In order for a hypnotherapist to convey positive suggestions for change, the patient must be in a receptive state. The state is called trance and the method of achieving a trance is through induction. Induction techniques are many and varied and involve the therapist offering suggestions that the patient follows. The formerly common "your eyes are getting heavy" suggestion may still exist, but other more reliable and acceptable (by the patient) forms of induction have come to the forefront. The artful hypnotherapist is always aware of the present condition of the patient and uses this information to lead him/her down the path of induction. In its lighter stages, trance can be noted by the relaxation of muscles. At this point, hands can levitate when given the suggestion, and paresthesia, a feeling of numbness, can be induced. In a medium trance, a patient can be led to experience partial or complete amnesia , or failure to recall events of the induction after the fact. A deep trance opens the patient to powerful auditory, visual, or kinesthetic experiences. The phenomenon of time distortion is experienced most profoundly at this level. Patients may believe they have been away briefly, and may react with disbelief when told they were away much longer. Although some work can be done in lighter states of trance, the best circumstance for implementing change is when the patient reaches a deep trance state. At this level, the patient is focused inwardly and is more receptive to positive suggestions for change. This is also the point at which the therapist can invoke posthypnotic suggestions, or instructions given to the patient so he/she will perform some act or experience some particular sensation following awakening from the trance. For example, these suggestions, if accepted by the patient, can be formed to make foods taste bad, cigarettes taste bad, delay impulses, curb hunger, or eliminate pain. However, it should be noted that posthypnotic suggestions given to a person, which run counter to the person's value system or are not something they are likely to do under ordinary circumstances, will not be accepted and therefore not implemented.
The U.S. Department of Health & Human Services recognizes the healing power of hypnosis and its proven effectiveness for anxiety, pain control, smoking cessation, headaches and more. Hypnosis may be safe and complementary way to augment medical attention you are receiving for a chronic illness or pain, or a way to resolve an addiction or phobia that you are otherwise unable to control. Hypnosis does not work on every person. When scientists began studying hypnosis in earnest, a report published by Stanford University titled “The Stanford Hypnotic Susceptibility Scale” demonstrated that different brains respond to hypnosis in varying degrees, and a very few do not respond at all. Working with a trained psychologist, you’ll soon determine whether you are a good candidate for the healing benefits of hypnotherapy.
Before people subject themselves to hypnotherapy they are advised to learn as much about the process and about the chosen therapist as is necessary to feel comfortable. Rapport and trust are two key ingredients in making a potential hypnotherapy patient comfortable. Therapists should be open and willing to answer all questions regarding qualifications, expertise, and methods used. A well-qualified professional will not undertake the use of hypnosis without interviewing the patient to ascertain their level of understanding of the process. This is very important for two reasons. First, it allows the patient the opportunity to have questions answered and to develop some rapport with the therapist. Second, it is important for the therapist to know the patient's expectations since meeting these expectations will enhance the likelihood of success.
Now say, "As you press down on my hand, you will begin to feel as though your eyelids are getting heavier and heavier. You feel yourself sitting in your living room late at night watching an old black and white movie on the television. You feel your eyes drooping as you struggle to stay awake." (Mentally count to three.) "Now close your eyes." (Mentally count to three.) "SLEEP!" Quickly swipe away your hand from them so they jerk forward in a falling motion. Remember to guide them to your shoulder, placing their head outward into the crook of your arm. Get some help and then put them in a chair seated upright comfortably. At this point, the person is in a trance and is highly suggestible.
Throughout Dr. Sapien’s medical career he always had a sense that mind was the original foundation of healing. After he trained at the Academy and began regularly using our methods in his medical practice, his premise was confirmed by how well his patients responded. He has stayed on as a practical skills coach to help new students in learning hypnotherapy and medical support hypnosis.
Most relaxation techniques require daily practice to be effective. A variety of formats for teaching relaxation and meditation exist, including classes as well as individual sessions. Relaxation can be taught in 1 session by conducting and audio taping a relaxation session. Using the audio tape, patients can then practice the techniques daily at home. Methods such as progressive muscle relaxation are easy to learn; yoga, tai chi, and meditation can take years to master completely.
