WORKS OF R. D. (SEAN) LONGACRE AND GERARD V.

SUNNEN AND GERARD

TABLE OF CONTENTS
MEDICAL USES OF HYPNOSIS ARTICLES BY GERARD V. SUNNEN
1. MEDICAL HYPNOSIS: AN INTRODUCTION AND CLINICAL GUIDE

1
A. PREFACE (BY ROBERTA TEMES)

1
B. THE EXPERIENCE OF HYPNOSIS

2
C. AGE REGRESSION AND REVIVIFICATION

8
D. CURRENT CONCEPTS OF HYPNOSIS

9
E. HYPNOSIS--QUESTIONS FOR THE FUTURE

15
2. TRANCE SCALE FOR HYPNOSIS, SELF-HYPNOSIS, AND MEDITATION 21
3. HYPNOSIS AND SELF HYPNOSIS IN HEALING

26
A. THE LANGUAGE OF HYPNOSIS
 27
B. APPROACHES TO SELF HYPNOTIC SKILLS

28
C. A PULMONARY CANCER EXPLORATION

29
4. MEDICAL HYPNOSIS IN THE HOSPITAL

30
A. CASE HISTORY

31
B. HYPNOSIS IN SURGERY

32
C. REHABILITATION MEDICINE
 33
D. HYPNOTIC APPROACHES TO CANCER TREATMENT

34
E. SUMMARY AND FUTURE DIRECTIONS

36
5. HYPNOSIS AND ANXIETY: GERARD V. SUNNEN

37
A. EVALUATION OF ANXIETY

38
B. HYPNOTIC TREATMENT OF ANXIETY

39
C. BIOFEEDBACK AND RELAXATION

42
D. RELATIONSHIP OF HYPNOSIS TO ...
 43
E. CASE HISTORY

44
6. HYPNOSIS IN PSYCHOSOMATIC MEDICINE: GERARD V. SUNNEN

46
A. GASTROINTESTINAL DISORDERS

47
B. ANOREXIA NERVOSA

48
C. RESPIRATORY DISORDERS

49
D. OTHER CONDITIONS
 50
7. HYPNOSIS IN PSYCHOTHERAPY: GERARD V. SUNNEN

51
A. ERICKSONIAN APPROACHES TO HYPNOTHERAPY

59
8. HYPNOTIC APPROACHES IN THE CANCER PATIENT: GERARD V. SUNNEN 61
A. TECHNIQUES OF PAIN RELIEF IN CANCER

62
B. CONTROL OF ANTICIPATORY ANXIETY

63
C. HYPNOTIC APPROACHES TO DRUG-INDUCED NAUSEA

64
D. HYPNOTIC APPROACHES TO PSYCHOLOGICAL ADJUSTMENTS 65
E. OTHER USES OF HYPNOSIS IN CANCER CARE

67
F. HYPNOSIS IN MANAGEMENT OF CANCER SYMPTOMS

68
G. HYPNOTIC TREATMENT OF CHEMOTHERAPY SIDE EFFECTS

70
9. HOW HYPNOSIS IS CLINICALLY UTILIZED TO ADDRESS THE
SPECTRUM OF CANCER'S PHYSICAL & PSYCHOLOGICAL DIMENSIONS 67
10. MEDITATIVE TREATMENT FOR ERECTILE DYSFUNCTION: SUNNEN 71
11. MISCELLANEOUS MEDICAL APPLICATIONS OF HYPNOSIS: SUNNEN 74
 A. HYPNOSIS IN OBSTETRICS

74

B. HYPNOSIS AND SURGERY

77
C. PREOPERATIVE PREPARATIONS

78
D. HYPNOSIS IN BURN PATIENTS

79
E. HYPNOSIS AND DENTISTRY

80
F. HYPNOSIS IN OTHER MEDICAL CONDITIONS

82
12. AUTHOR INTERVIEW WITH GÉRARD V. SUNNEN, M.D. ADVANCES
JOURNAL OF THE INSTITUTE FOR THE ADVANCEMENT OF HEALTH 84
13. TRANCE SCALE FOR HYPNOSIS, SELF-HYPNOSIS, AND MEDITATION:
G.V. SUNNEN

93
COMPLEMENTARY MEDICINE SELF-HEALING MANUSCRIPT: R. D. LONGACRE 1999
PREFACE / DEDICATION

107
ACKNOWLEDGMENT / FORWARD (FORWARD BY PAUL G. DURBIN)

108
14. INTRODUCTION

109
A. THE PHYSICAL LEVELS OF HEALING

111
B. THE MIND SYSTEMS OF HEALING
 112
C. THE SPIRITUAL SYSTEMS OF HEALING

112
D. CLINICAL CONCEPTS OF SELF-HEALING

115
15. SPIRITUAL MEDICINE

117
16. HYPNOTHERAPY AND RELIGION (PAUL G. DURBIN, PhD.)

123
17. VISUALIZATION AND PRAYER THERAPY: ( PAUL G. DURBIN, PhD)

124
18. THE EVOLUTION OF VISUALIZATION AND GUIDED IMAGERY

131
19. MEDICAL GUIDED IMAGERY CONCEPTS

134
20. SELF-HELP HEALING PRACTICES
 140
21. VISUALIZATION AND IMAGERY FOR GOOD HEALTH `

146
A. TREATMENT OF IRRITABLE BOWEL SYNDROME

147
B. PICTURE, PRETEND AND IMAGINE

149
C. THERAPEUTIC VISUALIZATION AND IMAGERY

156
(1) HEALTHY WEIGHT

156
(2) DR. LONGACRE’S HYPNODEPTHMETER

157
(3) LIVING LONGER AS A NON-SMOKER

157
(4) ALLEVIATING UNHEALTHY STRESS

158
(5) FREEDOM FROM WORRY

159
(6) SELF-CONFIDENCE

160
(7) ENJOYING A GOOD NIGHTS SLEEP

161
(8) ENJOYING EXERCISE

162
(9) UNHEALTHY ANGER AND HOSTILITY

163
(10) LETTING GO OF GUILT

165
(11) ALLEVIATING DEPRESSION
 166
(12) HEALING IMAGERY

167
(13) ALLEVIATING UNWANTED PAIN

168
(14) IMAGERY FOR UNCOMFORTABLE MEDICAL PROCEDURES 169
22. A COMPLEMENTARY MEDICAL APPROACH TO CANCER

170
23. NOTES FROM CLIENT-CENTERED HYPNOTHERAPY: R. D. LONGARCE 180
24. NOTES FROM INSIDEOUT: R.D. LONGACRE

180
25. NOTES FROM PRACTICAL THERAPIES: R. D. LONGACRE

182
26. VISUALIZATION AND GUIDED IMAGERY FOR PAIN MANAGEMENT:
R D LONGACRE

184
A. PAIN CONTROL THEORIES
 184
B. CLINICAL INTERVIEW PROTOCOL

185
C. HYPNOTIC CHILDBIRTH INDICATIONS

186
D. PAIN MANAGEMENT

187
 WORKS OF R. D. (SEAN) LONGACRE AND GERARD V. SUNNEN AND GERARD
ARTICLES BY DR. GERARD SUNNEN
1. MEDICAL HYPNOSIS: AN INTRODUCTION AND CLINICAL GUIDE
PREFACE (BY ROBERTA TEMES): When 12-year-old Karen opened her mouth
during an outpatient preoperative procedure, she had every intention of cooperating with the
otolaryngologist. As the instruments entered her throat, however, Karen realized that no matter
what her intention was, inevitably her jaws would clamp down on the hands that were to cure
her. The doctor could not complete his work, Karen was disappointed in herself, surgery was
scheduled for Wednesday, and I did not know how in the world to help my daughter.
A colleague at the mental health center where I was then employed listened to my tale
and offered a solution. "Why don't I try hypnotizing Karen to easily keep her mouth open and
feel no discomfort?" John suggested. I brought Karen into work with me the following day sat
on the couch next to her while John spoke to her for about 10 minutes, and wondered if it was
doing my good. I knew nothing about hypnosis back then, in the 1970s; it was never mentioned
in my classes or written about in my textbooks.
On Wednesday morning Karen breezed through the preoperative procedure and eagerly
went off to the operating room. I became a believer. I began my conversion to hypnosis by
reading books taking classes, attending conferences, and participating in workshops. For the last
two decades I have practiced hypnosis, lectured about it, and created hypnosis audiotapes.
Physicians use hypnosis to help patients in many ways: to control pain, prepare for surgery, quit
smoking, stick to a particular food program, and accomplish all the amazing feats described by
the authors of the chapters that follow.
[Dr. Gérard Sunnen begins this text by introducing us to theories of hypnosis and
describing the physiologic and cognitive effects of hypnosis on the human body and mind. Dr.
Sunnen's poetic writing elucidates the metaphysics of hypnosis.]
Next, Dr. Mel Gravitz presents an historic overview of hypnosis, which reminds us that
hypnotic techniques have been used for centuries. He tells us that 200 years ago mesmerism was
used as an anesthetic during a mastectomy.
Dr. Karen Olness presents the latest research in the mind/body linkage. Her careful
analyses of the published studies and her own investigations show no signs of the hyperbole so
common in the popular press. Instead, we read of the earnest travails of scrupulous scientific
examination and along the way we learn that intentional immunomodulation by humans is
possible.
In their exhaustive review of the literature, Drs. Rodger Kessler and Thomas Whalen
present evidence that the hypnotically prepared patient does better than the nonhypnotized
patient before, during, and after surgery.
When you read about Dr. Dabney Ewin's Emergency Room technique for repairing a
dislocated shoulder you will wish you could be an eye witness to this procedure.
Dr. Larry Goldman makes childbirth sound like fun and offers several easy-to-follow
hypnosis scripts to be used during pregnancy, labor, and delivery. Dr. Howard Hall describes the
range of hypnotic interventions with children and includes detailed case studies from both his
practice and his family. Drs. Elvira Lang and Eleanor Laser, recognizing the limits of
intravenous conscious sedation, have trained all their radiology suite personnel, not only the
nursing and medical staff, in the uses of hypnosis. Their case examples are illuminating. No
aborted MRIs in that unit; even claustrophobic patients remain calm.
Dr. Al Levitan describes the usefulness of hypnosis when treating the patient who has
cancer.
Contained within Dr. Marcia Wagaman's precise analysis of the role of hypnosis in the
treatment of respiratory disorders is a serious warning to physicians about what not to say to the
hypnotized patient who has asthma.
Dr. Samuel Perlman presents evidence that a trip to the dentist is akin to a trip to the
beach. You will enjoy and probably practice his description of the 20-second handshake
induction.
Dorothy Larkin's chapter will make you wish that every nurse in every hospital was
trained in the conversational hypnotic techniques she so aptly illustrates.
Dr. Ann Damsbo writes about the ways in which she uses hypnosis in her psychotherapy
practice and in her personal life.
Hypnosis is nonpharmacologic, noninvasive. and relatively inexpensive. The authors
cited above have demonstrated that it can effectively and positively influence our health. It is
only a matter of time before every medical center will advocate and every medical school will
teach hypnosis. Roberta Temes, Ph.D.
WHAT IS HYPNOSIS? GÉRARD V. SUNNEN, M.D.: INTRODUCTION: We are
witnessing a blossoming sophistication in the science of the mind and especially in the
elucidation of how the psyche interrelates with the physical body. It is in this domain that
hypnosis finds its rightful niche as a science that deals almost exclusively with mind/body
interactions; for this reason, hypnosis has had a fascinating historical trajectory.
Historically, hypnotic phenomena have been interpreted in different ways through the
tinted glass of each culture's ideology. In Grecian sleep temples, for example, hypnosis was seen
as a sleep state facilitating communication with deities (Zilboorg, 1941); in Mesmer's time, it
was conceptualized as an agitated condition stemming from the absorption of cosmic forces
(Crabtree 1993).
Hypnotic phenomena are not easily measured or quantifiably grasped. They are neither
countable bacterial colonies on an agar plate nor hypnotic phenomena capable of precise
delineation, as would be a cardiac rhythm. To some extent, they can be measured by any one of
many psychological tests gauging suggestibility, hypnotic susceptibility, or the aptitude for
imagery (Balthazard 1993, Field 1965, Bowers 1986). These tests may be administered before or
after hypnosis. Tests may also center upon physiological parameters expressed through the
electroencephalogram (EEG) or the metabolism of cerebral pathways (Graffin 1995). However,
the complexity factor in hypnosis resides in that its manifestations tend to be subjective as much
as objective, expressing themselves in the context of the global person (Mott 1995).
THE EXPERIENCE OF HYPNOSIS: Although there is fairly good general
agreement regarding the psychological and physiological phenomena elicited through hypnosis,
rich controversies exist regarding the mechanisms by which they occur (Kirsh 1995).
Participants vary greatly in their experiences during hypnosis (Hilgard 1965, Freundlich
1974). Certain feelings stand out as commonly encountered, whereas others remain idiosyncratic
or rare (Twenlow 1982). In clinical situations, some people exit from the hypnotic experience
astonished to have felt a state of mind so vastly different from their normal waking state,
whereas others talk as if nothing unusual had happened. In the former case, the vivid impact of
the experience will serve to facilitate further hypnotic work through the subject's conviction that
some tangible phenomenon has indeed taken place. In spite of any novel sensations in the latter
case, individuals may, much to their surprise, be able to show a full range of hypnotic
phenomena. For example, a severely overweight woman in her thirties, who had a long history
of failed attempts at following dietary regimens, came out of her first hypnotic session
disappointed. She imagined that she would have experienced a feeling of other-worldliness
during trance, whereas in fact, she reported only a slightly enhanced level of relaxation. As
treatment continued and suggestions were offered to follow a nutritional plan with ease, she
expressed surprise. In spite of the absence of subjective changes during hypnotic sessions, she
was able to actualize the message of the suggestions seemingly automatically.
During the deeper stages of hypnotic experience, participants may be asked to talk about
or to notice how they feel. The answers are usually spoken in monotone, slowly, and with
pauses. A query asked during hypnosis, even if not assiduously answered at the time, makes it
easier for more detailed reports to be shared after hypnosis because some degree of observing
self-awareness will have been kindled.
PHYSIO-MOTOR CHANGES: During hypnosis the motions and the internal workings
of the body often feel decelerated. There may be a sense of inertia or a feeling of not desiring to
move; if movements are made, they have a tendency to be carried out less frequently, to have
reduced range, and to be experienced internally as if made in slow motion. There is frequently a
pervasive sensation of comfortable heaviness permeating the neuromusculature. This sensation,
which goes hand-in-hand with physiological appeasement, may be looked for and suggested
during the induction because its presence tends to convince the participant that some real internal
change has indeed transpired.
One of the characteristics of hypnosis is physiological languor, but not all hypnotic
phenomena occur in this context (Malort 1984). Although in medical hypnosis we tend to
suggest to our patients a global relaxation response, there are hypnotic-like states in which
activation rather than relaxation is a prominent feature (Fellows 1993). Certain states are
sometimes elicited in the course of religious ceremonials, as is observed in Sufi dancing
dervishes (Rouget 1980). In modern clinical practice, suggestions of physical action in the
context of psychological relaxation are often utilized. It is possible, for example, to present
posthypnotic suggestions for the purpose of enhancing athletic performance, which requires
intense concentration and physical effort. The athlete, during trance, visualizes himself
actualizing a performance with peak mastery. Once these images are incorporated into memory
posthypnotically, they can exert a positive influence upon the performance itself (Liggett 1993,
Stanton 1994).
RELAXATION AND MEDITATION: Relaxation has both physical and psychological
components. Parallel with physiological parameters, the experience is one of repose and calm.
Of all the hypnotic phenomena, relaxation is the most easily and consistently observed. In some
individuals the relaxation can be extremely pronounced, and it is not infrequent for first-time
participants of hypnosis to say that they have never before felt a relaxation level so profound.
This important global response is already present in neutral hypnosis (i.e., hypnosis
without any overt suggestions or the phase of the hypnotic process following induction and
preceding the presentation of suggestions) (Edmonston 1977). By adding proper suggestions,
neutral hypnosis can be,amplified many times over. Once experienced by the patient, relaxation
can, through the techniques of self-hypnosis (the process by which a trance is brought on by the
participant himself) or posthypnotic suggestion, be applied during situations previously
experienced as stressful or anxiogenic. The feeling of relaxation in hypnosis can range from
mild, general deceleration to pervasive peacefulness. In the latter instance, the parts of the mind
that contribute to anxiety are quieted.
PHYSIOLOGICAL CHANGES OBSERVED IN HYPNOSIS: The literature
contains many accounts of physiological changes associated with hypnosis (Sturgis 1990). It is
important to note, however, that no physiological variable has been shown to be systematically
or regularly associated with hypnosis (Sarbin 1972). Most experiments that purportedly show a
correlative relationship to physiological variables fare equivocally on replication or are
methodologically imperfect.
The physiological changes observed during hypnosis are greatly influenced by the nature
of the suggestions administered. It stands to reason that incentives to relaxation will lead to a
different physiological response configuration compared with suggestions centering upon
activation in any one of its forms.
It is common to observe cardiac variability during the initial phase of hypnotic induction
(DeBenedittis 1994), which may be due to feelings of novelty about the upcoming experience,
especially if it is a first experience. This response is followed by a slowing regular rhythm as
deeper stages of hypnosis are achieved (Harris 1993).
Reduced bleeding time has been reported in patients undergoing surgical procedures with
the assistance of hypnoanesthesia (Bishay 1984). Vasodilation and increased circulation to
otherwise poorly perfused areas have also been reported in response to hypoanesthesia
instructions (Rossi 1997).
Longitudinal studies on blood pressure reduction through hypnosis have yielded erratic
results, depending upon the research approach. However, by means of training in self-hypnosis
(Deabler 1973) and especially with the integration of hypnosis with biofeedback support,
hypertensive subjects have been able to modulate and even normalize their blood pressure
readings (Friedman 1977).
A slowing of the breathing rate can be observed in individuals within the deeper
dimensions of the hypnotic experience (Sarbin 1956). Breathing is then more likely to show less
amplitude and to be more abdominally expressed. On the other hand, respiratory rate,
predictably, is found to increase when cognitions of fear, anger, pain, or muscular activity are
elicited (Dudley 1964).
A number of metabolic changes have been reported to take place following hypnotic
suggestions. Among them are alterations in blood glucose level, basal metabolic rate, calcium
metabolism, and oxygen saturation (Lovett-Doust 1953). There are also reports that the body
temperature may be raised or lowered, depending upon the suggestion presented (Margolis
1983).
The hypnotic experience has been approached through many physiological channels,
including gastric secretions (Klein 1989), cerebral blood flow (Diehl 1989), cerebral oxygen
consumption (Malolo 1969), and electrodermal activity (Boucsein 1992).
Few endocrine studies have been performed. Release of adrenocorticotropic hormone
(ACTH) by the pituitary gland can be affected directly by emotional stimuli, and some
researchers have reported a drop in plasma cortisol titers to significantly low levels shortly after
hypnotic induction (Sachar 1964). Cutaneous functions have occasionally shown marked
sensitivity to hypnotic influence (Burgess 1996).
A Sudden change in brain voltage that is initiated by an external stimulus is referred to as
an evoked potential (Davic-Jefdic 1993, Jutai 1993). Some experiments seem to show a
diminution of visual evoked potentials in hypnosis (Banyai 1981).
Numerous studies have attempted to analyze EEG patterns in hypnosis (DePascalis
1993). Some researchers have found enhancement of theta rhythm after hypnotic induction
(Tebecis 1975). EEG measurements comparing neutral hypnosis--which presumably would
reflect the physiological essence of the hypnotic state because of the absence of administered
suggestions--and the state of wakefulness have interested many researchers. Several studies have
shown an augmentation of alpha wave density during hypnosis (Melzack 1975). Others have
discovered EEG patterns in neutral hypnosis marked by enhanced delta and theta activity, with
concomitant reduction of alpha and beta wave manifestation (Saletu 1987).
Despite the efforts of numerous researchers, the hypnotic condition has not yielded
substantive physiological correspondence. Despite the growing sophistication of medical
technology, much needs to be accomplished to correlate psychological dynamics with some yet
elusive central nervous system alteration. We are nevertheless gently reminded of Freud's
futuristic remark that every thought--and presumably every alteration in mental state, including
hypnosis--will eventually prove to be accompanied by a specific neurophysiological event.
Anticipatory anxiety is a universal source of stress. Self-reproach, guilt, resentment, and
dwelling negatively on the past are also sidestepped, as the mind is asked to confine itself to an
experiential grounding in the very present time. There is a moving away from the perceived
complexities of the current life situation into self-reflection. Some contemporary theoretical
approaches suggest that the frontal lobes of the hypnotized individual act as if they have been
distanced from the nervous system (Crawford 1994, Gruzelier 1993). In the construct of this
rough neurophysiological model, the frontal lobes, in their psychological correlation with
concerns about the past and worries about the future, may function as if they had assumed
relative dormancy.
Relaxation is a complex global state involving not only physical and physiological realms
but also dimensions touching upon the emotions and thought processes. It is hardly possible for
an individual to be fully relaxed and physically at rest and at the same time emotionally
disquieted by ruminative feelings, such as resentment or shame or by activated thoughts fueled
by worry and unrest. Hypnosis in its relaxing action touches all dimensions of the body and the
psyche. In this sense, it can be said that hypnosis is the most potent nonpharmacological relaxing
agent known to science.
Descriptions of the subjective experience of the hypnotic trance often include alterations
in the perception of time flow and sensations of relative removal from the ties connecting the
individual to reality. Yet, during hypnosis, the individual may still feel, with varied intensity, the
presence of the hypnotherapist, and with it, a sense of security and reassurance. In hypnosis, the
elements of this relationship are closely intertwined with the experience of the trance because
part of the patient's psyche is linked to the hypnotist's psyche in a process of dynamic
communication, a dyadic alliance (Diamond 1984). The hypnotherapist may communicate with
one part of the subject's self, then with another, but there remains an interpersonal bridge,
regardless of the clinical approach of the hypnotist, which may be very permissive,
choice-giving, and open-ended in the manner that suggestions are presented. Indeed, no matter
what the style of the hypnotic process, the structure of the therapeutic relationship imbues its
experience.
Self-hypnosis expands the privilege of autonomy (Garver 1984). The link of
interpersonal rapport is dissolved as the experience becomes more fully intrapsychic. A more
conscious portion of the mind gives suggestions, affirmations, and directives to another, more
unconscious part (Sacerdote 1981). According to some authors, the autonomy accompanying
self-hypnosis may invite disproportionate wanderings of attention and less task orientation than
that observed in the more structured heterohypnosis (Fromm 1990).
Sometimes the individual enters a self-hypnotic state .and does not give himself specific
suggestions, which may be called neutral self-hypnosis, a state marked by relaxation,
free-floating imagery, and dream fragments or sequences. In neutral self-hypnosis, the sense of
control floats, undirected. In this unstructured trance state, the subject may observe and
remember or not observe and not remember.
If we add one ingredient to this self-induced trance state, we have meditation. That
ingredient is focused watchfulness.
The meditative trance is similar in quality to the self-hypnotic experience. In meditation,
however, the individual starts out with no overt induction process but rather with the resolve to
begin and continue the experience and to direct the observing self toward a meditative focus
(Sanders 1991). This point of convergence may be a part of the body (e.g., the solar plexus), an
imagined or spoken sound (mantra). a meditative image (mandala), or a selected spiritual idea
(Naranjo 1971). Meditative focusing is showing ever richer potential in harmonizing the
mind/body related dysfunctions (Shapiro 1982).
TIME CHANGES: In the experience of hypnosis, the sense of time is shifted from
external to internal events. Consequently, the sensation of time passing is correspondingly
stretched because internal events are subjectively slowed (Blakely 1991, Von Kirchenheim
1991). Time feels less insistently present, and it is not uncommon for a participant to estimate
the duration of a hypnotic session to have been 30 minutes, when in fact it has been only a few
minutes (St. Jean 1988). In other cases, time feels as if it has stood completely still, as if frozen.
BODY IMAGE CHANGE: The experience of how the body feels during the normal
waking state is often changed during hypnosis. With eyes closed, the waking subject, when
asked to convey the configuration of the body as it is experienced, will usually describe a fairly
anatomical rendition, with all the body parts in their respective positions. More precisely, the
hornunculus in the brain, with its disproportionate emphasis upon head, eyes, and feet, will
correspond to the imaginal rendition.
The experience of how the body feels during the normal waking state is often changed
during hypnosis. Without directive suggestions, the body may feel heavy, as if pushing into the
cushions of the chair; or the body may feel lighter, as if floating. At times the body will feel
larger, expanded, and macroscopic, as if filling the entire room. Rarely, it may feel microscopic
(Gill 1959, Freundlich 1974).
CHANGES IN THINKING PROCESSES: Along with physiological slowdown, the
flow of thoughts is likely to show variability in its velocity and direction. In any given day or
moment, the course of our thinking current, the rate at which one thought follows others, varies.
It may be faster in the evening than in the early morning. In depression, it is likely to be slowed
down. In hypomania and in psychostimulant intoxication, it will be accelerated.
What is the relationship of the flow of thought to the experience of being aware of
oneself? Is it ever possible to be devoid of thoughts and still be acutely conscious? In hypnosis,
the flow of thoughts sometimes is reported to stop completely. At the same time, the individual
is alert and aware, is not depressed, and knows that thoughts have ceased coming to mind. Often,
there is a sense of amazement that awareness of one's awareness is exquisitely preserved, when
all the while thoughts have desisted in manifesting themselves (Ludwig 1972).
When the current of thought is slowed, its structure is also likely to be changed. Trance
logic refers to mental mechanisms in which logically incongruous ideas can coexist without
clashing (Orne 1959). A student of mathematics, for example, came out of his hypnotic
experience with a feeling of wonderment. During his hypnotic session he said he had felt,
however fleetingly, the concept of infinite distance and endless time. After hypnosis, he talked
about the experience as an everlasting revelation that, in spite of his efforts, his rational self
could not experientially retrieve.
EMOTIONAL CHANGES: Although the word emotion most directly conveys the idea
of a feeling, it is in fact a conglomerate body of processes involving the autonomic nervous
system and many psychological associations (Bryant 1989).
Although it is possible in hypnosis to quell emotions as in deep relaxation, it is also
possible to enhance certain feeling states. Sometimes, during a hypnotherapeutic situation, a
solitary feeling may be presented to the patient for contemplation and amplification. A
demoralized individual, for example, may be asked to center solely upon a sensation of
optimism. For some participants this can be difficult because they may need to have an actual
memory trace or a contextual milieu for this feeling. In this situation, a specific life event can be
resurrected, one that was associated with happiness, feelings of self-confidence, and situational
mastery. These feelings, once recreated, can be then hypnotically intensified so that they may
exert their posthypnotic ego-strengthening influence.
An interesting feature of hypnotically induced feelings is that they tend to persist beyond
the hypnotic session. This phenomenon draws associations to Papez's description of how
emotions reverberate in the limbic system (Papez 1937). For example, a chronically depressed
patient at age 54 could not recall any instance during his life when he experienced feelings of
happiness. Then, during one of his sessions, he retrieved the memory of walking as a small boy
with his uncle in the countryside, not far from some railroad tracks. A train whistled in the
distance and he started imitating its sound and running in a skipping way. He remembered
feeling happy then, if only for a few evanescent moments. In hypnosis, he was asked to invite
those same feelings into his awareness, to then amplify them through meditative focusing. The
ability to experience feelings of joy and freedom became progressively easier, and he gradually
started to integrate them into his everyday life, coloring his existence with more joyfulness.
CHANGES IN IMAGINATION: To some degree, the ability to create mental images is
present in everyone. It is most pronounced in dreams when the messages flowing from the sense
organs are drastically reduced and awareness is shifted to the ever-ongoing inner mental life. In
the waking state, the effervescence of mental images surfaces in daydreams. The imagery of
daydreams is complex, under partial volitional control, and uniquely expressed in everyone; they
may contain visual impressions, feelings, some aesthetic sensations, the interplay of dialogue,
and intricate scenarios. Daydreams may be so engrossing that coming back to reality feels
shocking.
Clinically, it is important to know the style of imagery used by our patients. In hypnotic
induction and in treatment, the stimulation of imagery, in any one of its modalities, provides an
important vehicle for progress. It makes little sense, for example, to reduce relaxation by
suggesting a sense of heaviness in the body musculature when someone much more naturally
responds to suggestions of warmth (i.e., the image of lying down in heated sand), or to more
visual scenes (i.e., seeing oneself in a verdant garden or a sunbathed beach) (Kroger 1976).
The ability to create, intensify, and sustain images is enhanced in hypnosis (Hammond
1990). In certain participants, this faculty can be activated to such a degree that the sense of
reality recedes and imagery takes precedence. We then have a situation in which the processes of
wakefulness coexist with the processes of imagery formation. Further along this continuum,
imagery can be so intensely vivid that it is referred to as a hallucination: With eyes open, the
participant is able to see an object or a person as if it were there. Conversely, the participant
might also not see an object that really is there, a negative hallucination.
Imagery is turned into a therapeutic tool in hypnosis. Images constructed by the patient
can, through their real representations or the symbol they convey, point in the direction of
creative insight, enhanced self-perception, personal growth, and problem resolution. Through
their influence, they have been found to exert important therapeutic effects (Porter 1978, Sheikh
1978).
HYPNOTIC EFFECTS UPON THE SENSES: Every second, in the uncharted leap of
body to mind, billions of sensory inflow signals become actualized sensations. A hand dipped in
the icy water of a wintry lake, for example, will send signals via the lateral spinothalamic tract to
nuclei in the thalamus, then on to the postcentral gyrus. Somewhere along the way, feelings of
cold will be created. This raw sensation can, however, be modified by other areas of the mind.
The sudden startle of a flight of birds in our wintry scene will shift patterns of perception, and
the feeling of cold will momentarily be overridden.
Hypnosis mobilizes this ability to move into or away from sensory experience.
Sensations can be made to expand or recede. For example, a participant may be convinced to
feel pain more distant, less insistent, less sharp and more diffuse, less lancinating and more
soothingly warm, or anesthetizingly cold. The process by which this is done can be learned by
the patient for therapeutic gain. The stroke victim can be taught to home in on awareness of the
vestiges of sensory inputs in an affected limb, in order to make it more functional with time
(Appel 1992, Warner 1988). The child accident victim can be guided to veer away from the
insistent annoyance of uncomfortable casts to aid in the quality and speed of recovery.
MEMORY CHANGES: As dreams dramatically show, the distant and detailed
memories of childhood years can be vividly brought back to us as adults. The nervous system
stores every experience. New experiences are recorded in its substance, in a sequenced series of
bioexperiential events requiring, for their integrity, the proper functioning of short, intermediate,
and long-term memory mechanisms.
Many memories, although indelibly present, do not gain entrance to consciousness
because they are connected to too much anxiety or psychic pain. Others are cast aside because, in
the priority of things, they have little relevance. Conversely, some memories impinge too
insistently upon daily life experience and may be disruptive. With effort, one can push for the
retrieval of a forgotten detail or, as in suppression, one can consciously coax into oblivion an
uncomfortable fact.
The ability of the mind to modulate access to personal memory stores is itself a malleable
quality. In the hypnotic state, the individual may be asked to move away from present reality and
to rekindle the remembrance of an event (Dinges 1992, Schacter 1996). This phenomenon of
enhanced recall is called hypermnesia.
In the phenomenon of posthypnotic amnesia, the subject forgets what has transpired
during the hypnotic experience (Williamsen 1965). This effect may occur on its own, or may be
encouraged by suggestions (Kinnunen 1996). In either case, the elements of the experience
usually return to awareness at some point in the future, typically some days after the event.
AGE REGRESSION AND REVIVIFICATION: Whereas memory retrieval and
hypermnesia involve a coming to the surface of specific events and effects, age regression
implies a more complex phenomenon, namely the reliving of a part of the past in the context of
the developmental stage of that time (Orne 1951).
For example, an adult subject (it usually has to be a hypnotically talented one), is asked
to travel backward to relive some segment of his adolescence. The hypnotist advises, "You are
now about 15 years old. Can you talk about what you are doing and how you feel?" The
participant begins an inward search and then talks about an event with varying amounts of detail
and effect. Why, of all possible remembrances, did he home in on the memory he chose?
In the hypnotherapy situation, if the event is emotionally charged, the participant may be
asked to act as if he is on the side lines, as an observer, in order to reduce the possible affectual
impact and its possible disruptive effects. In complete age regression, the episode is relived in all
its immediacy and intensity. We are reminded of Penfield's patients who, when cortically
stimulated, could actually re-experience segments of their past in their proper sequence (Penfield
1950). With further regression, the expressions, verbal intonations, and the emotional responses
of the period re-emerge, turning back developmental time. Regressed to infancy, there may be
drooling, monosyllables, and sometimes, amazingly, a Babinski reflex (Raikov 1982). Clinically,
age regression and revivification find usefulness in the clarification, release, and reintegration of
repressed affect in preparation for conflict resolution and psychological liberation.
"ANESTHESIA AWARENESS" AND ITS RELATION TO HYPNOSIS: The
phenomenon of the possible preservation of portions of awareness during chemical anesthesia is
not strictly a mainstream feature of hypnosis. However, it presents fascinating theoretical
questions and research directions into the dynamics of awareness as they relate to various mental
states. The crucial connective thread between hypnosis and anesthesia comes from data
suggesting that events occurring during anesthesia may be retrieved by the use of hypnosis
(Edwin 1990), and that the process of anesthesia itself may be beneficially influenced by
hypnotic intervention (Erickson 1994).
It has been assumed for decades that a patient in the moderate or even deeper levels of
chemical anesthesia was in a state of other-worldliness and had relinquished all semblance of
consciousness. Some authors (Crile 1947), however, began to study the relationship between
anesthesia and awareness and described instances in which the coexistence of the two were not
necessarily incompatible.
Recent studies have increasingly focused upon hypnotic recollection of the anesthesia
experience (Rossi 1988). Although consciously, many of the patients have little or no memory of
their surgical experience, some (especially highly hypnotizable ones) are able to reconnect with
these buried memories, in the context of trance.
 It has been reasonably established that some patients in such situations are attuned to
meaningful communications by the treating personnel (Wilson 1969). This occurrence has
prompted hypnotherapists to introduce suggestions to patients awaiting operative procedures;
these suggestions are designed to protect the patients against inadvertent negative
communications, which may be reacted to, physiologically or psychologically, with nefarious
stress reactions. For example, in the event that one of the operating personnel mentions, "there is
a lot of blood loss here," the patient may respond with a rise in blood pressure and increased
heart rate, promoting cardiac instability. In such a situation, affirmative hypnotic suggestions can
act not only as a protective buffer but also as an activator to positive adaptation mechanisms,
making successful negotiation of the surgical process more likely (Nathan 1987).
CURRENT CONCEPTS OF HYPNOSIS: Although the manifestations and
capabilities of hypnosis have received increasing acknowledgment, the essence of its
mechanisms remains difficult to define (Chaves 1994). Today, even with the impressive
advances in the understanding of psychological mechanisms, theories of hypnosis are
remarkably numerous and divergent (Lynn 1991). The search for a unified theory has been
elusive. To be integrated, such a theory would have to explain the multitude of hypnotic
phenomena, from age regression to anesthesia and from catalepsy to hallucination; it would have
to account for the wide ranges of individual manifestations and show the reasons for the striking
subjective experiences that are often induced.
Because theories are approximations, it is probable that several of them are concurrently
valid, each seeing a portion of a multidimensional process involving psychological,
physiological, and social mechanisms. The following theories are important currents of thought
regarding hypnotic phenomena.
PHYSIOLOGICAL THEORIES: Those who correlate conditions of consciousness
with changes in the central nervous system or those who hold that physiological events may
precede all mental events look for physical reasons to explain hypnosis (i.e., variations in the
EEG, in evoked potentials, in cerebral blood flow, or in neurotransmitter dynamics) (Spiegel
1992). In the future, as the sophistication in noninvasive central nervous system visualization
techniques progresses, the most subtle elements of the physiological accompaniments of the
hypnotic condition may yield its yet elusive enigmas. Difficulties with this approach have to do
partly with the different manifestations of hypnotic states. For example, in passive or in neutral
self-hypnosis, in which participants are physiologically slowed down, we would expect readings
in all the previously mentioned tests to be different from those taken during active hypnosis,
where the participant, eyes open and alert, may be very task-oriented.
Investigations into the function of the reticular activating system, the diffuse thalamic
projections, the activities of the frontal lobes, and the limbic system have been inconclusive. We
still do not possess sufficient knowledge about the functioning of these areas of the central
nervous system as they relate to the creation of normal consciousness, let alone hypnosis.
There are investigators who share Charcot's concepts that hypnosis is based upon
physiological disturbances (Guillain 1955) or Pavlov's ideas of cortical alterations of function
and the mechanics of energy in psychic activity (Drabovitch 1934, Kraines 1969). For some, the
right hemisphere, with its connectedness to imagery and feeling states, is more involved with
hypnotic phenomena (Gabel 1988). Others have been impressed by behavioral or anatomical
capabilities such as the eye-roll sign (the capacity of the eyes to roll backward into the head) as
reliable indicators of hypnotic susceptibility (Spiegel 1978).
Because body and mind are likely to converge at some yet unknown interface of brain
function, it is conceivable that hypnosis, at some level, encompasses some tangible bodily
functions. The question remains then: If a particular neurophysiological constellation proves to
be a characteristic feature of hypnosis, is it an effect of hypnosis or a cause?
SLEEP STATE THEORY: Early magnetists were fooled by the resemblance of the
hypnotic state to sleep (Gravitz 1991). They assumed that because their subjects were in a state
of slumber, hypnosis was indeed a variant of the sleeping state. Yet, they could not resolve the
apparent contradiction that their subjects behaved, in many ways, more as if awake than asleep
(Darnton 1970).
In recent years, sleep has been increasingly studied and has become more equated with a
state of aliveness than one of suspended animation. It has been divided and subdivided into
stages, correlated with a variety of dreaming activities, neurohumoral shifts, neurotransmitter
metabolism changes, and chronobiological cycles. Sleep is a dynamic, phasic process with,
presumably, several functions, some of which are still unclear. Could hypnosis possibly be one
of the many sleep stages? Or is hypnosis a sleep stage with some degree of awareness added to
it, as in the phenomenon of lucid dreaming, in which the individual, while remaining asleep,
attains the awareness that the dream is, in actuality, part of the process of dreaming itself (Tart
1979)?
Pavlov termed hypnosis "partial sleep." In his view, both sleep and hypnosis resulted
from the inhibition of certain cerebral areas. In hypnosis, he postulated, the preservation of
"sentinel points" or channels of communication accounted for some limited reactivity to
surroundings (Pavlov 1923). Some investigators point out that light sleep can become
hypnotic-like by means of establishing rapport through response to suggestion, and that, at
times, hypnotized individuals have fallen asleep when left undisturbed or given appropriate
suggestions. (Greenleaf 1986).
Because hypnosis has some, albeit limited, common denominators to certain sleep states,
it is understandable that the functioning of the neurological pathways involved in the physiology
of sleep kindles special inquisitiveness. Among these are certain postulated subcortical
sleep-regulating nuclei adjoining the third ventricle, the contributions of the reticular formation,
selected pontine nuclei, and the neurotransmitter serotonin. Whether these structures and their
associated biochemical components are necessarily directly involved in hypnosis is unknown
(Levitt 1963). When global physiological measures are considered, however, hypnosis is very
close to wakefulness. Reflexes are not altered in hypnosis, whereas in sleep, they are diminished
or absent. Moreover, steep is accompanied by marked modifications in the output of awareness
because it is channeled into the environment, whereas in hypnosis, responsiveness to outside
stimuli is preserved. In the current analysis, hypnosis appears to be a condition that is neither the
usual waking state nor any of the sleep stages.
HYPNOSIS AS A MODIFIED OR SPECIAL STATE OF CONSCIOUSNESS: The
view that hypnosis is a special state of consciousness finds many followers (James 1935,
Silverman 1968) who point out that individuals often report experiences outside the realm of
their ordinary reality. Many deeply hypnotized participants describe how incredibly relaxed or
peaceful their experience was, and how differently they perceived the flow of time, the
configuration of their body image, or the experiencing of their awareness (Shor 1962). The usual
waking state has a familiar experiential quality. We know it to be there most of our waking
hours and, it is argued, we would know of any significant deviation from it.
During hypnosis, this subjective alteration in the personal field of awareness or aliveness
is correlated by "state of consciousness" (or state) theorists to depths of hypnosis (Tart 1975,
Ludwig 1972). To determine how "deeply" an individual has experienced trance in this system,
we would ask for an introspective report, usually with reference to an arbitrary scale (Tart 1979).
For example, zero could represent the usual waking state and 10 the deepest trance the
participant estimates could be attained.
State theorists posit quantitative (in, for example, the substantivity of consciousness), as
well as qualitative changes (certain mental processes may be more or less operational, that is,
shift to primary process thinking, alterations in ego mechanisms, or redirection to introspective
orientation).
A strong support for the state theory is the occurrence of trance logic that refers to the
ability of deeply hypnotized subjects to experience comfortably the coexistence of logically
inconsistent perceptions or ideas (Orne 1959). The "ability of the subject to mix freely his
perceptions derived from reality from those that stem from imagination and are perceived as
hallucinations" cannot be done by imitators (Martin 1996). However, trance logic is also found
in dreams, in primary process thinking, and in schizophrenia. How unique is it to hypnosis?
If the waking state is one state of consciousness, albeit the dominant one, and hypnosis is
another, we may then ask, how many states are there? Is there a spectrum of states? If so, how
does hypnosis fit into it? Is the usual state of consciousness experienced in the same fashion by
everyone, or are there significant individual variations?
The school of states of consciousness develops many of its concepts from Eastern
philosophies, which have a much longer tradition of interest in these areas (Sheikh 1981). In the
Western tradition, states of mind are often equated with neurological and psychiatric conditions
having repercussions upon consciousness (i.e., hyperalertness, sedation, stupor, light coma, or
deep coma) and part of the problem in defining hypnosis may be semantic: At this time, we may
not have developed the terminology to describe the complex and varied conscious mental
configuration in the mind's repertory.
Although theorists often put themselves in state and nonstate camps, these divisions may,
in the end, be unnecessarily polarizing (Perry 1992). A more integrated view would see hypnotic
phenomena as occurring within the context of certain mental sets (state theory) and as capable of
being intensified and shaped by many relevant influences, such as social communication,
cognitive factors, and interpersonal variables (nonstate theory).
HYPNOSIS AS AN ATAVISTIC PHENOMENON: This theoretical view holds that
hypnosis represents a more primordial style of mentation, a return to an archaic mental
functioning, in which suggestion plays an important role (Meares 1972). This primeval mental
state is normally superseded, but not replaced, in the waking state by logical, intellectual, and
critical faculties. In this model, during the antediluvian periods of their mental evolution,
humans functioned much more fully in modes of thought in which nonverbal communication,
"hypnotic-like" rapport, and body/mind connectedness were in prominent evidence (Nash 1989).
In the perspective of this theory, several facets of hypnosis may be explained: In many
hypnotic inductions, critical faculties are placed at bay by giving monotonous, repetitive
suggestions. The prestige of the hypnotherapist is influential, perhaps in the same way as that of
important figures long ago in our evolutionary past. Nonverbal communications are well known
to occur prominently in hypnosis (Erickson 1959). The participant often reports being able to
draw inferences from many subliminal cues and to have increased sensitivity to the
meta-meaning and the emotional messages inherent in communications.
In the atavistic hypothesis, depth of hypnosis can be equated to completeness of
regression. Spontaneous pseudo-trance or daydreams could represent a mixture of noetic and
atavistic processes. Posthypnotic suggestion phenomena, the remarkable action by which
instructions given during hypnosis are carried out seemingly automatically at some point in the
future, and sometimes in the distant future, are explained by a mechanism of introjection, in
which a participant accepts the hypnotist's messages as his own and carries them out as
self-fulfilling time-released personal actions.
The atavistic theory is attractive, but it does not adequately account for hypnotic phenomena
such as anesthesia and hallucinations.
PSYCHOANALYTICALLY ORIENTED THEORIES: Somewhat similar to the
atavistic theory, but much more centered on stages of personal development, are
psychoanalytically inspired theories of hypnosis that see portions of the participant's psyche as
regressing to an infantile ego state, with the hypnotherapist acting as a parental figure (Schilder
1956). The concept of hypnotic rapport becomes imbued with notions of transference, the
process by which feelings, attitudes, and wishes, originally linked with an important person in
one's earlier life, are channeled onto others (Gill 1959).
Freud had difficulty integrating hypnosis into his psychoanalytic theories. He was
strongly influenced by the ideas of both Charcot and Bernheim (Bernheim 1897), but came to
see hypnotic phenomena through the perspective of transference (Ellenberger 1970). We may
ask whether transference, like suggestibility, is a surface manifestation of hypnosis, or a primary
ingredient.
Ferenczi believed that hypnosis recapitulated the Oedipal situation (Ferenczi 1909). He
also used expressions such as "paternal hypnosis" and "maternal hypnosis to further describe the
nature of the libidinal regression. If the induction was of the authoritarian or commanding type,
the subject would associate the hypnotist with a strong father and, if permissive, with the
mother. Implied in this view is a gender-oriented element in the hypnotic condition that, barring
some claims by occasional subjects who experience erotic feelings in their trance, is not borne
out by clinical observations.
In the psychoanalytic view, hypnosis implies a regressed condition in which magical
expectations, dependency strivings, and primitive wishes and fears are operational (Schilder
1958, Gruenwald 1982). Because, seen from this Perspective, the hypnotist is placed in an
omnipotent position, many psychoanalysts have stayed away from its use. Others, however,
pointing to the rich potential of the transference condition implied in hypnosis, have integrated
its applications within the psychotherapeutic context (Wolberg 1964).
HYPNOSIS AS A DISSOCIATIVE CONDITION: To Haule, the concept of
dissociation was central to hypnosis (Haule 1986). Dissociation may be defined as a personality
trait, characterized by modification of connections between affect, cognition, and perception of
voluntary control over behavior, as well as modifications in the subjective experience of affect,
voluntary control, and perception (Sanders 1986). In this process, a body of ideas, emotions, and
behaviors is capable of splitting off from the personality to express itself with a certain degree of
autonomy. This dissociated material, actively separated from awareness, can be brought to
manifest itself through the use of certain techniques, among them hypnosis (Bowers 1991).
Automatic handwriting provides a poignant illustration of this phenomenon: The
participant, conscious and alert, can watch his hand write out answers to questions or even
produce lengthy narratives, as if detached from the supervision of the self. In this situation, there
is an observing ego and a dissociated ego that is perceived by the observing ego as acting
independently. In clinical situations, these two egos can be seen when the participant, during
induction with the arm levitation method, for example, is amazed to feel his arm rising,
seemingly by itself, to eventually touch his face, thus signaling the onset of hypnosis.
Although we do not know the precise nature of the mechanisms of dissociation (Counts
1990), either in the central nervous system or in the psychological architecture, this theory
describes some but not all of the characteristics of hypnosis. The relationship of hypnotizability
to the capacity for dissociation continues to require further elucidation (Frankel 1990).
EGO STATE THEORY: Ego state theory is closely connected to dissociation theory
and also to concepts dealing with the phenomenon of multiple personality, psychogenic amnesia,
and fugue states.
Ego state theory postulates the existence of networks of personality traits, experiences,
feelings and behaviors, which in various degrees of cohesion are bound by common principles
(Watkins 1991). Several ego states may coexist as fairly distinct entities within the same
individual, and their boundaries are thought to be loosely defined and malleable, in contrast to
the more rigidly constructed demarcations found in multiple personality syndromes. In the
hypnotic situation, different ego states may be communicated with, for the purpose of bringing
about a more global psychological integration (ego state therapy) (Beahrs 1982).
BEHAVIORAL THEORIES: This viewpoint contrasts with state theories of hypnosis,
seeking to strip the hypnotic state of its status as a separate entity or as a distinct condition of
consciousness. To bolster this position, some authors point out that all the phenomena said to
occur in the hypnotic condition can be produced in normal subjects in their normal waking state
(Barber 1995).
If, side by side, we observe a hypnotized subject and a simulator responding to the best
of their abilities to the suggestions of a hypnotherapist, we may have cause to wonder who is
who. Using this behavioral perspective, it is true that there may be difficulties in telling them
apart because responses to instructions can be so convincing in both situations. Is hypnosis a
more or less consciously determined simulation? A role play? Could hypnosis be the expression
of complex behaviors fashioned from perceptions to social cues?
To cut through the argument of outright mimicry, we could, as amply documented by
historical examples (the work of Esdaille in particular [Esdaille 1950]), attempt to perform a
major operation on the hypnotized individual without recourse to chemical anesthesia. It is likely
that the simulator, on approach of the scalpel, will quickly give up the charade. Simulators may,
in addition, have difficulties faking the appearance of a Babinski reflex during age regression, or
truly experiencing an auditory or visual hallucination.
Simulation is a conscious maneuver. On a more unconscious level, however, some
theorists believe (Sarbin 1972) that hypnosis derives from deep motivations to behave like a
hypnotized person should. The definition of what constitutes hypnotic behavior can be overtly or
subtly communicated by our culture or by the hypnotherapist who presents cues, verbal and
nonverbal, to this effect. This definition would explain the varied manifestations of hypnosis in
different cultures and during different historical periods, but it would not elucidate the deeper
intrapsychic mechanisms presumably needed for their creation.
The drive to behave in ways suggested by the hypnotherapist is related, in this model, to
the completeness of the hypnotic rapport. The strength of the motivation to fulfill the hypnotist's
expectations has been proven to be remarkably strong in some individuals (task motivation)
(Megas 1975). It is felt that the role-taking behavior of the subject may be so complete,
profound, and intense that there is total belief in its consistency and validity. The behavior of the
hypnotized individual becomes wholely congruent with self-image and the suggested perception
of reality assumes such complete self-syntonicity that phenomena, even phenomena involving
the deepest mechanisms of perception and the participation of the autonomic nervous system, are
spontaneously expressed.
HEMISPHERIC LATERALITY THEORY: It has been long assumed that the brain is
an organ whose symmetry implied an equal sharing, by each hemisphere, of its many functions.
For centuries, the contributions made by the brain were not realized; yet the Ebers Papyrus
(2500 BC) tells of a man who, as a result of head injuries "lost his ability for speech without
paralysis of his tongue." Later, Roman physicians described deficiencies in consciousness,
perception, and behavior due to cerebral traumas incurred by gladiators. In 1861, Broca
described a patient who had lost the "faculty for articulated speech," with the sparing of verbal
and written comprehension, as a result of a left hemispheric lesion. In 1874 Wernicke described
a different syndrome, loss of verbal comprehension with preservation of elocution, as a sequela
of a lesion in the posterior portion of the first temporal gyrus (Gardner 1975).
Since these early findings, the brain "localizationists" have worked to find discrete
territories for each of the many faculties expressed by humans. Although successful for purely
motor or sensory modalities, this compartmentalizing approach has had many difficulties with
the mapping of associational areas and with such psychological dimensions as emotionality,
intelligence, and other higher mental functions. This line of research has provided an
appreciation for the intricacies and the plasticity of the brain--as seen, for example, in its
adaptation to injury--and for the dynamic interrelatedness of both hemispheres as they
complement each other.
Sketching some global differences, the left hemisphere in most individuals has more
jurisdiction over expressive speech, syntax, writing, reading, arithmetic, and rhythm; the right
hemisphere has greater involvement in processing visual patterns, spatial configurations, holistic
analyses, melody, imagery, and the proper interpretation of special meaning and metaphors.
It is in this area that hypnosis and hemispheric function meet (Frumkin 1978). Can
resistance to induction be considered a manifestation of logical left hemispheric overbearance?
By what neurophysiological mechanisms do techniques such as confusion, paradox, double-bind
(the simultaneous communication of conflicting messages), or reframing (changing a person's
perspective of events or situations in order to change their meaning), work to circumvent them?
How can abilities inherently present in the right or the left hemisphere be best utilized to
enhance the effectiveness of therapeutic hypnotic intervention?
HYPNOSIS--QUESTIONS FOR THE FUTURE: The many unresolved issues
concerning the nature of hypnosis and the growing sophistication in its exercise make its future
promising in numerous areas, from research to clinical practice. At the same time, and this is
seen in the increasing volume of papers dealing with hypnosis (Graham 1991), there is widening
medical and public acceptance of its therapeutic potential (Fromm 1972). Since its birth as a
science, hypnosis has shown a cyclical evolution with fluctuating levels of interest from the
scientific community. Today, however, hypnosis appears to be firmly implanted as a medical
tool, and its future is likely to witness its progressive maturation in its varied applications to the
spectrum of medical practice (Morgan 1992).
Since the early work of Breuer and Freud, hypnosis has found a place in the study of
repression, conversion, dissociation, catharsis, and psychogenic amnesia, among other
preconscious and unconscious processes. Although relatively abandoned for decades in favor of
free association and dream interpretation (Cheek 1995), hypnosis has recently been
"rediscovered" for the experimental investigation of conflicts, for the study of ego-homeostasis
and enhancement, and for the therapeutic utilization of imagery. Somewhat akin to the
population of identified neurotropic molecules that is steadily growing in number, the dynamics
of the psychological processes in hypnosis will likely continue to yield ever greater evidence of
their variety, complexity, and plasticity. With this knowledge, techniques of hypnotic treatment
will become more efficient and more accessible to patients.
There is currently a tendency to integrate different therapeutic modalities in the promise
of achieving more efficient individual change. The future of hypnosis will likely witness studies
of its usefulness as a facilitator to other therapies, much as hypnobehavioral approaches have
already been applied to systematic desensitization, aversion, flooding, assertiveness training,
short-term dynamic psychotherapy, and imagery techniques.
As a quintessential facilitator to mind/body communications, hypnosis will continue to
become integrated into holistic patient care. Facilitating this integration is research that points to
the interconnectedness of all phenomena, mental and physical, in the organism.
Psychoneuroimmunology, for example--the science of the interactive relationship between
neurophysiological, immune system, and mental functions--continues to demonstrate the potent
contribution of the psyche to the function of all biological processes (Vishwanath 1996).
Some medical specialties geared to the management of human factors inherent to novel
technologies will invite specialized mind/body disciplines, including hypnosis, to enhance their
therapeutic capacity. In space medicine, for example, the possibility of applying hypnotic
phenomena to the problems encountered by space mission crews is being explored. Nausea
associated with prolonged weightlessness is a particularly disabling problem, poorly controlled
by medications. Self-hypnosis has clear potential to modify, and in many cases to abolish
space-engendered symptoms without depressing consciousness or creating side effects. It can
also assist in the adjustment to new circadian rhythms and in the attainment of deep relaxation
designed to make the best of erratic rest periods. It is conceivable, in future missions requiring
long travel time, that crew selection will privilege the ability to induce prolonged trances.
In view of these considerations, it is evident that hypnosis presents fascinating
opportunities for medical and psychotherapeutic research. Aside from these very tangible
promises, the mental mechanisms responsible for the vast array of hypnotic phenomena, once
understood, can open rich insights, not only into the most intimate connections of body to mind,
but into the nature of consciousness itself.
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2. TRANCE SCALE FOR HYPNOSIS, SELF-HYPNOSIS, AND MEDITATION: G.V.

SUNNEN
In recent years, disciplines of the mind which center upon special mental conditions to
achieve therapeutic gains have seen steady expansion. Hypnosis, self-hypnosis, and meditation
are all associated with special mental states which facilitate positive personal changes and
connect with higher dimensions of the psyche.
Medical hypnosis is increasingly recognized as a powerful healing modality with
applications in all fields of medicine. It is utilized to modulate pain, temper side effects of
medications, and to accelerate convalescence. Medical hypnosis has proven itself in its ability to
prepare patients for surgery, special procedures, and childbirth, by neutralizing anxiety and by
instilling affirmative healing imagery. Because of the fact that hypnosis allows the mind to
penetrate into the far reaches of the autonomic nervous system, investigations are under way to
determine its potential to positively influence the mechanisms of disease.
Self-hypnosis is a mental skill enabling the individual to self-guide into a trance. In this
practice, instructions are self-administered in order to orient the mind into new experiences of
awareness. In self-hypnosis, one part of the mind exercises its executive prerogatives to direct
the mind's other dimensions to travel in self- suggested directions. Self-given affirmations
progressively coax the mind to new levels of physical and mental relaxation. Meditation is a
term given to numerous practices designed to bring about harmonious control of the physical self
and the mind. Most forms of meditation draw upon the process or relaxed focused attention.
Meditative practices vary widely according to the discipline which spawned them. Focusing
upon the flow of breathing in a context of active contemplation is a central meditative method.
Hypnosis, self-hypnosis, and meditation, all have the capacity to reach special states of
the mind which center upon relaxation. Indeed, hypnosis may be called the most potent
non-pharmacological relaxant known to science. However, relaxation in this context signifies
more than the common notion of muscular repose. Relaxation may start at the level of the
neuromuscular system, but moves inwardly to involve the autonomic nervous system,
perception, cognition, the domain of emotions, and from there, the yet poorly charted highest
realms of the psyche. Each of these dimensions of relaxation is accompanied be experiential
changes which are delineated in the Scale. Hypnosis, self-hypnosis, and meditation may seem
like separate entities. On closer look and in their long term practice, however, they are found to
share common principles. Most importantly, they all can bring to light the fruits of greater
self-comprehension, relaxed self-control, existential centeredness, and spiritual blossoming.
In the context of a practice that has extended over 20 years and has passed the mark of
500 individuals treated with hypnosis, self-hypnosis, and meditation, it was thought that the
creation of a scale could facilitate therapeutic progress in several ways. The opportunity to
evaluate one's evolution into the art of producing trance is valuable in terms of stimulating
motivation and documenting the attainment of mastery. Furthermore, the items in the scale serve
to kindle awareness of trance territories that hitherto may have been overlooked.
This scale is based upon the subjective experiences of over 500 individuals who have
experienced trance. Experiences during trance states may vary widely from one individual to the
next, and within the same individual in the progression of training. By no means do the
experiences included in the Scale provide an exhaustive repertory of all varieties of trance
phenomena humans are capable of attaining. Instead, clusters of experiences have been grouped
in statistical fashion, with preference lent to those which have been observed to favor the
realization of more profound trance dimensions.
The Scale is composed of 20 subscales, each of which is graded from (0) to (5). The
goal, on the whole, is not to reach 100. Rather, it is to gauge one's progress over time. It is
usually self administered a short time after a trance experience. The experimenter, once having
exited from the trance, retroactively recaptures the elements of the trance and grades them
according to the Scale. (0) is indicative of no appreciable change from one's usual waking state,
while a reading of (5) represents a maximal change in that subscale. Nevertheless, a total score
may be calculated, which may then be depicted in graph form.
Progression in every subscale is not necessary for the achievement of trance. Frequently,
only a limited number of subscales are implicated in the trance experience; and those are the
ones that the experimenter may choose to focus upon and develop. It must be remembered that
trances, like fingerprints, manifest themselves in unique ways in every individual. The very
highest manifestations of trance, however, may prove to be universal in their expression.
The following experiences are referable to sensations usually associated with the physical
body. They include modifications of individual sensory modalities, but as trance depth
progresses, they tend to involve global bodily experiences.
GLOBAL PHYSICAL RELAXATION: This is a subjective evaluation of global
bodily relaxation. Relaxation, as an all-encompassing dimension involving all levels of body and
mind, has no boundaries.
* Perceptible relaxation of at least one part of the body i.e., the shoulders,back, arms, legs.
* Mild relaxation of the entire body.
* Substantial widespread relaxation.
* Intense global relaxation. A reading ofis paired with a statement such as, "I have never been
so relaxed in my entire life.":
Body Deceleration. The body slows down and physical tranquility expresses itself in
progressive disinclination to move and to speak. There is a gradual gravitation of the body to
stillness.
* Barely perceptible slowdown of breathing and heart rate.
* Marked slowdown of breathing and heart rate.
* Entire body feels decelerated.
* Comfortable immobility.
* Profound stillness in the context of relaxation:
Heaviness/Bouyancy. Initially, there may be feelings of either heaviness, or of lightness
(bouyancy). As trance progresses, lightness, the sensation of floating, usually takes precedence.
* Barely perceptible sensation of heaviness or lightness in arms and/or legs.
* Lightness or heaviness extends to entire body.
* Merging of heaviness and lightness into a novel sensation.
* Floating, weightless sensation.
* Sensation of airborne drifting or flying while staying still:
Breathing Awareness. The feelings linked to breathing are progressively intensified.
* Perceptible mental connection with muscles involved with breathing.
* Sensation of the air touching the inside of the lungs.
* Feelings of progressive blending with the lungs.
* Sensation of intense merging with the flow and rhythmicity of breathing.
* Feelings of energy flowing in the body with each breath: \
Body Volume: Body volume is the experience of the volume that the body occupies in
space. Eyes closed, in the normal waking state, this volume has a certain constancy. In trance,
enlargement of this volume is experienced.
* Awareness of body volume.
* Perceptible expansion of body volume.
* Continued expansion with awareness of connection between breathing and body volume.
* Body volume occupies the space of the surrounding room.
* The boundaries of the body feel like they extend beyond surrounding physical confines:
Body Configuration: The representation of the shape of the body usually undergoes
transformation during trance. In the normal waking state, eyes closed, the shape of the body is
well delineated in the mind's eye. In trance, parts merge. Arms, legs, thorax, abdomen, and head
become fused.
* Awareness of one's body configuration.
* Arms are felt in their entirety rather than in their separate elements.
* Emergence of sensations of blending of the hand, elbow, shoulder, and armmusculature into a
unified whole.
* Blending of arms and legs. Beginning merging of the extremities with therest of the body.
* Simultaneous awareness of the entire body, inside and out.
* The body, totally unified in awareness, feels like a sphere:
Temperature: Within trance, often in response to one's predilection, feelings of warmth
or coolness emerge. The experience is somewhat different from the application of a heating pad
or an ice pack. Warmth, as is freshness, is experienced as "psychic heat", or as "psychic
coolness". Either dimension may accompany progressive trance.
* Perceptible heat or coolness in one arm.
* Heat or coolness in both arms.
* Heat or coolness in both arms and legs.
* Entire body, notable sensations of coolness, or warmth.
* Merging of warmth and coolness to produce a novel sensation in entire body:
Organ Awareness: This dimension of trance is an extension of the breathing awareness
mentioned above. This awareness diffuses into all bodily spaces, and extends to organ systems
and their workings.
* Awareness of lungs.
* Added awareness of heart region.
* Added awareness of abdominal region.
* Awareness of other structures or organ systems: sexual organs, the spinal cord, structures
inside of head.
* Experience of ease of mental travel to any of the body's organ system: The following
experiences refer to perceptions usually associated with cognitive dimensions of the mind. The
mind's output of language relaxes. The flow of words ebbs. The tides of the emotions grow
quieter, then attain stillness. In deep trance, there is a pervasive sense of harmony which is
perceived as independent of thoughts, emotions, and mood.
Environment's Distancing. The perception of the environment is presence usually
constantly in attendance in consciousness, recedes. The mind's investment of energy into its
surroundings is redirected unto itself.
* The feeling of direct connection with the environment relaxes
* Beginning autonomy from surroundings is experienced.
* Surroundings feel substantially removed from attentiveness.
* Surroundings take up a minimal portion of awareness.
* Surroundings feel nonexistent and devoid of relevance:
Language Flow. The mind's usual spontaneous generation of words, thoughts, and
stream of memories relaxes.
* Increased awareness of individual words as they are expressed in their mental form.
* At times, increased word flow; most often, perceptibly lower word output.
* Diminution of word output and of sentence formation, with presence of truncated grammar
* Awareness markedly withdrawn from language.
* Complete word silence in the context of profound peacefulness, with the perception of "My
identity exists apart from my thoughts":
Sense of Time Flow. The sense of time elapsing is relaxed in trance.
* Perceptible lapses in the experience of the continuity of time.
* At times, initial increased awareness of time passing, most often followed by decrease, with
periods of absent time.
* Marked decrease in time awareness with frequent periods of silent or absent time.
* Sensation of time standing still.
* Sensation of the irrelevance of time passing, in the context of feeling enlightened by this new
perception:
Emotions/Mood: Emotions undergo relaxation in trance. Their intensity wanes, and
emotional quietude emerges. In the most profound trance the experiencing mind separates itself
from emotions. Mood, the ongoing background emotional tone, approaches, then attains a
peaceful neutrality.
* At times, initial increase in awareness of pre-trance emotional residues; most often, lowering
of emotional intensity.
* Perceptible softening of emotional tone.
* Marked emotional stillness with emerging feelings of harmony.
* Pervasive neutrality of mood with serenity.
* Disconnection of awareness from emotions and mood, with the feeling that "Myidentity is
separate from my emotions ":
Imagery/Sounds/Colors. This subscale measures the mind's potential for the creation of
imagery, which is intensified in trance.
* Awareness of eyes-closed visual inner space and/or of auditory space.
* Awareness of visual images, dream sequences, sounds, or even music is slightly kindled.
* Images begin to appear as they may do in dreams.
* Ability to hold images or sounds in the mind begins. Merging of colors and sounds to obtain
novel amalgamations.
* Images and sounds experienced contain a notion of universal significance: The following
experiences refer to perceptions belonging to what may be called the highest levels of human
consciousness. These experiences are described as transcendental and spiritual. Because
descriptive terms to denote these complex experiences are often unavailable in our language, the
experimenter is asked to intuitively grade the intensity of their manifestation on a scale of (0) to
(5).
Energy/Force: Progression into trance often leads to experiences of feelings of energy.
Energy is often described as currents, waves, or vibrations coursing through the body.
Descriptive terms include feelings of personal power, force, and vitality. In the maximal range
of this subscale, the feeling of mental energy reaches concentrated intensity:
Locus of Self. The experiencing of one's self borrows from several dimensions, some
physical, some psychological, others spiritual. This subscale gauges the feeling of self in relation
to personality as an entity which has a highly individual meaning. In trance, the personal
attachment to one's personality relaxes, sometimes profoundly. In the most intense manifestation
of this scale, it may be stated "My personality has a relationship to me, but it is not me":
Clarity/Knowledge: In this progression the central feature is a feeling of clarity of
understanding. At first there is the experience of the feeling of self knowledge. This feeling of
knowing oneself is independent of logic or outward fact. The progression continues to feelings
of knowing the world. At the most intense level of this subscale, conundrums or koans such as
"Has the universe always existed?" become understandable:
Happiness/Joy: Happiness and joy, as feelings, do not require logical reasons for their
existence. Nor do they require the process of thinking in order to be expressed. This progression
begins with feelings of enthusiasm for life, optimism, and evolves gradually to joyfulness and
elation:
Empathy/Love: This dimension of trance begins with feelings of affection, compassion,
and empathy with humankind, and ultimately, to feelings of love for all life:
Peacefulness: This progression begins with feelings of calm, evolving to include
experiences of tranquility, serenity, and ultimately, to profound feelings of peacefulness:
Oneness/Unity: The sense of oneself, in the waking state, includes the experiencing of
separateness from society and from the world at large. With trance progression, this feeling of
separateness recedes. Feelings of unification or amalgamation take its place. The usual
perspective of self-centering gives way to feelings of oneness and unity with and within all of
life:
Readers are invited to send their commentaries regarding this scale. Personal reports
related to the experiencing of any one of the dimensions of trance as outlined above, or any
others, are most welcomed. This scale is in progress and is open to ongoing evaluation and
modification. It will be modified according to the feedback given to it.
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3. HYPNOSIS AND SELF HYPNOSIS IN HEALING: GÉRARD V. SUNNEN, M.D.

