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.

We are pleased to announce a brand new special offer for these two-day workshops designed for hypnotherapists. Both workshops will take place at Jurys Inn Hotel, approximately five minutes walk from East Croydon train station. Only 15 minutes from London Bridge and Victoria.

Offer 1: Book a place on both courses and get a 10% discount on the overall cost.

Normal fee (for both courses): £621.00 inc.VAT
Discounted fee: £559.44 inc. VAT
Saving: £61.56

Offer 2: Book two or more places on either course and get a 10% discount on the overall cost.

Book two places on Smoking Cessation and save £52.80
Book two places on Sports Hypnosis and save £70.32

To qualify for these offers, bookings must be made at the same time and by 31/03/11. The offer applies only to the courses running in April 2011.

Sports Hypnosis Certificate with Gary Baker

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

Click here for further information.

Smoking Cessation Masterclass with Donald Robertson

This popular two-day course is for both experienced and newly-qualified, registered hypnotherapists. It teaches evidence-based techniques, and provides additional skills and resources designed to enable you to become a smoking cessation specialist, and boost your income.

You will receive an extremely detailed and comprehensive Smoke Freedom™ course manual with information, techniques, protocols, scripts, and forms for use in your practice.

Click here for further information.

Letter to The Medical Times (1847)

Excerpt from The Discovery of Hypnosis: The Complete Writings of James Braid[This small study could be considered to show, at best, either 30% or 60% “success” for Esdaile’s Mesmeric anaesthesia, depending on whether subjects who acted as if suffering pain but denied feeling pain can be counted as positive outcomes. Arguably, this is not a high success rate and conceivably within the potential range of a placebo anaesthetic. Either way it probably does not prove the efficacy of Esdaile’s specific method, but perhaps does suggest, as now seems likely, that non-specific factors (as found in placebo control group outcomes) might be expected to reduce pain.]

Facts & Observations as to the relative Value of Mesmeric and Hypnotic Coma, and Ethereal Narcotism, for the Mitigation or entire Prevention of Pain during Surgical Operations.

James Braid, M.R.C.S.E., etc.[…] The remarkable success of Dr. Esdaile, in India, was well calculated to arrest attention; and in an able article on the subject, in the British and Foreign Review, for October last, the author avows, as the result of a dispassionate consideration of the amount of evidence on the subject, together with the known influence of certain processes on the nervous system, that the time has arrived when it is the duty of the medical profession to test the matter fully and fairly.Inasmuch as this subject has been fairly tested last September, at Calcutta, before a committee appointed for the purpose, by the Government, I have thought it might be interesting to many of your readers to have the results of the investigation laid before them, so that they may compare the said results with those of the operations performed during the ethereal narcotism, so many interesting examples of which have lately appeared in The Medical Times. [….]My own experience of hypnotism, or Mesmerism was this, that in many cases of highly susceptible subjects, by proper management, they could be reduced to such condition as would enable them to undergo severe surgical operations without their manifesting the slightest symptoms of consciousness or pain during the sleep or nervous coma; and they would have no recollection of such awaking; that, in other cases, they might manifest physical indications of suffering pain during the artificially-induced sleep, but have no recollection of it after awaking; and that, in other cases there might be consciousness of what was being done whilst little or no pain was experienced by them. It always appeared to me, however, that a great drawback existed to these processes becoming generally available for such purposes, from the great length of time which was required in many cases to render the patients susceptible of going so deep into the sleep as is requisite to secure a complete immunity from pain, and especially so if they went into the sleep with the idea on their minds that the operation was to be performed there and then. In most cases it must have been necessary to put the patient repeatedly into the sleep, and to conceal from him the particular time when the operation was really intended to be performed – leading the patient, in fact, to expect it was to be done on some future day. Then, again, a considerable number of those who are susceptible of the influence to an extent sufficient for the cure of disease would not, even with all the above precautions, be readily reduced into the profound unconscious state requisite to ensure complete immunity from pain during surgical operations.Such was my personal experience, and for these reasons I considered Mesmerism and hypnotism far less available for such purposes with British subjects, than for the relief and cure of various forms of disease. The success of Dr. Esdaile, however, with Hindoos and Mohamedans, seems to have been very great; but still the objection as to the length of time required would be felt to be a serious inconvenience even with such subjects, compared with the rapidity with which the desired ethereal narcotism can be induced. Many individuals, for example, are not possessed of those physical and mental qualities requisite to secure entire success by the hypnotic and Mesmeric processes; and comparatively few could be reduced into the state, provided they chose to resist complying with the conditions required. […]But to return to Dr. Esdaile’s operations performed during Mesmeric coma. It is well-known to your readers that the doctor published a book last summer, detailing his great success [i.e., Mesmerism in India, and its Practical Application in Surgery and Medicine, 1846], of which cases you published a considerable number in The Medical Times. I shall not, therefore, now advert to the cases published in that volume, but confine any remarks and quotations to the cases operated on by him in presence of the committee above referred to, as your readers must feel assured they were not likely to afford the new heresy any special favour; and the following names will be sufficient guarantee as to the respectability and fitness of the individuals for the task imposed upon them by the Governor:–

