Hypnosis: From Myths to Reality

Vladimir Bernik, MD

Medical hypnosis (also called hypnotherapy) remains one of the most controversial therapeutical methods in Psychiatry. It was coldly received after the undue criticism of Sigmund Freud, the father of Psychoanalysis. But, it came back with renewed strength after the 2nd World War , supported as a valid method by the main international medical societies.

In Brazil, hypnosis has endured serious disbelief, due to its frequent use in stage shows, by non medically qualified persons and even having jeopardized the human "guinea pigs" which were used. Fortunately its use out of the medical environment has been prohibited by a presidential decree in the early 60ís.

Currently, hypnosis is recognized as an adequate treatment for certain psychiatric conditions, even as a method of value to increase the immunological resistance of the patients, increasing the level of white cells (leukocytes) for the defense of our organism against diseases. For this reason it has been very much used in the therapy of AIDS because its seem to be the method which leads to the fastest alteration of the psychoimmunology of the patients (alteration of the immune system by means of the psyche).

Hypnosis is seldom a treatment in itself. The different therapeutic methods used by psychiatry can be carried out better and faster under hypnosis. One of its advantages is the reduction of the treatment period, since there is a limitation to the activity of the super-ego under hypnosis.

It is one of the treatments used for:

to remove some symptoms of certain mental diseases, such as anxiety;

to reduce the stress and treat psychological traumas when its cause is irrelevant ;

to treat fears (or phobias), such as fear of dark and to help the alleviation of chronic pain such as in arthritis, the pain provoked by tumors, etc.

Hypnosis is also one the most efficient methods to control psychosomatic diseases (for example, stomach ulcers of nervous origin) being one of the methods which obtain the most brief and efficient results.

One of the greatest advantages of hypnosis is that, contrariwise to what fiction has shown many times, it is not capable of altering the patientís ethical and moral values. It is, possibly, one of the most serious medical treatments in Psychiatry and its international code of ethics for the physician is extremely strict. It is also very safe, and totally harmless when controlled by the physicians.

What is hypnosis?

Hypnosis uses the technique of inducement of trance, which is a state of semi consciousness relaxation, at the same time maintaining sensory contact with the environment.

The trance is induced in a gradual manner, in stages, by means of sensorial fatigue, which is generally imposed by the therapist using words, in a calm, monotonous, rhythmic and persistent way. When the trance installs itself, the suggestibility of the patient is increased, what demands a high ethical level from the physician. Hypnosis leads to several alterations of the sensorial perception, higher intellectual functions, increase of memory (hyperamnesia), attention and motor functions. It establishes an altered state of consciousness, a state that simulates sleep but it is not so (the person does not sleep during hypnosis): the electroencephalogram (EEG) registration of the patient under hypnosis is that of alertness and not of sleep.

It is still not well known how hypnosis influence the brain. One of the theories is that it affects the mechanisms of attention, in one area of the brain called the ascending reticular formation (ARF), located in its most basal part (brain stem). This area, which has many functions related to sleep, to alertness and to the sensorial perception, "bombards" continuously the brain with stimuli coming from the sense organs eliciting general excitation. The inhibition of ARF leads to states of somnolence and sensorial decoupling.

Is sensitivity to hypnosis a general one ? Yes. Around 90% of the persons may be hypnotized at least at level of the needs of medical therapy; some may not be hypnotized for deeper stages such as those needed by pure research. These 90% of patients have different levels of sensibility: all of them can be put under hypnosis, but this will depend on a stronger or less stronger effort on the part of the physician to do the job. What about the remaining 10%? Well, since hypnosis depends on word stimulation (weak, rhythmic, monotonous and persistent), only those deaf and those unable to understand the minimum essence of what is being said to them will be not hypnotized.