[Published in Cancer Forum: Publication of the Foundation for Advancement in Cancer
Therapy, Ltd. (Vol. 18, No. 3/4)] The psychological well-being of patients, in or out of the
hospital, is of paramount importance, not only for humane considerations but for reasons
connected to health and recovery: patients do better when undergoing procedures and operations,
or when negotiating the side effects of treatments, if they are relaxed, rested, and feeling
optimistic and hopeful.
THE SCIENCE OF HUMAN ADAPTATION: The science of human adaptation to
stress and trauma is clearly demonstrating the importance of psychological factors in achieving
success. Until recently, however, assisting patients to negotiate the labyrinths of their medical
trajectories, consisted of supportive or suggestive approaches, emphasizing relaxation in any one
of its physical, psychological, and emotional dimensions. A relaxed patient, it was correctly
thought, had a better chance of being a successful patient
The new science of psychological adaptation goes a step further. Its premise incorporates
the notion that beyond relaxation, the mind, through its innate capabilities, can proactively
contribute to the organism's response to stress. Within this perspective, the successful patient is
one who can relax and, in addition , who can mobilize special mental processes to gain mastery
of medical procedures and operations from the time of their planning to full recovery.
The study of these beneficial mental processes borrows from different yet related
disciplines: namely hypnosis, self hypnosis, and meditation. In all of these disciplines tire mind
makes use of special pathways to communicate within itself.
THE LANGUAGE OF HYPNOSIS: Hypnosis extends the range of influence of the
conscious mind. To contact the unconscious mind and the deep physiological functions of the
body, hypnosis utilizes communications, which because of their special characteristics, may be
called the language of hypnosis.
Communication venues for hypnosis include affirmations and mental images. The mind
continuously creates mental images. They appear in consciousness in many varieties with wide
individual differences. Not necessarily visual in form, mental images can involve all the senses.
Images are more likely to have therapeutic impact if they incorporate emotions. Positive images
tend to be synergistic with wellness and energy; in the mind they resonate with self confidence,
self esteem, optimism, and creativity. So-called negative images which include negative
scenarios about the future and allow feelings critical of oneself, tend to be inhibitory to self
expression, enticing guilt, pessimism, and fatigue. Therapeutic mental images carefully select
their ingredients to respect the unique psychological makeup and imagery style of each
individual.
No one can say for sure why negative images exist in the first place. After all, on the
surface of things, they do not appear to do much good. Why would such depression-promoting
mental processes as negative self esteem exist if they do not (by surface observation) benefit the
organism? Whatever the admittedly complex answers to these questions, the fact remains that
negative mental images are universally observed in the human psyche. Negative mental images
find their home in the repositories of the unconscious mind and are usually absorbed through the
repercussions of unfortunate experiences and relationships accumulated during lifetime, They
can exert nefarious influence upon the process of mastering medical stress. It is helpful to
discover and understand them so they do not detract from therapeutic thrust.
Although the mind's output of thoughts, emotions memories. and images has been
likened to the continuous flow of a stream, this is not to say that the mind remains a passive
experiencer of its own creations. In this analogy, streams can be altered to change their course
and can even be played with to channel them into new territories. The executive functions of the
mind describe mental capacities that enable the evaluation of information, the direction of
attention, and the planning for future action. This executive branch of the mind can also devote
its energy to allow the type of mental images it wishes to favor and to discourage those it wants
curtailed. A closely related mental dimension, creativity, has the therapeutic capability of
spawning entirely novel thoughts and images.
BOUNDLESS NEURAL PATHWAYS FOR THE MIND: Mental events have their
corresponding resonance in the circuitry of the nervous system. Dr. W. Penfield in the 1930's,
stimulating discreet locales of the exposed brain cortex in conscious patients undergoing
neurosurgery, demonstrated how thoughts, emotions. and memories, many of which were
hitherto unconscious, could be brought into consciousness by pinpointed electrical instigation. It
was deduced, as Dr. Sigmund Freud predicted, that each thought owns its proprietary neural
circuit. While this notion is not globally false, it is equally true that each mental event has
nervous system ramifications that connect it to all other areas of the brain. Visual, auditory,
somesthetic, and the still uncharted vast association areas are all communicating neighbors.
Synesthesia describes the phenomenon of the simultaneous experiencing of different senses.
Through the existence of awesomely intricate feedback networks, every one of our nervous
system's billions of cells interactively communicates with all others.
Our grasp of the nervous system is undergoing rapid metamorphosis. Diagrams of its
anatomical and biochemical networks are constantly upgraded toward sophistication. Whereas
several decades ago only a handful of neurotransmitters -- those molecules that determine the
flow of cell to cell message transmission -- identified themselves, there are now hundreds. It is
known that the nervous system is constantly in flux biochemically and even anatomically, and
that every experience leaves an imprint unto its very fabric.
While every neuron connects in some way to every other cell in the nervous system and
projects its influence into the most delicate tendrils of its outer reaches, it also interfaces with all
organ systems from heart and endocrine, to gastrointestinal and immune. Recently, the field of
psychoneuroimmunology has gathered extensive data to show the closely interlaced relationships
of nervous and immune systems to mental functions.
Mental images, through these neural pathways, are thus able to travel from their sites of
origin to transport their messages into the entire matrix of the organism. As messengers,
therapeutic mental images have the remarkable potential to impart their beneficent influence to
the core physiology and the biochemistry that sustain, our life.
APPROACHES TO SELF HYPNOTIC SKILLS: The cornerstone ingredients of self
hypnosis are relaxation and the universal ability to construct mental pictures. Relaxation
decreases the background noise of the mind. In relaxation, the body adopts natural rhythms of
repose, and the mind allows its spontaneous creation of thoughts to slow down. Within this
tranquility, creative imagination finds opportunities for sustaining mental images that project
intensity and therapeutic direction.
Self-hypnotic communications have greater impact if they involve a variety of senses. In
so doing, they recruit more areas of the brain. Pictorial images correspond to the activity of
visual and visual association areas in the occipital lobes. Adding language or music recruits
auditory regions around the temporal lobes. Integrating movement invites participation of the
parietal lobes. Very importantly, emotions animate the limbic system and its wealth of
connections to autonomic neural networks and to the neuroendocrine system.
Certain techniques have the capacity to deepen relaxation and to heighten the impact of
mental images. Hypnosis is a special state of mind permitting the experiencing of relaxation in
its most profound realms. Awakened is a freedom of mental actions to flow beyond the confines
of the waking state. While relaxation is generally believed to be the mere dissolution of tension,
it actually embraces the most subtle attributes of human experience. Relaxation is a long
continuum comprising physical and mental components. Beyond the dissipation of tension, the
body drifts into a state where breathing slows down to become deeply abdominal; heart rate
assumes a mellifluous cadence and blood pressure decompresses; and EEG rhythms shift into
cerebral harmony. In the exploration of relaxation, the mind enters layers of feelings that
traverse calm and move into peacefulness, finally entering states that, because of their essence,
may he called spiritual. Indeed, it may be said that relaxation knows no limits in its depths nor in
its boundaries.
Self hypnosis seeks the attainment of experiences similar to those searched for in
hypnosis. As in hypnosis, deep relaxation is created and the ability to summon mental directives
is enhanced, Mental images thus achieve clarity, focus, and steadfastness, and energizing
feelings such as self confidence and self mastery are more easily conjured. In self hypnosis,
however, the individual acts both as guide and experiencer solely through the impetus of self
regulation. Self hypnosis gives patients the opportunity to develop a sense of self determination
toward their condition, With practice, the patient can become a self hypnotic virtuoso with
possibilities of gaining increasing mastery over their symptoms In meditation, a close relative of
self hypnosis the thrust for self transformation is more likely to seek the attainment of
experiences, which by nature of their universality, may be called transcendental or mystical.
A PULMONARY CANCER EXPLORATION: A persistent cough of a few months
duration increasingly irritated this engaging 46 year old realtor. When the cough became mildly
productive and took on accompanying pain, she sought consultation. The process of
investigation eventually demonstrated an egg-sized lung mass in her right upper lung. She had
not smoked for many years, a fact that added to her initial disbelief in her diagnosis. A biopsy
was inconclusive but her imaging studies were highly suggestive of a neoplasm. She would have
to undergo a surgical exploration with possible tumor excision. A thoracotomy was scheduled.
She had spoken to the surgeon but admitted that, in the throes of her emotional turmoil. she had
either omitted to ask the proper questions, or failed to process them clearly. Her mind straining
under excess anxiety had retained only the most ominous eventualities. She remembered being
told that she would be intubated during the operation and that a portion of her lung might have
to be removed. Great concern came upon her. She recalled, as a little girl, the intensity of her
fright being stuck in a smoky elevator. Would she be able to breathe freely with this tube in her
throat? How much of her lung would they take out? Could it leave her breathless subsequent to,
or even during the operation?
The procedure was explained to her once again. A diagram was drawn to show her how
the operation would proceed. There would be wide patency of breathing conduits. She was told
that the greater the relaxation of her entire respiratory system, the easier air would flow.
A method of hypnotic induction which may be called the arm drift was used. With her
permission her wrist was taken and her arm brought straight in front of her, in the image of a
piece of wood floating on a lake. Eyes closed, she was asked to let her arm float and to create the
feeling in her mind's eye that a sense of comfortable heaviness was beginning to fill it, growing
more so with each breath. As the strength of her mental image increased, it was suggested, her
arm would follow its directive. Her arm, feeling ever heavier, slowly drifted downward until it
came to rest on her lap. This pleasant feeling of heaviness could now begin to drift into her other
arm, into all her muscles, and finally into her entire body. In this way mental images were shown
how to travel into autonomic networks and she could now tap into their therapeutic possibilities.
Therapeutic affirmations were then invited to dispel her fear-laden images. She would be
calm and composed in the days preceding the operation. She could visualize herself feeling
rested in the hospital, sleeping well, and unbothered by the activity of the personnel. During the
procedure she would not fight with operative interventions but would easily move through them.
Her breathing would be cadenced and unhurried,
Everything proceeded as in the imagination's best scenario. Before the operation she
noted her surprise at her lack of any anxious concern. In the hospital, she was able to observe all
the activity around her with a mental attitude of interest, and even at times of amusement. The
surgeon had known about the relaxation training of his patient. She called the day after the
procedure to report that she had seldom seen a patient so relaxed As a consequence, she said, the
operating team was less challenged and time was saved.
In the recuperation phase, the patient used self hypnosis to accelerate healing. Initially
bothered by shortness of breath with exertion because of the resection of a portion of her lung,
she worked on building her pulmonary reserve. Pain with movement of her right shoulder due to
scar formation and the severing of nerves was modulated so as to permit gradually greater ranges
of motion. Fleeting yet persistent feelings of being a partial invalid based upon thoughts of
having a cancer diagnosis were prevented from taking hold. She progressively replaced them
with feelings consonant with her core spiritual convictions.

4. MEDICAL HYPNOSIS IN THE HOSPITAL: GÉRARD V. SUNNEN, M.D.

[Hypnosis has many applications for relieving distress in hospitalized patients. Gérard V.
Sunnen, M.D., a psychiatrist and hypnotherapist, describes the ways in which hypnotic
techniques can help patients undergo medical procedures, surgery, and rehabilitation therapy and
cope with life-threatening illness. Sunnen cites evidence from the research literature of the
benefits of hypnosis for hospitalized patients with medical conditions and presents several case
illustrations.--Editor, Journal of the Institute for the Advancement of Health]
Hospitalization, even with all available medical technology, remains a trying experience.
The same concerns, apprehensions, and fears exist today as they did centuries ago in the face of
dangers to well-being and sometimes to life itself. The psychological well-being of hospitalized
patients is, therefore, not only for humane considerations but also for reasons connected to health
and recovery: patients may do better when undergoing procedures, recovering from operations,
or surmounting the side effects of treatments if they are relaxed, rested, and feeling hopeful.
Hypnosis is a process by which an individual is guided from his or her usual state of
consciousness to a condition that is marked by psychological and physical relaxation; altered
perceptions such as the slowing down of time or a change in one's body image; and a shift from
analytic to synesthetic thinking, that is, the mind shows less dependence on logic and a greater
receptivity to sensations and feelings. The resulting change in perception and thinking is known
as a trance. The nature of the trance state varies from one individual to another.
The ability of hypnosis to induce deep multilevel relaxation, to quell anticipatory
anxiety, to increase tolerance to adverse stimuli, and to intensify affirmative imagery can be
adapted to the hospital setting for maximizing the mind's contribution to healing.
Hypnosis has recently seen a resurgence in its medical applications, with increasing
sophistication in the ways it has been used for many clinical problems, in and out of the hospital.
Equally important, modern hypnotists, in contrast to earlier ones who tended to be authoritarian
in their approach, encourage patients to determine the nature of their own experiences, that is, to
develop their unique potential in their trance. They are also mindful of psychodynamic
considerations. Thus, they use permissive and often frankly meditative methods and function as
a guide to point the way to conditions of consciousness that are conducive to psychological
adjustment and growth.
HYPNOSIS IN SPECIAL PROCEDURES: Procedures performed under local
anesthesia with or without sedation are often anticipated by the patient with the same
apprehension as those requiring general anesthesia. The idea of being conscious during a
procedure may be reassuring in one respect and unsettling in another. On one hand, the patient's
sense of control is maintained; on the other hand, the patient may feel uncertain as to how he or
she will deal with the experience. Even a simple procedure, like a spinal tap, can be approached
with dramatic imagery: the mental picture of a needle may be much larger than the actual size of
the needle. Similar distortions may also occur with regard to other procedures, such as cardiac
catheterization, bone marrow biopsy, or sigmoidoscopy.
 The anticipatory anxiety generated by the patient's fantasies about a procedure should not
be neglected. It can turn a routine stay in the hospital into a nightmarish experience and
negatively sensitize the patient to future hospitalizations.
The following case history illustrates some of the principles of hypnosis when used
in the hospital with certain medical procedures: A 52-year old woman who had never been
hospitalized was admitted for workup of a lung shadow. She was to undergo a bronchoscopic
examination the following day. When she became agitated and highly anxious, a consultation
was requested. Hurriedly wiping away some traces of tears to appear more presentable, she
looked distraught and restless in her bed. Anticipation of the procedure, which had been
explained to her in a cursory and hurried fashion, had left her in a state of panic. She imagined a
large, cold, straight metallic tube being pushed into her throat and saw herself in the agonies of
choking. Yet, on another level, she spoke amazingly candidly and rationally: "Doctor, I've been
a smoker for many years. I think tomorrow they will find that I have cancer. But I think I can
come to terms with it." The procedure was explained once more to her. The tube was
described--a picture of it was even drawn--as flexible and as leaving plenty of space for air to
pass. She was told that the more relaxed she would be, the more easily air could pass. The
benefits of deep, autonomic nervous system relaxation were evident to her, and she heartily
agreed to attempt a hypnotic experience.
Because of her high level of anxiety, an approach more directive than normally used for
outpatient office procedures was invoked. With her permission, her wrist was taken; gently and
slowly her arm was brought straight out in front of her. She was presented with images of
heaviness and relaxation, and her arm slowly waved itself downward, the hand gently releasing
itself until it came to rest on the bed. With her eyes closed, all muscle tightness disappeared; her
respiration adopted a slow, tempered rhythm; her face appeared serene and seemed to
communicate a profound peacefulness.
Once the hypnotic induction had taken place, the goal centered on achieving the most
profound relaxation possible. Then, the patient was encouraged to dispel the fear-laden images
and to replace them with images that would be more consonant with her well-being. "You will
feel the tube," he said, "but at the same time your throat and all your air passages can be relaxed,
and it need not bother you. You will have plenty of air and with each breath you can feel more
and more relaxation sweeping through you. You may in fact be so relaxed that the whole
experience will seem to be occurring some distance from you, far away. Until then, you may
find yourself thinking very little about the procedure, if at all, leaving time for you to rest fully."
The next day the patient underwent the bronchoscopy. The procedure was completed in
just a few minutes; the patient was remarkably calm throughout. The tube met so little resistance
and there were so few bronchial secretions that the surgeon called the hypnotherapist to gain a
better understanding of this phenomenon. When asked about the experience, the hypnotherapist
described how, conscious of the whole procedure and feeling peaceful, the patient had felt the
tube inside her chest, as from a distance, and had mused to herself making a game of it,
imagining it was a little train coursing through some tunnels.
HYPNOSIS IN SURGERY: The hypnotic phenomenon that perhaps inspires the most
awe involves the patient who undergoes major surgery without chemical anesthesia. According
to Moll,(4) the first surgical operations on "magnetized" subjects were those performed by
Recamier in 1821. (At that time, hypnotic phenomena were thought to be produced by the
influence of magnetized objects.) Jules Cloquet followed him in 1829, Dr. John Elliotson in
England, Dr. Albert Wheeler in the United States, and the well-known Dr. James Esdaile in
India in 1840.
It is postulated that in certain individuals through hypnotic mechanisms, a sufficient level
of endogenous agents--that is, those agents that occur naturally in the body--may be produced to
block all perceptions of pain.
However, many author point out that pain is a sensation intimately intertwined with fear
and that surgical procedures performed with hypnotic anesthesia may owe their success to the
modulation of anxiety as much as to the neutralization of pain. Since 1950, interest in
hypnoanesthesia has rekindled. Suppressed by the discovery of chloroform, ether, and nitrous
oxide for more than a century, this renewed interest has been fueled not only by the growing
sophistication in understanding hypnosis, but by new philosophies of patient care, such as the
belief that patients should have access to any treatment modality capable of easing the stress of
illness and its treatment.
It is estimated by some investigators that 10 percent of the population could undergo
major procedures with hypnoanesthesia. Others estimate the figure to he far lower. Patient
selection appears to be very important.
Adequate studies are lacking, but good candidates for hypnoanesthesia are likely to be
highly hypnotizable and especially adept at altering the processing of painful stimuli. While
probably only a small percentage of patients can negotiate major surgery using the hypnotic
trance as the sole anesthetic, a far more important percentage can benefit from the "softer" or
more subtle therapeutic influence of hypnosis, as it is applied in an integrated fashion through
the continuum of the hospitalization sequence. As such, hypnotic intervention can begin in the
preoperative period, can be continued during the operation itself, and can be maintained through
the postoperative stage to assist the patient through all phases of psychological and physical
adjustment.
As is the case with hypnosis preceding medical procedures, preoperative hypnotic
preparations center on exploring the patient's fantasies about the operation, neutralizing the
mental set of anxious anticipation, and correcting the nefarious effects of destructive imagined
scenarios. The patient is introduced to the idea of deep relaxation, taken through the steps of
experiencing the hypnotic trance, and presented with affirmative images and statements relating
to the sequence of events likely to be encountered in the operative procedure. If the medical
hypnotherapist intends to be present during the operation, this fact is mentioned before surgery
so that hypnotic contact may be more easily reestablished while the patient is anesthetized.
It has been assumed for decades that a patient in the deeper or even moderate levels of
chemical anesthesia was in a state of other-worldliness and had shed all semblance of
consciousness. However, some clinicians and researchers have reported patients who have
remembered events that occurred during surgery when they were presumed to be unconscious.
Crile reported the case of a patient receiving nitrous oxide (as well as his own case in his
autobiography) where some awareness of the environment was preserved. While nay-sayers have
attributed these reports to insufficient levels of anesthesia, reports of more occurrences of partial
awareness in documented deep anesthesia prompted studies to investigate this phenomenon.
In one study, Wilson and Turner questioned 150 postcesarean patients. They found three
patients who accurately recalled actual events and 46 who retained some dreamlike
remembrances of the operation. More recent studies have focused on the hypnotic recollection of
the operative experience, that is, asking the hypnotized patient to recall an operation.
Consciously, some patients may have little or no recall, but others--especially those who are
highly hypnotizable--are able, in the context of trance, to reexperience important events within
the operative procedure. It has been reasonably well established that such patients are attuned, in
such situations, to meaningful communications by the personnel who are present in the operating
room, especially surgeons and anesthesiologists. It is therefore possible that surgical patients
may be aware of negative comments on their progress by surgical personnel, to which patients
may react.(11) If, for example, a surgeon says, "There's a lot of blood loss here," the patient may
respond with a rise in blood pressure and increased heart and respiratory rate, making
cardiovascular instability more likely, Hypnotherapists, in anticipation of this phenomenon, may
add preoperative suggestions such as, "You will remain calm, deeply relaxed, peaceful, totally
undisturbed by any conversation around you. Your mind centers on feelings of well-being
throughout the operation."
As far as the hypnotherapist is concerned, the clinical implication of the retention of
some awareness during anesthesia is that some degree of hypnotic contact and rapport may be
established--or reestablished, if the groundwork has previously been done--during the course of
the operation, for purposes of assisting the patient adjust to its vicissitudes. It is well known, for
example, that if the patient's abdominal muscles are tight, the surgeon may order more
anesthesia. This may not be necessary if the hypnotherapist gently whispers suggestions to the
deeply anesthetized patient to relax his or her muscles.
Postoperatively, the patient who has already experienced the trance state can easily be
given suggestions for dealing with all aspects of the recovery process, including rest, comfort,
and return to harmonious biological rhythms (that is, normal appetite and sleep).
REHABILITATION MEDICINE: People who have suffered catastrophic illnesses or
accidents usually have a long journey to recovery, and may require global adjustments in life
goals, family dynamics, and self-image. Stroke victims, amputees, and individuals with spinal
cord injuries, for example, need multi-level support to help them cope with their shattered world.
Rehabilitation. therefore, is both a physical and a psychosocial process, aimed at assisting
destabilized patients to regain optimal physical competency and psychological integrity. In the
face of cataclysmic loss (of bodily function--as in hemiparesis (paralysis of one side of the
body), aphasia (impairment or loss of speech), or quadriplegia (paralysis of both arms and
legs)--the patient often questions his or her will to live. Other traumatic though less debilitating
injuries, such as the loss of a finger, can engender severe depression, withdrawal from others,
self-destructive thoughts, and a loss of self-esteem. It is clear that adaptations to such tragedies
may have as much to do with their symbolic representations as with their objective realities.
The heartening advances of rehabilitation medicine are tied not only to technology but
also to an appreciation of the complex psychological needs of patients. Staff members know how
important their self-generated enthusiasm is in mobilizing their patients' optimism and how loss
of motivation can stunt progress or foster regression. The following case history illustrates the
application of hypnosis to the difficult process of rehabilitation.
A 35-year-old executive returning late from a company meeting was injured while
driving on a rainy highway. His only memory of his accident was of being carried on a stretcher
from a ditch, with the lights of ambulances flashing. He remembered the slow realization that he
could not move his arms or legs; even worse, that the feelings in his limbs and torso had been
snuffed out. He could only move his head from side to side and sink into his quadriplegic
nightmare.
A consultation with a hypnotherapist was requested three weeks into his rehabilitation,
because he was not progressing satisfactorily. He did poorly on the tilt table, which is used for
physical therapy, and he was not eating well. This highly intelligent man talked lucidly to the
hypnotherapist about his visions of his future: he would no longer be able to work, his already
shaky marriage would crumble, and he would most likely need a full-time caretaker. With all
this against him, he asked, how could he find a reason to live? Such questions are difficult to
counter rationally. Given the premises, he had drawn his own conclusions. To tap into his
motivational reservoir, his intellectualizing network would have to be bypassed.
This man agreed to undergo hypnosis and responded to hypnotic induction. Whereas
before the accident his analytical mind may have posed a defensive barrier to induction, his
despair and wish to be helped facilitated the process. The therapist placed his thumb in the
middle of the patient's forehead, providing a sensory focus for centering awareness. With the
patient's eyes closed and with his focus turned internally toward the contact point, a count was
started. In synchrony with the patient's breathing, each number symbolized a progression into a
relaxed mindfulness, toward a state of mind freed from the incessant pressure of thinking .
During the ensuing ten treatments, hypnotic therapy was aimed at different dimensions of
his condition. Aside from suggestions of physical comfort, efforts were made to extend the range
and intensity of the patient's sensory awareness. The boundaries of his sensitivity to touch were
determined, and suggestions were given to expand them farther into his torso, as far as he could
each time, and progressively he regained some, albeit minute, sensory ground. The therapist also
guided him to experience feelings of peace and to contemplate acceptance mixed with a
willingness to try his very best to improve. Finally, the patient was asked to dissolve all negative
future scripts created by his imagination. For the moment, he would have to attend fully to his
rehabilitation therapy. To this end, he began to apply himself diligently. He graduated from the
tilt table, grew stronger, and was eventually sent home with outpatient support services.
For hospitalized patients with catastrophic illnesses, hypnotic treatment does not stop
after the first consultation. A series of treatments over time is generally effective, as in the above
example, since the goals are approached in small steps over the course of weeks or months. In
such cases, it is advantageous to teach patients the skill of self-hypnosis so that they will he able
to surmount periods of private distress, regain autonomy, and participate in their own recovery.
HYPNOTIC APPROACHES TO CANCER TREATMENT: Cancer affects a person
on many levels, from the cellular to the psychological. While the baffling varieties of its
manifestations continue to he elucidated, there is an evolving awareness of its complex
psychological dimensions. Cancer patients are likely to experience intense distress and
pain--pain from the disease itself, from its treatments, and from the deep psychological and
social changes the disease and its treatments induce.
Recently there has been a growing appreciation of the needs of cancer patients for
support, open communication, understanding, and for the sensitivity and professionalism with
which life-threatening illnesses need to be approached.
Hypnosis is used at several levels of cancer care.(5)(6)(12-14) First, it is useful as a
means of dealing with the symptoms of the disease itself: pain and symptoms associated with
specific or organ systems; and nonspecific symptoms such as fatigue, malaise, irritability, and
insomnia. Second, hypnosis may be helpful in the management of the side effects of cancer
treatments. This is very important because the side effects of chemotherapy and radiation--such
as nausea and vomiting--are often so unpalatable that they may cause the patient to drop out of
therapy. Third, cancer patients are faced with major psychological adjustments. Many view their
diagnosis with nihilism and are forced to grapple with profound existential issues. Lastly, and
still somewhat controversially, hypnosis has been aimed at modifying the course of the disease
process itself through the medium of mental images.(15)(16)
 The individual in deep hypnotic trance may experience any one of a variety of shifts in
body image. The perception of oneself in space including, if appropriate, the presence of pain,
can then be modulated by the influence of hypnosis on cognitive processes and self-perception.
"I"--the core of the experiencing self--can be asked, in hypnosis, to modify its relationship to the
feeling of pain. When contemplated, pain may take on qualities that were not immediately
appreciated. It may he perceived as sharp, diffuse, warm or cold, as having volume, shape, color,
and even sound.
Painful stimuli are recognized consciously and then elaborated into complex variegated
sensations.(17) The mind can alter or neutralize the perception of painful stimuli. The wounded
soldier continuing to engage in battle is one example of the mind's influence on pain and, by
extension, all perception.
In a hypnotic trance, the field of consciousness has the potential of having more direct
access to pain, to its associative networks in the central nervous system, and to the mechanisms
underlying its processing. Thus, "hot" pain may be made to feel cool; pain that is perceived to be
large and looming may be made smaller in volume; pain that seems oppressively close can be
made to seem farther away; and, under certain conditions, pain can be abolished altogether.
In altering or removing pain, care must be taken not to block its warning function. In the
early stages of an illness, a new sensation of pain or discomfort may be an important indicator
for revising the therapeutic strategy. In more advanced cases, this is not as relevant. The
following case history demonstrates some principles of hypnotic alleviation of symptoms due to
cancer.
A 55-year-old man with carcinoma of the left colon that had been diagnosed two years
previously was referred by his oncologist for hypnotic treatment of pelvic pain. A recent
checkup had revealed metastatic liver nodules, and a bone scan showed a solitary lesion in the
pelvic bone. He had started taking aspirin, propoxyphene, and occasionally codeine. This highly
educated man was able to appraise the complexities of his situation with composure and
open-mindedness. He did not wish to discuss death at any length. He said that he had come to
terms with death. He stated succinctly, however, that he did not wish to squander his precious
time and that he wanted to be with his family, have time to take care of certain business matters,
and be as free of discomforts as possible. His intermittent pelvic pain interfered with walking
and sexuality. Because he was very ambivalent about plans for chemotherapy and radiation, he
opted for more time to make decisions about these matters.
This patient successfully learned to experience a medium level of trance--a perfectly
workable depth of hypnotic relaxation--which was induced using an arm levitation technique.
The hypnotherapist then helped the patient achieve glove anesthesia--a phenomenon marked by
a sensor void in an area of the body, in this case a hand--was achieved. The patient perceived a
prick of a skinfold near the thumb as a faraway flicker of touch. By way of the same mechanism
and progressive extension, he was taught to induce numbness to other parts of his body. The
hypnotherapist moved the patient's numbed hand to the patient's pelvis and told him: "Imagine
the numbness and coolness in your hand, seeping through your skin, extending into your thigh,
spreading. Like rings of water on the smooth surface of a pond, concentric rings of numbness
flow as deeply as you can imagine."
The learning process, extended to self-hypnosis gave him variable relief. Sometimes he
could dispel the pain completely.
At other times, especially when his mood was low, he could obtain only partial relief.
But overall, he felt more relaxed and consequently had more energy and was more active.
 In the last few years, we have witnessed an interest in exploring the uses of mental
techniques not only to guide cancer patients to a better frame of mind, but also to influence the
disease process itself.(15)(18) Techniques span a wide array of approaches, most of which
confine themselves to visualization in the context of hypnosis and/or meditation. Reports of
positive results using these techniques are largely anecdotal. In spite of mounting evidence of
links between the mind and the neurohumoral, immunological, and autonomic nervous system
mechanisms,(18-24) the efficacy of mental techniques such as imagery, with or without the use
of hypnosis, has not been demonstrated scientifically to affect the course of cancer. There is a
need for more systematized investigations of these methods.
SUMMARY AND FUTURE DIRECTIONS: In the evolving philosophy of patient
care, not only traditional and state-of-the-art therapies, but all modalities capable of enhancing
comfort and well-being are approached with a willingness for evaluation, with a special
awareness given to the importance of psychological factors in the healing, convalescent, and
rehabilitative processes.
Today, hospitalized patients, faced with an alien environment, time constraints, and a
panoply of novel procedures, are apt to need therapeutic approaches that attend to their
psychological needs and to the human dimensions of their experience.
Medical hypnosis, a clinical science has undergone extensive conceptual evolution and
technical sophistication in recent years, is increasingly understood as a treatment modality with
the capacity to be applied, in selected situations, to a wide range of problems encountered in the
hospital milieu.
Of the phenomena potentially manifested during trance, multi-level
(psychophysiological) relaxation, the modulation of painful sensations, the alleviation of drug
side effects and nonspecific symptoms such as malaise and insomnia, the reduction of
anticipatory anxiety, and the strengthening of motivation for recovery find the most usefulness.
Lastly, and still somewhat controversially, is the application of hypnotic imaginal techniques in
an attempt to influence the neurohumoral and immunological components of healing.
As the healing process becomes more acutely appreciated as a multidimensional,
dynamic phenomenon, and as therapeutic trance states become more accepted as valuable
gateways to the enhanced communication between mind and body, medical hypnosis will
increasingly solidify its role as an agent capable of assisting the individual toward achieving
global health and well-being.
REFERENCES: Fromm E. Significant developments in clinical hypnosis during the
past 26 years. Int J Clin & Exp Hyp 1987;35(4):215-30.
Baker EL. The state of the art of clinical hypnosis. Int J Clin & Exp Hyp 1987;35(4):203-14.
Gravitz MA. Early uses of hypnosis as surgical anesthesia. Am J Clin Hyp 1988;30(3);201-8.
Moll A. Hypnotism. London: Walter Scott Publishing, 1909.
Hilgard ER, Hilgard JR. Hypnosis in the relief of pain, 2nd ed. Los Altos, CA: Kaufman, 1983.
Kroger WS. Clinical and experimental hypnosis in medicine, dentistry, and psychology, 2nd ed.
Philadelphia: Lippincott, 1977.
Lederman EI, Fordyce CY, Stacy TE. Hypnosis as an adjunct to anesthesiology. Md Med J
1958;7:192-4.
Wallace G, Coppolino CA. Hypnosis in anesthesiology. NY J Med 1960;60:3258-73.
Crile GW. Autobiography. Philadelphia: Lippincott, 1947.
Wilson J, Turner DJ. Awareness during caesarean section under general anaesthesia. Br Med J
1969;1:280.
Goldman L, Shay MV, Hebden MW. Memory of cardiac anesthesia. Psychological sequelae in
cardiac patients of intraoperative suggestion and operating room conversation. Anaesthesia
1987;42(6);596-603.
Burrows GD, Dennerstein L, eds. Handbook of hypnosis and psychosomatic medicine.
Amsterdam: Elsevier/North Holland Biomedical Press, 1980.
Udolf R. Handbook of hypnosis for professionals. New York: Van Nostrand Reinhold, 1981.
Wester WC II, Smith AH Jr, eds. Clinical hypnosis--a multidisciplinary approach. Philadelphia:
Lippincott, 1984.
Hall HH. Hypnosis and the immune system: A review with implications for cancer and the
psychology of healing. Am J Clin Hyp 1982;25(2-3):92-103.
Newton BW. The use of hypnosis in the treatment of cancer patients. Am J Clin Hyp
1983;25(2-3):104-13.
Nauta WJ, Feirtag M. Fundamentals of neuroanatomy. New York: Freeman, 1986.
Goldberg B. Hypnosis and the immune system. Int J Psychosom 1985;32:34-6
Besedovsky HO, del Rey AE, Sorkin E, et al. Immunoregulation mediated by the sympathetic
nervous system. Cell Immunol 1979; 48:346-55.
Calabrese JR, Kling MA, Gold PW. Alterations in immunocompetence during stress,
bereavement, and depression: Focus on neuroendocrine regulation. Am J Phychiat
1987;144(9):1123-34.
Irwin M, Daniels M, Bloom ET, Smith TL, Weiner H. Life events, depressive symptoms, and
immune function. Am J Phychiat 1987;144(4):437-41.
Locke SE, Kraus L, Leserman J, et al. Life change stress, psychiatric symptoms, and natural
killer cell activity. Psychosom Med 1984;46:441-53.
Schleifer SJ, Keller SE, Siris SG, et al. Depression and immunity. Arch Gen Psychiat
1985;42:129-33.
Tecoma ES, Huey LY. Minireview: Psychic distress and the immune response. Life Sci
1985;36:1700-1812.
Sunnen G. Miscellaneous medical applications of hypnosis. In: DeBetz B, Sunnen G, eds. A
primer of clinical hypnosis. Boston: PSG Publishing, 1985, pp. 221-6.

5. HYPNOSIS AND ANXIETY: GERARD V. SUNNEN

Anxiety and anxiety-related conditions are the most common psychological
afflictions of man and account for a major percentage of initial complaints to
psychiatrists as well as to general practitioners. Although it is estimated
that some 5% of the population may suffer from acute or chronic anxiety, with
women outnumbering men two to one (Cohen and White, 1950), the numbers are
probably significantly higher.
As a symptom, anxiety is a final common pathway for many conditions,
physical as well as psychological. As syndromes, anxiety disorders are under
intensive study to define more precisely their etiologies and clinical
outcomes. Recent studies, showing disturbances of lactate metabolism in
certain anxious individuals, point to the possibility that some anxiety
states, like some depressive states, have strong biological and genetic
determinants.
Hypnosis finds its most common clinical utilization in the treatment of
anxiety and its related states, not only because of anxiety's prevalence, but
because hypnosis has such a clear role as a potent anti-anxiety agent. In this
chapter, we will examine hypnotic behavioral approaches to anxiety, while
hypnopsychotherapeutic approaches will be discussed in Chapter 14.
EVALUATION OF ANXIETY: The first task of the hypnotherapist is to
evaluate the anxiety condition. At the end of the initial interview, several
questions must be asked. Is the anxiety organically determined? Is there a
medical, physiological, or otherwise somatic basis for its existence? The list
of medical conditions which, as a by-product, contain anxiety is long:
hypertension, cardiac arrhythmias, anemia, hypoglycemia, withdrawal from
sedative hypnotics (including alcohol), and caffeinism, cocaine, and
psychostimulant abuse, among others. Anxiety is also sometimes confused with
medical conditions which, in their presentation, share its expressions.
Coronary artery disease, with chest pain, respiratory distress, and cardiac
symptoms can mimic anxiety states; so can hyperthyroidism, pheochromocytomas
and Meniere's disease. The treatment, while not obviating adjunctive
psychotherapeutic or hypnotherapeutic intervention, will of course be mainly
aimed at treating the primary medical condition.
Is the anxiety an aggravating component of a chronic medical syndrome?
Most psychosomatic conditions are intimately connected to anxiety and stress.
Flare-ups of such diseases as peptic ulcer, ulcerative colitis, or
hypertension produce anxiety. Conversely, difficulties with psychosocial
adjustment bring exacerbations in these conditions. Anxiety control is
important to ease the interactive play of psyche and soma.
Is the anxiety a part of another psychiatric syndrome? Anxiety weaves
into most psychiatric syndromes. Major depression is rarely seen without it,
and so is mania. Schizophrenia, especially in the decompensation phase, as the
individual experiences ego fragmentation, can be marked by fright--as can
organic brain syndromes with their cognitive disruptions. Treatment of anxiety
in these conditions is centered on correcting the global psychiatric syndrome.
When medical conditions and major psychiatric syndromes are eliminated
as reasons for anxiety, we are left with more functional causes.
It is useful, in our therapeutic approach, to see patients' experiences of
anxiety as falling into three general categories:
(1) individuals reporting chronic, free-floating feelings of fear (generalized
anxiety disorder);
(2) individuals manifesting discreet episodes of panic, but who, in between
attacks, are relatively anxiety free (panic disorders); and
(3) mixed syndromes.
There are other syndromes which contain anxiety as a core experiential
manifestation. Phobias are differentiated by the fact that they happen in the
context of identifiable situations. They are marked by anxiety and avoidance.
Thus agoraphobia is manifested in environments where the individual feels
trapped and unable to return to safety, ie, common places include elevators,
subways, planes, tunnels and bridges. Social phobias appear in interpersonal
situations; and simple phobias are persistent, irrational fears of specific
objects or animals. Phobias may be mildly bothersome or severely
incapacitating. There are individuals who stay imprisoned in their homes
because they fear the anxiety they may experience if they venture outside.
Posttraumatic stress disorders, acute or chronic, have generalized
anxiety as a major component of a constellation of somatic and psychological
disturbances following an accident, a loss, or any other disaster.
Obsessive compulsive disorders are characterized by tension stemming
from the conscious emergence of thoughts, desires, and wishes to perform
certain actions, and attempts to deny, ignore, undo, or suppress them. When
severe, the anxiety becomes generalized, chronic, and incapacitating.
Adjustment disorders represent maladaptive responses to identifiable
psychological stressors. Predominant symptoms in adjustment disorders with
anxious mood, are nervousness, worry, and jitteriness.
HYPNOTIC TREATMENT OF SYNDROMES MANIFESTING GENERALIZED ANXIETY:
Generalized anxiety disorder (DSM-III, 300.02) is characterized by pervasive,
persistent anxiety, manifested by motor tension--strained facies, fidgeting,
restlessness, fatigueability; autonomic hyperactivity-sweating, palpitations,
light-headedness, paresthesias, upset stomach, lump in the throat, high
resting pulse and respiratory rate; apprehensive expectation--worry,
rumination, anticipation of misfortune to self or others; hyperattentiveness
resulting in distractibility, difficulty in concentrating, insomnia,
irritability, and impatience. To meet diagnostic criteria, the anxious mood
has to have lasted at least a month.
Approaches to chronic generalized anxiety, which may incorporate
hypnotic intervention, may be roughly grouped into analytic or behavioral
types. Hypnoanalytic methods will be explored in a later chapter. Behavioral
techniques do not necessarily exclude the importance of psychodynamic factors
but rather, as in the case of anxiety, treat them as incidental to the illness
itself, ie, anxiety is not a reflection of an underlying disorder, it is the
illness; as a learned maladaptive response it needs to be unlearned. In this
model, anxiety, once removed, is not replaced by other symptoms. In clinical
practice, however, it is observed that some symptoms occur in a learned
maladaptive model, others in a conflict-generated model, and the rest as
admixtures of the two. Hypnosis may be woven into most behavioral techniques.
In this way, the therapeutic potential of both disciplines may act additively,
if not synergistically.
The following methods can be applied to the treatment of the generalized
anxiety syndrome.
* Hypnotically Induced Relaxation: While neutral hypnosis already assumes
generalized relaxation, special hypnotic procedures can allow for its
amplification. The therapist will want to know the anxiety's signature in his
particular patient. Where is the anxiety in the body? With what words can it
best be described? Does it restrict breathing, speaking clearly, thought,
motor performance, or coordination? These notions are important because,
during the course of relaxation training, the therapist may choose wording and
imagery accordingly. The subject who feels, for example, a burning sensation
in the abdomen as an anxiety equivalent, may be asked to imagine sensations of
coolness to counteract it; to someone whose anxiety comes out as tightness in
the neck muscles, sensations of warmth in these areas may be suggested.
It may be explained to the patient before the induction that relaxation
is both a physical and a mental state. It is pointed out that the body, in
relaxation, feels slowed down and reluctant to move, the visceral spaces are
experienced as comfortably rested, and breathing and heart rate attain natural
baseline rhythms. Psychologically, the mind progressively feels detached from
concerns, worries, and current stressful emotions.
Asking the subject, "What would you feel like if you were totally and
deeply relaxed?" is a useful avenue to explore. In addition to misconceptions
in need of modification, the responses may point to useful avenues for
tailoring the hypnotic process to powerful preconceived notions.
Knowing that the purpose of hypnotherapy for our patient is relaxation
training, the induction is geared to maximizing it. Suggestions are given for
feelings which regularly accompany relaxation, ie, restful heaviness of the
body. Similarities are drawn to states of mind the subject is already familiar
with, which in themselves contain relaxed feelings, ie, daydreaming, reveries,
or sleep. At the end of the induction, when the subject has already achieved
significant tension reduction, appropriate deepening procedures are used.
The therapist should have at his disposal several procedures for the
amplification of relaxation. Some may turn out to be much more effective than
others; however, since there is no reliable way to predict beforehand which
deepening technique will be most efficient, a trial-and-error approach often
has to be attempted. The following techniques are commonly used to dissolve
anxiety in the context of the hypnotic trance.
* Direct suggestion. Direct suggestions for generalized relaxation in the
subject who achieves a light to medium trance is often sufficient to attain
desired results. Suggestions for total body relaxation, for letting go of
tensions, physical and mental, are most effective when rhythmically timed with
respiration.
In the same way that anxiety is experienced differently by each
individual, so is relaxation. It is important, at the end of the first
session, to ask how relaxation manifested itself. If, for example, feelings of
floating or drifting were elicited, these same feelings can be directly
searched for, brought forth, and expanded in the following sessions for faster
induction and further deepening.
* Counting method. Some individuals respond best to a counting technique.
Many variations of this technique exist. It is explained, for example, that as
slow counting progresses from 1 to 20, relaxation will become more and more
profound, 20 representing the deepest level of relaxation the subject can
attain during the session.
* Counting with imagery. Counting may be combined with imagery. For example:
"As I count from 1 to 20, you can see yourself walking down 20 steps into the
garden of your subconscious mind. In your garden, you will find wonderful
feelings of total relaxation flowing throughout your body."
Progressive relaxation. Some subjects are most responsive to a stepwise and
methodical method. Individual muscle groups are focused on, starting from the
lower extremities or from the head and neck, until all muscle groups are
relaxed.
* Autogenic training. The production of relaxation in many individuals is
facilitated by suggestions or feelings of heaviness and sensations of warmth
in the body (see autogenic training, below).
* Pure imagery. Imagery techniques for relaxation are the most idiosyncratic
of all methods. While, for example, the image of a beach may be attractively
soothing for one person, it may leave another indifferent. Preliminary
discussions will give the hypnotherapist some idea of what constitutes
positive imagery for his patient. During hypnosis, the art of giving imagery
suggestions resides in good part on the utilization of multiple sensory
modalities--in a beach image, for example, a more engrossing effect can be
created by talking about the sights, sounds, smells, and sensations one is
likely to experience in such a setting.
* Use of touch: Touch, properly used and timed, is a powerful focusing
modality for the patient. In the same way that touch may be used to induce
analgesia in parts of the body, it may also be applied to suggest deep
feelings of relaxation. For example: "As I touch your shoulder, your entire
arm becomes deeply relaxed, all the way down to your fingertips. I'll touch
your other shoulder and now your forehead; as I do, feelings of deep
relaxation begin to drift throughout your body."
* Autogenic Training: Autogenic training is a method of psychophysiological
self-education containing elements of both hypnosis and meditation. The first
of many editions of Autogenic Training appeared in 1932. Its author, J.H.
Schultz, a German psychiatrist and neurologist, was influenced by research on
sleep and hypnosis performed by Oskar Voght at the Berlin Institute some 30
years before. Voght observed that some subjects could produce in themselves
states of mind similar or identical to hypnosis by performing certain
exercises; and that these self-induced states had therapeutic value--subjects
reported improvements in well-being, disappearance of headaches, lowering of
anxiety level, and reduction of fatigue and tension. Voght called these
exercise "prophylactic rest--autohypnosis."
* Schultz streamlined the exercises. He found that most deeply hypnotized
subjects invariably experienced sensations of heaviness and warmth in various
parts of their bodies and postulated that the creation of these sensations, in
a reverse psychophysiological process, could bring about the experience of the
trance state.
A series of exercises was designed, in a format of increasing
difficulty, and their practice gathered many followers throughout the world.
The first of these are physiologically oriented, focusing on the neuromuscular
and visceral systems. Subjects are asked, in exercises of introspective
creative imagination, to produce sensations of heaviness and pleasant warmth
in the limbs--it is easiest initially to produce them in these areas--then in
the chest and the abdominal regions. Once mastered, usually after six to 12
months of training, subjects graduate to meditative exercises, which focus on
the development of certain higher mental functions.
Preliminary instructions are for the use of a quiet dimly illuminated
room, free of disturbances. The subject, in loose clothing, may adopt a fully
reclined, semireclined, or a simple sitting posture.
* First stage--eyes are gently closed. A gentle bodily introspection
eliminates obvious internal muscular tension. The sensations of heaviness of
the dominant arm, as it lies on its support, is brought to awareness. Some
people find it helpful to repeat silently "my arm feels heavier and heavier."
When heaviness is experienced throughout the arm, the same feeling is extended
into the other arm through, as Schultz described, a process of generalization;
the legs come next, the back, and the regions of the head and neck. When the
whole body is experienced as being heavy, the second stage is attempted.
* Second stage--warmth. For most people, feelings of heaviness are more
easily conjured than those of warmth. The same process used to create feelings
of heaviness is applied to feelings of warmth, first starting on one
extremity, then progressing to the whole body, except for the forehead and
temples which are imbued with sensations of coolness. Autosuggestions may
help, ie, "my arm feels warmer, pleasantly warm," and imagery may be used, "my
body feels like it is resting on the warm sands of the beach."
* Third stage--regularization of cardiac rhythm and respiration. The object
of this stage is not to seek control of cardiac rhythm, as is the aim of some
yoga exercises, but to effect a slowdown and regularity of heart function
which is congruent with total relaxation. Deep hypnotic and meditative states
are accompanied by lowered metabolic work, decreased oxygen consumption, a
slow (50 to 60 beats per minute) heart rate, and slower, more abdominal
respiration. In the practice of the third stage, awareness is centered on the
internal sensations of cardiac pulsations--a hand may be placed over the
precordium--and self-instructions are given to help these desired results.
* Fourth stage--centering on the upper abdominal region. Borrowing from
ancient meditative exercises, the subject, having mastered the previous steps,
is guided to center a relaxed attentiveness on the upper abdominal regions.
Reported effects of autogenic training. Effects of autogenic training
are subjective as well as objective. Veteran practitioners talk about a
generalized sense of well-being, feelings of energy and stamina, and relative
freedom from symptoms commonly associated with stress. Objectively, during
autogenically induced states as in meditative states, there is evidence of
autonomic and metabolic slowdown.
Jacobson's Method Of Relaxation: While Schultz elaborated his method in
Berlin, Germany, Jacobson in the United States worked towards similar goals
but through different routes. His method is based on observations that the
mere thought of a muscular action brings on electromyographic changes. This,
he pointed out, bespeaks of a direct relationship between muscular tonus and
psychological tension. For the purpose of achieving relaxation at cortical
levels, Jacobson developed a methodical technique involving the progressive
relaxation of all muscular groups in the body. Jacobson's method, for proper
execution, requires a minimum of six months of training.
Methodology. Starting from the tip of one extremity--the right hand, for
example--the individual is guided to move his awareness to the wrist, the
forearm, in deliberate succession, to cover eventually the totality of the
musculature. To help in focusing awareness and to enhance the experience of
relaxation, each muscle group is sometimes tensed, then relaxed.
Hypnosis may be used with Jacobson's or modified Jacobson's techniques
to stimulate progress. Conversely, and much more frequently practiced, are
modified Jacobson techniques used in the context of the hypnotic trance to
achieve progressively deeper states of relaxation.
BIOFEEDBACK AND RELAXATION: Through modern biotechnology, many methods
of self-monitoring have been developed and applied to the treatment of
conditions such as tension headaches, anxiety, neuromuscular rehabilitation,
enuresis, hypertension, Raynaud's disease, migraine, asthma, cardiac
arrhythmias, bruxism, and epilepsy, among many others.
Applications to anxiety control and to the learning of relaxation states
include electromyographic (EMG), galvanic skin response (GSR), thermal, and
EEG biofeedback. Due to the fact that anxiety has different manifestations in
different individuals, one physiological parameter may be much more useful for
anxiety control than another. In some subjects, for "ample, whose surface
expressions of anxiety are translated into muscle activity, EMG training will
have greater applicability than, let us say, thermal feedback.
While some individuals do well with biofeedback for anxiety control,
others have difficulty generalizing the effects of training to the totality of
their experience. Some investigators point out that certain subjects may be
able to learn deep muscle relaxation, yet continue to report significant
anxiety. Orne and Paskewitz (1974), in studying EEG feedback showed,
similarly, that patients could generate high alpha rhythm and still experience
debilitating anxiety. These results contradicted the idea that low EMG or high
alpha were always incompatible with anxiety.
Some investigators, for purposes of increasing the efficacy of
biofeedback treatment, have combined it with hypnosis (hypnobiofeedback).
Since hypnosis can facilitate restriction of the field of awareness and
promote introspective centering, it is theorize that biofeedback learning can
be enhanced and accelerated in the context of a hypnotic state. While this
turns out to be true for some subjects, it is not so for all. More
sophistication is awaited in this potentially fruitful field, since there is
still a paucity of studies using these treatment combinations.
MEDITATIVE TRAINING: In the past three decades, systems of self-training
adapted from Eastern cultures, have been practiced on an increasingly large
scale in the Western world. The process of meditative training can be seen
from different perspectives. From the viewpoint of state theorists, meditation
can be understood as a body of methods designed to guide the individual into
special conditions of consciousness. Seen from a behavioral perspective,
meditation can be conceptualized as a physiological learning process, designed
to bring about autonomic slowdown and anxiety control.
In 1935, Dr. Therése Brosse, a Frenchwoman, traveled to India with a
portable ECG machine. She hooked up her machine to a veteran meditator and
demonstrated that cardiac rhythm could be influenced by willfulness. The ECG
showed a complete volitional stoppage of the heart for a few seconds. Modern
experiments have not only replicated the above effects, but have shown
wide-ranging bodily manifestations of meditative training: a toning down of
all physiological functions (decrease in heart rate and respiratory rate among
others), and of metabolism itself (decrease in oxygen consumption and lactate
production) (Wallace 1970).
In spite of considerable interest in meditative training, there remains
some confusion in the face of the number of techniques available; there have
also been difficulties applying methods meant to be practiced in a
sociocultural context so different from our own. In the United States, most of
the experimental work has been done with transcendental meditation (TM).
In the technique of transcendental meditation, the subject sits
comfortably, eyes closed, for 20 minutes twice a day and maintains persistent
awareness of a rhythmically repetitive--usually unspoken--mantra or sound. A
universally used sound is "Om," but the word one, which has a similar symbolic
meaning, may be substituted.
Studies of TM demonstrate that it stabilizes autonomic functioning and
lowers physiological arousal. In addition to its somatic effects, TM is
reported to produce ongoing psychological changes such as the positive
restructuring of self-concepts, the attainment of feelings of inner peace, and
the stabilizing of mood. In addition, veteran meditators describe experiencing
poorly definable or describable feelings of mood states, which may be termed
states of transcendence.
To be effective, this meditative technique needs to be practiced on a
long-term basis. Studies have shown that short-term meditation is no more
effective than placebo.
RELATIONSHIP OF HYPNOSIS TO MEDITATION, SELF-HYPNOSIS, AND NEUTRAL
HYPNOSIS: In describing the subjective experience of the hypnotic trance,
mention was made of alterations in the sense of time flow and of sensations of
relative removal from the bonds of the external reality situation. Usually,
there is less or no perceived need to move physically, attention is withdrawn
from concerns with bodily motion and balance, and there is less or no need to
interact socially. Yet, in hypnosis the individual still feels a presence and
has awareness of the rapport with another person--that being the hypnotist. In
hypnosis, the elements of this relationship are intertwined with the
experience of the trance. In hypnosis, part of the patient's psyche is linked
to the hypnotist's psyche, in a process of dynamic communication. The
hypnotist may communicate with one part of the subject's self, then with
another, but there is always a bridge. In the subjective experience of the
subject, he or she is not "free." Although the hypnotist may be very
permissive, very choice-giving, the confines of the relationship remain.
Self -hypnosis brings more autonomy. The link of rapport is broken and a
more conscious part of the psyche gives suggestions to another more
unconscious part. Usually, self-instructions are fairly specific and invite or
reinforce personal change.
Sometimes the individual enters a hypnotic state and does not give
himself or herself specific suggestions or directions. This is called neutral
hypnosis, a state marked by relaxation, free-floating imagery, and dream
fragments or sequences. In neutral hypnosis, the sense of control floats,
undirected. The subject may observe and remember or not observe and not
remember. It is an unstructured trance state.
If we add one ingredient to this trance state, we have meditation. That
ingredient is directed watchfulness. The meditative trance is similar in
quality to the self-hypnotic trance. In meditation, however, the individual
starts out with no overt trance-inducing signal, but rather, the resolve to
begin, and focuses the observing ego on a part of the body (eg, the solar
plexus), a sound (mantra), a symbolic image (mandala), a spiritual feeling, or
a universal idea.
Indications for meditative training. Although, like most therapies,
meditative training has been claimed to relieve many somatic and psychological
disorders, its clearest and best documented indication is in the treatment of
generalized anxiety.
Demands of meditative training. Meditative training takes dedication,
motivation, daily practice, patience, and requires a certain soundness of mind
from the practitioner. It is not for everyone because it demands an ability to
develop a certain mind set of internal relaxed watchfulness, an ability to
learn to deal with thought intrusions, and a capacity to accept intermittent
progress.
THE FOLLOWING CASE HISTORY ILLUSTRATES THE USE OF CLINICAL MEDITATION.
A 48-year-old businessman came for treatment of anxiety. He mentioned
distressing tightness in his chest and an uncomfortable feeling of heat in the
upper abdomen. He described a clinical picture typical of a generalized
chronic anxiety disorder which he had tried to live with for over a year. He
could not recount any significant antecedent changes in his life. A complete
medical check had shown no abnormality--even his blood pressure was normal.
Surprisingly early during the course of the evaluation, he wanted to talk
about treatment options; he had done some thinking and reading on his own and
had already come to some decisions about what he did not want. He would refuse
medications and was not prepared to spend much time with analytical methods.
When hypnotic relaxation training was mentioned, he replied that he did not
like the idea of it either. Options were dwindling. He had heard of
meditation, and he felt interested and comfortable with this suggestion. The
fact that during training he would be "in control" especially appealed to him.
After a preliminary relaxation exercise--a shortened Jacobson
technique--he was asked, as he sat calmly, eyes closed, to send his awareness
into his upper abdominal region and simply to leave it there for a few
minutes. Thought intrusions, he was told, were frequent and were best dealt
with by noticing them, letting them pass, and returning to the focus of
meditation. He was asked to terminate the experience himself, at his
discretion, by simply deciding to do so. Five minutes later, he opened his
eyes. The gnawing burning feeling in his abdomen had decreased "by at least
half," and his chest cavity felt considerably "lighter." Home. practice
consisted of two 10-minute sessions a day (this form of meditation is more
demanding than TM because more thought intrusions are usually experienced).
Six weeks later, he reported a very satisfactory diminution of anxiety
symptoms with frequent periods of total clearing.
HYPNOTIC TREATMENT OF PANIC DISORDERS: The most frequently treated
phobic disorder is reported to be agoraphobia. The first episode typically
occurs in the teens or early 20s. It is so dramatically frightening that all
the details of the experience as well as the exact date of occurrence are
clearly remembered. A second episode usually occurs several weeks or months
thereafter, and increasing anticipatory anxiety, avoidance, and progressive
withdrawal develop to the point where, several years later, it is not unusual
for the patient to have assumed psychological invalidism. The patient may
remain confined, chronically fearful, and depressed. In such patients, there
is reported a much higher incidence of alcoholism, hypertension, cardiac
illness, and suicide.
Treatment of this disorder has been shown to be most successful if it is
multimodal. Pharmacotherapy may include tricyclic antidepressants, monoamine
oxidase inhibitors, or alprazolam for the panic attacks; and benzodiazepines
for anticipatory anxiety. In addition, beta blockers may be used.
Psychotherapy and family therapy address themselves to support, insight and
working through. Finally, behavior therapy and hypnosis round out the overall
treatment process. Hypnosis is used to decrease anticipatory anxiety, improve
self-esteem, raise motivation, and teach the patient that he may regain
control over the relaxation process.
SUGGESTED READING AND REFERENCES: Benson H: The Relaxation Response. New
York, Avon Books, 1975. Brosse T: A psychophysiological study of yoga. Main Currents in
Modern Thought July 1946:77-84.
Cohen ME, White PD: Life situations, emotions, and neurocirculatory asthenia. Assoc Res Nerv
Dis Proc 1950;29:832.
Deikman A: Experimental meditation, in Tart C(ed): Altered States of Consciousness. New
York, Doubleday, 1972, pp 203-223, Diagnostic and Statistical Manual of Mental Disorders, ed
3. American Psychiatric Association, 1980.
Goldfried M, Davidson GE: Clinical Behavior Therapy. New York, Holt, Rhinehart & Winston,
1976.
Jacobson E: Progressive Relaxation. Chicago, University of Chicago Press, 1938.
Luder M: Behavior and anxiety: Physiologic mechanisms. J Clin Psychiatry 1983;44(11, Sec 2):
5-10.
Langen D: Autogenic training and psychosomatic medicine, in Burrows G, Dennerstein L (eds):
Handbook of Hypnosis and Psychosomatic Medicine. Amsterdam, Elsevier/North Holland
Biomedical Press, 1980.
Morse DR, Morton S, Furst ML, et al: A physiological and subjective evaluation of meditation,
hypnosis, and relaxation. Psychosomat Med 1977;39:304-324.
Orne MT, Paskewitz DA: Aversive situational effects on alpha feedback training. Science
1974;186:458.
Schultz JH, Luthe W: Autogenic Training. A Psychophysiologic Approach in Psychotherapy.
New York, Grune and Stratton, 1959.
Seyle H: The Stress of Life, ed 2. New York, McGraw-Hill, 1976. Schuchit M: Anxiety related
to medical disease. J Clin Psychiatry 1983;44(11, Sec 2):31-36.
Voght 0: Zur Kenntnis des Wesens und der pscyhologischen Bedeutung des Hypnotismus.
Zeitschift fur Hypnotismus 1894-95:3,227;1896:4,32,122,229. Wallace R: Physiological effects
of transcendental meditation. Science 1970;167:1751-1754.
Walsh R: Meditation practice and research. J Hum Psychol 1983;23(l):18-50.