Although he rejected the transcendental/metaphysical interpretation given to these phenomena outright, Braid accepted that these accounts of Oriental practices supported his view that the effects of hypnotism could be produced in solitude, without the presence of any other person (as he had already proved to his own satisfaction with the experiments he had conducted in November 1841); and he saw correlations between many of the "metaphysical" Oriental practices and his own "rational" neuro-hypnotism, and totally rejected all of the fluid theories and magnetic practices of the mesmerists. As he later wrote:
A typical hypnotherapy session has the patient seated comfortably with their feet on the floor and palms on their lap. Of course, the patient could choose to lie down if that option is available and if that will meet the patient's expectation of hypnosis. The therapist can even set the stage for a favorable outcome by asking questions like, "Would you prefer to undergo hypnosis in this chair or on the sofa?" Once patients make the choice, they are in effect agreeing to undergo hypnosis. Depending on the approach used by the therapist, the next events can vary, but generally will involve some form of relaxing the patient. Suggestions will lead the patient to an increasingly relaxed state. The therapist may wish to confirm the depth of trance by performing tests with the patient. For example, the therapist may suggest that when the eyes close that they will become locked and cannot be opened. The therapist then checks for this by having patients try to open their eyes. Following a successful trial showing the patient's inability to open the eyes, the therapist might then further relax them by using deepening techniques. Deepening techniques will vary for each patient and depend largely on whether the patient represents information through auditory, visual, or kinesthetic means. If the patient is more affected by auditory suggestions, the therapist would use comments such as "You hear the gentle patter of rain on the roof;" or, "The sound of the ocean waves allow you to relax more and more." For the visual person, the therapist might use statements such as, "You see the beautiful placid lake, with trees bending slightly with the breeze." Finally, with the kinesthetic person phrases such as, "You feel the warm sun and gentle breeze on your skin," could be used. It is important for the therapist to know if the patient has difficulty with the idea of floating or descending because these are sometimes used to enhance the experience for the patient. However, if the patient has a fear of heights or develops a feeling of oppression with the thought of traveling downward and going deeper and deeper, suggestions implying the unwanted or feared phenomenon will not be taken and can thwart the attempt.
In this special mental state, people feel uninhibited and relaxed. Presumably, this is because they tune out the worries and doubts that normally keep their actions in check. You might experience the same feeling while watching a movie: As you get engrossed in the plot, worries about your job, family, etc. fade away, until all you're thinking about is what's up on the screen.
Hypnotherapy has been studied for the treatment of irritable bowel syndrome. Hypnosis for IBS has received moderate support in the National Institute for Health and Clinical Excellence guidance published for UK health services. It has been used as an aid or alternative to chemical anesthesia, and it has been studied as a way to soothe skin ailments.
Braid made a rough distinction between different stages of hypnosis, which he termed the first and second conscious stage of hypnotism; he later replaced this with a distinction between "sub-hypnotic", "full hypnotic", and "hypnotic coma" stages. Jean-Martin Charcot made a similar distinction between stages which he named somnambulism, lethargy, and catalepsy. However, Ambroise-Auguste Liébeault and Hippolyte Bernheim introduced more complex hypnotic "depth" scales based on a combination of behavioural, physiological, and subjective responses, some of which were due to direct suggestion and some of which were not. In the first few decades of the 20th century, these early clinical "depth" scales were superseded by more sophisticated "hypnotic susceptibility" scales based on experimental research. The most influential were the Davis–Husband and Friedlander–Sarbin scales developed in the 1930s. André Weitzenhoffer and Ernest R. Hilgard developed the Stanford Scale of Hypnotic Susceptibility in 1959, consisting of 12 suggestion test items following a standardised hypnotic eye-fixation induction script, and this has become one of the most widely referenced research tools in the field of hypnosis. Soon after, in 1962, Ronald Shor and Emily Carota Orne developed a similar group scale called the Harvard Group Scale of Hypnotic Susceptibility (HGSHS).
Hypnotherapy is a therapy that spans hundreds of years and has many practitioners across the United States. Researchers have studied whether hypnosis can treat a variety of medical conditions, from irritable bowel syndrome to anxiety and depression. The goal for hypnotherapy is to help a patient learn to better control their state of awareness. In the case of depression, hypnotherapy sessions may be focused on helping a person achieve a state of relaxation. In this relaxed state, they can discuss their feelings and emotions without raising stress and anxiety levels.
