Hidden Depths: The Story of Hypnosis

by Waterfield, Robin

  Hypnotic induction is hard to direct. A hypnotist might be carrying out an induction on Miss Smith, only to find that Mr Jones, an innocent member of the audience, has gone under, as well as or even instead of Miss Smith. In 1946 the BBC prohibited any experiments in mass hypnosis over television, because a discreet experiment in their studios showed that it worked. This is of course not the same as banning the screening of stage hypnotism; but the televising of a hypnotic induction is still banned, in case an irresponsible person hypnotizes the viewing population of Britain. Myself, I doubt there's too much danger, because the TV is a distancing device; otherwise we'd get frightened watching the violence of the lions on nature programmes.

  The only consequence of hypnotherapy that can be severe is symptom substitution. This is when an apparent cure has dealt only with a symptom of an underlying disorder, which then makes its presence felt in some other way. For instance, a man comes for treatment for alcoholism. After a course of treatment he no longer drinks – but whatever it was that made him drink in the first place has not been cured, and may manifest as another addiction, or in some other way. I know this from my own experience: a long time ago I tried self-hypnosis to quit smoking. It worked: I didn't smoke for nine months. But I suffered from recurrent bouts of increasingly violent flu for the whole of those nine months, and they went away only when I took up smoking again. It was only many years later that I was able to give up smoking without suffering any side effects. Once in a blue moon, removing a symptom can have more disastrous consequences. Physician Bernard Raginsky tells a harrowing tale of a man in a psychiatric ward who was suffering from hysterical paralysis of the arm. A doctor hypnotized him and easily freed up the arm, much to the amusement of the other patients in the ward – but that night the patient committed suicide, arguably because ‘his method of defense against some inner conflict had been taken away and he was left vulnerable and exposed to the ridicule of the patients about him’.

  A very few people complain of headaches after hypnosis, but these were probably brought on by the focused concentration required, rather than from anything intrinsic to hypnotism. Another occasional complaint is a stiff neck or shoulder, but that too is almost certainly a result of sitting in one position for a long time rather than of hypnotism itself. Insomnia, a feeling of being ‘spaced out’, and other such after-effects are of equally short duration. Since college students are generally the guinea pigs for experiments in hypnosis, someone once had the bright idea of assessing the after-effects of hypnosis against the after-effects of college life in general. Hypnosis came out as rather more benign.

  In fact, the main dangers are to the hypnotist rather than his subject, since there is a possibility of the hypnotist being accused of all kinds of things after the event. That is why these days responsible stage hypnotists tape all their shows and tell their subjects afterwards what they had them do. Otherwise, a patient may suffer from partial amnesia, and accuse the hypnotist of indecent assault during the amnesic period, for instance. A few years ago the most famous stage hypnotist in the world, Paul McKenna, was sued by a man who claimed that he developed schizophrenia as a result of being hypnotized by him. McKenna won the case, but it was a Pyrrhic victory, in that (I have been told) he had to pay out-of-court costs rumoured to be as high as a million pounds.

  Studies have shown that adverse effects of hypnosis in a clinical setting generally occur only as a result of inadequate dehypnosis, debriefing or follow-up, and that these become problems chiefly when the hypnotist has departed from his usual area of competence. So, for instance, a dental hypnotist who then agrees to help a patient with her nicotine addiction is more likely to see negative after-effects than if he had stuck to dental analgesia. He might find his patient experiencing unexpected amnesia, and not know how to cope with it. He might find that his patient has transferred affection or hostility towards him, or that she was a dependent type who develops over-dependency on hypnosis. If the hypnotist has adequately screened his subject, ensures that she has been fully disengaged from the trance, and throughout the procedure respects his client's integrity, there is no more need to worry about hypnotherapy than there is about any other psychotherapeutic relationship.

  In short, the advantages of hypnotherapy hugely outweigh the disadvantages. Speaking for myself, I would far rather face the minimal disadvantages of hypnotherapy than the unpleasant side effects of a lot of drugs. The dangers can be reduced even further by improved and expanded programmes of research and education, greater clarification of standards for the clinical employment of hypnosis and legal sanctions against quacks.

