jay Lynn collaborated with the Buddhist teacher Lama Surya Das, and two other researchers, in an attempt to explore the possibility of combining elements of Buddhist mindfulness meditation practice, cognitive therapy, and hypnosis, drawing on recent research in cognitive psychology.

Mindfulness versus Thought Suppression

Over the past couple of decades, enthusiasm for mindfulness meditation techniques derived from Buddhism has flourished among cognitive-behavioural therapists, inspired by the early success of Jon Kabat-Zinn’s meditation programme for stress management. Meditation and acceptance strategies have been used to counteract the tendency of many clients to try to suppress, control, or “fight” distressing thoughts. Lynn et al. refer to the recent study by Wegner and his colleagues, which found that when people tried to deliberately suppress a thought there was evidence of a “rebound effect” in which they subsequently experienced more intrusions of the thought than a control group who were simply asked to think freely about the same thing. Other studies have found evidence that emotional suppression can inhibit memory and problem-solving and increase physiological signs of nervous arousal. Lynn and his colleagues report that of nearly a hundred subjects who were asked to keep their minds blank while listening to hypnotic suggestions, only one reported any success.

Where thought-control strategies backfire, mindfulness and acceptance have been seen as offering an alternative way of responding to distressing experiences. Lynn et al. follow other contemporary cognitive-behavioural therapists in contrasting non-judgemental mindfulness and acceptance with the unhealthy suppression of thoughts and feelings. (However, they fail to mention that experimental studies on this “rebound” effect in thought suppression have produced some mixed results – q.v. Clark & Beck, 2010, for a more detailed review.) Lynn et al. also cite a 2003 meta-analysis of mindfulness-based cognitive therapy and stress reduction approaches by Baer, which found a mean effect size of 0.59 (a medium-sized treatment effect) for this approach across various emotional problems and medical conditions. In other words, it probably works, but the effects are comparable to those of other therapies and not dramatically superior to them.

Mindfulness & Metacognition

Lynn et al. appeal to a cognitive model combining elements of Adrian Wells’ influential metacognitive theory and Lynn and Kirsch’s own “response set” theory to explain the mechanism underlying mindfulness meditation and its relationship with hypnosis. Contrary to Beck’s earlier cognitive therapy model, Wells introduced a focus on the notion of “metacognition”, thinking about thinking, or beliefs about beliefs. According to this model, negative automatic thoughts aren’t particularly unhealthy in themselves, but rather they become so because of our attitude toward them. In plain English, whereas Beck’s original cognitive therapy assumed that negative thoughts play a central role in the development of emotional disturbance, Wells points to the fact that many people experience lots of negative thoughts without becoming upset by them, whereas patients with severe emotional disorders appear to be unusually disturbed by individual negative thoughts and worries. Mindfulness meditation, likewise, can be seen as an attempt to adopt a more detached attitude toward our stream of consciousness, and thereby to modify our thinking about thinking, i.e., to see automatic (spontaneous) thoughts as relatively transient and harmless, rather than important and dangerous. Indeed, Beck has recently assimilated many aspects of Wells’ metacognitive approach into his revised cognitive therapy for anxiety (Clark & Beck, 2010).

Curiously, Lynn et al. don’t mention the fact that Wells’ metacognitive model raises serious problems for hypnotherapy because it suggests that the assumptions often made by hypnotherapists about the “power of thought” risk reinforcing maladaptive (metacognitive) assumptions held by many clients, i.e., the assumption that thoughts (including suggestions) are inherently powerful, whereas Wells teaches his clients that ideas are only as powerful as we believe them to be and we can learn to dismiss them as “mere thoughts”, lacking any real power or significance. Likewise, Lynn et al. cite the recent research by Twohig (2004), which found that by repeating a negative thought to oneself one hundred times, like a mantra or autosuggestion, subjects made it seem less believable rather than more so, as some hypnotists might assume. To borrow Wells’ terminology, hypnotism itself can be seen as a set of metacognitive beliefs rather than an altered state of consciousness or “hypnotic trance”. The belief that autosuggestions are powerful when phrased in certain ways and the strategy of attending to their meaning for a prolonged period, to the exclusion of distractions, are ways of “thinking about thinking” (metacognition), which it’s the aim of most “hypnotic inductions” to instantiate. In a sense, mindfulness meditation can be seen as a kind of “de-hypnosis” or “counter-hypnosis”, which aims to develop a metacognitive mind-set that weakens the hold of certain thoughts or suggestions, e.g., “Imagine that you are transparent, and disturbing thoughts and emotions cannot penetrate you or have any power to control your actions” (Lynn et al.), which contrasts sharply with typical preliminary hypnotic suggestions to experience certain ideas (suggestions) as powerful, controlling, and deeply penetrating into the mind, etc.

Combining Hypnosis & Meditation

Lynn et al. summarise the relevance of hypnosis to mindfulness training as follows,

1. Suggestions can be used to motivate clients to persevere with meditation practice on a regular basis.
2. Suggestions can be used to generate a patient mind-set, so that when the attention naturally wanders this is seen as normal and accepted.
3. Suggestions can be given about acceptance of things that cannot be changed.
4. Hypnosis can be used to help people avoid identification with thoughts and feelings.
5. Hypnosis can help clients to become more tolerant of unpleasant feelings.
6. Clients can be hypnotised to perceive negative thoughts as transient and unimportant.

They specifically recommend the use of the following hypnotherapy techniques in conjunction with mindfulness meditation, which generally involves exposure to aversive feelings and events in CBT,

1. Mental (“covert behavioural”) rehearsal of previously avoided situations.
2. Cue-controlled relaxation to help facilitate exposure to feared situations.
3. The use of hypnotic desensitisation to facilitate mental (“imaginal”) exposure .
4. The use of hypnotic regression or reliving as a form of imaginal exposure to traumatic memories (as in PTSD treatment).
5. The use of suggestion to help clients tolerate the discomfort and repetition of exposure therapy.

They add that the most basic use of hypnosis in combination with mindfulness-based CBT would be in the use of suggestion to directly develop an ongoing state of mindfulness. As Lynn et al. emphasise, virtually all modern researchers now take it for granted (following several well-known studies) that hypnosis does not necessarily entail any form of relaxation, although it is frequently accompanied by it. The same applies to meditation and Lynn et al. refer to a recent EEG brain imaging study in which subjects trained in relaxation showed markedly different brain activity from those trained in mindfulness meditation.

Negative Reactions

As an aside, Lynn et al. also note that a considerable body of research demonstrates the existence of transient, relatively superficial, negative reactions following standard hypnosis, i.e., things like headaches, feelings of nausea, anxiety, etc., in up to 29% of subjects. This is comparable to the rates of negative responses reported by control groups who are simply asked to sit with their eyes shut, without being hypnotised, for the same amount of time. However, similar negative reactions are also reported following meditation training, and may even be more frequent, being reported in up to 63% of subjects. Hence, we might say that although negative reactions can occur following hypnosis it may be as harmless (generally speaking) as common meditation or relaxation techniques.

References

Lynn, Steven Jay; Das, Lama Surya; Hallquist, Michael N.; Williams John C. (2006). Mindfulness, acceptance and hypnosis: cognitive and clinical perspectives. IJCEH, 54(2), 143-166.