Hypnosis in Psychiatry

The benefits of hypnosis were known to the old psychiatrists, Mesmer, Charcot, Faria Abade and even Freud; the latter, not knowing how to use it, declared it to be an hysterical phenomenon, Freudís disservice was a heavy burden which only lost its strength when psychiatric prejudice was enlightened and entities such as British Medical Association, American Medical Association, Canadian Medical Association and American Psychiatric Association acknowledged the power of hypnosis as a mean for diagnosis and treatment of specific psychiatric problems. Thus, researchers and university services have organized themselves to study more deeply these phenomena and its usefulness for particular techniques of diagnosis and therapy. An international society was founded, which publishes to-date a journal with high scientific standards, with the aim of disseminating knowledge. National societies were created in different countries and were affiliated to the International Society. Every day and at every discovery, those who study hypnosis find a new world opening towards the addition of new elements neuroscience, from research to diagnosis and treatment.

Yet, hypnosis did not managed to gain the total credibility of the physician, who is unaware of the neuroscientific basis of hypnosis

What are the uses of Hypnosis ?

Hypnosis has many specific indications in Psychology, Psychiatry and General Medicine.

To relieve pain is one its basic indications. In fact, as one may notlie to the patient under hypnosis, the suggestion is not that the pain has ceased to exist, but rather that it has gradually become a tolerable sensation of itching or warmth.

Another area of application for medical hypnosis which has achieved good results occurs in the psychosomatic diseases such as asthma, irritable colon and the psychodermatological problems (such as eczema).

The control of impulses is another excellent are of use for hypnotherapy. It has shown to be a great value for the treatment of behavioral disturbances dependent on impulse control, such as:

the alteration of alimentary behavior (obesity, anorexia and bulimia); the inhibited or exarcebated sexual impulses and the correction of its dysfunction at every age levels; the control of the gambling impulse, and also the intervention (by means of potentialization of psychotherapy under hypnosis) in different chemical addictions, such as alcohol, "crack" as well as smoking.

Hypnosis has also a value when used to complement other forms of psychotherapy such as in the treatment of phobic fears, to control the instances of development of the panic disorder (stressing the need of concurrent psychopharmacological treatment), in the control of anxiety, the emotional components of depression, in the control of suicide impulses and reactivating of the values of life, etc. In many of theses cases, hypnosis is also accompanied by the use of appropriated medicaments (such as antidepressants). It should not be forgotten that depression is a hereditary, organic disorder, not to be cured without the corresponding medication.

Hypnosis and Pseudoscience

The coming of the New Age and the amazing capacity of the patient under hypnosis to present phenomena of hyperamnesia (exacerbation of memory) has led to a wider exploitation of the techniques of regression to the childhood and adolescence phases instigated by insensible therapist to seek fantastic regressions to other dimensions, fetal life and even to other lives, throwing this serious medical techniques into the limbo of esoterism. Persons that even live and "relive" other lives. These pseudo therapists have forgotten that among the amazing properties of this technique there is that of delirium induction, capable of transforming the patientís latent fantasies into well elaborated self-reference delusions.

The only danger is, in fact, its misuse; "to navigate" through other lives, to create delusions and to believing them. To turn todayís hard life into a living hell or to dive, naïvely, into unreal fantasy with no way back. And, with the assistance of an unethical professional, to open to oneself the doors of perception to a psychosis of difficult control.

Vladimir Bernik, MD was a chairman of Psychiatry of the Faculty of Medical Sciences of Santos (up to 1995) and president of the Society of Medical Hypnosis of São Paulo and vice-president of the Brazilian Society of Medical Hypnoses. He is an organizer of the first board of the committee of Clinical Psychotherapy (in construction) of the Department of Psychiatry of the Medical Association of São Paulo. Editor and associate editor of the Medical Journal of São Paulo, Editor and president of the editorial board of the Brazilian Journal of Clinical and Therapeutics and editor of the section Psychiatry of the Brazilian Journal of Medicine. E-mail: vbernik@ibm.net

Self-training of hypnosis

A List of Internet resources on Hypnoterapy

Center for Biomedical Informatics,

State University of Campinas, Brazil