7. HYPNOSIS IN PSYCHOSOMATIC MEDICINE: GERARD V. SUNNEN

The Group for the Advancement of Psychiatry Report, Psychopathological
Disorders of Childhood: Theoretical Considerations and a Proposed
Classification (1966), refers to these disorders as ones in which there is
significant interaction between somatic and psychological components with
varying degrees of weighting of each component. This definition provides a
concept of dynamism, of interactional interdependency between body and mind
which very correctly identifies a central feature of psychophysiological
illnesses.
Certain conditions have long been known to have strong psychogenic
influence. This is the case for asthma, whose clinical description was so
accurately noted in the time of early Greek physicians. In the 20th century
and especially after 1940, a group of illnesses was identified as
"psychosomatic" in response to widespread observations that the patient's
emotional state had clear repercussions on the manifestations of the disease.
In this group were placed conditions such as essential hypertension, asthma,
ulcerative colitis, peptic ulcer, atopic dermatitis, and rheumatoid arthritis.
Since then, many other conditions have been added to the list (from the APA,
DSM-III): acne, allergic reactions, warts, urticaria, tension headaches skin
diseases such as neurodermatitis, angina pectoris, coronary heart disease,
diabetes mellitus, painful menstruation, obesity, migraine headaches,
hyperthyroidism, and hypoglycemia among others.
With our increasing medical and psychological sophistication, however,
we realize that more and more, if not all, diseases have some psychological
components. Even the common flu, for example, is well known to be more
virulent if the patient is depressed or stressed. The field of psychosomatic
medicine is especially fascinating because it directly opens theoretical doors
to issues concerning the relationship of the body to the mind.
Heinroth first used the word psychosomatic in 1817, applying it to
problems of insomnia. Freud (1900) elucidated mechanisms whereby psychic
conflicts expressed themselves in disorders of the voluntary nervous
system--the conversion reactions. Ferenczi (1910) expanded the concept of
conversion hysteria to apply it to the autonomic nervous system. Cannon (1927)
showed how different emotions produced patterns of physiological alterations,
emphasizing the importance of the autonomic network. Alexander (1934) stated
that psychosomatic illnesses were mediated only through the autonomic nervous
system--by definition--and that, in contrast to conversion hysteria, did not
have specific symbolic meanings; rather, he felt they derived from chronic
psychological states connected to unconscious drives in the context of
constitutional predisposing factors. Dunbar (1936) suggested specific
personality patterns to fit each psychosomatic disease; her approach, although
intuitively attractive, did not bear conclusive results. Deutsh (1939) and
Greenacre (1949) searched, equally inconclusively, for early putative
traumatic experiences. Seyle (1950) described the stress syndrome, emphasizing
the importance of hormonal factors. Wolff (1943) stated that physiological
changes, if prolonged, could lead to organ damage. Horney (1939) and others
postulated the importance of cultural influences. Grinker (1953) and Lipowski
(1970) championed the comprehensive, multifactorial approach to psychosomatic
disorders, viewing the patient in a holistic biopsychosocial context.
It is in this biopsychosocial concept of psychosomatic illness that
hypnosis finds its niche. To the extent that it can influence the mind-body
interaction, hypnosis can be utilized for the purpose of teaching the patient
general relaxation, somatic and visceral, for working out conflicts and for
modifying certain personality dynamics which may have aggravating influences.
Hypnosis has been used in the following psychosomatic conditions with
varying degrees of success. It must be appreciated, however, that hypnotic
success in this regard has less to do with the types of psychosomatic
illnesses present than it does with the particular patient involved.
GASTROINTESTINAL DISORDERS: The activity of the gastrointestinal tract
is intimately intertwined with emotional life, past and present. In our
language, metaphors abound connecting its functions--ingestion, digestion,
indigestion, elimination--with emotional states. "I can't stomach this fellow"
or, "he has a lot of guts" are some of the many common expressions which
attest to the role of emotions such as anger, sadness, loss, happiness, lust,
and courage, among others, in the workings of our digestive systems. In
endogenous depressions, there is lack of appetite, decreased salivation, and
intestinal peristalsis, constipation, and weight loss. Angry states are
sometimes accompanied by aerophagia, and anxious states are often associated
with diarrhea. Some individuals under stress show vomiting reactions
(psychogenic vomiting).
Alexander (1968) conceptualized upper gastrointestinal disorders as
connected, in mental life, to primitive conflicts surrounding the passive
incorporative and aggressive biting stages. He also postulated a concomitant
constitutional predisposition, as well as neuroendocrine factors, influencing
gastric blood flow.
Several clinical conditions have received a lot of attention because of
their psychological components. Indeed, when internists treat these disorders,
recommendations are often made for adjunctive psychological and/or
psychopharmacological treatment.
Peptic ulcer. This is manifested by chronic ulceration of the mucosa in
the esophagus, stomach, and duodenum. Ulcers in the duodenum are more
convincingly linked to psychological factors. It is said that the basic
psychodynamic trend in the hypersecreter-duodenal ulcer group has to do with
strong needs to be taken care of, to be nurtured, and to have close body
contact. These needs may be compensated with a character armor of
independence, self-reliance, and aggressiveness.
The hypnotherapist, in the evaluation of the duodenal ulcer patient,
will want to gain an understanding of emotional dynamics as they relate to
autonomic discharge. What unconscious emotions are experienced and how are
they adapted to? What conditions make them flare up to the extent of actually
injuring the gastric mucosa? What experiences--early and recent-contribute to
the targeting of the stomach? Hypnotherapy is aimed at the experiential
clarification of these issues and on visceral relaxation training. The patient
is shown how to recognize putative emotions early on and how to process them
more constructively, ie, through assertiveness training. Long-term
hypnotherapy goals center on the resolution and maturation of needs and
impulses--dependency, anger--and on the achievement of higher levels of
personality integration.
Wennerstrand, the Swedish hypnotherapist, reported the healing of
duodenal ulcers by the technique of prolonged "sleep" through hypnosis. This
method is, of course, impractical in modern life, but it shows how
hypnotically induced prolonged rest has antistress effects. Techniques such as
autogenic training and meditation have also claimed success in treating this
common psychosomatic condition.
Common lower intestinal psychologically influenced disorders include
ulcerative colitis, regional ileitis, and the irritable bowel syndrome. The
lower intestinal tract has rich connections to psychosexual development.
Characterological traits, unconscious emotions, and intestinal symptoms may
all be interwoven around issues of control versus lack of control, order
versus disorder, giving versus withdrawing, infantile anger and fear of
abandonment.
Ulcerative colitis. This is an inflammatory disease of the mucosa marked
by remissions and exacerbations, diarrhea, bleeding, and possible
complications in the colon and in other organ systems (hepatic, hematopoietic,
renal). Investigations of its causes, which are still unknown, are focused on
possible genetic, infectious, immunological, and psychosomatic factors.
 Personality characteristics of the ulcerative colitis patient, although
far from being universal, often sketch a patient who shows extreme
sensitivity, low self-esteem, dependency, and conscientiousness.
Psychosocial stressors are well known to exacerbate the illness. Real or
fantasized rejection, intense demands for performance--professionally or in a
relationship--disapproval or criticism, especially from important figures, all
can set the stage for a complex psychovisceral response which results in the
engorgement and sloughing of the colonic mucosa.
Psychotherapy provides a context for hypnotherapy in such patients who,
if willing, need longer-term explorative intervention. Hypnotherapy borrows
from different strategies, from direct suggestion for symptom attenuation or
removal, to the discharge of affect and abreaction, to relaxation, and finally
to the long-term goal of personality maturation.
Hypnosis can provide some--usually small but nevertheless
significant--positive influence on this complex psychosomatic condition which,
for proper treatment, needs the combined attention to medical, psychological,
and family-social dimensions of the patient's life.
ANOREXIA NERVOSA: This disorder, first called "nervous atrophy" by Rich
Morton in 1689, and given its name by William Gull in 1874, is characterized
by weight loss, intense fear of gaining weight, stubborn denial of the
illness, peculiar handling of food, disorders of the body image with intense
fear of becoming overweight, and often, hyperactivity. Gull recognized the
influence of conflicts in anorexia nervosa and recommended that the patient be
separated from the family. Theoretical approaches span from the purely
psychological--the rejection of pregnancy wish, oral sadistic impulses, fears
of sexuality--to purely genetic or biochemical ones, including hypothalamic
disorders.
Treatment of anorexia nervosa is biological, nutritional, behavioral,
family-oriented, and psychotherapeutic, and includes hypnotherapy. Only with
this multi-modal comprehensive intervention can this potentially lethal
disorder show positive response. Psychodynamic psychotherapy has not been
shown to be effective (Rollins and Blackwell, 1968; Bruch, 1970). Crasileck
and Hall (1975) report that more than half of 70 cases treated with hypnosis
showed marked improvement. Initially, suggestions for increased food intake
were given and once patients began to eat and to show stabilization of their
medical condition, explorative and supportive psychotherapy using hypnosis was
applied. In many patients with anorexia nervosa, however, there is no overt
acknowledgment of the disease and no cooperation or motivation to work
hypnotically.
CARDIOVASCULAR DISORDERS: The cardiovascular system has close, immediate
responsivity to the manifestations of many emotions. Fright is accompanied by
tachycardia, splanchnic vascular constriction, raised blood pressure, and
blood engorgement of voluntary muscles. Anger, excitement, chronic anxiety and
stress, elation, even love, have a direct bearing on the psychocardiovascular
network. Internally generated imagery also has a direct effect on heart
action. In hypnosis, where the experience of imagery is apt to be more
intensively perceived, individuals may enhance or decrease cardiovascular
responsiveness.
Essential hypertension. This is defined as blood pressure levels greater
than 160 mm Hg systolic and 95 mm Hg diastolic and accounts for 90% of all
hypertensive disorders. It appears at this time that there are likely to be
several subtypes of essential hypertension; some hypertensive conditions seem
to be more biologically mediated, while others are more dynamically connected
to emotional responses.
Personality analyses have not yielded specific congregations of traits
or intrapsychic conflicts peculiar to the hypertensive patient. The popular
notion that repressed hostility plays a major role has not been experimentally
substantiated, but there is ample clinical evidence that anger, guilt and
fear, and issues of expressing emotions versus containing them, are
operationally important. Hypertensive patients tend to respond with higher and
more prolonged blood pressure rises than do normotensives. Stress is also
implicated. Cobb and Rose (1973) found a high incidence of hypertension in
air-traffic controllers exposed to the pressures of high air-traffic density.
As with other psychosomatic conditions, comprehensive treatment
approaches derive from an awareness of the multi-causal nature of essential
hypertension. While some cases may simply respond to weight control or salt
restriction, others need additional measures such as pharmacotherapy and
psychotherapy.
Psychotherapy aims to evaluate and constructively change the
environmental impact, family interactions, intrapsychic conflicts, and
behaviors which may contribute to this maladaptive response. Since the process
of psychotherapy involves the unearthing of affect, care must be taken not to
do this too quickly or too intensively before new coping skills are learned.
Behavioral methods, including biofeedback, relaxation, meditation, and
hypnosis, are increasingly being used for the control of hypertension (Shapiro
et al, 1977). When using hypnosis, suggestions may be given for relaxation,
calm, a sense of internal peacefulness, and ease of handling such emotions as
anger. Imagery exercises may help the patient to visualize aggressive feelings
flowing away and out of his system.
RESPIRATORY DISORDERS: The breathing process represents a dynamic
interplay between voluntary and involuntary influences, reflecting the
involvement of all levels of the neuraxis from the medulla to the cortex.
Emotions play directly into the rate, rhythm, and patterns of respiration. Sad
or anxious individuals sigh; fear makes breathing shallow; relaxed states are
associated with more abdominal breathing.
The most common psychosomatic respiratory illness is asthma. Marked by
recurrent bronchial constriction, edema, and excessive secretion, the clinical
picture is manifested by recurrent attacks of dyspnea and prolonged
expirations with wheezing and coughing. During the attack, the patient usually
is tense, anxious, and frightened in the face of experiencing a lack of
availability of vital air. Symptoms may be mild and infrequent or severe and
life-threatening (status asthmaticus). Several subtypes of bronchial asthma
are being investigated. Some tend to be more clearly mediated by specific
immunological mechanisms and others by a wide range of irritants.
Psychoanalytic investigations have been enlightening in showing the
complexities of psychological factors contributing to asthma. Although no
single personality type is singled out, investigators have emphasized the
importance of the unconscious fear of the loss of the nurturing mother and
have noted the influence of antecedent feeling states of a sexual or hostile
nature.
The symptoms in some asthmatic patients are much more responsive to
psychological influences than in others. While in some, the exposure to an
allergen produces wheezing regardless of mental state, in others, stress or
upset is all that is needed to precipitate an attack. The famous case of the
glass rose, the sight of which alone brought on asthmatic symptoms, attests to
this phenomenon. Although uncontested explanations for the effectiveness of
hypnosis in asthma are lacking, clinically and pragmatically, hypnosis has had
clear success in this disorder. Many asthmatics suffer from anticipatory fear
of the next attack and, while in the throes of an attack, are panic stricken
with fears of choking and dying. Hypnosis is helpful in alleviating both
anticipatory anxiety and attack panic. It may, at some level, actually
increase bronchiolar dilatation and decrease airway resistance (Edwards,
1960). As with other psychosomatic conditions hypnosis, on a longer-term
basis, can be applied to the problems of personality integration and family
adjustment.
DERMATOLOGICAL CONDITIONS: The relationship of emotions to skin health
and distress is well known. This clear and, in some patients, very direct
pathway from the mind to the skin can be illustrated by the production,
through suggestion during the hypnotic trance, of erythema, blisters, and
urticaria. The literature also contains numerous studies dealing with the
hypnotically induced disappearance of warts. Experimental evidence suggests
that skin resistance to noxious stimuli--such as heat or irritants--may be
intensified through hypnotic suggestion, or decreased, with greater
vulnerability. Besides its applications in the treatment of warts and burns,
hypnosis has found usefulness in conditions such as ichthyosis, atopic eczema,
contact dermatitis, neurodermatitis, psoriasis, and acne rosea (Scott, 1960).
COMMENTARIES ON TREATMENT OF PSYCHOSOMATIC DISORDERS: We have seen how
psychosomatic disorders, in their close connections to the mind-body
interface, are determined by a multiplicity of factors. Emotions--most
commonly anxiety, depression, sadness, hostility, and guilt--have intimate
influence on remissions and exacerbations of these illnesses.
Characteristically, however, the complaints of psychosomatic patients remain
physical rather than psychiatric.
The comprehensive psychomedical treatment of these disorders recognizes
the multifactorial nature, the uniqueness of individual expression, and the
necessity for a combined approach to therapy. While in the acute stages of
psychosomatic illness, medical treatment is a mainstay, psychotherapeutic
measures are important to provide emotional ventilation, reassurance, and
support.
In this phase, hypnosis can be applied directly to symptom relief. In
the chronic phases or during remissions of the illness, psychotherapeutic
interventions assume primary importance, with goals centering on the discovery
of feelings, conflicts, needs, mood states, and personality dynamics which, if
worked through, can disconnect the somatization process.
Difficulties in psychotherapy have to do with patient resistance on
several levels. The hardest part of treatment may be obtaining the
acknowledgment from the patient that psychological dimensions need to be
attended to. Other difficulties include a tendency to "think somatically," a
dependency on secondary gains of symptoms, and in some patients, a possible
aggravation of symptoms and dropping out of therapy with the uncovering of
affects.
Psychological treatment, while rarely curative, may significantly change
the pattern of psychosomatic illness. Diabetics, for example, can be more
smoothly stabilized with the acceptance of diet and the regulation of
exercise; hypnotic treatment has, in some cases, led to decreased insulin
requirements. Hypertensives may similarly need lower doses of medications and
asthmatics less steroids or bronchodilators.
Hypnotic influence may be applied, in the context of medical and
psychosocial treatment, to anyone or all levels of the psychosomatic
continuum--from organ dysfunction to higher personality integration. To
general visceral relaxation, we may add the hypnotic effect on specific organ
systems. There is ample evidence that the psyche, through pathways tapped into
by hypnosis, yoga, autogenic training, and biofeedback, among others, can
positively modify the physiological functions of specific organs, ie, the
heart, skin, etc. On a different level, hypnosis can be applied to the
discovery and healthful expression of subconscious affects which directly and
symbolically alter--and destroy--specific organs. Finally, in combination with
supportive or insight oriented psychotherapy, hypnosis may help both to
accelerate the global maturation process and to transcend the funneling of
psychological energies into the soma.
SUGGESTED READING AND REFERENCES
Alexander F, French TM, Pollock GH: Psychosomatic Specificity: Experimental Study and
Results. Chicago, University of Chicago Press, 1968.
Bruch H: Psychotherapy in primary anorexia nervosa. J Nerv Ment Dis 1970;150:51.
Cannon WB: The Wisdom of the Body. New York, WW Norton, 1932. Cobb S, Rose RM:
Hypertension, peptic ulcer, and diabetes in air traffic controllers. JAMA 1973;224:489.
Crasileck HB, Hall JA: Clinical Hypnosis: Principles and Practice. New York, Grune & Stratton,
1975.
Dally P, Gomez J: Anorexia Nervosa. London, Heinemann, 1979. Deutsh F: The Choice of
organ in organ neurosis. Int J Psychoanal 1939;20:1.
Dunbar F: Emotions and Bodily Changes. New York, Columbia University Press, 1954.
Edwards F: Hypnotic treatment of asthma. Br Med J 1960;2:492. Engel G: The clinical
application of the biopsychosocial model. Am J Psychiatry 1980;137(5):535.
Ferenczi S: Further Contributions to the Theory and Technique of Psychoanalysis. London,
Hogarth Press, 1926.
Freud S: Fragment of an analysis of a case of hysteria, in Standard Edition of the Complete
Psychological Works of Sigmund Freud, Vol 7. London, Hogarth Press, 1953, p 40.
Greenacre P: Trauma, Growth and Personality. New York, WW Norton, 1953. Grinker R:
Psychosomatic Research. New York, WW Norton, 1953. Group for the Advancement of
Psychiatry: Psychopathological Disorders in Childhood: Theoretical Considerations and a
Proposed Classification. New York, Group for the Advancement of Psychiatry, 1966.
Gull W: Anorexia nervosa (apepsia hysterica, anorexia hysteria). Trans Clin Soc London
1874;7:22. Heinroth JC: Lehrbuch der Storungen des Seelenlebens oder der Seelenstorunger
under ihrer, in Behandlung, part 2, Leipzig, Vogel, 1818, p 76.
Horney K: The Neurotic Personality of Our Time. New York, WW Norton, 1937. Lipowski ZJ:
Psychosomatic perspectives. Can Psychiatry Assoc J 1970; 15:515. Morton R: Phthisiologia--or
a Treatise of Consumption, ed 2. London, Smith, 1720.
Rollins N, Blackwell A: The treatment of anorexia nervosa in children and adolescents: Stage I.
J Child Psychol Psychiatry 1968;9:81. Scott MJ: Hypnosis in Skin and Allergic Diseases.
Springfield, Ill, Charles C Thomas, 1960.
Seyle H: The Physiology and Pathology of Exposure to Stress. Montreal, Acta, 1950.
Shapiro AP, Schwartz GE, Ferguson DCE, et al: Behavioral methods in the treatment of
hypertension. Ann Intern Med 1977;86:626.
Thakur KS: Treatment of anorexia nervosa with hypnotherapy, in Wain HJ (ed): Clinical
Hypnosis in Medicine. Miami, Symposia Specialists, 1980, p 147.
Wolff S, Wolff HG: Human Gastric Function. New York, Oxford University Press, 1943.

8. HYPNOSIS IN PSYCHOTHERAPY: GERARD V. SUNNEN

The essence of psychotherapy is personal change. As a science dedicated
to alleviate emotional distress and devoted to personality growth and
individual development, modern psychotherapy brings together the findings of
many disciplines. To psychoanalysis, which has been the guiding light of this
interpersonal process for the first part of the 20th century, several new
approaches have been developed in response to society's needs and inspired
from contributions from related fields--from sociology to behavioral medicine.
The modern trend in psychotherapy, as in most fields, is increasing
efficiency. How, in the best and most streamlined way, without compromising
quality of care, can this individual's dilemmas and distresses be alleviated
in the shortest possible time? This question is as important to the patient as
it is to the therapist. Times have changed since the days when the only
quality option was the couch, five times a week, in strict analytic style.
Today, combination treatments are likely to be considered, with the idea
that one treatment need not displace another. It is not uncommon, for example,
to see a patient engaged in psychoanalytically oriented psychotherapy also be
concomitantly treated, when indicated, by psychotropic medication or
behavioral adjuncts.
It is in this context that hypnotherapy finds its most sophisticated
applications. Hypnosis, in its therapeutic infancy, was used to remove
symptoms by a direct head-on approach. Symptoms were ordered out, cajoled into
disappearing, and threatened lest they came back--which they often did. In the
early days of hypnosis, symptoms were seen as thorns and hypnosis as tweezers.
In this model, the patient had the subjective sensation that a magical cure
had been performed, that the resolution of symptoms had been done by forces
beyond his control without participation of personal resources, and that ego
strength had not been enhanced. Direct symptom removal is, however, not a
useless technique. In the right patient, at the right time and for the right
reasons, symptoms may be hypnotically banished without symptoms
substitution--especially if new experiences or adaptive behaviors are learned
concomitantly.
Today, with much greater, but undoubtedly still rudimentary,
understanding of mental mechanisms, we see symptoms and resistances in the
context of what has been called the ecology of the mind--as compromises in a
dynamic structure of forces.
Hypnosis, responding to the increased sophistication of psychological
concepts, is used as much to explore psychodynamics as it is to foster the
experience of conflict resolution, all in the interest of increasing ego
integrity.
Analytic hypnotherapy refers to a set of techniques which integrate
hypnosis with analytically oriented psychotherapy. Using the patient's trance
capacity and some of the phenomena inherent in hypnosis, from relaxation to
dream formation, hypnotherapy holds the promise of making personal change more
efficient and more rapid.
This is not to say that hypnotherapy seeks to compress in time all
phases of psychotherapy. Indeed, certain phases, especially those dealing with
the creation and solidification of human contact and rapport, need and must
have ample time. Other phases, however, can be condensed or otherwise
accelerated, without compromising clinical effectiveness. In fact, speedier
discovery of conflicts and shortened resolution time, by the impact of the
reality of positive change, often have a galvanizing effect, inspiring
patients to the possibility of further change.
The practice of hypnotherapy has no set formula. Hypnosis may be used in
the early (investigative), middle (working through), or final (termination)
stages of psychotherapy. Some clinicians use it consistently, dividing each
session into a hypnotic and nonhypnotic part; others apply it on an as-needed
basis.
Regardless of theoretical perspectives, there are certain practical
issues which must be attended to in any psychotherapeutic interchange. The
patient presents with an awareness of emotional difficulties which may be
stated explicitly or may remain couched in the most general terms. At times,
the stated complaints are not the real ones--the conscious explanation being
only a mirror of the unconscious distress, ie, the patient presenting with
tension headaches who, despite initial denial, turns out to have a depressive
condition.
The initial task of the therapist is to clarify issues at hand. Why is
this individual seeking therapy at this time? Very often, the patient does not
know. Anxiety, fears, feelings of guilt, depression, and aggressive ideation
are final common pathways to conflicts which, resurfacing now, may have long
roots in the patient's past. Clarification may happen during all phases of
treatment, from exploration of current issues in the initial sessions, to the
elucidation of more historical conflicts further on.
Sometimes, presenting conflicts are directly related to experiences
repressed for years. Clarification in such cases entails not only an
exploration of current symptoms but necessarily demands the bringing to light
of these important experiences which directly feed them. The following case
illustrates clarification by the use of a technique called the affect bridge
(Watkins, 1971), whereby the current emotion is linked to its epigenetic
center. In psychotherapy, the same technique is used when we ask: When did you
first experience this emotion? Hypnotherapy can make for shorter transit time
from current emotion to its antecedent repressed counterpart. A bomber copilot
sought help for inner turmoil, tension, and generalized anxiety which had
built up appreciably in the past 24 hours. He had just flown a mission and was
very apprehensive about leaving on another one soon. Very distressed, he
admitted having had frightening, destructive fantasies while last flying the
airplane: an impulse to punch out the control panels had left him shaken and
doubtful of himself.
This high level of anxiety prevented him from being insightful about his
situation. Searching for clues to these recent feelings, he mentioned a
personality conflict with the pilot, but could not make it account for the
degree of turmoil he experienced. His apprehension about the next mission was
all the more fueled by his need to save face--he had to fly; he could not
accept the idea of being taken off flying status and possibly being looked
down upon.
He accepted the suggestion of using hypnosis for relaxation and,
perhaps, clarification of his feelings. His anxiety level dropped off
considerably during the latter part of the induction, and deepening of the
trance left him sitting without any sign of the tremulous anxiety he
manifested when first stepping through the door. In searching for the emotions
accompanying, and hidden by, his anxiety, he was asked to go back, in mental
image, to his seat in the cockpit of the airplane. Invited to talk, he
described an insidiously escalating conflict between himself and the pilot. He
was angry, sullen, and felt violent. In hypnosis, he showed mildly strained,
reddened facies. 'When was it, back in time, that you felt similar feelings?"
After fleeting moments, he started talking slowly. He was back with his older
brother 15 years previously, playing around his family home. He was taunted by
him and a group of his friends, belittled, infantilized. Overwrought with
rage, he had gone back home, where, in privacy, he had kicked his brother's
belongings. This incident stood out as one among several similar ones.
"It is clear to you and to me, as you sit here, that the pilot, although
he reminded you of your brother by some of his actions toward you, is not your
brother. This will be very clear to you from now on, and you will, as a
consequence, act toward your colleague only as the present situation warrants;
you will not bring anything into it back from your past."
He was also given ego-strengthening suggestions, ie, enhancement of the
ability to handle emotions, development of his ability to relax and master
situations, etc. Future missions were completely uneventful and three
follow-up sessions centering on his relationship with his brother served to
free up old angers and liberate some self-esteem.
In this example, several processes were called into play during the
hypnotic intervention. The patient was led to the elucidation of current
affects. Then, through a bridging technique, he was able to age regress and to
reexperience the pictorial and emotional imagery which tied into his
conflicts. He was provided with cognitive restructuring, ie, "the pilot is not
your brother," and finally, in the context of ego-supportive measures, was
able to integrate previously unconscious material into his field of
consciousness.
Clarification of conflicts basically entails the discovery of all the
feelings that enter into them. The following case example illustrates this
process, used hypnotically, in a conflict involving the superego in its
relationship to a constellation of sexual feelings, guilt, anxiety, and anger.
An attractive young woman was brought to the emergency room by the
police. She had been wandering around the street, early in the morning, with
few clothes, no papers, and no money. She was alert, suffered no trauma, and
was clear medically. Her eyes were lucid and her demeanor appropriate; she was
tense, polite, and concerned about her situation. Especially disturbing to her
was the fact that the very last memory she had about herself dated back an
entire week when she was attending to her job as a secretary in a neighboring
city. She could talk about her life, her family in Europe, her strict
religious schooling, her immigration to the United States, in detail, but she
could not, however hard she tried, recall any of the events for an entire week
that culminated in her dramatic admission to a major city hospital.
An amobarbitol sodium (Amytal) interview could have been done at this
point. The amnesic hiatus--a week of this woman's life subtracted from the
reach of her conscious mind--could be retrieved; but as the drug leaves the
body, the amnesia returns. Using hypnosis, if feasible, is preferable because
not only can memories and their emotional connections be brought out of the
unconscious, but they can be worked with to encourage resolution.
She spoke and related well. The fact that she was in a helping
environment was clear to her. She consented to hypnosis, with assurances that
utmost care would be taken to make the experience as gentle as possible. Her
somewhat agitated state gave way to a certain torpor, as a counting method was
underway: "10, 11, 12, as we get to 20 we are more and more able to
communicate with your subconscious mind. As you may know, your subconscious is
a powerful part of your mind that contains dreams and all memories, from
childhood on. And if your subconscious mind is willing, maybe it can let us in
on some things it knows, at its own pace, for the purpose of making you feel
better, more complete and whole ... 13, 14 . . ." Hand levitation followed.
"As you sit here in deep hypnosis, and we are here with you, maybe you can
begin to think back to the time, some weeks ago, when you were working as a
secretary ..."
She began to speak. During her narrative, she was questioned, open
endedly, about the sequence of events in her recent past. At times she became
anxious and had to be guided back into relaxation before returning to her
story. She described how, in the last few weeks, she had felt alone and with
few friends. She had received an invitation to spend a day with a "family
friend," a man she had known peripherally for a number of years. To her
surprise, when she came to his home, he had prepared dinner, and to quell her
feelings of shyness and social anxiety, she readily accepted the many drinks
he offered her.
In the first hypnotic session, she could not recall the events that
transpired from dinner time to the next few hours when, in the very early
light of the morning, she found herself, half dressed, stumbling out of the
apartment into the street. An amnesic core stayed on, which, in subsequent
sessions, was clarified and eventually integrated. The forces of her superego,
fueled by her intensive education and family tradition had pushed this first
sexual experience beyond the doors of awareness, and at the same time, for the
sake of ensuring completeness, had taken a whole week of her life along with
it. Hypnotherapy was mixed with short-term psychotherapy to modify some of the
strong superego forces (by tempering their severity), to help with the
ventilation and attenuation of affect, and to restore and even enhance
self-esteem. She left the hospital two days later with all memories at her
conscious disposal.
Psychogenic amnesia is a defense and a resistance protecting the
equilibrium of the psyche from sudden overwhelming affect. Resistance, the sum
of forces resisting therapeutic change, is a hallmark of any psychotherapeutic
process, hypnotic or not, and although only few affects are involved--anxiety
being the main one-its manifestation has many faces, from coming late or
missing sessions to avoiding certain topics, from developing other symptoms to
acting out. Hypnotherapy must treat defenses as forces with a purpose and not
as static barriers in need of being broken.
In most hypnoanalytic interventions, supportive as well as insight
methods are used. Supportive measures, in this context, do not imply blanket
reassurances for the patient. Rather, they convey, first, an understanding of
dynamic forces, then a strategy of encouraging or reinforcing healthy
constructive ones and repressing or weakening those which are not. In the
above example, punitive superego forces are dampened, with a view toward
expanding the self-concept to accept the healthiness of having sexual desires.
Another facet of the therapy involves the ventilation and catharsis of
repressed affect, which although not integrative in itself, provides for
attenuation of emotion and for subsequent easier handling. Several techniques
exist for hypnotic catharsis including open, expressive catharsis; implosive
desensitization; or silent abreaction, ie, the use of projective imagery to
"see oneself" emote.
Hypnotherapy may similarly be used to treat phobic disorders, when the
phobia has a focal beginning in the patient's life. In such cases, "depth
hypnotherapy"--hypnosis to retrieve painful experiences and historical
conflicts--may be combined with more "surface hypnotherapy"--hypnosis to teach
relaxation and to control the manifestations of anxiety.
The following case demonstrates how the capacity to create dream imagery
in hypnosis may be tapped to arrive at traumatic memories. Dream induction is
often preferable to other techniques for phobia exploration because the
subject is able to protect himself from intense anxiety through a number of
different mechanisms including dissociation (the dreamer as observer witnesses
the scene) and symbolization. At the same time, dreams provide dues which,
like guideposts in a forest, weave through the barriers of defense to lead to
better understanding.
A church organist came for consultation because of increasing anxiety,
sometimes bordering on panic, during his performances. At 38, he was an
accomplished musician whose services were very much sought after. Two months
before, during a well-attended service, he remembers looking up at the high
vaults and the rose windows and feeling twinges of apprehension; his fingers
developed mild numbness, and he began to sweat. He was puzzled, and even more
so when the same feelings, more pronounced, returned during his next
performance a few days later. By now, he was clearly apprehensive. He could
not understand this novel and distressing reaction which only occurred in this
setting. His syndrome worsened and, when his anticipatory anxiety began
consistently to darken his daily activities, he sought help.
He brought up the possibility of using hypnosis himself. Clinical
experience shows that when patients do so, they are more likely to respond and
benefit from the treatment.
The induction led to deep relaxation and to a good working trance level.
Some time was spent making him aware of how deep relaxation felt within his
body. "As you sit here deeply relaxed in a soothing hypnotic trance, I am
going to ask the part of your mind that creates dreams to help us today. We
have talked about the distressing feelings you have had recently, and it would
be very helpful to know more about how they came to be. Your subconscious mind
knows about that, I am almost certain. So I'll ask that part of your mind, if
it would be kind enough to, to put together a dream that will tell us about
your feelings, using any images it wants, for whatever length of time. Please
let it do so after I count to three, and I will remain quiet until you signal
me with your right index finger (ideomotor response) that you have stopped."
 Four minutes later he raised his index finger. He was guided out of the
trance and recounted the following dream. "I was real small, maybe 7 or 8
years old and I visited our neighbor, an older woman who used to give me
candies. She gave me some, and then started singing a song, a religious song.
I found it strange because I had never heard her sing. It was getting very
noisy; I looked up and I saw the chandelier shaking, then the ceiling. I got
scared, so I cupped my hands over my ears and hid under the table."
Using this dream and free association to elucidate symbolism, we arrived
in time at the following memory: as a child of five, his mother (the neighbor
in the dream) took him to church. It was a special occasion; maybe, he thinks,
a mass for someone's death. The church was packed with people standing all
around him. He held his mother's hand as the coats, dresses, and knees of
people pressed against him. The music was loud, sonorous. It was a hot day
(loud in the dream) and even hotter inside. He felt pushed, pressed,
constricted--and frightened. He wanted to leave, to get some fresh air, some
light. He looked up to see his mother but could not, because of obstructing
faces, and instead fixed his eyes on a rose window high above. The church felt
like it was spinning; then he fainted.
Subsequent exploration revealed that he had had his first anxiety
episode, two months before, on the first anniversary of his mother's death.
When all these memories and connections fell into place, he experienced a
sense of release and relief. Given, in addition, posthypnotic suggestions for
relaxation and self-mastery, he continued in his work symptom-free and with
unhampered creativity.
The dream techniques carry a prominent position in hypnotherapy because
they can be applied to a wide range of clinical problems--from exploration of
complaints and resolution of symptoms to the task of finding creative
solutions. The hypnotized subject may be asked to create a dream during the
trance or, more open endedly, may be given a posthypnotic suggestion to have
and remember any number of dreams until the next session. Depending on the
patient, and current therapeutic demands, instructions for the elaboration of
dreams may center on the distant past, on present reality-based problems, or
on the future, ie, "as you see yourself in this future situation, how do you
imagine yourself feeling? How would you like to see yourself experiencing and
handling this event? What do you envision would be best for you?"
Symbolism, condensation, displacement, and other primary process
mechanisms in hypnotic dreams are the same as those found in sleep dreams. In
hypnotic dreams, however, some degree of volitional control and guidance may
be applied in the context of hypnotic rapport so that, if need be, the patient
may be asked to redream about the same conflict, to use different, perhaps
more understandable symbols, to remember the dream clearly, and to be
insightful about its meanings.
Clarification of the presenting dilemma sometimes is the only treatment
needed as is exemplified in the following case. A highly successful
50-year-old marketing specialist came to be treated for an ill-defined sense
of unhappiness. Although happily married with two children doing exceedingly
well, productive and financially rewarded in his work, he had had, for several
months, a sense of following a path in life "that is not quite right." He made
the following analogy "I feel I am on a fast moving train but that maybe I
should be on another." Sifting the details of his life failed to bring up
solid reasons for his sense of disquietude; in addition, he showed no evidence
of any psychiatric or medical disorder. He mentioned that recently he had
published his third article in a fiction magazine, and he had remarked, with
some wonderment, on finding himself more interested in European history than
at any time in his life.
A man with a flair for new experiences, he readily accepted a trial of
hypnosis for purposes of clarification of these vague feelings of unhappiness.
"I would ask you, as you sit here in hypnosis, to bring up some of the
feelings we have been talking about, and for you to approach them and
experience them even more than you have so far (affect enhancement), so that
you, can describe them better. Maybe this feeling of unhappiness contains
other feelings. If it does, look at them with an eye on identifying them more
and more clearly. If at any time you want to say something, please do;
otherwise, I'll just stay here quietly while you search . . .
He said nothing. Minutes later, a smile came across his face, which some
seconds later left an imperceptible glow of contentment. After exiting from
hypnosis, he was asked about the meaning of his smile. He described that
moment of smiling as one of discovery; his dilemma was understood--not
resolved, but understood. He clearly saw how he was trapped by success. He was
living his life much too much as he "should be," "should" referring to the
expectations of all those around him, reinforced by the tangible evidence of
his proficiencies. He always had strong leanings to devote energies to
writing, only to be stifled (well meaningly so he admitted) by his parents who
pushed his business career. He was afraid to rearrange his priorities. Would
he lose the interest, respect, and support of those around him if he tried to
be even a part time writer? Could he possibly make a transition to what was
closer to his heart, writing, yet be equally successful?
He had had, as is not uncommon, an "ah ha" experience during hypnosis.
Although he may have had this realization by himself in his own time at some
point in the future, in psychotherapy or not, hypnosis provided the context
for several discongruent dimensions of his life to be suddenly perceived as a
"whole." In this case, one hypnotic session provided him with what he wanted.
He eventually reached a solution of compromise, cutting down his job
responsibilities progressively, and at the same time, writing and getting
published.
This case illustrates the growing attention to what may be called
problems of personal meaning or existential worth. It is increasingly realized
clinically that a wide range of human problems are generated by frustrations
to the creative expression of the drive for individual meta-significance.
Hypnotherapy may be called upon to deal with more complex patterns of
mentation and behavior which, unlike delineated symptoms, have diffuse
ramifications for the personality, permeating, often destructively, the
patient's life pattern.
Ego state therapy (Watkins, 1979), based on the contributions of Federn
(1952), sees patterns of behavior and experience as manifestations of ego
subsystems which have a certain autonomy and internal consistency. Unlike
multiple personality disorders, which have relatively rigid boundaries, ego
states are more loosely integrated into the total personality. Yet, as
structures of drives, fears, wishes, cognitions, and experiences rooted in
their own developmental stages, they have the power to influence the final
common pathways to behavior.
When a patient is to be treated with ego state therapy, it is helpful to
begin with an exploration of these concepts in the waking state, with mention
that the hypnotherapist, during hypnosis, may ask to communicate with some
subparts of the personality. Often, concerns about having multiple
personalities are raised by the patient; but differences should then be
brought out, including the fact that many of the expressions of ego states are
already known to the patient.
A computer-science student sought therapy for reasons that she could not
clearly define in the first sessions. Especially bothersome to her, yet
somehow comforting, was her lifestyle. At 28, she found herself alone most of
the time, experiencing intense feelings of separateness. She worked out her
schedule so that she was up most of the night and attended some classes in the
late afternoon. The idea that she was sabotaging relationships was not new to
her. At times, she would have a series of several dates; but when a male
relationship became important to her, she started "behaving erratically,"
leading predictably, to its dissolution.
Explorative psychotherapy led to discussion about her family life.
Having lived alone for over 10 years, she recalled with anxious sadness the
turmoil between her parents. Her much older sister had already left the
household. She brought back images of her parents fighting constantly, her
father and her mother threatening to leave each other, and her comforting her
mother who, often crying in her room by herself, would tell her what a
crucifixion marriage was. She also tried to placate her father so that he
would calm down enough to stay in the family.
In her daily routine, she felt alone and painfully awake in the early
hours of the morning, dealing with gnawing sensations of internal void and of
bitterness mixed, all too rarely, with fleeting hope. There was maybe, she
would tell herself, a reason for all this, a way out, and a promise of a more
normal life. This is how she sought therapy.
Agreement was made for exploration with hypnotherapy. She reached medium
to deep hypnotic trance levels. 'Could you let us know [notice the use of "us"
to reinforce the idea of a therapeutic alliance] if some of the feelings we
have talked about in your daily life have connections with the experiences you
had in your family as you were growing up?" It didn't take much time for her
to nod yes. "I know it may be a little uncomfortable for you to do so, but let
us, if you would, go back to that time, so we can retrieve some experiences,
some feelings that can help our understanding of you, some memories that will
help you eventually to feel better and happier."
Within a few moments she started talking. She placed herself in the
middle of a heated argument between her parents. Each threatened the other
with instantaneous departure. Frantically, yet unable to do much, she tried to
ease their threats. What if my mother left, or father, or both? I would be all
alone (like I am now, living out what I dreaded most).
She was asked to give this part of her, the one caught in this
triangular family scenario, a name. First she said "the mediator." Later, she
changed it to "the savior" (of the family), and later, in subsequent sessions,
she called it "the frightened little girl."
The "frightened little girl" carried with her a vision of relationships
wrought with tragedy. In hypnosis, she was able to answer questions, almost as
a separate entity, about her own likes, dislikes, fears, and fantasies. In
adult life, when a relationship became intimate, the "frightened little girl,"
through subconscious mechanisms, was able to alter total behavior, making the
patient erratic"--emotionally labile, irritable and angry, suddenly sullen. In
hypnosis she said "If it goes any farther, I will be faced with the same
situation like with mom and dad."
In ego state therapy, these subparts of the patient are not told to go
away or to stop their bothersome activities. From their perspective, these
semiautonomous ego states are looking out for their welfare and existence,
presumably in the interest of the whole person. Instead, efforts are made for
their fears and wishes to be expressed and understood, and in turn, for them
to understand, albeit in their own primitive ways, how certain changes could
benefit all parties involved.
The cases and the commentaries above give the reader an idea of the
tremendous range of applicability hypnosis has in the psychotherapeutic
context. One should not remain, however, with the impression that hypnotherapy
is a magical royal road to mental health. Like any other therapeutic
intervention, it has to deal with the fabric of the patient's character
structure and the various defensive forces along the way. There are also
failures of hypnotherapy, stemming from misperceptions or misconceptions of
patients' problems. Even Erickson writes of a seemingly innocuous hypnotic
suggestion which set back therapeutic progress for three weeks. He asked a
young woman "to see the loveliest thing you ever saw in your life," and she
recreated her mother's lovely face in the aftermath of a fatal automobile
accident.
Hypnotic phenomena, however, much like snow tires on an icy road, can be
applied to therapeutic traction, helping many phases of psychotherapeutic
work, from the exploration of the past and resolution of the present to the
shaping of one's future directions.
ERICKSONIAN APPROACHES TO HYPNOTHERAPY: There are many ways to integrate
hypnosis into psychotherapy, and many more are undoubtedly awaiting discovery.
One integrative approach which has received a lot of attention derives from
the work of Milton Erickson whose teachings of clinical hypnosis have been
noted for their creativity and their attention to complex human psychological
dynamics.
Erickson's style and methods of dealing with the hypnotic situation were
unique and innovative enough so that the title "Ericksonian approaches to
hypnotherapy" is clearly warranted. His beliefs were opposed to all strictly
formulated theories for psychotherapy, with or without hypnosis (Moore, 1982).
For him, theoretical constructs of human mentation and behavior were unduly
restrictive and inhibited the therapist's awareness of the unique individual
to individual interactions between himself and his patient. No one
psychotherapeutic encounter is identical to the next; indeed, each moment of
psychotherapy is unique in its own right.
Erickson did not have a personality theory into which the patient could
fit. Rather, it was the other way around; he developed a personality theory
for each patient, taking account of the patient's private way of processing
life. Even his use of the terms "conscious" and "unconscious" were
personalized to the patient. Rather than adhering to a Freudian topographic
model, he preferred to think of the conscious in the dynamic context of the
unconscious, with both dimensions being accessible to the many levels of
interpersonal communication.
In view of the fact that these techniques require integration into the
personal style of the therapist, a high degree of skill and intuitive
understanding, they are not for the beginner. They are, first and foremost,
strategies of psychotherapy to which hypnosis may be judiciously applied, and
for this reason, a "how-to" explanation could not do them justice. Although
the art of his craft poses challenges to the observer, in view of the
complexities of the hypnotic interaction, the lack of controls, and the
uniqueness of each individual patient treated, certain concepts may
nevertheless be extracted from his work which, when integrated, become the
essence of his therapeutic illuminations.
Erickson used formal induction in less than 10% of his cases. Instead,
he infused the important elements of induction into the stream of
interpersonal communication. In the trance, the individual's locus of self
moves from external to internal realities.
The therapist observes and experiences the patient's mode of
communication on as many different levels as possible--verbal, nonverbal,
emotional, styles of imagery, cognitive functioning, and "enters" the
patient's frame of reference, ie, his interpretation of reality, internal, and
external. The therapist gradually modifies the patient's cognitions and
behaviors so that the resulting change will be experienced by the patient as
self-benefiting and ego syntonic.
To move with and around the critical observing and defensive ego,
various techniques may be used, usually unobtrusively, and integrated into the
casual conversation. Confusing the logical mind, much in the same way as the
"koan"--the insoluble riddles of Zen--opens the way for new perceptions
outside the patient's ordinary frame of reference. Surprise statements,
paradoxes, and double binds jolt ordinary perspectives and call for novel ways
to consider solutions. Indirect approaches sidestep ego vigilance, and
focusing awareness on different sense modalities opens doors to the use of
other mental areas (the right hemisphere for example).
Symptoms and their connected defensive forces are approached with
respect and with the understanding that they represent purposeful, albeit
maladaptive, compromises. The aim of hypnotherapy, or of all psychotherapy for
that matter, is for the patient to incorporate symptoms into his field of
control, in ways that will benefit growth, maturation, and happiness. Symptoms
are then "mastered" and may be recreated or let go at will. To this end,
different techniques may be called upon. Symptom prescription allows the
patient to approach dreaded or distasteful symptoms with less fear or
repulsion and to establish some jurisdiction over when, where, and how
strongly or weakly they appear. The patient may then be asked to practice
experiencing a mood, a feeling, or performing certain behaviors that already
exist, or even to encourage the continuation of a symptom that appears to be
waning. Prescribing the symptom to its worst extreme or to the absurd carries
the process even further.
Defenses and resistances, as parts of the symptom complex, are similarly
handled, sometimes encouraging them, sometimes challenging them, always in a
style that is nonrigid, fluid, and adaptive. One is reminded of the Japanese
method of psychological and physical training, Aikido, where force is not met
with counterforce but is allowed to spend itself or to be diverted to new
directions.
Many of Erickson's therapeutic results have yet to be adequately
explained, their mechanisms comprehensively systematized, and their outcomes
replicated. This is an example of how the clinical practice of hypnosis
differs from laboratory analysis, how techniques relate to their craft, and
how theory has yet to account for the uncharted areas of the human mind.
SUGGESTED READING AND REFERENCES:
Ader R (ed): Psychoneuroimmunology. New York, Academic Press, 1981. Bommer K,
Newberry BH (eds): Stress and Cancer. Toronto, Hogrefe, 1981.
Cangello VW: Hypnosis for the patient with cancer. Am J Clin Hypn
1962;4:215-226.
Dash J: Hypnosis with pediatric cancer patients, in Kellerman J (ed):
Psychological Aspects of Childhood Cancer. Springfield, Ill, Charles C Thomas,
1980.
DiGiusto EL, Bond HW: Imagery and the autonomic nervous system: Some
methodological issues. Perceptual Motor Skills 1979;48:427-438.
Erickson MH: Hypnosis in painful terminal illness, in Haley J (ed): Advanced
Techniques of Hypnosis and Therapy: Selected Papers of Milton Erickson, MD.
New York, Crune & Stratton, 1967.
Hall H: Hypnosis and the immune system: A review with implications for cancer
and the psychology of healing. Am J Clin Hypn1982/1983;25(2-3):92-103.
Hilgard ER, Hilgard JR: Hypnosis in the Relief of Pain. Los Altos, Calif,
William Kaufman, 1975.
Hoffman E: Hypnosis in general surgery. Am Surg 1959:5:163.
Kubler-Ross E: On Death and Dying. London, Macmillan, 1969.
Meares A: Meditation: A psychological approach to cancer treatment.
Practitioner 1979;222:119-122.
Melzack R, Torgerson W: On the language of pain. Anaesthesiology 1971;34:50.
Newton B: The use of hypnosis in the treatment of cancer patients. Am J Clin
Hypn 1982;25(2-3):92-104.
Redd W, Rosenberger P, Hendler C: Controlling chemotherapy side effects. Am J
Clin Hypn 1982/1983;25(2-3):161-172.
Rogers MP, Dubly D, Reich P: The influence of the psyche and the brain on
immunity and disease susceptibility: A critical review. Psychosomat Med
1979;41:147-164.
Sacerdote P: Hypnosis and terminal illness, in Burrows G, Dennerstein L (eds):
Handbook of Hypnosis and Psychosomatic Medicine. Amsterdam,
Elsevier/North-Holland Biomedical Press, 1980, pp 421-440.
Sachs LB: Hypnotic self regulation of chronic pain. Am J Clin Hypn
1977;20:106.
Simonton OC, Mathews-Simonton S, Sparks TF: Psychological intervention in the
treatment of cancer. Psychosomatics 1980;21:226-233.
Spiegel H, Spiegel D: Trance and Treatment: Clinical Uses of Hypnosis. New
York, Basic Books, 1978.
Sternbach R: Clinical aspects of pain, in Sternbach RA (ed): The Psychology of
Pain. New York, Raven Press, 1978.
Zeltzer L: The adolescent with cancer, in Kellerman J (ed): Psychological
Aspects of Childhood Cancer. Springfield, Ill, Charles C Thomas, 1980.

9. HYPNOTIC APPROACHES IN THE CANCER PATIENT: GERARD V. SUNNEN

Cancer is a multisystem illness, involving all levels of the organism,
from the cellular to the psychological. While the baffling varieties of its
manifestations continue to be elucidated, there is a growing awareness of its
complex psychological dimensions. Of most humane concern is the intense
travail and the varieties of pain cancer patients are likely to experience --
pain from the disease itself, from its treatments, and from the deep
intrapsychic and social changes it induces. Recently, there has been an
expanding appreciation for the varied needs of cancer patients: needs for
support, openness of communication, and understanding; and for the sensitivity
and professionalism with which issues of death and dying need to be
approached.
Hypnosis finds applications at several levels of cancer care. First, it
is useful as a means of dealing with the symptoms of the disease itself: pain
and symptoms referable to specific organ systems, and nonspecific general
symptoms, ie, fatigue, malaise, irritability, and insomnia. Secondly, hypnosis
is useful in the management of the side effects of cancer treatments. This is
very important because side effects of chemotherapy and radiation are often so
uncomfortable that they may cause the patient to drop out of therapy. Thirdly,
cancer patients are faced with major psychological adjustments. Many view
their diagnosis as a death sentence and are forced to grapple with profound
existential issues. Hypnosis has a place in helping with this difficult
situation. Lastly and somewhat controversially, hypnosis has been aimed at
modifying the course of the disease process itself through the use of imagery.
While the first three applications are of proven clinical efficacy, the last
has mostly anecdotal support. It will be briefly mentioned, however, because
of its current interest and for the fact that it raises interesting issues for
research.
Hypnosis in Management of Cancer Symptoms: Symptoms attributable to
cancer are as varied as its subtypes. Pain, the most common symptom aside from
fatigue, is highly variable. Some patients with advanced disease report no
pain at all, while others suffer from it at the onset. Pain may be dull,
constant, diffuse, and related to motion, or it may be sharp, localized, and
lancinating. The hypnotherapist will want to know about the history of the
pain, its distribution, quality, and evolution, in addition to details about
its context in the patient. Is the patient anxious? Depressed? Are there
associated symptoms producing concern or worry, ie, difficulty in breathing,
swallowing, or walking?
There is a relationship between pain and anxiety. Usually, one will feed
into the other, making both worse. If the patient is feeling despair, pain is
experienced as more unbearable and hopelessly endless.
Paying attention to the contextual milieu of cancer pain may suggest
adjunctive treatment strategies, such as evaluation for a trial of
antidepressant therapy or for the addition of antianxiety medications.
In altering or removing pain, care must be taken not to block its
warning function. In the early stages of the illness, a new discomfort may
herald metastasis and may be important for purposes of changing therapeutic
course. In more advanced cases, this is not as relevant. The following case
history demonstrates some principles of hypnosis use in symptoms due to
cancer.
A 55-year-old man, with a diagnosis of left colon carcinoma made two
years previously was referred by his oncologist for hypnotic treatment of
pelvic pain. A recent check-up had revealed metastatic liver nodules, and a
bone scan showed a solitary lesion in the right pelvic bone. He had started
taking aspirin, propoxyphene and, occasionally, codeine. This highly educated
man was able to appraise the complexities of his situation with aplomb mixed
with open-mindedness. He did not wish to discuss the issues of his death.
Those, he said, were clear to him, and many of the feelings he had could not,
in his estimation, be communicated adequately. He felt that to do so would be
a squandering of his precious time. He stated succinctly, however, that he
wanted to be with his family, have time to take care of certain business
matters, and be as free as possible of discomfort. His intermittent pelvic
pain interfered with walking and with the sexual aspects of his life. Very
ambivalent about plans for chemotherapy and radiation, he opted for more time
to make a decision about these matters.
He was successful in achieving a medium trance with the arm levitation
technique. By gently and repeatedly touching his right hand with a finger and
associating suggestions for numbness and coolness (some patients prefer
warmth), glove anesthesia was induced. A prick of a thenar skinfold was
perceived by him as a faraway flicker of touch. He was told that, by way of
the same mechanisms that removed the sensations in his hand, he could induce
numbness in any part of his body. His numb hand was brought to rest on his
right pelvis. "Imagine the numbness and coolness in your hand, seeping through
your skin, extending into your body with each breath, as if you've touched the
smooth surface of a pond, and see the concentric rings spreading out in all
directions. Please keep your hand there until the numbness is clearly all
through your pelvis." His hand, after three minutes, lifted off. "Your ability
to repeat this process will stay with you, and you will be able to use it on
your own by learning self-hypnosis."
The relief he obtained was variable. Sometimes he could dispel the pain
completely and could walk comfortably for up to half an hour. At other times,
especially when his mood was low, he could obtain only partial relief. But
overall, he felt more relaxed, consequently had more energy, and was more
active. He later applied self-hypnosis to help himself cope with chemotherapy.
Techniques of Pain Relief in Cancer: It is well documented that hypnosis
has significant potential for alleviating cancer pain, and when used
adjunctively with analgesics, serves to reduce their dosage. The following
approaches may be used singly or concomitantly in any patient, depending on
hypnotic aptitude.
Direct suggestions for pain removal Some patients respond adequately to
direct suggestions that the pain will diminish in intensity to the point of
becoming unnoticeable. There is some controversy as to whether the word "pain"
should be used during hypnosis or be replaced by a euphemism such as
"discomfort." There is no proof that either approach is superior.
Glove anesthesia with extension As in the case above, hypnotic focusing
on a part of the body, ie, the hand, is sometimes helpful for the production
of sensory alterations. Once the experience is established in the hand, it is
only a small psychological step to transfer it to other parts of the body.
Altering the configuration of pain: The representation of pain in the
mind -- the pain "body image" -- may be compressed to occupy a "smaller
space." Neurophysiologically, this corresponds to a shutting down of
association networks. Suggestions are made for the pain to decrease in size as
the patient is asked to visualize the pain as a three-dimensional shape in
space, shrinking progressively.
Altering the qualitative aspects of pain As pain fibers project from
thalamic nuclei through diffuse thalamic radiations to corrical areas, they
become associated with the process of experiencing. The feelings within the
experiential process are unique to each individual and are malleable by
cortical influences. Hypnotic intervention may be able to change the quality
of the pain, to associate it with coolness or warmth, or numbness, in order to
make it less insistent and less immediate.
CONTROL OF ANTICIPATORY ANXIETY: Anxiety acts synergistically with pain.
Anticipatory anxiety -- the anxious sensation that pain may worsen --
heightens the dolorous experience. Helping the patient relax, both at the
moment and for the future, can provide significant analgesia.
IMAGERY: With some individuals, hypnotic absorption in imagery is the
best antidote for pain. The type of imagery to be used with a particular
patient will depend on their eidetic style (visual, auditory, somesthetic) and
on their personal experience (happy, uplifting, "high" memories). The
hypnotherapist obtains an impression of the imagery potential of the patient
during the preinduction interview and feeds back appropriate images during the
trance.
Dissociation: Dissociation is a very important and effective mechanism
by which the pain may be experienced as an event moving away from the locus of
awareness. "It is there but it doesn't feel like it belongs to me," is a
common comment from subjects adept at dissociation.
HYPNOTIC TREATMENT OF CHEMOTHERAPY SIDE EFFECTS: Particularly bothersome
for some patients are certain side effects of chemotherapy. Sometimes, in a
simple conditioning paradigm, a patient will become so sensitized by the
aftereffects of the first treatments that subsequent sessions, or even the
thought of them, bring about great autonomic distress. Typically, a
nausea-vomiting response occurs one to two hours after the injection of
antineoplastic drugs, and it is estimated that at least 25% of chemotherapy
patients manifest such respondent conditioning.
Conditioned anticipatory emesis can make chemotherapy excruciatingly
unpleasant and contributes directly to
patients dropping out of treatment.
Antiemetics are usually marginally
effective and have side effects of their
own.
Hypnosis has been well documented to have therapeutic potential for
conditioned anticipatory emesis. The following case illustrates some of the
treatment principles in this condition.
A man of 26 with stage three Hodgkins disease was receiving combination
chemotherapy (doxorubicin, bleomycin, vinblastine). Although physically
tolerating this regimen well, he became increasingly distressed by nausea
following his treatments. Experienced for the first time less than one half
hour after the first treatment, it had worsened each time. At the third
treatment, he was reporting significant nausea as well as anticipatory anxiety
several hours before treatment was started, and described how the mere
picturing of the doctor's office had brought him waves of autonomic distress.
At the fourth treatment, the feelings had brought on repeated vomiting.
Antinausea drugs (prochlorperazine, trimethobenzamide) were unsuccessful, and
he was referred for hypnotherapy.
Induction using a standard arm levitation method was followed by medium
trance. An ideomotor technique was used to signal degrees of internal
discomfort. Every time nausea was experienced, his right index finger moved
sideways on the armchair cushion. When it was relieved, he moved it back
towards his other fingers. To counter nauseous feelings, sensations of hunger
were elicited. A history was obtained of his favorite foods, restaurants, and
memorable gastronomical experiences; associated feelings of appetite and
hunger were hypnotically rekindled. By small steps, he was asked to imagine
the sequence of events characteristic of a typical treatment session, and
feelings of hunger were repeatedly reinforced. When nausea appeared during the
process, suggestions were given for total relaxation until it disappeared.
During the third session, he was able to visualize himself receiving treatment
with no comfort. In the actual treatment situation, he experienced only mild
nausea but no vomiting, and he was able to finish his entire regimen protocol.
HYPNOTIC APPROACHES TO DRUG-INDUCED NAUSEA: Relaxation Inducing deep
feelings of relaxation is an effective antinausea treatment. Deep relaxation
induces a slowing down of peristalsis and a toning down of autonomic
hyperactivity. Many patients, by relaxation alone, will significantly decrease
the intensity of their experience of nausea. Direct suggestions for the
removal of nausea are often of marginal effectiveness. Because nausea stems
from massive and extensive autonomic discharge, it tends to be difficult to
dispel. Some individuals, however, will easily respond to simple suggestions
for its dissolution.
Using hunger as an antidote Feelings of hunger and the physiological
changes that they produce are neutralizing to nausea. Direct suggestions for
hunger sensations are made, sometimes using the patient's favorite food, or
foods served on special holidays. When the patient is actively nauseous, it is
usually best at first to induce a deep state of relaxation, then to introduce
hunger imagery.
Imagery: For some subjects, imagery remains the most effective pathway
for autonomic control. Images have the property of beckoning the subject's
awareness away from negative experiential states to positive ones. Conjured
images of significant positive experiences, or of fantasized idealized
settings, may lead the patient into experiencing feelings that are
incompatible with distress.
Systematic desensitization: This is perhaps the longest method but it is
the most consistently successful, especially in refractory cases. The patient
needs to be motivated to participate in this, at times, somewhat tedious
procedure. Relaxation, or relaxation with suggestions of hunger, gradually
paired with a narrative of the treatment situation, from its most neutral to
its most adverse conditions, until the latter can be experienced, in the
imagination, in a more acceptable context.
Dissociation: Some individuals are very adept at hypnotically pushing
nausea away from direct experience. It can then be felt as distant, "barely
touching me," or as a tolerable annoyance, thus defusing the gnawing immediacy
which may lead to an emetic response.
Sensory alteration: Suggestions may be given for the nausea to change in
quality to make it less stressful. Having' the patient imagine drinking a tall
glass of icy water, feeling the sensations of soothing cold seeping through
the chest and abdomen, can take the edge off the burning sensation nauseous
patients are apt to experience.
HYPNOSIS IN TREATMENT OF PROBLEMS PERTINENT TO CANCER PATIENTS: We have
talked about the applications of hypnosis in the care of the outward
manifestations of cancer: pain, fatigue, insomnia, and treatment side effects,
among others. Beyond these surface symptoms lie deeply personal, intrapsychic
issues. The cancer patient is usually experiencing great inner turmoil and is
working with massive personal readjustments. While modern treatment procedures
have lightened the ominous implications of a cancer diagnosis, many patients
are directly thrown into difficult issues of dying and death.
The hypnotherapist needs to develop a personal philosophy of death,
especially as it relates to dealing with patients, and needs to elicit,
understand, empathize, and respond to the complex manifestations of death
anxiety. Before hypnotherapy begins, especially if it is aimed at helping
intrapsychic adjustments, illness and patient must be understood in their
relationship to each other. Sometime during the first interview, several
questions have to be examined. What is the reality of the patient's clinical
situation? How does he fit into the social-familial milieu? To what extent has
the patient incorporated the diagnosis and its implications? How much denial
is being used? What are his strengths and adaptation potentials? What are the
patient's philosophies, wishes, aspirations?
Kubler-Ross (1969) delineated five psychological stages of dying:
denial, anger, bargaining, depression, and acceptance. It is well recognized
that these stages, which may occur as sequelae of any poignant loss, are
highly variable in each patient, may not happen in this sequence, and may
often manifest themselves concurrently. Some dying individuals use denial
until death; others accept, then deny; others spin into a catastrophic
depression or mobilize themselves into a frenzied angry rebellion. The dying
patient often experiences a multitude of feelings, many of which are poorly
describable. The sensitive clinician should be alert to feelings of hope,
bitterness, alienation, envy, self-blame, love for life, dependency, and
existential despair, among many others. Rare is the individual who accepts
death with wisdom.
HYPNOTIC APPROACHES TO PSYCHOLOGICAL ADJUSTMENTS TO CANCER: Cancer
patients are commonly prone to certain feelings and coping mechanisms. Besides
anxiety, which is universal, there are feelings of helplessness and loss of
control; feelings of alienation and aloneness; feelings of guilt -- that
somehow their forbidden impulses have brought about this great misfortune; and
feelings of loss of self-esteem -- that somehow they have proven to be supreme
failures .
Before proceeding with hypnotherapy, one must have a clear idea of its
goals. This will be influenced by the therapist's own approach to death. For
some, it is to help the patient look straight on at reality and to map out a
rational course of action. Some physicians indeed, in a counterphobic stance,
like to "lay it on the line" with a clear breakdown of prognosis, sequence of
probable events, and even approximate time of death. Other physicians, as a
way of giving in to their own anxieties, are adept at skirting the issues even
if confronted directly by their patients.
The goal of hypnotherapy is to maximize the quality of life, to bring
comfort, sustenance, freedom from stress and pain, and to work out meaningful
family communications. It is important for the therapist to respect denial and
work with it, not against it; to acknowledge the legitimacy of the patient's
angers; to identify the losses that are faced; to offer ongoing emotional
support, yet not give false hopes; to discuss issues relating to personal
meaning; to acknowledge the patient's wishes and rights to remain in control
by providing choices about treatment; to identify misconceptions the patient
may have; and to help set obtainable goals and maintain a hopeful attitude
towards achieving them. It is important for the therapist to "be with" the
patient at all times and to stay on the lookout for personal reactions which
mitigate against the patient's welfare: anxiety, annoyance, withdrawal, or
feelings of hopelessness.
Hypnotic approaches to treatment will necessarily be geared to these
goals. Very often, hypnotic alleviation of pain and regulation of
physiological functions (digestion, insomnia) will bring about marked
psychological recovery. The following hypnotic techniques may be used in the
context of total patient care.
Inducing relaxation and teaching self-hypnosis The patient's experiences
of a state of mind (hypnosis) containing profound feelings of relaxation,
peacefulness, tranquillity, and freedom from worry in the context of a
positively altered state of consciousness can be very uplifting and
inspirational. Practicing self-hypnosis to recapture these feelings of
relaxation further adds to a sense of inner mastery.
Ego strengthening Feelings of guilt and self-blame, hopelessness, loss
of self-esteem, alienation and aloneness, dejection and hurt, and
helplessness, which are so commonly experienced by cancer patients, can be
directly countered by suggestions reaffirming the integrity of the self-image.
Strengthening repression: A 28-year-old man with malignant melanoma
complained that the oppressive thoughts of the reality of his cancer were
constantly with him. "Doctor, there isn't ten minutes that I'm not thinking
about it. I can't enjoy myself, I can't live." Hypnosis was used to expand
these "free" periods from ten minutes to hours, and to help him suppress and
repress the constant insidious thoughts of finality. He was then much more
able to enjoy each day for itself.
Imagery: Imagery may be used to strengthen adaptation mechanisms, induce
positive feeling states, brighten self-esteem, speed adjustments to stresses,
foster acceptance of the illness, focus on realistic goals, decrease
anticipatory anxieties, ease hurt, anger, and alienation, and to bolster
feelings of self-control and hope. Visualizations of many different types are
woven in with appropriate suggestions. Effective images are often created by
the patient and the hypnotherapist, working as a dyad. The patient will
usually communicate, verbally or nonverbally, his preferences for certain
kinds of imagery. Through rapport and intuitive understanding as well as the
exploration of different themes, imagery becomes fitted to the patient. Scenes
of seashores, mountains, underwater places, or fantasized lands may be as
absorbing as the personal memories of peak experiences. Through the medium of
hypnotic imagery, the patient can learn to transcend many of the negative
cognitions he may have built about his condition.
OTHER USES OF HYPNOSIS IN CANCER CARE: Recently, there has been an
interest in imagery not only to guide cancer patients to better frames of
mind, but to influence the disease process itself. It is postulated that
imagery, through connections with neurohumoral mechanisms, has indirect
influences on the immune system. Strengthening the immune system, in this
holistic approach to the mind/body problem, could slow down the progress of
cancer. Anecdotal case reports tend to support the beneficial influence of
imagery. Longitudinal studies, however, have yet to be carefully designed.
The following case history provides an example of this kind of imagery
usage in cancer. Although results cannot, of course, be held conclusive, the
technique serves to illustrate an important therapeutic function: it can give
the patient the sense of playing an active role in the treatment of his cancer
and can be instrumental in developing a feeling of being in charge of the
situation.
A 30-year-old woman studying the performing arts noted a small nodule in
her left armpit. She preferred not to think much of it. Three months later she
woke up in the middle of the night with pain in her axilla radiating to her
breast. She received surgery as well as radiation and chemotherapy for
carcinoma of the breast. She coped well with some nausea and hair loss and was
stabilized. Although there was no evidence of metastasis, she became
increasingly worried about this possibility. She came for consultation for the
specific reason of learning imagery techniques and with strong motivations to
do everything in her power to vanquish her cancer. She had attempted
visualization exercises with the help of a therapist, which consisted of
imagining white globules, symbolic of her healthy defenses, fighting off black
particies, symbolic of cancer cells. She had the conviction, however, that
with the help of hypnosis, she could create more effective imagery. This in
fact happened. Her eidetic potential was stronger, more "real" in the context
of trance.
In medium to deep hypnosis, she repeated the exercise but came to
realize that it did not feel right for her -- she did not like the idea of
fighting, even though it was only globules. Because of this philosophical
penchant, it was suggested that she create an image of a glow, a light, or
sunlike aura, to see and feel it enveloping her, growing in intensity with
each breath until she could actually feel warmth throughout her body. The
symbolism was clear but it was nevertheless discussed to make it more
meaningful: light, she said, for her symbolized life, and had the property to
outshine everything, including cancer. She felt comfortable with this imagery
and has continued to use it daily in self-hypnotic practice. It gives her a
feeling of self-control and inner peace because she is actively participating
in her own health care.
SUMMARY: The adjunctive hypnotic treatment of cancer may be directed to
any level in the spectrum of its manifestations. Physical symptoms of cancer,
the most common of which is pain, and the physical effects of its treatment
(weakness, nausea, and vomiting) may be modified to render daily living more
palatable. Hypnosis may also be woven into psychotherapy to assist in the
uniquely personal adjustments each patient has to make to his illness.