  Mind and Body

  It's obvious that in thinking about how hypnotherapy works, we need to understand more about the relation between the mind and the body.

  Genetic, environmental, social and other factors are increasingly recognized as having roles in the history of illnesses. Therefore it is no longer acceptable to ascribe a single cause to an illness and the term ‘psychosomatic’, intended to be helpful in healing the rift between mind and body of Cartesian dualism, now seems almost derogatory when used in the causative sense, ‘It's all in your mind.’ What is acceptable to the hypnotherapist is the psychosomatic approach, the assumption that amongst the many factors influencing the efficiency of a person's response to the situation in which he finds himself are his level of arousal, his thoughts about the situation, and his assumptions about himself. These assumptions include his level of self-esteem, his degree of trust in his conscious and unconscious mechanisms to see him through to a perceived, optimistic outcome. The modification of all these responses is within the scope of hypnosis.

  In order to see how something as immaterial as your self-esteem can have a physical effect, we should look, first, at the various nervous systems of the body. The most important nervous system is the central nervous system (CNS), located chiefly in the brain and spinal column. Every part of the body is connected directly or indirectly to the CNS, and the psychological aspect of the CNS is an individual's personality, emotional life and so on. It is easy to see that emotions affect bodily functions: I weep in grief or joy, laugh with pleasure, blush in pride or embarrassment, find that my heart rate and breathing change with anger. In most of us, these emotions and the physical changes come and go. But what about neurotic patients, whose whole lives are given over to emotions? It was found that they developed chronic physical responses – say, paralysis of an arm. The idea that all illnesses had an organic cause had to go, and the concept of a ‘functional’ disturbance, one in which the mind as well as the body was involved, began to creep into medicine.

  It is also easy to see that a functional disorder can lead to an organic disorder. Here is a simple example. Suppose someone is suffering from neurotic paralysis of his arm. This is a functional disorder, but it will soon cause an organic problem, as the arm's muscles and joints begin to degenerate. But appreciating that there was such a thing as psychosomatic illness was one thing; understanding how it happened was another. The picture is still far from complete, but scientists now understand that the CNS (especially the limbic-hypothalamic part of the brain) has an effect not only on the nerve impulses, but on the endocrine glands (which govern health by regulating the transportation of chemicals all around the body in the bloodstream), and on the immune system (which governs our susceptibility to and speed of recovery from illnesses).

  Those two realms [the brain and the immune system] were once thought to be fairly separate – your immune system kills bacteria, makes antibodies, hunts for tumors; your brain thinks up poetry, invents the wheel, has favorite TV shows. Yet the dogma of the separation of the immune and nervous systems has fallen by the wayside. The autonomic nervous system sends nerves into the tissues that form or store the cells of the immune system that wind up in the circulation. Furthermore, tissue of the immune system turns out to be sensitive to (that is, it has receptors for) all the interesting hormones released by the pituitary under the control of the brain. The re
sult is that the brain has a vast potential for sticking its nose into the immune system's business.

  The branch of science which studies the interaction between the mind and the endocrine and immune systems is called psychoneuroimmunology (PNI). Although PNI is as complex a science as its name, it is now perfectly clear that, for instance, stress depresses the immune system, delaying the production of antibodies and making us more liable to viral infections and slower to throw them off; that a secure, warm childhood increases one's immunity; and that bereavement and, perhaps above all, the feeling of helplessness in the face of the difficulties of modern life, lower your resistance to illness. As long as you have control, or think you have control, you have considerably less chance of a stress-related disease. Viewing life as a challenge and being committed to your own health are also important factors; if you don't think so, just read the autobiographical section of psychiatrist Viktor Frankl's Man's Search for Meaning, in which he illuminates the factors that allowed him and others to survive the horrors and degradations of Nazi death camps. Finding life meaningful – as in having religious faith – also helps hugely. When you think that even some forms of cancer are viral, you can begin to see the potential importance of these discoveries. Laughter, as Shakespeare knew long ago, is the best medicine:

  Your honour's players, hearing your amendment,

  Are come to play a pleasant comedy,

  For so your doctors hold it very meet,

  Seeing too much sadness hath congealed your blood,

  And melancholy is the nurse of frenzy.

