Clinical Hypnosis is not Hypnotherapy

When our health is threatened, we take extreme measures to protect and restore it. Staying alive, after all, is necessary to anything else. For this reason, when sick or injured we are vulnerable to deception and self-serving by those claiming to restore us to wellness.

To the extent that wellness exists in the body, the methods of science have much to offer those that need healing.

In the medical field, the precepts of science are easy to fulfill. We can diagnose the patient’s condition using objective observations. We can stage clinical trials that compare the efficacy and side-effects of various treatments. And we can apply the methods of engineering to standardize therapies and minimize cost.

Recognizing these benefits, states adopted licensing laws to ensure that medical practitioners adhered to sound scientific practices.

In the 1800s, those caring for the mentally ill encountered diseases that seemed to fit the medical model. Foremost of these was syphilitic meningitis (in which the syphilis bacteria attacks the brain). For this reason, psychiatry was made part of the medical world. Various alternative forms of therapy were grandfathered in, including hypnosis and psychoanalysis.

Psychiatry and psychotherapy were thus granted the imprimatur of science, and states eventually interceded to license their practice. Unfortunately, as generation after generation of therapeutic methods was applied and disproven, it became clear that mental illness was far more difficult to characterize than illness in the body. Schizophrenia, depression, and neurosis were split and blended until with the DSM-V (Diagnostic and Statistical Manual v. 5) there are more than 200 recognized conditions, most of which are recognized as covering a spectrum of severity.

Now this seems wonderfully scientific, but there’s a catch: who among us doesn’t have a psychiatric condition at the low end of the spectrum? This is not idle speculation. Under licensing laws, only a licensed clinician can treat psychiatric conditions.

In California, the methods identified by use for clinicians include interviewing, counseling, drugs, and hypnosis. When the licensing law was proposed, other professions took exception to reservation of those methods. Among those granted specific exceptions were attorneys, religious leaders, and hypnotherapists.

Now hypnotherapy and psychotherapy are often both seen as “mental health” disciplines, but the legal definition of hypnotherapy defies that: it says that hypnotherapists may utilize hypnosis for “vocational and avocational self-improvement.” This is an essential distinction. What it says is that the hypnotherapist’s client knows what changes they want in their behavior, and seeks assistance in accomplishing those changes. Through experience, a hypnotherapist may offer additional guidance, but at every step it is the client who chooses what is inserted into the subconscious mind.

Conversely the psychiatric patient has a generalized malaise and doesn’t know how to change. A psychiatrist is thus allowed to change the patient’s mind with prescribed medication or therapy.

Considering the application of hypnosis, how does clinical practice differ from hypnotherapy? An excellent example is found in the introduction to Erickson’s “My Voice Will Follow You.” Erickson was visited by a woman who was systematically sexually abused by her father until leaving the house at 17. The woman described her painful fear of an erect penis. Erickson’s therapy was to call her “stupid” as she didn’t realize that her vagina could “render any penis soft.” With that established, he suggested that she enjoy “vicious pleasure” in exercising that power.

How is this a hypnotic approach? In calling her “stupid,” Erickson validated her worst fears to achieve a shock induction (kind of like throwing her in front of a bus). He then gave the subconscious a strong image of personal power (the effect of her vagina) before encouraging her to enjoy the exercise of that power.

I don’t know whether he considered the impact on her subsequent sexual victim. At least, given the summary, I hope that there was only one, as that was the plan she had upon leaving the clinic.

Obviously Erickson is skating on the edge of disaster here, and only as a highly experienced clinician should he ever have exercised that authority. If the wheels came off the bus (so to speak) during the shock induction he had the authority to prescribe medication and commit the patient for observation. The problem is that this bravado is typical of clinical hypnotists. As evidenced in the continuation of the introduction, at least some of Erickson’s proteges revel in demonstrations of that kind of power – seemingly magical cures achieved with just a few words.

But this is not what I do as a hypnotherapist. Having heard that this woman suffered childhood sexual abuse, I would have recognized that she was suffering from a mental wound and referred her to a licensed clinician. If she came in complaining only of frigidity, I would have asked her to explain the imagery she associated with intercourse, and helped her develop alternatives that might release her anxiety. All of this would be done in conversation before hypnosis was induced to associate the new imagery with intercourse – and followed by referral to her medical doctor to verify that no health issue existed.

