How can we improve the reach of clinical hypnosis in medicine and pediatrics?
Hypnosis: An aid in working with patients with narcolepsy
Narcolepsy is a primary neurological sleep disorder characterized by excessive daytime sleepiness, and in a majority of patients, cataplexy, which is sudden muscle weakness brought on by strong emotion. While often thought of as an adult condition, narcolepsy can be present at any age and may occur as often as 1 in 2000 individuals. Regardless of age, its effects are far-reaching, resulting in missed school or work days, poor school or work performance and all associated ramifications. In children and young-adults, narcolepsy can masquerade for years as anxiety, depression, attention deficit disorder and even bipolar disorder, thus delaying diagnosis. Most patients diagnosed with narcolepsy receive significant benefit from standard medication. In addition to medication, however, this article describes promising roles for clinical hypnosis in the care of young patients with narcolepsy, including through teaching them how to have more control over their sleepiness and the emotions that can induce cataplexy, while minimizing side effects that can occur when using narcolepsy medication.
A vision to enhance self-regulation in children: The promise of pediatric hypnosis
Pediatric hypnosis practices are a valuable tool for enhancing emotional self-regulation and promoting resilience. Hypnotically informed materials, toys, and language are simple ways to encourage relaxation and stress management. By learning hypnosis skills such as becoming imaginatively absorbed in imagery, "belly breathing," and using simple toys to promote muscle relaxation, children can access natural and novel ways to navigate life's challenges. An example of these hypnotically informed materials and skills training exercises can be found in Comfort Kits (developed by Dr. Karen Olness circa 1996 and widely distributed by Drs. Culbert and Olness since 2004, used by thousands of children in hospitals and in community settings following natural disasters and wars. Extending this supportive tool and self-hypnosis training into schools presents an opportunity to introduce children to self-directed stress management skills in a practical and convenient manner. Training children to use hypnotically informed self-regulation skills begins to fill the gap between the need for mental health services and available resources. By incorporating hypnotically informed stress management training and self-hypnosis practices into schools, we can equip children with essential tools for improved mental well-being, particularly when they need psychological first aid. Using hypnotic practices and skills can help children manage difficult experiences and develop a sense of comfort and control. Next steps include looking at the feasibility and efficacy of positioning self-directed self-regulation practices (like those found in Comfort Kits and used by clinicians trained in therapeutic pediatric hypnosis) in schools, including through consultation with experts in curriculum development and assessment.
Why all child clinicians should be hypnosis-informed. Advantages, benefits, creativity, & development: ABC's & D
This paper advocates for all child clinicians to learn hypnosis skills as a distinct advantage to enhance their understanding of child development in the treatment of children. It examines the interface of child development and hypnosis. Clinical hypnosis with children follows the child's developmentally determined self-expressions. The clinician must tend to the way in which the child expresses a "problem," structuring treatment goals and pace, and evoking and utilizing opportunities for therapeutic suggestion. This article defines hypnosis as a set of skills and principles. It defines trance as psychoneurobiological plasticity. Eight variables, shared across therapeutic interventions, are explored in the context of working hypnotically with children and adolescents. These are 1) Relationships, rapport, attachment; 2) Attention, absorption, focus; 3) Use of language and therapeutic suggestions; 4) Expectations; 5) Resources; 6) Dissociation and Unconscious; 7) Trauma parallels with trance; 8) Development. Becoming hypnosis-informed is the ABC's, & D, for child clinicians. A case illustrates the application of skills, principles, and variables.
The "well-sibling" syndrome: Hypnosis for the siblings of special needs children
Often overlooked by caregivers because of their ability to adapt to a challenging home life by making few demands themselves, the siblings of special needs children have unacknowledged needs of their own. They often are reluctant to participate in therapy because of their self-concept of having to be the "normal" or "perfect" child. Therapy with these children requires non-pathologizing and attuned rapport building focused on creative self-exploration without requests for change. Two composite case vignettes illustrate the power and versatility of clinical hypnosis to facilitate new learning about becoming visible in the therapeutic relationship and beyond.
Treatment of plantar warts using medical hypnosis: a case report
In this case study, we describe the case of an adult patient who struggled with persistent warts on the plantar surface of the foot for several years. All medical therapies were exhausted, so the patient turned to medical hypnosis as a last resort. Despite years of unsuccessful conventional medical treatments, the patient experienced complete resolution of all his warts after three sessions of medical hypnosis. The suggestions used in the treatment included strengthening the immune system, increasing blood flow in the foot, visualizing immune mechanisms destroying infected cells, and the regrowth of healthy tissue. After 3 years, we are still in contact with the patient and he reports no recurrence of the disease. This case report adds to the existing body of the literature supporting the use of medical hypnosis in the treatment of warts. It demonstrates that medical hypnosis can be a valuable complementary or alternative treatment option for patients with persistent warts who have not responded to conventional therapies. It also highlights the need for further research to better understand the mechanisms by which hypnosis influences the resolution of warts and to identify the most effective types of suggestions for treatment.