  Therefore they thought it good you hear a play

  And frame your mind to mirth and merriment,

  Which bars a thousand harms and lengthens life.

  Laughter, of course, should be taken as a cure only in conjunction with proper medical prescriptions from your doctor – but then even your doctor's attitude can influence whether or not you give in to an illness. The mind may or may not be able to move mountains, but it can certainly move molecules.

  A particularly clear demonstration that the body and mind are intertwined came with the development of biofeedback technology. Suppose you are shooting a rifle at a target. You see that your first shot goes left of centre, and so you adjust your sights. That seeing and adjustment is feedback. Biofeedback is just feedback related to the body. By hooking people up to complex instruments which show them what they are doing with their bodies, they can be trained, with surprising ease and rapidity, to change things, even in parts of the body previously thought to be beyond conscious control. Blushers need not blush, warts can be dissolved, migraines vanish and so on. The instruments teach people to see what is going on in their bodies, and to make the appropriate adjustments.

  The mind can affect the body in three ways. It can affect our voluntary behaviour: we anticipate meeting an attractive member of the opposite sex at a party and choose to dress accordingly. It can affect what are called our ‘expressive innervations’: blushing, weeping, laughing and so on. But it can also affect our vegetative responses, the working of our internal organs. To take an extreme example, there are reports that certain yoga masters can raise the rate at which their hearts beat from 80 to 300 beats a minute. This kind of ability – obviously less extreme in most of us – came as a surprise because these functions were supposed to be involuntary. This (in a hugely simplified version) is how it happens.

  The nervous system as a whole has the job of maintaining the body in a state at which our oxygen, temperature and so on are at optimum levels. This state is called ‘homeostasis’, though physicians also talk about ‘allostasis’, which refers to the fact that under different conditions what counts as an optimum level is different. The nervous system is constantly trying to restore equilibrium, although things impinge on our bodies and our minds to disrupt it. The things that impinge and disrupt homeostasis are ‘stressors’, and the ‘stressresponse’ is the body's attempt to restore equilibrium.

  The nervous system achieves this goal by giving different parts of itself different specific jobs. The CNS regulates our relations with the external world, while the autonomic nervous system (ANS) looks after the internal vegetative processes. The ANS in turn has two parts. The parasympathetic division is concerned with the conservation of the body: it does things like stimulating digestion so that we absorb food and excrete waste matter, or like checking the level of sugar in the liver. The sympathetic part of the ANS is responsible for the functioning of the internal organs in emergency situations; it shuts down things like your digestive system (which is unnecessary in the circumstances, and is handled by the parasympathetic system) and focuses only on fight-or-flight responses. You could say that the parasympathetic nervous system slows down the functioning of the body, while the sympathetic nervous system speeds it up.

  The division of the ANS into sympathetic and parasympathetic parts has important consequences for understanding how psychosomatic illnesses work, and how, just as certain pathological micro-organisms have a special affinity for certain organs, so certain emotional conflicts afflict certain organs too. Anger is an emotional response to an emergency situation, a perceived threat; it affects the internal organs in such a way as to get the body ready to fight. Now, suppose we repress that anger, as we commonly do in civilized societies: the body has been got ready to fight, but no fight has taken place. Fine – or at least fine for most of us, since we don't spend all that much time in a state of anger. But what about those who suffer chronically from repressed anger? In the due course of time, just as we saw above with the example of the paralysed arm, the effect of more-or-less constant anger on the internal organs may well create organic disturbances. It won't necessarily create organic disorders, because nothing in this new medicine is straightforwardly mechanical; other factors, such as diet, or having hobbies or a supportive family environment, can offset the risk.