Obviously there is an ambiguous line here: in the first case, the clinician heals the client; in the second, the hypnotherapist helps her strengthen her personality. Is that “strengthening” also a healing? That’s hard to tell. But the question is whether a client wishing to strengthen her personality should be denied the opportunity to have a hypnotherapist facilitate that process.

California’s Business and Professional Practices Code answers emphatically “No!”

The reason that I emphasize this at this juncture is that Psychology Today defines “hypnotherapy” as clinical hypnosis, and pointedly excludes from its recommendation graduates of accredited Colleges of Hypnotherapy (such as the Hypnosis Motivation Institute). Furthermore, psychotherapists often tell their patients that they cannot also seek the assistance of a hypnotherapist. As I see it, both the magazine and the therapist are engaged in illegal restraint of trade – and you can be certain that if I had the resources I would see them in court for it.

Hypnotherapy is a distinct discipline with its own methods, intellectual frameworks and scope of application. So long as services rendered are “vocational and avocational self-improvement,” the public has the right to engage a hypnotherapist to strengthen their personality. If clinician wishes to constrain such use, it must come with a strong written argument that the benefits sought by the client are potentially harmful to their self-interest.

Basics, Mind Management

The Ethics of NLP

Neuro-Linguistic Programming (NLP) is a discipline developed by Richard Bandler and Eric Grinder. If you think of computer programming as “cyber-linguistic programming,” you’ll get the gist of NLP. Assuming that the mind is an information processing device, NLP proposes a model of how the mind receives and filters information, and then provides methods of communication that allow us to hack the program.

NLP was popularized in the 1990s by Tony Robbins, whose Unleash the Power Within seminars use a form of group hypnosis to encourage people to cast off their self-limiting beliefs. During business networking, I have encountered life coaches, mediators, sales people and hypnotists who testify to have mastered these practices in seminars typically lasting a week or so.

A characteristic moment from Robbins’ seminar illustrates the technique. Tony may start “you like me – want to get the most out of this weekend.” Through emphasis, that innocuous sentence embeds the suggestion that “I like him.” The suggestion is obscured by the pause between “you” and “like,” and so may be discarded by the conscious mind when the sentence is completed. But the emotional effect lingers on in the subconscious, and subsequently affects our behaviors.

I could elaborate the NLP model, but I hesitate for ethical reasons. That caution was codified by Milton Erickson when founding the America Society for Clinical Hypnosis (ASCH). All members must be licensed clinicians with a degree in mental health. (That’s right: I don’t qualify for membership.)

This is significant because Erickson was one of the clinical luminaries that Bandler and Grinder studied to develop the communication patterns that give NLP its power. Erickson’s caution is illustrated in a published paper that applies those patterns to his own work: “Transcript of Trance Induction with Commentary.”

The value of the paper is not just in its elucidation of the techniques that would be adopted in NLP, but also for what it reveals about the context in which those methods were developed. Erickson was an academic researcher, and coaxed many of his patients to serve as experimental subjects before beginning therapy. This was because Erickson felt that successful therapy required the application of “hypnotic work” that was accessible only after twenty or more hours of conditioning. But the experimental subjects were not limited to patients. Erickson and his wife also hosted weekend gatherings in which friends and colleagues were encouraged to explore hypnotic experience.

“Transcript…” is interesting on its face because it shows how skillfully and gently Erickson went about bringing his subjects into hypnotic experience. But for the concerns of this post, the important point is made near the end of the session. Erickson takes the subject into an age regression. The commentary reads:

Her hand didn’t point, so then I started narrowing down. Have her point with her left hand. When she failed to do that, I knew how deep in the water I was. I was out of contact with her.

The problem is in having convinced the subject that she was about eighteen years old, severe trauma would occur if she awoke in that mental state in a room with people who related to her as a thirty-year-old – not least her husband.

NLP techniques are powerful in part because they bypass the conscious mind – but that in itself is why they are so dangerous. The subject changes their behavior and doesn’t understand why. They begin to fear that they are losing their grip on themselves, and so that they might begin to express their worst tendencies. The mind turns against itself and may break.

As I summarized in a prior post, Erickson was extremely sensitive to this vulnerability, and eventually began to try to dissuade practitioners from application of his methods of speaking. Paraphrasing, his observation was

Do not believe that you can adopt my manner of speaking and thereby achieve the same therapeutic results.

I believe that he left silent the stronger caution: that in fact, the subject can be harmed when linguistic methods are applied with neither psychological understanding nor compassionate intuition. (This is not a hypothetical: I have interviewed a client who was so affected.)