Exploring hypnotist trance: the experiences of skilled practitioners
Milton Erickson first conceptualized the hypnotist trance (HT) as a unique psychological state developed in clinicians during hypnosis sessions. This qualitative study aimed to investigates HT through the experiences of 12 skilled Clinician Hypnosis Specialists (CHS). Data were collected via semi-structured face-to-face interviews, exploring participants' attitudes toward HT, its impact on their practice, and their strategies for developing and regulating it. Thematic analysis revealed that most CHS view HT as enhancing empathy, communication, and therapeutic effectiveness. However, challenges such as time distortion, hypnotic regression, and countertransference issues were also noted. The study highlights HT's dual nature - offering significant therapeutic benefits while presenting challenges that need careful management. These findings emphasize the importance of comprehensive HT training in hypnotherapy education and advocate for further research to explore HT across diverse contexts and expertise levels to deepen understanding of this complex phenomenon.
Use of the 49word protocol (alert hypnosis) to reduce anxiety: a case series
David Wark's latest iteration of alert hypnosis, the "49word protocol," reduces performance anxiety. Several case studies have demonstrated improvements in the behavioral responses of subjects using this technique. This case series focuses on the more immediate emotional impact, such as the reported reduction in anxiety, on subjects who have benefited from David Wark's "49word protocol." In this study, we compare the benefits of the "49word protocol" to those of the mindfulness protocol. We compared the anxiety-reducing elements of alert hypnosis (49word protocol) and a mindfulness technique (Otani, Akira) called "touch and return." The Profile of Mood States tension and anger-hostility subtests were administered before and after each intervention as self-reported measures of mood and anxiety.
A case study of hypnosis for tongue thrusting: confusion of tongues
In this case study, the author reviews the benefits of hypnosis for a middle-aged female suffering from an unwanted habit of rubbing her tongue against her teeth, also known as tongue thrusting. At the time of the initial consultation, she had already undergone several months of physical therapy for a lifetime habit of tongue thrusting. During the consultation, she expressed complaints of pain and chronic irritation, along with feelings of distraction and hopelessness regarding treatment. Treatment included one session after initial consultation and hypnotizability testing, at which time patient scored low on Elkins Hypnotizability Scale (EHS). She reported to her psychiatrist the unwanted habit ceased following one follow-up hypnosis intervention. She retained habit change for at least 1-year following hypnosis treatment.
Integrating mindful self-hypnosis with resistance training to reduce stress: a case study
This case study explores the effects of a combined intervention involving Mindful Self-Hypnosis (MSH) and Resistance Training (RT) on perceived stress levels and well-being in a university student. The participant, Ms. P, engaged in a 12-week program comprised of two weekly RT sessions accompanied by MSH inductions. Perceived stress levels were evaluated using the Perceived Stress Scale (PSS), and well-being was assessed using the WHO-5 Well-Being Index. Intervention sessions were designed to enhance focus and calmness, along with imagery of performing the workout. Results from the case study reveal a notable reduction in Ms. P's perceived stress levels over the intervention period as indicated by a 30.8% decrease in PSS scores. Additionally, Ms. P demonstrated an improved strength in leg press 1-repetition maximum by an increased weight of 153.9%. This case study suggests that integrating MSH and RT may offer a beneficial strategy for stress reduction and enhancing well-being in university students. The findings underscore the potential applicability of this intervention to address stress-related challenges in this population. Future research with a larger sample size is needed to determine general efficacy of an MSH + RT intervention for stress reduction.
Sleepiness may predict hypnotizability, while personality traits do not
Sleepiness and personality traits have been controversially reported as associated to individual hypnotizability level i.e. receptiveness to hypnotic suggestions and behave accordingly. In this study, we further investigate the relationship between the level of general daytime sleepiness and personality traits with the level of hypnotizability. Seventy-eight healthy young volunteers (34 women) completed the fast assessment of general daytime sleepiness and personality with the Epworth Sleepiness Scale and the 10-item Big Five Inventory respectively, and underwent hypnotic evaluation through the Harvard Group Scale of Hypnotic Susceptibility Form A (HGSHS:A). Main findings revealed a correlation between sleepiness and hypnotizability levels, and no influence of personality traits. Interestingly, women exhibited higher levels of hypnotizability compared to men. Taken together, these results suggest that sleepiness assessment might be considered as a predictive tool to hypnotic suggestions, which would offer practical insight for enhancing hypnosis intervention efficacy.