The committee consisted of James Atkinson, Inspector-General of Hospitals, as chairman; Evelyn N. Gordon; D. Stewart, Presidency Surgeon; James Hulme; J. Jackson, Surgeon to the Native Hospital; A. Rodgers; W. B. O’Shaughnessy, M.D., F.R.S., secretary to the committee. The second, fourth, and sixth gentlemen named are high officials in the Honourable East India Company’s service. I believe they are judges. The preliminary arrangements having been agreed upon, the committee assembled at the hospital on the 7^th of September, 1846, when Dr. W. B. O’Shaughnessy was requested to act as secretary, record each day’s proceedings, and keep minutes of the cases. It was also agreed that the minutes of each day should be read at the next meeting in Dr. Esdaile’s presence, and that the meetings should take place at half-past seven a.m.

The committee accordingly assembled on fourteen successive days, and had under their consideration ten surgical cases taken by Dr. Esdaile from the general wards of the native hospitals, all needing operations of more or less severity. These cases are given in outline in the journal, and any remarkable phenomena exhibited are farther recorded minutely in the statement of each day’s proceedings. From the facts elicited by these cases, the committee deduced the following conclusions, as in their opinion being strictly warranted by the premises:–

The patients treated were all native males, from eighteen to forty years old, Hindoos and Mahomedans [i.e., Hindus and Muslims]; in all conditions of general health, from extreme emaciation to ordinary strength. Their diseases are specified in the annexed table:–

Dr. Esdaile had stipulated that he should only operate on natives and that he should have the sole management or medical charge of the hospital wards set apart for his patients to be submitted to operation during the Mesmeric coma; that he should have for his own subordinate hospital establishment, those employed by him as Mesmerisers in Hooghly; and that there should be a daily sitting of the committee. The committee assented to these conditions, and made arrangements for three apartments being at Dr. Esdaile’s disposal: one as a committee and operating room, the other two rooms provided with three beds each for the accommodation of the patients. The doors of these rooms opened into the committee-room and into each other, so that the committee could either enter these sleeping wards, or observe the appearance and conduct of the patients from their own room, as they might incline. Here, then, every precaution had been taken to guard against error or deception.

The Mesmerisers employed by Dr. Esdaile were young men, Hindoos and Mahomedans, from fourteen to thirty years of age, most of them compounders and dressers from the Hooghly Hospital. To each patient a separate Mesmeriser was assigned. The room in which they operated was darkened, but from time to time the committee were enabled to witness, through small apertures made in the door panels, the manner in which the processes were carried on. Profound silence was observed. The processes were continued for about two hours each day in ten cases, for eight hours in one case in one day, and for six hours, in another case, without interruption. Three cases of the ten, Bissonath, Deeloo, and Neechul, were dismissed without satisfactory effect; Bissonath suffering from slight cough, which Dr. Esdaile considered to render the Mesmeric manipulation inefficient; Deeloo, on the fifth day, for having taken spirits; and Neechul having resisted the Mesmeric processes during eleven days without conclusive result. [That gives a 30% combined drop-out/failure rate at the outset of treatment.] In seven cases, in a period varying from one to seven sittings, deep sleep followed the processes above described.