10. HOW HYPNOSIS IS CLINICALLY UTILIZED TO ADDRESS THE SPECTRUM OF CANCER'S

PHYSICAL AND PSYCHOLOGICAL DIMENSIONS: GERARD V. SUNNEN
INTRODUCTION: Medical hypnosis is a science increasingly recognized for
its therapeutic applications. Applied to the comprehensive treatment of
cancer, medical hypnosis offers unique possibilities due to its capacities for
enhancing mind to body communication. This article describes how hypnosis is
clinically utilized to address the spectrum of cancer's physical and
psychological dimensions.
ABSTRACT: Adjunctive hypnotic therapy in cancer may be directed to many
levels of its manifestations. Physical symptoms of cancer, the most common of
which are pain and fatigue, and the physical effects of its treatment may be
alleviated to enhance quality of life. Hypnotherapy can significantly help
patients through medical procedures and operations. Hypnosis may also be woven
into psychotherapy to assist the uniquely personal adjustments facing each
individual. Self hypnosis allows patients to actively contribute to their
treatment. Finally, hypnosis and self-hypnosis may be recruited to stimulate
healing spiritual discoveries.
HYPNOTIC AND SELF-HYPNOTIC APPROACHES TO COMPREHENSIVE CANCER CARE:
Cancer is a multisystem condition, involving all levels of the organism, from
the cellular to the psychological. While the baffling manifestations of its
varieties continue to be elucidated, there is an ever-growing awareness of its
complex psychological dimensions (Benjenke, 2000; Steggles, 1997). Of most
humane concern are the intense travail and the spectrum of adjustments cancer
patients are likely to face - adjustments to the condition itself, to its
treatments, and to the poignant intrapsychic, family, and social changes it
may induce (Kubler-Ross, 1969).
In hypnosis, an individual is guided from their usual state of
consciousness to an experience marked by multi-level relaxation. In this
special state of consciousness, novel perceptions may be experienced, such as
feelings of enhanced communication with one's body, of the slowing down of the
passage of time, and of shifts from analytic to synesthetic thinking, thus
allowing the mind greater interaction with sensations and feelings (Sunnen,
1999). In self-hypnosis the individual acts both as a guide and an
experiencer. Through the use of self-oriented directives, progressive
relaxation can bring about states of mind and body where, within the
background of profound repose, mental images, healing emotions, and
therapeutic affirmations can exert beneficent actions (Fromm and Kahn, 1990).
Hypnosis and self-hypnosis find applications at several levels of cancer
care. Firstly, it is useful as a means of dealing directly with the symptoms
of the condition: pain and symptoms referable to specific organ systems, and
nonspecific symptoms such as fatigue, malaise, and insomnia. Secondly,
hypnosis is useful in the management of the side effects of cancer treatments.
Thirdly, cancer patients are faced with major psychological adjustments. Many
pair their diagnosis with existential demands for the reframing of life
priorities. Lastly, and somewhat controversially, hypnosis has been aimed at
modifying the course of the disease process itself through the use of imagery,
and via the therapeutic potential of special states of mind, which may be
called meditative or transcendental.
HYPNOSIS IN MANAGEMENT OF CANCER SYMPTOMS: Symptoms attributable to
cancer vary according to its etiology. Pain is the most common symptom aside
from fatigue. Hypnosis has been amply documented to be a potent pain modulator
(Chaves, 1994; Hilgard and Hilgard, 1994; Holroyd, 1996; Lynch, 1999; Peter,
1996; Schafer, 1996). There is a synergistic relationship between pain and
anxiety, and pain and depression. The following case history demonstrates the
role of hypnotherapy in modifying symptoms associated with cancer.
A stockbroker with a diagnosis of colon carcinoma established two years
previously was referred by his oncologist for hypnotic treatment of pelvic
pain. A recent examination revealed metastatic liver nodules, and a solitary
lesion in the pelvic bone. Ambivalent about plans for chemotherapy and
radiation, he opted for more time to make a decision about these matters. He
achieved a hypnotic trance with an arm levitation technique. This technique,
like many others, recruits the ability of the mind to experience imagined
sensations. He raised his arm in front of him in the image of a piece of wood
floating on a lake. Eyes closed he could imagine lightness and buoyancy
filling his arm, as would a light gas lifting a balloon. "Let those buoyant
feelings move your arm upward and gently toward your face." His hand gently
touched his face, then rested on his thigh. In the same way that he was able
to imagine lightness, he could conjure feelings of numbness in his hand.
"Imagine a cold breeze from a snow-capped mountain coursing through your
hand." A pinch of a thenar skinfold was eventually perceived by him as a
faraway flicker of touch. "The numbness in your hand can travel into your
thigh, as if touching the smooth surface of a pond; you may be able to
visualize the concentric rings of numbness spreading within your body in all
directions. This ability now becomes your own, and you will be able to use it
in self-hypnosis."
The relief he obtained was incontrovertible. Sometimes he could banish
the pain completely and could walk comfortably for an hour or so. At other
times, especially when his mood was low, he could gain only partial relief. He
felt significantly more relaxed, reported more energy, and clearly enjoyed his
heightened capacity for pain-free activity.
States of mind reached in hypnosis often have the property of ushering a
propitious milieu for experiencing insights. "Eyes closed, your body can
contact its deepest rhythms and your mind can drift into the endless expanse
of relaxation. Opening doors to the vast knowledge within you, you can let
your unconscious mind offer you insights about how best to proceed with your
medical treatment."
Through this exercise, he gained clear perception to undertake
chemotherapy. He successfully applied self-hypnosis to modulate its side
effects. He also recruited self-hypnosis to heighten energizing feelings of
optimism and self-esteem, which robustly assisted him in his medical
trajectory.
TECHNIQUES OF PAIN RELIEF IN CANCER: When used adjunctively with
analgesics, hypnosis can serve to reduce their dosage (Pinnell, 2000). The
following approaches may be used singly or concomitantly in any patient,
depending upon their hypnotic proficiencies (Edwin, 2001).
HYPNOTIC RELAXATION. Hypnosis may be described as the most potent
non-pharmacological relaxant known to science. An important mechanism of
hypnotic pain reduction centers upon its remarkable property for quelling
anxiety in any one of its myriad expressions. Anticipatory anxiety - the
anxious sensation that pain may ominously appear or worsen - may be so
relentless that it creates its own anxiety. Relaxation can significant assist
analgesia and enrich quality of life (Levitan, 1999).
DIRECT SUGGESTIONS FOR PAIN REMOVAL. Some patients easily assimilate
direct suggestions that the pain will diminish in intensity to the point of
becoming unnoticeable. In spite of psychoanalytic assertions that symptom
removal necessarily implies symptom substitution, it is often gratifying to
observe patients responding unequivocally to such suggestions as: "Your mind
has the capacity to let go of the discomforts and the pains you have been
experiencing. With each breath, let discomforts give up their intensity to the
point where they lose their power, and possibly even vanish."
HAND ANESTHESIA WITH EXTENSION AND DIFFUSION. The hand is ideally suited
as a starting point for hypnotic anesthesia because it is so richly endowed
with sensory innervation and occupies such a prominent place in the cortical
homunculus. Once the anesthetic experience is established in the hand, it is a
relatively small step to transfer it to other parts of the body. Altering the
configuration of pain. The representation of pain in the mind - the pain's
body image - may be reconfigured to occupy a smaller space in the mind's eye,
therefore assuming less experiential presence. Neurophysiologically, this
corresponds to a shrinking of cortical association networks. Suggestions are
made for the pain to decrease in size as the patient is asked to visualize the
pain as a progressively dwindling three-dimensional shape in mental space
(Hammond, 1990).
Altering the qualitative aspects of pain. As pain fibers project from
thalamic nuclei through diffuse thalamic radiations into cortical association
networks, they gather complex nuances of experiencing. Pain is a multisensory
dimension malleable by cortical influences. Hypnotic intervention, by the
medium of recruitment of cortical overide, is thus able to change pain's
qualitative expressions. Pain may be paired with coolness, warmth, heaviness,
or other sensory modality, in order to soften the sharpness of its impact.
IMAGERY. With some individuals, hypnotic imagery is the most effective
pathway to pain control. The type of imagery favored depends upon the
patient's eidetic style. The imagery proclivities of the patient are noted in
order to match imagery style with appropriate suggestions (Hammond, 1990).
"Imagine a garden richly endowed with beautiful vegetation bathed in sunlight.
The garden represents the forces in your mind. You notice some plants that do
not appear to fit in this space. They represent your discomforts and your
difficult symptoms. As you approach this unwanted vegetation you can begin to
decide ways you want to deal with them."
DISSOCIATION. Dissociation is an effective mechanism by which the pain
may be experienced as moving away from the locus of awareness (Rainville et
al., 1999). " The pain is not sticking to you. It begins to disconnect from
your body, traveling outward, moving with each breath further and further into
the distance; so far that it may even feel that it no longer belongs to you."
HYPNOTIC TREATMENT OF CHEMOTHERAPY SIDE EFFECTS: Particularly
bothersome for some patients are certain side effects of chemotherapy.
Sometimes a patient will become so sensitized by treatment after-effects that
even the thought of subsequent sessions brings about great autonomic distress.
Hypnosis has been well documented to have therapeutic potential for
conditioned anticipatory emesis (Genuis, 1995; Marchioro, 2000).
The following case illustrates some of the treatment principles in this
condition. A 26 year old graduate student with stage three Hodgkin's disease
was receiving combination chemotherapy. Although physically tolerating this
regimen, he became increasingly distressed by post-treatment nausea. During
the third treatment, his nausea became so bothersome that he inquired about
other treatment options. He complained of anticipatory anxiety and described
how the mere picturing of the doctor's office had brought him waves of gastric
turmoil.
Induction made use of the hypnotic technique of awareness of breath, an
ancient discipline central to many practices of meditation. Eyes closed, he
was asked to dispatch his feelings into his breathing and open his perception
to the sensation of air touching the inside of his lungs. An ideomotor
technique signaled degrees of internal discomfort. When nausea was
experienced, his index finger moved sideways. When nausea was relieved, he
moved it back. To counter nauseous feelings, sensations of hunger were
elicited. Did he like the fresh taste of mint? What were his favorite foods
and memorable gastronomical experiences? He imagined a typical treatment
session gradually pairing treatment scenarios with intestinal comfort.
Dissociation strategies were used to repel nausea further and further away in
mind space. During the third session, he was able to visualize himself
receiving treatment with no distress. In the actual treatment situation, he
experienced only mild nausea but no vomiting, and he was able to gracefully
finish his entire regimen protocol.
Hypnosis in preparing patients for medical procedures and operations
Cancer patients, in their medical trajectories, are likely to encounter a
variety of diagnostic procedures and operative interventions. Confronted by an
expanding array of medical tests and complex surgical options, the mind often
reacts with perplexity and apprehension.
Hypnotic techniques are used to reduce anticipatory worry and to
regulate sleep and other biological rhythms, thus saving the organism's energy
reserves (Kessler, 1996; Montgomery, 2002). Post-hypnotic suggestions ñ
affirmations designed to actualize themselves at a future time ñ can express
themselves during the operative procedure so as to stabilize physiological
parameters, even while anesthesia is administered (Eger, 1999).
Postoperatively, hypnotic intervention aims to accelerate the physical and
psychological task of convalescent healing (Holden Lund, 1988)
HYPNOTIC APPROACHES TO PSYCHOLOGICAL ADJUSTMENTS TO CANCER. A panoply of
emotions is regularly encountered in the psychological response to cancer.
Aside from anxiety, which is universal, there can be feelings of helplessness,
anger, alienation, aloneness, guilt, low self-esteem, hopelessness, and loss.
Hypnotherapy, to be maximally effective, relies heavily upon empathic
emotional understanding between patient and hypnotherapist. The following
hypnotic techniques can be helpful in achieving psychological harmony.
LEARNING RELAXATION, LEARNING SELF-HYPNOSIS. Relaxation, in its deeper
realms, contains feelings of peacefulness, tranquility, and a profound sense
of centeredness. Learning and practicing self-hypnosis to kindle these
feelings can promote a satisfying sense of self-mastery. Ego strengthening.
"Please send your feelings into a place in your mind we may call your personal
force. It contains strength, self-confidence and energy." Hypnotic ego
strengthening encourages all the positive feelings that invigorate the
personality is adaptive functions (McNeal and Frederick, 1993).
STRENGTHENING REPRESSION. A 28-year-old man with malignant melanoma
complained that the oppressive thoughts about his cancer were constantly
present. "There isn't five minutes that I'm not thinking about it. My mind is
glued to my diagnosis to the point that it's hardly possible for me to live."
Hypnosis was used to gradually expand minuscule "thought-free" periods from
minutes to hours and to increase the ability of unconscious mechanisms to
repress anxiogenic thought intrusions.
 IMAGERY. The most effective images are usually the ones formulated by
the patients themselves, and these are often best arrived at by the conjoint
efforts of the hypnotherapist and the patient working as a dyad. Recently,
there has been an interest in imagery not only to guide cancer patients to
better frames of mind, but also to influence the disease process itself. It is
logical to assume ñ and it is well documented - that imagery, through its
cortical connections with neurohumoral networks, has far-reaching influence on
immune system function (Hannigan, 1999; Kalt, 2000; Miller et al., 2001;
Ruzyla-Smith et al., 1995; Walker, 1998).
The following clinical story provides an example of this kind of imagery
usage in cancer. The technique serves to illustrate an important therapeutic
function, namely giving the patient the sense of playing an active role in the
management of their condition. A performing artist noted a small nodule in her
armpit. Three months later she woke up during the night with pain in her
axilla radiating to her breast. She received surgery and chemotherapy for
breast carcinoma. Although there was no evidence of metastasis, she became
increasingly worried about this possibility. She came for consultation for the
specific reason of learning therapeutic imagery. She had previously attempted
visualization exercises imagining white globules, symbolic of her healthy
defenses, fighting off dark particles, symbolic of cancer cells. She reasoned
that hypnosis could intensify imagery. This, in fact, was so. Her eidetic
potential was stronger, more "real" in the context of trance.
In hypnosis, she realized that the exercise did not feel right for her -
she did not like the idea of fighting, even though it only involved globules.
" If so, allow your unconscious mind free reign to offer you images that
symbolize your healing forces." After some time in hypnotic contemplation she
described a gentle current imbued with a greenish glow coursing through her,
intensifying with each respiration. With practice, she developed a solid
conviction and solace that this life current could energize all her organ
systems, including her immune functions.
CONNECTIONS BETWEEN HYPNOSIS AND SPIRITUALITY. The commonly observed
psychological responses to end of life issues may be seen as adaptations of
the ego to the possible end of the ego. Once the individual has traversed
these psychological passages, what comes next? What lies beyond the ego's
relationship to its own end?
The human psyche has the capacity to experience myriad states of
consciousness (Austin, 2000; James, 1935; O'Brien, 1964). Some contain
perceptions of oneself which, by the nature of their essence, may be called
spiritual or transcendental. Still relatively unexplored, these may become
manifested in the practice of disciplines such as hypnosis and self-hypnosis,
and may be called upon, in the example of cancer patients, to the task of
reaching new level of personal adjustment (Hornyak, 2000). Psychotherapy ñ
including hypnotherapy ñ to be maximally effective, is best practiced when it
touches upon the mind's highest functions (Karasu, 1999). The following
history illustrates the spiritual dimensions of hypnotic intervention.
 A librarian's gynecological symptoms prompted diagnostic tests revealing
ovarian cancer. Within the space of a few months she had experienced
chemotherapy and had weathered the travails of adjusting to her diagnosis.
Knowledgeable about many subjects, she was intrigued by the health benefits of
hypnosis. Interesting to her, was the potential of hypnosis to help her with
her practice of meditation, a closely related discipline she had started some
months before her diagnosis. Now, she felt compelled to explore it.
Her hypnotic induction centered on the creation of feelings of heaviness
and warmth in one arm with subsequent extension to the rest of her body
(Schultz, 1956). Pairing these sensations with breathing awareness, she knew
she entered trance when she felt her body's internal configuration expand
beyond its usual subjective boundaries. "Please focus upon the thrust your
mind seeks to pursue. Before the exercise, you had chosen the word "spiritual.
In that case let that, or any other word of your choice, gently repeat itself
in your mind. Allow your unconscious mind to give you the healing images it
wants you to have."
Upon emerging from hypnosis, she struggled to put into words a most
unusual experience. "I felt physically larger than life, as if I filled this
room. At the same time I experienced the inside of my body as never before. My
lungs, my heart, my stomach all felt so much closer to me. My enlarged body
swayed like a feather in the wind all the while remaining in place. Hard as it
is to put into words, I saw myself, the person with a name on one hand, and
the energy of my spirit on the other, connected but so distinct from each
other."
She pursued her spiritual practice. She learned to recapitulate the
experiences of hypnosis via her own means, and eventually developed a personal
technique which could best be described as a mixture of self hypnosis and
meditation (Cardena, 2000; Gibbons, 1972; Meares, 1979). SUMMARY:
Adjunctive hypnotic therapy in cancer may be directed to many levels of its
manifestations. Physical symptoms of cancer, the most common of which are pain
and fatigue, and the physical effects of its treatment may be alleviated to
enhance quality of life. Hypnotherapy can significantly help patients through
medical procedures and operations. Hypnosis may also be woven into
psychotherapy to assist the uniquely personal adjustments facing each
individual. Self hypnosis allows patients to actively contribute to their
treatment. Finally, hypnosis and self-hypnosis may be recruited to stimulate
healing spiritual discoveries.
F. MEDICAL HYPNOSIS IN THE HOSPITAL: Hypnosis has many applications for
relieving distress in hospitalized patients. Gérard V. Sunnen, M.D., a
psychiatrist and hypnotherapist, describes the ways in which hypnotic
techniques can help patients undergo medical procedures, surgery, and
rehabilitation therapy and cope with life-threatening illness. Sunnen cites
evidence from the research literature of the benefits of hypnosis for
hospitalized patients with medical conditions and presents several case
illustrations.--Editor, Journal of the Institute for the Advancement of Health
 Hospitalization, even with all available medical technology, remains a
trying experience. The same concerns, apprehensions, and fears exist today as
they did centuries ago in the face of dangers to well-being and sometimes to
life itself. The psychological well-being of hospitalized patients is,
therefore, not only for humane considerations but also for reasons connected
to health and recovery: patients may do better when undergoing procedures,
recovering from operations, or surmounting the side effects of treatments if
they are relaxed, rested, and feeling hopeful.
Hypnosis is a process by which an individual is guided from his or her
usual state of consciousness to a condition that is marked by psychological
and physical relaxation; altered perceptions such as the slowing down of time
or a change in one's body image; and a shift from analytic to synesthetic
thinking, that is, the mind shows less dependence on logic and a greater
receptivity to sensations and feelings. The resulting change in perception and
thinking is known as a trance. The nature of the trance state varies from one
individual to another.
The ability of hypnosis to induce deep multilevel relaxation, to quell
anticipatory anxiety, to increase tolerance to adverse stimuli, and to
intensify affirmative imagery can be adapted to the hospital setting for
maximizing the mind's contribution to healing.
Hypnosis has recently seen a resurgence in its medical applications,
with increasing sophistication in the ways it has been used for many clinical
problems, in and out of the hospital. Equally important, modern hypnotists, in
contrast to earlier ones who tended to be authoritarian in their approach,
encourage patients to determine the nature of their own experiences, that is,
to develop their unique potential in their trance. They are also mindful of
psychodynamic considerations. Thus, they use permissive and often frankly
meditative methods and function as a guide to point the way to conditions of
consciousness that are conducive to psychological adjustment and growth.
HYPNOSIS IN SPECIAL PROCEDURES: Procedures performed under local
anesthesia with or without sedation are often anticipated by the patient with
the same apprehension as those requiring general anesthesia. The idea of being
conscious during a procedure may be reassuring in one respect and unsettling
in another. On one hand, the patient's sense of control is maintained; on the
other hand, the patient may feel uncertain as to how he or she will deal with
the experience. Even a simple procedure, like a spinal tap, can be approached
with dramatic imagery: the mental picture of a needle may be much larger than
the actual size of the needle. Similar distortions may also occur with regard
to other procedures, such as cardiac catheterization, bone marrow biopsy, or
sigmoidoscopy.
The anticipatory anxiety generated by the patient's fantasies about a
procedure should not be neglected. It can turn a routine stay in the hospital
into a nightmarish experience and negatively sensitize the patient to future
hospitalizations.
The following case history illustrates some of the principles of
hypnosis when used in the hospital with certain medical procedures: A 52-year
old woman who had never been hospitalized was admitted for workup of a lung
shadow. She was to undergo a bronchoscopic examination the following day. When
she became agitated and highly anxious, a consultation was requested.
Hurriedly wiping away some traces of tears to appear more presentable, she
looked distraught and restless in her bed. Anticipation of the procedure,
which had been explained to her in a cursory and hurried fashion, had left her
in a state of panic. She imagined a large, cold, straight metallic tube being
pushed into her throat and saw herself in the agonies of choking. Yet, on
another level, she spoke amazingly candidly and rationally: "Doctor, I've been
a smoker for many years. I think tomorrow they will find that I have cancer.
But I think I can come to terms with it." The procedure was explained once
more to her. The tube was described--a picture of it was even drawn--as
flexible and as leaving plenty of space for air to pass. She was told that the
more relaxed she would be, the more easily air could pass. The benefits of
deep, autonomic nervous system relaxation were evident to her, and she
heartily agreed to attempt a hypnotic experience.
Because of her high level of anxiety, an approach more directive than
normally used for outpatient office procedures was invoked. With her
permission, her wrist was taken; gently and slowly her arm was brought
straight out in front of her. She was presented with images of heaviness and
relaxation, and her arm slowly waved itself downward, the hand gently
releasing itself until it came to rest on the bed. With her eyes closed, all
muscle tightness disappeared; her respiration adopted a slow, tempered rhythm;
her face appeared serene and seemed to communicate a profound peacefulness.
Once the hypnotic induction had taken place, the goal centered on
achieving the most profound relaxation possible. Then, the patient was
encouraged to dispel the fear-laden images and to replace them with images
that would be more consonant with her well-being. "You will feel the tube," he
said, "but at the same time your throat and all your air passages can be
relaxed, and it need not bother you. You will have plenty of air and with each
breath you can feel more and more relaxation sweeping through you. You may in
fact be so relaxed that the whole experience will seem to be occurring some
distance from you, far away. Until then, you may find yourself thinking very
little about the procedure, if at all, leaving time for you to rest fully."
The next day the patient underwent the bronchoscopy. The procedure was
completed in just a few minutes; the patient was remarkably calm throughout.
The tube met so little resistance and there were so few bronchial secretions
that the surgeon called the hypnotherapist to gain a better understanding of
this phenomenon. When asked about the experience, the hypnotherapist described
how, conscious of the whole procedure and feeling peaceful, the patient had
felt the tube inside her chest, as from a distance, and had mused to herself
making a game of it, imagining it was a little train coursing through some
tunnels.
HYPNOSIS IN SURGERY: The hypnotic phenomenon that perhaps inspires the
most awe involves the patient who undergoes major surgery without chemical
anesthesia.(3) According to Moll,(4) the first surgical operations on
"magnetized" subjects were those performed by Recamier in 1821. (At that time,
hypnotic phenomena were thought to be produced by the influence of magnetized
objects.) Jules Cloquet followed him in 1829, Dr. John Elliotson in England,
Dr. Albert Wheeler in the United States, and the well-known Dr. James Esdaile
in India in 1840. It is postulated that in certain individuals through
hypnotic mechanisms, a sufficient level of endogenous agents--that is, those
agents that occur naturally in the body--may be produced to block all
perceptions of pain.
However, many author point out that pain is a sensation intimately
intertwined with fear and that surgical procedures performed with hypnotic
anesthesia may owe their success to the modulation of anxiety as much as to
the neutralization of pain. Since 1950, interest in hypnoanesthesia has
rekindled. Suppressed by the discovery of chloroform, ether, and nitrous oxide
for more than a century, this renewed interest has been fueled not only by the
growing sophistication in understanding hypnosis, but by new philosophies of
patient care, such as the belief that patients should have access to any
treatment modality capable of easing the stress of illness and its treatment.
It is estimated by some investigators that 10 percent of the population
could undergo major procedures with hypnoanesthesia. Others estimate the
figure to he far lower. Patient selection appears to be very important.
Adequate studies are lacking, but good candidates for hypnoanesthesia are
likely to be highly hypnotizable and especially adept at altering the
processing of painful stimuli. While probably only a small percentage of
patients can negotiate major surgery using the hypnotic trance as the sole
anesthetic, a far more important percentage can benefit from the "softer" or
more subtle therapeutic influence of hypnosis, as it is applied in an
integrated fashion through the continuum of the hospitalization sequence. As
such, hypnotic intervention can begin in the preoperative period, can be
continued during the operation itself, and can be maintained through the
postoperative stage to assist the patient through all phases of psychological
and physical adjustment.
As is the case with hypnosis preceding medical procedures, preoperative
hypnotic preparations center on exploring the patient's fantasies about the
operation, neutralizing the mental set of anxious anticipation, and correcting
the nefarious effects of destructive imagined scenarios. The patient is
introduced to the idea of deep relaxation, taken through the steps of
experiencing the hypnotic trance, and presented with affirmative images and
statements relating to the sequence of events likely to be encountered in the
operative procedure. If the medical hypnotherapist intends to be present
during the operation, this fact is mentioned before surgery so that hypnotic
contact may be more easily reestablished while the patient is anesthetized.
It has been assumed for decades that a patient in the deeper or even
moderate levels of chemical anesthesia was in a state of other-worldliness and
had shed all semblance of consciousness. However, some clinicians and
researchers have reported patients who have remembered events that occurred
during surgery when they were presumed to be unconscious. Crile(9) reported
the case of a patient receiving nitrous oxide (as well as his own case in his
autobiography) where some awareness of the environment was preserved. While
nay-sayers have attributed these reports to insufficient levels of anesthesia,
reports of more occurrences of partial awareness in documented deep anesthesia
prompted studies to investigate this phenomenon.
In one study, Wilson and Turner questioned 150 postcesarean patients.
(10) They found three patients who accurately recalled actual events and 46
who retained some dreamlike remembrances of the operation. More recent studies
have focused on the hypnotic recollection of the operative experience, that
is, asking the hypnotized patient to recall an operation. Consciously, some
patients may have little or no recall, but others--especially those who are
highly hypnotizable--are able, in the context of trance, to reexperience
important events within the operative procedure. It has been reasonably well
established that such patients are attuned, in such situations, to meaningful
communications by the personnel who are present in the operating room,
especially surgeons and anesthesiologists. It is therefore possible that
surgical patients may be aware of negative comments on their progress by
surgical personnel, to which patients may react. If, for example, a surgeon
says, "There's a lot of blood loss here," the patient may respond with a rise
in blood pressure and increased heart and respiratory rate, making
cardiovascular instability more likely, Hypnotherapists, in anticipation of
this phenomenon, may add preoperative suggestions such as, "You will remain
calm, deeply relaxed, peaceful, totally undisturbed by any conversation around
you. Your mind centers on feelings of well-being throughout the operation."
As far as the hypnotherapist is concerned, the clinical implication of
the retention of some awareness during anesthesia is that some degree of
hypnotic contact and rapport may be established--or reestablished, if the
groundwork has previously been done--during the course of the operation, for
purposes of assisting the patient adjust to its vicissitudes. It is well
known, for example, that if the patient's abdominal muscles are tight, the
surgeon may order more anesthesia. This may not be necessary if the
hypnotherapist gently whispers suggestions to the deeply anesthetized patient
to relax his or her muscles.
Postoperatively, the patient who has already experienced the trance
state can easily be given suggestions for dealing with all aspects of the
recovery process, including rest, comfort, and return to harmonious biological
rhythms (that is, normal appetite and sleep).
REHABILITATION MEDICINE: People who have suffered catastrophic illnesses
or accidents usually have a long journey to recovery, and may require global
adjustments in life goals, family dynamics, and self-image. Stroke victims,
amputees, and individuals with spinal cord injuries, for example, need
multi-level support to help them cope with their shattered world.
Rehabilitation. therefore, is both a physical and a psychosocial process,
aimed at assisting destabilized patients to regain optimal physical competency
and psychological integrity. In the face of cataclysmic loss (of bodily
function--as in hemiparesis (paralysis of one side of the body), aphasia
(impairment or loss of speech), or quadriplegia (paralysis of both arms and
legs)--the patient often questions his or her will to live. Other traumatic
though less debilitating injuries, such as the loss of a finger, can engender
severe depression, withdrawal from others, self-destructive thoughts, and a
loss of self-esteem. It is clear that adaptations to such tragedies may have
as much to do with their symbolic representations as with their objective
realities.
The heartening advances of rehabilitation medicine are tied not only to
technology but also to an appreciation of the complex psychological needs of
patients. Staff members know how important their self-generated enthusiasm is
in mobilizing their patients' optimism and how loss of motivation can stunt
progress or foster regression. The following case history illustrates the
application of hypnosis to the difficult process of rehabilitation.
A 35-year-old executive returning late from a company meeting was
injured while driving on a rainy highway. His only memory of his accident was
of being carried on a stretcher from a ditch, with the lights of ambulances
flashing. He remembered the slow realization that he could not move his arms
or legs; even worse, that the feelings in his limbs and torso had been snuffed
out. He could only move his head from side to side and sink into his
quadriplegic nightmare.
A consultation with a hypnotherapist was requested three weeks into his
rehabilitation, because he was not progressing satisfactorily. He did poorly
on the tilt table, which is used for physical therapy, and he was not eating
well. This highly intelligent man talked lucidly to the hypnotherapist about
his visions of his future: he would no longer be able to work, his already
shaky marriage would crumble, and he would most likely need a full-time
caretaker. With all this against him, he asked, how could he find a reason to
live? Such questions are difficult to counter rationally. Given the premises,
he had drawn his own conclusions. To tap into his motivational reservoir, his
intellectualizing network would have to be bypassed.
This man agreed to undergo hypnosis and responded to hypnotic induction.
Whereas before the accident his analytical mind may have posed a defensive
barrier to induction, his despair and wish to be helped facilitated the
process. The therapist placed his thumb in the middle of the patient's
forehead, providing a sensory focus for centering awareness. With the
patient's eyes closed and with his focus turned internally toward the contact
point, a count was started. In synchrony with the patient's breathing, each
number symbolized a progression into a relaxed mindfulness, toward a state of
mind freed from the incessant pressure of thinking .
During the ensuing ten treatments, hypnotic therapy was aimed at
different dimensions of his condition. Aside from suggestions of physical
comfort, efforts were made to extend the range and intensity of the patient's
sensory awareness. The boundaries of his sensitivity to touch were determined,
and suggestions were given to expand them farther into his torso, as far as he
could each time, and progressively he regained some, albeit minute, sensory
ground. The therapist also guided him to experience feelings of peace and to
contemplate acceptance mixed with a willingness to try his very best to
improve. Finally, the patient was asked to dissolve all negative future
scripts created by his imagination. For the moment, he would have to attend
fully to his rehabilitation therapy. To this end, he began to apply himself
diligently. He graduated from the tilt table, grew stronger, and was
eventually sent home with outpatient support services.
For hospitalized patients with catastrophic illnesses, hypnotic
treatment does not stop after the first consultation. A series of treatments
over time is generally effective, as in the above example, since the goals are
approached in small steps over the course of weeks or months. In such cases,
it is advantageous to teach patients the skill of self-hypnosis so that they
will he able to surmount periods of private distress, regain autonomy, and
participate in their own recovery.
HYPNOTIC APPROACHES TO CANCER TREATMENT: Cancer affects a person on many
levels, from the cellular to the psychological. While the baffling varieties
of its manifestations continue to he elucidated, there is an evolving
awareness of its complex psychological dimensions. Cancer patients are likely
to experience intense distress and pain--pain from the disease itself, from
its treatments, and from the deep psychological and social changes the disease
and its treatments induce.
Recently there has been a growing appreciation of the needs of cancer
patients for support, open communication, understanding, and for the
sensitivity and professionalism with which life-threatening illnesses need to
be approached.
Hypnosis is used at several levels of cancer care. First, it is useful
as a means of dealing with the symptoms of the disease itself: pain and
symptoms associated with specific or organ systems; and nonspecific symptoms
such as fatigue, malaise, irritability, and insomnia. Second, hypnosis may be
helpful in the management of the side effects of cancer treatments. This is
very important because the side effects of chemotherapy and radiation--such as
nausea and vomiting--are often so unpalatable that they may cause the patient
to drop out of therapy. Third, cancer patients are faced with major
psychological adjustments. Many view their diagnosis with nihilism and are
forced to grapple with profound existential issues. Lastly, and still somewhat
controversially, hypnosis has been aimed at modifying the course of the
disease process itself through the medium of mental images.
The individual in deep hypnotic trance may experience any one of a
variety of shifts in body image. The perception of oneself in space including,
if appropriate, the presence of pain, can then be modulated by the influence
of hypnosis on cognitive processes and self-perception. "I"--the core of the
experiencing self--can be asked, in hypnosis, to modify its relationship to
the feeling of pain. When contemplated, pain may take on qualities that were
not immediately appreciated. It may he perceived as sharp, diffuse, warm or
cold, as having volume, shape, color, and even sound.
Painful stimuli are recognized consciously and then elaborated into
complex variegated sensations.(17) The mind can alter or neutralize the
perception of painful stimuli. The wounded soldier continuing to engage in
battle is one example of the mind's influence on pain and, by extension, all
perception.
In a hypnotic trance, the field of consciousness has the potential of
having more direct access to pain, to its associative networks in the central
nervous system, and to the mechanisms underlying its processing. Thus, "hot"
pain may be made to feel cool; pain that is perceived to be large and looming
may be made smaller in volume; pain that seems oppressively close can be made
to seem farther away; and, under certain conditions, pain can be abolished
altogether.
In altering or removing pain, care must be taken not to block its
warning function. In the early stages of an illness, a new sensation of pain
or discomfort may be an important indicator for revising the therapeutic
strategy. In more advanced cases, this is not as relevant. The following case
history demonstrates some principles of hypnotic alleviation of symptoms due
to cancer.
A 55-year-old man with carcinoma of the left colon that had been
diagnosed two years previously was referred by his oncologist for hypnotic
treatment of pelvic pain. A recent checkup had revealed metastatic liver
nodules, and a bone scan showed a solitary lesion in the pelvic bone. He had
started taking aspirin, propoxyphene, and occasionally codeine. This highly
educated man was able to appraise the complexities of his situation with
composure and open-mindedness. He did not wish to discuss death at any length.
He said that he had come to terms with death. He stated succinctly, however,
that he did not wish to squander his precious time and that he wanted to be
with his family, have time to take care of certain business matters, and be as
free of discomforts as possible. His intermittent pelvic pain interfered with
walking and sexuality. Because he was very ambivalent about plans for
chemotherapy and radiation, he opted for more time to make decisions about
these matters.
This patient successfully learned to experience a medium level of
trance--a perfectly workable depth of hypnotic relaxation--which was induced
using an arm levitation technique. The hypnotherapist then helped the patient
achieve glove anesthesia--a phenomenon marked by a sensor void in an area of
the body, in this case a hand--was achieved. The patient perceived a prick of
a skinfold near the thumb as a faraway flicker of touch. By way of the same
mechanism and progressive extension, he was taught to induce numbness to other
parts of his body. The hypnotherapist moved the patient's numbed hand to the
patient's pelvis and told him: "Imagine the numbness and coolness in your
hand, seeping through your skin, extending into your thigh, spreading. Like
rings of water on the smooth surface of a pond, concentric rings of numbness
flow as deeply as you can imagine."
The learning process, extended to self-hypnosis gave him variable
relief. Sometimes he could dispel the pain completely. At other times,
especially when his mood was low, he could obtain only partial relief. But
overall, he felt more relaxed and consequently had more energy and was more
active.
In the last few years, we have witnessed an interest in exploring the
uses of mental techniques not only to guide cancer patients to a better frame
of mind, but also to influence the disease process itself.(15)(18) Techniques
span a wide array of approaches, most of which confine themselves to
visualization in the context of hypnosis and/or meditation. Reports of
positive results using these techniques are largely anecdotal. In spite of
mounting evidence of links between the mind and the neurohumoral,
immunological, and autonomic nervous system mechanisms,(18-24) the efficacy of
mental techniques such as imagery, with or without the use of hypnosis, has
not been demonstrated scientifically to affect the course of cancer. There is
a need for more systematized investigations of these methods.
SUMMARY AND FUTURE DIRECTIONS: In the evolving philosophy of patient
care, not only traditional and state-of-the-art therapies, but all modalities
capable of enhancing comfort and well-being are approached with a willingness
for evaluation, with a special awareness given to the importance of
psychological factors in the healing, convalescent, and rehabilitative
processes.
Today, hospitalized patients, faced with an alien environment, time
constraints, and a panoply of novel procedures, are apt to need therapeutic
approaches that attend to their psychological needs and to the human
dimensions of their experience.
Medical hypnosis, a clinical science has undergone extensive conceptual
evolution and technical sophistication in recent years, is increasingly
understood as a treatment modality with the capacity to be applied, in
selected situations, to a wide range of problems encountered in the hospital
milieu.
Of the phenomena potentially manifested during trance, multi-level
(psychophysiological) relaxation, the modulation of painful sensations, the
alleviation of drug side effects and nonspecific symptoms such as malaise and
insomnia, the reduction of anticipatory anxiety, and the strengthening of
motivation for recovery find the most usefulness. Lastly, and still somewhat
controversially, is the application of hypnotic imaginal techniques in an
attempt to influence the neurohumoral and immunological components of healing.
As the healing process becomes more acutely appreciated as a multidimensional,
dynamic phenomenon, and as therapeutic trance states become more accepted as
valuable gateways to the enhanced communication between mind and body, medical
hypnosis will increasingly solidify its role as an agent capable of assisting
the individual toward achieving global health and well-being. Gérard V.
Sunnen, M.D., is Associate Clinical Professor of Psychiatry at the New York
University Bellevue Hospital Medical Center. He is in private practice of
psychiatry and clinical hypnosis in New York City.
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McNeal S, Frederick C. (1993) Inner strength and other techniques for ego
strengthening. American Journal of Clinical Hypnosis, 35(3), 170-178. Meares
A. (1979) Meditation: A psychological approach to cancer treatment.
Practitioner, 222, 119-122.
Miller GE, Cohen S. (2001) Psychological interventions and the immune system:
A meta-analytic review and critique. Health Psychology, 20, 47-63. Montgomery
GH, Weltz CR, Seltz M, et al., (2002 Jan) Brief presurgery hypnosis reduces
distress and pain in excisional breast biopsy patients.
International Journal of Clinical and Experimental Hypnosis, 50(1), 17-32.
O'Brien E. (1964) Varieties of Mystic Experiences. Holt, Rhinehart & Winston:
New York.
Peter B. (1996) Hypnosis in the treatment of cancer pain. Hypnos, 23(2),
99-108.
Pinnell CM, Covino NA. (2000 April) Empirical findings on the use of hypnosis
in medicine: A critical review. The International Journal of Clinical and
Experimental Hypnosis, 48(2), 170-194.
Rainville P, Carrier B, Hofbauer RK, et al. (1999) Dissociation of affective
dimensions of pain using hypnotic modulation. Pain 82, 159-171.
Ruzyla-Smith P, Barabasz A, Barabasz, et al. (1995) Effects of hypnosis on the
immune response: B-cell, T-cells, helper and suppressor cells. American
Journal of Clinical Hypnosis, 38(2), 71-79.
Schafer DW. (1996) Relieving Pain: A Basic Hypnotherapeutic Approach.
Northvale, NJ: Jason Aronson.
Schultz JH. (1956) Das Autogene Training. Stuttgart: Verlag.
Steggles S, Maxwell J, Lightfoot NE, et al. (1997) Hypnosis and cancer: An
annotated bibliography 1985-1995. American Journal of Clinical Hypnosis,
39(3), 187-200.
Sunnen G. (1999) What is hypnosis? In Temes R, Micozzi MS (Eds) Medical
Hypnosis: An Introduction and Clinical Guide. London: Churchill Livingstone
(7-20).
Walker LG. (1998) Hypnosis and cancer: Host defenses, quality of life and
survival. Contemporary Hypnosis, 15(10), 34-38.

11. MEDITATIVE TREATMENT FOR ERECTILE DYSFUNCTION: GERARD V. SUNNEN

In recent years the potential of volition to change the functioning of
the autonomic nervous system has been increasingly explored. Treatment
modalities including hypnosis, biofeedback, relaxation training as well as
meditative techniques have indicated that bodily processes occurring below the
level of awareness can surface into the area of conscious control with
implications for self-management (Schwartz, 1973; Griffith, 1972).
Meditative treatment has been used successfully to modify arousal states
and to induce altered states of consciousness (Deikman, 1963; Maupin, 1969).
The early study of Indian yogis (Brosse, 1946) demonstrated their capacity for
heart-rate control. Since then, studies of meditative practices have yielded
information on their potential to slow respiratory rate, lower blood pressure,
decrease oxygen consumption, lower skin conductivity, and induce EEG changes
with increases in alpha wave preponderance and amplitude (Anand et al., 1961;
Wallace & Benson, 1972; Benson et al., 1975).
The rationale for using a meditative technique for the treatment of
sexual impotence came from different sources. During the course of evaluation,
one patient in this study remarked that he had noted a virtual disappearance
of sexual feelings in his genitals, especially marked at times when he
attempted to have intercourse. He described it as sexual anaesthesia and
contrasted it to the familiar sense of fullness and warmth he had experienced
before his condition developed. Subsequently, all individuals in this study
were screened for this phenomenon; six out of nine men reported an absence of
genital feelings, and the remaining three men reported a partial decrease in
their genital sensations.
The mechanisms leading to erectile response involve a relaxation of the
vascular musculature with consequent engorgement of the penile spongiosum.
When asked to introspect into the genital areas during in erectile response,
individuals will invariably describe sensations of fullness and warmth.
A recent study of the male sexual response (Koshids & Sohado, 1977)
making use of thermography showed increases in genital warmth occurring 2
minutes after exposure to an erotic movie. It was hypothesized that some
cases of secondary impotence may involve a deficit in those
psychophysiological systems responsible for the expression of genital warmth
and that training the individual to reexperience this sensation could
reestablish sexual competence. Meditation seemed highly suited for this
purpose because it can provide direct amplification of bodily sensations and
bring about concentrated intervention into the locus of altered physiological
mechanisms.
METHOD: Nine patients with secondary impotence and a mean age of 32
years were included in this study. All had this symptom for more than a month
with a mean of 2-1/2 months. Five patients had experienced a relatively acute
onset in response to a traumatic situation, while four others reported an
insidious symptom progression. The former tended to have more than one sexual
partner, and the latter related their difficulties to chronic discontent with
one partner. Medical checkup revealed no abnormalities.
The rationale for using meditation in treatment was explained to each
one as casually as possible to minimize suggestion effects. Instruction was
given in the mechanics of the meditative process. Preliminaries to meditation
include the choice of an appropriate setting as well as the adoption of a
mental set where all outside events, concerns, fears and fantasies unrelated
to the experience are disregarded. Instructions were given in the art of
sidestepping intruding thoughts and in the task of maintaining clear awareness
without drifting off to sleep. Each patient was asked to reach a baseline
relaxation level by sitting and focusing attentiveness on the rhythm of
breathing. This usually took about 3 minutes, and then respiratory rate, heart
rate, and muscle tone dropped to a resting minimum. At that time patients were
asked to shift their focus of attention to their genital area and to meditate
on the experience of pleasant sensations of radiating warmth, taking care not
to tense any pelvic muscles when so doing. After preliminary exercises in the
office, each patient was asked to repeat the process twice daily for 15-minute
periods.
RESULTS: Five patients reported the experience of minimal genital warmth
within 10 days, and two others after 2 weeks of practice. This sensation
became stronger and could be elicited more quickly as training continued. The
two remaining patients reported fleeting sensations but were continuously
distracted by intruding thoughts and could not sustain a workable focus of
attention. These patients, although motivated, did not consistently achieve
genital warmth and did not develop erectile competence. One of these patients
persisted for 7 days, and the other for 2 weeks before becoming discouraged
with the technique.
Those who were able to bring about genital warmth were able to reproduce
it consistently with subsequent meditative trials. The seven successful
patients reported the return of erectile experiences within 2 weeks of the
attainment of genital warmth. Coital performance was reported in these
individuals to have returned to presymptom levels, and in three patients to
have improved beyond that.
Two patients developed the ability to achieve erections at will while in
the meditative state, usually after 10 minutes of exercising the technique.
Follow-up at 3 months after the achievement of erectile competence showed
stability of therapeutic gains in five patients. One patient was lost to
follow-up.
DISCUSSION: The experience with this small group of patients suggests
that certain modified meditative techniques may be helpful in the treatment of
erectile incompetence. Individuals best suited for this modality are
sufficiently motivated to set aside two 15-minute periods daily for meditative
practice and have some ability to ease away from their thought streams in
order to focus attention on an anatomical part, search for and amplify
feelings of heat, and at the same time remain alert and relaxed. The 2
individuals who did not benefit from the technique seemed to have some
difficulty with one or another aspect of this complex mental process.
In viewing the results of this study, it is helpful to note that in some
studies the rate of spontaneous remission from secondary impotence has been
reported to be high. Ansari (1976) found a 68% remission rate 8 months after
initial evaluation.
Experienced meditators have been shown to process stress more
efficiently as their experience increases (Goleman & Schwartz, 1976). It is
possible that our successful subjects were able to handle sexual situations
with greater calm than in their previous experience, and therefore less
inhibition of sexual response. Interestingly, all successful individuals in
this study reported increased feelings of inner peace in their daily lives,
while the two men who did not respond to this treatment modality reported no
change in their ability to cope with stress.
The efficacy of the technique may also rest on the specific learning of
control pathways into the genital ANS. The fact that successful subjects
reported genital warmth within a few minutes of exercising, whereas they could
not do so before their treatment, and that two individuals reported an
acquired ability to create erections voluntarily may support this hypothesis.
The therapeutic possibilities of this technique await further study but
already lend some hope to selected individuals suffering from secondary
erectile dysfunction.
REFERENCES:
Allison, J. Respiration changes during transcendental meditation. Lancet, 1,
833-834 (1970).
Anand, B. K., Chhina, G. S. & Singh, B. Some aspects of
electroencephalographic studies in yogis. Electroencephalography and Clinical
Neurophysiology, 13, 452-456 (1961).
Ansari, J. M. Impotence: Prognosis (a controlled study). British Journal of
Psychiatry, 128, 194-198 (1976).
Benson, H., Greenwood, M. M. & Klemchuk, H. The relaxation response:
Psychophysiologic aspects and clinical applications. International Journal of
Psychiatry in Medicine, 6, 87-98 (1975).
Benson, H., Rosner, B. A. & Marzetta, B. R. Decreased systolic blood pressure
in hypertensive subjects who practice meditation. Journal of Clinical
Investigation, 52, 80 (1973).
Brosse, T. A psychophysiological study. Main Currents in Modern Thought, 4,
77-84 (1946).
Goleman, D. & Schwartz, G. E. Meditation as an intervention in stress
reactivity. Journal of Consulting and Clinical Psychology, 44, 456-466 (1976).
Griffith, F. Meditation research: Its personal and social implications.
Frontiers of Consciousness, pp. 138-161. Ed. J. White. Avon, N.Y. (1974).
Koshids, Y. & Sohado, J. Application of thermography in diagnosing impotency.
Hospital Tribune, 11, 13 (1977).
Masters, W. H. & Johnson, V. E. Human Sexual Inadequacy. Churchill, London
(1970).
Maupin, W. On Meditation. Altered States of Consciousness, pp. 181-190. Ed. C.
T. Tart. Wiley, N.Y. (1969).
Schwartz, G. E. Biofeedback as therapy: Some theoretical and practical issues.
American Psychologist, 28, 666-673 (1973).
Wallace, R. K. & Benson, H. The physiology of meditation. Scientific American,
226, 84-90 (1972).
[The above article was published in Love and Attraction, edited by Mark Cook &
Glenn Wilson, Pergamon Press]

12. MISCELLANEOUS MEDICAL APPLICATIONS OF HYPNOSIS: GERARD V. SUNNEN

[This article was one chapter in A Primer of Clinical Hypnosis,
co-authored by Dr. Sunnen and Barbara DeBetz.] While hypnosis, in the medical
setting, has traditionally been used for anxiety and pain control -- its most
popular applications -- it has also been used for some of the individual needs
of medicine's specialties. Each specialty, dealing with different facets of
human problems and treatment, has found ways to apply hypnosis successfully to
the problem of improving patient care.
HYPNOSIS IN OBSTETRICS: The practice of hypnotically assisted
deliveries has a history of over a century. Falling into disfavor due to
competition from chemical anesthesia, hypnosis has seen a revival in the last
two decades. One important reason for this comeback is the realization that
hypnosis may find usefulness not only in obstetric analgesia or anesthesia,
but in all phases of giving birth from pregnancy to postpartum recovery.
Russian medicine has had extensive experience with obstetric hypnosis.
Platanov, in the 1920s, became well known for his hypnoobstetric successes.
Impressed by this approach, Stalin later set up a nationwide program headed by
Velvoski, who originally combined hypnosis with Pavlovian techniques but
eventually used the later almost exclusively. Ferdinand Lamaze, having visited
Russia, brought back to France "childbirth without pain through the
psychological method," which in turn showed more reflexologic than hypnotic
inspiration.
In the Western hemisphere, Roig-Garcia used suggestion, given in the
hypnotic trance during predelivery training, to decondition, mostly by verbal
means, the patient's culturally determined associations to childbirth. Seeking
to counter the deeply ingrained but nevertheless learned concepts that equate
uterine contraction with pain and fear, Roig- Garcia, in his hypnoreflexogenic
method, worked to manage delivery in a state of "vigil," where the patient,
fully awake, aware, and conscious of uterine contractions, is free of a "pain
complex or component." In hypnotically assisted deliveries, it is found that
the well-relaxed patient makes smoother transitions from one stage of labor to
the next. Relaxed deliveries are not noted for their rapidity -- nor should
they be. Deliveries that are unhurried and made within the context of global
physiological and psychological comfort allow all tissues -- the mother's as
well as the child's -- to adapt gently to changing conditions.
In the United States there has been an increased interest in these
methods since the 1960s. The reasons are undoubtedly complex. Often cited is a
trend towards respect for natural physiological processes, and dissatisfaction
with chemical, mechanical, or operative interventions. There is, indeed,
always some risk to the mother and to the infant when chemical anesthetics are
used. Hypnosis, on the other hand, has never been shown to be injurious to
either. Werner, in the United States, delivered over 3000 babies since 1959
with hypnotic adjunctive techniques (before that time he delivered 6000 babies
with chemical anesthesia). Ten percent of women did not respond to trance
induction; 30% required some and always less, chemical anesthesia; the
remaining 60% used no chemical anesthesia at all.
Advantages of using hypnosis in obstetrics The advantages of using
hypnosis in the delivery process are summarized below. Hypnosis as a
physiological and psychological relaxant can make the delivery process more
humane. By giving the patient a sense of handling this natural function by her
own mental resources, self-esteem is increased. If adjunctive chemical
anesthetics are needed, they can be administered promptly and easily. The
interesting feature, however, is that if they need to be used, lesser amounts
are clinically effective, with benefits to mother and child (August, 1960;
Oystragh 1970).
Hypnosis does not inhibit normal emotional responses to the birth
process and the immediate bonding to the child, as does chemical anesthesia.
If properly negotiated in a natural fashion, giving birth in the state of
vigil is a profound, deeply constructive human experience. Hypnosis helps in
the preparation for delivery and in the recovery process. Anticipatory anxiety
can be lessened and the return to normal functioning can be optimized. Often,
chemical anesthetics cause a hangover which can last up to two days. Using
hypnotic techniques, there is smoother transition back to normalcy.
Objections to using hypnosis in obstetrics In 1961, the American
Psychiatric Association issued an official statement which contained the
following: "Hypnosis is a specialized psychiatric procedure and, as such, is
an aspect of the doctor-patient relationship. Hypnosis provides an adjunct to
research, to diagnosis, and to treatment in psychiatric practice. It is also
of some value in other areas of medical practice and research"; and "whoever
makes use of hypnotic techniques, therefore, should have sufficient knowledge
of psychiatry, and particularly psychiatric dynamics, to avoid its use in
clinical situations where it is is contraindicated or even dangerous." This
ruling has dampened the general use of hypnosis in obstetrics, and there are
still controversies deriving from it. By all evidence, a rational stance may
be embodied in the opinion that obstetric hypnosis is safe in the hands of
adequately trained medical personnel. In cases where the patient has shown
psychopathology, by history or mental status, it may be argued that special
consultation be made with a psychiatrically oriented hypnotherapist.
Is hypnosis too time-consuming? The same question is often posed
concerning dental hypnosis. Perhaps, at face value, the patient hours spent
for hypnotic training do not appear to be cost-efficient. However, if we look
at other factors, such as ease of delivery, increased speed of recovery, and
the global benefits to the mother as well as the child, the question may be
quickly settled.
Practical considerations: Women may receive hypnotic training
individually or in groups. While individual sessions suit the needs of many
patients, the group experience offers the opportunity to share important
feelings. In training sessions, the patient is taught how to produce a trance,
first through the doctor-patient relationship (heterohypnosis), then by
herself (autohypnosis). An important part of the program is education: the
anatomy, physiology, chronobiology, and physiology of the birth process
including an exploration of the feelings commonly encountered and how to
experience them in natural perspective, ie, tension as tension, not as pain.
Training progresses to the learning of deep relaxation and to the technique of
dissociation, ie, "if you begin to feel the uterus contracting strongly, and
if you want to take a rest while it does so by itself, simply let yourself
drift further into deep trance . . . "
Hypnotic training may begin, ideally, as early as the first trimester of
pregnancy. Many patients, however, who have not had the benefit of advance
preparation, may be helped by trance induction even when labor has already
begun.
Utilized during pregnancy, hypnosis may help patients cope with some of
its physiological effects. Nausea and vomiting, a frequent manifestation (up
to 50%) of pregnancies, usually starting in the fourth or fifth week and
lasting for an indefinite period, can be debilitating and even dangerous.
Drugs, of course, should be avoided because of possible teratogenic effects.
Hypnotic treatment, of nausea and vomiting has been talked about in Chapter
11. Although resulting from different mechanisms than those responsible for
anti-neoplastic drug effects, nausea and vomiting during pregnancy can be
successfully approached through these same techniques. Since many women
complain of unpleasant metallic tastes in the mouth, suggestions are given for
fresh minty breath, as well as for easy transit of foods. Ptyalism (the
overproduction of saliva), pruritus, and heartburn are all antenatal
conditions which may respond to hypnotic treatment.
Hypnosis and related natural childbirth methods Several methods of
preparation for childbirth have been developed in the last few decades, and
the number of participants attest to the interest and need of women for a
holistic approach to giving birth. The natural childbirth method of Read
(1953), the psychoprophylactic method of Velvoski, and the painless childbirth
method of Lamaze (1958) all use suggestion to various degrees, emphasize
relaxation, and give the patient reassurance and a sense of control over the
entire process. Although no formal induction exists in these methods, the
degree of similitude to hypnosis is striking.
HYPNOSIS AND SURGERY: The hypnotic phenomenon which perhaps inspires
the most awe and drama involves the unanesthetized patient who undergoes major
surgery. According to Moll, the first surgical operations on magnetized
subjects were those performed by Recamier in 1821. Cloquet followed him in
1829, Elliotson in England, Dr. Albert Wheeler in the United States, and the
well-known Dr. Esdaille in India (1840).
In suitable subjects, it is recognized that through hypnotic mechanisms,
a sufficient level of anesthesia may be produced to block all subjective
perceptions of pain. However, many authors point out that pain is a sensation
intimately intertwined with fear and that surgical procedures performed with
hypnotic anesthesia owe their success to the abolition of anxiety as much as
to the abolition of pain. Furthermore, a careful analysis of historical cases,
as well as modern ones, points to the fact that major operations may not have
been as pain free as originally supposed.
Since 1950, interest in hypnoanesthesia has rekindled. Suppressed by the
discovery of chloroform, ether, and nitrous oxide for over a century, this new
interest has been fueled not only by the growing sophistication in
understanding hypnosis, but by new philosophies of patient care: patients
should have access to any treatment modality capable of easing the stress of
disease and its treatments.
If hypnosis is able to achieve pain block in only a small minority of
patients, it is pointed out that as a partial anesthetic and a tranquilizer,
it may reduce the dosage of premedication and of anesthetics. Seeing that many
patients have compromised pulmonary, cardiac and renal status, and that
anesthetic deaths account for one per ten thousand cases, hypnotic
intervention could have appreciable benefits. Several modern accounts of
surgery using hypnoanesthesia -- usually used because of the patient's poor
previous response to anesthetics, and for such procedures as prostatectomy,
breast tumor or thyroid nodule excision, and temporal lobectomy among others
-- indicate that hypnosis has a wide range of effectiveness for anxiety and
pain reduction. In a small proportion of cases where hypnoanesthesia was
unaccompanied by any medications, some patients appeared to experience pain
sensations, as evidenced by increased blood pressure, increased cardiac and
respiratory rate, wincing, and frowning, while others did not. In those who
seemed to feel pain, recollection was variable, and in cases where adjunctive
medications were used, ie, opiates, local anesthetics, sedatives, and
anxiolytics, doses were usually smaller than in the average case.
It is estimated by some investigators that 10% of the population could
undergo major procedures with hypnoanesthesia (Lederman et al, 1958); others
estimate the figure to be far lower (Wallace and Coppolino, 1960). Patient
selection appears to be very important. Adequate studies are lacking, but we
would expect good candidates for hypnoanesthesia to be highly hypnotizable.
However, high hypnotizability is not necessarily correlated with heightened
ability to achieve anesthesia. The importance of other factors, including
motivation and rapport, has not been measured. Few people today seriously
suggest that hypnoanesthesia should be used as the sole anesthetic in major
surgery. The percentage of suitable candidates is too few and the variables
and unpredictability of responses are too great. The combination of chemical
and hypno-anesthesia, however, is stimulating serious interest. Besides the
already mentioned effects of reducing doses of sedatives and analgesics,
hypnosis may address itself to subconscious mechanisms which may positively
influence operative outcome and recovery.
PREOPERATIVE PREPARATIONS: The preoperative hypnotic preparation of the
patient can be handled in a variety of ways. Some authors recommend that that
there be a rehearsal of the operation under hypnosis, with recreated
conditions made to be as real as possible, to familiarize the patient with the
procedures, the sensations commonly encountered, ie, the wet sponge to prep
the skin for incision, the sound of clamps, hemostats, etc (Crasilneck and
Hall, 1975). Less time-consuming, but possibly not as effective, is a
preoperative hypnotic induction during which a general description of the
procedure is drawn and appropriate suggestions are given. Mention may be made
before the operation that the patient will be calm, will rest soundly, and eat
or not eat as required, with comfort; that, as anesthesia is given, it is to
be accepted willingly and that pain sensations will be blocked; that during
the operation, breathing will be restfully slowed and healing dreams are
likely to be encountered. For the postoperative period, the patient is told
that recovery will be rapid, discomfort minimal, and healing accelerated.
Such hypnotic procedures may be applied to any phase of the operative
process. Preoperatively, it allays anticipatory anxiety and allows for more
restful adaptation. If the hypnotherapist is to be present during the
operation, this should be mentioned to the patient because it will set the
stage for future hypnotic rapport.
Commentaries on "anesthesia awareness" It has been assumed for decades
that a patient in the deeper or even moderate levels of chemical anesthesia
was in a state of other worldliness and had given up all semblance of
consciousness. Crile (1947) reported the case of a patient receiving nitrous
oxide (as well as his own case in his autobiography) where some awareness of
the environment was preserved. While insufficient levels of anesthesia were
first invoked, reports of more cases of preservation of partial awareness in
documented deep levels of anesthesia prompted studies to investigate this
phenomenon. Wilson and Turner (1969), in a study involving questioning of 150
postcesarean patients, found three who accurately recalled factual events and
46 who maintained some dreamlike experiences of the operation. More recent
studies have focused on the hypnotic recollection of the operative experience.
While consciously, patients may have little or no recall, some -- especially
highly hypnotizable ones -- are able in the context of trance, to reexperience
important events within the operative procedure. It has been reasonably
established that such patients are attuned, in such situations, to meaningful
communications by the treating personnel, especially the perceived significant
personnel, ie, the surgeon and anesthesiologist. This has prompted
hypnotherapists in their preoperative hypnotic induction to add suggestions to
protect their patients against inadvertently negative communications which may
be reacted to, physiologically and psychologically, with stress reactions. If,
for example, one of the surgeons mentions "there's a lot of blood loss here,"
the patient may respond with a rise in blood pressure and increased heart
rate, making cardiac instability more likely.
USES OF HYPNOSIS DURING THE OPERATION: The clinical implications of the
maintenance of some awareness during anesthesia, as far as the hypnotherapist
is concerned, is that some degree of hypnotic contact may be established
during the course of the operation for purposes of helping the patient adjust
to its vicissitudes. It is well known, for example, that given some tightness
of the abdominal muscles, surgeons often ask for more anesthesia. This may not
be necessary, if the hypnotherapist gently whispers suggestions to that effect
to his deeply anesthetized patient.
Hypnosis in the postoperative period If the patient has been adequately
prepared in the preoperative hypnotic session, very little time need be spent
in the postoperative induction. The patient, readily entering the trance, can
be given suggestions for dealing with all phases of the recovery process:
rest, comfort, biological functions, control of bleeding, etc.
HYPNOSIS IN BURN PATIENTS: Patients who are severely burned
characteristically show a variety of major problems. In addition to severe
constant pain and the trauma engendered by the need for repeated treatments
such as debridement, there are loss of appetite, contractures, poor mobility,
and often severe psychological symptoms: despair, hopelessness, helplessness,
regression, and a psychological set of "giving up." Nausea and anorexia
compound the problem by causing weight loss. The treatment of the burned
patient may start as early as a few minutes to several hours after the time of
the burn. Some clinicians report that post-burn hypnotic anesthesia can
decrease the inflammatory response and lead to lessened destructiveness of the
injury. Suggestions may be given for coolness of all burned areas by using
imagery of ice and snow (Ewin, 1978). The burned patient has a long, arduous
road to recovery, and hypnosis may be of help in reestablishing adequate
physiological functions and in maintaining hope and the will to live.
HYPNOSIS AND DENTISTRY: The use of hypnosis in dentistry has a long
history. In 1837, Oudet, a French dentist, used hypnoanesthesia for a dental
extraction -- the first reported case. Ribaud and Kiaro, in Poitiers, France,
similarly excised a tumor of the jaw in 1847. Since then, many reports dealing
with hypnodontia -- the use of hypnosis in dentistry -- have attested to the
increasing sophistication of hypnotic procedures to deal with the special
problems of the dental patient. Besides smoothing out dental procedures by way
of its generalized antianxiety effects, it can increase overall patient
comfort, make the dental experience acceptable and bearable, decrease
resistance to future intervention, and through posthypnotic suggestions,
encourage more rapid recovery.
The orofacial region holds special importance for its connections to
vital functions and for its place in the individual's psychosexual
development. This area is inherently connected to major sensory pathways --
vision, hearing, sight, smell, and touch -- and has intimate jurisdiction over
breathing, food intake, and communication of speech and feelings. Freud (1953)
labeled the oropharynx as an erotogenic zone and Erickson (1950) described
early oral experiences as of central importance to the development of basic
trust. Teeth, in reality and symbolically, have priceless value.
Indications for using hypnosis in dentistry It is understandable, in
view of these considerations, that many individuals have anxieties about
dental procedures. Some, in fact, are so phobic that they prefer to allow
serious pathology to develop, rather than to seek help. Apprehensive patients
usually have difficulties citing specific fears they may have about dental
procedures -- fears of pain while constrained in the chair, a variant of
claustrophobia is often cited, as is the fear of choking or drowning in
secretions, the fear of mutilation, the fear of fainting, of being unable to
talk, and the fear of disapproval by the dentist for lack of self care. Some
of these fears may tie into other, more primitive ones, such as the fear of
castration, helplessness, or oral aggression.
While some anxiety and tension is normal with most dental procedures,
higher levels interfere significantly with the treatment. Some investigators
place the incidence of dental phobias at 6.9% of the general population, and
16% in school-age children (Gale and Ayer, 1969). When mild, an anxiety
tension response can be managed by the dentist through the use of reassurance,
explanation, and suggestions for relaxation. Of significant benefit is
mellifluous music as well as the pleasant chattiness of the dentist.
When phobias are more severe, the patient is commonly found sitting
stiffly in the chair or exhibiting strained movements, The facial and nuchal
muscles are contracted, the jaw barely open, and attempts at evaluation and
treatment are met with stiff unvolitional opposition. Ordinary relaxation
procedures are partially and inadequately effective. A sedative hypnotic taken
an hour before the visit is also only partially effective and has the drawback
of sedating the patient for several hours. Such a patient may benefit from a
formal hypnotic induction with the examination and treatment done in the
trance state or in a posthypnotic relaxed state. While some dentists may balk
at the idea of taking time to tap into the benefits of hypnosis, it is pointed
out that once the patient is relaxed, procedures are done much more quickly
and subsequent procedures are handled much more smoothly through the use of
posthypnotic suggestions.
Sample suggestions may include the following "as you sit relaxed, I'd
like you to listen to the music around you, letting yourself flow with it. It
takes you automatically into relaxation, your whole body becoming more relaxed
with each breath; your jaw and mouth and gums and throat become so relaxed
that the muscles get softer. While you're listening to the music, your entire
mouth can feelfeel to be further and further away from you -- you feel it but
it is out there in the distance; and as I open your jaw gently and take a look
at your gums, you may feel your whole body becoming more comfortable and
relaxed. As I do my work, I'll describe everything that I do beforehand so
that you know what is going on." Some dental phobias may require
hypnobehavioral techniques, ie, hypnodesensitization, flooding (anxiety
evoking stimuli are presented to the hypnotized patient in stepwise fashion or
the hypnotized patient is presented with maximally anxiogenic material). Other
approaches include psychotherapy or hypnotic age regression. Stolzenberg
(1950) used the latter method to elicit from two patients the fact that they
were frightened because of dental stories that they had heard several years
previously.
Gagging is connected to anxiety and can present major problems for the
dental patient. Some patients find it very difficult to have impressions taken
or to wear dentures. Hypnosis has had marked success in the control of this
unpleasant reflex.
Hypnosis for dental analgesia Using hypnosis in dentistry for analgesia
presents several benefits over chemical anesthesia. It does not produce
chemical numbness, which annoys the patient for several hours after the
procedure and is responsible for patients slurring their speech or
inadvertently biting their inner cheek; it avoids chemical risk factors; and
it avoids the often dreaded needle. As in hypnoanesthesia used in surgery,
unfortunately, it can only be satisfactorily and completely effective when
used alone in about 10% of the population. However, it is partially and
significantly effective in a much larger percentage, and when more extensive
dental work is necessary it is able to reduce chemical anesthetic dosages.
Extractions, root canal procedures, deep filling, and periodontal work can all
be made to be more pleasant and paradoxically less time-consuming by
attempting a simple induction and giving suggestions for numbness and
relaxation. In the dental setting, numbness of the index finger can first be
produced; the patient's hand is then guided into his mouth to touch the gums
and teeth. Seeing the interrelationship of pain and anxiety previously
mentioned, suggestions are also provided for calm and for "being here now," to
dissipate anticipatory ideation. In an alternative technique, the dentist,
while the patient is in a trance, touches the area of the jaw, first
externally then internally with paired suggestions for relaxation and
numbness, gradually extending numbness to the entire oropharynx, with
preservation of essential reflexes such as swallowing and gagging. Control of
bleeding The purported ability of hypnosis to decrease bleeding has been
widely mentioned in the literature (Newman, 1974). Anecdotal reports attest to
a phenomenon found in hypnotized patients in which incisions are remarkably
free of bleeders. A study comparing clotting before and during the hypnotic
trance did not demonstrate significant changes. Hypnosis, however, if indeed
it has effects on bleeding, probably does so at the tissue arteriolar level
rather than on clotting time.
Because bleeding in dental procedures is not a serious problem, the use
of hypnosis to control bleeding has mostly been indicated for hemophiliacs.
Pediatric dental hypnosis Good dental education is best done early. Due to the
impressionable and highly suggestible nature of children, it is especially
important to provide, from the start, programs of dental care which are as
free of discomfort as possible and even possibly somewhat fun. Some dentists,
for example, with commendable imagination, mention to their young patients
that the dental office can be thought of as a modified spaceship. In most
cases, an unhurried empathic attitude, combined with reassurances will
suffice. Hypnosis may be indicated for the child needing more involved work or
the child who has had previous negative experiences.
Hypnotic work with children, while similar to adult hypnosis in
substance, requires some modifications. The shorter attention span of children
requires more absorbing, interesting, and innovative induction procedures. The
suggestions and language must correspond to the child's verbal capabilities.
The child needs immediate reward and praise for his hypnotic achievements.
Successful techniques are more apt to use fantasy or imagery, concrete
suggestions using specific images, and ego -- strengthening methods to enhance
the child's self-image for mastering the problems at hand.
HYPNOSIS IN OTHER MEDICAL CONDITIONS AND SPECIALTIES: The
hypnotherapist, to be maximally effective and innovative, needs to develop
knowledge of the wide ranges of possible applications of hypnotic techniques
in different medical settings and for different medical problems. The
literature contains many examples of how hypnosis has been applied, often
creatively, to aid in the overall management of patients with specialized
problems.
Neurological applications have included using hypnosis in Parkinsonism
since psychological factors tend to aggravate the expression of disease. Along
with chemotherapy, hypnosis can be applied to relaxation, to the improvement
of ambulation and speech, and to the diminution or abolition of negative
scenarios the patient may have built up about his illness.
The symptoms of multiple sclerosis, whose remissions and exacerbations
can be accompanied -- and contributed to -- by anxiety, depression, and
stress, can be better managed by the adjunctive use of hypnosis. Although the
pathophysiology of the lesions is not altered by hypnosis, the subjectively
ominous or catastrophic reactions to exacerbations can be softened. In
orthopedics, hypnosis can be used for helping the patient adjust to different
positions required for longer-term healing. In the emergency situation,
hypnosis can assist the frightened and tense patient who needs a reduction
procedure.
In plastic surgery, similarly, when it may be necessary for the patient
to maintain an uncomfortable position for successful skin or pedicle grafting,
hypnosis can minimize bodily irritations and the desire to move. In
gynecology, clinicians have used hypnosis for functional dysmenorrhea,
premenstrual and menopausal syndromes, and special procedures. The
ophthalmological and otolaryngeal specialties have found hypnosis to have
positive effects on glaucoma (Berger and Zamet, 1960) and suppression of
amblyopia; it has also been used in cataract removal and for the adjustment to
contact lenses. Globus hystericus, hysterical aphonia, gagging, and tinnitus
are other conditions with strong psychogenic overlays which are especially
responsive to hypnotherapy.
In urology, hypnosis has found applications in cystoscopy and vasectomy,
not only to make the procedures more comfortable, but to help ensure smooth
psychological adjustment. All symptoms and all diseases have or are
repercussions on some aspect of mental functioning. Keeping this fact in mind,
the clinician may, when applicable and appropriate, think about using hypnosis
to enhance total patient care.
SUGGESTED READING AND REFERENCES:
Abramson M, Freenfield I, Heron WT: Response to or perception of auditory
stimuli under deep surgical anesthesia. Ain J Obstet Gynecol 1966;96:584.
American Psychiatric Association: Training in Medical Hypnosis: A Statement of
Position by the APA. Document available from the Central Office, Washington,
D.C. Feb. 15, 1961, p 3.
August R: Hypnosis in Obstetrics. New York, McGraw-Hill, 1961.
Berger AJ, Zamet CH: Emotional factors in primary glaucoma. Psychosomat Med
1960;22:391.
Bernstein HR: Observations on the use of hypnosis with burned patients on a
pediatric ward. Int J Clin Exp Hypn 1965; 13: 1.
Bowers KS: Hypnosis and Healing. Aust J Clin Exp Hypn 1979;7:261.
Brunn JT: The capacity to hear, understand, and to remember experiences during
chemoanesthesia: A personal experience. Ain J Clin Hypn 1963;6:27.
Cheek DB: Use of preoperative hypnosis to protect patients from careless
conversation. Am J Clin Hypn 1960;3:101.
Chertok LS: Psychosomatic Methods in Painless Childbirth: History, Theory and
Practice. New York, Pergamon Press, 1959.
Coulton D: Prenatal and postpartum uses of hypnosis. Am J Clin Hypn
1966;8:192.
Crasilneck HB, Hall JA: Clinical Hypnosis: Principles and Applications. New
York, Grune and Stratton, 1975.
Crile GW: Autobiography. Philadelphia, JB Lippincott, 1947, p 197.
Erickson EH: Childhood and Society. New York, WW Norton, 1950.
Ewin DM: Clinical use of hypnosis for attenuation of burn depth, in Frankel
FH, Zamansky HS (eds): Hypnosis at its Bicentennial -- Selected Papers from
the Seventh International Congress of Hypnosis and Psychosomatic Medicine. New
York, Plenum Press, 1978.
Faithful NS: Awareness during anaesthesia. Br Med J 1969;2:117.
Freud S: Three essays on the theory of sexuality, Standard Edition of the
Complete Psychological Works of Sigmund Freud vol 7. London, Hogarth Press,
1953, p 135.
Gaal JM, Goldsmith L, Needs RE: The use of hypnosis, as an adjunct to
anaesthesia, to reduce pre and post operative anxiety in children. Presented
at the annual meeting of the American Society of Clinical Hypnosis,
Minneapolis, November 1980.
Gate EM, Ayer WA: Treatment of dental phobias. J Ain Dent Assoc
1969;79:1304-1307.
Golan HP: Control of fear reaction in dental patients by hypnosis. Ain J Clin
Hypn 1971;13:279.
Gershman J, Reade G: Hypnosis and dentistry, in Burrows G, Dennerstein L
(eds): Handbook of Hypnosis and Psychosomatic Medicine. New York,
Elsevier/North Holland Biomedical Press, 1980, p 443-475.
Hutchings DD: The value of suggestion given under anaesthesia: A report and
evaluation of 200 consecutive cases. Ain J Clin Hypn 1961;4:26.
Kroger WS: Clinical and Experimental Hypnosis in Medicine, Dentistry and
Psychology, ed 2. Philadelphia, JB Lippincott, 1977.
Lamaze F: Painless Childbirth. London, Burke, 1958.
Leckie FH: Hypnotherapy in gynecological disorders. Int J Clin Exp Hypn
1964;12:121.
Lederman EI, Fordyce CY, Stacy TE: Hypnosis as an adjunct to anaesthesiology.
Md Med J 1958;7:192-194.
Levinson BW: States of awareness during general anaesthesia, in Lassner J
(ed): Hypnosis and Psychosomatic Medicine. New York, Springer Verlag, 1967.
Moll A: The Study of Hypnosis. 1889. Reprint. New York, Julian Press, 1958.
Morgan G: Hypnosis in Ophthalmology. Birmingham, Ala, Aesculapius Publishing,
1980.
Newman M: Hypnosis in haemophiliacs. J Aust Dent Assoc 1974;88:273.
Oystragh P: The use of hypnosis in general and obstetrical practice. Med J
Aust 1970;2:731.
Platanov K: The Word as a Physiological and Therapeutic-Factor. Moscow,
Foreign Languages Publishing House, 1955.
Read GD: Childbirth without Fear. New York, Harper, 1953.
Roig-Garcia S: Report from Pan American Medical Association Special Panel on
Clinical Hypnosis, May 1960.
Silverberg EL: Hypnosis in the treatment of warts. Arch Gen Psychiatry
1973;28:439-441.
Stolzenberg J: Psychosomatics and Suggestion Therapy in Dentistry. New York,
Philosophical Library, 1950, pp 21-22.
Van Dyke PB: Some uses of hypnosis in the management of the surgical patient.
Am J Clin Hypn 1970;12:227.
Wallace G, Coppolino CA: Hypnosis in anaesthesiology. NY J Med
1960;60:3258-3273.
Werner W, Schauble P, Knudson M: An argument for the revival of hypnosis in
obstetrics. Ain J Clin Hypn 1982;24(3):143.
Wilson J, Turner DJ: Awareness during caesarean section under general
anaesthesia. Br Med J 1969;1:280.
Zimmerman D: Hypnotherapy in surgical management: A review. J R Soc Med
1980;73:579.

