The goal becomes dissociation from conscious logic, an “altered state of consciousness” with focused attention, and in which a subject lowers critical testing and is more open to suggestions. Even though hypnotizability has measurable characteristics of a trait, and direct suggestion works best for those who have this trait, the ability to go into a state of trance sufficient to analyze implicit imprints with ideomotor signals seems to be almost universal.
Confusion of the conscious mind is relieved by just turning it off. Milton Erickson could rapidly induce an eyes open trance with his confusion techniques.
Eye fixation with an upward gaze tires the weak levator palpebrae muscles so that the eyes ultimately close from fatigue, and the illogical idea that they are closing because the hypnotist suggests it is an abandonment of conscious logic.
Eye roll induction is unique. With eyes closed and eyeballs rolled upward, it is almost impossible to think of a mathematical problem or anything logical. For me, it rapidly brings on a meditative state where my mind can be blank (left brain turned off), or I can do ideomotor self-analysis or analyze my own dreams.
Repetitive meaningless stimuli like a swinging watch, a blinking light (particularly if timed with alpha waves), or a military drum beat require no logical thought or attention, and lead into trance-like states requiring no logical thinking. Counting sheep to turn off the day and get to sleep is amusing, but historically it works. Monotonous verbal repetition acts the same. Dull lectures induce daydreams, and the best time to pass the plate in church is right after the sermon, when we either feel inspired by the message or guilty for dozing off.
Back drop induction is used often by stage hypnotists because it is almost instantaneous. Asking the subject to “Imagine that your body is a board, standing on end” has the compliant volunteer in an instant daydream, with left brain logic turned off.
Trauma. The first law of nature is self-preservation. When there is a perception that life is threatened, nothing else matters. Fear is the strongest of all emotions. We have fire drills because in an emergency we immediately drop logic and go into automatic, and a pre-programmed escape plan avoids desperate measures like jumping out of a tenth story window.
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36. First induction double bind
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I don’t like to argue with a patient about whether or not he/she was hypnotized.
I start my first induction with a question. “Do you know what you are most likely to do that will interfere with this?” “No.” “You’re likely to try too hard. Or you may try to be the best patient I ever had. I want you not to give a hoot whether or not you do it right, and I want you to avoid any attempt to test it because you have to be out of trance to test whether you are in. So just do what I ask you to do and let it happen” (Thing 5).
If the patient subsequently protests that he/she wasn’t hypnotized, I agree. The only way he/she would know is to be focused on that issue and testing. So I say “Of course not. You were testing, which I told you interferes with success. Next time, you can see what happens when you don’t give a hoot, and just do what I ask you to do. On the other hand, there’s nothing wrong with getting well without ever going into trance, except that it takes a lot longer and I make more money.”
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37. Intake question is like a
Google – ask the wrong search
word, and get a useless answer
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On the same day, I Googled “anesthesia” (American spelling) and got 10,900,000 references, then used “anaesthesia” (British spelling) and got 3,080,000 references.
In trance, patients tend to assign very literal meanings to the words that describe the way they picture their lives. This has led me to devise a carefully worded intake history that evokes maximal clues to the patient’s subconscious content. The wording is on page 25 of Ewin and Eimer (2006).
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38. The patient’s name
carries emotion
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I ask a new patient “What do you like your friends to call you? May I call you that?” I’m expecting to ask some intimate questions, and this is an indirect suggestion that I want to be thought of as a friend, and to have permission to enter the circle of friendship. I’m amazed at how many people don’t like their given names, and don’t even like some nicknames that their “friends” call them.
Pronunciation matters. I did a demonstration in England with a doctor named Kathleen, who preferred the English form with the accent on the first syllable. I inadvertently used the Irish form, with the accent on the last syllable, and I could feel the loss of rapport even though I didn’t realize what I had done until later. The IRA was bombing England at the time, and my demonstration bummed out also.
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39. Importance of the last
question on the intake
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The last question of my intake is “Is there anything else you think I ought to know?” Invariably, if the patient answers it, he/she is telling me the problem.
It’s as though the subconscious is saying “Since you never asked the right question, I’ll tell you what the problem is.” If the answer is “No,” I hope I took good notes, because the patient feels he/she has already told me what’s important, even if it was just in a gratuitous clause.