I have considered it unnecessary to give their Mesmerising processes in detail, but I beg the reader’s special attention to the following description of the peculiar character of the sleep thus induced, which I shall transcribe verbatim from the report:–

This sleep, in its most perfect state, differed from ordinary natural sleep, as follows. The individual could not be aroused by loud noises, the pupils were insensible to light; and great, and in some cases apparently perfect, insensibility to pain was witnessed on burning, pinching, and cutting the skin and other sensitive organs. This sleep, in its general character, differed from that which would be produced by narcotic drugs, in the quickness with which, in eight out of ten cases, the patient was awoke, after certain transverse passes and fanning by the Mesmeriser, and blowing upon the face and on the eyes; in the natural condition of the pupils of the eye and the conjunctivae in all the cases after awaking, in the absence of stertorous breathing, and of subsequent delirium or hallucination, and of many other symptoms familiar to medical observers, which are produced by alcoholic liquors, opium, hemp, and other narcotic drugs. It is right, however, to add that in two cases the patients showed much confusion and disinclination to answer, and complained of giddiness for some time after being suddenly aroused.

Here then, we have proof of careful observation and minute record of facts, as well as clear and accurate deductions, both as to the reality and peculiarity of the sleep thus induced.

In seven cases (thus continued) surgical operations were performed, in the state of sleep above described.In the ease of Nilmoney Dutt, there was not the slightest indication of the operation having been felt by the patient. It consisted in the removal of tumour. It lasted four minutes. The patient’s hands or legs were not held. He did not move, or groan, or his countenance change; and, when awoke after the operation, he declared he had no recollection of what had occurred.In another case, Hyder Khan, an emaciated man, suffering from mortification of the leg, amputation of the thigh was performed, and no sign of its causing pain was evinced.In a third case, Murali Doss (the operation he underwent being very severe), moved his body and arms, breathing in gasps, but his countenance underwent little change, and the features expressed no suffering; and, on awaking, he declared he knew of nothing having been done to him during his sleep.A case of tapping one side of a double hydrocele is passed over as insignificant and inconclusive, although apparently painless, for the operation was repeated on the other side while the patient was awake, with the same result. The operation, too, is one daily borne without material suffering by numerous patients in all our hospitals.In the three other cases observed by the committee, during the performance of operations in the state of sleep above described, various phenomena were witnessed, which require to be specially pointed out. While the patients did not open their eyes, or utter articulate sounds, or require to be held, there were vague and convulsive movements of the upper limbs, writhing of the body, distortion of the features, giving the face a hideous expression of suppressed agony; the respiration became heaving, with deep sighs. There were, in short, all the signs of intense pain which a dumb person undergoing operation might be expected to exhibit, except resistance to the operator.But in all these cases, without exception, after the operation was completed, the patients expressed no knowledge or recollection of what had occurred, denied having dreamed, and complained of no pain till their attention was directed to the place where the operation was performed.It, therefore, becomes a question whether the writhings and distorted features, in the three cases above described, are to be regarded as proof that the operations occasioned at the time the actual agony of which such symptoms are the usual evidence, or whether they were mere “instinctive movements” (reflex or automatic movements) as Dr. Esdaile represents them. But our province is only to record facts, and not to enter upon that of the physiologist or the metaphysician.The general result arrived, at then, on the question of pain during the Mesmeric surgical operations we witnessed, amounts to this, that in three cases there is no proof whatever that any pain was suffered, and that in the three other cases the manifestations of pain during the operations are opposed by the positive statement of the patients that no pain was experienced.

The following table shows the curious fact that, in the three cases in which there was no evidence of pain, the pulse rose remarkably during the operation. But in the cases in which there were the [behavioural] symptoms of pain, described in paragraph 20, the pulse continued exactly the same before and during the operations.

This acceleration of the pulse, in cases which showed no evidence of suffering pain during the operation, whilst it remained unaltered in those cases which were accompanied with writhing and distortion of features, seems to have puzzled and perplexed both Dr. Esdaile and the committee, as it may many others, who would naturally have expected the very opposite results. The fact is very easily explained, however, and the solution of this apparent anomaly will at once suggest itself to all who have read my little treatise on Hypnotism [Neurypnology, 1843] with attention. In the former cases the stimulus of the knife has excited a greater or lesser degree of rigid catalepsy, which is always attended with acceleration of pulse, generally in the ratio of the intensity of the rigidity (and it also suspends motion); whilst in the latter cases, accompanied by distortion of features and jactitation [i.e., restless agitation] of the limbs, there being no rigidity of muscles to obstruct the transmission of blood through the limbs, there would not necessarily be any acceleration of the pulse, unless from mental emotion. The tranquillity of the pulse in these cases, therefore, was the surest possible indication that the patients spoke the truth in declaring that they had felt no pain. The jactitation of the limbs, and convulsive movements of the muscles of the face, in the latter, as well as the rigidity in the former cases, might all arise as reflex or automatic actions, of which the brain might take no cognizance, as is well-known to every physiologist, and is daily witnessed during the second conscious state [i.e., artificial somnambulism] of nervous sleep.Dr. Esdaile considered much less blood was lost by patients who were operated on during the Mesmeric sleep; but three of the four medical members of the committee expressed as their opinion, that there was no material difference observable. Neither did the medical members consider that the after-treatment of the patients was in any degree ameliorated, or the cure accelerated, by the operation having been performed in the Mesmeric sleep.[1]The following is the only case to which the committee attached any importance to renewing the dressings of sores during the sleep:–

