I have invited my dear friend the Rev. Dr. Peregrine Murphy Kavros to be a guest blogger today. Please visit her web site by clicking on the Focus link on the lower right side of this blog.
Recent articles in the Wall Street Journal (Nov. 12, 2008), the New York Times (Nov. 4, 2008), the Wichita Eagle, and National Public Radio (Feb. 4, 2009) present a disparate and incomplete image of hypnosis – credentials and licensure of professionals providing the treatment not readily apparent, expertise and training variable, application misunderstood, and supportive research not reported. Articles such as these kindle considerable concern in members of the medical and psychotherapeutic community who strive to maintain ethical and professional standards of practice, particularly when using hypnosis. Retta Blaney has kindly offered her blog to counterbalance misperceptions.
As an Episcopal priest I am familiar with the ancient history and ameliorative agency of contemplative prayer on individuals and communities of worship. It was not until I studied cognitive neuroscience as a clinical psychologist, however, that I became aware of the powerful affect of imagery and suggestion on discipline, discernment, attention, and action. Nyberg (2001) found that similar brain regions are activated when individuals engage in a movement as when they are simply imagining or rehearsing the movement (Neuroimage). Decety (2006) continues to investigate the power of the imagination when applied to direct activity (Brain Research). It is not surprising that Cognitive Behavior Therapy (CBT), one of the most effective treatments of individuals who are highly anxious, involves continued exposure to a feared stimulus either through imagined or real presentation. In this case, brain regions after repeated exposure decrease their response to the feared object or situation. Not everyone, though, is willing to undertake repeated exposure to a situation that produces discomfort. In October of 2008, at the annual meeting of the Society of Clinical and Experimental Hypnosis, I encountered physicians, psychologists, social workers, and other licensed professionals who have experienced successful treatment of resistance and other disorders, however, using hypnosis – sometimes alone, and at other times as an adjunct to CBT and other therapies.
Hypnosis is sometimes viewed as a form of meditative imagery, but it is different. Hypnosis involves a state of heightened attention in an individual, while their critical or skeptical nature and the consequent resistance to new ideas is bypassed, so that the therapist or the individual can deliver acceptable suggestions.
Perhaps the disparate perceptions of hypnosis emerge from its history. Hypnosis traces its early roots from the late 18th century when Franz Anton Mesmer introduced the concept of animal magnetism to France. The practice lost favor when King Louis XVI sought Benjamin Franklin to head a commission investigating the practice. Franklin was not supportive of the practice, said it had to be something other then magnetism, and discouraged its development. James Braid, an English physician, demonstrated that the “something other” was focused attention. Practitioners still found hypnosis therapeutic: surgeons John Elliotson and James Esdaile performed over 300 surgical procedures using hypnotic suggestion for anesthesia, which resulted in a substantial drop of infection from 50% to 5%. Alternatively, Jean Martin Charcot, chief of neurology at the Salpetriere Hospital in Paris, believed that hypnosis induced a trance, which he believed was pathological. Charcot’s student Pierre Janet (and a colleague of Freud) used hypnosis to uncover the traumatic origin of symptoms and produced cathartic cures. Despite these contradictions, acceptance of hypnosis in medicine evolved and research has shown that hypnosis effectively treats a variety of maladies. Dr. Stewart’s (2005) review presents a number of clinical trials using hypnosis ranging from allergies to urology (Mayo Clinic Proceedings). Dr. David Wark (2008) summarizes more recent investigations and enhanced outcome to include 37 more disorders (American Journal of Clinical Hypnosis).
Professional organizations, such as the Society for Clinical and Experimental Hypnosis (http://www.sceh.us), the American Society of Clinical Hypnosis (http://www.asch.net), the International Society of Hypnosis (http://www.ish-web.org), among others, have worked actively to correct misunderstandings regarding hypnosis and can help guide individuals seeking hypnosis’ healing efficacy to appropriately trained practitioners and clinical trials. Hypnosis is not a benign procedure. When hypnosis is offered without sensitivity and appropriate professional assessments its practice can be dangerous. While many individuals can be trained in hypnosis, practitioners who are licensed in their own profession are mandated to safeguard the clinical and ethical interests of their patients.
It is misleading when news articles highlight controversy, while omitting scientific evidence supporting an alternative consideration. Movement away from superstition and fallacy surrounding hypnosis will be achieved with the validation of scientific research as well as sound reporting of public information.