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I don’t consider myself to be a hoarder. So maybe it is because of the sort of work I do – as a therapist and a teacher – than every drawer in my study is full of papers, essays, articles, magazines and written material of every description. I was trying to clear some of this out the other day when I came across a very interesting short article about hypnosis and hypnotherapy which appeared in the Lancet in 1999 – Hypnosis Makes Headway in the Clinic by Marilynn Larkin (The Lancet. vol 353. January 30th 1999). My reaction to this article was optimism – and frustration. This is what the article said:

It begins with some good news. Hypnotherapy is becoming more mainstream. Some 150 articles per year about hypnosis and its applications are published every year in scientific and medical journals. The American Medical Association recognizes hypnotherapy as a valid medical treatment.

Then there is a bulletin on some recent research by Donald Price of the University of Florida. His study shows that hypnosis doesn’t turn the brain off. On the contrary, some areas of the brain become more active. (In the technical jargon: Hypnotic relaxation causes increased activity in the occipital region and the caudal part of the cingulate cortex and decreased activity in the right inferior parietal lobe. Hypnosis with suggestion causes an increase in activity in the frontal cortices and the medial and lateral posterior parietal cortices). This could take us some way towards establishing some physiological defining characteristics of hypnosis or the hypnotic trance.

Next, there is a quotation from Irving Kirsch – the same Irving Kirsch who carried out the meta-analysis on the placebo effect which I wrote about in my article The Placebo Effect and the Power of Suggestion – in which he states that the effectiveness of hypnosis is dependent upon the expectations of the subject and repeats the highly dubious assertion that there is nothing you can do with hypnosis that you cannot do without it. We then turn to the practical uses of hypnosis and are offered an example which completely refutes Kirsch’s statement.

A patient, recovering from a bladder operation, required regular cystoscopy. This proved so painful that it took 5 or 6 people to hold the (male) patient down. He had previously refused general anaesthtetic and an epidural was considered too risky. He was taught self-hypnosis and was subsequently able to undergo cystoscopy with minimal discomfort and without a crowd of people holding him down. Other pain-relief uses are then briefly discussed. The article ends by giving the opinion that hypnosis is a “context in which you do therapy” and not a therapy itself yet another airing.

Grounds for optimism, then. Research into hypnosis and its applications are ongoing. The medical and scientific communities are not entirely unaware of the applications and benefits of hypnosis. Yet also grounds for concern. Anyone who has worked with hypnosis will know that its effect differs hugely from person to person – and it cannot be, as Kirsch suggests, simply a matter of “expectation”. The same induction may have little perceivable impact upon one person while allowing another person to enter such a deep state of relaxation that it may take the subject several minutes fully to come round. I would imagine that there are similar differences in brain activity. None of this necessarily means that one hypnotic state is more effective than the other.

Pain is a very interesting area and here the advantages and practical applications of hypnosis are too obvious to spell out. Yet in all my years in practice I have done very little work with pain. I lack formal medical training, so if a patient or client reports pain I quickly refer them to their GP. To treat pain without informed medical input is irresponsible as you could end up masking important symptoms. Here is one area in which mutual cooperation and trust between doctor and therapist is vital

But I guess it will be many years before the medical profession regularly calls upon hypnotherapists to assist in the treatment of pain. Why call someone in if you can simply prescribe painkillers? I have met and spoken with GPs. I recently gave a talk to GPs and nurses at a local surgery. But the problem hypnotherapists face is that GPs are often no better informed about hypnosis and hypnotherapy than the person in the street. Still – if articles such as this get published in journals like the Lancet on a regular basis, who knows what may happen in the future?

Larkin, M., (1999 Hypnosis Makes Headway in the Clinic, The Lancet, vol 353, January 30

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