Age regression in the treatment of needle phobia: a case report
Trypanophobia (needle phobia) frequently occurs because of negative encounters with medical procedures and/or needles. Trypanophobia ranges in severity from causing mild anxiety, including apprehension about medical procedures, to severe anxiety and complete avoidance of medical care. In this case report, we describe a 29-year-old who underwent hypnosis-facilitated age regression therapy to improve his trypanophobia. Through the guidance of his subconscious, he realized his reaction to needles may not have been directly related to a difficult medical procedure he had undergone at the age of two. The patient's subconscious turned his attention to the anxiety he felt from being separated from his mother at the time of the procedure.
Hypnotherapy influence on maternal psychological, breastfeeding, mRNA-OXTR expression, and OXTR protein
Hypnotherapy has emerged as a potential alternative to improve exclusive breastfeeding rates, particularly in countries like Indonesia where they are below optimal levels. This study aims to evaluate the impact of audio hypnotherapy on the psychological, exclusive breastfeeding behavior, the OXTR protein and mRNA expression gene OXTR in mothers of infants aged 0-6 months. This study employed a Pragmatic Randomized Controlled Trial design, conducted from November 2022 to May 2023 in 11 primary health centers. The study population included breastfeeding mothers with infants aged 0-6 months, with a total sample size of 70 respondents who were randomly divided into intervention (received audio hypnotherapy) and control groups (received standard care). The psychological condition was measured using the Depression Anxiety Stress Scale. Exclusive breastfeeding behavior was assessed based on both quality and quantity. Genetic factors were evaluated through mRNA OXTR expression using real-time PCR and protein OXTR levels using ELISA. Analyzing data using linear and logistic regression models. Both bivariate and multivariate analyses revealed significant differences in psychological condition ( < .0001). There were big differences in the exclusive breastfeeding behavior ( < .0001), as well as in the amounts of protein OXTR and mRNA expression of the OXTR gene ( < .0001). We recommend the implementation of audio hypnotherapy as an effective complementary therapeutic approach to manage the psychological well-being, exclusive breastfeeding behavior, the mRNA expression of the OXTR gene and levels of OXTR protein in mothers of infants aged 0-6 months.
Associative learning, priming, and the fostering of adaptive flexibility
Therapies, including those incorporating clinical hypnosis, occur in the context of consciously mediated interpersonal interactions. While the presence of the non-conscious and its content is often acknowledged, how non-conscious content is accessed and utilized in the training curricula to which clinical hypnosis students are exposed is under-emphasized. This article explores two phenomena - priming and the innate tendency of the human brain to engage in associative learning - that, when incorporated into the interpersonal process that constitutes clinical hypnosis, could expand and enrich outcomes for clients. The processes by which non-conscious processing shapes conscious experience, the role of the social environment in prioritizing and predisposing certain content that later makes its way into consciousness, and examples of how that content can be used to enhance clients' adaptive flexibility are discussed.
The role of hearing and listening in hypnotic responsiveness
The hypnosis literature emphasizes features of suggestion, induction, and communication that are described as evoking heightened responsiveness on the part of the subject or client. This article explores what is often overlooked: to have an effect, the subject must not only hear the suggestion but listen to it. The process of listening is described across multiple levels ranging from the acoustic signal to its transduction into a meaning-filled and motivationally enriched message that spurs action. That journey traverses challenging terrain, with numerous obstacles that serve to maintain past habits and response patterns, despite a client's stated desire for adaptive change. The article highlights those obstacles and then provides descriptions of five language structures that can reach the client consciously or non-consciously, but always in ways that increase the odds that the therapeutic messaging is packaged in a manner that optimizes it being "heard," absorbed, and enacted. Applications of each language structure are provided using relevant clinical case examples.