13. AUTHOR INTERVIEW WITH GÉRARD V. SUNNEN, M.D. ADVANCES: JOURNAL OF THE
INSTITUTE FOR THE ADVANCEMENT OF HEALTH: GERARD V. SUNNEN
How did you become involved in medical hypnosis? When I was a college
student, I learned hypnosis and self-hypnosis. Years later when I was a
surgical intern, I removed a small tumor from a patient's arm using hypnosis
because he said he was allergic to the anesthetic. At first, I was hesitant to
use hypnosis for a surgical procedure without anesthetic drugs, although I had
read the literature that many operations had been performed with hypnosis
alone. However, it went very well, and it impressed me very much. It was a
personal step toward trusting hypnotic anesthesia. This was the pivotal point
in my career.
How has your work evolved over the years? My internship was in medicine
and surgery, and then I did my residency in psychiatry. I began to apply
hypnosis to psychiatric problems. My current specialty is hypnotherapy, which
uses hypnotic trance in combination with traditional psychotherapy.
Hypnotherapy is sometimes used to find out why a change is not occurring--that
is, if there is a "block." It can facilitate the translation of an insight
into change as well as the discovery of the insight itself. The individual is
more apt to be able to work through insights--to translate them into internal
changes--in the trance state than in the normal waking state.
How is this approach applicable to physical health? Patients who are
physically ill often need to gain a psychodynamic understanding of their
situation. Hypnotherapy is used not only for removing symptoms or for giving
direct suggestions. Hypnotherapy also has to do with the patient's
interpretation and image of the situation, which involves a deeper level of
understanding and change.
What difficulties have you encountered in pursuing a career in medical
hypnosis? One of the problems in this field is that there is no formal
training for medical hypnosis. One has to find one's own way. There are no
institutes of medical hypnosis. There is varied training, and one has to find
one's own mentors.
What have you learned from this work? Throughout my hospital-based
career, I have seen the need for relaxation training, with or without
hypnosis, for hospitalized patients. Giving patients medication is not the
answer to help them adjust to the hospital situation at all. Taking the time
to talk with patients, explaining procedures, and paying attention to their
mental state is more important. I have found that relatively little time is
spent paying attention to patients' mental state. Their physical state and
their basic needs are taken care of. However, if patients indicate that they
are having anxiety, they are given tranquilizers. Sedating patients doesn't
create positive moods and affects that aid healing. I see the role of
hypnosis in the hospital as helping to allay patients' fears and anxieties.
Usually, hospitalized patients are placed in a passive, dependent role. Not
only do patients need to be involved in the decision-making process with
regard to their care. They also need to become a force for healing themselves.
What do you see as future directions in this field? In the future, more
work needs to be done not only with patients, but also with health
professionals. Hospital personnel often do not see the value of helping
patients through nonorthodox techniques. Nurses, physicians, and surgeons may
be ignorant of or biased negatively against these techniques. These treatment
personnel must be educated with regard to the value of hypnosis. For example,
the surgeon mentioned in the preceding article, who called to ask me about the
hypnosis for the woman who underwent a bronchoscopy, later referred several
hospitalized patients to me because he saw how effective hypnosis had been in
this one case.

13. TRANCE SCALE FOR HYPNOSIS, SELF-HYPNOSIS, AND MEDITATION: G.V.

SUNNEN
In recent years, disciplines of the mind which center upon special mental conditions to
achieve therapeutic gains have seen steady expansion. Hypnosis, self-hypnosis, and meditation
are all associated with special mental states which facilitate positive personal changes and
connect with higher dimensions of the psyche.
Medical hypnosis is increasingly recognized as a powerful healing modality with
applications in all fields of medicine. It is utilized to modulate pain, temper side effects of
medications, and to accelerate convalescence. Medical hypnosis has proven itself in its ability to
prepare patients for surgery, special procedures, and childbirth, by neutralizing anxiety and by
instilling affirmative healing imagery. Because of the fact that hypnosis allows the mind to
penetrate into the far reaches of the autonomic nervous system, investigations are under way to
determine its potential to positively influence the mechanisms of disease.
Self-hypnosis is a mental skill enabling the individual to self-guide into a trance. In this
practice, instructions are self-administered in order to orient the mind into new experiences of
awareness. In self-hypnosis, one part of the mind exercises its executive prerogatives to direct
the mind's other dimensions to travel in self- suggested directions. Self-given affirmations
progressively coax the mind to new levels of physical and mental relaxation. Meditation is a
term given to numerous practices designed to bring about harmonious control of the physical self
and the mind. Most forms of meditation draw upon the process or relaxed focused attention.
Meditative practices vary widely according to the discipline which spawned them. Focusing
upon the flow of breathing in a context of active contemplation is a central meditative method.
Hypnosis, self-hypnosis, and meditation, all have the capacity to reach special states of
the mind which center upon relaxation. Indeed, hypnosis may be called the most potent
non-pharmacological relaxant known to science. However, relaxation in this context signifies
more than the common notion of muscular repose. Relaxation may start at the level of the
neuromuscular system, but moves inwardly to involve the autonomic nervous system,
perception, cognition, the domain of emotions, and from there, the yet poorly charted highest
realms of the psyche. Each of these dimensions of relaxation is accompanied be experiential
changes which are delineated in the Scale. Hypnosis, self-hypnosis, and meditation may seem
like separate entities. On closer look and in their long term practice, however, they are found to
share common principles. Most importantly, they all can bring to light the fruits of greater
self-comprehension, relaxed self-control, existential centeredness, and spiritual blossoming.
In the context of a practice that has extended over 20 years and has passed the mark of
500 individuals treated with hypnosis, self-hypnosis, and meditation, it was thought that the
creation of a scale could facilitate therapeutic progress in several ways. The opportunity to
evaluate one's evolution into the art of producing trance is valuable in terms of stimulating
motivation and documenting the attainment of mastery. Furthermore, the items in the scale serve
to kindle awareness of trance territories that hitherto may have been overlooked.
 This scale is based upon the subjective experiences of over 500 individuals who have
experienced trance. Experiences during trance states may vary widely from one individual to the
next, and within the same individual in the progression of training. By no means do the
experiences included in the Scale provide an exhaustive repertory of all varieties of trance
phenomena humans are capable of attaining. Instead, clusters of experiences have been grouped
in statistical fashion, with preference lent to those which have been observed to favor the
realization of more profound trance dimensions.
The Scale is composed of 20 subscales, each of which is graded from (0) to (5). The
goal, on the whole, is not to reach 100. Rather, it is to gauge one's progress over time. It is
usually self administered a short time after a trance experience. The experimenter, once having
exited from the trance, retroactively recaptures the elements of the trance and grades them
according to the Scale. (0) is indicative of no appreciable change from one's usual waking state,
while a reading of (5) represents a maximal change in that subscale. Nevertheless, a total score
may be calculated, which may then be depicted in graph form.
Progression in every subscale is not necessary for the achievement of trance. Frequently,
only a limited number of subscales are implicated in the trance experience; and those are the
ones that the experimenter may choose to focus upon and develop. It must be remembered that
trances, like fingerprints, manifest themselves in unique ways in every individual. The very
highest manifestations of trance, however, may prove to be universal in their expression.
The following experiences are referable to sensations usually associated with the physical
body. They include modifications of individual sensory modalities, but as trance depth
progresses, they tend to involve global bodily experiences.
Global Physical Relaxation: This is a subjective evaluation of global bodily relaxation.
Relaxation, as an all-encompassing dimension involving all levels of body and mind, has no
boundaries.
* Perceptible relaxation of at least one part of the body i.e., the shoulders,back, arms, legs.
* Mild relaxation of the entire body.
* Substantial widespread relaxation.
* Intense global relaxation. A reading ofis paired with a statement such as, "I have never been
so relaxed in my entire life.":
Body Deceleration. The body slows down and physical tranquility expresses itself in
progressive disinclination to move and to speak. There is a gradual gravitation of the body to
stillness.
* Barely perceptible slowdown of breathing and heart rate.
* Marked slowdown of breathing and heart rate.
* Entire body feels decelerated.
* Comfortable immobility.
* Profound stillness in the context of relaxation:
Heaviness/Bouyancy. Initially, there may be feelings of either heaviness, or of lightness
(bouyancy). As trance progresses, lightness, the sensation of floating, usually takes precedence.
* Barely perceptible sensation of heaviness or lightness in arms and/or legs.
* Lightness or heaviness extends to entire body.
* Merging of heaviness and lightness into a novel sensation.
* Floating, weightless sensation.
* Sensation of airborne drifting or flying while staying still:
Breathing Awareness. The feelings linked to breathing are progressively intensified.
* Perceptible mental connection with muscles involved with breathing.
* Sensation of the air touching the inside of the lungs.
* Feelings of progressive blending with the lungs.
* Sensation of intense merging with the flow and rhythmicity of breathing.
* Feelings of energy flowing in the body with each breath:

Body Volume: Body volume is the experience of the volume that the body occupies in
space. Eyes closed, in the normal waking state, this volume has a certain constancy. In trance,
enlargement of this volume is experienced.
* Awareness of body volume.
* Perceptible expansion of body volume.
* Continued expansion with awareness of connection between breathing and body volume.
* Body volume occupies the space of the surrounding room.
* The boundaries of the body feel like they extend beyond surrounding physical confines:
Body Configuration: The representation of the shape of the body usually undergoes
transformation during trance. In the normal waking state, eyes closed, the shape of the body is
well delineated in the mind's eye. In trance, parts merge. Arms, legs, thorax, abdomen, and head
become fused.
* Awareness of one's body configuration.
* Arms are felt in their entirety rather than in their separate elements.
* Emergence of sensations of blending of the hand, elbow, shoulder, and armmusculature into a
unified whole.
* Blending of arms and legs. Beginning merging of the extremities with therest of the body.
* Simultaneous awareness of the entire body, inside and out.
* The body, totally unified in awareness, feels like a sphere:
Temperature: Within trance, often in response to one's predilection, feelings of warmth
or coolness emerge. The experience is somewhat different from the application of a heating pad
or an ice pack. Warmth, as is freshness, is experienced as "psychic heat", or as "psychic
coolness". Either dimension may accompany progressive trance.
* Perceptible heat or coolness in one arm.
* Heat or coolness in both arms.
* Heat or coolness in both arms and legs.
* Entire body, notable sensations of coolness, or warmth.
* Merging of warmth and coolness to produce a novel sensation in entire body:
Organ Awareness: This dimension of trance is an extension of the breathing awareness
mentioned above. This awareness diffuses into all bodily spaces, and extends to organ systems
and their workings.
* Awareness of lungs.
* Added awareness of heart region.
* Added awareness of abdominal region.
* Awareness of other structures or organ systems: sexual organs, the spinal cord, structures
inside of head.
* Experience of ease of mental travel to any of the body's organ system: The following
experiences refer to perceptions usually associated with cognitive dimensions of the mind. The
mind's output of language relaxes. The flow of words ebbs. The tides of the emotions grow
quieter, then attain stillness. In deep trance, there is a pervasive sense of harmony which is
perceived as independent of thoughts, emotions, and mood.
Environment's Distancing. The perception of the environment is presence usually
constantly in attendance in consciousness, recedes. The mind's investment of energy into its
surroundings is redirected unto itself.
* The feeling of direct connection with the environment relaxes
* Beginning autonomy from surroundings is experienced.
* Surroundings feel substantially removed from attentiveness.
* Surroundings take up a minimal portion of awareness.
* Surroundings feel nonexistent and devoid of relevance:
Language Flow. The mind's usual spontaneous generation of words, thoughts, and stream of
memories relaxes.
* Increased awareness of individual words as they are expressed in their mental form.
* At times, increased word flow; most often, perceptibly lower word output.
* Diminution of word output and of sentence formation, with presence of truncated grammar
* Awareness markedly withdrawn from language.
* Complete word silence in the context of profound peacefulness, with the perception of "My
identity exists apart from my thoughts":
Sense of Time Flow. The sense of time elapsing is relaxed in trance.
* Perceptible lapses in the experience of the continuity of time.
* At times, initial increased awareness of time passing, most often followed by decrease, with
periods of absent time.
* Marked decrease in time awareness with frequent periods of silent or absent time.
* Sensation of time standing still.
* Sensation of the irrelevance of time passing, in the context of feeling enlightened by this new
perception:
Emotions/Mood: Emotions undergo relaxation in trance. Their intensity wanes, and
emotional quietude emerges. In the most profound trance the experiencing mind separates itself
from emotions. Mood, the ongoing background emotional tone, approaches, then attains a
peaceful neutrality.
* At times, initial increase in awareness of pre-trance emotional residues; most often, lowering
of emotional intensity.
* Perceptible softening of emotional tone.
* Marked emotional stillness with emerging feelings of harmony.
* Pervasive neutrality of mood with serenity.
* Disconnection of awareness from emotions and mood, with the feeling that "Myidentity is
separate from my emotions ":
Imagery/Sounds/Colors. This subscale measures the mind's potential for the creation of
imagery, which is intensified in trance.
* Awareness of eyes-closed visual inner space and/or of auditory space.
* Awareness of visual images, dream sequences, sounds, or even music is slightly kindled.
* Images begin to appear as they may do in dreams.
* Ability to hold images or sounds in the mind begins. Merging of colors and sounds to obtain
novel amalgamations.
* Images and sounds experienced contain a notion of universal significance: The following
experiences refer to perceptions belonging to what may be called the highest levels of human
consciousness. These experiences are described as transcendental and spiritual. Because
descriptive terms to denote these complex experiences are often unavailable in our language, the
experimenter is asked to intuitively grade the intensity of their manifestation on a scale of (0) to
(5).
Energy/Force: Progression into trance often leads to experiences of feelings of energy.
Energy is often described as currents, waves, or vibrations coursing through the body.
Descriptive terms include feelings of personal power, force, and vitality. In the maximal range
of this subscale, the feeling of mental energy reaches concentrated intensity:
Locus of Self. The experiencing of one's self borrows from several dimensions, some
physical, some psychological, others spiritual. This subscale gauges the feeling of self in relation
to personality as an entity which has a highly individual meaning. In trance, the personal
attachment to one's personality relaxes, sometimes profoundly. In the most intense manifestation
of this scale, it may be stated "My personality has a relationship to me, but it is not me":
Clarity/Knowledge: In this progression the central feature is a feeling of clarity of
understanding. At first there is the experience of the feeling of self knowledge. This feeling of
knowing oneself is independent of logic or outward fact. The progression continues to feelings
of knowing the world. At the most intense level of this subscale, conundrums or koans such as
"Has the universe always existed?" become understandable:
Happiness/Joy: Happiness and joy, as feelings, do not require logical reasons for their
existence. Nor do they require the process of thinking in order to be expressed. This progression
begins with feelings of enthusiasm for life, optimism, and evolves gradually to joyfulness and
elation:
Empathy/Love: This dimension of trance begins with feelings of affection, compassion,
and empathy with humankind, and ultimately, to feelings of love for all life:
Peacefulness: This progression begins with feelings of calm, evolving to include
experiences of tranquility, serenity, and ultimately, to profound feelings of peacefulness:
Oneness/Unity: The sense of oneself, in the waking state, includes the experiencing of
separateness from society and from the world at large. With trance progression, this feeling of
separateness recedes. Feelings of unification or amalgamation take its place. The usual
perspective of self-centering gives way to feelings of oneness and unity with and within all of
life:
Readers are invited to send their commentaries regarding this scale. Personal reports
related to the experiencing of any one of the dimensions of trance as outlined above, or any
others, are most welcomed. This scale is in progress and is open to ongoing evaluation and
modification. It will be modified according to the feedback given to it.
BIBLIOGRAPHY:
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Burrows GD, Stanley R (Eds). Contemporary International Hypnosis. John Wiley, New York,
1995
Fromm E, Nash MR. Contemporary Hypnosis Research. Guilford Press, New York, 1992
Michaux D. La Trance et L'Hypnose, Imago, Paris, 1995
Miura I, Sasaki R. The Zen Koan: Its History and Use in Rinzai Zen, Harcourt, Brace, New
York, 1965
O'Brien. Varieties of Mystic Experience. Holt, Rinehart & Winston, New York, 1964
Sheehan PW, McConkey KM. Hypnosis and Experience: The Exploration of Phenomena and
Process. Brunner Mazel, New York, 1996
Sunnen G. Medical Hypnosis in the Hospital. Advances. Journal of the Institute for the
Advancement of Health 1988; 5(2): 5-14
Sunnen G. What is Hypnosis? In, Temes R. (Ed), Medical Hypnosis: An Introduction and
Clinical Guide. Churchill Livingstone, New York, 1999
Sunnen G. Omniforce. Volumes 1 to 11. International Rights, Ltd., New York, 1995 to 2001
Tart CT (Ed). Altered States of Consciousness. Doubleday Anchor, Garden City NY, 1972
Udolf R. Handbook of Hypnosis for Professionals. Jason Aronson, New York, 1995

White J (Ed). The Highest State of Consciousness. Anchor, New York, 1972
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New York, 1986
Zinberg N (Ed). Alternate States of Consciousness. Free Press, New York, 1977

NOTES FROM CLIENT-CENTERED HYPNOTHERAPY: R. D. LONGARCE, Ph.D. (1995)

Kindall/Hunt. Dubuque, IA):
There is a consensus that how a subject responds to hypno-suggestion depends far less
that had previously been supposed on the hypnotist's formal induction and far more on the many
other complex interrelated variables, most of which pertain to the subject rather than the
hypnotist. These interacting variables which determine responsiveness includes: the subject's
expectancies and beliefs about hypnosis: the subject's attitudes and motivations toward specific
situations; the subject's pre-existing abilities to imagine, fantasize and daydream; the subject's
feelings toward and beliefs about the hypnotherapist; and the hypnotherapist; communicative
skills in presenting suggestions that are personally meaningful for the particular client or patient.
(p.2)
Misdirection of attention is the common component of any induction technique... Before
the hypnotherapist begins to formulate his own client-centered or creative induction techniques,
he would review the concept of misdirection of attention. (p. 17) There are over a thousand
and one ways to misdirect attention. The question is, how many can you create and employ in
your professional work? The answer is an infinite number when you let your own creative
subconscious mind experience the possibilities. (p. 18)
Low self-esteem is a significant factor in problems experienced by children who are
having difficulties in school, in family situations or sports activities. Children are highly
suggestible and even an off-hand remark can decrease a youngster's sense of self-esteem or self-
worth. A child who is teased and told that he or she is stupid or clumsy may well act on the
unintended remark and begin acting clumsy or stupid. A child who is admonished to preform at
peak proficiency in a sports event or classroom exercise may feel extremely tense, nervous and
anxious. The inability to break the feeling of tension may lead to a sense of frustration and an
even greater felling of nervousness an lower self-esteem. Oftentimes low self-esteem can be
enhanced if just one person believes in a child and allows the child to create their own solutions
to a given problem by believing in themselves. One person who can make a difference in the
areas of low self-esteem, low motivation, enhanced concentration and memory is the client-
centered hypnotherapist. The hypnotherapist can also provide a child with a life-long tool for
alleviating inappropriate tension and anxiety. (p.127-128)

31. NOTES FROM INSIDEOUT: R.D. LONGACRE, Ph.D. (1989) Therapeutic Educational
Group Pub. Glendale, AZ):
As we grow up we use the best information and knowledge available at a given time to
solve a problem we are facing. As we solve the problem, we file information and the learning
experience in our subconscious mind. As an adult we call upon this stored information to
logically solve adult problems. Unfortunately the information we use to solve the adult problem
may be childish thinking that we are not aware of. (p. 18)
The critical sensor is a necessary part of the human computer. It alerts us in a time of
danger and often prevents us from making so called "stupid mistakes." However the critical
sensor is often the cause of roadblocks to developing right brain or subconscious programs that
can be used to improve our quality and enjoyment of life.
In order to program a pathway for change in the powerful right brain portion of the
human computer, three things must happen simulataneousely. The left brain input functions
must be placed in the pause mode or instructed to only report one idea or sound source to the
critical sensor. The critical sensor must be bypassed by activating the "I want" key and the right
brain or subconscious mind must be give permission to develop new and creative programs. (p.
24)
Rev. Dr. Paul G. Durbin writes about the triangle concept in his book Awakening the
spiritual connection. "The foundation for my work in hypnotherapy is based on what I refer to
as the human trinity. Whether you are a Christian or not, you would probably know what I
meant if I referred to the Holy Trinity: God the Father , the Son, and the Holy Spirit. I believe
in the Holy Trinity and I also believe in human trinity. Each of us is a trinity within himself or
herself. What is the human trinity? The human trinity is the concept that we are made up of
body, mind and spirit. We are physical, emotional and spiritual beings." (p. 35)
The word "try" is often the villain. "Try" is a do nothing word. The word try means,
maybe I can and maybe I can't. The word try means, it's OK to not do something. The word try
means, probably nothing will happen anyway. (p. 38)
THE VICTIM: Just as we can fall a victim to a disease or illness, we can also become a
victim of an unwanted habit, behavior or a series of circumstance that interrupt the joy of living.
(p. 39)
THE LAW OF SELF-FULFILLING PROPHECY: This law states that if you think
about something long enough, what you are thinking about tends to happen. (p. 39)
THE RESCUER: The rescuer of the human triangle is a storehouse of information and
has the ability to create infinite pathways to change... The rescuer is our God given ability of the
subconscious mind that insures the strength and integrity of the human triangle. (p. 41)
THE ACCUSER: No matter which way you turn a triangle, there is always one side that
becomes bottom. This side provides the balance and strength for the triangle. This balance is
also necessary in the human triangle. Notice that the rescuer part of the triangle is on the bottom
or at one side of the balance line. The Accuser is on the opposite of the bottom or balance line.
The accuser provides balance when it is operating in a positive manner. When the accuser is
operating in a negative way it sill maintains balance, but at the expense of the rescuer. When
the accuser becomes a villain it negates the positive thinking and creative actions of the rescuer.
(p. 42)
Stress affects any kind of system be it the environment, a steel beam or our bodies.
When a given system is stressed, the individual molecules which make up that system or a
substance are altered. When we are mentally or emotionally stressed, our body systems, i.e.
digestive system, elimination system, etc. do not work as they were meant to. When the body is
stressed to a point where it is unable to process and eliminant food as it should, it begins to find
an alternate route for dealing with food energy. This alternate route require the body to alter or
break down long chains of amino acids into harmless looking 6-carbon rings known as sugar.
The sugar can then be stored for later energy use in the form of something we have all been
taught to dread, fat. (p. 88)

32. NOTES FROM PRACTICAL THERAPIES: R. D. LONGACRE, Ph.D. (1990)

Therapeutic Educational Group, Glendale, CA):
While we do not know how the mind body connection healing takes place in each
individual situation, we are beginning to understand how a mental thought pattern (imagery)
can alter physiological disturbance or change the biochemistry of an individual. (Dr. Cherylanne
Atwood) (p. 6)
It was long thought that the control of the ANS was involuntary. In other words, there
was nothing we could do to regulate this activity. We know now that by using appropriate
mental pictures or images, we can create the relaxation response at will with just a little training
and effort. When the physical body is relaxed, nerve energy and blood flow is enhanced,
thereby promoting wellness by the immune system which works in the blood. Therefor
enhanced blood circulation triggered by the relaxation response can have a direct effect on the
healing response.
Today a growing number of physicians and health care providers ar endorsing the
concept of "Holistic Health". Holistic health is a combination of techniques that modalities
that treat the whole person, not just the physical complaint." Holistic health treatment includes
the body, mind, and the spiritual parts of a patient. While this approach is perceived by many to
be a modern approach, it has been praised, ridiculed, defended and revived time after time
throughout history. (p. 10)
Today the concept of holistic health and the power of the mind to heal the body is an
important tool in the armamentarium of all physicians. Thanks to the pioneering work of people
like Bernie Siegel, M.D., Norman Cousins, Lawrence LeShan, M.D., patients are learning that
here is a mind body connection and it can be used to create new health. (p. 12)
(TRUE PRAYER): As I begin writing this chapter, I am reminded of an evening my
five and one half year old daughter explained to me how to pray. Binkey, my nickname for this
inquisitive and energetic child, was kneeling beside her bed saying her prayers as I listened from
the hallway. As I waited for her to get to the God bless mommy and daddy part, I realized that
she wast saying words. Binkey was reciting the alphabet over and over. Slowly, deliberately
and in hushed tones she repeated each letter. The time through the alphabet, my curiosity got the
best of me. "Binkey", what are you doing?" "I'm praying daddy," she stated in a matter of fact
voice. "What do you mean by praying." I replied. "Well you see daddy, I'm not old enough to
know all the words yet so I just keep saying the letters because God will put the words together
for me.(p. 13-14)
Dr. Paul Durbin, a good friend, who is the Director of Pastoral Care at Pendleton
Memorial Methodist Hospital in New Orleans and serves a Chaplain of the board of directors of
the National Board for Hypnotherapy and Hypnotic Anaesthesiology shared the following story
that illustrates creative reasoning.
An older woman patient was confined to the hospital for treatment of her cancer. Her
treatment required chemotherapy which was given intravenously and left her feeling ill
afterwards. Since she was a very religious woman, Dr. Durbin was hesitant to mention hypnosis
because of her possible religious objections. During their conversation about guided imagery the
woman looked at the IV bag hanging on the pole and said, "That bag could be filled with the
healing blood of Jesus."
Dr. Durbin confirmed that indeed it could and this became the image the woman used
during chemotherapy treatment. The woman's creative reasoning served her well as there were
no more reports of extreme nausea following chemotherapy. (p. 15)
The subconscious mind can also be a safe harbor for negative emotions that the
conscious mind refuses to let out. Repressed negative emotions and denial of current reality also
play a role in catastrophic illness and can be roadblocks to a return to wellness. You won't find
the word wellness in the dictionary, but I use it to distinguish between illness, health (physical)
and emotional plus physical plus spiritual health. All three aspects of health are included in the
term wellness. (p. 29)
We can make a logical conclusion that if the subconscious mind is inactive in providing
solutions to living or harboring negative attitudes, it can also be used to crate now pathways to
health by release of negative thinking. This is because the right brain or subconscious mind does
not have to obey any given set of rules or reason why before taking action. (p. 30)
"I'm not worthy of healing", "I deserve to be sick because I've made a mess of my life",
and "God is punishing me for my sins" are just a few of the excuses I've heard from people who
are tying too hard to earn spirituality. Spirituality is a gift and plentiful for everyone when they
unbolt the door that is shutting it out of their life. I am an ordained minister and believe in God,
however, it is not my purpose in this book to convert anyone to my brand of faith. It is my
purpose to share with you ways you can heal your spiritual nature along with your physical
nature. In fact the spiritual haling must take place before physical healing can begin. The
answer is faith, love and hope. (p. 37-38)
Faith is not the childish belief that something is true despite the lack of solid or hard
evidence. Spiritual faith is the inner knowledge that something is already happening before we
are aware of it consciously. Faith is a powerful force constantly working in the subconscious
mind. Faith is the comminution channel and receiving agent for abundant gifts promised by a
higher power. While faith in ourselves is an admirable activity of the conscious mind, inner faith
is the result of just being ourselves complete with all of our imperfections. Faith is not only a
mystical or magical aspect of our spirituality, it can also operate of a very practical. (p. 38)
Spiritual love is not something you can measure. It is not something that you can earn by
making promise or doing specific deeds. Spiritual love is not the result of religious upbringing
or conversion to a church. Spiritual love is an inner knowledge and peace that has always been
inside of everyone waiting for permission to balance and bring a sense of wholeness to each
individual life. (p. 46-47)
Hope is the third aspect of our spiritual nature. It has been said that without hope life is
lost. Hope is an intriguing word because it has dual meaning in relationship to the mind-body
connection. Hope can be a powerful weapon for survival and it can also be and excuse do
nothing. (p. 47)
Common dream patterns can be used only as a guide in that there can be hundreds of
interpretations for each individual dream pattern.
(1) Falling from a height: This dream can be due to feeling of anxiety or losing something from
another person or eve escape form some apparently unsolvable problem. (p. 68)
(2) Flying through the air: Flying dreams generally indicate pleasure ranging from juvenile to
adult states. They can also be an urge to free oneself from life's problems or as a death token
with the dreamer taking off for heavenly realms.
(3) Finding money or valuable articles: These are dreams of intense desire, which reach a state
of temporary fulfillment before they fade away. The intense desire though, is general, not for
money. When money is found in a dream it can be an indicator that something else is desired
such as acceptance and love.
(4) Losing money or valuable articles: This is the opposite of the "finding" dream but with a
different meaning. The dream may be quite disturbing but the greater the loss the happier the
awakening. (p. 69)
(5) Being chased or hunted: This dream is generally viewed as an indication of repressed desire.
(6) Pursuing someone or something: Pursing suggests aggression, so this dream can logical
represent an aggressive urge of the dreamer.
(7) Impeding danger: Freudian interpretation of this dream suggests elements of repressed wish-
fulfillment; other authorities see this as antagonism or secret guilt. (p. 70)
(8) Being trapped in tight places: Maybe the result of repressed antagonism or secret guilt,
however it can also indicate a struggle taking place in the dreamer waking life.
(9) Missing the boat: This is a dream of losing a real opportunity. If the dreamer gets on board,
it indicates that can work through the problem.
(10) Interrupting preparation: Inability to do something. Can mean to banish past mistakes and
guilt. (p. 71)
(11) Taking an examination: Confrontations for real life problems. (p.71-72)
(12) Insufficient clothing: Feelings of embarrassment to outright exhibitionism. Feeling inferior
and perhaps guilty.
(13) Water and swimming: May have a religious meaning or a search for something
immediately beyond the reach.
(14) Fire and flame: Favorable if dreamer doesn't get burned. May mean love. (p.72)
(15) Rescuing someone: Desire for renunciation of something unattainable. The victim may be
the dreamer himself.
(16) Being rescued: Desire for spiritual attainment.
(17) Being lost: Afraid of undesirable acquaintances catching up with them. (p. 73)
(18) Losing some necessary item: A person may lose an item that will prevent them from going
somewhere the didn't want to go.
(19) Food and eating: Ingestion of massive amounts of food may indicate a desire to literally eat
up all opposition. (p. 74)
(20) Teeth dreams: Hope of eliminating a bothersome problem. (p. 75)
VISUALIZATION AND GUIDED IMAGERY FOR PAIN MANAGEMENT: R D
LONGACRE: 1995) Kendall/Hunt. Dubuque, IA
In other words, using visualization and guided imagery is as simple as picturing and
imagining something you desire and then allowing yourself to enjoy this picture or image as if it
was already completed. (p. xi-xii) Religious people may identify with the phrase, "Whatsoever
you ask, believing that you shall receive." Entrepreneurs and those working in business may
discover the meaning of visualization and guided imagery by reflecting on the quote attributed to
Henry Ford, "Think you can, think you can't, either way you're right." (p. xii)
Generally a new idea must pass through three phases before it is accepted. At first the
idea is thought to be impossible. Then the idea is considered sacrilegious or preposterous.
Finally the idea is axiomatic; everyone knew it would work long before the idea was generally
accepted. (p. 5)
The deep state of hypnosis is seldom indicated for clinical hypnotherapy. Specialists in
hypnotic anaesthesia take patients to a deep state of hypnosis to facilitate analgesia for surgery.
(p. 14)
PAIN CONTROL THEORIES: The control gate theory postulates that pain impulses
traveling to the mind must pass through a control gate or valve before reaching a command
center in the left brain. This command center or switchboard analyzes the information and then
channels the pain stimuli to appropriate pain response centers that instigate a physiological
response. When the left brain or conscious side of the mind has a narrowed focus or span of
attention, the control gate allows only wanted or selected pain impulses to enter and trigger a
physiological response, i.e. the sensation of pain. The control gate closes when the attention of
the conscious mind is misdirected or centered on a fixed focus such as the therapist's voice or a
visual object, real or imagined. The control gate theory assumes that physiological pain is
ignored by the mind due to an increase of the individual pain threshold. (p. 15)
The autonomic (involuntary) nervous system (ANS) has two branches or sides; the
sympathetic and the parasympathetic. The sympathetic side is the fight or flight branch. The
parasympathetic side is the relaxation branch. Emotional or physical stimulation of the
sympathetic side results in accelerated breathing and heart rate as well as psychological survival
instincts and behaviors. The sympathetic side of the ANS responds to tension, anxiety, fear and
pain. The parasympathetic side of the ANS triggers the relaxation response. With relaxation the
breathing and heart rate returns to a normal range and minor discomfort is ignored as the body
recuperates from a stressful experience.
The ANS Inhibition Theory suggest that with hypnosis, the sympathetic branch can be
controlled by the parasympathetic or relaxation side. In other words, the relaxation response can
inhibit or ameliorate pain stimuli. With deep relaxation pain can be interpreted as pressure on
the mind. (p. 15)
The body is a Robot Theory: This theory is easily understood by patients or clients
and presents a good explanation of hypnotic pain control phenomena. "The Body is a Robot
Theory" assumes that only the mind can think and the body is a robot controlled by the mind.
Therefore, what the mind chooses to accepts that pain only pressure then the body's
physiological response must be response to pressure rather than pain. (p. 16)
Specific contraindications for hypnotherapy are predicated on the therapist's training,
skill, experience and clinical objective of therapy. When working in the areas of hypnotic
anaesthesia, hypnodontics and pain management, direct symptom removal of pain is always
contraindicated without the approval of a physician. (p.27)
CLINICAL INTERVIEW PROTOCOL:
(1) Solicit information about the patient's occupation, hobbies and special interest.
(2) Inquire about the patient's previous experience with hypnosis or their familiarity with the
phenomena.
(3) Determine if the patient really wants the expected outcome of therapy.
(4) Establish rapport with patient by telling them a little about your training and past experience
in helping people with similar problem.
(5) Explain to the patient how you plan to help them with their problem and the results thy can
expect from therapy.
(6) Ask the patient if they want you to help them overcome their problem.
(7) Listen to the patient's choice of words and tone of voice during the interview. Watch for
expressions both verbal and nonverbal that may provide clues as to their primary learning
system. Remember that all hypnosis is really self-hypnosis and the patient will usually only
achieve the results they honestly want and desire. (p. 29)
 PREINDUCTION PROTOCOL: The preinduction visit is the portion of time during
the initial meeting when the patient that is used to explain what hypnosis is, what it is not and
how hypnosis works.
(1) Explain what hypnosis is. Two basis definitions you may wish to use are: "Hypnosis is an
artificially induced state, usually (though not always) resembling sleep, but physiologically
distinct from it, which is characterized by heightened suggestibility, as a result of which certain
sensory, motor and memory abnormalities may be induced more readily than in the normal state.
(Warren's Dictionary of Psychology). In a hypnotic state the body is a robot controlled by the
mind. What the mind perceives or imagines as reality, the body will do and accept as reality. (p.
33)
(2) Explain what hypnosis is not. Hypnosis is not physical sleep. Hypnosis is not a state of
unconsciousness. Hypnosis is not gullible. Hypnosis is not being week minded. Hypnosis is not
being controlled by someone else. Hypnosis is not a loss of self-control. Hypnosis is not
divulging secrets. No one can be hypnotized against their will or do anything in a state of
hypnosis that violates their moral, religious, or personal principles. (p. 33-34)
(3) Demonstrate to the patient what hypnosis feel like.
(4) Dispel the myths about stage hypnosis.
(5) Give a simple explanation of how therapeutic hypnosis works and why it is different from
stage hypnosis.
(6) Demonstrate clinical hypnotic phenomena to the patient by conducting various suggestibility
tests. (p. 34-35)
HYPNOTIC CHILDBIRTH INDICATIONS:
(1) Reduction or eradication of fear, tension and pain before, during and after labor and delivery
with a resultant elevation of the pain threshold.
(2) Reduction of the amount of pain medication required to maintain the patient's comfort.
(3) Patient control of painful uterine contractions which may be experienced during normal labor
and delivery.
(4) Decreased shock and speedier recovery.
(5) Amelioration of undesirable post operative effects.
(6) Hypnosis shorten the first stage of labor by approximately three to four hours for mothers
who are experiencing labor and delivery for the first time.
(7) Hypnosis raises resistance to fatigue concomitant with arduous or prolonged labor.
Therefore maternal exhaustion can be alleviated and mothers can be more alert and aware when
their baby is born. (p.65)
(8) Hypnotic rapport can be transferred to a nurse, associate, husband or childbirth coach.
Individuals participating in the birthing process do not need special training to assist patient
using self-hypnosis.(p. 66)
PRECAUTIONS: When working with patients who are using self-hypnosis for labor
and delivery, the health care provider should remember that the patient is in a heightened state of
awareness and suggestibility. When communicating with the patient, the following words and
phrases should be avoided: labor pain, pain medication, this will hurt a little, and are your pains
getting worse. The use of self-hypnosis does not negate the need for necessary pain medication.
Pain medication should be readily available for the patient. Only one in four mothers have the
ability to forego analgesia completely during labor and delivery. All childbirth patients should
be informed that pain medication is available upon request. The patient should also be assured
that they need not feel guilty when requesting medication to help them maintain comfort during
the birthing process.
SIX SESSION PROTOCOL: (p. 68-75)
Hypnotic anaesthesia is indicated for alleviation of pain in the hospital setting, during
dentistry and for patients suffering chronic pain for a variety of physiological or psychogenic
disorders. (p. 81)
HYPNODONTICS: Aaron Moss, DDS, coined the term "Hypnodontics" to dispel the
myths about hypnosis for dental patients who could be helped with this safe, effective and
natural health care alternative to chemical analgesia. (p. 95)
INDICATIONS:
(1) Elimination of the patient's tension, anxiety or fear of pain and related discomfort.
(2) Accustoming the patient to orthodontic or prosthetic appliances after the patient has agreed to
accept them.
(3) Maintenance of the patient's comfort during long and arduous periods of dental work.
(4) Modification of noxious dental habits like bruxism, unconscious grinding of the teeth.
(5) Reduction of anaesthesia or analgesia during dental procedures. (p. 95)
(6) Substitution for, or in combination with, premedication for general anaesthesia.
(7) Amnesia for unpleasant work.
(8) Prevention of gagging and nausea.
(9) Control of salivary flow.
(10) control of bleeding.
(11) Postoperative analgesia.
PRECAUTIONS: The major precaution for the use of hypnosis in dentistry is
symptomatic pain removal. Professional hypnotherapist should not attempt to deal with
symptomatic pain due to oral dysfunction or disease without consulting with a dental physician.
(p. 96)
FUSSY PATIENTS: Fussy patients often put off going to the dentist until the pain or
dental problem can no longer be ignored. These patients for a variety of reasons are fearful,
tense, nervous and anxious before and during the dental visit. Often these fussy patients will
request a tranquilizer or complain of extreme anxiety one or two days prior to seeing a dentist
for a simple check-up. Fussy patients may be a small minority in the population of an average
dental practice however, they often present the majority of problems the dentist encounters in his
daily routine. Fussy patients take extra time and require special consideration by the dentist and
his staff.
Hypnosis can readily ameliorate the tension, nervousness and unreasonable fear of pain
often exhibited by the fussy patient. (p. 96)
PAIN MANAGEMENT: Much of the pain we experience in our daily living is due in
part to stress and tension. Hypnosis has been proven to be effective in the alleviation of stress
and tension. The subjective experience of pain is also related to a variety of psychogenic factors
such as the fear of pin and the conditions and circumstances surrounding the "pain experience."
Hypnosis is indicated for the management of psychogenic pin and also useful for the
management of physiological pain resulting from acute trauma or disease. (p. 191)
Before beginning hypnotherapy for pain management,...the therapist should ask the
patient to provide a medical referral or prescription for pain management. (p. 101)
Pain causes tension and a tightening up of affected areas in the body. Our normal
response to pain is to resist the pain by tightening up even more and becoming more tense. This
exacerbates the severity of the pain experience. Hypnotherapy can help patients learn how to
relax the affected areas of the body causing the pain and ameliorate concomitant fear, stress and
tension. (p.103)

COMPLEMENTARY MEDICINE SELF-HELP HEALING: MANUSCRIPT EDITION: R.D.

Longacre, Ph.D. F.B.H.A. 1999: FOLLOWED BY BERNEL SANDER’S AIH COURSES:
14. PREFACE:
During my over thirty years of experience as an allied health practitioner,
hypnotherapists and counselor, I have read many fine works on hypnotherapy, visualization and
guided imagery. These books were the body of work of some of the leading experts in the field
during the late 1800's and middle 1900's. While the concepts and techniques presented in this
material are still valid and useful in the training of hypnotic techniques, they tend to be outdated
in light of the new body of knowledge about modem Complementary Medicine
Hypnotherapy and mind-body-spirit therapy used as an adjunct modality to traditional western
medicine.
In my previous books, Hypnotic Anaesthesia for Childbirth, Dentistry and Pain
Management, Client Centered Hypnotherapy, Visualization and Guided Imagery in Pain
Management and Visualization and Guided Imagery in Complementary Medicine, I have
attempted to present often cumbersome concepts in an easy to understand manner and provide
up to date and practical applications of modem hypnotherapy that are used in the training
programs and courses of many schools and hospitals across the country.
In this book I have focused on the need for an instructional manual for individual
patients and clients that can be readily understood without the help of a trained therapist. This
information can be used immediately to promote healing and wellness for a variety of medical
and emotional problems as well as the challenges of cancer prevention and treatment.
I believe the reader, both lay person and professional practitioner, will find
"Complementary Medicine: Self-Help Healing" a valuable resource for quickly developing a
straight forward and easy to use treatment program.
DEDICATION: This book is dedicated to my wife, help mate and best friend, Sheila
Spear Longacre, who has devoted every day of our courtship and marriage to walking in front of
me in order to smooth out the rough spots in the road that she intuitively knew I would stumble
across
And to my daughter Leslie Nicole Longacre, who always knew how to make the clouds
disappear on a rainy day and inspired me to discover the wonderful world of a child within
myself. Despite being just 14 years old, she seemed to understand my changing moods and
physical limitations as I dealt with my diagnosis of cancer.
And to my mother in law, Miriam J. Spear, who even when I was wrong, would find a
part of me that was right and became the mother I lost when I was nine years old.
And to John David Spear, my father in law, who was always there to offer prayerful and
loving advice and never offended if was not taken or acted upon.
And to Father Molrin, Father Gino, Chaplain Paul G. Durbin who are spiritual advisors
who live by example the meaning of truth.
And to Michael and Penny who I met during chemotherapy who from their personal
experience with a catastrophic illness filled in the blanks to all the questions I forgot to ask my
doctor. And to my many friends, colleagues and students for their gift of sharing and the
enrichments they have added to my life.
 ACKNOWLEDGMENTS: I am extremely grateful to my many friends and colleagues
who inspired me to write this book, they shared with me information from their personal and
professional experience that provided me with new insights and a greater understanding of the
power we all have within to heal our body, mind and spirit. It would require many pages to
thank each of these dedicated and caring people by name, however I wish to acknowledge those
who have made a special contribution to the contents of this work.
THANK YOU:
Paul G. Durbin, Ph.D., F.B.H.A., Director of Pastoral Care, Pendleton Methodist
Memorial Hospital, New Orleans, Louisiana, and author of "Kissing Frogs: The Practical
Applications Of Hypnotherapy", who unselfishly contributed material on Religion and
Hypnotherapy, and the use of Prayer in self-help healing.
Father Gino, a Franciscan Priest, who's playful and gentle manner and observable
spirituality provided me with new insights into the mysteries of faith and self-help healing.
Father Richard Rohr, a Franciscan Pries who has traveled world over as a retreat leader
and much sought after lecturer, who's teachings on spirituality are reflected in many parts of this
book.
Gerald F. Kein, F.B.H.A., who's talented ability as an educator and leadership as Director
of the Omni Hypnosis Training Center in Deland, Florida has help thousands of patients to a
more abundant and fruitful life.
A. M. Krasner, Ph.D., Founder of the American Institute of Hypnotherapy and my first
hypnotherapy instructor, who encouraged me to specialize in Pain Management and Medical
Hypnotherapy and provided me with free office space until I could establish my practice.
Christopher J. Verde, M.D.I for reviewing this material from the viewpoint of an
Oncologist who I highly recommended to anyone dealing with cancer.
FORWARD: Since we first met in 1987, I have had great respect for Dr. R. D. “Sean”
Longacre, both as a highly regarded clinical hypnotherapist and a close personal friend. Dr.
Longacre conducted a seminar at the National Association of Clergy Hypnotherapist (now
Clergy Special Interest Group/National Guild of Hypnotists) Convention in California on “The
Yellow Brick Road: Working With Hospital Personals.” Following that Convention, we
developed a professional and personal relationship that has endure and strengthen with the
passing of time.
I was deeply touched when Dr. Longacre called to tell me that he had cancer and since
that day, I have said a special prayer for him and his family. I encouraged him to use the
techniques that he had been presenting for years. Like the woman who once told me when I was
facing a difficult decision, “Practice what you preach.” Dr.Longacre has been practicing what
he preached and as a results has come to a new understanding of the power of the mind and the
spirit on the body.
Much has been written about the mind/body/spirit connection over the last 40 years, but
most have focused on the mind/body with nothing or only a tip of the hat to the spiritual. Since
I began hypnotherapy, I have called my hypnotherapy “Human Trinity Hypnotherapy” which
happened to be the title of my first book, now out of print. I believe that each individual is a
trinity within himself/herself. I am a trinity, you are a trinity. We humans are made up of a
trinity of our own: "the human trinity." We are three-in-one: body (physical), mind
(psychological/emotional, and spirit (spiritual).These three aspects of our being are so different
and yet so integrated that one part of the human trinity cannot be affected without having some
effect on the other two.
 The French philosopher Rene' Descartes is best know for his five-word maxim: "I think,
therefore I am." Another of his revelations and one much less accurate and truthful has had
much greater impact of the western world. More than 300 years ago, Descartes concluded that
the mind, body, spirit are distinct, autonomous, mutually exclusive entities. This assumption is
at odds with his famous statement, "I think therefor I am." Unfortunately for centuries the
Western approach to health, illness and medical treatment has been based on Descartes belief of
the mind, body and spirit are separate entities. Today, we are discovering that what we think has
a profound effect upon our health. Dr. David Felton, professor of neurobiology anatomy at the
University of Rochester in New York said, "I can't imagine anyone (today) thinking that the
mind and body can be separated" To complete the picture of the integration of the mind and
body, I would add a third entity which is spirit.
I believe that to be the whole person that our creator meant for us to be, we must develop
the spiritual side of our being as well as the emotional and physical. An airplane doesn't cease to
be an airplane when it sets in the hanger or takes off along the runway, but its true nature
becomes apparent only when it is airborne. Similarly, a person is a human being even when he
or she is functioning only on the physical and psychological planes, but one shows his or her
essential humanness when he rises to the spiritual dimension.
A man asked his three daughters how much they loved him. The oldest of them replied
that she loved him more than all the gold and silver in the world. The father was noticeably
pleased with her answer, through his arm around her and thanked her. The second daughter
responded, "I love you more that the most valuable jewels in the world." The father was pleased
with her response so through his aims around her and thanked her. The third and youngest
daughter said, "I love you better than salt." The man was not especially elated with her remark
and dismissed it lightly as an indication of her immaturity. Nevertheless, he put his arms around
her and thank her. His wife, their mother, overhearing the conversation, left salt out of her
husband's next meal. As he ate, he was thus confronted with the deep meaning of his youngest
daughter's remark. She was saying that he was the flavoring and spice of her life. Developing
the spiritual aspect is the life what salt is to food. The spiritual dimension gives flavor and
seasoning to life. When one is functioning on all levels (physical, emotional and spiritual), life
is more productive and more healthy.
Dr. Longacre has done a magnificent job putting back together the human trinity which
Rene Descartes split or so he thought. Dr. Longacre looked at all three aspect of the human
trinity and has welded them together through a therapy that will help the individual: physically,
emotionally and spiritually. The visualization and guided imagery scripts can be very helpful for
people working to regain health, others working with those who are sick and to each one who
uses it to maintain health. Read, learn and use the information found in this book for your own
wellbeing and to help others balance the physical, emotional and spiritual.
Chaplain Paul G. Durbin, Ph.D.
Director of Pastoral Care
Pendleton Memorial Methodist Hospital
5620 Read Blvd
New Orleans, La 70127
14. INTRODUCTION
If your personal reality and interpretation of the word medicine is based on the
model of the western world which emphasizes outside intervention to treat something that is
occurring within, you may, at first, have difficulty in understanding the mind-body-spirit
connection or internal healing systems that form the philosophy of many altemative therapies.
The practice of medicine may seem to be a noble experiment to prove with scientific
studies that alternative means of healing are old fashioned. Some say that alternative therapies
offer little more than a reason to believe in myths that are perpetuated by anecdotal stories of
seemingly miraculous cures. However, if only myth and make believe is the substance of
alternative therapies, why is there a growing body of work to suggest that traditional medical
treatment combined with alternative therapies often produce very remarkable results?
Western medicine emphasizes outside intervention to treat disease. Alternative medicine
(complementary medicine) emphasizes internal healing philosophies to treat disease. Are not
these two approaches completely opposite? How can one be argued to be better than the other
and at the same time be used together?
The scientific community offers the reader volumes of studies, tests and arguments
that validate their beliefs. Alternative practitioners and healers put forth archives of human
experiential evidence that support their understanding of healing processes. Then there is even
more material available from the religious communities of both the eastern and western world to
aid us in the understanding freedom from disease or return to health and well being. The
ultimate test of the facts, regardless of what you now believe, lies not in researching the
literature, but in allowing yourself to simply know what is the best path to wellness for you.
Please keep your mind open and purposely do not form any conclusion as you read the
message I am sharing with you. You may reject my thoughts out of hand or simply ignore them,
either way you’re right, for the learning is not in this article or at the end of the article. The
learning is within you and will be discovered when you are ready to hear it as if it were your
own unique awakening.
I can almost hear colleagues of mine and other familiar with my style of writing and
previous publications and articles saying, "What got into Longacre, he was always such a
conservative author, now he's writing about a philosophical or religious conversion experience."
Be assured that I am quite sane and still well grounded. The difference in my writing style is due
to an emphasis on concept and wisdom rather than technique and clinical practice.
Many times during lectures I have conducted on hypnotherapy for pain management,
students will first want to know what techniques I use. Then they want to know how they can
incorporate my techniques into their private practice. While this knowledge is important
information it must not become the only information the student retains from the learning
experience. The most important part of the educational experience is to learn the clinical
confidence builders that are necessary to pass the information on to client and patients.
The most important concept in the practice of Complementary Medicine Hypnotherapy is
the understanding that the healing or instruction does not come from you, the therapist, and go to
the client or patient. The healing process comes from outside of you and merely passes through
you to the patient. The client or patient already possesses the healing, they received it as a gift
at birth. The healing is a natural part of their physical body and intuitively connected to their
mind and spirit. The therapist is only a teacher who shows the client or patient how to awaken a
path of consciousness that allows the healing to happen on demand.
A contemporary medicine hypnotherapist does not hypnotize people, they do not perform
mystical rituals or deeds or bring about trance states. A complementary medicine
hypnotherapist, in reality does nothing, for nothing is required from them. This is not to say that
proper training and a firm grasp of theory, techniques and clinical applications is not required. It
just means that the outcome of the therapeutic process belongs to the client or patient who
received the information.
Healing is a basic part of the human body on three different levels: physical, mental and
spiritual. The physical level is the body, the mental level is the mind and the spiritual level is the
soul or personal faith. Since the role of traditional western medicine seems to focus primarily on
the physical body, I will begin with this level of healing or treatment and then discuss the mind
and spiritual levels.
The Physical Level Of Healing: From the time of conception the human body begins to
detect disease and begin a healing process as the embryo develops and continues to detect and
heal throughout the lifetime of our physical being. DNA structures in each cell are transmitted
into RNA structures that govern the replacement of every individual cell. Due to the almost
infinite number of cell replacement and generation messages that need to be carried out,
mistakes will happen. Sometimes the instruction will become garbled and a new cell will receive
misinformation causing it to replicate in a manner that interferes with the natural functions of
surrounding cells or organs. You might call these misinformed cells a type of cancer, as they do
not follow the laws of physiology prescribed by the original DNA molecules. When this
happens, the body naturally senses the offending cells and eliminates them via the immune
system. I realize that this is a very simplified example of the immune system. Andrew Well,
M.D., in his book "Spontaneous Healing" provides an excellent explanation of the immune
system in clinical terms that are quite understandable.
The immune system also diagnoses and begins repair when the body is invaded by
foreign organisms that cause disease. Again, the immune response is a natural process of the
body healing itself.
Another example of the body's ability to detect, prescribe and repair injury is the healing
of a cut on the skin. When the skin is cut, blood flows to the area to cleanse the wound, platelets
in the blood provide a thick material that seals the blood and then dries into a scab to protect the
site until new cells replace damaged ones and the cut heals.
After reviewing Dr. Well's discussion of this physical healing system, it is possible to
draw a few conclusions: Healing is an inherent capacity of life. DNA has within it all the
information, needed to manufacture enzymes to repair itself. The healing system operates
continuously and is always on call. The healing system has a diagnostic capability; it can
recognize damage. The healing system can remove damaged structure and replace it with normal
structure. The healing system not only acts to neutralize the effects of serious injury, it also
directs the ordinary, moment-to-moment corrections that maintain normal structure and function
of the body.
Healing is spontaneous. We do not have to will the body to heal. We do not have to
perform a prescribed ritual or take a magic medicine for healing to occur. Healing will happen
unless we do something purposeful to inhibit this natural process.
The healing system of the physical body is connected to the Mind System of Healing.
While the physical system does not need instructions from the mind, stimulus from the mind can
enhance the physical healing process or detract from the process.
Negative emotions, anger, blame, guilt, grief and unhealthy stress often inhibit the
function of the immune system. When the immune systems is under attack from these outside
elements, disease is more likely to occur. Many times these negative mental elements are hidden
from the conscious mind. Complementary medicine hypnotherapy can address these hidden
mental elements and help bring the immune system back into balance and promote healing on
both a physical and mental level.
 The Mind System Of Healing: The human brain has 10 to 15 million neurons in which
to process and store information. Each neuron has the capacity to store a tremendous number
of "bits" of information and memories. The brain also has one or more synapses or switches
on each single neuron. The sum of limitless possibilities, associations or potential interactions
for memories, feelings, ideas and attitudes stagers the imagination.
These interactions in the brain operate on a system or words, thoughts, feelings and
mental images (words pictures). Positive thought processes promote healing of the body and
negative thought processes inhibit healing and health. Every thought in the mind produces a
physiological reaction in the body, even if the thoughts occur on a level that is beneath our
normal conscious awareness.
Scientific investigators have been studying these thought processes and related physical
responses since the middle 1800s. James Braid, a Scottish physician, reported on the power of
suggestion as it was observed with hypnosis. Dr. Braid, considered by many to be the father of
modern therapeutic hypnosis, later demonstrated the effect of suggestions or thoughts as an
anesthetic for surgery. At a time when medical anaesthesia was unknown. Another physician of
that time period was Dr.Esdaile who performed hundreds of surgeries in India using hypnosis as
the sole means of anaesthesia. He reported a rem the result of hypnotic suggestion.
Modem investigation into the mechanisms of hypnosis has been somewhat limited due to
the requirements of measurements used to validate scientific theories in the western study
medicine. However certain facts have been substantiated that verify the role of the mind in
regard to physiological functions of the body.
The autonomic nervous system which originates in the brain has two main divisions or
branches. One branch is the Sympathetic Nervous System. The other branch is the
Parasympathetic Nervous System. The sympathetic nervous system is often referred to as the
"Fight" or "Flight" side. When the mind receives sensory information from the body that are
perceived as life threatening a"d requiring evasive action, the sympathetic branch redirects blood
now to peripheral blood vessels and organs that enable us to nm faster, see clearer and increase
strength in the muscles of the body required for survival. When there is no perceived danger or
the "fight" or "flight" system is no longer needed, the parasympathetic branch slows down
respiration, heart rate and redirects blood flow to the internal organs that deal with digestion and
cellular regrowth.
It was once assumed that these two branches worked independently on a voluntary basis
and that the mind was not actively involved in the process at a conscious level. In other words,
we did not have to think about our Perceptions of fear or Safety, the required response to
threat or tranquillity just happened. We know that we can activate a subconscious level of
thinking that will override the body's natural response and create the parasympathetic System
response with forms of meditation, prayer and autohypnosis (self-hypnosis).
Herbert Benson M.D., has conducted studies at Harvard University which conclude that
this relaxation response can dramatically reduce the debilitating aspects of unhealthy stress.
According to Benson's work, 60 to 90 percent of doctor visits are for stress related diseases, such
as hypertension, infertility, insomnia and cardiovascular disease.
Harold Koenig, M.D., Duke University School of Medicine finds that stress impairs the
immune system by making it produce an inflammatory agent called Interleukin-6, which is
associated with chronic infections, diabetes, cancer and cardiovascular disease.
The mind can also release a stored sequence of memories or traumatic events in the
memory that is blocking it's ability to foster a natural healing process.
 Negative images or word pictures can be uncovered using Interactive Guided Imagery or
Non-Directed Regression Therapy. In both of these techniques, dialogue with the patient who is
in a hypnotic state allows the patient to symbolically describe the negative emotions or traumatic
event and then release it. These techniques will be discussed further in another chapter.
The mind healing system is a conceptual explanation of the power of suggestion and the
effect of mental suggestions on the physical body. Anecdotal reports seem to support this form
of mental healing.
The Spiritual System Of Healing: How the spiritual system of healing operates is a
mystery of faith or a personal wisdom that just seems to become operative in our human
existence without a need for explanation or external documentation.
Therapists often answer the question of "What is Hypnosis?" by offering explanations
of what hypnosis is not. What spirituality is not, may be the best way to receive information
about our own spirituality and relationship with the healing powers of God.
I am not a theological scholar or a representative of the clergy. While I have a deep faith
in God or a higher power that operates outside our human level of understanding, my concept of
spirituality is not an interpretation provided by religious training or membership in any given
religion.
My comments about spirituality and it's role in complementary medicine hypnotherapy
are a collection of thoughts, dreams and quiet moments from my personal experience. You may
accept or reject my experiences as this is your own spiritual freedom of choice. Please do not
regard my remarks as preaching or an effort to influence your way of thinking. I ask that you not
stop at the end of a sentence or paragraph to make a judgment as to the truth of spirituality in my
own life, rather read with an open mind to the end of this Section and then in a quiet moment of
meditation, reflect on the message quietly to see if there is something of personal benefit that
yourinner self was meant to hear.
My daughter Leslie was sharing her experiences as a baby-sitter with me the other day by
explaining ways she handled problems and the various routes she had instituted with a number of
neighborhood children she was hired to care for. When I asked her what she enjoyed most about
baby-sitting she replied, " Finally I can answer a question with, ‘Just Because!" How often
during the years she was growing up did I use the same answer because I really didn't have a
better answer for her. “Just Because" may be the best answer for understanding spirituality.
There is a story or instruction from eastern religious philosophy that says, "A man of
wisdom does nothing, and everything gets done". This says to me that action or a quest for
knowledge about the subject of spirituality is not necessary because the inner wisdom of healing
and oneness with God is a gift or message that has been with us since our creation and only
requires us to quietly sit and listen for it.
Spirituality is not doing Something, joining a community of like minded believers or
structuring our life to be exemplary and therefor worthy of the gift. There are many people who
regularly attend church, perform countless acts of charity and are Perceived by others as being
high up on the ladder of religious understanding who have never experienced spirituality or
inner faith. There are also people who are considered outcasts or lepers of a community,
prostitutes, murderers and thieves who have come to discover a spirituality unknown to the
pious. Spirituality is not the result Of doing things or acquiring success and riches. In fact
success and wealth may actually inhibit our ability to reflect or meditate because we have bought
the lie that we already have what we have never discovered.
One cannot turn to a leader of a particular religious community or system and be
instructed in how to gain spirituality. Ram Dass, a psychology professor at Harvard and Stanford
Universities spent years searching for an answer to spirituality. Not finding an answer in western
teachings, he turned to eastern teachings and there found that the answer apparently came by
looking and meditating on our personal thoughts, both good and bad, and then waiting for an
answer for a specific though by just waiting quietly for the answer to come. If the answer does
not come right away, that's all right because, over your lifetime the question will come up again
when you are ready to hear the answer. In other words, the answer is your personal prescription
from God, given in just the right amount and at just the right time for it to be divine remedy for
your soul.
There are two stories from eastern mythology that especially enjoy as they provide
seeds for thought and meditation. I share these stories without relying on the original text and
have changed the content a little in light of my understanding of them.
"Once there was a very gifted and talented music stand craftsman. His music stands were
considered by everyone to be the most magnificent and beautiful in the world. His fame was so
great that the King appointed him to be his personal music stand maker. Wanting to be as
proficient and respected as the Kings music stand maker, a group of craftsmen went to the palace
and asked the music stand maker how he created such wonderful works of art. He shared the
following method or technique with them.
"First I fast for five days until I forget that I am the Kings music stand maker. Then I fast
for another five days until I forget how to make a music stand. Finally I go into the forest and
fast for yet another five days. The rest is easy, I just look for a tree that has a perfect music stand
inside of it and then simply strip the outer layers of wood away.”
The other Story is aboot a teacher, student and two potatoes. “A student went to his
teacher and asked how to discover spirituality and the inner sense of oneness or wholeness with
the harmony of the universe that the teacher often lectured about. The teacher gave the student
the following instructions. “Take two potatoes and go to the edge Of the river. Wash the
potatoes in the river water and then eat both of them. When you have done this return for more
instructions"
The student followed the instructions and was eating the first potato when an old man
who was starving appeared and said to him, "Sir, you have hrvo potatoes, I am feeble and
starving and have none, please I beg you give me the second potato.
The student thought about what his teacher had said. He was suppose to eat both Of the
Potatoes but for some inner reason he could not refuse the beggar. So as he continued to eat the
first potato, he gave the second one to the beggar.
The student finished his potato and began walking back to the dwelling in the village
occupied by his teacher. When he was almost there, the teacher came running out of the dwelling
Shouting at him. "You fool, You fool, I told your to eat both potatoes, You stupid idiot, now
you have cast your fate and destiny and there is nothing I or anyone else can do about it leave
my presence and do not ever return.”
The student grew into manhood, married and had many children. Hi, life was
comfortable and free of illness. H, amassed a vast fortune and all of his children became
Prosperous and leaders of the community. His many Srandchildren where strong and
healthy and brilliant thinkers near the time of his death he though to himself, what a wonderful
life, what a remarkable destiny, and all of this from eating only one potato.
At the time of his transition to the life beyond the man was peaceful and without fear and
content in the expectation of a new life. As he took his last breath his former teacher appeared
and
asked him, "What do you think your life would have been like if you had eaten both potatoes?"
Each of us will come up with a different answer to the two potato question. The answer I
have chosen is that the beggar on the riverbank was an illusion of the teacher.
Who is God? What is God? What does God look like? These are also good questions for
reflection and spiritual meditation. It is my experience that God is the soul and spirit of
humankind. God is a spiritual element that is as real and identifiable as any physical element but
becomes manifest in our soul as a perfect peace and balance to the stresses of the physical world
that surround us. God looks like us since we were created in his image. The image of God can
be left open to discussion with no answer being entirely right or entirely wrong because God's
image is perfect love within our soul or inner space. God within us can be seen by our heart and
passed on to others by faith that do not require good works or special talents.
As I stated at the beginning of this introduction, the wisdom of a God or Spiritual
Director in our lives does not require action, rather just the opposite. The willingness to do
nothing and just listen. The willingness to surrender our will be done for God's will to be done.
The willingness to feel our physical body, our breathing, our fears, our troubling questions and
then hang on to them tightly for a moment and then gently let go. Just hang on tightly for a
moment and gently let go.
Clinical Concepts of Complementary Medicine Self -Help Healing: The three systems
of healing, physical, mental and spiritual, are each a separate aspect of the mind that are
interconnected. While each system produces results in a slightly different manner, the mind may
be considered the entry point for information that is acted upon by each system. This is the focus
of Complementary Medicine Hypnotherapy.
The mind can effect the physical healing system by contemplating negative and positive
thoughts or ideas. Negative thoughts such as anger, blame and prolonged anxiety stress the
respiratory system, the circulatory system, the digestive system and can also cause someone to
be prone to cancer. Positive thoughts Promote the natural harmony of the body, wellness and
healing. By simply repeating a strong positive statement several a day, it can cause the body to
function at a more efficient
Hypnotherapy to enhance the Physical healing system should be directed toward images
that allow the client to Imagine the body in a constant state of wellness and revitalization. When
disease occurs, suggestions emphasize that this is only a temporary setback and by focusing on
positive thoughts wellness Can naturally return.
Suggestions for diet and exercise are also beneficial. It is generally recommended that the
diet should be low in protein and fats, especially saturated and polyunsaturated fats.
Consumption Of red meat should be reduced and foods such as dairy products, fish and dried
beans be used as a source of protein. It is also 'ecommended that the diet should include targe
portions of vegetables, especially dark green vegetables and plenty of fresh fruit. Exercise can
be enhanced with suggestions that allow the patient to visualize themselves doing their chosen
exercise easily and enjoying it, looking fo'ward to it and finding the exercise to be relaxing while
they are doing it.
Suggestions directed by the subconscious mind can be formulated so that the patient can
imagine the various physical system of the body working normally and naturally and at peak
efficiency. Someexamples are:
Respiratory System: "Your breathing is natural and mythmical and you concentrate 0" the
breath, breathing in pure relaxation and exhaling all the tension.
Circulatory System: "Blood flows effortlessly throughout the body providing nutrients and
oxygen to every tiny cell and revitalizes and renews the structures and organs of the body.
Anger and Blame: “There is not need to carry unhealthy anger and blame within you. No mater
waht the situation, in the past you made the best choice based upon your current awareness and
understanding, you are making new and exciting and rewarding choices now and letting the
anger and blame just disappear like the clouds of an angry stormy sky as the clouds drift away
and the sunshine appears.
Both physical and emotional problems can be helped with non-directive imagery and
with interactive guided imagery.
Non-directive imagery allows the client to regress to the point in time that was the cause
of their problem With non-directive imagery the therapist is careful not to interrupt the client
with suggestions until they have reached the cause of the problem . Then the only question
asked is "Tell me what is happening?" More information about non-directive imagery can be
found in the book, Visualization and Guided Imagery in Complementary Medicine.
Interactive guided imagery involves a set of questions and responses from the client or
patient. Questions might be: "is there a part of you that will help you solve your problem?"
"What do you need to do in order for that part to help you?" "Describe that part of the body or
idea that will help you, does it have a name or a shape?"
The mind system can also facilitate meditation and spiritual healing by processing
suggestions of relaxation and a resting mind that is uncluttered with thoughts and ideas and waits
in the stillness and quiet, listening for whatever information, learning or teaching that might
be revealed. Meditation may be considered to be a hypnoidal state of hypnosis, however I prefer
to identify meditation as a conscious experience of centering, contemplation and awareness of an
internal environment free of outside thoughts and distractions.
I will explain these concepts in more detail and provide imagery scripts for specific
conditions and meditation exercises in later chapters pertaining to specific applications to
various disease or emotional categories
Many alternative therapy books are written professional health care provider. These
books are often difficult for the average person to apply to their personal situation as they have
to learn all of the material on their own, in otherwords become their own health care procider.
Other books are written for the lay person, unfortuanately they may often lack the detail desired
by the professional practitioner. In this book I have tried to blend both easy to use information
for the client or patient
I have organized the book so that I could provide an overview of the spiritual component
of Complementary Medicine Hypnotherapy first. By doing this I trust that the reader will
become readily familiar with the need and applications of spirituality in all remedial and
therapeutic work. The spirituality I discuss can be applied in a variety of beliefs about God,
Religion, or just the sense of an inner of greater power for those who are not religious.
I have divided this book into three sections. The first section deals with concepts of
mind body healing and background information that will aid you in immediately using the
material resented. The second section is an overview of body healing and background
information that will aid you in immediately using the material resented. The second section is
an overview of Complementary Medicine Hypnotherapy. The third section contains
suggestions for spiritual exercises, mental imagery and actual scrips for a variety of issues,
problems and diseases.
15. SPIRITUAL MEDICINE
The meaning of the word spirituality seems to be confusing because it generally is used to
describe a state of mind or sense of being that can not be used in a conversation between two
people without the true meaning constantly being changed.
As a young boy, spirituality was something that a Priest, Monk or Num had. It was
something to do with going to church on Sunday and being quiet in Sunday School class.
Spirituality didn't seem to be something that would be very much fun . The only benefit of being
spiritual at that time was the ability to sit quietly for ten minutes or longer and not questioning
the endings of Bible stories. When I was a teenager, Spirituality, was one of the catagories of
things you are suppose to do that was on my list to ignore. Spirituality was not on the top of the
list, but it ranked close to making my bed every morning, saying my prayers every night and
practicing my trombone.
My first casual look at eastern religion was in the 1970's when I was approached by a
group of collage age students. There heads were shaved bald and they were wearing a long
orange cloth that was draped over one shoulder and wrapped around their waist. There chanting
and dancing drew my attention. What kind of a cult group is this, I thought to myself. They
were gathered on a street corner in Salt Lake City, Utah on a snowy winter afternoon beating on
little drums and symbols and asking for money. A passerby informed me that they were an
Eastern Religion that believed in reincarnation and were living a spiritual journey on earth.
They looked more like some lost hippies from California to me as they stood them with arms,
shoulders and legs exposed to the cold. The apparent leader of the group was wearing his cloth
Over a sweat shirt and sweat pants. He looked like the most spiritual one.
I jest somewhat about my first impression spirituality because they seemed to have
unconsciously influenced regarding my grasp of the concept Of inner peace and serenity for a
majority of my adult life. When I realized that spirituality has always been a part of me my
previous occupation with finding an explanation for something that really can't be explained
became One of those old memories We like to look back on an laugh about.
We begin the process of learning how to speak, what is acceptable and not acceptable and
patterns of thinking by listening to others. In our very formative years, others are usually our
parents and members of OUT Immediate family. This close knit communal structure then
Slowly expands to include our neighborhood community and almost anyone else who is bigger
or older or who we have been told is an authority figure we should listen to. At the beginning Of
the 21st Century, authority figures were somewhat limited to the category of police officer,
School teacher, Priests and ministers, religious educators and those who worked in the our
everyday life. These people were fairly easy to identify and for the most part what you heard
from them was consistent with what you heard from other authority figures. The general
consensus of what was required to live a good life was conservative and embodied the need for
working hard and doing good things in order to succeed and have the blessings of a prosperous
life.
Near the end of the 21st Century the traditionally accepted message for success began to
change slightly and the ideas became a syllabus of seemingly contradictory positions and
outcomes.
The court system and the practice of law could be looked at from two Points of view.
"The Truth, Whole Truth and Nothing But The Truth", appeared to mean," the truth as best as I
can recall it.”
The political system said "God, Duty and Country" during times of war and during
election years. At other times political leaders and many public service officials seem to adhere
to a philosophy of "Whatever works is right," and "Don't do what I do, Do as I say I will do.
Economically the country was flourishing and most Americans seemed to be content
with the status quo. We had bought a dream that "happiness" required only the acquisition of
possessions, money and being able to control our life by emoting our feelings and then letting
these feelings become our sense of reality.
For the most part, spirituality had been redefined as a type of goods or service that was
desirable but not as important as having not only enough "stuff” but lots of it. If we wanted
spirituality it was for sell almost everywhere. Bookstores were filled with self-improvement
titles and spiritual training cassettes. Television offered almost wall to wall religious programing
from ministries that reflected various denominational ideas and changed the minister or message
much like entertainment programing did in order to capture more audience and viewer
contributions.
Serious seekers of the real truth and reality of almost any contemplated thought could be
easily confused with all of the mixed messages and casual anecdotal treatment of semi fact and
almost true fiction. How could someone sort out all of this information or make any sense of it?
The new morality, the revised more just form of spirituality may be here, but the new age
messages are often a complete dichotomy to the truth that had always existed from the beginning
of eternity.
When we want an answer to a problem or understanding of an urgent situation we are
accustom to resolving the answer quickly, often in a matter of moments. Maybe the best
approach
to discerning reality and truth from rumors and stories can best be illustrated with a conversation
my daughter had with me when she was in the second grade.
One particular day, Leslie had taken extra time and care when dressing for school. It was
Pride day at Pioneer Elementary School and all of the students were to show their support for the
school by dressing in the school colors of red and white. Leslie was very emphatic that I help her
pick out the best white shirt and red pants that she owned. 'You have to dress just right on Pride
Day Daddy," she said. I watched her start to school which was just down the block from where
we lived. remember thinking how quite she look in her school colors and the smile she had on
her face as she turned back to wave goodby again.
When I greeted Leslie on her return from school she was sobbing. Her body quivered as
she tried to talk, a babbling sound that sounded like "I'm stupid, I'm ugly and stupid, they all say
so” I realized that she hadn't been injured or physically picked on, so still bewildered, I took her
into the house and sat down with her on the couch. "Leslie, stop crying now and tell me what's
wrong. You know I can make things better.:
Slowly, Leslie somewhat gathered her composure and began to explain the great
indignity she has suffered while at school. Like many of her stories it began, my friends -.
It seems that there was more to Pioneer Pride, Red and White day than I had imagined.
Apparently there was some unwritten and often forgotten dress code that required the wearing of
a red shirt and white pants, not the white shirt and red pants that Leslie had worn to demonstrate
her school pride. Her so called friends had taunted her for not wearing the school colors in the
right combination and told her she was stupid and ugly. The more Leslie defended her right to
dress the way she did and questioned the authority of her friends to dictate some new rule, the
more they taunted her and of course, the more frustrated she became.
I tried to explain how kids her age can be cruel and hurtful without really meaning it,
how this was just a misunderstanding that wasn't worth all the fuss and attempted to logically
reason why she was not stupid or ugly. For some reason I knew that Leslie wasn't hearing a word
I was saying. Then her crying changed to a whimper and suddenly stopped as she got up from
the couch and said, "That’s OK Daddy," and left the room.
A short time later, Leslie came into the den were I was working, and made a solemn
pronouncement. "Daddy, I figured out the Red and White day. My friends couldn't have really
meant what they said, because we were all dressed exactly alike, just opposite!"
It is my feeling that before we can truly appreciate the truth of spirituality, we must
accept the fact that there is know one answer or no perfect method of practice. Spirituality is a
inner wisdom and bliss that must come from within without conscious or contrived effort on our
part. Spirituality is a gift that just happened despite all the paradoxes and opposites that we
encounter in life.
Healing spirituality is the blessing of a world of silence and solitude that exists within
each human heart and soul. This is a place where God or a Higher Power can meet you exactly
where you are in this embodied spirit that you are. All that we need to do is to give ourselves
permission to get out of our head what we have heard about the mystery of spirituality,
abandoned our sacred explanations, our sacred theologies and be willing to serenader to the
mystery of healing and life. You will know when you have entered the mystery of spirituality
because the truths that reveal themselves to you inner wisdom will be consistent and will not
have to take up the question of all the paradoxes and confusion in life. True spirituality is
simply letting the mystery reveal itself in your life.
Richard Rohr, a Franciscan Priest, retreat master and scholar advises groups he addresses
to recognize our need to change reality, our need to meddle with our own souls and ourselves.
From that position of nothingness and nakedness we can discover the great mystery simply by
getting out of the way, letting go and letting God.
I sometimes wonder if the hardest roadblock to simply letting go is realizing that we
really have nothing to let go of. We can into this world from a world of nothing. We brought
nothing into this world that is really just a temporary illusion. We will leave this world with
nothing and return to nothing.
Now before you read to much into the word "nothing" consider that nothing is the
opposite of something, and something in this context refers to possessions and things, imagined
to quantify and identify our personality, position in life, status in the community and in a sense
self-worth and justification for being the person you think you are or want to be.
Nothing is a different dimension of the universe were nothing is required to be accepted,
loved and cared for, nothing is complete and unconditional pardon from guilt or blame and
nothing is a spirit of oneness with the creator who has always existed inside our spirit.
Although spirituality is better experienced than explained, an overview of Eastern and
Western spiritual philosophy may prove useful in provoking a willingness to listen with a new
curiosity to old ideas that we may have summarily dismissed as to mystical to fit into our
modem technological lifestyle.
Buddhism is a particular belief system of Eastern origin in a oneness and eternal
connection with a supreme creator and spiritual knowledge found in our inner wisdom mind.
In his translation of the book "Understanding Through Understanding In The Between",
also known in the west as "The Tibetan Book Of The Dead", Robert A.F. Thurman provides a
summary of Eastern spiritual traditions often referred to as Buddhism.
Buddhism is a teaching originated Buddha about 2500 years ago. It is not based on or a
refom of any religion existing in ancient Indian culture. Nor was it based on a revelation
received from any sort of deity. The Buddha flatly rejected the contemporary Indian form of the
religious belief in an omnipotent world creator. Buddha did not "believe in God" as Westerners
understand God To many he would appear an atheist. He did not consider belief or faith and
end in itself and he encouraged people to question authority and use their power of reason and
not just accept irrational traditions. In his personal quest of truth, he was often quite unreligious.
Shakyamuni was called a "Buddha," and "Awakened" or "Enlightened" person, because
he claimed to have achieved a perfect understanding of the nature and structure of reality. After
a normal education as a warrior prince of his era, he devoted six years of concentrated study,
yogi discipline, and meditative contemplation to the quest for reality.
Buddha considered the human mind capable of reaching a full understanding of
everything, given enough native ability, the correct education and heroic effort. Having reached
that full understanding himself during his thirty-fifth year, he felt that other humans would also
be able to achieve it. He dedicated the next forty years to teaching all kinds of people.
History records that large numbers of his contemporaries did succeed in reaching high
levels of realization. They formed a broad-based movement that gradually spread through the
countries of the Indian subcontinent and eventually throughout most of Asia. This movement
often did have a religious dimension, but it had equally important social and intellectual
dimensions.
The Buddha used the Sanskrit word "Dharma" to designate his Truth or Teaching. In the
process he added a new dimension of meaning to the word. "Dharma" was derived from the verb
idhr “to hold” and had a range of important meanings associated with holding. It could be mean
a distinct phenomenon, one that held a particular character, or also the particular character itself.
It could mean a custom, duty, or law that held human behavior in a particular pattern of belief
and ritual. But the core of the Buddha's discovery was the essential reality of freedom; that
underlying the lived reality of existence is the immediacy of total freedom, especially freedom
from suffering, from bondage, and from ignorance. This essential freedom can be realizer and
most true condition.
This realization makes it possible for freedom to prevail over the habitual suffering of
personal experience. So the realized individual is thenceforth "held apart" from suffering; not
"held" in anything, but "held out" Of binding patterns. Thus the new range of meanings of
"Dhamra" concerned being "held away from” suffering
Dharma came to mean the Teaching, the path of practice of the Teaching, the virtue of
that practice, the reality or Truth taught in that Teaching and the freedom of that realty or Truth,
nirvana itself.
The written language of Buddhist meditation practices is mystical and vibrantly colorful
in form. For many Westerners this type of Imagery is intriguing due to the many pictures one
can imagine in their conscious mind. The written vocabulary, in and of itself, is open to many
interpretations and not hampered with the simple definitions of Western words often associated
with spiritual and religious practice. Th, meditation practices of Buddhism a's not in conflict
with Western Religious Theology as the image of a Master, Creator, Saint or Exalted Teacher
can be any revered Person or though of as God, Jesus Christ, a Christian Saint or Martyr or the
Virgin Mary.
The Practice of Buddhism embraces the inter-connection Of all people through one
spiritual power that can be referred to as a giant net of gems and Precious stones. Each person is
a unique and separate individual like the precious jewels of the net, but all connected to the
oneness of universal truth and wisdom that has existed from the beginning of time in their nature
mind.
The spirituality of Buddhism is parallel to that of Western religions with the exception of
the teachings on reincarnation. Even this issue should not dissuade a Christian from seeking a
Buddhist form of spiritual enlightenment, as the reincarnation teachings also allow for the
individual to elect to pass through death and abide with the Creator, “God" for all of eternity if
they desire to do so.
Western spirituality has it's beginnings around 34 AD after the crucifiction of Jesus
Christ. The early followers of Christ where Jews who formed a Jewish sect known as Christians.
They embraced the teachings preached by the apostles and recording in the Holy Gospel of the
New Testament. They believed in God as being the Father Almighty and that Jesus Christ was
the Son of God who was conceived by the Holy Spirit, born of the Virgin Mary, suffered under
Pontius Pilot, was crucified and died and on the third day was reborn and transcending into the
Kingdom of Heaven. This spirit of Christ was one spirit with the Father And the Holy Spirit,
creating a oneness or presence directly with God that was available to anyone who asked for
everlasting peace and the active participation of God in their heart, mind and soul.
Within a few years from the formation of this earliest Christian movement, religious
politics caused the group to splinter into different groups. It is interesting to note that it was not
the Jewish people who persecuted the early Christians. There main concern with the spread of
Christianity was the abandonment of Jewish laws related to not eating certain meat or drinking
the blood of an animal.
The first Jewish Christians celebrated the mystical spirit of Christ by gathering for a
meal. This was not the Eucharist that we observe today. This was a regular meal shared
community that included plates of bread and glasses of wine. As the bread and wine was shared,
the group would invoke the spirit of God and Christ and refer to the bread as the Body of Christ
and the wine as the blood of Christ. Traditional Jews voiced there objections to this alleged
violation of Jewish law loudly and to all who would listen. This open disapproval provided an
excuse for the Roman authorities to begin to try and stop the Christian movement by attaching is
leaders. Today Christians gather in worship and share in the mystery of the Eucharist or "Holly
Communion" in a symbolic way with small wafers or pieces of bread and a sip of wine to
represent in inward blessing of the body and blood of Christ which was shed so that they could
know freedom and be one with the Father and Son and Holy Spirit.
One litmus test for the truth of spiritual matters Is consistency. If it was once true, then it
is always true. This consistency has been demonstrated in the Christian faith for thousand of
years in the mystery of the sacrament of communion. Just as the truth of Buddhism survived the
centuries so has the truth of Christianity despite all attempts to suppress it or relegate the
teachings of the Gospel to a particular religious belief.
It will not make any difference as to the approach you use to experience spirituality.
Buddhist's traditions have a structured nature and may seem more difficult to perform.
Christian exorcizes may be easier if you are religious person. just the act of sitting quietly and
listen to silence with a can be as beneficial.
Please feel welcome to disagree with any of my observation about spirituality for I can
use only words to describe it. I am not a Priest or Clergyman or a religious
scholar or theologian. I am just a man who has found new meaning to life and freedom from
suffering and pain by giving myself permission to be a child of God, a brother of Christ and a
fellow traveler on a path of destiny that was given to me as a gift with no strings attached.
 I will provide more information on Meditation Practices that can be used for healing and
the technique for experiencing them in section three of this book.