In Ramchund, an examination of the wound, of a peculiarly painful nature, was required (dressing) involving two separate incisions; just as the first was completed (it lasted about a quarter of a minute, and caused writhing of the body and distortion of the face) he awoke, and, on proceeding to the second step, he shouted aloud in pain and terror, and struggled so violently that the operator could not proceed.

This seems pretty conclusive evidence, that whilst he was a person of keen feelings, the induced sleep had saved him much suffering during the first incision. It also tends to support the truth of his statement, as to having suffered no pain when first operated on, on the 13^th of September. It strikingly proves, moreover, the superiority of sleep thus induced for such purposes from that induced by an opiate, as the following case will show:–

The committee, having adjourned to the Native Hospital, inspected No. 4, Neechul, upon whom Dr. Jackson operated, removing the hypertrophied prepuce [foreskin] at one stroke.Ninety drops of laudanum had been administered half an hour previously, and the patient was sound sleep when operated on: pulse 90.At the moment of operating, he shouted aloud, struggled violently, drew up his legs, and kicked hard: pulse rose to 120; he continued to struggle for several minutes.

In paragraph twenty-seven, the committee express a similar opinion to that which I have already stated as my own conviction, respecting the great length of time required destroying its general applicability in surgical practice. They say:–

The uncertainty of the time required in producing the intense condition of the Mesmeric sleep, in the majority of the cases now under notice, appeared very unfavourable to the general introduction of Mesmeric manipulations in the practice of surgery, especially in hospitals. But Dr. Esdaile states positively, that by frequently changing the Mesmerisers, and performing the manipulations without interruption, the same results may possibly be produced in one day, which would, in the manner pursued before the committee, have been necessarily extended over several days. In the cases of Hyder Khan and Murali Doss, several Mesmerisers were successively employed, and the result seemed to the committee corroborative of Dr. Esdaile’s statement.The committee farther apprehend that a serious practical obstacle to the universally useful application of Mesmeric processes exists in the resistance to the sleep, which, Dr. Esdaile acknowledges, is given by cough, by pain, by mental excitement, by fever, and by the sinking state of the vital system induced by protracted and dangerous diseases.

I can state, as the result of my own experience, that patients with restless and excitable minds are generally, if not always, difficult to be reduced into a deep state of nervous sleep. In cases of fever, so long as it is possible to arouse and arrest the attention of the patient, he may be affected; I have failed, however, with one of the most susceptible subjects I ever met with, when in a state of such profound delirium from fever that the attention could not be arrested and fixed: a clear proof that hypnotism is as much a mental as a physical influence.The fears expressed in paragraph 30, that the repetition of the processes may bring the nervous systems of patients into a morbidly impressible condition, which might render them liable to numerous nervous maladies, I feel assured, from very extensive experience, is a groundless fear, provided the patients are treated with care and judgement. In the whole course of my experience I have met with no such untoward result, although I have hypnotised some patients daily for several months successively.I most heartily concur in the just tribute of praise awarded to Dr. Esdaile in the concluding paragraph of the committee’s report:–

The committee are unanimously of opinion that great credit is due to Dr. Esdaile for the zeal, ability, and boldness with which he has taken up and pursued this inquiry.

They further add:–

His sphere, however, has been hitherto limited, but the committee hope that his further investigation may be extended to medical as well as surgical cases, to European as well as native patients, and to the elucidation of the several questions which have been adverted to in the course of this report.