Clark, David A.; Beck, Aaron T. (2010). Cognitive Therapy of Anxiety Disorders: Science and Practice.

 Welcome to our March 2012 Newsletter

Are you considering a new career as a hypnotherapist?

Our Diploma in Cognitive-Behavioural Hypnotherapy provides a complete accredited training in clinical hypnosis. It is open to complete beginners to the subject as well as experienced therapists interested in adding hypnosis to their existing skills. Our next intake is on Saturday 7th July, and a 25% early booking discount is available for bookings received by the 7th April. Click here for further information, prices and to book your place.

Interest-Free Payment Plans available

Anyone attending either our Foundation Certificate or Diploma can spread the cost of their course fees over ten months after payment of a small deposit. (UK bank account required). This is completely interest free, so works out to exactly the same amount as for those paying in advance.

Self-Hypnosis Taster Workshop – Bring a guest free of charge!

Attend our one-day Self-Hypnosis Taster Workshop on Saturday 12th May. This workshop can be taken on its own and will provide you with an excellent insight into our training as well as teaching you some fantastic tools for self-help and personal development. Our self-hypnosis workshop also forms the first day of our diploma training. You can bring a guest to the workshop completely free of charge! Click here to secure your place.

UK College recommended course:

Sports Hypnosis Certificate

The Centre for Sports Hypnosis will be running their popular two-day sports hypnosis certificate course on the 26th – 27th May. This course is open to qualified hypnotherapists and those currently working towards a diploma.

Places are limited so book online today to avoid disappointment! Early booking discount available.

Learn how to work effectively with amateur and elite sportspeople in a wide range of sports using proven techniques. This specialist course will give you a thorough understanding of the foundations of sports psychology, and the techniques used in sports psychology and sports hypnosis to help top athletes achieve their best.

Any Questions?

Please feel free to get in touch either by replying to this email or by phoning us on 0800 195 9809 (+44 (0) 1403 248266) and we’ll be more than happy to help. If you would like a copy of our prospectus sent to you by email, just reply to this message.

Copyright © Donald Robertson, 2010-2012.  All rights reserved.

“Rhetoric” is the ancient name for what, to a large extent, we now call the art of “communication”, “persuasion”, etc.  However, the systematic study of rhetoric as a formal professional and academic discipline is over two thousand years old. It was one of the most important studies in ancient Graeco-Roman society, many hundreds of books were written about it, and it formed the basis of their children’s education system. However, the abuse of rhetoric by lawyers, politicians and gurus (the “Sophists”) led to condemnation from rational philosophers like Socrates who argued that truth should be prized above verbal manipulation.  This seems to have caused the word “rhetoric” to acquire negative connotations over the centuries, although Socrates and his followers felt that verbal prowess still had a valuable and legitimate place as the servant of philosophy rather than its master.  Indeed, classical rhetoric has always been closely connected to the “therapeutic” aims of Graeco-Roman philosophy, e.g., Marcus Aurelius employs rhetorical exercises as part of his meditations on Stoicism.  The article below makes some analogies between ancient rhetorical concepts and modern therapy strategies, particularly the wording of techniques and scripts in hypnotherapy.

Nor, after all, is this power of [hypnotic] suggestion, or persuasion, or concealed fascination, so remarkable or unaccountable as at first sight it appears to be. The secret of success with all sophistical [i.e., rhetorical] writers and orators is of a similar nature. They make repeated appeals to the feelings, as well as to the reason, until the minds of their readers or hearers get bewildered and withdrawn from the true bearings of the main points of the case and the assumed, and apparent sincerity and energy, of the writer, and still more so of the orator, who, to his other aids of words and arguments, adds that of his physical manifestations, to captivate and carry his entranced hearers along with him, through the power of sympathy and imitation, and fixed attention, at last irresistibly moulds them to his will. In support of this I might appeal to the personal feelings and experience of most people who have watched the effect upon a jury of a powerful and eloquent special pleader [in a court of law]; or observed the effect of an accomplished actor or actress on the stage, over an audience excited and entranced by the felicitous impersonation of fictitious dangers and difficulties, pains and perils, joy or sorrow, fear or courage, compassion, hatred, or revenge. – James Braid, 1852

Aristotle’s On Rhetoric

One of the classic texts of ancient rhetoric was Aristotle’s book on the subject, written in the 4^thCentury BC, in which he introduced the following tripartite schema for the analysis of rhetorical communication. These are the ingredients of any inter-personal communication and apply equally well to political oratory before an audience or to the inter-action between a hypnotherapist and an individual client.

1. Ethos(Character)

The character of the speaker, their reputation, prestige, appearance, and personality, e.g., the reputation or core qualities of the therapist (empathy, congruence, positive regard) identified by Rogers and Traux.

2. Logos(Speech)

The things said, their structure and format, the speech or arguments used to influence others, e.g., the techniques, metaphors, scripts, etc., of a therapist.

3. Pathos(Emotion)

The mental and emotional state of the audience, e.g., or the emotional state of the client or hypnotic “state”, etc.

Rhetorical Figures of Speech

Under the heading of “logos”, or verbal technique, classical rhetoric identifies a huge array of both verbal and non-verbal tactics and strategies used to create an effect upon the audience. Many of these will already be familiar from a variety of sources, as they are engrained in our culture. There are hundreds of relevant concepts, from which a small handful of those most relevant to therapeutic communication may serve as an illustration. Figures of speech are conventionally divided into “schemes” which create an effect by changing the structure of a phrase, or “tropes” which change the meaning of the words being used.

Rhetorical Schemes

Accumulation. A “summing up” which concludes by restating a preceding argument in a short and forceful manner. Note that this resembles the practice of repeating a short affirmation at the end of a lengthy hypnosis script. For example, a detailed description of confident behaviour in the workplace, describing its component behaviours and consequences, etc., might be reinforced by concluding with the suggestion, “You are now completely and utterly confident at work.”

Alliteration. Repeating a series of words that start with similar sounds, or lead with like letters. For example, “You are now growing powerful, peaceful, and poised.” This is sometimes considered euphonic, pleasant-sounding. It may also have a mnemonic effect, making slogans more memorable, e.g., “The three R’s: Reading, Writing, and ‘rithmetic.”

Anaphora. Repetition of the same, or similar, words at the beginning of successive clauses. This is sometimes used in hypnotic scripts. For example, “Sleep comes easily to you, sleep is something you enjoy, sleep is pleasant and comfortable.” See also Epistrophe.

Antithesis.The juxtaposition of contrasting or opposing concepts, e.g., “You are strong enough to make your point heard, and gentle enough to listen to the needs of others.” Erickson refers to a similar language pattern which he calls “apposition of opposites.” However, reference to antagonistic or conflicting ideas is presumed in most traditional “challenge suggestions” which appear to function by evoking mutually incompatible responses. For instance, “The more you try to bend your arm the more rigid it becomes”, a typical arm catalepsy suggestion, could be seen as employing a kind of rhetorical antithesis.

Assonance. The repetition of similar vowelsounds, e.g., “Heinz means beans.” This is more common in poetry than in prose, however.