16. HYPNOTHERAPY AND RELIGION: (CONTRIBUTION OF PAUL G. DURBIN, PhD)

The modem practice of Complementary Medicine Hypnotherapy has little resemblance to
the ancient practice of Hypnosis, however the myths and misinformation that continue to be
perpetuated by the media and some hypnotists may prevent a religious person from seriously
considering this valuable form of self-help therapy.
Chaplain Paul G. Durbin, Director of Pastoral Care at Pendleton Memorial Hospital in
New Orleans, Louisiana, offers some practical answers about hypnotherapy and Religion in his
book, "Kissing Frogs; Practical Applications of Hypnotherapy.
One may ask, "Why does a person of religious faith need hypnosis?" believe that
question can be responded to by referring to a statement of Jesus in John 10:10 (KJV), "I am
come that they may have life and that they might have it more abundantly."Hypnosis is one of
the gifts of God which helps people experience the more abundant life.
Jesus said, "The spirit of the Lord is upon me, because He hath anointed me to preach the
gospel to the poor, He hath sent me to heal the brokenhearted, to preach deliverance to the
captives, and recovery of sight to the blind, to set at liberty them that are bruised. Luke 4:18
(KJV). Jesus called his followers to "preach the kingdom of God and to heal the sick." Luke 9:2
(KJV). These verses and others indicate that Jesus meant for his church to have a healing
mission. Obeying the commission of Jesus to heal the sick and in cooperation with a doctor, a
pastor can use hypnosis to reduce pain, to lessen the side-effects of chemotherapy and to hasten
the healing process. By properly using hypnosis, the clergy can heal the brokenhearted, bring
deliverance to those in captivity to pain, give sight to the emotionally and spiritually blind and
set at liberty those who are bound by unwanted habits.
The first recorded use of hypnosis is found in the book of Genesis 2:21-22 (ASV), "So
the Lord caused a deep sleep to fall upon man, and while he slept took one of his ribs and closed
up its place with flesh; and the rib which God took from the man He made into a woman and
brought her to the man." In this incident, God used hypnosis as an anaesthesia so that Adam felt
no pain during the removal of his rib. Since that time, hypnosis has been used in almost every
age and culture under a variety of names.
In addition to the references hypnotic techniques in Genesis, mention hypnotic
techniques are found in other sources concerning the Egyptian "sleep temples". In the temples,
Egyptian priests used hypnotic-like procedures to improve health. These temples were so
popular that they spread to Greece and throughout Asia Minor.
Though he may have stretched his point, Chaplain W. Leo Peacock gives a number of
New Testament illustrations of hypnosis. He makes a point with his interpretation of an account
of Matthew regarding Joseph's dream about Mary, (Matt 1:20-25). He believes that this scripture
is a clear description of an individual being hypnotized and while under hypnosis being given a
post-hypnotic suggestion on which he immediately acts as soon as he comes out of his hypnotic
trance. The Scripture tells us that an angel came to Joseph in a dream and told him to take Mary
as his wife. Upon waking, Joseph goes to Mary and they are married.
The practice of "laying on of hands," mentioned in the Bible, used techniques which are
similar to hypnosis. In the 18th century, a Roman Catholic priest, Father Gassner, gained a
reputation as a healer. Those desiring to be healed were brought into a room and told to wait. As
their expectation mounted, Father Gassner would majestically enter the room, lower his cross on
the head of a patient and command him to sleep. The person would then collapse and when told
to awaken would rise praising God for the healing.
The modem history of hypnosis is considered to have begun with Dr. Franz Anton
Mesmer who was greatly influenced by Father Gassner.
Over a half century ago, Dr. Emil Coue' of France saw the power of suggestion. He
taught people auto-suggestion. His favorite phrase was, "Day by day, in every way, I am getting
better and better. His methods were based on two principles: (1) "When willpower and
imagination come into conflict, the power of imagination wins out, and (2) Imagination can be
trained more rapidly than willpower.
One of the misconceptions about hypnosis is that it is anti-religious. Hypnosis is neither
anti-religious nor pro-religious. It can be used for good or bad depending on the hypnotherapist
and the subject.
Most religious groups accept the proper ethical use of hypnosis for helping people.
Exceptions are Christian Science, Seventh-Day Adventists and some individuals of various
denominations. In recent years, the Seventh-Day Adventists have lessened their resistance by
using a patient directed form of hypnotherapy often referred to as relaxation therapy and
suggestion therapy. Christian Science practitioners are against the use of hypnosis for healing,
however they use a form of hypnosis in their own healing services.
In an address to the National Association of Clergy Hypnotherapists, Rev. Fred R.
Krauss stated that religion has traditionally used hypnotic techniques in a variety of ways. The
atmosphere of the religious service is geared to the induction of the trance state. The
architecture, decor, and religious symbols have a profound spiritual effect on believers. The
altar, cross, and flickering candles provide a fixation point for concentration and meditation. In
prayer, most Christians bow their heads and close their eyes which can be a very similar
experience to hypnosis.
Prayer hypnosis is a method that can be used for those who may find a formal or
traditional hypnotic induction technique objectionable.
I was asked to help a patient who was experiencing considerable pain but had religious
reservations concerning hypnosis. I suggested that we pray together. I began the prayer, "As I
pray, just let yourself relax because the more relaxed you are, the more effective this prayer will
be. Now I want you to use your imagination so that the prayer will be even more effective. In
Mark 11:24, Jesus seems to be saying that imagery with prayer causes the prayer to be more
effective. 'Therefore 1 say unto you, what things soever you desire when ye pray, believe that ye
receive them, and ye shall have them.
Following this introduction, I used the imagery of Jesus coming and placing His hand on
the area of discomfort. concluded with the words of comfort and healing followed by, "in Jesus'
name, Amen." Since this patient was very relaxed and comfortable at the end of our prayer, I
suggested that she close her eyes again and drift into a peaceful and restful sleep.
A client with a close and personal relationship with God may want to investigate the
Scriptures and discover on their own that hypnotherapy is a healing gift of God and therapeutic
results are directed by God if they choose this to be so.
A Complementary Medicine Hypnotherapist can teach the religious client or patient how
to use the God given abilities they already possess to make a positive change in their lives.

17. VISUALIZATION AND PRAYER THERAPY: (CONTRIBUTION OF PAUL G.

DURBIN, PhD)
 I often wonder how many of us think of prayer as asking for something. I know I used to
when I was younger. I would make a list of the things I wanted or thought I needed and then
examine my behavior to see if I was good enough for God to listen. If I had been a bit
mischievous that week, I would shorten my prayer list. Some weeks even one item seemed like a
lot to ask. Many times I viewed prayer as begging for something I thought I had been denied.
Other people had good health, why was God being mean and not curing my illness? Sometimes
prayer was a way of saying thank you that the bad thing that had happened to someone I knew,
had not happened to me.
When was preoccupied with making a list or understanding prayer as a one sided
dialogue about wants, material things and special privileges, I was not able to realize that prayer
is really just a conversation with God. Praying may be one of the hardest things for many of use
to do. What is the correct form of prayer? What words are more powerful than others? What is
the best time and the best place to pray? Religious institutions have their preferences for the
form of prayer and all of them are quite acceptable, however we must still realize that prayer is
just a conversation and God loves to listen and share with us.
There are no prerequisites for having a conversation with God. We do not need to be
worthy, we do not need to achieve a certain level of spirituality and we do not need to be free of
anger, fear and blame. All we need to do is just be ourselves and surrender or devote our heart
to God, so that we can hear what he is saying in this special kind of conversation.
Annie Dillard wrote the book, "Pilgrim At Tinker Creek". In this book she shares some
insights on prayer that I have found very helpful. Ms. Dillard tells us; "God needs nothing, God
asks nothing, and demands nothing. Like the stars, you do not have to sit outside in the dark, if
however, you want to look at the stars, you will find that the darkness is quite necessary. But the
stars themselves neither require it or demand it. You do not have to do these religious things at
all, not at all. God does not, I regret to report, give a hoot."
This should be a great comfort for religious people who are not accustom to saying a
particular form of prayer such as the rosary or reading prayers found in a prayer book or Sunday
missel. The stars do not say it has to be dark outside if you want to see them, and God doesn’t
demand that we say a special prayer or prayer form because one is as good as the other if it gets
us back to the place where all things are one. And if a particular prayer form is keeping you
from getting back to that place of oneness, then it is not the best prayer form for you, even if it is
the best prayer form for some other reason.
Those of faith will tell you that prayer works because they have experienced it for
themselves. Well, it may have worked for you but how do I know it will work for me, you may
ask. Scientific studies of prayer indicate that for whatever reason, prayer does work whether you
were the one praying or not. Chaplain Paul G. Durbin provides some thought provoking
examples in his book, "Kissing Frogs: The Practical Application of Hypnotherapy.
Dr. Parker and Ms. St. John detailed a ten year experiment of Prayer Therapy at the
University of Redlands in the book "Prayer Can Change Your Life". Their study showed that
prayer brought renewal, rebirth, that men and women received "beauty for ashes, and were
released from fears, depression, discouragement, and marital difficulties. Dramatic physical
healing resulted with stuttering, arthritis, headaches, and high blood pressure as a response to
the power of prayer. There were some spectacular recoveries from various diseases, but just as
important were the day to day adjustments to life, the "life more abundant," the joy and peace
achieved right were they were by individuals who made remarkable adjustments to life.
In their experiments, they had three groups. Group One was the "Psychotherapy" group.
They received psychotherapy with no mention of prayer or religion. These people showed a 65%
noticeable improvement in both test and symptoms. Group Two was designated, "Random
Prayer." These people prayed on their own every night without benefit of psychological insight.
They showed no progress in the test, backsliding in some instances. Symptoms were not
improved. Group Three was the ."Prayer Therapy" group. The Prayer Therapy group received 7
instructions o~ positive praying and psychological guidance. The Prayer Therapy group made a
72% improvement in test and improvement of symptoms.
These findings indicate that something was wrong with prayer as understood and
practiced by the Random Prayer group. They must some how have unknowingly prayed amiss
for "having asked; received not." The Prayer Therapy group had asked and received. Another
result indicate that Prayer Therapy provided something additional to psychotherapy.
James Wagner in his book, Ministry of Christ in the Church Today, writes of another
prayer research project that was conducted by cardiologist, Dr. Randy Byrd. Dr. Byrd's was
unique in that in this experiment, the patients were unaware that they were being prayed for by
groups recruited by Dr. Byrd.
He assigned 393 heart patients, each of whom had been admitted to the coronary unit
during a ten-month period, to two groups. Dr. Byrd factored the patients ages and severity of
their disease into the division process.
Dr. Byrd then located persons around the country who agreed to pray once a day for each
of the 192 patients in the experimental group. Each patient in this group had from five to seven
people praying for him or her, but were not told so by the researchers. The second group of 201
patients didn't have individuals from Dr. Byrd's prayer groups praying for them. Dr. Byrd found
that the prayed for patients had significantly fewer instances of complication. Only three
required antibiotics, compared to sixteen in the other group.
One of the blessings of faith in God is the assurance that God hears and answers prayer,
but at times, we fail to experience that assurance. Could it be that we have no real expectation or
confidence that God hears or answers prayer? Perhaps some can identify with the man that
associated prayer with playing a slot machine. He said, -'lt doesn't cost much to play and I might
win." That type of experience does not lend itself to a very satisfying prayer life.
As we seek a more meaningful prayer life, maybe we should ask the question "Why
pray?" Why teach yourself to pray? Why study to improve your prayer experience? Is it really
necessary? Is it an elective in the university of life? Is it a kind of hobby, an optional extra to the
main business of being, or should it be an important ingredient of our daily life?
Chaplain Durbin at Pendleton Methodist Memorial Hospital in New Orleans,
Louisiana, writes; "it is my belief that we were created by God to have fellowship with Him. We
do not always know what life is all about, but we do know that it exists primarily for relations. A
stone is dead, a horse is alive; a stone cannot enter into a relationship with its environment, a
horse can. A person can enter into a relationship not only with nature, but also with other people
and with God. The richness of our personal life depends upon the quality and depth of our
personal relationships. The highest relationship possible is fellowship with God.
In human life, we enter into relationship through fellowship and communication. This is
also true of our relationship with God. A person who never prays may know a lot about
God-Only the
person who prays can know God. This is the strongest reason to pray and the most rewarding.
Listen to the Psalmist in 73:25-26, "Whom have I in heaven but Thee? My flesh and heart may
fail, but God is the strength of my heart and my portion forever. We pray then in order to enter
into, maintain, and deepen our fellowship with God.
As we accept the need to pray, we see that our image or concept of God greatly affects
our understanding of prayer. Dr. William Parker tells of a little boy who was sitting on the floor
and drawing on paper. The boy seemed to be so involved in his work that his mother asked,
"What are you drawing?" The little boy answered, "I am drawing a picture of God." She
responded, "But son, nobody knows what God looks like." The little boy continued to draw and
with confidence replied, "Well, they will know what God looks like when I get finished.
Whether we realize it or not, each of us has his or her own image of what God is like in
our mind's eye. According to our image of God, we think, we feel, we act, we live and we pray.
People see God being: "Not there, "Far away," "Up there," "in the hills from which cometh my
help," "In the church, "At the altar," "in the Bible," "Closer than breathing," "Everywhere".
If God is "Not there," then we waste our time to even consider prayer. If God is "Far
away," how loud do we have to pray to get God's attention? If God is "Up there," how high do
we have to fly in order to communicate with him? If God is "in the hills," what about those of us
who live in the low land, such as New Orleans where there is not a hill in sight? If God is only
"in the church," do we only get close to him when we go to church? If God is only "At the altar,"
do we only experience his presence in Holy Communion or at altar calls? If God is only to be
found "in the Bible, must we have to have a Bible with us at all times in order to be near God? If
God is "Closer than breathing" and "Everywhere, then we can begin to communicate with him
wherever we are. Personalizing the statement, "God is everywhere" means "right where I am
God is. God is with me. Jesus said "The Kingdom of God is within you. God is here with us
"closer than breathing," for the scriptures tells us that God is the friend that sticketh closer than a
brother.
Each of us needs to communicate with God in order to reach our fullest potential as a
person. Why did Jesus pray? Because he had needs that he could meet in no other way. Why did
the disciples pray? For the same reason. As they witnessed the pray life of Jesus, they somehow
realized that the deeper needs of their life could be expressed in no other way. It was through
prayer that the emptiness of their lives were filled, their faith strengthened, and their hope
renewed. Through prayer, they were able to reach their full potential as human beings and so can
we.
There is a hymn which speaks to the meaning of prayer. "Lord, what a change within us
one short hour spent in your presence will prevail to make, what heavy burden from our bosoms
take, what parched grounds refreshed as with a shower! We kneel, and all around us seems to
tower, we rise and all the distant and the far, stands forth in sunny outline, brave and clear. We
kneel, how weak, we rise, how full of power! Why, therefore, should we do our selves this
wrong, or others, that we are not always strong. That we are ever overbore with care, that we
should ever weak or heartless be, anxious or troubled when with us is prayer, and joy, and
strength, and courage with Thee.
There are times when we do not feel God's presence. What do we do then? During those
times when I do not feel God's presence, my prayer goes something like this, "Lord, even though
I do not feel you near me at this moment, I accept the fact that you are, so I am going to live my
life this day on the basis of your promise to be with me." I have come to discover that in
expressing my honest feeling of aloneness that God's presence becomes for me, once again, a
reality.
You may be thinking, "I can see the need of prayer, but how do I pray?" As in most of
our learning, we learn by doing. You may learn the techniques of playing baseball by studying a
book on baseball, but you will never learn to play baseball until you get on the field and make
the attempt. This is not to say that the study of theory or techniques is of no value. It is
frequently helpful and sometimes essential, but it is not sufficient by itself. Some skills are
required almost entirely by practice: typing, playing baseball, driving a car. This is undoubtedly
true of the most important way of learning to pray. Prayer is learned in the school of practice.
Prayer may be words, thoughts, or images. Prayer can express feeling of inspiration,
devotion, and affirmation. Our prayers are communication with God, but also prayers are closely
associated with autosuggestion. Dr. Byrd's experiments show that prayer has elements beyond
autosuggestion. Prayers for healing can create an attitude where healing can take place. This is
true whether the prayer is for yourself or others.
A prayer I often pray while walking, driving, or just contemplating is, "God's love, joy,
peace, and health fills my body, mind, and spirit."
Barbara Von Froggle, a psychology teacher, said that psychologists agree that a person's
thoughts affect the body. "We know that the brain releases chemicals. More than two hundred of
these are mood-altering. So what you think you do produce in your brain chemically. Taking
that medical base, I believe, when you pray, there is a balancing which takes place in the body.
You relax, the Holy Spirit has a power of its own that relaxes you and makes you function as
God intended.
Our prayer should be affirmations of what we are praying to experience. A lack of
affirmations creates a negative attitude which diminishes the effect of one's prayers. The lack of
affirmations was a cause for the failure of the Random Prayer Group. "Their form of prayer was
negative as well as in complete violation of definite instruction to pray, 'believing ye have you
received and ye shall receive.' That promise was fulfilled because as they reiterated their
unhappy symptom, holding them directly in the focus of their minds, reaffirming them, then
hold them firmly in place. Negative prayer produced negative results."
The Random Prayer group members were often holding their unhappy symptoms directly
in the focus of their attention. Over and over they declared they were unhappy, suffering, sinful,
and unworthy. As they focused on their problems instead of their solutions, they got what their
prayer focused on. They went right on being unhappy, ill, sinful, just as they had been in past. "it
is done unto us as we believe." Their words may have requested change, healing, renewal; but
their minds focused on their problems.
In our prayers of affirmation, may we learn to see ourselves as we desire to be. As we
continue to hold this image in our minds, we reemphasize it. We tend to experience the images
we hold in our mind.
In her book, How to Manage Stress; Heal Yourself and Be Whole Again, Lou
Coffey-Lewis states that we do not have to shout, demand, or be dramatic in our prayer. Simply
ask with childlike faith and trust and your prayers will be answered.
Another element of effective prayer is to pray with the belief that the answer is already
there before you even see the evidence of it. Give thanks for the answer before you have
experienced it. To give thanks and know without doubt that God has already answered your
prayers take a great deal of faith and trust.
Pray as if talking to a close personal friend. Believe that God hears and loves you and let
His loving response come to you. God's answer may not always come in the way you expected,
but it will come.
When we pray, we must not stop thinking. The mind is the connection link between God
and the individual. Prayer should have an element of creative thinking. Emersom said, "Prayer is
the contemplation of the facts of life from the highest point of view." Prayer can not help us
unless it helps us to change or control our thoughts for as we think in our heart, that is what we
are. Change your thoughts and you change your experience.
Dr. Parker and Ms. St. John developed the following guidelines for praying during their
research at the University of Redlands.
1. Recognize a God of love and meditate on God's love and your relation to him.
2. Understand that God desires healing, wholeness, and abundant life for each person.
3. Release any negative aspects of your life such as insecurity, incompetence, anger, guilt, fear,
hate, etc.
4. In time of prayer and throughout the day hold a positive, healthful, wholesome thoughts and
images that are in line with God's love.
5. When praying, believe that you have received the help you have requested and act as if you
have received it.
6. In prayer recognize others as in the circle of God's love also and pray for their well-being.
7. Spend time in silence and allow a strong feeling of victory, peace, and serenity to feel your
being.
8. Go forth with hopeful expectation.
It may be helpful to know that God isn't so much concerned with our saying
the right things as He is with us saying the real thing. To share with God our feeling and what is
on our minds is heard by God just that way stumble for words to express it. St. Paul in his
letter to the Romans (8:26-20) put it this way, "We do not even know how we ought to
pray, but through our inarticulate groans the Spirit himself is pleading for us, and God who
searches our utmost being knows what the Spirit means.
When my daughter Leslie was three years old, she spent her first overnight weekend at
Grandma's house. My wife and I were a bit apprehensive about her being gone for the whole
weekend because she was a very active child and at times quite demanding. My wife worried
that she might be a bit to tiring for Grandma who was a senior citizen. Apparently all went well,
because on her return home, Leslie was full of stories about how much fun she had had, going to
church with Grandma and Grandpa and how Grandma had taught her to pray.
On Monday evening I was in charge of putting Leslie to bed. She said she wasn't sleepy
yet and seemed to find a lot of things that needed attending to before getting into bed. I told her
she could stay up for five more minutes and then I would be back to tuck her in. When I returned
she was kneeling next to her bed with her hands carefully folded in front of her and was
solemnly repeating the alphabet. "A - B - C - D" - and so on till the letter z and then she started
the alphabet all over again. Thinking that she was playing a game to delay going to bed, I asked
her, "Leslie, what are you doing?" Her answer to my question, "I’m praying daddy, I'm not old
enough to remember all the words Grandma taught me so I am just saying the letters because
God will put the letters together into words for me.
Chaplain Durbin shares some of his favorite prayer stories when he lectures at national
hypnotherapy conventions and complementary medicine conferences.
LUKE’S STORY: At the request of a patient I was called to the Emergency Room at
Methodist Hospital. I arrived to find a very disturbed man. Luke was a drifter who had taken an
overdose of drugs. When I went to his room and introduced myself, he began to cry. With tears
running down his face, he said to me, "Why doesn't God love me? I have tried so hard to do
what is right, but something always happens to make me 90 wrong." We talked for awhile about
his life and what got him to this point in time. He talked about wanting to experience God's love,
presence and
peace. He said, "Chaplain, will you pray for me?"
I took his hand and said, "Now just let you eyes closed and begin to relax. In the Psalms,
David wrote,'Be still and know that I am God. St. Paul wrote to the Romans,'And in the same
way, the Spirit helps us in our weakness; for when we do not know how to pray as we should,
the Spirit intercedes for us with groaning to deep for words. God hears you Luke, even when
you do not know what words to say.
Let me tell you about a fish in search of water. This little fish was swimming near the
edge of the river and he heard a teacher speaking to his students. As the teacher and the students
were sitting on the banks of the river, the little fish could hear the teacher tell his students,
"Water is absolutely necessary for life. Without water, we would perish in a few days." The little
fish thought, "if what the man said is true, I better find some of that precious substance called
'water' or I shall die in a few days.
The little fish found other fish and asked them where he could find water, but none of
them knew where he could find water. From stream to stream, the frightened fish searched for
this life-sustaining water. The little fish found the wisest fish in the river and said, "Please,
where can I find the precious substance called 'water' that will give me life. "Waters?" replied
the wise fish. "You were conceived and born in water. Water is your environment, water
supports your very life. You are surrounded by water!"
You ask, "Where is God?" You are surrounded by God's loving spiritual presence right
now. You are conceived in it. You were born in it and your life is sustained by it. You are
immersed in God's loving presence. You can now feel his presence all about you as the little
fish felt the water all about him.
I was quiet for several seconds to give Luke time to let the story of the little fish sink into
his subconscious. Now, Luke, use your imagination and put yourself into this story that I'm
going to tell you: Now, with your eyes closed let this story of the disciple in the midst of the
storm speak to you the message you are ready to hear. Just imagine that you have been with
Jesus all day and he has been teaching from the boat because there were so many people there to
hear him. Jesus concludes his message and needs a rest so he tells you and the other disciples to
sail to the other side. As the boat sets sail for the other side, Jesus lies down and goes to sleep.
You and the rest of the company are in no hurry 50 you decide to do some fishing. It is a terrific
day and you have a big catch of fish. All of you are very happy and excited. Meanwhile the
gentle waves rock the boat back and forth, back and forth which allow Jesus to sleep soundly.
Almost without warning the sky turns black and the winds begin to blow. The storm
winds intensify and the waves rock the boat even harder. Lightening strikes the water near the
boat and the boat rocks and tosses as water leaps over the side of the boat. You are afraid that the
boat will sink.
As you use your imagination, let that storm on the Sea of Galilee represent any storm that may
be going on in your personal life. It may be that you are in the storm of physical pain, of illness,
or injury. It could be a financial storm. Do you feel like the disciple? Can you cry out, "Wake up
Jesus? Don't you care about us?"
Jesus responded to the cries of the disciples by reassuring them of his presence. "Peace be
still, I am with you." When the disciples heard those words, the heart of each disciple began to
grow calm. At almost the same time, it was as if the storm was listening for the storm itself
became calm. If you listen now you can hear Jesus say, "Peace be still, I am with you. Peace can
come to you with or without a change in your circumstances. In the Bible, the word "peace"
never simply means just the absence of trouble or discard. When Jesus comes to us and speaks
"Peace be still, I am with you," he is offering the gift of his presence-not just to resolve
disharmony, but also to bring us the gift of meaning.
When the cold, black winds of pain, sorrow, illness, injury, financial set backs, or
emotion upset blow, there is calm and comfort in the presence of Jesus. When the storm of doubt
seeks to uproot the very foundation of faith, there is the presence of Jesus.
No, you are not on the Sea of Galilee, but you feel the winds of the storm and perhaps
you are questioning your resources to cope with the situation. The storm in your life may be
caused by unrealized dreams, dashed hopes, impairment of health, domestic difficulties, tension
on the job, insecurity of position, inadequate finances or conflicts with family or friends.
When the storm of life comes we want to cry out, "Wake up Jesus. Don't you care about
us." As we express our need, Jesus comes to us saying, "Peace be still, I am with you," and we
experience his presence with us to calm the storm. When the uncertain winds of anxiety blow,
there is a steady safety in the presence of Jesus. When the harsh winds of illness or injury blow,
there is calm and comfort in the presence of Jesus. When the cold, bleak winds of sorrow and
grief blow, there is peace and security in the presence of Jesus. I am not saying that Jesus is a
magic cure, but He is with us to either still the storm or help us cope with the storm. To
experience the presence of Jesus is to experience peace in the midst of the storm. May you
experience that peace today. "in Jesus name, Amen.
With the "Amen, he thanked me and said, "Do you want to know what meant most to
me?" I responded, "Yes, please tell me." He said, "You to touched me.
I saw Luke the next day before he was discharged and he looked like a different person.
He said, "That was an unusual prayer you prayed yesterday. I don't remember ever hearing a
prayer like that before. You made me a part of the prayer. I was living the prayer. It seemed like
I was in the boat with Jesus during the storm. Thank goodness Jesus woke up and said, "peace be
still. How is Luke doing now? I don't know for I have not seen him since his discharge from
Methodist Hospital.
Louis Fischer, who was Mahatma Gandhi's friend and biographer wrote in his book,
"India To Independence" about a visit he made to Gandhi's hut. He writes that he saw only one
decoration on the mud walls of the hut; a black and white print of a painting of Jesus with the
inscription, "He is our peace. Mr. Fischer asked Gandhi about it and he responded, "I am a
Christian, and a Hindu, and a Moslem, and a Jew." This is a parable of God's love and even
though it may be difficult to attain, may we never be too narrow to admire it when it flashes
across our horizons.
Gandhi once wrote, "in the midst of death, life persists; in the midst of untruth, truth
persists; in the midst of darkness, light persists; hence I gather that God is life, truth, and love.
He is love. He is the supreme Good.
[CLOUDS ARE NOT THE CHEEKS OF ANGELS, YOU KNOW. THERE ARE JUST
CLOUDS, ANGRY SOMETIMES YOU CAN NEVER BE SURE. IF I HAD LONER ARMS I
WOULD REACH UP AND PUSH THE CLOUDS AWAY, OR MAKE THEM HANG
ABOVE THE WATER SOMEPLACE ELSE. BUT I’M JUST A PERSON LOOKING FOR
THAT THING THAT’S HARDEST TO FIND. LORD HELP ME! PLEASE.]

18. THE EVOLUTION OF VISUALIZATION AND GUIDED IMAGERY

The power of the mind over the body is finally coming of age in traditional medicine due
to new research being conducted by the medical and psychological communities.
 Today, scientists are taking pictures of emotions and mapping the communication lines
between the brain and the body. More and more doctors are increasingly prescribing
meditation instead of medication for such common problems as chronic pain, high blood
pressure and even infertility.
According to Herbert Benson, M.D., Director of the Mind-Body Medical Institute at
New England Deaconess Hospital in Boston, "When all proven therapies are brought together,
we will see much more of a balance between what we can do for our selves and what can be
done for us,
The new interest in the medical applications of visualization and guided imagery is the
result of the demand for less expensive health care alternatives by the public and the desire to
offer better health care at a lower cost by health care providers. Unfortunately this was not the
case just a decade ago.
Visualization and guided imagery was often perceived as just another term for hypnosis.
In the eyes of the public hypnosis was suspect due to persisting myths about the powers of
hypnotists perpetuated by the media performers and stage hypnosis claims by so called as well
as outlandish claims by so called "hypnotherapists" who generally had very little training in the
medical applications of a developing scientific method of self help therapy.
Private vocational schools where springing up across the United States and offering
students short courses on hypnosis and hypnotherapy. These courses were often designed by
entrepreneurs as a money making opportunity more than a forum for serious research,
knowledge and the development of broad clinical skills.
Participants who completed these training programs often advertised themselves as being
able to treat almost any disease or disorder solely through the use of hypnosis. Many of these
therapists cited their vocational school diploma as a license to practice hypnosis as a separate and
distinct profession and disregarded the established therapies of psychologists and other allied
health professionals. A large number of these hypnotherapists had little academic training
beyond a high school diploma which was often the only requirement for attending a
hypnotherapy school.
It appeared that hypnotherapy was the latest money making fad and when one
term such as "clinical hypnosis" failed to attract customers, another term would replace it, like
"stress management therapy" or "visualization and guided imagery". These lay hypnotherapist
relied more on media advertising programs and personal salesmanship than they did on the type
of continuing education and research required in the health professions. For many years the
public and the medical communities viewed hypnotherapy as more "Hyp" than therapy.
A large number of hypnotherapy organizations also developed during this time period as
a means to certify graduates from vocational hypnotherapy schools and lobby to keep the
practice of hypnotherapy from being regulated or held accountable to any government or
health care agency.
Fortunately, a few respected hypnotherapy organizations rejected this outlandish
approach to the advancement of hypnotherapy and forged ahead with research and meaningful
educational programs that have resulted in the efficacious techniques of visualization and guided
imagery that are now being accepted by the health professions as part of a team approach to
traditional Western medicine.
In this decade, news reports have begun to focus on the benefits of visualization and
guided imagery and the new requirements of training and clinical practice that are being
established by organizations that are made up of Physicians, Nurses, Dentists, Psychologists, and
other health professionals with advanced training in clinical and medical hypnotherapy.
So far, the most solid mind/body connections have been made from stress research
pioneered largely by Benson, of Harvard Medical School, whose institute was inaugurated on
May 5, 1990 and is supported in part by the American Cancer Society and the National Institutes
of Health.
Stress is important to understand because it produces a broad spectrum of common
physical complaints and emotions, including chest pain, dizziness, heart palpitations, fear, anger,
hostility and depression.
Benson says these symptoms are due to the "stress response" in which metabolism,
breathing, blood pressure and demand for blood flow all increase. At the same time, the immune
system becomes depressed, lowering it's ability to fight disease.
ADVERSE EFFECTS OF UNHEALTHY STRESS When prolonged, this stress
response:
1. Causes permanent high blood pressure and potentially fatal irregular heartbeat.
2. Worsens all forms of pain by lowering an individual's ability to cope with pain at other
than very low levels of discomfort.
3. Leads to female infertility.
4. Leads to anxiety disorders, including panic attacks.
5. Influences progression of infectious diseases by lowering the production of white blood
cells.
Deepak Chopra, M.D., President of the American Association of Ayurvedic Medicine
says, "in the East, we say if you want to know what your mind was like in the past, examine
your body now. If you want to know what your body will look like in the future examine your
mind now.
The American Association of Ayurvedic Medicine, based on a five thousand year-old
form of mind/body medicine from India. Fortunately, whatever ravages the mind creates, it can
undo, through what Benson calls the relaxation response which is a Western version of
transcendental meditation, which is one of the essential elements of Eastern mind/body
medicine.
Dr. Benson recommends a simple technique where you sit quietly, close your eyes and
breathe slowly. With each out breath repeat silently to yourself a word, sound prayer or phrase.
Benson suggests that this be done twice a day for about 20 minutes. "About 80% of my patients
choose a prayer," says Benson. "Over time, I saw that I was teaching prayer and found that
rather silly as a physician. But overall, this is the most proven mind/body effect and is a
cornerstone of behavior medicine. Meditation, visualization and guided has many benefits
including the alleviation of depression, anxiety, anger and hostility.
BENEFITS OF MEDITATION, VISUALIZATION AND GUIDED IMAGERY:
Beneficial results of meditation, visualization and guided imagery have helped patients suffering
from:
1. High blood pressure and type A behavior.
2. Premenstrual syndrome and infertility in women who are not sterile.
3. Addictions, tension and migraine headaches, cancer pain and low back pain.
4. Nausea and vomiting induced by chemotherapy.
Dr.Richard Glass, deputy managing editor for the Journal of the American Medical
Association, has provided a forum for several landmark studies on the mind/body link. "it is a
quite legitimate area for scientific investigation,” says Glass. "There are still some skeptics, but
the people who tend to be the most accepting are the clinicians who see this mind/body
connection daily in their patients.
FINDINGS FROM NOTABLE STUDIES RECENTLY PUBLISHED IN THE
JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION: Meditation, yoga and a
vegetarian diet reverses
blockages in the coronary arteries.
Elderly people can delay death until after an important event.
Men in demanding jobs without the ability to control the demands placed on them are at
increased risk for high blood pressure.
Bernie Siegel, M.D., who founded the Exceptional Cancer Patients Center in New
Haven, Conn., says, "Your body knows what's going on in your life. Hope despair and
hopelessness shorten it." Hope and love prolong life, and despair and hopelessness shorten it.
Visualization and Guided Imagery is the modem day application of hypnosis in medical
settings and for medical purposes that utilize updated techniques of hypnosis which are more
reliant on the use of positive suggestions and mind body interaction than the previously
developed ridged techniques used since the early 1950's.
Therapists who practice complementary medicine hypnotherapy are part of a health
care team and often found on the staff of major hospitals or patient health education programs at
health care maintenance organizations. These therapist work in conjunction with physicians and
psychologists as an adjunct part of a total health care team. They emphasize that they teach
visualization and guided imagery as a self help modality rather than hypnotize people. They can
document a meaningful educational background in health and psychological sciences and
certification and or recognition by professional organizations that require graduate level training
such as the National Board for Hypnotherapy and Hypnotic Anaesthesiology.
Complementary medicine hypnotherapists demonstrating the value of visualization and
guided Imagery with case studies and research that is verifiable and repeatable, two requirements
for consistent and quality therapy programs.
Visualization and Guided Imagery is beneficial in many areas of health care including
behavior modification therapy for unwanted habits and the treatment of substance abuse.
Visualization and Guided Imagery is applicable in many areas of nursing care. Surgical
patients can gain confidence that the procedure being performed will have positive results,
thereby reducing preoperative fear and anxiety. Post-operative problems such as urine retention,
nausea and pain can be ameliorated. Post-operative discomfort due to sitting, standing or
ambulating can be alleviated.
Visualization and Guided Imagery can help intensive care patients gain much needed
periods of rest and relaxation. Patients in CCU with cardiovascular insults such as
supraventricular arrhythmia's, paroxysmal tachycardia and ventricular ectopic beats can
benefit from relaxation and guided imagery.
This self-help modality is useful in psychiatric nursing to teach agitated and depressed
patients how to relax and alleviate undesired stress and tension.
Visualization rehabilitation and Guided Imagery can be applied in rehabilition nursing to
teach patients preventative and restorative skills
While hypnotists and lay hypnotherapists may make unsubstantiated claims as to the
results of their form of therapy, visualization and guided imagery therapist practice in an area
that combines the aspects of mind, body, spirit and soul in both remedial and clinical work.
[THE WAY WE THINK IS AS INTERCONNECTED IN OUR MIND PHYSICAL AND
SPIRITUAL BODY AS THE ELEMENTS OF THE EARTH AND SKY AR
INTERCONNECTED IN THE UNIVERSE. Dr R. D. Longacre]

19. MEDICAL GUIDED IMAGERY CONCEPTS

The question most often asked by doctors, dentists, psychologists, hypnotherapists and
other health professionals who have attended my lectures and seminars across the nation is,
"How do you work with someone who has objections to hypnosis?" Traditionalists believe
the correct answer is to educate the client or patient about hypnosis. In other words, dispel the
myths of hypnosis and gently persuade the client or patient to accept the modality on the
therapist's terms. While this approach is effective in many cases it is contraindicated in
complementary medicine hypnotherapy.
A student who has completed a basic course in hypnotherapy, visualization guided
imagery will tell you, positive words, statements, affirmations and enhancement of the client's
self-esteem are key ingredients to a hypnotherapy session. Negative words like try, hope, maybe
or thoughts like, I will and I must, will not allow the client to achieve the results they desire
from the therapy session.
As members of the helping professions, we are entitled to our personal and professional
opinions regarding hypnotherapy and the techniques we employ. The traditional
hypnotist-centered approach with direct suggestions and ritualistic induction procedures has
helped millions, but it has also been ineffective for thousands of others. The medical
hypnotherapist helps the client or patient by providing and imagery format that the individual
wants and the way they want it.
A good illustration of this important concept is the weekend routine of my daughter
when she was three years old. It was the custom in our home for me to help Leslie dress in the
morning an take her to preschool. My wife left very early to commute to her office. As Leslie
and I prepared for the day we discussed what she would be doing in school that day, upcoming
family outings an events and why today would be a special day. The concepts presented in our
morning routine were not unlike a hypnotherapy session.
While driving Leslie to school, she would invariably ask, "Daddy, will you buy me a
treat?" My answer was always positive and then we would discuss what kind of treat she would
like to have. Now realize that I am biased in my opinion of this delightful, intelligent and good
hearted child, however, I was always amazed at the number of choices she gave to pick from
when buying "her" treat. The list of treats included candy, special good worker or good listener
stickers, new clothes for her doll or cookies. Leslie at age of three knew what she wanted and
how she wanted it (in a bag, the whole bag, a certain color or at a special time). Rather than
argue with her choice of an anticipated reward I looked at one of the rewards she had mentioned
as a category.
Candy can be a reward category rather than a specific item or reward outsome. Candy
can be anything that tastes good and is not usually served at dinner time. As a parent I practiced
my own form of therapy with my child much the same as I do with clients in my professional
work. In teaching Leslie how to grow, I utilized the concept of giving her what she wanted and
how she wanted it, but in a way it enhanced her anticipated results from a morning conversation
with Daddy . Leslie did not know what hypnosis was or what a hypnotherapist was supposed to
do. Leslie did know what she wanted to accomplish for herself and the way she wanted me to
help her do it. I could have said "no" to candy and tried to explain why candy is bad because it
has too much sugar and tried to get her to accept my point of view. However, I preferred to
work within her frame of reference and let her develop her own conclusion about the joy of
getting special praise for being the marvelous little person that she is.
I am sure that hypnotherapists who employ this concept in their work will be as richly
rewarded by comments they receive from their clients as I was when Leslie would walk into my
den and announce with a big smile on her face, "Daddy, your Binky girl is home.
My work as a specialist in hypnotic anaesthesia does not always provide me with the
opportunity to explain to each patient or client what hypnosis is or more easily explained, what
hypnosis is not. Oftentimes the urgency of the situation leaves no time for any explanation other
than, "I am here to help you feel comfortable.
Many people have come to believe that a therapist hypnotizes them or does something to
them. Sometimes this belief is perpetuated by "lay hypnotists" who guarantee to hypnotize a
person in order for them to stop smoking or loose weight. The concept of being hypnotized is
false, because all hypnosis is really self-hypnosis. In other words, whatever a client or patient
accepts or perceives as reality, their mind will order their body to do. The client or patient
controls their own subjective experience independent of what may or may not be suggested by a
therapist. This is why Medical Hypnotherapists devote hours of study to learning how to
properly formulate therapeutic suggestions that empower the client or patient to develop their
own individual spiral of belief.
The primary purpose of medical hypnotherapy is to enable the client or patient to build
their own belief system and achieve the goals and outcomes that are important or significant for
them at a given time in the present or the future. The terminology preferred by the
hypnotherapist is not as important as the end result of the therapeutic work undertaken.
If the explanation of circumstance or situation indicates another the results that can
be obtained, the word hypnosis or hypnotherapy can be cast aside and replaced with a term more
acceptable to the client or patient. The term "hypnosis" can be replaced with Visualization
Therapy, Guided Imagery Therapy, Creative self-help Therapy, or Relaxation Therapy. The
therapeutic results of hypnotherapy by any other name are still positive results for the individual
who has negative feelings or thoughts regarding the myths or outdated practice of hypnosis. The
results of a therapy that is directed toward the subconscious mind will remain the same
regardless of the term used to describe or label it.
I have often said that it is more important regarding what the therapist does not say
during a therapy session, than what the therapist does say.
Dr. Cherylanne Atwood, the Director of a nationally recognized hypnotherapy and career
training institute in Arizona, shared the following experience with me during a directors
meeting of the National Board for Hypnotherapy and Hypnotic Anaesthesiology.
"This lady really believed that hypnosis would help her but was concerned about the
technique I would use to hypnotize her," said Dr. Atwood. "She explained to me that she could
only be hypnotized by a watch and asked me if that was how I did it. My answer was, of course
that's how I do it. I asked her to give me a moment to give a message to my receptionist and left
the room to find a watch.
The following incident experienced by a Southern California hypnotherapist is a good
illustration of another concept of allowing the patient to build their own belief system.
A young lady had been referred to this therapist by a former client who had explained
how the hypnotherapist induced hypnosis by having her put on a set of head phones and listen
until she was deeply relaxed. What the referring client failed to explain is that a standard
progressive relaxation induction is played through the headset and then the therapist stops the
pre-recorded induction tape and then personally gives explain is that a played through the
therapeutic suggestions over a small microphone placed on the corner of his desk.
While the young lady was in the waiting room, she observed another patient putting on a
headset in a therapy room and the door closed. A short time later she was greeted by the patient
who explained how pleased she had been with her session.
When it was time for her session the therapist placed the headset over her ears and asked
her to listen while he left the room for a few minutes to get a drink water. Upon his return, the
young lady appeared to be deeply relaxed and in a state of hypnosis. The therapist picked up his
own headset to hear what the young lady was listening to and how far along she was in listening
to the pre-recorded induction tape.
He was surprise there was nothing playing through the headsets and realized that he had
forgotten to turn on the pre-recorded induction tape.
In this case, The patient expected to be hypnotized by putting on a headset and listening.
She had not been told to listen for a voice or told that by simply putting on a headset she would
and enter a state of hypnosis. The static and lack of sound in the headset was her creative
induction.
While the above may hypnotherapists, it illustrates that it ir what you say, rather what
you don't say.
It is said that a picture is better than a thousand words. Medical hypnotherapy is about
words that become pictures in the subconscious
The mind can be thought of as having two sides. The left side deals with conscious
thoughts and regulates for the most part which thoughts or memories will be passed over and
stored in the right side where subconscious word pictures are processed and acted upon. The left
brain deals with concrete facts, figures and precise ideas, while the right brain deals with abstract
be humorous to seasoned that it is not as important as to thoughts and feelings as the sights,
sounds, colors, emotional and spiritual feelings created by the client..
The medical hypnotherapist can use suggestions to help the client create pictures that
they desire for self-help therapy by carefully interviewing the client and individualizing imagery
in a manner that the client might easily choose for themselves. On the other hand, since the
choice of the right word pictures is entirely up to the client, any individual can easily develop
their own word pictures without the aid of a therapist. I will explain how to do this in Section
Three; In the Chapter on self-help therapies . The results of these special pictures created by the
Individual have unlimited power to heal the body, mind and spirit.
It was my experience in the 1960's to be greeted by a clerk in a hardware store, clothing
store or shoe store who would say, can I help you. Now I already knew how he could help me
by ringing up my purchase, finding my size or directing me to the appropriate isle where I could
find the nails or tools I wanted to purchase. Grammatically his statement was wrong, he should
have said, "How may I help you." I didn't mind that the question was in the wrong grammatical
form because he smiled and seemed to really want to help me. Though the grammar was
incorrect, it was obvious that his offer of help was sincere.
Today it is hard to find a clerk in any store I visit. Sometimes I wonder if there are any
clerks left in our modem society. It appears that the term clerk has been replaced with a variety
of titles; sales person, consumer counselor, customer service representative or department
supervisor.
Many members of the helping professions still cling to the past and forget to begin a
session with a heart felt smile. They are often so preoccupied with proving the validity of a
dogmatic approach that they seem to be saying, "How can I help you. Fortunately there is a new
awareness and dedication to helping others help themselves by therapists in all the modalities of
the helping professions.
Complementary medicine therapists are now asking the question, "How may I help you?"
This principle element and concept of complementary medicine hypnotherapy can be
summarized as: "What do you want," and " How do you want it."
The first step in employing these concepts in the practice of complementary medicine
hypnotherapy is to explore how the hypnotic formula provides the individual easy access to the
positive thought processes of the right brain or subconscious mind and creates naturally desired
therapeutic outcomes for individuals or groups.
The Hypnotic Formula can be written: Hypnosis equals plus Imagination, plus belief,
which then equals conviction. The catalyst of the formula that allows positive and thoughts to
pass to the subconscious mind is of attention (Md.A.) H = E + B = C.
The above diagram represents the concept that complementary medicine hypnotherapy
and self-help therapy is the result of Expectation + Imagination + Belief + Conviction that
enables the individual to realize that they have successfully used ability of their subconscious
mind to accomplish a state of hypnosis.
You will notice in the diagram that the formula is reversible. In other words, if the
therapists work fails to allow the client to logically be convinced that something really happened
as a result of the individuals own efforts, the formula falls apart and the therapist must start over
again to assist the individual to develop their own preferred spiral of belief.
The catalyst of the formula (the factor that makes it work) is Misdirection of Attention (Md.A.).
Misdirection of attention is facilitated by simply having an individual notice their breathing
slowing down or the relaxation in the chest when they exhale or any other simple thought that
directs the body to relax. An individual practicing the self-help therapies in the next section,
need only to take a moment to enter a meditative, prayerful or quiet state of mind while
imagining a peaceful or relaxing thought.
Now let's take a closer look at the other elements of the hypnotic formula. The prestige
of the therapist, establishing rapport and the use of therapeutic terminology acceptable to the
client are important aspects of creating enhanced expectation by the client. I have found in my
own practice that my openness and active participation as an educator is more effective in
increasing expectation than providing a litany of my experience, advanced training and my
professional recognition.
Clients coming to my office may see certificates I have received for advanced training or
articles I have written for various publications and ask questions about the course or conference
I attended or the article they read. Answering their questions provides me with another
opportunity to help them build their own spiral of belief when I emphasize involvement in
complementary medicine hypnotherapy is the result of my ability to teach them how to do it for
themselves, rather than simply show them a method and a form.
I encourage therapists to share the message that they are teachers and not hypnotist with
their local communities. The following experience illustrates how community visibility can
interact in the clinical setting.
I was attending a convention of hospital and medical employees where I was to speak on
the topic of "Alleviating Job Related Stress. Several of the convention participants had attended
a lecture I gave several months earlier at a nursing convention and were commenting on an
article I had written in a professional journal about "Visualization and Imagery in Nursing.”
Another participant overheard the conversation and joined the group. After outlining an
unpleasant experience she had experienced with a hypnotist she had hoped would help her with a
severe anxiety problem, the group recommended that she should seek me out at the convention
and ask me to refer her to a competent professional in her area.
After introducing herself, this middle-aged woman told me that she was afraid to be
hypnotized anymore due to her previous experience, but desperately wanted to overcome her
fear of elevators, high places and small rooms. I suggested that we find a quiet alcove in the
conference center and talk.
Since she had learned of my professional background and training from a group of
medical employees, she had already assumed I would help her and had a heightened sense of
expectation. After talking with her for a few moments, I agreed that being hypnotized was not
the best form of therapy in her case, and suggested that I teach her a simple technique that she
could use to alleviate her discomfort.
I asked her to close her eyes and pretend she could see a blackboard with the numbers
one to ten written across the top. I then asked her to pretend she was erasing the number ten and
when it was gone to nod her head. She proceeded to erase each number the same way and when
number one was erased, entered a very nice state of self-hypnosis. This simple induction which
took only a few moments and taught her how to easily relax and misdirect her attention, was
then followed by appropriate therapeutic suggestions for her phobias. The relaxation lesson I
taught her was effective because working with numbers was something she did at her job and
was not related to her experience of fear.
Before I left the convention the next day, this lady looked me up again and thanked me
for my help. She explained that she could now easily and quickly erase the numbers from a
blackboard and it significantly helped her when taking the elevator to her room on the Ilth floor.
Once a client has enhanced expectation as to therapeutic results, positive thoughts and
statements can be formulated to allow them to come to believe that they can accomplish a simple
task with mental imagery.
This simple task might be something like picturing and imagining biting into a lemon.
Many therapists know this imagery as a suggestibility test. However, the term 'test' is not
relevant because it "fail the test. Suggestibility tests should be viewed as mini induction's or
relaxation exercises that the individual client or patient can use on their own any time they desire
to do so and expect positive results.
Utilizing the imagery of holding a lemon, the client is directed to concentrate on the palm
of their hand. In other words, misdirect their attention by narrowing the focus of all sensory
input to a spot on the palm of the hand where an imaginary or 'let's pretend' lemon is supposed to
be.
By misdirecting attention or narrowing the focus of sensory stimuli the subconscious
mind is able to act on suggestions without interference from the conscious or logical mind.
There are an infinite number of ways to aid a client in misdirecting attention. I have
demon started this concept to students by having them hold a wood chip in the palm of their
hand, closing the hand and then imagining all the different shapes, feelings or relaxing things
the wood chip could be.
The way the therapist misdirects attention is limited only by his or her own creativity in
their therapeutic work.. It is not necessary to abandon older and more conservative techniques to
narrow attention, focus or misdirect attention in therapy sessions, however, the hypnotherapist
should be aware that adherence to ridged hypnotic traditions and dogma is not mandatory if the
client, situation or circumstance presents an opportunity to be more flexible in their
hypnotherapeutic work.
Conviction is the end result of the hypnotic formula and is predicated on carefully
helping the client to use the formula to achieve the result they wanted and demonstrating to the
client that they have used their own ability to achieve results.
The prestige of the therapist, client expectation and the technique used to help a client
enter a state of self-hypnosis are insignificant if the client cannot logically realize that they have
entered an altered state of consciousness or utilized their own imagery to effect a positive change
in emotional or physical well being.
The use of convincers and post hypnotic suggestions are ways to demonstrate to a client
that they have used their own subconscious ability to enter a state of self-hypnosis to achieve
their desired outcome.
Convincers are generally suggested during the therapy session and might be those that
produce arm or eye catalepsy. Demonstrating glove anaesthesia, a hand that is stuck to the lap or
an arm t hat floats up into the air are other convincers that may be used.
Post hypnotic suggestions might be to find the chair too uncomfortable to sit in unless
you stand up and then sit down or finding a w writing pen too slippery to hold onto when you
return to an awake state. Unfortunately, the use of traditional convincers and post hypnotic
suggestions are only appropriate in complementary medicine hypnotherapy sessions because the
convincer must be suggested by the therapist. When the client or patient is practicing their own
self-hypnosis or visualization and guided imagery exercise, the convincer must be an integral
part of the exercise. I have included a depth meter type of convincer in the self-help healing
practices in the next chapter.
The use of convincers will facilitate conviction on the part of the client who expected to
be hypnotized. But what about the client who reservations about hypnosis and is expecting
positive results from relaxation therapy, visualization therapy, guided imagery or prayer
therapy? If careful attention is paid to all aspects of the hypnotic formula, the results will speak
for themselves and the patient will reach the stage of conviction without any contrived help
from the therapist.
The most effective type of convincer is to suggest a simple exercise that the client or
patient can do to induce the same depth of relaxation experienced during the therapy session
with the therapist. This exercise is suggested during the therapeutic imagery portion of the
session and again before alerting the client
The two convincer exercises that I have found to be the most useful for the client to use
on their own are the depthmeter exercise and the rhythmic breathing exercise.
The depthmeter is used as an easy induction technique and then can be remembered in
the awake state to provide lo provide the client with the level of relaxation they reached during
the session.
The rhythmic breathing technique is used the same way with the exception that the depth
of relaxation increases or deepens each time the exercise is practiced.
The visualization and imagery used for each of these inductions/convincers is found in
the chapter on self-help practices.