  Doctors now have to look at personality types, and at lifestyles and how they might be changed to assist healing. Ayurvedic medicine in India has always known this, but now even arch-rationalists among the Western medical community are, at least to this extent, holistic. Even cultural factors play a part in some disorders: anorexia nervosa is predominantly found among middle-class teenage girls; Jews of an eastern European origin suffer more from nervous disorders than others. Typically, a person who affects his neuroendocrine systems by means of the sympathetic nervous system will suffer from things like migraine, hypertension, hyperthyroidism, cardiac neuroses and arthritis, while a person who does so by means of the parasympathetic nervous system will find himself suffering from things like peptic ulcers, constipation or diarrhoea, colitis, fatigue and asthma. This is not to say that all ailments and illnesses are ‘psychogenic’ (caused by the mind), but it is to say that a number are, and that certain personality types are more liable to certain illnesses than others. This is a controversial area: some doctors think that there is, for instance, a cancer-prone personality and an arthritis-prone personality; others are more cautious and speak only in a more general fashion of the type of personality – basically one which is subject to all kinds of stresses – which is liable to have an adverse effect on the immune system, and of another type which is stress-resistant.

  Of course, many diseases are caused by particular microorganisms, and there are powerful medicines available to destroy those organisms. But the psychogenic origin of some human illnesses has long been known, and so have the psychological benefits of a healthy attitude. In medieval times both illnesses and cures might be attributed to the imagination, and in the nineteenth and twentieth centuries the remarkable cures achieved by hypnotists brought the point home forcefully. We've long known that moving house, getting married (or divorced) and so on are stressful and likely to cause an illness; we've long spoken of emotions in physical terms – ‘cold feet’, ‘butterflies in the stomach’ – and known that people can die of a broken heart. You look around at your family members and see that it's the cheerful one who doesn't get
the cold everyone else is suffering from. You've heard of ‘phantom limbs’ – of how a person whose leg has been amputated can still feel pain in the missing leg.

  But understanding the whys and wherefores only really began in the 1930s, with research accelerating since the 1960s. Until recently, then, as the name implies, the autonomic nervous system was thought to be out of reach. Liébeault and Bernheim, ahead in this respect as in so many others, suggested that it was not as independent as it might seem; but they lived decades before this idea could be proved. So did the respectable English doctor Hack Tuke, who in 1872 published his Illustrations of the Influence of the Mind upon the Body in Health and Disease. But now psychosomatic medicine is a fast-developing area of research. In the seventeenth century the French philosopher René Descartes tried to separate the mind from the body, but that is no longer possible. We are each a unit of mind and body, and changes in one system result in changes in the other. In a nice turn of phrase, PNI specialists talk of ‘the biology of hope’ and ‘the biology of belief’. PET scans have shown that remembering a visual event activates the same parts of the brain as the original seeing; in other words, the supposedly ‘purely mental’ activity of remembering has the same physiological result as the supposedly ‘purely physical’ activity of using the senses.

  We all knew most of this anyway, but it is nice to have it confirmed by the men and women in white coats. But the point is this: if the mind can help to cause illness, can it also help to cure it? This is where hypnotherapy comes in. It can help, obviously, with psychosomatic illnesses; and it can help, psychosomatically, even with illnesses that were not psychogenic in origin. But how does it do so? The problem is, in a sense, one of communication. If I know only English and you speak only Urdu, we need a translator before we can communicate. Similarly, you could say that the body speaks one language and the mind another. Yet it is clear that they do communicate. Discovering the biology of how they do so is the job of PNI, but hypnosis research, especially by Ernest Rossi, an associate of Milton Erickson, has come up with some interesting results too, to suggest just how hypnosis acts on the brain's structures and chemistry to facilitate that communication process and aid healing. In brief, Rossi believes that hypnosis acts on the limbic-hypothalamic part of the brain, which coordinates and can alter mind-body interactions, and that it achieves this coordination and these alterations by normalizing the body's ultradian rhythms, disruption of which is a major cause of stress-related diseases. Our bodies are subject to a rhythmic cycle of roughly 90–150 minutes, from a peak of high energy down to a trough of low energy and back again. If we go along with these cycles (by, for example, resting from strenuous mental or physical activity when we're in the trough), we avoid stress. Hypnosis, according to Rossi, puts us back in tune with our natural rhythms.