Asyndeton. The omission of conjunctions between related clauses. For example, “You learn to speak out, contradict, attack” as opposed to “…speak out, contradict and attack.” “We came, we saw, we conquered” (Julius Caesar). Aristotle’s Rhetoric concludes, ‘I have done. You have heard me. The facts are before you. I ask for your judgement.’ Winston Churchill’s famous “We shall fight them on the beaches,” speech exploits this scheme at great length.  Asyndeton tends to create a more hurried effect, usually used to stimulate an energetic emotional reaction. This scheme can be used consistently throughout a script designed to suggest, e.g., energy and alertness. See polysyndeton.

Rhetorical Climax. The use of several successive words or phrases in ascending scale or importance. As the theme tune to the television show Friendsputs it, “It hasn’t been my day, my month, my week, or even my year.” The opposite, rhetorical “anti-climax”, where diminishing ideas are evoked, is perhaps less useful in therapy.  For instance, the goals of therapy can be affirmed rhetorically, “You’re going to learn to believe a little in yourself, to patiently acquire methods of helping yourself, to prepare to face your fears with my help, to face them first in small steps, to confront them repeatedly and with growing confidence, learning to depend upon yourself more and more as you approach the greatest challenges which face you, and finally to conquer them once and for all.”

Epistrophe. The repetition of the same, or similar, words at the end of successive clauses. This is also sometimes found in hypnotic scripts. For example, “You enjoy study, you embrace study, and you take pride in your ability to study.” See Anaphora.

Hendiadys. Which literally means “one through two.” (A bit like the “Buy one get one free” of rhetoric.) The use of two similar-meaning words or short phrases for rhetorical effect, usually two nouns instead of a single noun or adjective. For example, “You now grow relaxed and peaceful”, instead of “You now grow peacefully relaxed.” Further examples would include expressions like “null and void”, “heart and soul”, and “pushing and shoving.” The repetition of meaning is logically unnecessary (tautological) but adds rhetoricalforce to the idea.

Hendiatris. Like hendiadys, but meaning “one through three.” The use of three similar-meaning words or short phrases to express one common idea, such as “free, gratis, and without charge.” The ancients appreciated that threefold repetition often sounded appealing, e.g., Caesar’s famous veni, vidi, vici; “we came, we saw, we conquered.” Estate agents exclaim, “location, location, location”; politicians, “education, education, education”; sports coaches, “practice, practice, practice.” Hence, “You now grow calm, relaxed, and peaceful.”

Polysyndeton. The use of additional conjunctions for rhetorical effect. This is very common indeed in hypnotherapy scripts. For example, “Allow yourself to relax, and let go, and feel comfortable” as opposed to “…relax, let go, feel comfortable.” This slows down the rhythm of speech and usually creates a solemn or relaxing effect. See asyndeton.

Rhetorical Tautology and Synonymy. Tautology refers to the repetition of an idea in different words for rhetorical emphasis. Saying the same thing in a different way. This is frequently the case in hypnosis scripts where a similar is repeated many times, using different phrases to reinforce the same underlying ideas. Sometimes this can be by implication, e.g., “A male bachelor without a wife.”  Synonymy is similar to tautology but more specifically involves the deliberate use of individual words which mean the same thing.  Hypnotherapy scripts are full of synonyms, so much that hypnotists can often make good use of a simple thesaurus in designing their scripts, by including as many variations on the same concept as possible.

Verbification & Reification. The technique of changing a noun into a verb, sometimes called “verbification” or “verbing”, is mainly attributed to Korzybski’s General Semantics in modern therapy. Sometimes it can lead to strange neologisms, as in “Verbing weirds language”.  Albert Ellis made extensive use of verbification in his early writings on Rational Emotive Behaviour Therapy (REBT), coining such terms as “awfulising” and “catastrophising”.  Korzybksi famously argued that the verb “to be” was responsible for confusion and deadening of language. For example, “I am tense” can be replaced with “I am tensing my body.” Doing so encourages the speaker to be more specific and also to adopt responsibility for their current activity, which can lead to changing behaviour. The opposite process, “reification”, occurs when a process or activity is treated as if it were a substance (a “thing”), usually by referring to it by means of a noun. The familiar notion of doing something “unconsciously”, is transformed into the notion that it is done “by the unconscious” by introducing the noun and thereby reifying the concept, something which humanistic and behavioural therapists roundly criticised Freud for doing.

Calvin and Hobbes on "Verbing"

Rhetorical Tropes

Allegory.A short story that serves to illustrate a central message, i.e., the stories told by Erickson, or the ancient fables of Aesop.

Aphorism.A concise sentence, maxim, or statement that powerfully sums up an idea, e.g., “Hypnosis helps those who help themselves”, “All hypnosis is self-hypnosis”, etc.

Apophasis. Meaning “saying no”, apophasis is the ancient term for the rhetorical trope which evokes an idea by superficially denying it, e.g., “I don’t want you to become obsessed with using this self-hypnosis technique”, “Nobody’s suggesting it was your fault”, “Don’t think of an elephant”, etc. In a televised political debate in 1984, Ronald Reagan said he would never look to take political advantage of his opponent’s youth and inexperience, thereby indirectly but effectively undermining his credibility. This concept is central to the practice of hypnotic suggestion and presupposed by the common rules of suggestion, i.e., that suggestions should generally be phrased in the positive.

Euphemism. Using a more palatable phrase for one that might offence. Euphemisms are commonplace in marketing, e.g., high calorie drinks, which are potentially very unhealthy because of the large quantities of refined sugar in them, are simply relabelled “high energy” – a more positive-sounding way of saying the same thing.  In hypnotherapy, e.g., we might refer to “that unpleasant feeling” instead of “pain” to refer to it without evokingthe sensation. A therapist might refer to “those old emotions fading away” to avoid saying, “you’re not panicking and crying like a baby anymore.” In smoking cessation we might refer to “that old habit” to avoid conjuring up the images associated with more explicit and evocative phrases like “smoking cigarettes.”

Hyperbole. The use of exaggeration (“hype”) to emphasise a point, e.g., “You feel as if the whole world is applauding you”, “Your legs feel like they weigh a ton.” Hyperbole is also commonly used in hypnotic suggestion. It’s opposite, Litotes, deliberate understatement, is less common in hypnotherapy, except in the form of euphemism.

Irony.The use of a word or phrase in a paradoxical manner made significant precisely through the conflict with its normal meaning. The term specifically derives from Socrates’ professed ignorance. Assuming that he “knew only that he knew nothing”, was (ironically) the basis of his legendary wisdom. Picasso, e.g., said “Art is a form of lying in order to tell the truth.” Irony is common in therapy, e.g., clients’ attempts to achieve things often (ironically) result in the opposite. Ironically, trying not to think about something tends to make you think about it even more.  Trying too hard to make people love you, ironically, can drive them away. Trying to fall asleep, ironically, can keep you awake. Believing that you can’t be hypnotised, ironically, is itself a form of negative self-hypnosis.

Metaphor. Metaphors are specifically verbal combinations of one concept with another which gain meaning by the comparison, e.g., “He had the heart of a lion”, “The speaker was shot down in flames.” Confusion is caused when metaphors are taken too literally by people who misunderstand them, e.g., the notion of “trance” is arguably a metaphor in hypnotherapy, used to describe normal disorientation, selective awareness, or imaginal absorption.  People, however, take it in a more literal sense and assume that it refers to some sort of unnatural state such as the unconsciousness or automatism of a zombie. Hence, some modern hypnotherapists prefer to speak of a “trance-like feeling”, “feeling as if you’re in a trance”, turning the metaphor into an explicit simile.