2. SELF-HELP HEALING PRACTICES

Self-help healing is not a treatment modality that is a substitute for traditional medical
care. It is important that these healing practices be used in combination with other therapies and
remedies prescribe by a physician as part of a team approach to complementary medicine.
Complementary Medicine Visualization and Guided Imagery can be used to enhance the
desired outcome of prescribed medications as well as alleviate side effects of medications. In
the treatment of cancer with radiation and chemotherapy, Visualization and Guided Imagery is
beneficial in alleviating side effects such as nausea and vomiting.
I recommend that you use these healing practices after you have consulted a physician
and have an accurate diagnosis of your illness or disease and your primary care physician has
prescribe a treatment program for you.
The healing practices presented in this chapter are a combination of Visualization and
Guided Imagery, and Spiritual Healing techniques. I refer to these techniques as "Practices"
because you do not have to have special training or be accomplished in visualization and guided
imagery, or in prayer or meditation to personally experience remarkable results.
It has been my experience that the idea of learning something new or studying a
series of lessons is often more difficult that understanding the actual material presented in the
lesson. We seem to first want to analyze how hard it will be to remember all of the material and
use it to our own advantage, before we begin the learning process. If we perceive the learning
process to be difficult, we may put the whole idea aside or put off starting a project until we
absolutely have to. Please be assured that it is not necessary to study this whole chapter or read
this entire book to create physical and spiritual healing in your life.
I suggest that you read these healing practices like a story rather than a lesson that has to
be learned and allow the true power of the practice to reveal itself in your deepest heart and
subconscious mind, before questioning the technique or the form of the practice.
Visualization and Guided Imagery deals primarily with the hypnotherapeutic concepts of
mind body healing. This is a process where self-hypnosis is induced by narrowing the focus of
the conscious mind (left brain) and letting the body completely relax. Once the body is relaxed a
series of word pictures or thoughts (misdirection of attention) provides a means to let go of
conscious thinking and accept positive and healing suggestions into the subconscious mind (right
brain). Once these images of physical and emotional healing are stored in the subconscious
mind, they automatically tell the body what to do in order to strengthen the immune system and
naturally cure disease.
Spiritual healing works primarily at the conscious level in that you do not have to induce
a form of self-hypnosis in order for the results to become manifest. While spiritual practices
may induce feelings of deep relaxation and tranquillity, the true power of the practice comes
from a higher source outside of the self. In a spiritual healing practice the psyche is put aside and
replaced with a desire to surrender or burdens, pain and disease to a higher power and accept the
healing as this higher power prescribes it. In other words, "Let Go and Let God".
It has been my experience that many patients perceive learning self-hypnosis as difficult
and for this reason have trouble entering a deeply relaxed state during their self-hypnosis
practice. Their mind seems to keep wandering back to the left brain (conscious state) trying to
remember what to do or think next. Even well experienced hypnotherapists may experience
difficulty in achieving a deep state of self-hypnosis. Therapist are prone to analyze what they are
doing in light of their previous training. This analytical thinking (left brain) actually prevents
them from entering the hypnotic state. In order to prevent the stumbling blocks of left brain
thinking, I have formatted these practices in a right brain experiential manner rather than a
formal method of induction and imagery.
The experiential format of the practices are broken down into uncomplicated steps that
are easy for the patient or client to learn and use on their own. This format will also aid the
therapist who Is experiencing difficulty entering their own self-hypnotic state.
THE FORMAT OF THE PRACTICES:
PREPARATION: The preparation is a way to begin to relax the body and quiet the mind before
beginning the practice. Just as an athlete must cool down the body after a period of vigorous
exercise, so must we calm down the mind and body from our normal routine before deeply
relaxing in a healing practice. The preparation allows us to focus on the practice and ignore the
distractions of the everyday world around us. The preparation is similar to the beginning of a
session with a hypnotherapist, when the therapist suggest that you take a few deep breaths, close
your eyes and begin to concentrate on their voice.
INVOCATION: The invocation allows us to state out loud the purpose of the practice and
affirm our belief in a higher power to bring about the outcome that we desire from the practice.
When we call upon a higher power to help us and become one with us during the practice, we
are connecting to the spiritual aspect of the mind, body and spirit healing process. This may be
the most important part of the healing process as it brings about a sense of peace and tranquillity
and expectation of positive results.
THE HEART OF THE PRACTICE: The heart of the practice is a time of deep relaxation and
images of healing that prompt the subconscious mind to give appropriate suggestions the healing
systems of the body. These images will develop naturally and spontaneously and require no
conscious effort. The images presented in the individual practices may take another form in
your subconscious mind that the printed words might suggest. This is perfectly normal as each
individual intuitively knows the type of suggestions and word pictures that work best for them.
The images presented in the heart of the practice may also change and become even more
meaningful for healing the more you experience the practice. The important thing to remember
is that there is no right or wrong way to do the practice. Each time you experience the practice
there is a healing benefit. The heart of the practice is similar to the visualization and guided
imagery suggestions for deep relaxation and the therapeutic suggestions given by a therapist
during a hypnotherapy session.
RESTING IN THE PRACTICE: Once a series of suggestion or images are implanted or stored
in the subconscious mind, they will continue to operate until you consciously decide you do not
want them to. Resting in the practice allows the images you have selected to gain power and
momentum and remain operating long after you have completed the practice.
Resting in the practice also provides an opportunity to enjoy the deeply relaxing
experience of the practice and enjoy a period of physical comfort if unwanted pain is associated
with your illness or disease.
By resting in the practice you provide your mind and body with a time to gradually
return to your awake or normal conscious state on both a physical and spiritual level. This
gradual return to the thoughts and activities of your everyday life is much the same as the warm
up exercises performed by an athlete before beginning a physical exercise or competing in an
event. Resting in the practice is similar to the awakening and post hypnotic suggestions given by
a hypnotherapist.
I have outlined several preparation exercises before presenting different self-help healing
practices. Although the preparation is part of the practice, you may wish to try different ones
and determine which preparation is the most meaningful to you before beginning the actual
practices.
Once you have selected the invocation or invocations you wish to use, complete a
selected practice. The first time you experience a practice you may wish to read one part of the
practice and then close your eyes and repeat silently what you have just read. Leave your eyes
closed for a moment and then tell yourself that when you open your eyes you will go even
deeper relaxed as you read the next portion and go even deeper relaxed each time you close your
eyes. After you have experienced a practice for several times, you will find that there is no
need to read portions of it anymore. This is the best way to develop your skills at performing the
practice. If you try to memorize or remember the whole practice before doing it, you will be
using mostly left brain thinking, which can hinder your natural inner mind and spiritual ability to
perform the practice.
Remember, even if you feel frustrated or think you are not doing the practice correctly,
you are benefitting from the practice every time you do it. If you feel it is necessary you may
wish to consult with a Complementary Medicine Hypnotherapist, Certified by the National
Board for Hypnotherapy and Hypnotic Anaesthesiology. A Board Certified NBHA therapist
can provide you with personal instruction and help you design your own personal self-help
healing practice.
INVOCATIONS:
Close your eyes and imagine that Jesus is smiling at you. Breath slowly an allow yourself
to imagine Jesus with you and then say out loud, "Dear God I am struggling with this disease, in
the name of Jesus help me heal my body, mind and spirit. Jesus help me now."
OR
Say this phrase out load, "My inner most mind and spirit is healing my body, my inner
most mind and spirit is healing my body, my inner most mind and spirit is healing my body,"
now close your eyes and repeat once more, "My inner most mind and spirit is healing my body
as I go deeply relaxed.
OR

Sing the following phrase as if it was a one note song, "I am at one with the universe, I
am at one with a higher power and eternal wisdom, I am interconnected with all things visible
and invisible, I am accepting the healing of my mind and body." Now close your eyes and listen
to the song repeat itself in your mind.
OR
Pray out loud, "Lord help me now, Lord heal me now, Lord enter my heart and lead me
now. I ask this in the name of your son Jesus Christ."
OR
Say out loud, "My body is healing itself, there is no reason my body will not heal itself.
Take a deep breath and then as you slowly exhale make the sound - "Ah" - "eel/' - "oh" -
"m". Begin the sound at the back of the throat and roll it forward to the front of the mouth,
closing the mouth on the "m" sound. Make the sound last as long as you can. Repeat the sound
for three to five minutes.
This is a vibrating meditative sound used in Eastern meditation that relaxes the mind and
the body. This preparation should be done while seated in a straight back chair with the
shoulders held upright and the hands folded in the lap
OR
While laying in bed on your back: Breath in as slowly as you can and concentrate on
your breath as it flows into the body and then all the way down to your toes. Exhale slowly
through your mouth and feel the breath move up through the body like a gentle wave of
relaxation. Experience each breath as a gentle wave flowing in and flowing out and blocking out
all sensations of discomfort and allow your mind to concentrate only on your breathing as other
fleeting thoughts just seem to flow out of the mind with each out breath. Perform the breathing
preparation for three to five minutes or longer if you wish. If laying on your back is
uncomfortable, place a piIlow beneath your knees.
OR
Focus your eyes on a religious or spiritual picture or object and allow your gaze to
become blurry and your eyes to become heavy until they close.
This preparation is especially suited for someone who is bedridden or wishes to do the
practice just before going to sleep.
While laying on your side, imagine that you are laying on a large circle of ground in the
desert on a warm winter day. Notice the vegetation in the area around you and then allow all of
the scenery to disappear until only the bare ground is left. Next imagine a beautiful blue sky
above you. Focus on your thoughts for a moment. Each time you have a thought, look at the
thought or feel the thought and then let it go, as if it were a tiny little puffy cloud just floating by
in the sky. Let each thought become a cloud and disappear until you mind quiets and becomes
silent. Now listen only to the silence. Anytime a thought interrupts the silence make the thought
into a cloud and let it disappear. When your mind has been silent for three to five minutes, begin
the practice you have selected.
OR
Read or recite your favorite prayer or a poem you find inspirational and calming.
There are four prayers that I have found very meaningful in my own practice sessions.
One is a prayer composed for me by Dr. Paul G. Durbin, the Chaplain of the National Board for
Hypnotherapy and hypnotic Anaesthesiology. The others are a prayer to St. Peregine, the patron
against cancer, the Peace Prayer of St. Francis of Assisi and The Serenity Prayer of Alcoholics
Anonymous.
CHAPLAIN DURBIN'S PRAYER: “The light of God surround me, The love of God
enfold me, The power of God protect me, Wherever I am God is.”
St. Peregrine Lazioski was a Roman Catholic Priest who was canonized 1726. A
constant beacon of hope and courage for the sick, he himself was afflicted with cancer of the
foot which was excruciatingly painful. But he bore all his sufferings with Christ-like patience
without a murmur. At last a surgeon decided that his only hope was amputation of the foot.
St. Peregrine spent the night before the operation in trustful prayer before falling to
sleep. In a dream, Christ seemed to reached out from the cross and touch his diseased leg. On
awakening, Peregrine knew it was more than a dream. He awoke completely cured. This
miracle greatly enhanced the reputation which this holy man had already acquired by his
exemplary life.
PRAYER OF ST. PEREGRINE: “O God who gave to St. Peregrine an Angel for his
companion, the Mother of God for his teacher, and Jesus as the Physician of his malady, grant
we beseech You through his merits that we may on earth intensely love our holy Angel, the
blessed Virgin Mary, and our Savior, and in Him bless them forever. Grant that we may receive
the favor which we now petition. We ask this through the same Christ our Lord. Amen.”
One fateful day young St. Francis of Assisi stripped in public; handed his clothes back to
his father and waled out of town naked. Considered mad by his family, who were prosperous
silk merchants, he went to live in a ruined chapel which he set out repairing. A former solder,
St. Francis so profoundly moved by two visions of Christ, now dedicated his life to poverty and
hardship.
Surprisingly, others followed St. Francis’s example, including some of the leading
citizens of the town. In a short time, he had disciples who joined him in living the life that took
the Gospel message literally and applied it radically. Francis and his companions based their life
on poverty, love of all people and nature.
Francis’s new way of life gained official status in the Roman Catholic Church in 1210
when the pope approved the order. Two years later St. Glare joined him to create a community
that would become known as the Poor Glares. The order is known today as the Franciscans.
PEACE PRAYER OF ST. FRANCIS OF ASSISI: “Lord, make me an instrument of
Your peace: where there is hatred let me sow love, where there is injury let me sow pardon,
where there is doubt let me sow faith, where there is disappear let me give hope, where there is
darkness let me give light, where there is sadness let me give joy. O Divine Master, grant that I
may: not try to be comforted but to comfort, not try to be understood but to understand, not try
to be loved but to love.
Because it is in the giving that we receive, it is in forgiving that we are forgiven,
and it is in dying that we are born to eternal life.”
SERENITY PRAYER FROM ALCOHOLICS ANONYMOUS: “God grant me the
serenity to accept the things I cannot change, the courage to change the things I can, and the
wisdom to know the difference.”
PRACTICES:
PRACTICE FOR MIND, BODY AND SPIRIT RELAXATION:
Invocation: Say out loud; I am going to count from three down to O"e. With each number my
eyelids are becoming heavier and heavier and on the number one, so heavy they don't want to
stay open and I go deeply relaxed. Simple close and to heavy to open as
The Heart Of The Practice: Allow your eyelids to relax and slowly close as you say each
number and become too heavy to open as you repeat silently; Three, my eyelids are relaxing and
becoming heavy, two, my eyelids are becoming to heavy to stay open, O"e, my eyelids are so
very, very, heavy, the more I try to open them the heavier they become and go deeper relaxed.
Each time I test my eyelids they become heavier and do not want to open. There is no need to
keep testing my eyelids, my whole body is going even deeper relaxed.
Resting In The Practice: Notice your breathing, how easy and natural it is. Pay attention to each
breath. Feel the relaxation enter your body on each in breath. Feel all the tension leave the body
as you exhale. When you feel relaxed, say to yourself; "Every time I allow my eyelids to
become heavy, am relaxing as deeply O' deeper than I am right now. Then slowly count from
one to three and open your eyes on three.
MIND AND SPIRIT WISDOM PRACTICE:
Invocation: Close your eyes and pretend that you are laying or sitting in a circle of ground that
is bare of all scenery for as far as you can picture and imagine. Count silently from three down
to one and let your eyelids become more relaxed and heavier with each number. Allow the
eyelids to become to heavy to open on the number three.
The Heart Of The Practice: Pretend you are looking up into a sky that is perfectly blue. Let
your mind drift and notice any thought or feeling that comes up. Notice the thought briefly and
then let it go as if it were a puffy little cloud floating across the sky and disappearing from view.
Notice the next thought and then let it disappear. Continue experiencing each thought until your
mind becomes quiet and silent.
Resting In The Practice: Listen to the silence for as long as you can. If a thought or feeling
comes into your mind, examine it briefly, let it go and return to the silence. After four or five
minutes repeat silently to yourself, "Every time I close my eyes and count from three deeper
down, relaxing to one, I go even deeper relaxed than I am right now." Now count from one to
three and open your eyes on three. Notice how relaxed and comfortable you feel.
SPIRITUAL HEALING PRACTICE:
Invocation: Repeat each of the following phrases silently and allow your eyes to become sleepy
and more relaxed with each phrase.
Be still and know that I am God (a higher power)
Be still and know that I am
Be still and know
Be still
Be
The Heart Of The Practice: Imagine you are looking at your face in a mirror. Now picture and
imagine the face of Jesus (or any spiritual master) in the sky above you. Now allow the face of
Jesus to merge with your face until only the face of Jesus remains in your thoughts.
Resting In The Practice: Allow yourself to sense the healing hands and power of Jesus touch
every part of your body and enter the space next to your heart. Repeat silently, "Thank you
Jesus for being present in my mind, body and heart and your healing touch and spirit."
Remember how you imagined the face of Jesus as you count from one to three and slowly open
your eyes on the number three.
PHYSICAL HEALING PRACTICE:
Invocation: Picture and imagine a warming sun shining down on you. Count from three down to
one and allow you eyes to become heavy and close with each number. As your eyelids become
to heavy to stay open, imagine a safe and relaxing place of your own choosing. Relax deeper in
this place and notice all there is to see, touch, feel, smell, taste or any other sensation that makes
this place so safe and relaxing. Go there now and enjoy all the relaxing thoughts that come to
mind.
The Heart Of The Practice:Imagine the sun changing into the image of God and allow all the
enlightenment and physical healing of God to be embodied in the presence of a white light in the
sky. Picture and imagine the healing light of God to beam down in a thousand rays and penetrate
into every part of your body and mind. Imagine and feel the warmth of healing light as it
restores every cell in your body to health, balance and harmony. Drift down deeper relaxed and
rest in the comfort
of the healing as damaged and diseased cells are washed from the body by the powerful light of
healing. Rest in the healing power of the practice for three to five minutes.
Resting In The Practice: Pretend you are setting an imaginary alarm clock to awake you in five
minutes. Picture and imagine the hands of the clock or the digital numbers marking each minute.
Say to yourself, "The clock in my mind's eye will alert me in five minutes from now. When my
eyes open will feel natural and normal, as if I have had a refreshing healing nap.

21. VISUALIZATION AND IMAGERY FOR GOOD HEALTH

Many human diseases are associated with or caused in part by stress, the use of tobacco,
unhealthy eating and excessive weight, and harmful emotions such as anger and blame.
Negative thinking and thoughts can also contribute to illness. Low self-esteem, a sense of being
unworthy and periods of depression also create an imbalance in the body, mind and spirit that
inhibits our subconscious mind from storing positive and rejuvenating messages for good health.
Visualization and Imagery is beneficial for trading unhealthy habits for new and more
satisfying patterns of behavior that nourish the body rather than create a predisposition for poor
health. Visualization and imagery is a powerful and creative way to replace negative and hurtful
thoughts with positive affirmations that promote well being and healing.
Often times we handle stressful or difficult situations by articulating negative phrases or
expressions such as, "My boss gives me a pain in the next," "There's so much to worry about, I'll
never get to sleep tonight," or "What's the use, things will just get worse anyway. Henry Ford
once said, "Think you can, think you can't, either way your night!" In the late 19th century to
French researchers discovered the power of suggestion for healing. Ambroise Auguste Liebeault
and Hippolyt Marie Bemheim are credited for discovering modem psychotherapy as well as
hypnotherapy. They are known for the popular phrase, "I am getting better every day in each
and every way". Repeating a simple phrase or affirmation such as, "My body is healing itself, or
"There is no reason why my body can't heal itself, can produce surprising results in an
individuals mental as well as physical state of well being.
Visualization and imagery practices can be tailored to treat the major symptom or
problem of a disease or several different problems that are part of the disease process in different
body systems. An example of the use of visualization and imagery to treat problems related to
bowel movement with irritable Dowel Syndrome or IBS is found in the following article
published in Volume 14, Number 4, 4th Quarter Edition of Adventures In Education,
Complementary Medicine and holistic Health News.
THE TREATMENT OF CHOICE FOR IRRITABLE BOWEL SYNDROME:
Visualization and imagery (hypnosis) should be the treatment of choice for severe cases of
irritable Dowel Syndrome (IBS), says Adriane Fugh-Berman, M.D., in the June 1998 edition of
Prevention Magazine. Dr. Fugh-Derman is the author of Alternative Medicine: What Works
published by Williams and Wilkins, 1997. She is also the chair of the National Women's Health
Network in Washington, DC.
Irritable Bowel Syndrome (IBS) is a disturbance of intestinal function of unknown
causes. Clinically, the patient has intermittent symptoms of abdominal discomfort including
painful cramping, severe bloating and altered bowel activity such as constipation and or
diarrhea. The symptoms of IBS are often initiated or exacerbated by mental or social stress.
Traditional medical treatment includes supportive therapy and reassurance that the illness
is not life threatening. Antispasmodics and non-narcotic analgesics may be given to help with
the discomfort of cramping. However, over-the-counter pain medications may contribute to
constipation. Constipation may be treated with hydrophilic colloids which are substances that
stay suspended in water and provide extra bulk to bowel material. This extra bulk helps the
bowel to work more effectively in the elimination of fecal waste. Diet and exercise are also
important in the treatment of IBS. A high fiber diet provides natural bulk and exercise
stimulates circulation to the bowel which improves bowel function.
The efficacy of hypnosis as an adjunct therapy has been demonstrated in studies
conducted by P.J. Whorwell, M.D. at the University of Manchester Hospital in England. Dr.
Whorwell reported that by using hypnosis, the symptoms of IBS were greatly relieved and in
some cases completely eliminated in most people.
It is not surprising that hypnotherapy or visualization and guided imagery are effective in
the treatment of IBS. This self-help type of therapy enables the patient to alleviate both physical
and emotional stress by profoundly relaxing all the muscle of the body and provides the effect of
an antispasmodic medication. Hypnotherapy also teaches the patient how create mind's eye
images that enhance natural bowel function. Hypnotherapy is also an easy to learn technique
that the patient can use for a lifetime to instantly relax from the stress of daily activities.
Dr. P.J. Whorwell attributed his success rate with IBS patients to a "gut directed" type of
imagery. He is quoted in an article by Mike McGrath, published in Prevention Magazine, as
being adamant that hypnosis is not a placebo treatment which he demonstrated in his first
published study. In this study Dr. Whonnrell gave a sugar pill (placebo) and standard
psychotherapy to one group of people and hypnotherapy alone to the other group. Those who
received only hypnotherapy improved, while those who took the pill and received psychotherapy
did not.
Hypnotherapy was used in a U.S. study by S. Palsson, Psy.D., a clinical psychologist and
Director of the Behavioral Medicine Clinic at the Eastern Virginia Medical School in Norfolk.
In Dr. Palsson's study, he wrote down everything the hypnotherapist would say so that
each patient would received the exact same therapeutic suggestions. The study consisted of
seven hypnotherapy sessions that lasted from 30 to 40 minutes. After the patient reached a very
deep level of physical relaxation, gut-specific imagery was presented such as a strong, protective
coating being applied to the insides of their intestines that would soothe the gut and do away
with their symptoms. The patients were also given a 15 minute audio tape to use once a day to
reinforce the imagery suggestions.
Dr. Palsson reported the results of his study at the annual meeting of the American
Gastroenterological Association in 1997. His study demonstrated a high level of improvement;
less pain, less bloating and better formed stools, in 17 of 18 patients.
These studies used imagery that was gut-specific or gut directed, however non directive,
end result imagery can be just as beneficial. Non directive imagery allows the therapists to offer
therapeutic suggestions that address normal bowel function as well as other issues such as stress
and self-esteem. When non directive imagery is presented in an "end result" manner, the imagery
may be perceived as already happening and promote easier acceptance of the suggestions as well
as faster healing.
The following is an example of non directive, end result imagery for IBS.
SUGGESTED IMAGERY FOR THE COMPLEMENTARY MEDICINE
HYPNOTHERAPIST WORKING WITH IBS: And as you go so easily even deeper relaxed,
recognizing and realizing that there is not need for physical or emotional stress in body and the
stress and tension of life is often simply the result of dwelling on thoughts that are now longer
needed as you go even deeper relaxed.
Picture and imagine in your mind's eye, just a little pretend game, and you are in a very
safe and relaxing place, your favorite place, a place that is always filled with happy and pleasant
memories and soothing to you. Go to that special very private place and take just a moment to
notice and enjoy all the things in this place that make it so wonderful and relaxing for you.
Picture all the things in this place, listen to the sounds of this place if that's appropriate,
savor all the aromas or tastes, feel the comfort or touch everything that makes this place so
unique and special. Go to your special, favorite safe place now as every muscle in the body
relaxes even more and the tension leaves the body with each and every relaxing breath.
Notice your breathing, breathing in pure relaxation and exhaling all the stress and tension
and the muscles of the gut and intestine relax and work properly. Discomfort in the gut and
intestines just seems to fade away and is replaced with a soothing coating of new comfort and
well being. The bowels work harmoniously with all the relaxing muscles of the body and are
massaged with a rejuvenating new supply of oxygen and nutrients and the the bowels now
normally and naturally through the intestines.
Give yourself permission to relax for a moment and when I alert you, you are able to
relax even deeper that you are now,
Visualization and imagery can also be used to treat the other related factors or symptoms
of Irritable Bowel Syndrome such as unhealthy stress and to motivate the patient to eat a high
fiber diet and take regular exercise.
A combination of visualization and imagery practices can help prevent the onset of type
II Adult Onset Diabetes as well as to treat and manage the disease.
Adult onset diabetes is primarily a disease of the pancreas which regulates blood sugar
levels by producing insulin. Insulin pushes glucose into the cells of the body where it is
converted into energy for the cell. If the pancreas does not produce enough insulin the cells do
not get enough energy and blood sugar builds up in the circulatory system impeding the normal
flow of blood, especially to the extremities. This high level of blood sugar than makes it harder
for the blood to clot and close wounds to the skin as well as fight infection at wound sites.
Diabetes also causes problems with eyesight. Adult onset diabetes may also be the result of the
cells inability to absorb glucose. If this is the case oral medication may be prescribed.
Fortunately Adult onset diabetes is not life threatening and can be fairly easily managed
with proper diet and exercise. One of the most important aspects of managing this disease is the
cessation of smoking if the patient uses cigarettes or any other kind of tobacco. The nicotine in
cigarettes causes the blood vessels to constrict creating further problems for the patient who
already has blood vessels that are already being clogged with excess blood sugar. Smoking
impedes the flow of nutrients and oxygen to the cells as well as impedes the work of the immune
system.
Visualization and imagery is beneficial in treating the addiction to tobacco, motivating
proper exercise and following a diabetic exchange food program. In the case of Adult onset
diabetes several different visualization and imagery practices may be used, depending ., the area
of diabetic management that the individual needs help with.
Visualization and imagery is primarily directed toward the mind-body systems although
there is an overlapping spiritual component. of desire and belief. Desire in this case is a
willingness to take charge of the situation and honestly admit that will power or good intentions
are not enough to bring about new healthy habits and thoughts of healing. Belief is part
expectation in positive results and a spiritual surrender to a higher power to help you manage
something that is beyond your conscious control .
Visualization and imagery Is the natural process of storing positive thoughts, word
pictures and images in the subconscious mind. Once stored as a mental prescription for health,
they are dispensed automatically without any purposeful or special effort on the part of the
individual.
The benefits of visualization and imagery are accomplished through a mind-body
relaxation exercise often referred to as self-hypnosis or by hetero-hypnosis. Self-hypnosis is an
exercise that the individual completes on their own. Hetero-hypnosis is an exercise the
individual participates in with a therapist formulating the imagery for the desired outcome. As
the mind and body relax during this exercise an individuals attention to the world around them Is
narrowed so that their conscious awareness is heightened and focused only on the word pictures
or images that promote good health and healing. The media often refers to this heighten state of
concentration and awareness as a trance or hypnosis that is the result of being hypnotized. This
media representation of hypnosis is false and inaccurate.
All forms of hypnosis, including the advanced technique of visualization and imagery,
are in reality, self-hypnosis In other words, an individual only accepts suggestions that they feel
are in their own best interest. The individual may often change a word picture suggestion into
another picture or image that is more meaningful to them. At all times during a hypnotic
experience, the individual is in total and complete control.
The hypnosis experience is not a trance experience as most people interpret the word
trance. The individual does not fall asleep, loose consciousness or feel different than they do
when sitting quietly in a chair. They are always aware of what is going on around them and can
alert themselves to their normal awareness any time they desire to do so. Possibly the best way
to describe the experience of hypnosis is day dreaming. Most everyone experiences a type of
day dream twice a day. First when just waking up and second, just before going to sleep. In both
of these instances an individual is aware of the sounds and other activities going on around them
but simply chooses to ignore them for a while until they are ready to actually get up, or quiet the
mind for sleep.
The following imagery demonstrates what self-hypnosis feels like and how word pictures
stored in the subconscious mind can produce physical changes in the body.
PICTURE, PRETEND AND IMAGINE: Hold your hand out in front of you and look
at the palm of your hand as if you are expecting something to appear. Consider for a moment
what kind of object or food might magically appear in the palm of your hand.
Now just pretend in your minds eye that you are holding a freshly picked lemon, a lemon
right off the tree that might even have the stem and a leaf or two still attached to it. Think about
the lemon, how it feels in your hand, how it will taste if you slice it and take a bite. Notice the
texture of the skin of this imaginary lemon and remember the color of the lemon. Give yourself
permission to picture and imagine the lemon as if it were real and actually hold it and the picture
of the lemon in your mind.
Now repeat silently to yourself as you continue to stare into the palm of your hand, "I am
going to count from one to three and on the number three I will put the lemon quickly into my
mouth and take a big bite out of it. One, two, and putting your hand to your mouth say three!"
Did you feel the lemon in your hand? Did you picture or imagine that you were holding a
lemon? Did you taste the lemon when you took a bite? Did your mouth salivate wnen you bit
into the lemon? As you think about your reactions to the lemon ask yourself, "Why did i have
these experiences of holding and biting into a lemon that really wasn't there',
The answer to your question is that the body is a robot and only your mind can think.
Your hand or any other part of your body must accept what the mind tells it to do. In this case,
the hand could not tell the mind it was not really holding a lemon. The mouth could not tell the
mind it was not really biting into a lemon. Whatever the mind accepts or perceives as reality the
body must do. The body's physical response to biting into the lemon was demonstrated by the
mind ordering the mouth to salivate. In much the same way, the mind orders the body to
strengthen the immune system, heal damaged cells and remember to perform activities that
bring about wellness.
Old time hypnotists often refer to the above exercise as a "Suggestibility Test". I suspect
they prefer the word test because most people want to pass a test. The experience with the lemon
is not a test, it is a mini induction and experience of self-hypnosis. Every time you allow
yourself to experience a focused and directed type of relaxation or heightened attention, you will
become more proficient in repeating this state at a deeper level the next time you practice it.
Self-hypnosis is as easy as daydreaming and you get better at it each time you do it. This is why
i refer to the imagery presented in this chapter as practices.
THE FORMAT OF THE IMAGERY: There are four parts to the visualization and
imagery outlined in this chapter. The first part is the induction. The induction allows you to
narrow your concentration and relax your body and conscious mind. The second part is
deepening the relaxation and heightening your awareness of a higher power within the wisdom
portion of your subconscious mind. You might say that this is the part of the mind that
represents your soul and the memory portion that stores information that affects your health.
The third portion of the imagery represents the therapeutic suggestions that are beneficial for
the outcome you The fourth portion of the visualization and imagery practice empowers you to
make the practice even more meaningful and more powerful every time you do it, and gently
brings you back to your normal conscious way of thinking.
There are three methods you can use to begin your visualization and imagery practice. You can
record the induction, deepening, and imagery which also alerts you to your normal awareness,
on an audio cassette and then do the practice by simply sitting back in a comfortable chair,
closing your eyes and listening to the practice. You can also do the practice by sitting back with
your eyes closed and have a friend or family member read the practice to you as it is written╖
Have your friend or family member read one phrase or sentence at a time and then repeat the
sentence or phrase silently. Ask them to read slowly as if they were singing a lullaby and pause
between phrases or sentences to give you enough time to repeat it in your mind. If you are to
tired or uncomfortable sitting in a chair, you may also do the practice by laying in bed on your
back with your arms placed at your side. The third way of doing the practice is to arrange a
session with an NBHA Board Certified Complementary Medicine Hypnotherapist. During this
session the therapists can use the imagery you selected from the text and guide you through it or
change it slightly to meet your individual needs. Information about how to find a therapist
certified by The National Board for Hypnotherapy and Hypnotic Anaesthesiology can be found
at the end of this book.
You will find that after listening to a selected practice one or two times, you will easily
remember the entire practice and be able to recall it from your subconscious mind. You will also
find that each time you do a given practice, you will relax even deeper and the practice will
become more powerful.
INDICATIONS FOR SELF -RELAXATION PRACTICE:
Focal Point Induction: Focus your eyes on a spot in front of you on the wall or directly above
you, if you are laying down, and stare at this spot. Pretend this is a magical or mystical spot and
concentrate on it for a moment or two. Now proceed with the following imagery:
In a very few short minutes I am going to be more relaxed than I have ever known
myself to be. My eyes are becoming heavy and to heavy to keep open. The spot in front of me is
changing as I notice my thoughts about this spot, its size and shape, the little things or just the
spot and go even deeper relaxed. My eyelids are becoming droopy, sleepy, heavy as I count from
three deeper down relaxing to one. With each number my mind and body goes even deeper
relaxed, sleepy and comfortable. Three, my eyelids are becoming too heavy and want to flutter
and close. Two, my eyelids so relaxed, fluttering and so heavy now. On the next number my
eyelids will be to heavy to hold open. The more I try to keep them open, the heavier my eyelids
are. And One, my eyelids closed and so heavy. Every time open them they become even heavier
and just close. Every time I close them they become heavier and I go even deeper down relaxed
and more comfortable than I have ever known myself to be. I am going to go even more relaxed
now.
My breathing is so easy and natural. With each breath I am going more and more
relaxed. I am breathing in pure, refreshing relaxation and every time I exhale, I feel all the
tension leaving my body. I am enjoying the relaxation of each breath in and each breath out and
storing this ability to deeply relax in the memory banks of my subconscious mind.
Every time I close my eyes and take a few deep lung cleansing breaths, I am relaxing
deeper, even deeper than I am now. I am relaxing easier and faster every time I choose to do so.
I am relaxing my entire body from the top of my head to the tip of my toes and the wisdom
portion of my subconscious mind is healing my body, soul and spirit.
I am going to open my eyes in just a moment and am feeling very refreshed as if I have
had a natural and marvelous nap. Every cell in my body is refreshed and renewed and I am
feeling better and becoming more healthy in each and every way. I will become more alert with
each number as I count from one to three. One, more alert now, two becoming awake and
feeling refreshed and three, eyes open and alert and normal in every
Tense And Relax Induction: This is a non-verbal form of a Progressive Relaxation
Induction. Every time a part of your body which is tense, relaxes, a message or signal is sent to
the mind indicating that the body is relaxing. This repetitious relaxation then quiets the
conscious portion of the mind and allows the wisdom portion of the subconscious mind to be
receptive to healing and comforting images or word pictures.
This induction may be used anytime you want to quickly relax or alleviate unnecessary
tension in a stressful situation.
Beginning with your toes, tighten them as hard as you Mn, wait a few seconds and then
let them relax. Continue in this manner with each of the following muscles.
Tighten and relax the muscles in the back of your lower legs.
Tighten the muscles in the front and the back of your upper legs.
Tighten and relax the muscles of your butter.
Tighten and relax the muscles of your abdomen.
Tighten and relax the fingers of your hands.
Tighten and relax the muscles of your lower arms.
Tighten and relax the muscles of your upper arms.
Squeeze your shoulders together and then relax them.
Frown and tighten the muscles of your face and then relax them.
Close your eyelids as hard as you can and then relax them .
Now gently close your eyes and notice every part of your body that is relaxed. If a part still feels
tense, tighten and relax that part one more time.
Now gently open your eyes your eyes again and say to yourself, "I am wide awake and
alert, normal and natural in every way and feeling better and better each and every day.
 Progressive Relaxation Induction: Sit back in an easy chair or recliner with your arms
placed comfortably in your lap or on the arms of the chair. Place your feet flat on the floor or
beside each other on the ottoman of the recliner chair. Now close your eyes and repeat the
following thoughts and phrases silently to yourself or listen to your recording of the induction.
Now all the tension, stress and anxiety is leaving my body. With each and every breath
my whole body begins to relax beginning with the top of my head. all the tiny little muscles and
nerve endings on the top of my head are relaxing and this wonderful feeling of relaxation goes
deeper down from my head to my forehead.
My forehead is relaxing and the relaxation continues deeper down as all the little worry lines in
the forehead smooth out and this soothing feeling of relaxation goes down into the area around
my eyes.
My eyelids are so relaxed and heavy now, my eyes are so sleepy and comfortable and the
relaxation spreads to all the little muscles and nerves in my facial area. My jaw bone relaxes and
becomes heavy, my teeth may even part a little as I relax deeper and even deeper and the
relaxation spreads to the area behind my ears.
The relaxation spreads out to the back of my neck and into my shoulders. My shoulders
relax even deeper and drop a little as I go even deeper relaxed. I am concentrating only on this
feeling of relaxation and listening only to thoughts of comfort and relaxation as my body
continues to sleep.
This soothing and quieting sense of relaxation goes deeper down into the spinal column
now, and deeper down into the small of the back. Every muscle bone and fiber just relaxes in the
back area and the relaxation continues down into the buttock, down to the back of the thighs,
down past the hollow of the knees, into the calf area of the legs and deeper down.
The relaxation easily continues farther down into the heal of the feet and across the
bottom of With each and every breath the relaxation doubles as I relax the rest of my body.
My throat area is relaxing now and the relaxation goes deeper down into the chest. The chest
area relaxes even more every time I breath out. And the relaxation spreads out to the upper arms,
and down the arms to the elbow and even deeper down to the wrists and out into the hands and
deeper down to each and every finger.
Every time I breath, I am breathing in pure relaxation and breathing out all the stress and
tension in the body. And the relaxation doubles and continues to spread from the chest area
across the abdomen and down the front of the thighs, over the knees, into the ankles, across the
top of the foot and out into each and every toe.
I am so very calm and relaxed, peaceful more relaxed than I have ever known myself to
be. returning to this wonderful feeling of relaxation choose to do so by just closing my eyes and
myself, relax.
Every time I close my eyes and say relax, my body goes even deeper relaxed. Every time
I choose to relax, am relaxing faster and easier and so naturally as my wisdom mind heals my
body, soul and spirit.
Now I am picturing and Imagining a pretend alarm clock in my mind's eye. The clock
has large easy to imagine numbers and hands that mark the time and it may even tick the passing
minutes. I am setting the alarm to alert me in three minutes from now. I am resting for three
minutes and the alarm clock will alert me and my eyes will open. My eyes will open three
minutes from now.
COMBINED INDUCTION, DEEPENING THERAPEUTIC IMAGERY AND
ALERTING PRACTICES: These practices are designed to be recorded on an audio cassette
which you will listen to for the first few times so that the images can be stored automatically in
the memory banks of your subconscious mind. When you have listened to the cassette several
times, you will be able to recall the practice from your subconscious mind withouttaking time or
making a special effort to consciously memorize the practice.
To record a practice, select the therapeutic imagery you wish to include in your practice
and then have a family member, close, trusted, friend or your pastor, priest or minister record
onto the tape the following induction, deepening imagery then the therapeutic imagery you have
selected for this tape and the alerting imagery which will conclude the tape.
Ask the person recording the tape to read the words as written and to read slowly. The
imagery should be read in a relaxing, lullaby manner as if they were reading a young child to
sleep. A series of dots have been placed in the imagery to indicate phrases that should be read as
if they were one sentence.
The first time you listen to the Practice remember the number you experienced while
doing the deepening portion. Each time you do a selected practice, this number will get smaller
indicating your progress at achieving a more powerful and beneficial healing experience.
CHECK LIST FOR RECORDING A VISUALIZATION AND IMAGERY PRACTICE
WITH A SPECIFIC GOAL OR OUTCOME IN MIND:
1. Record the induction and then press the pause button on the tape recorder.
2. When you are ready, release the pause button and record the deepening imagery, then press
the pause button again. Take a short break if necessary.
3. Release the pause button and record the desired therapeutic imagery. Only record one
therapeutic imagery selection on this tape. After recording the therapeutic imagery, press the
pause button again.
4. Finally release the pause button and record the alerting imagery. This will conclude the tape.
HELPFUL HINTS: It takes about thirty minutes to record a complete practice on
cassette. It is best to allow ample time when you will not be interrupted and record the tape in a
quiet room.
Imagery for cancer, found in the next chapter, should be recorded in the same manner
after first recording the induction and deepening portion of the practice, which follows:
INDUCTION PORTION OF THE PRACTICE: Relax... just let yourself... relax... take a
deep breath and let it out... slowly. Close your eyes and breathe... slowly and... deeply... Each
time you exhale want you to feel all the tension leaving the chest area... In just a few moments
you are going to be more relaxed than you have ever known yourself to be... I am going to
mention different parts of your body... and as I do... I want you to feel that part... slowly begin
to relax... Just let that part slowly begin to relax.
Beginning with the top of your head... I want you to imagine all the tiny little muscles
and nerves on the top of the head... relaxing... and as each and every tissue and fiber relaxes...
the wonderful feeling of relaxation goes down from the head deeper and even deeper. And as
you relax deeper and... even deeper that warm wonderful feeling of relaxation begins to spread...
from the top of your head to your forehead.... and the forehead begins to relax and continuing to
go deeper and even deeper feel all the little worry lines in the forehead smoothing out and
this warm feeling of relaxation goes even deeper down to the area around the eyes. And now the
eyelids become very... very heavy They may want to flutter a little... that's OK... just feel how
heavy they are.
This wonderful feeling of relaxation goes down to all the tiny little muscles in the facial
area now... all the muscles in the facial area... just seem to...relax.. relaxing more and more... so
that the jaw bone becomes heavy... the teeth may even part... The mouth may open a little as you
go deeper and deeper relaxed. comfortable.. so peaceful.
Now allow yourself. .. let yourself relax even deeper and the relaxation spreads to the
area behind the ears .. . and going even deeper feel the relaxation coming to the back of the
neck... and out into the shoulders... so much tension just seems to go out of the shoulders... they
may even drop a little... And relaxing more and more now as this warm sense of relaxation
spreads to the spinal column... and down the spinal column to the small of the back... And as you
go even deeper relaxed.., every muscle ... every nerve and fiber in the back relaxes more and
more...
And the relaxation continues even deeper... down over the buttocks and into the back of
the thighs... down to the hollow of the knees ... and even deeper to the calf of the legs ... and
farther down to the heel of the foot. .. across the bottom of the foot... and out into each and every
toe ... as you relax deeper and even deeper..
I am going to proceed to relax the rest of you now... beginning with the throat muscles ...
Feel all the throat muscles start to relax. .. and as you go deeper and even deeper.. . this
wonderful sense of relaxation goes down to the front of the shoulders... down into the upper arm
and deeper down over the elbow.., into the forearms... down the wrists... out into the hands and
deeper down to the tip of each and every finger... The fingers may even want to move a little as
you go deeper and even deeper relaxed ..
Now concentrate on the throat area again. .. every muscle and nerve ending so very
relaxed.., and with each lung filling, relaxing breath you go deeper and even deeper relaxed. ..
And the relaxation continues deeper down into the chest area... down into the abdomen.., and all
the muscles of the abdomen and the organs in the stomach area easily relax.
Now the relaxation spreads deeper down from the stomach area over the front of the
upper thighs... over the top of the knees...down the front of the leg and into the top of the foot....
The relaxation continues deeper from the top of the foot out into each and every toe. I am going
to let you rest for a moment and when you hear my voice again you are going even deeper
relaxed. Each and every breath taking you deeper down and more relaxed.
DEEPENING IMAGERY: Now I want you to picture and imagine that there is a
yardstick leaning against a wall. The yardstick has large easy to read numbers. Picture and
imagine the numbers or just know that they are there. The number 36 is at the top of the
yardstick and the number 1 is at the bottom of the yardstick. Concentrate on the yardstick with
your mind's eye. Now picture and imagine that a large arrow is pointing to a number on the
yardstick. The arrow can point to any number you choose. And the question is what do the
numbers mean?
The numbers on the yardstick have special meaning and are personal numbers for you. If
the arrow is pointing to number 36 and deeper down to number 25, it means you are in a light
state of comfortable hypnosis. If the arrow is pointing to number 24 down to number 13, it
means you are in a medium, very relaxed and comfortable state of hypnosis and if the arrow
points to numbers from 12 down to 1, it means you are in a very relaxed, tranquil, comfortable
and enjoyable state of hypnosis.
With your mind's eye, imagine the yardstick and the arrow. When I ask you what number
the arrow is pointing to, you are able to tell me the number out load and go deeper relaxed.
Concentrate on the number the arrow is pointing to and when you know the number, nod
your head please. Very well, what number is the arrow pointing to.
Very well, and you are able to go as deeply relaxed or even deeper than you are now, just
by picturing and imagining the yardstick and the arrow sliding down to the number that is
appropriate for you...... Every time you close your eyes and take a few deep lung cleansing
breaths, the arrow instantly goes down, pointing to the number you choose as the best number
for you.... You are remembering the number and going down to this number or even lower every
time you picture the yardstick and the arrow.
THERAPEUTIC VISUALIZATION AND IMAGERY:
A Healthy Weight And Food Plan For Living: As you go deeper and deeper now, I want you to
picture and imagine yourself in a very beautiful and special place. This is a place where you
enjoy relaxing. A place you may remember from the past, or a place you are creating now or a
place in the future that is always peaceful and comforting to you. A special place filled with a
thousand happy thoughts and marvelous feelings and where you are so very relaxed. In this
unique and personal place you are the perfect size shape you want to be and deserve to be.
Go to this place now and you are enjoying all there is to see, to touch, to smell, to hear
and this marvelous, happy, peaceful and tranquil place is of your own design and choosing. And
you are eating the amount of food and the kind of food that you know is right for you. And
realizing now that you have no desire to trade this wonderful place and feeling for the wrong
sweet, fattening or unhealthy food, because you don't need or want them.
Now enjoy sitting down to a beautiful meal and eating only the foods and the amount of
food that you know is good for you. You are enjoying your meal, chewing your food longer,
chewing your food slowly and every single mouthful seems to fill you up so much faster and is
more satisfying than food has ever been before.
You are easily following a food plan for living that nourishes your body and your
feelings and emotions. And you are getting more filling satisfaction from eating the right amount
and type of food. Recognizing and realizing that eating the right amount of food the more you
enjoy your meal and like yourself. And eating only enough to sustain your good health. And
that's all you really need and all you really want.
Now I want you to change the scene and pretend that you are trying on some of the
clothes in your size you couldn't fit into before. You look nice and it feels good to be the size
and shape you want to be. And this wonderful feeling is a fantastic reward from your food plan
for living.
Now visualize yourself as the wonderful and happy person you have always been and the
size and shape that is best for you. You no longer need to chase a false idea or imagine of what
others say you should look like or weigh. You have discovered a new and perfect you. You look
attractive in your clothes and are completely comfortable within your own skin. You are
enjoying life more and more each and every day.
Now change the picture again and imagine or pretend that you are getting dressed to go
out for a very special occasion. And you look and feel wonderful, content, peaceful, and life is
so very beautiful and you are a very special and fantastic individual. And you have no desire to
lose this new you or give away your health for the wrong foods and attitudes about nourishing
and healthful eating.
Before eating anything wrong or even too much of the right food you are thinking and
saying to yourself, do I really need this, do I really want this and finding that every time you
make healthy choices a wonderful feeling of satisfaction and contentment comes over you.
I want you to count from one to three. On the number three your eyes will open and you
will be alert and wide awake. When your eyes open you are enjoying life more and more every
day in each and every way. Coming up now, one, more alert and awake, two, and wide awake
and enjoying healthy eating and the size and shape you deserve to be, three.
Dr. Longacre's Hypnodepthmeter: Now I want you to picture and imagine that there is a
yardstick leaning against a wall. The yardstick has large, easy to read numbers. The number 36
is at the top of the yardstick and the number 1 is at the bottom of the yard stick.
Concentrate on the yardstick with your mind's eye. Now picture and imagine that a large
arrow is pointing to a number on the yardstick. The arrow can point to any number you choose.
The numbers on the yardstick have special meaning and are personal numbers for you. If
the arrow is pointing numbers from 36 down to 25, it means you are in a light state of
comfortable hypnosis. If the arrow points to the numbers 24 down to 13, it means you are in a
medium very relaxed and comfortable state of hypnosis and if the arrow points to numbers from
12 down to i, it means you are in a very relaxed, tranquil, comfortable and enjoyable state of
hypnosis.
With your mind's eye, imagine the yardstick and the arrow. When I ask you what number
the arrow is pointing to, you will be able to tell me the number you see, imagine or feel and
remain deeply relaxed and comfortable. Concentrate on the number the arrow is pointing to and
when you know the number, nod your head please. Very well, what number is the arrow
pointing to.
When the hypnodepthmeter is used as a deepening technique, have the patient imagine
that the arrow is sliding down the yardstick as you count from five to one and then ask them
what number the arrow is pointing to. This can be repeated until they answer a number below
ten. If further deepening is desired, change the color of the arrow to blue and repeat the above
suggestions .
Living Longer As A Non Smoker: Now as you go deeper and even deeper relaxed,
picture and imagine you are in a very beautiful, peaceful and relaxing place, a special place that
you always enjoy being in. A place of your own design and choosing. And see, touch feel and
listen to all there is in this place that makes it so very wonderful for you. Go to that place now
and enjoy all the wonderful sensations and feelings of a non-smoker. Allow all of the sights to
become vivid in your mind's eye and enjoy all the sounds of relaxation and happiness and feel
and touch ail there is that rewards your healthy choice to be a non smoker. You are more happy
and content than you have ever known yourself to be.
Your heart beats so strong and rhythmically, so effortlessly and pumping life-giving
oxygen into the blood and to every tissue and cell in your body. Your lungs are renewing all the
smoke damaged tissue, the lungs are creating nice clean, pink, and healthy tissue now because
you are a non smoker. And enjoying this wonderful feeling and new picture of good health, you
are realizing that you would not trade the treasures a long and healthy life for a cigarette filled
with toxins and poisons.
You wouldn't trade your life or the life of a loved one for a million dollars and certainly
not for a cigarette. And you are a non-smoker and do not need cigarettes anymore. You don't
want them, need them or desire them because you are enjoying years of life, happiness and good
health more than a few moments of a habit with a useless cigarette.
And as you enjoy your special place filled with health and happiness, you are discover
that other people smoking around you does not bother you at all. Your daily activities no longer
remind you of smoking a cigarette. You are no longer a smoker when talking on the phone,
drinking a cup
of coffee, finishing a meal or when you are apprehensive or nervous.
You are saying no thank you to a cigarette and experiencing a wonderful sense of
satisfaction and well being. And a wonderful sense of pride and realizing that you would not
trade these feelings and a new picture of good health and joyful energy for some chopped up
weeds wrapped in a piece of burning paper.
You are a non-smoker and your food tastes so much better. Every time you think about
a cigarette you are simply closing your eyes and taking a few deep lung cleansing breaths, filling
your lungs with crisp, healthy, clean oxygen as the desire for your old and unwanted habit fades
away. You no longer need or desire to fill your lungs with black smoke and scorching heat from
a cigarette. By just closing your eyes and taking a few deep breaths all cravings for nicotine or
something to hold in your hand and put into your mouth just disappear and vanish.
Your powerful ability to use your mind to create new health, vigor and vitality becomes
stronger every time you think of yourself as a non smoker. Every time you relax you realize that
cigarettes no longer have any control over you. Every time an advertisement or another person
mentions smoking cigarettes, the thought reminds you that you are a non smoker and no longer
interested in this useless product or life threatening activity.
Picture and imagine the first time you smoked a cigarette. Let yourself remember your
first reaction to the smoke choking your lungs, the unpleasant taste, the coughing or any other
experiences that are appropriate for you. You are recognizing and realizing that you are a non
smoker now and there is no need to go through childlike ritual again. As an adult you are using
the power of your inner mind and a new wisdom of living to create new and more meaningful
and satisfying things in your life. Let the thoughts and sensations of that first cigarette drift away
now and relax in a new and healthier life as a non smoker.
I am going to alert you in a few moments and when I do all the powerful images and
pictures of a non smoker will be patterns of new health and more satisfying living in your
subconscious mind.
You can deeply relax as deep or even deeper as you are now and enjoy being a non
smoker anytime you desire to do so just by closing your eyes and taking a few lung cleansing
and smoke free breaths.
I am going to count from one to three. On the number three you will be wide awake and
alert and a non smoker. Coming up now with a wonderful sense of well being, one, becoming
more alert now and enjoying your new life as a non smoker, two, coming way up now, looking
forward to new energy, vitality and enjoying life so very much more, and wide awake now,
three.
Alleviating Unhealthy Stress: And as you continue to drift way down even deeper,
relaxing, you are realizing that day by day you are becoming Increasingly able to handle all
those situations that previously elicited stress, tension and anxiety. And you are doing this so
naturally, day by day, in every conceivable way. And you find yourself following certain
guidelines. And you no longer resort or fall back to irrational behavior and or habit forming
substances.
You are realizing that irritability, shouting, carrying on and fuming do little to alleviate
the tension and are often counter-productive. You are a confident and a loving person and are
realizing that irrational behavior is potentially harmful to yourself as well as friends and family
who must bear the brunt of your attacks. And you are releasing all the stress and tension
without seeking solace in the consumption of large quantifies of alcohol, tobacco or food,
since these add physical injury to already strained bodies and And you have a new and powerful
sense of self-worth and self-esteem.
You have new insight into unhealthy stress. You are recognizing that the danger in a
stressful situation is not the actual experience, rather in your individual reaction to it. Stress may
be the result of any change in the life situation and the changes can be negative or positive. And
since change is a fact of life you are reacting to change that creates stress in a new way. You are
now recognizing your own stress signals and taking positive steps to alleviate the stress and
definite actions to enrich your life and satisfaction with yourself and others around you.
At the first sign of stress you are withdrawing a bit and taking stock of the situation and
your reactions to it. And you are beginning to locate and be aware of the situations and things
that cause stress in your life. And you are making time to take a close and critical look at your
personal relationships with people, both important and seemingly unimportant to you. And
finding new ways to make your relationships more meaningful. When appropriate, you are
changing the stressful situation by talking to and negotiating with the other person or persons.
And if the situation cannot be changed, you are accepting that fact, realizing that there is no
written or unwritten law of the universe that says another person must not do whatever it is that
stresses you.
It would be nice if people would change and be the way you want them to be, but what is
more important is for you to decide what is best for you in any and all situations. The advantages
of the job, personal relationships or whatever the life situation might be are not worth the
potential disadvantages and effects on your personal health and emotional well-being. And you
have a choice in any given situation and you are making the choices that are right for you and
you have new abilities and confidence in making the best decisions for you.
You are cleansing your body and mind of unhealthy stress by taking advantage of time to
exercise and enjoy recreation or other activities that are pleasurable to you. And you are
enjoying thinking positive and happy thoughts as you fall asleep and realize that it is not external
events that make you happy or sad, but the attitude you take to these events. And with ever
increasing frequency you are learning to accept people and things as they are. And realizing that
compromise and reasonable solutions are both necessary and possible and more and more you
are substituting the habit of relaxation for the habit of stress.
In stressful situations you are letting the stress go by simply taking a deep breath and as
you exhale feeling all the tension and stress leaving the chest area and relaxing and in your
mind's eye picturing and imagining how calm, peaceful, intelligent and composed you are. And
every time you do this you are relaxing more and more as the stress seems to drift away.
I am going to alert you by counting from one to three. On the number three your eyes
will open and you will feel wide awake, alert and ignoring unhealthy stress. One, Two, eyes
open now, and Three, wide awake and alert.
[WORRY AND FEARS HAVE TWO THINGS IN COMMON. THE WORST THING YOU
CAN IMAGINE SELDOM HAPPENS.]
Freedom From Worry: And continuing to relax and doing so very well now, you are
reaching down deeper into your subconscious mind and discovering new insights and thoughts
about the wasted effort of worrying and new ways to resolve problems and conflicts in all your
daily activities.
It is said that 80% of all things we worry about never happen and 15% of the things we
worry about are things we can't do anything about. So only 5% of what we worry about is really
important.
And the small amount of things that are important are being resolved as you are
becoming increasingly successful in overcoming worry and finding that there is less and less
need to worry about future problems and dangers which are quite imaginary.
 Now picture and imagine in your mind's eye your abilities to determine the real dangers
about the things you fear and the possibility of those things actually happening. And you are
understanding that most of the things you worry about never happen and day by day you are
finding yourself more and more successful overcoming such pointless and self-defeating worry.
You are living one day at a time and making the most of each day and enjoying life more and
more in each and every way.
Now see yourself, hear yourself and feel yourself becoming more and more aware of
what is happening in the present and you are responding to what is happening now and not to
what has happened in the past or may happen in the future. And you are occupying yourself with
only one thing at a time and concentrating all of your awareness, responsiveness and energy on
the immediate task at hand.
You are dealing with each day in a relaxed, peaceful and confident manner free of
nervousness and apprehension.
You are realizing that half of all the worry in the world is caused by people trying to
make decisions before they have sufficient knowledge on which to base a decision. And you are
making your decisions wisely after considering the consequences of your decisions. You are
making decisions and resting in the knowledge that you have made a wise decision and then
dismissing it from your mind. And you no longer worry about or second guess your decisions
and are more flexible in your decisions and making decisions in light of your best present
knowledge. And if you require more knowledge you are using your abilities to make a new
decision in the light of new knowledge.
And you are finding with each and every passing day that there is little need to think so
much about yourself, you are replacing wasted and useless thoughts of worry with pleasant,
positive and wholesome thoughts and images And finding yourself in a situation that formerly
elicited worry, you are responding by first choosing all the possible positive outcomes. And you
are concentrating on the best possible positive outcome and experiencing it as vividly as possible
with all of your senses both physical and emotional. And you are doing this by simply closing
your eyes, taking a deep, lung cleansing relaxing breath, and exhaling slowly and picturing and
imagining how peaceful and relaxed you are, as peaceful and relaxed as you are now.
I am going to alert you now by counting from one to three. On the number three your
eyes will open and you will be wide awake. One, coming up now, two, eyes opening, and Three,
eyes open, wide awake, alert and normal and natural in every way.
Self-Confidence: And continuing to relax more and more you are realizing that you are
a special person with a strength and ability that is continually improving and you are acquiring
new confidence in yourself. And you are allowing a new feeling to develop within you and you
are now handling any situation with a new sense of self-confidence.
You are a confident person and are using your special and unique abilities to handle any
situation you meet and are making decisions wisely. You are making the right decisions after
considering the consequences of your decisions and resting in the knowledge that you've made
the best decision possible for any situation at any given time. And making a decision to the best
of your ability, you are dismissing it from your mind. You are making each decision in the light
of your best present knowledge and when acquiring new knowledge making decisions in the
light of that new knowledge.
You are a wonderful, unique and marvelous person and you like and respect yourself and
because of this others like and respect you. Your circle of friends grows each and every day and
you are making new friends because of your own confidence and personality. Each new person
you meet is a possible friend and you like people. Because of this people like you and it's easy
for you to make new friends and when meeting new people you are realizing your many social
assets and confident that people are interested in you.
Now picture and imagine you are meeting people. You are interested in the new people
you meet and are totally confident in any social situation. You are confident of your ability to
join a group and become part of that group.
And you others. You are confident in your ability to contribute something to that group
and are enjoying yourself at a gathering of new friends and acquaintances. Picture and imagine
you are entering a room and you are confident about your appearance and you feel poised and
are of the group. See yourself, hear yourself and feel yourself enjoying activities and
participating in group activities whatever they might be. You are mixing with the group easily
and freely and entering discussions and listening with genuine interest and other people are
interested in you. And you are interested in other people and personalities, viewpoints and
contributions to the group meeting or party.
You have confidence in your ability join a party, have fun and thoroughly enjoy yourself.
You are feeling good about yourself and are exercising your ability to handle any situation;
social, personal, or professional and as you continue to go even deeper relaxed you are
realizing that if shyness is a particular problem your life it is the result of an attitude that you
have developed which has nothing to do with your true worth as a person. And you no longer
need to dwell on negative thoughts or predict failure in any situation.
Each and every day you are finding it easy and rewarding to put positive thoughts into
your life and becoming increasingly aware of people and things outside of yourself. You are no
longer dwelling nearly so much upon yourself and your difficulties or real or imagined
shortcomings. And finding yourself feeling more and more independent, and sticking up for
yourself and standing on your own two feet'
You are holding your own no matter how difficult or trying things seem to be. You are a
confident and caring person and you like others and others like you. are accepting and enjoying
the contribution of You are confident in your ability to contribute
And when you open your eyes in a few moments are enjoying a new sense of confidence.
You are feeling much more contented, happier and more optimistic because you are using your
special ability of self confidence you are self-assured in any situation or setting. And all of these
powerful and positive thoughts are growing each and every day and you are discovering new
talents and abilities within yourself as a self-assured and confident marvelous individual.
I am going to count from one to five and with each number your ability to feel confident
and self assured in any situation will double as you become alert. Your eyes will open and you
will be wide awake and alert on the number five. Coming up with a wonderful sense of well
being, one, and become more alert, two and coming way up and enjoying a new feeling of self
confidence three, and coming way up now, four and eyes open, wide awake and alert five.
[WHEN I LET MYSELF BE IM A WONDERFUL ME.]
Enjoying A Healthy Nights Sleep: And relaxing more and more you are letting yourself
and allowing yourself to enjoy all the feelings of relaxation and paying attention only to sounds
that are relaxing to you as if you were daydreaming or experiencing twilight sleep. And when I
alert you in a few moments you are experiencing deep relaxation anytime you desire to do so.
And each time you return to this marvelous, peaceful, tranquil and calm state of relaxation you
are easily and naturally preparing for a refreshing nap or sleep.
Now I want you to picture and imagine in your mind's eye that you are a lookout, on
guard duty or just watching for something to appear in the sky, whatever is appropriate for you.
And as you concentrate all your senses on this imaginary let's pretend game you are looking
forward to a comfortable and refreshing night's sleep. I am going to give you some suggestions
that are in your best interest and acceptable, suggestions that are enabling you to. enjoy a
wonderful and peaceful period of rest and sleep. These suggestions are becoming active in your
subconscious mind as you listen to them now, and you are following these suggestions exactly
and in the order I am giving them to you and it is easy to do this as you prepare for sleep each
night when you go to bed.
You are relaxing every portion of your body, as relaxed as you are now. And you are
doing this without the slightest effort and you are not trying to force yourself to do this. And you
are using your subconscious mind to deeply relax.
Because your conscious mind creates a tenseness in your body that defeats its own
purpose and you are relaxing unconsciously as you prepare for bed. And exactly five minutes
after your head touches the pillow you are with the greatest of ease relaxing deeper into a
daydream and falling into a deep slumber and sleeping so soundly that you have no need to
awaken before the appropriate time in the morning.
You are awakening in the morning and feeling very refreshed and have the utmost
amount of rest as a result of your sleep. You are alert and clear headed when you awaken and
looking forward to a marvelous day with positive thoughts and restored energy. And you are
carrying on the duties of the day with perfect calmness and a heightened state of alertness and
enjoying a wonderful, refreshing and uninterrupted nights sleep.
Now let these suggestions drift all the way down into your subconscious mind and
become active and powerful in your life. Let this happen now and make it so. And these
beneficial and powerful thoughts are dissolving any of the negative thoughts that interrupt your
sleep and you are sleeping soundly because you prepare for bed and expect to go to sleep and
sleep without interruption.
When you realize that it is bedtime, you are giving yourself a few moments to think
about sleep like if you were on night guard duty or watching the late night sky and then taking a
few deep lung filling relaxing breaths and then lying down and watching in your mind's eye the
faint twinkling of a star or far off light. Each time you exhale feeling all the tension leaving the
chest area and the body and going deeper relaxed into a normal, natural and easy sleep. I am
going to count from one to five and on each number you will awaken and look forward to a
wonderful natural nights sleep at anytime it is appropriate for you.
One, two, three, coming way up now, four, eyes open and wide awake and alert, five.
Enjoying Exercise: And as you continue to go even deeper relaxed you are recognizing
and realizing that exercise is a normal and natural body process and a part of your everyday
living.
All of us exercise daily in some way or another without even thinking about it. Exercise
is good for the body, mind and spirit and with exercise comes a wonderful sense of well-being
and a radiant glow of good health. Sometimes we do not exercise enough and feel sluggish, tired
or lethargic. Sometimes we are overzealous and exercise too much. The important thing you
are learning now is that proper exercise always makes you feel good. Proper exercise gives you
a sense of well-being and vitality and is an enjoyable experience.
Picture and imagine now that you are preparing to begin a specific exercise that you
know is good for your health and your body and mind. And you are beginning your exercise
activity by concentrating in your mind on all the benefits and good feelings that exercise will
bring. And you are now mentally preparing for whatever exercise routine you choose to enjoy.
`Now take a few deep lung cleansing and relaxing breaths and pretend you are doing the exercise
relaxed and confident and doing that activity easily without unnecessary stress, strain or tension.
And you are seeing yourself and feeling yourself enjoying all the movement and motion of this
particular exercise. Your heart and lungs are working together in perfect harmony and fresh
dean rejuvenating oxygen is flowing through your entire body. And you are concentrating on
your breathing. Feeling how easy, normal and natural it is. All the muscles and organs within the
body pulsate with a new sense of health. And you are beginning your exercise routine slowly
and making an honest effort toaccomplish the goal you have set for yourself for your particular
exercise. You are cognizant and aware of the body signals that allow you to pace your exercise
so that it is beneficial to your body and mind. And you are completing the exercise activity with
a wonderful sense of well-being and renewed health, vigor and vitality. Every time you prepare
to exercise you are looking forward to that particular activity more than ever before.
Before you begin your exercise you are simply closing your eyes, taking a few deep
breaths and imagining the wonderful feelings and rewards of exercise. And enjoying the
marvelous sense of well-being and good health flowing through your body and you are opening
your eyes and beginning the exercise that is appropriate for you. You are preparing emotionally,
physically and mentally for your periods of exercise and enjoying your exercise activities more
and more each and every day
I am going to count from one to five and on the number five your eyes will open and you
will feel wide awake and alert and ready to enjoy exercise anytime you desire to participate in
this healthy activity. Coming up now, wide awake and alert on five, one, two, three, four, wide
awake, five.
Unhealthy Anger and Hostility: And as you drift way down now, relaxing deeper and
deeper you are learning to resolve unhealthy anger and hostility and create a new and healthy
way of living.
As you continue to relax you are realizing that anger is the most destructive of all our
emotions because it lies hidden and unrecognized and causes many types of maladjustment. In
guilt we are angry at ourselves. In hate we are angry at the objects of our hatred. In self -pity we
are angry at the situations or people who frustrate us.
Anger may be overt but often it is insidious with many disguises. Unhealthy anger
accounts for many of our miseries. No one can become so emotionally mature that they can
completely free themselves of anger, but by minimizing it we can lead happier lives. When we
succeed in shaking off the worn-out clothes of hostility it is often replaced with pity and even
amusement at the emotional infants who take hostile thrusts at us.
Anger can cause a great amount of distress and many forms of illness. And as you
continue to relax even deeper you are realizing that when you are angry your brain is inhibited
and you are reduced to something less than your full human potential. You are leanings a new
way to express yourself and alleviate unnecessary anger and hostility. You are enjoying a new
sense of physical and emotional health and finding that you have a feeling of peace and harmony
in situations that used to be disagreeable or uncomfortable. You like people and people like you
and you are accepting other people and yourself. And you are realizing that each personality is a
product of heredity and experience. You are understanding now that if you had been born with
someone else's body and had gone through the exact same experiences and the exact same
order of experiences, you would probably act the exact same way they do. And you are growing
in wisdom and understanding and accepting others as they are.
 A new ability and truth is surfacing from your subconscious mind and you are feeling
emotions of sympathy and understanding when others do things that you do not approve of. And
you are in complete control of your problems at all times, even what others believe to be
stressful and trying conditions. And this gives you a great and wonderful feeling of satisfaction
and inner health.
Now pretend in your mind's eye that you are in a situation that used to make you angry
picture and imagine that you are using your new and powerful abilities and diffusing the angry
feelings. You are feeling and expressing only the good healthful emotions of love, sympathy and
tolerance of others. You love and respect other people for their good qualities and you forgive
them for acts that you disapprove of. And you know that they are doing what anyone else would
do with the same body experience and level of awareness.
You are a friendly and loving person and have a kind word and smile for everyone. Your
pleasant disposition creates a chain reaction in others and they have pleasant feelings about you
and they in turn treat others better because you have made a difference and in understanding
others the people you are in contact with treat a growing circle of people better. Your abilities to
inspire others is like a rock tossed into a pond and the ripples reach out and sparkle and are signs
of your good nature, understanding and tolerance.
You are using your special abilities to smile at those who are angry. And you find it is
easy to think clearly and choose the proper words because you are calm, competent and relaxed.
You are in complete control of your emotions and only the good and healthy emotions, thoughts
and positive reactions are present in your subconscious conscious mind. And these healthy
emotions are feeding back into daily living and you are becoming more happy and contented
each and every day. You are understanding forgiving. You are a tolerant person and like yourself
others and are forgiving others for what they have because you accept others.
These powerful thoughts and techniques of healthy living are growing stronger and
more effective in subconscious mind every passing day. You are in charge of every situation
and expressing yourself appropriately to others.
And you are understanding the things you cannot change and changing the things you
can with a positive feeling of well-being. Your subconscious mind is where the emotions reside
and is guiding you to selecting good health emotional responses and you are a friendly, warm,
loving and caring person.
I am going to count from one to five and on the number five your eyes will open and you
will be wide awake and alert. All of these powerful suggestions are stored in your subconscious
mind and will automatically come to you any time you are faced with a situation that tends to
cause you to be angry. One, coming up now, two coming more awake, three starting to awaken,
four coming way up now, five, wide awake and alert, normal and natural in every way.
[HALT: H-AVOID GETTING HUNGRY, A-AVOID GETTING ANGRY, L-AVOID
GETTING LONELY, T-AVOID GETTING TIRED. A saying from AA]
Letting Go Of Guilt: Now let yourself and allow yourself to drift even deeper down and
relaxing more and more. And going even deeper relaxed you are realizing that guilt is a form of
self-punishment. We punish ourselves for real or imagined wrongs by disturbing vital life
functions and inviting illness and depression. When we try to rid ourselves of guilt by justifying
our thoughts or actions with our conscious mind we often begin to harbor unhealthy feelings and
emotions about guilt.
The harder we try to justify our guilt the more disruptive and entrenched our guilt
becomes in our daily living. And you are realizing now that harboring guilt serves no
worthwhile purpose and doesn't right any wrongs or help anyone or anything. And if you are
punishing yourself with feelings of guilt you are actually breaking the laws of nature. Everyone
makes mistakes and you have the right to be wrong, but you do not have the right to punish a
healthy body and make it sick, even if it belongs to you.
You are helping yourself now by learning new ways to handle situations that create
unnecessary and unwanted feelings of guilt. Now picture and imagine yourself amending
genuine wrongs to the best of your ability and current understanding and awareness. You are
recognizing that an honest effort is sufficient to get on with living the joyful life you deserve. If
you really caused some harm, you are asking yourself wt~at you can do to make things better.
And you are no longer creating a problem where there is none. And you are resolving now to
examine the standards by which you judge yourself. You are realizing if these standards are
those you accept or if they have been drummed into you by parents, teachers, employers or some
other person or situation. And you are asking yourself if these standards are reasonable,
necessary and a part of the way you want to live.
You are establishing new and more meaningful standards of emotional peace and
tranquillity. You are accepting your imperfections and realizing that being perfect may be a
noble and spiritual goal, but it is not part of the condition of human life. Perfection is an
unattainable goal and ideal and is not a requirement for a worthwhile, joyful and fulfilling life.
You are learning now that people often have to act without full knowledge of the
consequences. For example even if they try their best, parents can never know enough to deal
perfectly with all the problems of raising a child and all the problems of parenting.
Now picture and imagine that you are using these tools of emotional health and a new
sense of awareness in your daily living. You are no longer burdening yourself with unrealistic
demands. You are no longer expecting to be free of anger in oppressive situations and there is no
need or desire to punish yourself for a lack of purity in thought, word or deed. And each and
every day you are recognizing the ways that others may try to make you feel guilty no matter
how close they may be to you or how lofty their intentions.
Knowing now that it is impossible to win universal approval no matter how hard you try
to mold yourself to external or internal demands. You are realizing that you do not need to
please everybody. Since everyone is a unique individual you are allowing them to be responsible
for their own feelings and are concentrating on your own life, living well and decently in the
present according to the standards that are the most appropriate and comforting to you.
You are dealing creatively with other people who criticize and express their own feelings
of disappointment.
You are trading unwanted and unhealthy feelings of guilt for new rewards by reviewing
what you have actually done that makes you feel guilty and what you are learning from it. And
you are facing the fact that you cannot change the past but you are learning from it and using
these lessons to create a more rewarding and satisfying present and there is no value to excessive
guilt.
Picture and imagine you are throwing the heavy yoke of guilt off your shoulders and
forgiving yourself and anyone else because you know that no one is perfect. We are all products
of our inheritance and our environment. And with your new knowledge and understanding you
are forgiving yourself and starting each day with a clean slate.
You are enjoying a marvelous and wonderful sense of freedom, you like yourself and
others and are a caring person and because of this people sense your understanding and they
like you because of it. You are radiating love and kindness in all you do and you are forgiving
yourself and others for past deeds, real or imagined and are at peace with the world and more
important, at peace with yourself. You are turning past and present experiences of guilt into
Opportunities to find out what your values really are. And you are practicing the art of
self-forgiveness and defining what you accept as a good life in the present.
Now I am going to count from one to five. On the number five you will be wide awake
and alert and enjoying a marvelous life and new awareness that will help you in all that you do.
Coming up now, one, more awake, two, coming way up now, three, alert and awake, four, wide
awake, five.
[ANGER TURNED INWARD RESULTS IN BLAME AND GUILT. FORGIVE YOU GUILT
LIKE BEST WOULD AND RESTORE A SPIRITUAL RELATIONSHIP WITH YOURSELF.]
Alleviating Depression: And as you continue to drift deeper and even deeper, so very
calm, peaceful and so very, very relaxed, you are recognizing and realizing that depression is a
signal that your life is somehow out of balance and the challenge to you now is finding the
source of the signal.
The major danger of depression is that it immobilize you and to overcome this you are now
recognizing that depression is an opportunity to learn, to grow and to heal. And it is all ri9ht to
feel the pain that depression brings and letting that pain alert you to the real problems.
Depression can be the motivating force to revitalize your life and you are asking yourself
if depression is a wise and necessary withdrawal from having pushed yourself into to much
striving and stimulation. It could be that you have simply worn yourself out in activities and
relationships that were not sufficiently nourishing and this is a time to realize what you really
value in life. Sometimes depression is caused by a loss of a relationship or a personal defeat that
stirs up old unhappy memories about yourself that go far deeper than the immediate situation. If
your depression hangs on, you are resolving to explore this possibility and taking advantage of
this chance to face that time from the past and build a stronger self for the future.
And if you discover that your depression is caused by some error that you have
committed or dissatisfaction with something you have done you are allowing yourself to avoid
self-blame. Self-blame is defeating and worse than the error you regret. You are learning that to
error is human. You are turning past mistakes into opportunities for future growth and personal
accomplishment. Sometimes you may gain relief and enrich your sense of well-being by
expressing your feelings of guilt or anger. And you are remembering to direct the anger at the
appropriate target. If you blame the wrong person or circumstance you may feel even more
guilty and guilt is often the root of depression. And you are resolving to search for secret
resentments that may be the cause of guilt.
And you are learning that depression can be caused by bottled up anger. Anger that we feel
about and toward people that we are supposed to love. And you are giving yourself permission
to feel anger and express it out loud to yourself. You may even indulge in angry fantasies and
finding safe and effective ways to express your anger in your imagination. And you have the
ability to do or act to create positive change and you are doing things that are enriching your
life and feelings of self-worth and contentment.
You are rewarding yourself for what you do without questioning how well you did it.
You are no longer concerned with perfection, rather you find new joy and meaning in positive
thoughts and actions. You are taking better care of yourself and giving special attention to your
appearance. You are trading the unwanted and hurtful feelings of depression for a satisfying and
rewarding feeling of self-esteem and inner peace and contentment. When you are feeling low
you treat yourself to something out of the ordinary that you really enjoy. You are rewarding
yourself with an activity that restores your sense and feeling of balance and energy. And you are
making your own decisions rather than waiting for outside events or other people to passively
make them for you.
And you are recognizing things and situations that you cannot change and if you cannot
leave the situation or circumstance that is hurtful to you, you are using your new abilities and
understanding to prevent reoccurring depression. Day by day you are becoming more
successful
and making positive and vital steps to become absorbed in all the positive aspects of your life.
I am going to alert you now by counting from one to five. With each number you will
become more alert and wide awake on the number five. One, awakening now, two, three,
coming way up now, four, wide awake, five.
[LAUGHTER IS DAY, AND SOBRIETY IS NIGHT; A SMILE IS THE TWILIGHT THAT
HOVERS GENTLY BETWEEN THEM BOTH, MOE BEWITCHING THAN EITHER. Henry
Ward Beecher]
Healing Imagery: And as you relax even deeper you are developing a powerful
technique for healing parts of your body that have been invaded by disease or injury. You are
developing a special friend, personal healer or agent that can travel through the body and heal
any part as you relax and concentrate on thoughts of wellness.
To help you find this special friend or powerful healer, I want you to picture and imagine
a special store or shop with hundreds of shelves of soothing and healing suggestions that
you can use any time you desire to pick one out and take it home. Picture and imagine browsing
through this shop. You may be finding a furry little animal, or a ferocious tiger than can eat up
disease causing parasites or organisms. And it might be a special weapon invented in the healing
laboratory of your mind or even a magic thought that can change shape, design, and color as you
let it become a picture in your mind.
Browse through this special healing store now and pick out something that you like and
pretend in your mind's eye that you are taking it home with you. Now the question is, how can
this healing device, friend, animal or magical machine travel through your body and begin the
healing process. And the answer is by giving it a road map and directions to the area to be
healed. And you are doing this by simply thinking about a transportation system inside your
body.
This healing system might be the blood stream, or the breathing system or secret tunnels
and passages that you already know. You are telling your healing agent which path to follow
and giving it permission to heal the invaded or injured area, tissue, muscle or bone, whatever is
appropriate for you. And if you are unsure of the path to prescribe you are giving your healing
agent permission to find the best path that it can use and giving it permission to travel to the area
and go to work.
From time to time, your special healing friend, agent or weapon is reporting back to you
on the progress it is making. You are complimenting it for the good job it is doing and
encouraging it to continue working on your behalf. Each time you do this the healing grows
stronger and more powerful and you are concentrating your healing thoughts on any area in the
body and your body, spirit and mind respond and your special healing agent becomes more
powerful. Each time your healing agent reports back to you, you are giving it updated
instructions. You may wish to speak to it softly in a relaxed manner, or you may hear yourself
saying strong positive and expressive words. You may simply thank it for the good work that it
is doing and encourage it to work longer hours in getting the job done.
 You are encouraging the healing process with understanding and patience and by simply
closing your eyes the process magically begins and every time you close your eyes and allow the
process to travel and work in any part of your body you are realizing and recognizing that the
healing powers of your mind are stronger and more effective in each and every way.
I'm going to alert you know by counting from one to five. Slowly awakening, one,
becoming more alert, two, coming more and more awake, three, feeling relaxed and alert, four,
wide awake, eyes open, five.
Alleviating Unwanted Pain: And just continuing to drift deeper and deeper down now
and so very calm, peaceful and so very relaxed in body, mind and spirit. And as you drift down
deeper relaxed you are realizing how many of us experience sensations that we would regard as
unpleasant such as pain, discomfort, tension, stress, strain or anxiety. And we have already
learned one method of dealing with these sensations and that is just breathing deeply and
removing all parts of stress by relaxing the entire body. And you are using this technique now
and effectively dealing with the unwanted sensations or discomfort you may be experiencing.
And you are realizing that the symptoms of unpleasant or unwanted sensations are very
subjective experiences. We feel them but, as we know only too well, it is often difficult to
consciously modify feelings. It is much easier to modify objects and shapes. And you are
learning now to change unpleasant sensations into an object. Letting yourself and allowing
yourself to do this now and making it happen.
And the object may be something you are seeing, feeling or hearing or something that
you just know it to be. If you have a pain or discomfort or if you feel somewhat tense or anxious
just take that unpleasant feeling or sensation and turn it into an object. It can be an abstract
shape, without numbered sides or a top or bottom. It can be a concrete shape with easy to see
lines. Or it can be a shape with geometric design or a loose irregular circle like a puffy cloud
floating, fluttering and changing like a bit of white fluff in a powder blue sky. Whatever shape
first comes into your mind's eye is the right shape for you. And you are recognizing that the first
shape is the best shape and any other shape is a conscious judgmental effort and does not have
the power of the first shape developed in your subconscious mind.
And as you relax even deeper give that first shape a color and a size. And you can give it
a size by comparing it to something else or by just knowing the size, and the question is wt~at
does the size and the color of your shape mean to you.
The answer is that the shape is a symbol of your discomfort and the larger it is the more
discomfort you are experiencing and the smaller it is becoming, the more comfortable you are.
The more vivid the color the more you are aware of your discomfort and you allow yourself to
experience a relaxing feeling of comfort and the color to fade as you relax deeper and even
deeper.
And you are practicing now making the shape first a little bigger and brighter and then
taking a few deep lung cleansing and body relaxing breaths and making the shape smaller and
the color fades and you are becoming more and more comfortable. And you are realizing that
you can make the shape smaller by just imagining it to be smaller or using some easy techniques
you are learning now.
If the shape is like a balloon you put a needle into it or kick it away, throw it away or tie
it onto the back of a boat, truck, airplane or car and are watching it become smaller as
it disappears. And you are letting it become smaller and disappearing like a tiny twig
floating down a mountain stream or the leaf of a tree blowing away in a refreshing spring breeze.
And you are making this shape smaller and smaller any time you desire to do so by just closing
your eyes and taking a few deep lung cleansing and relaxing breaths and picturing and imagining
the shape fading every time you breath out and release all the tension and anxiety from your
body.
And concentrating now on any discomfort, tension or anxiety you are feeling and making
the shape smaller and it is so easy for you to do this. And wherever and whenever you have
unnecessary discomfort you are giving it a shape, giving it a size and then making the shape
smaller and the color fade as the discomfort leaves your body and you are releasing the tension
and anxiety and every time you do this your ability to create a sense of comfort and well-being is
enhanced in each and every way.
I am going to alert you by counting from one to five. On the number five you will
awaken and feel as if you have had a marvelous nap. One, coming up now, two, three,
becoming alert now four, wide awake and alert, five.
Imagery For Uncomfortable Medical Procedures: And just relaxing more and more,
deeper down now, picture and imagine a very safe place, a place that is always filled with happy
thoughts and memories, a place that is always relaxing and peaceful. This may be your favorite
place of a safe place. And this may be a place from the past or a place from the future or a place
you are creating now.
You are relaxing and enjoying this place during your medical visit and remain
comfortable and very relaxed, ignoring all that is going on around you until you are told that the
procedure or test is over.
Go to this special safe place now and with each and every breath enjoy all there is that
calms and soothes you. See everything there is to see, listen to all there is to hear, feel all there is
to touch or thoughts of comfort and safety, savor all of the aromas if that is appropriate to you.
And you are recognizing and realizing that this is your private place and of your own
creation and design. Because of this you can include in your safe place anyone you wish to, and
you can keep out anyone or any thought that is not comforting to you. You are calm, peaceful
and tranquil in this place and are enjoying this place anytime you desire to do so by simply
closing your eyes and taking three deep lung cleansing breaths and easily and quickly relaxing as
deep or even deeper than you are now.
You are answering questions and following directions about your test or procedure and
remaining deeply relaxed until you are told the visit is over. Then your eyes open naturally and
you are alert to your present surroundings, remaining very refreshed and comfortable.
I am going to count from one to five. On the number five you will be awake and alert
and able to return to this safe place anytime you desire to do so by simply closing your eyes,
taking three deep breaths and imagining you are in your safe place. One coming up now, two,
able to return to this place anytime you wish to, three, awakening now, four, coming way up,
five, eyes open, wide awake and normal and natural in every way.