Relaxation techniques are often integrated into other health care practices; they may be included in programs of cognitive behavioral therapy in pain clinics or occupational therapy in psychiatric units. Complementary therapists, including osteopaths and massage therapists, may include some relaxation techniques in their work. Some nurses use relaxation techniques in the acute care setting, such as to prepare patients for surgery, and in a few general practices, classes in relaxation, yoga, or tai chi are regularly available.
Confusion can occur when one seeks a hypnotherapist, as a result of the various titles, certifications, and licenses in the field. Many states do not regulate the title "hypnotist" or "hypnotherapist," so care must be exercised when selecting someone to see. As a rule, it is best to consult a professional in the field of mental health or medicine, although alternative sources for hypnosis are available. Care must be taken also by the therapist to ensure adequate training and sufficient experience for rendering this specialized service. The therapist must be well grounded in a psychotherapeutic approach before undertaking the use of hypnotherapy. Professionals should not attempt hypnotherapy with any disorder for which they would not use traditional therapeutic approaches. The patient seeking hypnotherapy is reminded that unskilled or amateur hypnotists can cause harm and should not be consulted for the purpose of implementing positive change in an individual's life. The detrimental effects of being subjected to amateur or inadequately trained persons can be severe and long lasting. (See abnormal results below.)
Finally, the neural underpinnings of PHA will be even clearer when we incorporate its most important aspect in imaging studies—the dissociation between implicit and explicit memory. In PHA (and in functional amnesia) the person is unable to explicitly recall certain information, yet we see evidence of this material on implicit measures. For instance, a participant given PHA may fail to recall the word “doctor,” learned earlier, but will have no trouble completing the word fragment “d _ _ t _ r”. Mendelsohn et al. did not assess implicit memory. Rather, they tested recognition, which in a sense confounds explicit and implicit memory. We’d like to compare brain scans of a PHA group trying to explicitly recall the movie (they should show reduced activation, as above) with brain scans of the same group completing an implicit memory measure of the movie (they should show normal activation). This would be tricky to do—implicit measures of complex material such as movies and autobiographical memories are hard to find or construct. But it would contribute to a more complete neural picture of the processes involved in these fascinating forms of forgetting.
Hence, the social constructionism and role-taking theory of hypnosis suggests that individuals are enacting (as opposed to merely playing) a role and that really there is no such thing as a hypnotic trance. A socially constructed relationship is built depending on how much rapport has been established between the "hypnotist" and the subject (see Hawthorne effect, Pygmalion effect, and placebo effect).
Poor regulation of hypnosis and deeper relaxation techniques is more serious. Although several professional organizations exist, these groups do not regulate or certify practitioners in hypnotherapy or relaxation. Hypnotherapists with a conventional health care background (such as psychologists, physicians, dentists, and nurses) are regulated by their professional regulatory bodies. Psychotherapists who use hypnotherapy as an adjunctive treatment modality require appropriate training. Individuals who have received a master's degree in counseling or social work or a doctorate in clinical or counseling psychology will be likely to have received appropriate training and supervision.
Following the French committee's findings, Dugald Stewart, an influential academic philosopher of the "Scottish School of Common Sense", encouraged physicians in his Elements of the Philosophy of the Human Mind (1818) to salvage elements of Mesmerism by replacing the supernatural theory of "animal magnetism" with a new interpretation based upon "common sense" laws of physiology and psychology. Braid quotes the following passage from Stewart:
“With hypnosis, you might help someone stop smoking by suggesting the taste or smell of cigarettes is worse than it actually is. But a hypnotherapist can also use age regression to examine the impulse that fuels the client’s habit and discover old conclusions and behaviors. The healing will take place when the client creates new conclusions about old memories and chooses new behaviors rather than smoking.”
Modern hypnotherapy is widely accepted for the treatment of certain habit disorders, to control irrational fears, as well as in the treatment of conditions such as insomnia and addiction. Hypnosis has also been used to enhance recovery from non-psychological conditions such as after surgical procedures, in breast cancer care and even with gastro-intestinal problems, including IBS.