Metonymy.Use of a word to refer to something associated with it, or of which it is one part. Lacan defined metonymy as “part for whole.” For instance, “the press” symbolises the media by association with the printing press, “the crown” symbolises the monarchy by association, “top brass” symbolises the military command.

Simile.Similes are like metaphors but made explicit by the use of a phrase such as “as if”, “as though”, or “like” which verbally indicates a comparison, “It was as if he had the heart of a lion.”

Neologism.The invention of a new word to create a new concept and add emphasis to it, e.g., therapists often turn nouns into verbs such as “You are catastrophising things” instead of “This is a catastrophe.”

Onomatopoeia. Words which sound like the thing they describe, e.g., “the buzz of the fly”, “the crack of the whip”, “the pop of the cork”, etc. The Greeks called foreigners “barbarians” (barbaroi) because they thought they sounded like they were just saying “bar, bar…”, the Greek equivalent of “blah, blah…” Not much used in hypnotherapy.

Oxymoron.A real or apparent contradiction in terms, the opposite of a tautology, e.g., “He was a likeable rogue”, or “It was a square circle”, “The midday Sun at midnight”, etc. Not much used in hypnotherapy.

Paradox. “Paradox” means contrary to (popular) opinion. Plato’s views were described as paradoxical because they seemed to turn received wisdom on its head. Paradoxes feature in therapy because human nature is paradoxical and many popular assumptions are based on misconceptions. For example, “paradoxical therapy” or “symptom prescription” revolves around the idea that deliberately engaging in a behaviour may make it lesslikely to continue as a habit in the future.

Paradoxes have rhetorical effect because they are surprising and therefore capture attention and stick in the memory. The most important paradoxes for the purposes of therapy are “apparent” but not “real.” For example, it may seem paradoxical that people can learn to reduce pain by first learning how to intensify it, but there is probably an explanation for this.

Personification (Prosopopoeia).Attributing inhuman things with human qualities. Sometimes called “the pathetic fallacy” in logic, or “anthropomorphism” in psychology and anthropology. For example, “The land was thirsty for rain”, “The book was staring back at him”, “The universe has got it in for me.”

Rhetorical Question (Erotema).The practice of posing a question in order to presuppose or imply a conclusion, e.g., “Do you really want to make yourself the whore of Big Tobacco by smoking yourself into an early grave?”

Synaesthesia.The use of words normally descriptive of one sense to describe another, e.g., “This wine tastes like an autumn breeze with an aftertaste that’s like warming your toes by an open fire”, “His voice sounded warm”, “The kitten looks sweet.”

Truism. An obvious, self-evident statement used for rhetorical effect, e.g., “Pain hurts!”, “Stupid people do stupid things”, “Some you win; some you lose.”

Logical Fallacies in Rhetoric

The study of logical fallacies is another important area in rhetoric, closely resembling the disputation of thinking errors in cognitive therapy.  However, it lies beyond the scope of this brief article.

Further Reading

Corbett, E.J. (1990). Classical Rhetoric for the Modern Student. Oxford: OUP.

What Works and What Doesn’t

Copyright © Donald Robertson, 2002-2011.  All rights reserved.

• See the UK College website for details of our two-day certificate workshop on cognitive-behavioural hypnotherapy for smoking cessation, approved by the National Council for Hypnotherapy (NCH) for CPD.

Numerous research studies show hypnotherapy to be effective as a means of stopping smoking.  However, results are highly variable; more so perhaps than for any other problem.  Some approaches to hypnotherapy appear inadequate, such as direct/scripted suggestion or regression, whereas others have been found to work much better, usually by integrating hypnosis with elements of established cognitive and/or behavioural therapy.

Nevertheless, many hypnotherapists employ simple direct suggestion scripts for smoking cessation.  I’ve heard several times of clients being treated by hypnotherapists who read a script to them from a sheet of paper or leave the room while they play a recorded script.  (That’s clearly not very professional, of course!)  By contrast, most modern researchers and evidence-based practitioners agree that direct verbal suggestion, of the kind found in most CDs and scripted approaches, is the bedrock of hypnotherapy for smoking cessation but totally inadequate by itself to achieve significant outcomes,

The most basic procedure, one on which you can build your own approach, involves a hypnotic induction and deepening routine, followed by suggestions that from now on the client will be a non-smoker and have no desire to smoke ever again. This approach is unlikely to yield an abstention rate (continuous over, say, 1 year) that is much above the 5-7% rate achieved by those smokers who spontaneously decide to quit. (Heap & Aravind, 2002: 299)

A more detailed review of the research on smoking cessation (and weight loss) hypnotherapy concluded that direct suggestion hypnosis was not particularly effective when used alone (Waddon & Anderton, 1982). Hence, hypnotherapy methods for smoking cessation which are based on simple direct suggestion scripts are unlikely to be anywhere near as effective as more sophisticated multi-component treatments.  The most effective treatments for smoking cessation, across the board, are “multi-component” in nature and tend to involve several cognitive-behavioural strategies used in conjunction.  In the case of hypnotherapy, the most effective approaches tend also to be highly multi-component and to incorporate elements of cognitive-behavioural therapy (CBT).

Multi-Component / Cognitive-Behavioural Hypnotherapy

As no single (“uni-modal”) therapy intervention has been found to be particularly effective for smoking cessation when used in isolation, the general consensus is that a package or combination of techniques specially tailored for the problem is indicated, i.e., a multi-component or “multi-modal” approach.

Cognitive-behavioural approaches to smoking cessation typically include a range of different interventions designed to tackle the problem at different levels, and can therefore also be designated “broad spectrum” or “multimodal.” The combination of hypnotherapy and CBT called “cognitive-behavioural hypnotherapy” (CBH) is even more broad spectrum in nature, as it combines a wide range of different, evidence-based, interventions. As Marks, a specialist in this area, observes, “CBT methods can improve the results of any treatment programme.” (2005, 16). The inclusion of hypnosis also seems to generally improve outcomes, so it is not surprising that the combination of a tailored CBT and hypnosis package might be considered the treatment of choice for smoking cessation.

In 2000, Green and Lynn conducted a careful systematic review of the research on hypnotherapy for smoking cessation which concluded that hypnotherapy was a promising treatment for smoking but that it probably achieved its results mainly by the incorporation of cognitive and behavioural strategies rather than because of the inherent power of hypnotic suggestion alone,

This article reviews 56 studies of hypnosis and smoking cessation as to whether the research empirically supports hypnosis as a treatment. Whereas hypnotic procedures generally yield higher rates of abstinence relative to wait list and no treatment conditions, hypnotic interventions are generally comparable to a variety of nonhypnotic treatments. […] Furthermore, in many cases, it is impossible to rule out cognitive/behavioral and educational interventions as the source of positive treatment gains associated with hypnotic treatments. Hypnosis cannot, as yet, be regarded as a well-established treatment for smoking cessation. Nevertheless, it seems justified to classify hypnosis as a “possibly efficacious” treatment [according to APA criteria for empirically-validated treatments] for smoking cessation. (Green & Lynn, 2000)

In short, hypnosis may work well as a means of enhancing a combination of cognitive-behavioural interventions, and may even be superior to standard CBT in some cases, but direct hypnotic suggestion used alone is unlikely to be effective.  Individuals seeking hypnotherapy to stop smoking would therefore be well-advised to check whether their therapist intends to employ a scripted or direct suggestion approach alone or whether they plan to work according to an evidence-based “multi-component” model, incorporating a number of cognitive-behavioural strategies supported by the clinical research literature.