In the Deputy Governor’s reply to the above report, he says:–

So far has the possibility of rendering the most serious surgical operations painless to the subject of them been, in his honour’s opinion (it was written by the secretary), established by the late experiments performed under the eye of a committee appointed for the purpose, as to render it incumbent on the Government to afford to the meritorious and zealous officer by whom the subject was first brought to its notice, such assistance as may facilitate his investigations, and enable him to prosecute his interesting experiments under the most favourable and promising circumstances.With this view his honour has determined, with the sanction of the Supreme Government, to place Dr. Esdaile for one year in charge of a small experimental hospital, in some favourable situation in Calcutta, in order that he may, as recommended by the committee, extend his investigations to the applicability of this alleged agency to all descriptions of cases, medical as well as surgical, and all classes of patients, European as well as native. Dr. Esdaile will be directed to encourage the resort to his hospital of all respectable persons desirous of satisfying themselves of the nature and effects of his experiments, especially medical and scientific individuals in or out of the service. Medical officers of the presidency are also to be appointed as “visitors”, to inspect the proceedings of Dr. Esdaile, and report thereon to the Government, but without interfering with the doctor’s proceedings.

Here, then, we have an example of the most judicious, praiseworthy, and enlightened conduct, both on the part of the Government and the committee, which has ever been recorded, in connection with this highly interesting inquiry. It is conduct not only deserving of all praise, but also worthy of universal imitation. Extending the inquiry and treatment to medical cases, I feel confident, is a movement in the right direction, as it may be rendered of far more avail for the relief and cure of disease, than for suspending the anguish of painful surgical operations; and the latter application is the less important now that we can achieve the like purpose so much more generally and rapidly by ethereal narcotism. […]In theory I entirely differ from Dr. Esdaile. He is a Mesmerist – that is, he believes in the transmission of some peculiar occult influence from the operator to the patient, as the cause of the subsequent phenomena. He has entirely failed, however, in adducing any new or additional evidence in support of this position, which had not been adduced before by European Mesmerists; with which opinions I am entirely at issue for reasons which are well-known to your readers, from my previous contributions to The Medical Times. In these papers I have illustrated and explained, as the ground of my dissent from the occult influence theory, that all the well-ascertained phenomena of Mesmerism can be equally, readily, and more satisfactorily explained, without the aid of any occult or exoteric influence. It is gratifying to me to be able to add, in support of my opinion on this point, that since the publication of my observations “On the Power of the Mind over the Body”, I have had the honour to receive numerous letters from some of the most eminent members of the profession and of general science, expressive of their entire concurrence with my views of the nature and cause and extent of Mesmeric phenomena generally; and also of my mode of explaining the extraordinary phenomena adduced by Baron Reichenbach, as proof of a “new imponderable”. On this last point I have only met with one or two dissentients, and these were parties who were previously strongly committed to the mystical notions of the Mesmerists.Dr. Carpenter, in the third edition of his “Principles of Human Physiology” – one of the most perfect and valuable works on physiology extant – has fully admitted the reality and peculiarity of all the Mesmeric phenomena which I contend for. He says to that extent he considers they have “as just a title to the attention of the scientific physiologist as that which is possessed by any other class of well-established facts”. Dr. Carpenter was present at a private conversazione at my house[2], when he had an opportunity of investigating the phenomena most minutely; and the lucid manner in which he has described the nature and modes of educing the genuine manifestations does him infinite credit. In respect to my mode of operating, he has done me the honour to say, at page 757, that he “considers that this curious class of phenomena cannot be better prosecuted than by that method [i.e. Braid’s hypnotism].”I have thus endeavoured, to the best of my ability, to submit to your readers a candid estimate of the relative value of hypnotism, Mesmerism, and ethereal narcotism, for the relief and cure of disease, as well as for suspending consciousness, and thus relieving or entirely preventing pain during surgical operations. I shall be glad if my public endeavours may in any degree tend to the advancement of what seems to be so well calculated to promise amelioration to suffering humanity.3, St. Peter’s Square,Manchester.January 30^th [1847].[A long postscript on the use of chemical anaesthetic follows which has been omitted from this edition, as being of no discernable relevance to hypnotism.][Braid, “Facts and Observations as to the Relative Value of Mesmeric and Hypnotic Coma and Ethereal Narcotism, for the Mitigation or entire Prevention of Pain during Surgical Operations”, Medical Times, 13^th February, 1847, vol. XV, 1846-47, pp. 381-382; continued vol. XVI., 27^th February, 1847: 10-11.]

[1] [That is, by comparison with no anaesthetic; there might have been more difference if Mesmeric subjects were compared with patients under chemical anaesthetic.][2] [This visit from Carpenter possibly signals the beginning of an ongoing dialogue between the two, and their growing mutual support.]