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40. One issue at a time
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Patients often have multiple complaints, sometimes even bringing in a written list.
In doing hypnoanalysis, when this occurs I ask “If you could solve one problem today, what would it be?” The answer is what’s on top of the patient’s mind, and it’s what we should concentrate on.
Often, it’s not what seems most important to me, but as we unravel it some of the other issues usually fall into place or lose some of their importance.
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41. Piloerection test
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Every hair cell has a tiny muscle called a piloerector. It’s what makes a cat’s hair stand up when it “bristles” in defense.
When I do an intake on a new patient, if the hair on the back of my neck stands up, I won’t hypnotize that patient. It means that I don’t like him/her, and I think it’s best for us both if I refer that patient to another therapist.
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42. Value of marathon treatment
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Helen Watkins taught us the value of this intense form of hypnotherapy. As a new patient gives the intake history, all sorts of subconscious memories, associations, and feelings are being scanned and are fresh. Continuing with therapy at this time is much more productive than weekly visits.
My outcomes are regularly better and use less time when I set up four to six consecutive hours with a patient. Strike while the iron is hot! At the least, I schedule my initial visit for two hours, and make sure to include an induction (Thing 24) with some ego strengthening suggestions.
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43. Return to actual date from
an age regression
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When a patient is in a true regression and abreacting in the present tense, the suggestion “Come back to today” may not end it because today is the day he/she has regressed to, and confusion results.
One should be specific and say something like “Time now to return to today, November 12, 2009, here in my office and feeling safe and secure.”
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44. Amnesia is a test for analgesia
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When a patient goes deep enough to have the numbers disappear as he counts backward, he is deep enough to take a suggestion to produce analgesia sufficient to suture a laceration, relocate a dislocation, or manipulate a fracture.
Involuntary muscle spasm fights against fracture reduction, a
nd the relaxation obtained with hypnosis makes it easy. I usually inject some local anesthetic into the hematoma of a Colles’ fracture of the wrist, since it makes me feel more comfortable.
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45. Make the subconscious
issue conscious
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Prescribe the symptom. “Try to have the tic.” This gets the benefit of the word try (see Thing 6) and what previously was an unconscious motor activity now becomes a conscious issue, except that it seems silly to consciously do it.
I have a couple of patients who are denizens of the French Quarter. They worry that they will not be able to get into the Mardi Gras costumes they have made so carefully. They come in early December, fearful of gaining weight during the holidays. I tell them to go ahead and enjoy the parties and even gain a little weight, and return on January 2 and we can get the weight controlled. Surprisingly, they’ve usually lost one to three pounds on the next visit, subconsciously controlling their intake without effort, and not feeling deprived.
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46. Let the patient do his
own brainwash
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Fred Evans (1989) reported an interesting technique he literally called a “brainwash.” I have gotten good, quick results using this with patients who come in with a long list of bizarre symptoms.
I say something like “You sound like you have accumulated so much crap in your brain that you can’t sort it out. Why don’t we do a brainwash and start off with a clean slate?” Then, in trance, the patient pictures a zipper around his/her head, we unzip and open the skull, and there is this awful, ugly, dirty brain. I gently take it out and place it in a bucket of lukewarm water, hose out the base of the skull until it’s glistening clean, and then go to the bucket. I used to be ever so gentle, knowing as I do how delicate the brain is. I would use a soft sponge and mild detergent, and perhaps a cotton swab in the gyri to get it clean, then return it to the skull and zip it closed. Then we would pick one problem that really mattered and work on that (Thing 40).
Then I learned something. A patient told me I didn’t know anything about really cleaning up, and his result was poor. So I said “Teach me how to do it right,” and took him back and let him do the cleaning. He took a wire brush, some strong detergent, and hot water and really did a (daydream) number on his brain. He was tired of all the crap. I just shut up while he was focused on this, and asked for a nod of his head when he was through scrubbing. The clean brain was replaced, and the scalp zipped shut. It worked fine and he made a nice recovery. Since then, I have always let the patient do the cleanup.