Hypnosis facilitates psychosomatic improvement in a patient with treatment-resistant idiopathic tinnitus
Chronic tinnitus, also known as phantom sound perception, is a pervasive and often debilitating condition, affecting 15 to 20% of the population. Due to its idiopathic and persistent nature, chronic tinnitus is frequently associated with co-occurring psychiatric disorders as well as decreased sleep and quality of life. Additionally, heterogeneous presentations of tinnitus create challenges for treatment. In this paper, we present a case study of a 70-year-old female patient who presented with severe bilateral tinnitus over a period of 5 years. After failing multiple treatment trials such as transtympanic electric stimulation, acupuncture, Eye Movement Desensitization and Reprocessing, and medication, the patient found relief only through hypnotherapy. Results may be explained by alterations in interoceptive processing, increased cognitive flexibility, or somatosensory changes, with corresponding changes in functional neural structures. Given the results of this case study, we recommend hypnosis as an alternative or adjunct to current treatment modalities for tinnitus and further investigation in this area.
Re-thinking the treatment of depression: have we been misinformed about antidepressants? A webinar discussion with Irving Kirsch, Ph.D. and Michael D. Yapko, Ph.D
This article provides an edited transcript of a moderated discussion between depression experts Irving Kirsch and Michael Yapko regarding the role of antidepressants in the treatment of major depression. It includes references to the role of expectancy and the merits of hypnosis in treatment. This presentation was sponsored by , an Australian-based digital therapeutics company (mindsethealth.com) and took place online on March 28, 2023. As a webinar offered at no cost, it was open to anyone with an interest in the subject. Dr. Kirsch described his landmark research on the placebo effect and its curious relationship to the presumed merits of antidepressant medications. Dr. Yapko discussed the limitations of drug treatment based on the substantial evidence indicating that depression is much more a social problem than a medical one. The moderator for this discussion is Claire Davidson, who serves as the Research Lead at . Drs. Kirsch and Yapko both serve on the Scientific Advisory Board.
Guest editorial: hypnosis in treating depression: the despair of young people
Hypnotically enhancing behavioral activation in the treatment of depression
Depressive disorders are common conditions associated with high personal and economic burdens. The best treatment outcomes occur in patients receiving both psychotherapy and antidepressant medications. Behavioral activation is one approach within the most widely available and studied psychotherapy frameworks (cognitive behavioral therapy, CBT) utilized for depression, and is effective in treating depression even in isolation from the rest of the CBT approach. Many hypnosis treatments for depression have been developed to incorporate various CBT techniques, including behavioral activation. However, research regarding the applications of hypnosis to facilitate behavioral activation has been slow to emerge. Addressing this relative gap in the literature may be possible through a broader review of the relevant literature. There is quality evidence speaking to the efficacy of diverse clinician-guided visualization or imagery exercises in the treatment of depression by means of behavioral activation. While not explicitly hypnosis, the similarities of these interventions to more typical hypnosis interventions are highly salient. Clinicians and researchers interested in hypnosis's applications to treating depression would benefit from adopting a more comprehensive consideration of the relevant literature.
Future focused strategies in treating depression
Depression commonly features the experience of hopelessness and a loss of the ability to imagine and believe in one's positive future. This article considers this important feature of depression and how effective recovery from depression includes the restoration of hope and a belief in actualizing a positive future. It provides in detail a treatment strategy that is focused on cocreating with the patient a positive therapeutic outcome in the patient's future and encourages patients to internalize a representation of the future experience of recovery and restoration of hope. This approach is described in detail and begins by guiding the client suffering from depression to experience a positive therapeutic outcome during hypnosis. This is followed by having the client internalize this positive resolution and recovery and integrate this experience on conscious and subconscious levels. As the client "returns from the future" to the present, bringing back with them this experience of having achieved a resolution and recovery from depression, this corrective emotional experience can affect their daily behavior in the present arising from a significant change in thoughts, feelings, and actions. Case examples that illustrate the use of the future focused strategy in clinical practice are included.
Symphonic resonance: optimizing hypnotic suggestions with music to harmonize depression and rumination
Depression is a complex, multi-dimensional disorder that is recognized as a leading cause of human suffering and disability. A wide variety of treatments, both physical and psychological, have been developed to lessen the burden on depressed individuals and those they may affect. Hypnosis has been shown to be an effective vehicle for delivering psychological treatments for alleviating depression in a number of studies, but it is always a challenge to increase the effectiveness of suggestions given in hypnosis. The addition of music to enhance hypnotic approaches has been studied and received substantial support for its potential effectiveness. This article explores the merits of incorporating music into the delivery of hypnosis sessions and offers specific recommendations for the use of rhythmic methods as a means of deepening hypnosis and increasing the impact of one's suggestions for reducing depressive ruminations. Five case examples are provided to illustrate the successful use of this integrative approach to treatment.