A two-day workshop for newly qualified and experienced hypnotherapists

Thursday 10th – Friday 11th March 2011, Croydon South London (15 minutes from London Bridge and Victoria)

Click here to book your place securely online.

We are delighted to introduce this new workshop on the use of hypnosis and mindfulness for pregnancy and childbirth. It will be taught by experienced hypnotherapist Sophie Fletcher, co-founder of Mindful Mamma. Sophie is qualified in the Mongan Method and the Leclaire Method of Hypnobirthing.

Course Overview

This childbirth and hypnosis course examines the different approaches to hypnosis for birth, and looks both at pain managment and the principles underpinning the assumption that birth does not have to be painful. The theory and history of hypnosis for birth.

• Introduction to different forms of hypnosis for birth.
• Why it makes a difference to the baby.
• Background to other forms of pain relief during labour.
• Learn a range of techniques that you can teach mothers to assist both normal birth.
• Techniques to improving the outcomes of surgical birth (Natural Ceasarean).
• The psychological importance of the birthing partners role.
• How to market hypnosis for birth classes.

Course Fee: £264.00 inc. VAT

About Hypnosis & Hypnotherapy

Copyright © Donald Robertson, 2011.  All rights reserved.

The internet is, unfortunately, awash with false information about hypnotism, often perpetuated by poorly-trained hypnotherapists.  Here are five basic points about hypnosis and hypnotherapy that every hypnotherapist should be aware of.  These facts can easily be gleaned, or substantiated, by reading modern books and journals on the subject…

1. Hypnotism is the opposite of Mesmerism

Indeed, hypnotism very much evolved in active (at times, fierce) opposition to Mesmerism.  Many people confusedly believe that Franz Mesmer was the first hypnotist but in fact, the word “hypnotism” and the practice of hypnotherapy were founded in 1841 by the Scottish surgeon James Braid.  Braid spent his latter decades battling against Mesmerism, which he rejected as a pseudoscientific theory.  Mesmer and his followers believed that they cured patients by projecting an invisible “fluid” called “animal magnetism” into the bodies of patients.  Braid thought this was hocus pocus and carried out many debunking experiments, proposing instead that the effects were due to suggestion and focused attention on imaginative ideas, accompanied by expectation, the conceptualisation underlying most subsequent hypnotism.

2. Stage hypnosis has very little to do with experimental hypnotism or hypnotherapy

“Stage hypnosis” is actually older than hypnosis, if that makes sense.  That’s because virtually identical performances were carried out in the early 19th century by showmen (or conmen, depending on how you look at it) who claimed that subjects on stage were entering a trance-like state, responding to hallucinatory dramas, etc., because of the performer’s telepathic powers, or animal magnetism, etc.  When hypnotism became popular, showmen carried on performing the same tricks but labelled what they were doing as “stage hypnosis” to provide a more plausible, psychological explanation, as audiences became more sceptical about the paranormal over the decades.  However, many of the traditional stunts used in stage hypnosis shows have nothing whatsoever to do with either suggestion or hypnosis and merely involve “smoke and mirrors” type deception. 

For example, the most popular stage hypnosis trick was traditionally, the “human plank”, in which a subject supposedly in a “trance” was suspended rigid between two chairs while someone stood on top of their body.  This is a “playground trick” that merely depends on the fact that the human body is much more capable of supporting pressure in that position than audiences tend to assume.  It has absolutely nothing to do with hypnosis, and the trick works with or without any hypnotic induction or even suggestions.  Many stage hypnotists are happy to confess behind the scenes that their acts do not require “hypnotic trance” and often deceive the audiences.  For example, the famous magician and stage hypnotist of twenty years, Kreskin, has become  a kind of “whistleblower” concerning stage hypnosis, having written several books debunking the acts from an “insider” perspective.  Nevertheless, even many hypnotherapists are fooled into believing that stage hypnosis is what it appears to be, sometimes even attending training courses in hypnotherapy run by stage hypnotists.  Most stage hypnotists are neither therapists nor psychologists.  Many have little knowledge relating to hypnotherapy and are not actually qualified to deliver therapeutic training.