Some confirmation of this caution is found in Hammond’s “Handbook of Hypnotic Suggestions and Metaphors.” Hammond summarized the collected wisdom of the ASCH, and in surveying research on the effectiveness of techniques for formulating suggestions, reported studies that showed NLP was of marginal therapeutic value.

For those of us without clinical degrees, Cheryl O’Neil’s Therapeutic Imagery program, the culmination of the lay hypnotherapy program formulated by Dr. John Kappas at HMI, is a safe practice. The therapeutic method facilitates self-improvement through gradual reconciliation of conscious and subconscious perspectives. The pacing of the process is under the full control of the subconscious mind, whose over-riding concern is to preserve the subject’s well-being.


Guiding Your Journey

If your mind is a garden of tangled thoughts and emotions, I’ll help you prune and straighten them. Hypnotherapy goes below the surface, gently helping you to explore, clear space, and strengthen the qualities that you desire most. As you release doubt, anxiety, fear and confusion, you’ll find greater peace, clarity, enthusiasm, strength, and wellness. You’ll feel more connected to yourself and the world.

Hypnotherapy isn’t mind control, it’s a conversation with your oldest, dearest friend – your subconscious (the part of your mind that takes over when you’re preoccupied). As a scientist and empath, I guide that conversation by blending the sophisticated hypnotic techniques taught at America’s oldest accredited college of hypnotherapy. For the concerns that I can address, hypnotherapy is far faster than talk therapy.

Call me for a free consultation. Together we’ll build a self-improvement plan, reminding you in the first session to feel well in your skin, and then encourage the best of you to rise to the surface.

Let’s Bring Your Whole Self to Life!


The Kappasinian Difference

The public considers hypnotherapy to be “woo-woo” principally because most demonstrations celebrate the dominance of the “operator.” The “subject” appears to relinquish control – something that only the frivolous or desperate would tolerate.

Graduates from the HMI College of Hypnotherapy are trained in methods that ensure clients understand and participate fully in their behavioral development. The founder, Dr. John Kappas, actually proposed California’s legal scope for hypnotherapy: “vocational and avocational self-improvement.”

For people able to set and pursue goals (i.e. – those without clinical psychological disorders), Kappasinian hypnotherapy has deep and diverse methods for addressing the entire gamut of problematic and self-limiting behaviors. Even more, clients will receive a basic, common-sense understanding of personal behavior and development. Given in non-technical language, it is an understanding that they can carry forward into the rest of their lives.

If you have been considering hypnotherapy, look for an HMI graduate in your area, or contact one of us (myself included) well-versed in phone and web sessions. You’ll not just find your behavior corrected, you’ll find yourself empowered to step confidently into a more fulfilling future.


Hypnowars: Team Kappas vs. Erickson Camp

When choosing a hypnotherapist, clients should understand that we do not all use the same techniques. This post will compare the two most important bodies of techniques: those developed by Milton Erickson and John Kappas.

Our methods are always the same: attain depth and change thinking. As depth increases:

  • the regulatory activity of the conscious mind decreases, and
  • the elements of the subconscious mind operate more independently (they disassociate).

When the right depth is attained, behavior at that depth is changed through suggestions. These suggestions must match the expectations of the conscious mind, which must still interpret them for the subconscious mind that regulates the body and motivations.

Prior to Erickson and Kappas, many hypnotherapists worked at shallow depth and used scripted suggestions. This limited both the pool of clients and the types of behaviors that could be changed. Both Erickson and Kappas used systematic studies to create techniques that made it possible to attain any depth and address almost any behavior.

While they shared the same goals, Erickson and Kappas worked in entirely different contexts.

Milton Erickson

Erickson was a practicing psychotherapist in an academic setting. Many of his published papers recount experimental sessions where he attempted to teach the curious how to do “hypnotic work.” This “work” included (among others) catalepsy (muscle rigidity), analgesia (pain suppression), amnesia (lose memories) and age regression (revisit old memories). These skills were also important in therapeutic settings but are rarely emphasized in his reports.

Erickson’s methods are powerful but require great care. Depth cannot be created willy-nilly but must be done as a spelunker enters a cave, with markers and lights left in place to ensure that the patient can be brought out if something ugly is encountered. For this reason, the American Clinical Hypnosis Society he founded requires that all members be licensed psychologists.