Applying hypnotic associative - dissociative techniques in psychotherapy for psychosomatic symptoms
Patients experiencing psychosomatic symptoms frequently have difficulty obtaining correct treatment. They are often reluctant to partially attribute their symptoms to psychological factors and, as a result, delay referrals to mental health professionals. Furthermore, the dropout rate from therapy is high and relapses are common. Hypnosis is a complex psycho-physiological phenomenon. Hence, hypnotic psychotherapy may play an important role in managing and treating psychosomatic symptoms and disorders that involve both the mind and body. In the current study, we propose a clinically oriented, four-phase, hypnotic approach, the hypnotic associative-dissociative approach (HADA), which may be useful in encouraging more patients with psychosomatic problems to engage in psychotherapy, thereby achieving effective long-term effects.
Self-image Building protocol for treating depression in hypnosis
This article explains the method of treating depression with an intervention called Self-Image Building. Several antecedents or correlates of depression are briefly discussed as they form a gestalt backdrop for the many therapeutic approaches that have been researched and promoted as treatment or solutions to depression. The rationale and construction of the intervention is illustrated with a brief case example. Self-Image Building is discussed in the context of other theories of self-image, over-generalization, negativity bias, and as an internal discriminative stimulus for performance. Self-Image Building is used to construct an actual referent and not a cognitive abstraction about how people make conclusions about themselves.
Hypnosis in treating depression: Applying multidimensional perspectives
Creating critical palliative hypnotic adjustments: temporality, hope, and meaning
When cure is not possible, suffering often takes form as pain and distressing symptoms, death anxiety, existential distress, and meaninglessness. This paper describes important elements connecting palliative care principles with hypnotic approaches designed to provide support, palliate symptoms, foster hope, and address existential and spiritual distress. We offer a developmental process for and examples of hypnotic suggestions customized to simultaneously ameliorate physical symptoms and address profound distress arising from physical, social, psychological, existential, and spiritual challenges commonly encountered in terminal illness. This process necessarily requires use of the patient's vernacular to hypnotically deepen inwardly focused attention in order to explore and access internal resources, reframe negative automatic thoughts, and create positive meanings for experiences that disinvite suffering. Effective delivery utilizes cognitive tools such as clinical and scientific principles, artistic forms such as poetry and haiku, and a thorough assessment of needs. This approach strategically addresses an overarching dimension of temporality through suggestions that sequentially address multiple sources of suffering that are layered throughout the various dimensions of self. This requires focus and presence in the present moment; it ultimately fosters a therapeutic relationship that can safely hold past painful experience as helpful new meanings emerge that build resiliency for that experience. This work benefits from inwardly focused concentration and a holding environment to identify and access helpful inner resources, which include an increasingly malleable relationship with temporal memories.
Spiritual healing in palliative care with clinical hypnosis: neuroscience and therapy
The neuroscientific features of inner consciousness, including its role in suffering and in accessing states of mind that relieve suffering; details salient meditative and hypnotic approaches appropriate for palliative settings of care; discusses core principles and orientations shared by effective approaches; and proposes early integration of hypnotic training as a coping skill and a platform for spiritual exploration, as desired.
When hope is lost
Rehabilitation Medicine and Palliative medicine have much in common as both specialties deal with loss and impending loss related to incurable medical conditions. Significant losses are encountered by patients in both rehabilitation and palliative care settings, and often threaten quality of life, hopefulness, and resiliency. The losses are related to what the patient has identified as self. In this article the author suggests a way of approaching loss and suffering that incorporates, mindfulness, Disidentification and Ego-State work to help preserve a sense of self that is not identified with what is happening to the body.
Palliative hypnosis approaches in the symptomatic treatment of amyotrophic lateral sclerosis (ALS)
Amyotrophic lateral sclerosis (ALS) is a rare, incurable, and ultimately fatal, devastating, progressive degenerative neurologic disease. It causes upheaval in the lives of patients and family caregivers alike. Palliative care can play an important supportive role in the care of patients and families dealing with the devastation of this illness. Clinical hypnosis has demonstrated benefits in treating the symptoms associated with severe chronic illness. There are, however, few studies looking at the benefits of clinical hypnosis in treating the symptom burden of ALS. This article describes palliative care and how it can provide an additional layer of support to seriously ill patients. A brief review of previous studies of hypnosis in the supportive, symptomatic treatment of ALS is provided, followed by a description of a case series of 30 Veterans who received clinical hypnosis and self-hypnosis training as a complementary treatment for the symptoms of ALS. Details of three case histories are included to highlight and discuss specific strategies and emblematic clinical responses. There is evidence that clinical hypnosis can benefit ALS patients and family caregivers struggling with this devastating illness.