22. A COMPLEMENTARY MEDICAL APPROACH TO CANCER

A Team Plan For Mind-Body-Spirit Wellness: During the past decade, the death Fate
from cancer has been declining due in part to research that has resulted in public awareness as to
the causes of cancer and measures individuals can take to prevent the disease. The primary
recommendations for preventing cancer are: Avoidance to tobacco products; Avoidance of
toxic substances to the body, including environmental substances and man made toxic waste;
Eating a balanced diet that is low in fat, low to moderate in protein, includes at least five
servings of fruits and vegetables a day and is high in fiber; And regular physical examinations
that will detect cancer early.
Research and case studies compiled by Carl O. Symington, M.D., a radiation
oncologist who practices at the Symington Cancer Center in Pacific Palisades in California and
Bernie Siegel, M.D., a surgeon, who started Exceptional Cancer patients, a specialized form of
individual and group therapy to facilitate personal change and healing, have also demonstrated
that the death rate and a longer survival rate with a good quality of life has resulted when
patients choose a primary physician who they felt comfortable with and then became actively
involved in their treatment program and therapy. Both of these nationally recognized
researchers and clinicians recommend a form of visualization or imagery be included in the
treatment of their patients.
For the past 15 years, The National Hypnotherapy and Hypnotic Anaesthesiology
has been developing specialized visualization and imagery techniques that are designed to be an
adjunct modality for the medical and psychological professions. This form of Complementary
Medicine Hypnotherapy includes concepts of mind, body and spirit healing and emphasize
patient education therapy rather than the outdated methods of hypnotism and hypnosis.
In light of this new body of information about the benefits of cancer prevention and a
"Whole Person" approach to management and treatment of the disease, one would think that
Complementary Medicine Treatment Programs who be readily available anywhere in the
country. Unfortunately this is not the case, however, many hospitals are now adopting
complementary medicine programs that incorporate mind, body and spirit healing and physicians
in private practice are becoming more aware of a holistic approach to patient care championed
by Deepak Chopra, M.D., one of the most powerful writers in the field of mind-body medicine
and Andrew Well, M.D., Director of the program in Integrative Medicine at University of
Arizona in Tucson.
This chapter is devoted to understanding and applying the components of a Mind, Body
and Spirit education and therapy program as part of a team approach in the treatment of cancer.
This type of patient management does not argue with traditional western medicine as it is
physician friendly. The approach provides valuable healing techniques for the patient by
outlining self-help healing practices that are easy to learn and require only about 15 minutes a
day, three times a day. to perform in the comfort of their own home.
Taking Personal Control Of Your Healing Process MEDICAL EVALUATION,
PROGNOSIS AND TREATMENT: It has been the experience of physicians and therapist
teaching complementary medicine imagery and self-help techniques for cancer patients that
there are three parts of the total treatment program that are essential in creating wellness.
The patient must select a primary physician and or oncologist who will be Supportive of
their efforts in using visualization and imagery and spiritual techniques to assist in their healing
process. A team approach treatment plan must be managed by the physician and medical
management can not be dismissed in favor of just using non-traditional or alternative methods of
treatment.
If a physician seems less than enthusiastic about Incorporating complementary
medicine hypnosis into the treatment program as an adjunct modality, it is usually because
they are not familiar with the latest work in this field and are reticent to personally endorse the
use of the modality for their patient. If this is the case you may wish to lend the physician a
copy of this book or suggest that he or she contact The National Board for Hypnotherapy and
Hypnotic Anaesthesiology for answers to their questions about visualiration and imagery.
You will also want to thoroughly understand the physicians medical treatment plan.
Will it include surgery, radiation, chemotherapy and laboratory tests or other diagnostic
procedures. Ask about any side effects you may experience with your medical treatment.
Knowing the possible side effects in advance will give you the opportunity to create your own
visualization and imagery to alleviate or ameliorate these possible side effects. I use the term
"possible" side effects because every patient reacts differently to the same type of treatment and
all patients do not experience anticipated side effects to the same degree. If you are having
difficulty with a side effect the physician can also slightly modify your medications or prescribe
other medications that will make the side effects more tolerable for you.
When you discuss your medical treatment plan with your physician, I suggest that you
take your spouse or family member with you and also tape record the office visit. During times
of crisis or when receiving information about a life threatening medical problem, We often are
prone to selectively remember what is said in order to soften the blow or feel more comfortable
about our situation. We tend to hear only the best news or the worse possible news depending on
our current state of health and the emotional mood we are in. Talking over the office visit with a
family member or listening to a tape recording of the visit after you have returned home will
help you put the challenge facing you into better perspective and make better decisions about
accepting or rejecting medical treatment. Regardless how hopeless you situation may seem to
you, remember it is human nature to see the worst possible outcome first and then upon
reflection begin to realize that all things are possible including a longer life with reasonable
levels of health and happiness and wellness from cancer. While no one can guarantee a cure,
there is no reason that you can not expect the best possible outcome from your treatment when
you add your own belief system and inner wisdom and faith to the healing process. Do not be
overly disturbed about the medical terms used to describe your type of cancer or your prognosis.
When the physician talks about life expectancy they are talking about a data base of other
patients with the same type of cancer and not about you as an individual. Your personal
participation on a mind, body and spiritual level will determine the type and quality of life and
recovery you can expect for yourself.
MAKING A PERSONAL COMMITMENT TO WELLNESS: Your faith and desire to
create wellness and your personal belief in the medications and treatments being used can be
more powerful than the actual medication or treatment. This type of commitment to wellness
often results in spontaneous remissions of cancer or so called miracle cures. The placebo effect
is another term for these unexpected results when no medication is given other than a physicians
assurance that what is being administered will solve your problem.
A placebo type of medication was usually given only to patients who chronically
complained of a disease or symptoms that had no medical or scientific explanation. Physicians
were reluctant to use this kind of treatment because it had the appearance of being quackery or a
type of snake oil medicine left over from the 1800's.
Further resistance to the use of placebo's may have developed in the 1950's when news
reports revealed that a new cancer drug was nothing more than sterile water.
In his book, "Getting Well Again", Dr. Carl O. Symington, et al, discuss the research of
Dr. Bruno Klopfer who was involved in the testing of the cancer drug Krebiosen. Krebiosen had
received sensational national publicity as a "cure" for cancer and was being tested by the U.S.
Food and Drug Administration.
One of Dr. Klopfer's patients had a far-advanced malignancy and huge tumor masses
throughout his body. At the patient's insistent request, Dr. Klpfler gave him Krebiozen
treatments. The patient's tumors diminished dramatically and he was able to resume a normal
life, including flying his private airplane. When the American Medical Association and the
Federal Dnrg Administration published negative results regarding the testing of Krebiozen, the
patient took a dramatic turn for the worse. Dr. Klopfer than allegedly told this patient that he had
obtained a new, supper refined, double-strength form of the drug that would produce better
results. This time the patient's recovery was even more remarkable and remained symptom free
for two months. Then further stories of the AMA and FDA's tests appeared in the press, stating
that Krebiozen was a worthless drug in the treatment of cancer. Within a few days the patient
died. Krebiozen was actually not a drug, just sterile water.
While this incident may have been shocking to the medical community and the public, it
did bring up the need to further investigate the question of why patients who strongly believe in
the benefit of a treatment do better than those who do not expect the same results no matter how
efficacious the treatment is that they received. The placebo effect is now commonly referred to
as spontaneous remission in medical circles and miracle cures in the spiritual community. Both
of these terms may be as misleading as to the real nature of healing involved as the
psychosomatic term, placebo.
Spontaneous remission would seem to indicate that the cancer disappeared without
anything of a medical nature having happened. We know that the mind can control the disease as
well as the healing factors of the body. In order for remission of cancer to take place, something
of a physiological nature must happen. The term "Miracle Cure" is also misleading because in
my opinion it infers that God or a higher power is granting a special favor to someone who
deserves or has earned a special privilege or divine intervention. I think a more spiritual way to
view a so called miracle cure is to see it as the divine wisdom of our inner mind in action. In
other words, those who develop the ability to really hear the silent words of the wisdom mind
can trust that only the best outcome possible will happen in their lives.
Spiritual wisdom is comprised of words that come from silence and can not really be
explained to another person. The best way to learn and heal is to experience the silence of "just
knowing" as a daily practice in your approach to self-help healing. Before discussing this
spiritual practice, it is important to review and update the concept of spirituality in action.
The popular conception of the mind-body-spirit connection often views each part as a
separate entity with a distinct function and purpose. The more holistic view is to view all three
parts as being interconnected and the mind operating in an expanded role as the soul. When the
mind merges both the physical and spiritual aspects of our being the action part of spirituality is
formed in our heart. I use the term "heart" in the biblical sense which is to say that we see from
the heart, live from the heart, hear from the heart and act from the heart.
A holistic view of action spirituality is better represented by seeing the interconnection as
spirit, body and soul (mind).
When speaking about God ( or a higher power ) spirit is generally considered to be
masculine. Many organized religions see God as a father or masculine figure. New age
spirituality may view God as a female or mother. The concept of God as a female is not new.
The early Christians Apostles stated in the Nicene Creed, their belief in God as being a trinity or
three parts in one. God the Father, was the masculine image, God the Son, was the man child
image and God the Holy Ghost, was the spirit image. However, the role of the Virgin Mary as a
female image was also included in the Nicene Creed by recognizing her as the mother of the
man child or Jesus. In other words, Mary represents the female aspect of God.
Spirit has two gender aspects. Logos is the masculine aspect and deals with the written
and unwritten word of God (or a higher power), illumination, the order of things, naked truth
and clarity. Clarity in a spiritual sense is the need to prioritize our thoughts and emotions in
terms of absolutes. In other words, it can only be one way or another way, It must be right or
wrong, answers to questions must be of a yes or no nature.
Sofia is the feminine aspect of spirit. This feminine nature allows us to process wisdom
language without the need for clarity. Sofia is a montage of feelings and emotions which are not
formed in Logos. This feminine nature of spirit does not require that we first know sorrow
before we can truly experience joy. Sofia allows us to find comfort and peace when dealing
with the paradoxes of life by accepting thoughts and feelings that seemingly contradict each
other. This then enables us to deal with a whirlpool of emotions and meaning to life, but this
feminine nature has one drawback that we must be aware of. Because Sofia has no order, no
clarity or down to earth thinking, we have a tendency to fly back into the realm of masculine
spirit before realizing a spiritual plan of action for health and healing.
Body also has two gender aspects which are male and female. In terms of spirituality,
body is our instinctual or animal nature. Body defines our awareness of our position in the
"Great Chain of Being". This philosophy was developed in the 13th Century and views humanity
and each individual human being as part of a universal and infinite oneness rather that standing
apart or separate from the rest of the universe. The "Great Chain of Being" includes God, the
Angels, the Heavenly Court, the Saints and other spiritual masters, Humanity, those who have
died, the animal kingdom and the plants and other elements that make up the earth and the
universe.
Primal man identified with the animal kingdom and nature because they mirrored
different parts of his psyche. When we see ourselves as being separate from other living
creatures and our earthly environment, we loose touch with our instinctual self.
[HOLISTIC SPIRITUALITY: SPIRIT Logos=Masculine Sofie=Feminine HEART Combined
Spirit-body-spirit. Body Animal Nature Male-Female Soul Mind & Soul Male and Female]
Soul has a masculine and female aspect with the female aspect of soul being imagination.
This is the imagination that works with our mental images of health and healing in our
subconscious mind.
Father Richard Rhoor, who teaches spirituality at the Center for Action and
Contemplation in Albuquerque, New Mexico, explains soul this way: Soul takes us to the edges
of what we have already experienced and then pushes us through to the next state. You really
experience your experiences through soul. Up to this point it just remains and idea or theory or
theology. But soul pulls it down into the heart and it's you. It's united with instinct and
realization. These are the things you live for and die for. No one lives or dies for a theology, but
when it becomes your soul nothing can get in your way or stop you.
If you are not committed to go to the line in your commitments to healing it is
because you have not completed your soul work and allowed God to put the different parts of
soul together. When soul work is completed you have what the Buddhists call "Beginners
Mind", where a whole new vista opens up like the mind of a child and we can listen and hear
afresh.
When dealing with cancer a whirlpool of emotions surface and often our natural
tendency is to ignore or refuse to work with the emotions that seem mean hearted or vengeful. It
is important not to avoid these emotions as they are possibly the most important part of soul
work. These so called unworthy emotions are feels of hatred, envy, jealousy, anger, ect. Many
Christians believe that these are not nice thoughts and should be avoided. However it is not the
thoughts but how we deal with these feelings that is important. Everybody has really hated
something at one time in their life, rather they will admit it or not. To maintain hatred or other
unworthy emotions will abort soul, but to let these feelings arise and admit they are there, and to
taste them, and let them teach you and then let them go, is what creates the atmosphere for
physical, emotional and spiritual healing.
When dealing with cancer from the time of diagnosis through treatment and resolution,
these feelings can be our friend or our foe. By completing soul work, even the negative feelings
can be turned into powerful tools of recovery and healing.
Soul work is completed by "Action" and "Contemplation". list action first because
contemplation is little more than repetitive worrying if there is no action of commitment to
healing and giving service to others who are facing similar challenges in their lives.
The preferred method for soul work is contemplative meditation or prayer. You may use
any of the Spiritual Practices put forth in Chapter 7, Self-Help Healing Practices, however I
suggest in the case of cancer that you practice the following form of meditation or prayer:
SOUL WORK MEDITATION: Admit to God or your higher power and yourself that
your life is in chaos and needs spiritual cleansing and new direction. You do not have to use
specific words-to do this, just knowing this to be your situation in your thoughts and feelings
will enable you to really listen for answers to your spiritual needs.
Select a quiet place where you will not be interrupted by any outside demands on your
time for at least thirty minutes while you do your meditation. Since the "Beginner's Mind" deals
with symbols and images rather than words and facts, choose a symbol or image to focus your
eyes on while you meditate. If you are a religious person the symbol might represent your faith
such as a cross or crucifix, a bible, a religious painting or picture or a religious statue or lighted
candle. If you are not particularly religious or just prefer to do so, you may select a picture from
nature or a living plant or another object that reminds you of being a part of a greater universe.
As you focus your eyes on the symbol or object you have chosen, concentrate only on
your hearing and listen to the silence around you. Ignore any sounds you might hear and imagine
you are in a quiet place next to your soul or spiritual heart deep inside of you. In your mind's
eye, go to this Inner Heart Space and let your mind rest there without thinking about your
problems are reviewing a list of questions you are seeking answers to.
As you become aware of the silence, thoughts or feelings may come to mind. When you
find yourself thinking about a particular thought or feeling, admit that it has come to mind and
then hold it firmly for a moment and then gently let it go. Allow these thoughts or feelings to
simple drift away from you and disappear from your mind. One way to do this is to focus on
your breathing. Each time you exhale, pretend in your mind that you are still exhaling when you
take your next in-breath.
You will find that as you continue with this meditation that thoughts and feelings will
begin to slow down and come father apart with longer periods of silence in between. The goal
of the meditation is to experience the longest possible period of silence. With repeated practice
the period of silence will eventually fill the whole period of your meditation.
At the conclusion of your meditation do not attempt to discover any answers to your
problems or dwell on the thoughts or feelings that may have surfaced during the meditation. Let
your mind stay quiet and enjoy the peaceful feelings that meditation produces.
Be patient and wait for specific answers and spiritual direction which will come to you
over the next several days or weeks when you least expect it. Being patient and waiting for
answers is possibly the most important part of this meditation.
SELF-HELP HEALING ACTION PLAN: Your action plan for treating cancer should
include: your personal image for your cancer and your ally or weapon to defeat it; a daily
calendar of times to practice meditation and visualization and imagery exercises; and an
assigned time for physical exercise.
It is human nature to want to get everything started at once and jump right into a
new activity. However I caution you not to do this. It is important that you be consistent in
carrying out any plan you make and complete it in a methodical and purposeful manner. When
we rush right into something, we tend to do well at first and then find reasons to put a part of the
activity off in favor of some other matter that always seems to come up. When you first begin to
treat your cancer there are enough disconnected emotions, scattered feelings and interruptions
already occurring in your life. Taking time to let these new and disquieting experiences smooth
out and settle down is just as therapeutic as your meditation and imagery periods are. I urge you
to devote a week to contemplative meditation before developing your personal imagery for
defeating or curing your cancer.
The first step in developing your imagery for cancer is to decide if your are a "Fighter"
or a "Healer".
If you are comfortable in confrontational situations and have a habit of fighting back
against something that is threatening you emotionally or physically, you may choose a "Fighter"
image. You may wish to imagine your defense against cancer as a powerful animal, army or
hero figure that attacks and defeats the enemy. This image should be absolutely fearless and
always win no matter how difficult the battle. This image should be something that is the color
white and represents the good guys or purity. Some of the images that have been used are white
sharks or white polar bears that kill and eat the cancer, or vast armies that sweep through the
body killing the cancer. If you are imagining a battle scene make it swift and decisive with your
hero always wining quickly and easily. Avoid images that can be negative or have more than one
outcome.
A cancer patient began using imagery as part of their treatment program and was doing
well for several weeks with good results. When the results seemed to diminish, prompting the
therapist to ask the patient about the type of imagery they were using. The patient explained that
they visualized a big black rat as the attacker and the cancer as rat poison. According to the
patient, this worked well at first but then the rat stopped eating the poison. In this case the good
guy (rat) really wore the cloak of an enemy (black) and had a choice of eating the poison or not
eating the poison. In another case with limited results, the patient imagined their tiny white
blood cells traveling through the body and picking away at the large cancer tumors. In this image
the attacker was small and overpowered by the large tumors. The attacker was also at a
disadvantage because it took a lot of time to pick away at the large tumors, so the battle was not
quick and decisive. Both of these patients began improving when they changed their imagery to
a powerful, quick, decisive and win-win situation.
Many people are not comfortable with confrontational thoughts or ideas about killing
something. I prefer to refer to this type of individual as a "Healer". Imagery for healers should
also be strong and powerful, however, the attacker can be imagined as a symbol or inanimate
object such as a pac-man character from the video game or other pretend character that doesn't
really exist in the real world. If you are a healer be careful to avoid fantasy images. One patient
imagined the healer to be a white cat and the cancer to be the cat's favorite cat food. The patient
got results with this image at first and then stopped using it because the cat got so fat eating the
cat food that it wasn't hungry anymore. Healer imagery may also include God or a higher power
as an ally. Chaplain Paul Durbin told me about a patient who did remarkably well by imagining
the chemotherapy drug they were receiving as being the blood of Christ that dripped from the IV
bag into their vein and then flowed through there body washing away all of the cancer cells. If
you are a spiritual person, you may wish to let your spiritual meditation suggest a healing image.
Once you have established an image for your defense against cancer, you will want to
create an image for the cancer itself.
The cancer image should be weak, sickly, disorganized and unable to stand up for itself.
This is an image of reality because cancer cells are weak and disorganized and highly susceptible
to being destroyed by the body's natural defenses and immune system. You may wish to give the
image a color that is pale or light gray. The size of your cancer image should be small or soft
and jelly like, so that it easily melts or breaks apart.
An easy technique for creating your imagery is to draw a picture that shows your attacker
image or symbol and the cancer image you wish to use. I suggest that you use a full sheet of 81/2
by 11 paper to draw your picture on. You may wish to draw in color. If you do your picture in
color, have a full box of colored crayons including black and white available so that you can find
any color that first comes to mind. Draw you images in a bold open manner and use the image
that first comes to mind. If several different images occur to you, make a separate picture for
each attacker - cancer image. Now you can look at the picture or pictures you have drawn and
determine which one will work best. Look to see if your attacker is strong and powerful. Is your
attacker ridding your body of cancer with a decisive and fool proof plan? Is your cancer image
weak and fearful of the attacker? Is there anyway the cancer image can outsmart the attacker?
Once you have selected an image for your attacker and the cancer, you are ready to put
your self-help visualization and imagery session together. Each session should consist of an
invocation , a relaxation induction, a deepening technique, your imagery of the cancer being
destroyed, imagery of your life and activities with the cancer gone and an alerting or awakening
imagery.
The invocation can be a spiritual meditation practice or a prayer.
The relaxation induction can be a physical or mental progressive relaxation exercise or it
can be a short version such as saying to yourself: "in a very few moments i am going to be more
relaxed than I have ever known myself to be. I am going to count from three down to one, and
on each number my eyelids will become more and more heavy and so heavy on the number one
that they close and are two heavy to open.
Three, my eyelids are becoming heavy now, tiring, relaxing and wanting to close. Two,
my eyelids are so heavy, they want to fluttera little and close, they are becoming to heavy to
keep open. One, my eyelids are to heavy to open, the more I try to open them the heavier they
become and the deeper relaxed I go. The more I try to open my eyelids the more they become
stuck together and will not open. No need to try to open them anymore as I go even deeper
relaxed."
Follow your relaxation induction with the deepening technique. With a little practice
you may find that you can just begin with the deepening technique which can be used as a
combination induction and deepening.
Now visualize your attacker or healer destroying the cancer. It is important that your
attacker be bold, resourceful and all powerful and the weak cancer completely defeated or
cleansed from your entire body during this session. Remember that your conscious mind deals
with facts and numbers and your subconscious mind deals with abstract thoughts. The conscious
mind knows that it may take weeks or months to overcome the cancer, but your subconscious
mind only knows that the cancer is present or it has been removed or eradicated.
 Before alerting yourself, visualize and imagine your new life, free of cancer. Picture
activities you will enjoy, people you are seeing and places you are going. It is important to
imagine these things as happening now, and not in the future. This way of imagining events is
referred to as end result imagery. This is imagery that is happening in the present. An example
is imagining playing golf again. In this case, see yourself actually playing on the golf course.
Picture your entire game and all the landscaping you come across. See yourself as a great golfer
having a wonderful game and achieving an impressive score. Notice the other people you are
playing with and how nice the weather is. Also include in your imagery how good you feel and
all the fun you are having.
The alerting technique can be simply opening your eyes and stretching for a moment or
you may wish to pretend you are taking a short nap and will awaken refreshed and full of
energy. To do this, pretend you are setting an imaginary alarm clock with easy to picture and
imagine numbers and an alarm that will go off in five minutes. Set the alarm to go off in five
minutes from the time you set it in your mind and then wait for your eyes to open. Don't wony
about not being able to alert yourself. It has been the experience of all of my patients that their
eyes opened within thirty seconds of setting their imaginary alarm clock. Unless you are
extremely tired and wanted to take a nap anyway, you will be pleasantly surprised at how
accurate the imaginary clock in your mind is.
The following example of a self-help healing session includes both a "fighter" and a
"healer" approach. This is the visualization and imagery I used that enabled me to shrink tumors
in the lung and liver and other cancerous growths on my skin. do not suggest that you copy this
imagery for yourself, as your own creative imagery will be far more powerful and effective for
you and your personal situation.
Invocation: Dear Lord, my life has become unmanageable and I am powerless to cure
the cancer without your divine help and guidance. Almighty God, enter the space of my heart
and soul with your presence and promise of healing and take charge of my life and recovery. In
Jesus Name I pray, Amen .
Induction and Deepening: I prefer the short form eye closure induction and the
depthmeter deepening technique.
Visualization and Imagery for Cancer: The cancer is represented as tiny little gray seeds
trying to grow. The tumors a loose piles of seeds that easily fall apart. The attackers are
thousands of kernels of popped corn that represent white blood cells and beams of ultra bright
white lights coming from God that vaporize the cancer cells.
I begin by picturing myself lying on my side in an open space of bare ground in the
desert on a warm winter day with the perfect temperature and the sky a clear blue and without
any clouds. As I rest as if almost napping, I imagine a large popcorn popping machine like one
in a movie theater and then turn it on. The lid opens and thousands of kernels of pop com tumble
out and into my blood stream. These are powerful white blood cells that instantly travel through
my blood stream to every part of my body and out into surrounding tissue and smother and
sponge up every cancer cell they come into contact with. The white blood cells then carry the
cancer cells to my liver and bladder where they are discharged out of my body. Every time a
white blood cells becomes soiled with the little gray cancer seeds, it leaves the body and is
replaced by a hundred more new white super blood cells.
Next I turn on a switch to another pop corn machine that makes little red balls that spill
into the blood. These are special red blood cells that carry oxygen to all my bodies healthy cells
but Ignore the cancer cells so that they will not get any help to grow or replace themselves.
 During chemotherapy sessions I also turn on a glue pot that represents the chemo
medicine. The glue flows throughout the blood stream and the body and coats the cancer cells
with a coating that hardens and dries. This prevents the cancer cells from getting any
nourishment or oxygen, so that they shrivel up and die.
Now I leave all the machines running and imagine the whole process happening at
lightening speed and go back to my image of laying on the ground. I picture an image of Jesus
and have the image fade into thousands of beams of light. These beams are a brilliant white and
radiate down over my entire body and into all parts of my body. The light is warming and
creates a wonderful feeling of comfort. I visualize the beams of light touching each area of
cancer and imagine vapor coming out of the cancer cell as it shrinks and dries up into a speck of
dust and then disappears as if it has been all burned up and vanished into the air.
Finally I picture and imagine my entire body from the top of my head to the bottom of
my toes and recognize that all of the cancer has disappeared and been removed. Then I imagine
teaching classes to other cancer patients, listening to their success stories and lecturing for
students and physicians at conferences and hospitals. Sometimes I imagine attending my
daughters high school graduation or a family event I am looking forward to or reaching a goal I
have set for myself to achieve sometime in the future.
Alerting Technique: I prefer to hold onto my last happy thought and simply open my
eyes as if I were having a daydream.
Many times we are prone to question rather we were really relaxed enough or in a
subconscious or self-hypnosis state during our visualization and imagery session. One way to
assure yourself that you were in fact, in a state of hypnosis, is to look into a mirror right after
your eyes open and see if they are watery. Moisture in the eyes is a sign the body was deeply
relaxed and you were in a state of hypnosis. Another way to check your depth of relaxation and
hypnosis is to recall the number you chose to indicate your level of hypnosis when using the
depthmeter deepening technique. The lower the number you imagined the arrow to be pointing
at on the yardstick, the more deeply relaxed you were.
Now it is time to go to work treating your cancer. Establish times to do your meditation
and visualization and imagery each day. You may find that early in the morning, when you first
wake up, is a good time because you are already still relaxed from a nights sleep. Another time
during the late morning, before lunch or in the early afternoon can be added to your routine.
Your third session can be scheduled for just before bed time. Remember that the time you
practice your meditation and imagery is not as important as being consistent and completing
your self-help sessions at least three times a day. Think of your time for visualization and
imagery as a Doctors appointment with yourself.
In addition to your visualization and imagery sessions, make time to exercise for thirty
minutes once each day. exercise can be simply walking briskly around the block. You may wish
to start out with a short walk of ten to fifteen minutes and then build up to thirty minutes or even
an hour, depending on your physical condition. If you find it difficult to motivate yourself to
exercise, incorporate the imagery for "Exercise" into your healing session.
Many of the side effects of chemotherapy can be alleviated with visualization and
imagery. If you suffer from Insomnia you can add extra sessions of meditation, prayer and
imagery during the time you are awake. You can also practice contemplative meditation or
prayer. These healing sessions can be done while laying in bed. You might also wish to refrain
from watching n/ news or action dramas before going to bed. The news media seems to have a
penchant for dramatic and vivid pictures and news dialogue. These images tend to over stimulate
the mind and may linger on in your subconscious mind after you go to sleep. Reading a few
pages from an inspirational book is also a good natural sleep remedy.
If your emotions become bothersome, avoid trying to work things out in your conscious
mind by worrying about your circumstances or progress of your treatment. Use the imagery for
worry, guilt or blame to bring you back into balance.
Another method for enhancing your healing is to keep a journal or diary. We all have a
tendency to remember the hard times and forget the good times. By keeping a diary journal or
diary, we can go back and read about the good days, things that made us feel better or
encouraged us to work even harder. Look for a high point to remember each day and think of
difficult spots as minor setbacks rather than a reversal of positive results from treatment.
Keep a positive attitude by setting goals and avoid making bargains. When we make a
bargain with God or ourselves, our natural tendency is to feel we have to keep the bargain when
the conditions of our agreement have been met. This is in reality a mental suggestion to stop
trying or give up at a specified time. When we set a goal and reach it, we can give ourselves a
mental suggestion to keep on going by setting a new goal.

23. NOTES FROM CLIENT-CENTERED HYPNOTHERAPY: R. D. LONGARCE, Ph.D.

(1995)
Kindall/Hunt. Dubuque, IA):
There is a consensus that how a subject responds to hypno-suggestion depends far less
that had previously been supposed on the hypnotist's formal induction and far more on the many
other complex interrelated variables, most of which pertain to the subject rather than the
hypnotist. These interacting variables which determine responsiveness includes: the subject's
expectancies and beliefs about hypnosis: the subject's attitudes and motivations toward specific
situations; the subject's pre-existing abilities to imagine, fantasize and daydream; the subject's
feelings toward and beliefs about the hypnotherapist; and the hypnotherapist; communicative
skills in presenting suggestions that are personally meaningful for the particular client or patient.
(p.2)
Misdirection of attention is the common component of any induction technique... Before
the hypnotherapist begins to formulate his own client-centered or creative induction techniques,
he would review the concept of misdirection of attention. (p. 17) There are over a thousand
and one ways to misdirect attention. The question is, how many can you create and employ in
your professional work? The answer is an infinite number when you let your own creative
subconscious mind experience the possibilities. (p. 18)
Low self-esteem is a significant factor in problems experienced by children who are
having difficulties in school, in family situations or sports activities. Children are highly
suggestible and even an off-hand remark can decrease a youngster's sense of self-esteem or self-
worth. A child who is teased and told that he or she is stupid or clumsy may well act on the
unintended remark and begin acting clumsy or stupid. A child who is admonished to preform at
peak proficiency in a sports event or classroom exercise may feel extremely tense, nervous and
anxious. The inability to break the feeling of tension may lead to a sense of frustration and an
even greater felling of nervousness an lower self-esteem. Oftentimes low self-esteem can be
enhanced if just one person believes in a child and allows the child to create their own solutions
to a given problem by believing in themselves. One person who can make a difference in the
areas of low self-esteem, low motivation, enhanced concentration and memory is the client-
centered hypnotherapist. The hypnotherapist can also provide a child with a life-long tool for
alleviating inappropriate tension and anxiety. (p.127-128)

24. NOTES FROM INSIDEOUT: R.D. LONGACRE, Ph.D. (1989) Therapeutic Educational
Group Pub. Glendale, AZ):
As we grow up we use the best information and knowledge available at a given time to
solve a problem we are facing. As we solve the problem, we file information and the learning
experience in our subconscious mind. As an adult we call upon this stored information to
logically solve adult problems. Unfortunately the information we use to solve the adult problem
may be childish thinking that we are not aware of. (p. 18)
The critical sensor is a necessary part of the human computer. It alerts us in a time of
danger and often prevents us from making so called "stupid mistakes." However the critical
sensor is often the cause of roadblocks to developing right brain or subconscious programs that
can be used to improve our quality and enjoyment of life.
In order to program a pathway for change in the powerful right brain portion of the
human computer, three things must happen simulataneousely. The left brain input functions
must be placed in the pause mode or instructed to only report one idea or sound source to the
critical sensor. The critical sensor must be bypassed by activating the "I want" key and the right
brain or subconscious mind must be give permission to develop new and creative programs. (p.
24)
Rev. Dr. Paul G. Durbin writes about the triangle concept in his book Awakening the
spiritual connection. "The foundation for my work in hypnotherapy is based on what I refer to
as the human trinity. Whether you are a Christian or not, you would probably know what I
meant if I referred to the Holy Trinity: God the Father , the Son, and the Holy Spirit. I believe
in the Holy Trinity and I also believe in human trinity. Each of us is a trinity within himself or
herself. What is the human trinity? The human trinity is the concept that we are made up of
body, mind and spirit. We are physical, emotional and spiritual beings." (p. 35)
The word "try" is often the villain. "Try" is a do nothing word. The word try means,
maybe I can and maybe I can't. The word try means, it's OK to not do something. The word try
means, probably nothing will happen anyway. (p. 38)
THE VICTIM: Just as we can fall a victim to a disease or illness, we can also become a
victim of an unwanted habit, behavior or a series of circumstance that interrupt the joy of living.
(p. 39)
THE LAW OF SELF-FULFILLING PROPHECY: This law states that if you think
about something long enough, what you are thinking about tends to happen. (p. 39)
THE RESCUER: The rescuer of the human triangle is a storehouse of information and
has the ability to create infinite pathways to change... The rescuer is our God given ability of the
subconscious mind that insures the strength and integrity of the human triangle. (p. 41)
THE ACCUSER: No matter which way you turn a triangle, there is always one side that
becomes bottom. This side provides the balance and strength for the triangle. This balance is
also necessary in the human triangle. Notice that the rescuer part of the triangle is on the bottom
or at one side of the balance line. The Accuser is on the opposite of the bottom or balance line.
The accuser provides balance when it is operating in a positive manner. When the accuser is
operating in a negative way it sill maintains balance, but at the expense of the rescuer. When
the accuser becomes a villain it negates the positive thinking and creative actions of the rescuer.
(p. 42)
Stress affects any kind of system be it the environment, a steel beam or our bodies.
When a given system is stressed, the individual molecules which make up that system or a
substance are altered. When we are mentally or emotionally stressed, our body systems, i.e.
digestive system, elimination system, etc. do not work as they were meant to. When the body is
stressed to a point where it is unable to process and eliminant food as it should, it begins to find
an alternate route for dealing with food energy. This alternate route require the body to alter or
break down long chains of amino acids into harmless looking 6-carbon rings known as sugar.
The sugar can then be stored for later energy use in the form of something we have all been
taught to dread, fat. (p. 88)

25. NOTES FROM PRACTICAL THERAPIES: R. D. LONGACRE, Ph.D. (1990)

Therapeutic Educational Group, Glendale, CA):
While we do not know how the mind body connection healing takes place in each
individual situation, we are beginning to understand how a mental thought pattern (imagery)
can alter physiological disturbance or change the biochemistry of an individual. (Dr. Cherylanne
Atwood) (p. 6)
It was long thought that the control of the ANS was involuntary. In other words, there
was nothing we could do to regulate this activity. We know now that by using appropriate
mental pictures or images, we can create the relaxation response at will with just a little training
and effort. When the physical body is relaxed, nerve energy and blood flow is enhanced,
thereby promoting wellness by the immune system which works in the blood. Therefor
enhanced blood circulation triggered by the relaxation response can have a direct effect on the
healing response.
Today a growing number of physicians and health care providers ar endorsing the
concept of "Holistic Health". Holistic health is a combination of techniques that modalities
that treat the whole person, not just the physical complaint." Holistic health treatment includes
the body, mind, and the spiritual parts of a patient. While this approach is perceived by many to
be a modern approach, it has been praised, ridiculed, defended and revived time after time
throughout history. (p. 10)
Today the concept of holistic health and the power of the mind to heal the body is an
important tool in the armamentarium of all physicians. Thanks to the pioneering work of people
like Bernie Siegel, M.D., Norman Cousins, Lawrence LeShan, M.D., patients are learning that
here is a mind body connection and it can be used to create new health. (p. 12)
(TRUE PRAYER): As I begin writing this chapter, I am reminded of an evening my
five and one half year old daughter explained to me how to pray. Binkey, my nickname for this
inquisitive and energetic child, was kneeling beside her bed saying her prayers as I listened from
the hallway. As I waited for her to get to the God bless mommy and daddy part, I realized that
she wast saying words. Binkey was reciting the alphabet over and over. Slowly, deliberately
and in hushed tones she repeated each letter. The time through the alphabet, my curiosity got the
best of me. "Binkey", what are you doing?" "I'm praying daddy," she stated in a matter of fact
voice. "What do you mean by praying." I replied. "Well you see daddy, I'm not old enough to
know all the words yet so I just keep saying the letters because God will put the words together
for me.(p. 13-14)
Dr. Paul Durbin, a good friend, who is the Director of Pastoral Care at Pendleton
Memorial Methodist Hospital in New Orleans and serves a Chaplain of the board of directors of
the National Board for Hypnotherapy and Hypnotic Anaesthesiology shared the following story
that illustrates creative reasoning.
 An older woman patient was confined to the hospital for treatment of her cancer. Her
treatment required chemotherapy which was given intravenously and left her feeling ill
afterwards. Since she was a very religious woman, Dr. Durbin was hesitant to mention hypnosis
because of her possible religious objections. During their conversation about guided imagery the
woman looked at the IV bag hanging on the pole and said, "That bag could be filled with the
healing blood of Jesus."
Dr. Durbin confirmed that indeed it could and this became the image the woman used
during chemotherapy treatment. The woman's creative reasoning served her well as there were
no more reports of extreme nausea following chemotherapy. (p. 15)
The subconscious mind can also be a safe harbor for negative emotions that the
conscious mind refuses to let out. Repressed negative emotions and denial of current reality also
play a role in catastrophic illness and can be roadblocks to a return to wellness. You won't find
the word wellness in the dictionary, but I use it to distinguish between illness, health (physical)
and emotional plus physical plus spiritual health. All three aspects of health are included in the
term wellness. (p. 29)
We can make a logical conclusion that if the subconscious mind is inactive in providing
solutions to living or harboring negative attitudes, it can also be used to crate now pathways to
health by release of negative thinking. This is because the right brain or subconscious mind does
not have to obey any given set of rules or reason why before taking action. (p. 30)
"I'm not worthy of healing", "I deserve to be sick because I've made a mess of my life",
and "God is punishing me for my sins" are just a few of the excuses I've heard from people who
are tying too hard to earn spirituality. Spirituality is a gift and plentiful for everyone when they
unbolt the door that is shutting it out of their life. I am an ordained minister and believe in God,
however, it is not my purpose in this book to convert anyone to my brand of faith. It is my
purpose to share with you ways you can heal your spiritual nature along with your physical
nature. In fact the spiritual haling must take place before physical healing can begin. The
answer is faith, love and hope. (p. 37-38)
Faith is not the childish belief that something is true despite the lack of solid or hard
evidence. Spiritual faith is the inner knowledge that something is already happening before we
are aware of it consciously. Faith is a powerful force constantly working in the subconscious
mind. Faith is the comminution channel and receiving agent for abundant gifts promised by a
higher power. While faith in ourselves is an admirable activity of the conscious mind, inner faith
is the result of just being ourselves complete with all of our imperfections. Faith is not only a
mystical or magical aspect of our spirituality, it can also operate of a very practical. (p. 38)
Spiritual love is not something you can measure. It is not something that you can earn by
making promise or doing specific deeds. Spiritual love is not the result of religious upbringing
or conversion to a church. Spiritual love is an inner knowledge and peace that has always been
inside of everyone waiting for permission to balance and bring a sense of wholeness to each
individual life. (p. 46-47)
Hope is the third aspect of our spiritual nature. It has been said that without hope life is
lost. Hope is an intriguing word because it has dual meaning in relationship to the mind-body
connection. Hope can be a powerful weapon for survival and it can also be and excuse do
nothing. (p. 47)
Common dream patterns can be used only as a guide in that there can be hundreds of
interpretations for each individual dream pattern.
(1) Falling from a height: This dream can be due to feeling of anxiety or losing something from
another person or eve escape form some apparently unsolvable problem. (p. 68)
(2) Flying through the air: Flying dreams generally indicate pleasure ranging from juvenile to
adult states. They can also be an urge to free oneself from life's problems or as a death token
with the dreamer taking off for heavenly realms.
(3) Finding money or valuable articles: These are dreams of intense desire, which reach a state
of temporary fulfillment before they fade away. The intense desire though, is general, not for
money. When money is found in a dream it can be an indicator that something else is desired
such as acceptance and love.
(4) Losing money or valuable articles: This is the opposite of the "finding" dream but with a
different meaning. The dream may be quite disturbing but the greater the loss the happier the
awakening. (p. 69)
(5) Being chased or hunted: This dream is generally viewed as an indication of repressed desire.
(6) Pursuing someone or something: Pursing suggests aggression, so this dream can logical
represent an aggressive urge of the dreamer.
(7) Impeding danger: Freudian interpretation of this dream suggests elements of repressed wish-
fulfillment; other authorities see this as antagonism or secret guilt. (p. 70)
(8) Being trapped in tight places: Maybe the result of repressed antagonism or secret guilt,
however it can also indicate a struggle taking place in the dreamer waking life.
(9) Missing the boat: This is a dream of losing a real opportunity. If the dreamer gets on board,
it indicates that can work through the problem.
(10) Interrupting preparation: Inability to do something. Can mean to banish past mistakes and
guilt. (p. 71)
(11) Taking an examination: Confrontations for real life problems. (p.71-72)
(12) Insufficient clothing: Feelings of embarrassment to outright exhibitionism. Feeling inferior
and perhaps guilty.
(13) Water and swimming: May have a religious meaning or a search for something
immediately beyond the reach.
(14) Fire and flame: Favorable if dreamer doesn't get burned. May mean love. (p.72)
(15) Rescuing someone: Desire for renunciation of something unattainable. The victim may be
the dreamer himself.
(16) Being rescued: Desire for spiritual attainment.
(17) Being lost: Afraid of undesirable acquaintances catching up with them. (p. 73)
(18) Losing some necessary item: A person may lose an item that will prevent them from going
somewhere the didn't want to go.
(19) Food and eating: Ingestion of massive amounts of food may indicate a desire to literally eat
up all opposition. (p. 74)
(20) Teeth dreams: Hope of eliminating a bothersome problem. (p. 75)

26. VISUALIZATION AND GUIDED IMAGERY FOR PAIN MANAGEMENT: R D

LONGACRE: 1995) Kendall/Hunt. Dubuque, IA
In other words, using visualization and guided imagery is as simple as picturing and
imagining something you desire and then allowing yourself to enjoy this picture or image as if it
was already completed. (p. xi-xii) Religious people may identify with the phrase, "Whatsoever
you ask, believing that you shall receive." Entrepreneurs and those working in business may
discover the meaning of visualization and guided imagery by reflecting on the quote attributed to
Henry Ford, "Think you can, think you can't, either way you're right." (p. xii)
 Generally a new idea must pass through three phases before it is accepted. At first the
idea is thought to be impossible. Then the idea is considered sacrilegious or preposterous.
Finally the idea is axiomatic; everyone knew it would work long before the idea was generally
accepted. (p. 5)
The deep state of hypnosis is seldom indicated for clinical hypnotherapy. Specialists in
hypnotic anaesthesia take patients to a deep state of hypnosis to facilitate analgesia for surgery.
(p. 14)
PAIN CONTROL THEORIES: The control gate theory postulates that pain impulses
traveling to the mind must pass through a control gate or valve before reaching a command
center in the left brain. This command center or switchboard analyzes the information and then
channels the pain stimuli to appropriate pain response centers that instigate a physiological
response. When the left brain or conscious side of the mind has a narrowed focus or span of
attention, the control gate allows only wanted or selected pain impulses to enter and trigger a
physiological response, i.e. the sensation of pain. The control gate closes when the attention of
the conscious mind is misdirected or centered on a fixed focus such as the therapist's voice or a
visual object, real or imagined. The control gate theory assumes that physiological pain is
ignored by the mind due to an increase of the individual pain threshold. (p. 15)
The autonomic (involuntary) nervous system (ANS) has two branches or sides; the
sympathetic and the parasympathetic. The sympathetic side is the fight or flight branch. The
parasympathetic side is the relaxation branch. Emotional or physical stimulation of the
sympathetic side results in accelerated breathing and heart rate as well as psychological survival
instincts and behaviors. The sympathetic side of the ANS responds to tension, anxiety, fear and
pain. The parasympathetic side of the ANS triggers the relaxation response. With relaxation the
breathing and heart rate returns to a normal range and minor discomfort is ignored as the body
recuperates from a stressful experience.
The ANS Inhibition Theory suggest that with hypnosis, the sympathetic branch can be
controlled by the parasympathetic or relaxation side. In other words, the relaxation response can
inhibit or ameliorate pain stimuli. With deep relaxation pain can be interpreted as pressure on
the mind. (p. 15)
The body is a Robot Theory: This theory is easily understood by patients or clients
and presents a good explanation of hypnotic pain control phenomena. "The Body is a Robot
Theory" assumes that only the mind can think and the body is a robot controlled by the mind.
Therefore, what the mind chooses to accepts that pain only pressure then the body's
physiological response must be response to pressure rather than pain. (p. 16)
Specific contraindications for hypnotherapy are predicated on the therapist's training,
skill, experience and clinical objective of therapy. When working in the areas of hypnotic
anaesthesia, hypnodontics and pain management, direct symptom removal of pain is always
contraindicated without the approval of a physician. (p.27)
CLINICAL INTERVIEW PROTOCOL:
(1) Solicit information about the patient's occupation, hobbies and special interest.
(2) Inquire about the patient's previous experience with hypnosis or their familiarity with the
phenomena.
(3) Determine if the patient really wants the expected outcome of therapy.
(4) Establish rapport with patient by telling them a little about your training and past experience
in helping people with similar problem.
(5) Explain to the patient how you plan to help them with their problem and the results thy can
expect from therapy.
(6) Ask the patient if they want you to help them overcome their problem.
(7) Listen to the patient's choice of words and tone of voice during the interview. Watch for
expressions both verbal and nonverbal that may provide clues as to their primary learning
system. Remember that all hypnosis is really self-hypnosis and the patient will usually only
achieve the results they honestly want and desire. (p. 29)
PREINDUCTION PROTOCOL: The preinduction visit is the portion of time during
the initial meeting when the patient that is used to explain what hypnosis is, what it is not and
how hypnosis works.
(1) Explain what hypnosis is. Two basis definitions you may wish to use are: "Hypnosis is an
artificially induced state, usually (though not always) resembling sleep, but physiologically
distinct from it, which is characterized by heightened suggestibility, as a result of which certain
sensory, motor and memory abnormalities may be induced more readily than in the normal state.
(Warren's Dictionary of Psychology). In a hypnotic state the body is a robot controlled by the
mind. What the mind perceives or imagines as reality, the body will do and accept as reality. (p.
33)
(2) Explain what hypnosis is not. Hypnosis is not physical sleep. Hypnosis is not a state of
unconsciousness. Hypnosis is not gullible. Hypnosis is not being week minded. Hypnosis is not
being controlled by someone else. Hypnosis is not a loss of self-control. Hypnosis is not
divulging secrets. No one can be hypnotized against their will or do anything in a state of
hypnosis that violates their moral, religious, or personal principles. (p. 33-34)
(3) Demonstrate to the patient what hypnosis feel like.
(4) Dispel the myths about stage hypnosis.
(5) Give a simple explanation of how therapeutic hypnosis works and why it is different from
stage hypnosis.
(6) Demonstrate clinical hypnotic phenomena to the patient by conducting various suggestibility
tests. (p. 34-35)
HYPNOTIC CHILDBIRTH INDICATIONS:
(1) Reduction or eradication of fear, tension and pain before, during and after labor and delivery
with a resultant elevation of the pain threshold.
(2) Reduction of the amount of pain medication required to maintain the patient's comfort.
(3) Patient control of painful uterine contractions which may be experienced during normal labor
and delivery.
(4) Decreased shock and speedier recovery.
(5) Amelioration of undesirable post operative effects.
(6) Hypnosis shorten the first stage of labor by approximately three to four hours for mothers
who are experiencing labor and delivery for the first time.
(7) Hypnosis raises resistance to fatigue concomitant with arduous or prolonged labor.
Therefore maternal exhaustion can be alleviated and mothers can be more alert and aware when
their baby is born. (p.65)
(8) Hypnotic rapport can be transferred to a nurse, associate, husband or childbirth coach.
Individuals participating in the birthing process do not need special training to assist patient
using self-hypnosis.(p. 66)
PRECAUTIONS: When working with patients who are using self-hypnosis for labor
and delivery, the health care provider should remember that the patient is in a heightened state of
awareness and suggestibility. When communicating with the patient, the following words and
phrases should be avoided: labor pain, pain medication, this will hurt a little, and are your pains
getting worse. The use of self-hypnosis does not negate the need for necessary pain medication.
Pain medication should be readily available for the patient. Only one in four mothers have the
ability to forego analgesia completely during labor and delivery. All childbirth patients should
be informed that pain medication is available upon request. The patient should also be assured
that they need not feel guilty when requesting medication to help them maintain comfort during
the birthing process.
SIX SESSION PROTOCOL: (p. 68-75)
Hypnotic anaesthesia is indicated for alleviation of pain in the hospital setting, during
dentistry and for patients suffering chronic pain for a variety of physiological or psychogenic
disorders. (p. 81)
HYPNODONTICS: Aaron Moss, DDS, coined the term "Hypnodontics" to dispel the
myths about hypnosis for dental patients who could be helped with this safe, effective and
natural health care alternative to chemical analgesia. (p. 95)
INDICATIONS:
(1) Elimination of the patient's tension, anxiety or fear of pain and related discomfort.
(2) Accustoming the patient to orthodontic or prosthetic appliances after the patient has agreed to
accept them.
(3) Maintenance of the patient's comfort during long and arduous periods of dental work.
(4) Modification of noxious dental habits like bruxism, unconscious grinding of the teeth.
(5) Reduction of anaesthesia or analgesia during dental procedures. (p. 95)
(6) Substitution for, or in combination with, premedication for general anaesthesia.
(7) Amnesia for unpleasant work.
(8) Prevention of gagging and nausea.
(9) Control of salivary flow.
(10) control of bleeding.
(11) Postoperative analgesia.
PRECAUTIONS: The major precaution for the use of hypnosis in dentistry is
symptomatic pain removal. Professional hypnotherapist should not attempt to deal with
symptomatic pain due to oral dysfunction or disease without consulting with a dental physician.
(p. 96)
FUSSY PATIENTS: Fussy patients often put off going to the dentist until the pain or
dental problem can no longer be ignored. These patients for a variety of reasons are fearful,
tense, nervous and anxious before and during the dental visit. Often these fussy patients will
request a tranquilizer or complain of extreme anxiety one or two days prior to seeing a dentist
for a simple check-up. Fussy patients may be a small minority in the population of an average
dental practice however, they often present the majority of problems the dentist encounters in his
daily routine. Fussy patients take extra time and require special consideration by the dentist and
his staff.
Hypnosis can readily ameliorate the tension, nervousness and unreasonable fear of pain
often exhibited by the fussy patient. (p. 96)
PAIN MANAGEMENT: Much of the pain we experience in our daily living is due in
part to stress and tension. Hypnosis has been proven to be effective in the alleviation of stress
and tension. The subjective experience of pain is also related to a variety of psychogenic factors
such as the fear of pin and the conditions and circumstances surrounding the "pain experience."
Hypnosis is indicated for the management of psychogenic pin and also useful for the
management of physiological pain resulting from acute trauma or disease. (p. 191)
Before beginning hypnotherapy for pain management,...the therapist should ask the
patient to provide a medical referral or prescription for pain management. (p. 101)
Pain causes tension and a tightening up of affected areas in the body. Our normal
response to pain is to resist the pain by tightening up even more and becoming more tense. This
exacerbates the severity of the pain experience. Hypnotherapy can help patients learn how to
relax the affected. areas of the body causing the pain and ameliorate concomitant fear, stress and
tension. (p.103)

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