3. Hypnotism has nothing to do with “hypnotic trance”

It’s another common misconception, shared by many hypnotherapists, that hypnosis works by inducing an “altered state of consciousness” called “hypnotic trance.”  In fact, the founders of hypnotherapy, in the Victorian era, Braid and Bernheim, never proposed that hypnotism had anything to do with a “hypnotic trance”, this idea partly comes from stage hypnosis and partly from the widespread confusion of hypnotism and Mesmerism.  Virtually all modern researchers either completely reject the concept of “hypnotic trance” or posit something very far removed or watered down compared to what most people take that term to mean.  Attempts to induce hypnotic trance are well-known, from the accumulated evidence of a great many research studies, to have relatively small effects, e.g., increasing suggestibility by around 15-20% above an already moderately high baseline level. 

Most modern researchers now prefer to conceptualise hypnotism in terms of ordinary “cognitive” factors, i.e., beliefs and attitudes, such as the expectancy of responding to suggestions and focused attention, etc.  In other words, hypnotherapy seems to work quite well but not because it induces a hypnotic trance, even people who want to stick by this old idea are forced to admit that attempting to induce a “trance” has very mild effects, which sceptics attribute to increased expectation and focused attention.  (As an aside, there is very little evidence to support the notion of “indirect suggestion” made popular by Milton Erickson and his followers, which his contemporaries pointed out appeared to be something other than “hypnotism” and to employ fundamentally different processes, etc.)

4. A fairly large volume of positive research evidence exists concerning hypnotism

James Braid, the founder of hypnotherapy, was a passionate empiricist and insisted that hypnotism should be subjected to careful experimental investigation, as far back as 1841.  Since that time psychologists have continued to carry out many experiments on hypnosis.  In 1933, Clark L. Hull, arguably the most influential American behavioural psychologist, and president of the American Psychological Association, published a groundbreaking book detailing a whole programme of systematic behavioural research carried out on hypnosis.  Hull paved the way for many subsequent psychologists to carry out serious research on hypnosis, long before research began on any other psychological therapy. 

PubMed, the public face of the National Institute for Health’s database of books and articles in medicine, the largest and most important database of its kind, contains a whole category for “hypnosis” with approximately 11,000 books and articles listed, more than for any other psychological therapy apart from cognitive-behavioural therapy (CBT).  Recent reviews of evidence from clinical trials has generally provided good evidence for the efficacy of hypnotherapy, especially in the treatment of pain and anxiety.  However, unlike most other psychological therapies, hypnotherapy has also been subjected to considerable experimental investigation, i.e., in laboratory settings, where brain scans or behavioural experiments have been used to examine what happens to hypnotic subjects.  Because hypnosis lends itself well to experimental studies like these a whole category of research evidence exists that other psychological therapies cannot easily imitate.

5. Hypnotism is simple and easy and anyone can do it

No other subject is surrounded by so much misconception.  All the false information about hypnotism tends to confuse subjects and a number of research studies have shown that popular misconceptions about the nature of hypnosis actually inhibit people from responding properly.  These inhibiting ideas come mainly from stage hypnosis, such as the idea that it involves being under the hypnotists “control” or that the subject should be unconscious or asleep or amnestic for the experience, etc.  Braid originally defined hypnotism as an extension of normal psychological functioning, involving heightened focused attention on imaginative ideas, or mental images, of some response, accompanied by increased expectation of it occurring.  No special altered state of consciousness or “trance” is required to do this, just the ability to imagine things or adopt a confident, expectant mind-set.  Research on hypnosis has consistently shown that hypnotic inductions are not necessary to respond to hypnotic suggestions, although they may help slightly by raising expectation and focusing attention, etc.  Likewise, when people are asked to put themselves into self-hypnosis, they tend to respond about as well to subsequent suggestions as when another person, a hypnotist, attempts to induce a “trance”. 

A great many studies have measured hypnotic responsiveness in large samples and shown that it follows a standard “bell-shaped” distribution (slightly positively skewed), i.e., the majority of people are moderately responsive to hypnosis, about 20% are highly responsive and about 15% are poorly responsive.  However, many studies, largely stemming from Prof. Nicholas Spanos’ seminal research at Carleton University in Canada, have shown that people who respond poorly can normally be trained within an hour or so to become moderately or even highly responsive.  This has been found to largely require changing their attitudes toward hypnosis to dispel common misconceptions, which seem to have an inhibiting effect.  In particular, the “wait and see” attitude of passivity encouraged by hypnotherapists who tell clients things like “hypnosis is an altered state in which I will speak directly to your unconscious mind”, seems to generally be counter-productive, and subjects tend to respond better when asked to consciously and actively “think along” with suggestions by imagining the things being suggested by the hypnotist.