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47. Laughter enhances immunity
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The autoimmune disorders (lupus, rheumatoid arthritis, psoriasis, etc.) are the most difficult chronic diseases we treat in medicine. Stress is implicated as part of the origin of most, and removing it often produces remission. The medicines that suppress immune function are powerful and usually have dangerous side effects. We need a healthy immune system to protect us from infections.
Specific stress reduction can be done by hypnoanalysis, but there is a universal non-specific remedy that is too often overlooked – laughter. Norman Cousins cured himself of ankylosing spondylitis with humor and the stress vitamin, vitamin C. His little book The Anatomy of an Illness (Cousins 1979) should be required reading for everyone in the healing professions. We benefit when we get serious about humor.
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48. Laughing place
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In hypnotic imagery it is common to seek a “safe place,” a “special place,” or even a “happy place.” All of these are somewhat protective, internal, and self-soothing. Laughing is more a shared activity and gets us out of ourselves. A real smile starts in the eyes (looking outward), and projects an altruistic feeling of warmth – what we feel when we smile at a pet, a child, or a loved one.
For many years I have obtained good results directing my burned patients to go to their laughing place while I do all the work. In the Disney movie Song of the South, Br’er Rabbit sings “Everybody’s got a laughing place.” He was “born and bred” in the brier patch, a place where nothing can bother, nothing can disturb.
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49. Use patient’s own words
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This is the left brain title under a right brain picture (Thing 58). If he says he stammers, for him it’s different from stuttering, even though I consider them synonymous. If he says he “upchucks,” I don’t ask about vomiting or throwing up. If his headaches are “whoppers,” I don’t try to redefine them as migraines. I ask how often he has a whopper and what brings on a whopper. For him, migraines are something other people have.
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50. You pray for me, and
I’ll pray for you
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This has been a valuable strategy for me when treating religious patients who tell me they pray every day to get well. Nothing has happened after many prayers and the patient is in my office for treatment.
When I pray for myself, my subconscious mind starts rationalizing God’s possible reasons not to grant my wish, because of any number of transgressions. But when I pray for someone else I have no negative feedback, and feel every expectation that something good will happen. So I suggest that we do something different, saying something like “God works in many ways. Would you be willing to approach Him in a different way, and instead of praying for yourself, ask God to give me the knowledge, understanding, and wisdom to be the means by which He heals you? I will pray for you, and you can pray for me.”
I have to be careful with this, because it’s like plugging into Louisiana Power and Light. It’s powerful, and I must be completely trustworthy (godlike?). I take this seriously and do include the patient in my prayers, which makes that patient special. Perhaps I ruminate more deeply about the nature of the suffering of these patients. Sometimes the results are seemingly “miraculous.”
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51. If something bothers me, my
patient will become disturbed too
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Sir William Osler of Johns Hopkins, known as the father of medicine in the US, said “in the physician or surgeon no quality takes rank with imperturbability … it means coolness and presence of mind under all circumstances, calmness amid storm, clearness of judgment in moments of grave peril, immobility, impassiveness, … phlegm” (Osler 1905).
I have a noisy office on street level, and I have learned to include in my induction the positive suggestion “Paying attention only to the sound of my voice. Any other sound that you hear will be very pleasant in the background, and just help you to go deeper and deeper. It’s comforting to know that the rest of the world is going on about its business, while you and I go about ours.”
Some of my deepest trances occurred when they were putting up a building across the street. The pile driver made a loud “wham” and shook the building with every blow. My response was “Every time the hammer hits, it will drive you deeper and deeper,” and I could use the time for therapy without spending time on deepening.
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52. Finger signals make a patient
more aware of true feelings
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Awareness means “conscious of.” Part of emotional illness is to suppress true feelings, and often a patient is unaware or unwilling to admit to them.
When I get an ideomotor response, I give a tactile feedback (I touch the finger and gently push it back down) and also give verbal feedback “That’s right, the answer is …” It may surprise a patient to admit to an implicit negative or positive feeling that had been unknown or deemed unacceptable at a conscious level. But it is comforting because it is honest, and can be dealt with honestly. “And ye shall know the truth, and the truth shall make you free” (Joh
n 8:32).
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101 Things I Wish I'd Known When I Started Using Hypnosis Page 3