Addendum: Dave Elman & Regression Hypnotherapy

We still hear, albeit very rarely, of therapists employing regression as their primary technique in smoking cessation.  (Despite the fact that Sigmund Freud, the originator of the hypnotic regression approach died from mouth cancer due to a cigar-smoking habit he was unable to extinguish.)  Regression therapy has never been widely employed as a treatment for smoking cessation and is not supported by any credible research evidence in this area. As Spiegel, an authority on hypnotherapy for smoking cessation, writes,

To delve into the reasons they started to smoke is irrelevant, because at the time most adults of today [1978] started smoking it was not known to be harmful. No matter what reasons are uncovered, the critical information is not there. Smoking was not known with any certainty to be malignant until 1964. The reasons for stopping the habit were then based on information not available when the smoking started. This specific habit became a fair starting point to study habit change without taking the time to explore the [historical] reasons behind the habit. (Spiegel & Spiegel, 1978: 210)

In other words, after the US Surgeon General’s report condemning smoking was published in 1964 a strong motivation to stop smoking was introduced which people were not widely aware of when they initially developed the habit. This suggested that “regression to cause” might be irrelevant in treating these clients and so the cognitive-behavioural treatment of smoking, focused on the here and now, became common practice.

Dave Elman, one of the most popular and influential advocates of regression hypnotherapy, emphasised his failure with smoking cessation, in the following exchange,

Doctor: What can we do about the cigarette habit?

Elman: Hypnosis is of as little value in permanently correcting the cigarette habit as superficial suggestion is in correcting alcoholism. I have succeeded in giving hypnotic suggestions to people who declared sincerely that they wanted to stop smoking or stop drinking, and I have managed to make the suggestions hold for as long as a month, sometimes for two or three months or even longer. But if you follow up these same cases six months or a year after the hypnotic suggestions have been given, you find that the patients are smoking or drinking as much as ever; the hypnotic suggestions have had no permanent effect. […] Moreover, since the smoking habit isn’t usually based on any very serious emotional disturbance, even hypnoanalysis is of little value. You cannot unearth and correct a traumatic event when there is no trauma. (Elman, Hypnotherapy, 1964: 324-325)

Of course, Elman was himself a smoker and apparently smoked in front of his class when hypnotising patients. However, Elman was also unfamiliar with the principles of cognitive-behavioural therapy, such as relapse prevention, cognitive restructuring, etc. His limited set of tools, even in the hands of an acknowledged master of his art, were deeply unsuited to the task of smoking cessation. However, subsequent researchers reported considerably more success employing hypnosis in conjunction with simple cognitive-behavioural methods. Consequently, even advocates of hypnoanalysis have tended to favour the combination of hypnosis with elements of CBT or behaviour therapy.

• See the UK College website for details of our two-day certificate workshop on cognitive-behavioural hypnotherapy for smoking cessation, approved by the National Council for Hypnotherapy (NCH) for CPD.

Copyright © Donald Robertson, 1998.  All rights reserved.

[This is one of the first articles I published online.  Retrieved from an archive as the original website no longer exists.  I had to explain to some people at the time that this was primarily a historical article, exploring Freudian theory.  I don’t actually endorse Freud’s theory or practice, particularly in relation to hypnosis.]

We psychoanalysts may claim to be its [hypnotism’s] legitimate heirs and we do not forget how much encouragement and theoretical clarification we owe to it.  (Freud, Introductory Lectures, 1917: 516)

Freud’s Psychoanalysis & Bernheim’s Hypnotherapy

Everyone who knows psychoanalysis knows that Freud’s initiation into psychotherapy was via the only genuinely psychical treatment available in his day, hypnotherapy. I will, however, leave aside the fascinating historical and theoretical issues relating to hypnosis and the prehistory of psychoanalysis, in order to concentrate on the somewhat belated theoretical explanations offered by Freud, Ernest Jones, and Sandor Ferenczi. However, some preliminary remarks are in order.

Freud began the serious use hypnosis in his practice in 1887, only a year later he translated the principal textbook of 19th century hypnotherapy into German: Bernheim’s On Suggestion and its Therapeutic Application, to which Freud added his preface. However, he was frustrated by his own difficulty in inducing hypnotic trance, and puzzled by the variability in effectiveness and duration of his suggestions. Freud had always been uncomfortable with the tendency prevailing in his day to ground psychology on the irreducible concept of ‘suggestion’. Consequently he could never accept Bernheim’s influential attempt to reduce hypnosis to the patient’s susceptibility to suggestion, protesting, in his own words, ‘against the view that suggestion, which explained everything, was itself to be exempt from explanation.’ (1921:89). Freud was always to maintain that he was more in sympathy with the views of Bernheim’s great rival Charcot, that hypnotic suggestibility was not an irreducible psychical phenomenon but a symptom of the complex psychopathology of hysteria.

In his clinical research Freud became convinced first of the sexual and then of the infantile origins of the neuroses. Charcot’s innovation was to medicalise hysteria, which had previously been viewed as simple malingering. Freud’s innovation was to see not only hysteria but neuroses in general, as originating in infantile psychosexual attachments – in terms, that is, of erotic desire, relationally. A historical turning point occurred, however, when he began to interpret the one-sided relationship between the patient and doctor as itself a fundamentally neurotic one, a transference on the part of the patient of repressed infantile reactions onto the doctor; referred to as transference-neurosis. Like Charcot, then, Freud saw suggestibility as a symptom of neurosis, or rather as a feature of the underlying mechanisms of neurosis, mechanisms which functioned quasi-neurotically in the irrational activities of everyday life: in dreams, in slips of the tongue, in memory lapses, in love, in humour. Freud, thereby, medicalised normality – remember he wrote the title The Psychopathology of Everyday Life. Likewise, in relation to Charcot’s identification of hypnosis and hysteria Ernest Jones said that the dictum ‘Everyone is a little hysterical’ is a literal fact. Whereas Bernheim objected against Charcot that hypnosis could not be a symptom of hysteria since even non-hysterics could be hypnotised, Freud objected against Bernheim that non-hysterics were nevertheless only suggestible insofar as they were subject to the everyday manifestations of fundamentally neurotic processes.

Hypnosis, therefore, was viewed as the precipitate of an unconscious sexual relationship, a transference-neurosis on the part of the patient, directed toward the doctor or hypnotist. Ferenczi notes with irony the implied reversal, when he writes: ‘The unconscious mental forces of the [patient] appear as the real active agent, whereas the hypnotist, previously pictured as all-powerful, has to content himself with the part of an object used by the unconscious of the apparently unresisting [patient] according to the latter’s individual and temporary disposition’ (1916). What cause variability in the effects of suggestion, therefore, are fluctuations in libido, transferred by the patient onto the hypnotist. Hence, Freud provides the following definition in an article written for the Encyclopaedia Brittanica,

Transference is a proof of the fact that adults have not overcome their former childish dependence; it coincides with the force which has been named “suggestion”; and it is only by learning to make use of it that the physician is enabled to induce the patient to overcome his internal resistances and do away with his repressions.

Although Freud says here that suggestion and transference ‘coincide’ it is doubtful if this can be taken literally, if only because transference is ambivalent, i.e., containing both loving and hostile possibilities. Insofar as hostility predominates the patient will exhibit a general recalcitrance to suggestion. Hence, Ferenczi and Jones both insist that suggestion is just one species of transference relationship. Moreover, even a predominantly positive transference seems unlikely to exhibit the degree or kind of suggestibility occurring in profound hypnotic trance, and Freud admits that suggestibility cannot be straightforwardly reduced to a form of transference. Suggestibility and transference, then, are not simply the same thing. Nevertheless, for psychoanalysis, the phenomenon of suggestion is implicated in the clinical conception of transference, and vice versa.

Consequently, it was possible for psychoanalysts to explain the variable duration of post-hypnotic suggestions by appeal to the inevitable impoverishment of the subject’s transference onto the hypnotist. Months or years after being hypnotised, when the subjects affective attachment to the hypnotist has faded into the past and been replaced by new libidinal ties, hitherto effective suggestions will be rendered impotent. Likewise fluctuations in the effectiveness of suggestion during the course of therapy can be attributed to the vicissitudes of the transference relationship. And of course, the notorious variability in effectiveness of hypnosis between different individual practitioners -who may be employing identical techniques- can be explained in terms of their potential for eliciting a positive transference from particular subjects. Psychoanalysis differed from Bernheim’s hypnotherapy, however, in aiming, among other things, at the resolution of the transference. This resolution is achieved primarily through the judicious use of interpretations, which are offered to the analysand in an attempt to bring his infantile erotic relation to the analyst into consciousness in their specificity. As Ernest Jones puts it, in analysis ‘the suggestive influence of the physician is expressly resolved into its constituent elements’ (Jones, 1911). Consequently, as he states elsewhere, it is generally accepted by analysts that ‘when a patient really recovers from his neurosis his abnormal suggestibility […] greatly diminishes or ceases’ (1910), along with his general propensity for transference.

In other words, clinical psychoanalysis proceeds, in part, by the interpretation and analysis of the very mechanisms which determine suggestibility. For this reason we would expect Freud to provide us with a generalised theoretical interpretation of the phenomenon of suggestibility in terms of the same libidinal mechanisms which determine transference. To provide a psychoanalytic theory of hypnotic suggestion. This does not happen explicitly until 1921, about 20 years after Freud’s discovery of transference, and is tucked obscurely away in his Group Psychology & the Analysis of the Ego. There, ironically, he complains that in the thirty years since Bernheim’s book was published ‘there has been no explanation of the nature of suggestion, that is, of the conditions under which influence without adequate logical foundation takes place,’ (1921:90) and that the concept of suggestion acts as a screen obscuring the fundamentally sexual basis of interpersonal influence.

Love & Hypnosis

Freud’s discussion of hypnosis is embedded within a longer investigation of group processes. The kind of groups which concern Freud are ones which depend for their survival on the influence of a powerful leader, generally this is because they lack the degree of organisation required to function as a genuine democracy. The principle concept which Freud uses to theorise group relations is that of identification. Precisely, what Freud means by identification, however, is not always clear, and his exploration of its various forms is protracted and somewhat tortured. ‘We do not ourselves,’ concedes Freud, ‘regard our analysis of identification as exhaustive […]’ (1921).

In groups, Freud, notes, suggestion and identification generally function along two discrete axes. Firstly, there is a degree of mutual identification between the members of the group -colleagues, comrades, classmates- this form of identification resembles that between siblings; a horizontal axis. Secondly, a qualitatively different identification, one between the individual group members and their leader, teacher, God, or abstract ideal, the father figure; a vertical axis. Identification between group members, however, is strictly subordinate to their identification with the leader, which in a more sublimated form may be replaced by an abstract ideology. (Incidentally, this aspect of Freud’s theory is virtually identical to Sartre’s account of group cohesion in Being & Nothingness, 1943.)

The so-called herd instinct of the group is derived by Freud from the mutually aggressive desire of its members to replace one another in the desire of its leader. The ontogenetic model is this: siblings are jealous of each other for the love they receive from their parents, they want to kill each other but their father won’t let them. Their response to this is to repress their aggression and defend themselves against its subsequent irruption by developing the opposite affect, love (reaction-formation). Moreover, this love is not allowed to be erotic either (sibling incest is cross-culturally the strongest taboo) so it becomes inhibited in its aim, sexual hunger becomes Platonic affection. This Platonic love then regresses to the level of a narcissistic identification, something facilitated by the similarity between siblings-comrades, and their shared attachment to the father-leader. Moreover, this defensive reaction provides a secondary gain, in that identification with the other permits the vicarious enjoyment of the love and approval received by them from the leader or parent. In Freud’s words, ‘social feeling is based upon the reversal of what was first a hostile feeling into a positively-toned tie in the nature of an identification […] under the influence of a common affectionate tie with a person outside the group’ (1921). The development of this narcissistic identification, then, accounts for such phenomena as group hysteria, and mass hallucination; referred to as ‘group contagion’. However, it does so only by appeal to the relation of each group member to the leader, group contagion is subordinate to the vertical axis of suggestion, that between father and child.

Freud several times describes hypnosis as ‘group psychology without a group’. It is unlike group formation in that it consist in a relationship between two people (Freud was presumably not in a position to consider the technique of group-hypnosis). In this respect hypnosis is more like love, indeed, Freud assures us that ‘From being in love to hypnosis is only a short step’ (1921). For Freud, love develops out of primitive sexual attachment by a process of aim-inhibition and sublimation. Love differs from libido, but only by being a refined species of the former. Pure sexual arousal is inherently short-lived, once satisfied it is, at least temporarily, quiescent. Once the aim of sexual satisfaction is inhibited, however, libidinal attachments can never be fully discharged. Making of love a more enduring relationship than libidinal lust, a development that ultimately contributes to group formation and to socialisation. Most love involves some element of primitive erotic gratification, even if it is only through touch or sight. Love, then differs from pure libido by degree of aim-inhibition. Freud places hypnosis at the opposite end of this scale from primitive sexual lust, as the single most aim-inhibited species of love; ‘the unlimited devotion of someone in love, but with sexual satisfaction excluded’ (1921). This, then, is the completely desexualised love of the child for his parents which develops out of the massive psychical reorganisation of the Oedipus situation.

To this schema Ferenczi added an innovative distinction between two forms of hypnotic suggestibility, between a maternal and paternal hypnotic relationship. Ferenczi rightly observed that hypnosis generally takes either of two forms, a warm, permissive, and supportive approach and an aggressive, authoritarian, and directive form. The permissive approach encourages the subject to transfer his identification to the mother onto the hypnotist, the directive approach invokes a paternal transference. Both may entail qualitatively different forms of identification, derived from the identifications of the Oedipal triangle. Little is said about the mechanisms of maternal hypnosis by Freud, Jones or Ferenczi, however I would suggest that it resembles in some respects the narcissistic identification involved in group contagion. (However, identification with the mother ontogenetically precedes the relationship with the father in a way that sibling identification does not).

Regarding the phenomenon of paternal hypnosis, Freud provides a formula which crucially distinguishes it from group contagion. The hypnotic subject’s paternal transference-identification puts the hypnotist ‘in the place of his superego’. The superego, is that part of the mind which critically observes the ego, and which represents the ego-ideal, the image of perfection which it aspires to. Moreover, the superego is for Freud a monument to the psychical trauma of the Oedipus situation. It is both a developmental and a defensive reaction to the threat of castration anxiety. On Freud’s model the prohibitions which the father represents against the infants erotic desire for his mother are introjected, internalised in such a vigorous manner as to constitute an autonomous psychical agency, split off in its functioning from the child’s ego. In paternal hypnosis, then, the subject acts out his infantile relationship to his father, and regresses back to a level of psychical organisation where his superego is not differentiated from his father.

This, then, is my (tentative, and incomplete) overview of the Freudian model of hypnotic suggestion. To it, in conclusion, I would add one more observation. Freud tells us that, depending on how the Oedipus situation is resolved, the degree of dissociation between superego and ego may vary. Moreover, he suggests that it may fluctuate periodically (something he relates to mood swings in manic depression). If Freud is right that authoritarian hypnosis depends on eliciting a paternal transference-identification, then is it possible to employ this approach with an individual whose superego is relatively undifferentiated from his ego, or at stages in a therapy where this dissociation seems to have temporarily waned (as in periods of mania)? Likewise is the permissive maternalistic approach to hypnosis contra-indicated for use with individuals exhibiting a high degree of superego differentiation (such as obsessives)?

Braid on Hypnotism, Childbirth and Infants

Excerpts from The Discovery of Hypnosis: The Complete Writings of James Braid, The Father of Hypnotherapy (2009).

www.James-Braid.com

Hydro-Hypnotism of Infants

The following method of producing and prolonging sleep at will – which may be designated hydro-hypnotism – is adopted by the peasantry residing among the Himalaya Mountains.  An aged female is generally appointed to watch a number of infants whilst their mothers are engaged out of doors in agricultural labours. The infants are wrapped up like little mummies, laid on their backs arranged in a semicircle, and from a number of small spouts, a little of water is made to fall upon and flow over the head of each infant. The natives believe that this process strengthens the children, and makes them hardy. However this may be, it appears to be a most effectual method of sending them into a state of sleep and quietude, for, at page 272 of Lloyd and Gerard’s Travels, they state, as eye-witness of the fact, frequently seen by them, “The most refractory imp, when tied up, let it yell never so loud, will, when the stream has for a few seconds bathed its head, fall into a most noiseless slumber.”

First Reported Hypnotic Childbirth

The following is another highly interesting case of the influence of mental impression changing physical action. The patient was one of those subjects who pass into the second-conscious state of hypnotism, and had been cured by hypnotism of paralysis, both of sense and motion, of one side of the head and face. The following effect of the expectant idea, however, relates to what occurred when she was in the waking condition. This patient, Mrs –––, was the mother of three living children, the last of which was a cross birth, delivery being accomplished with great difficulty. The two subsequent births were of largely developed children, both still-born, both having been shoulder presentations, the labour far advanced, and the shoulder and arm advanced within the pelvis before medical assistance arrived. Upon careful examination of the bones of the pelvis of this patient, it was clearly ascertained that there was such advancement forward, and depression of the promontory of the sacrum and lumbar vertebrae, as to preclude the hope of her ever giving birth to a full-sized living child; and, therefore, when she again became pregnant, I explained how matters stood to her husband, as well as to the patient, and recommended that premature labour should be induced, as affording the only chance of her bearing another living child, and as affording the greatest safety, moreover, for the mother. Both parties were perfectly satisfied to abide by my decision on this point, so that I was to consider myself at perfect liberty to act in the matter as I thought best, both as to the method to be adopted for accomplishing such purpose, and also in regard to the time when I was to induce premature labour. About two weeks beyond the seventh month was the period which I had fixed on for inducing labour. I had seen the patient a few days before this period, and found her in excellent health, experiencing no inconvenience of any sort. I told her that in three or four days I intended to do something for her to bring on labour as had previously been agreed upon should be done. She was quite agreeable to this proposal, and seemed to entertain no anxiety whatever on the subject. In two days thereafter, however, I was sent for to the patient, and ascertained that the mere mental impression had been sufficient to bring on labour, for the os uteri was not only fully dilated, but, as in the three former labours, the shoulder was presenting. In this case, from the small size of the infant, I was enabled with great ease to turn and deliver the mother of a living child.

Lactation Induced by Hypnotism

Having told a gentleman that the expectant idea in the mind of a patient was quite adequate to produce a corresponding change in the physical function of any organ or part of the body to which it was directed, he expressed his incredulity. I asked him if his wife was not then nursing, to which he replied she was; and I therefore offered to prove my position, if he chose, by causing an increased flow of milk to come into ONE of her breasts, by directing her attention particularly to that breast during the sleep. This gentleman’s wife had been a patient of mine some eight months previously, and was then cured of violent headaches by hypnotism; and I knew she was one of those subjects who pass into the second-conscious or full state, and upon whom the power of suggestion manifests its greatest influence. The lady was sent for, and asked if she had any objections to being hypnotised, for her husband to have an opportunity of seeing her in that state. She readily gave her assent, and whilst standing on her feet, I held my lancet case over her head, in my usual way, and requested her to gaze upon it, and speedily her eyelids closed, with the twitter peculiar to the hypnotic sleep. After she had remained in this state a little while, I gently drew the tips of my fingers two or three times over the left mamma, when the patient slowly raised her left arm towards her breast. I then inquired “What is it?” To which she replied “Baby.” “What about baby?” To which she answered, “Oh this is so tight,” pointing to her left breast. In this state I allowed her to remain for a few minutes, her mind riveted to the idea of her baby, and the fullness of her breast. With a clap of my hands I now aroused the patient, who had no recollection whatever of anything said or done when she was asleep.  I asked if any part of her body felt different from its usual condition. To which she replied, pointing to the left breast, “This breast feels very tight.” I asked her what had made it so. To this she replied, she could not tell, but that it felt so. Her husband now remarked, “That is what Mr. Braid said he would do – he said he would bring a rush of milk into it.” To this the lady replied, “That will be no easy matter, for my baby is fourteen months old, and I have scarcely any milk.” I requested her to bring baby and try, as I felt assured that now there would be no lack of milk in that breast. The baby was applied to that breast, and, notwithstanding he was fourteen months old, the flow of milk was so copious that it nearly choked him.

A few days thereafter this lady complained that I had disfigured her, as I had made her over-protuberant on the left side. I said I can soon settle that matter, for, by putting you to sleep again, I can take it down as readily as it was increased in size during former sleep. She most willingly assented to this, but when she was asleep, instead of taking it down (which a suggested idea to that effect would have done), I acted on the other breast in precisely the same manner as on the left breast, and with precisely similar results. The most important point, however, still remains to be told – viz., that although her child was fourteen months old, and before being hypnotised she complained of having had very little milk, these hypnotic processes had given such a stimulus to the mamma, that this lady was enabled to continue to suckle her child from an overflowing breast for six months longer.  [Hence, Braid appears to have enlarged both breasts by inducing lactation, and the child was breast-fed until it was a year and eight months old.]

Alfred A. Barrios, PhD

Copyright © Alfred Barrios.  Reproduced by kind permission of the author.

[The original version of the article is available from Dr. Barrios’ Self-Programmed Control Center (SPCC) website and from The Great Debate website.  See also the NCH article on Dr. Barrios' theory of hypnosis and this article on Pavlov and hypnosis.]

The question of whether man does or does not have free will has been debated down through the centuries by some of the greatest minds but has never been fully answered. There are those, call them idealists, who say that of course we have free will; we can control our own destiny; we can choose between misery and happiness. Then there are the realists who point to all the miserable people in the world and ask did all these people freely choose to be miserable?

Do we really have free will? Do we really have control over our own destiny? Can we change our behaviors at will if we see that they are detrimental to us? Or is everything set in stone, pre-determined? In order to finally answer this question, we must first properly define our terms. Although there are currently many definitions of free will, I believe the most correct one is: Free will is the ability to control our automatic side, our subconscious behavior, by means of the power of sufficiently concentrated thought. And by concentrated thought I mean the ability to block the interference from any negative automatic behavior or thought that would tend to contradict the action or change we wish to empower.

If you stop to think about it, most people’s behavior is of an automatic nature: habits, attitudes and beliefs that have been so deeply programmed in over the years as to be so automatic that they are very hard to change. In this sense then you could say that many people are automatons, governed and slaves to this automatic (subconscious) behavior. [The "subconscious" is to be differentiated from the "unconscious" here. I define the subconscious as behavior that has been so deeply programmed as to occur automatically, below conscious awareness and often beyond conscious control. The unconscious can be defined as engrams or memories beyond immediate conscious recall.]

So from this definition of free will we can see that the answer to the question of whether there is free will or not is that all humans have the POTENTIAL for free will because all humans have the potential to enter this state of concentrated thought and thus have the potential to re-program themselves at will (an ability that differentiates humans from the rest of the animal kingdom). But not everyone has learned how to do this. Consequently, people differ from one another in the amount of free will they have.

However, there is a way of achieving this state of sufficiently concentrated thought and that is by developing a heightened state of belief in the outcome or change you are trying to program in; for I define belief as concentration on a thought to the exclusion of anything that would contradict that thought. Or another way of putting it: a state of heightened belief includes a strong inhibitory set which can suppress the existing negative program you are trying to replace sufficiently so as to keep it from interfering with the re-programming you are attempting.

This is why hypnosis is such a powerful tool for facilitating change since I define hypnosis (as did B.F. Skinner) as a heightened state of belief. This is strongly supported by the evidence showing that hypnotherapy is the most effective form of psychotherapy. I refer the reader to the review of the literature I presented in my article “Hypnotherapy: A Reappraisal” (Psychotherapy: Theory, Research and Practice, 1970). It was found that the average success rate for hypnotherapy was 93% after an average of 6 sessions; this compared to 72% after an average of 22 sessions for behavior therapy, and 38% after an average of 600 sessions for psychoanalysis.

This is also one of the reasons why religion is so deeply entrenched in the hearts of many since religion offers another way to a heightened state of belief. It also explains why the placebo effect in medicine (both standard and alternative) and psychotherapy plays such a big role in facilitating positive changes in humans since the placebo is based on the power of belief.

Those among you who are adherents of determinism need not feel that this approach to free will contradicts your beliefs – if you define determinism in terms of the lawfulness of nature instead of the opposite of free will as some mistakenly do. What is the opposite of free will is fatalism. If you believe that your life i pre-ordained or pre-destined and that you cannot change it from that, then you are a fatalist and do not believe in free will.

We should also clearly differentiate between the terms “heightened belief” and “beliefs”. When I refer to the power of heightened belief, I am referring to the power of concentrated (unhindered) thought. When I refer to the term “beliefs”, I mean specific attitudes, ideas, ways of seeing things a person might have.

I also feel it is important to differentiate between the concepts of faith and belief. Faith I define as a form of guided or directed belief. And I like to point out that belief alone is often not enough for positive change. If it is directed in a negative direction, it can be harmful and dangerous.

Finally, with regards to how thoughts can directly affect human reactions I refer you to Pavlov’s writings on the power of speech (as well as inner speech which is how Pavlovians refer to thoughts) to affect humans:

Obviously for man speech provides conditioned stimuli which are just as real as any other stimuli… 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, signaling 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.

All articles and quotes referred to above can be found in the “Dr. Barrios Articles” section of my website: www.SPCcenter.com, including my theory of hypnosis. See especially my articles: “Science in Support of Religion: From the Perspective of a Behavioral Scientist” and “Hypnotherapy: A Reappraisal“.

Copyright © Alfred Barrios. Reproduced by kind permission of the author.

[The original version of the article is available from Dr. Barrios’ Self-Programmed Control Center (SPCC) website and from The Great Debate website.]

From our LondonCognitive.com Website

Here are a recent selection of articles on hypnosis and hypnotherapy from one of our other websites, the Solutions™ therapy clinic,

www.LondonCognitive.com

You can view all current hypnosis articles via the link below,

http://londoncognitive.com/category/hypnosis/

Articles on Hypnosis

Hypnotic Relaxation Script (Traditional Style)

This is the full script of a standard hypnotic relaxation exercise, for use either with individuals or groups.

How to do Self-Hypnosis

This is a brief introduction to the practice of self-hypnosis, with some basic instruction on how to approach the initial practical skills.

The Practice of Cognitive-Behavioural Hypnotherapy

This is an outline of the forthcoming book The Practice of Cognitive-Behavioural Hypnotherapy by Donald Robertson, due for publication in 2011.

Self-Hypnosis MP3 for Assertiveness

This is a link to an MP3 version of our old self-hypnosis CD for assertiveness and emotional authenticity.

In collaboration with The Centre for Sports Hypnosis

Saturday 16th – Sunday 17th April 2011, Central Croydon, South London.

Click here for further information and to book your place.

There is still time to book your place on this popular two-day specialist training for hypnotherapists. Book two or more places on this course by the 31st March and recieve a 10% discount. Click here for details.

The Certificate in Sports Hypnosis (Cert.SportsHyp) covers:

• History of Sports Hypnosis
• Assessments & case formulation
• Sports psychology theory
• Sports psychology interventions
• Integrating hypnosis into sports psychology
• Case Studies
• Practical applications

Learn how to:

• Conduct an assessment in sport
• Restore and build confidence
• Improve motivation for training and competition
• Manage competition anxiety
• Control arousal levels
• Stop negative self-talk
• Improve focus and concentration
• Create training and performance goals
• Develop sports-specific routines for golf, tennis, swimming and more
• Help athletes prepare for competitions
• Work with injured athletes

This 2-day Post-Qualifying Certificate course provides foundation level training in sports psychology and sports hypnosis for qualified hypnotherapists. The course is an even mixture of theory and practice, and plenty of opportunities are provided to practice various techniques. Assessment is by a short examination which you complete online at home after the course. On successful completion of the exam, participants can be listed on the Centre for Sports Hypnosis directory of Sports Hypnotists.

Interested in finding out more about sports hypnosis? Read this short article ‘Understanding Hypnosis in Sport’ written by course trainer Gary Baker.