Erickson’s ethics were impeccable. In his favorite paper (“Deep Hypnosis and Its Induction”) he offers the following principles.

A subject needs to be protected at all times as a personality possessed of rights, privileges, and privacies and recognized as being placed in a seemingly vulnerable position in the hypnotic situation. …

This protection should properly be given the subject in both the waking and the trance states. …

There should be a constant minimization of the role of the hypnotist and a constant enlargement of the subject’s role.

These principles came to full expression in his paper “The Burden of Responsibility in Effective Psychotherapy.” In the three cases reported, each cure was achieved as the patient slowly and laboriously explained his condition and described the behavior that would resolve it. Erickson did nothing more than suggest a powerful compulsion to do as the patient himself said.

Erickson was not followed by an intellectual heir. In part this reflected his choice of cases. Personal fondness or intellectual challenge seemed to play a large influence. When writing of patients (rather than volunteers) Erickson focused on complex cases often involving medical or psychological disorders. Many of his patients were referred to him as a “last resort” following ineffective surgical or drug treatment.

For less acute treatments, Erickson’s desire to guard the integrity of the patient’s autonomy led him to use images and metaphors familiar to them – again increasing the flavor of his therapy.

Given the diversity of his cases, it was unlikely that a formal manual of Ericksonian technique would arise. That does not mean that others have not built upon his legacy. Neural-Linguistic Programming (NLP) offers a model of information processing (although Hammond, in Hypnotic Suggestions and Metaphors, disputes its efficacy). Erickson’s use of implication in suggestions is a hallmark of a certain therapeutic style. Zeig and others focus on hypnotic disassociation as the key to effective therapy.

John Kappas

Kappas learned hypnosis at a young age, using it informally with family and friends. He polished his skills at a school for professional stage hypnotists. Although a terrible performer, Kappas was recognized for his hypnotic technique. He was picked by a pair of TV producers to represent the profession in a never-aired series.

In contrast to Erickson, Kappas was directive in his style. However, he recognized the need to utilize natural processes in allowing the mind to seek balance and health. To facilitate this, he devoted years to developing a theory of mind that – while psychologically sound – was understood by people from all walks of life.

Four pillars formed the basis of most Kappasinian therapy. The Theory of Mind was extended with Eric Erikson’s Stages of Development. The tendency of the mind to shift emotional pain to physical pain is explained in a basic theory of body syndromes. The Institute recognized the importance of dream process – both as relates to developing new behaviors and releasing obsessions and trauma.

Most importantly Kappas developed a fundamental theory of relationships (the Emotional / Physical dichotomy known here as Protector / Adventurer). While harder to explain than the Theory of Mind, E&P accounts for many of the most serious conflicts we face in our relationships, giving clients hope that they can work their way to a resolution. In this process, Kappas (as Erickson) was protective of the client’s goals and preferences, passing no moral judgment on behaviors that many would consider deviant.

We might expect that Kappas as a therapist was focused on the nuts-and-bolts of everyday living. Indeed, his recorded cases histories are dominated by commonplace issues, including fears and phobias, neurotic behavior (especially obsessive/compulsive personalities), marital disputes, and inexplicable pains, tics, and allergies.

As he aged, Kappas became more sympathetic to Erickson’s ethic, guiding the development of Cheryl O’Neil’s therapeutic imagery program. In this technique, the client constructs resources before venturing out into their subconscious landscape. The therapeutic imagery comes from the client’s own words.

From these elements, Kappas and his team at the Hypnosis Motivation Institute constructed an accredited hypnotherapy training program. Successful students have been applying those methods for fifty years.

What should be appreciated, however, is that Kappas designed a sandbox that minimized the chance that a therapist could upset the mental balance of the client. Age regression is almost never used – rather hidden trauma clears through the dream process. A limited set of therapeutic practices is employed. Recommended session length is one hour at weekly intervals.

The effect is that the client develops an understanding of their behavior and emerges with a strengthened partnership between the conscious and subconscious minds. It is that outcome that is most important to me as a therapist. Kappasinian hypnotherapy is not limited to helping the client accomplish their goals. It improves their understanding of their mind, empowering them to confront future challenges with their whole being, rather than just the part that they reason with.

And the Winner Is…

Always the Kappasinian client and the Ericksonian patient.

Neither approach is better than the other. Erickson left less in the way of organized therapeutic techniques, and those we have require greater control and discipline attained through formal psychological training. Kappas left a large and well-motivated body of techniques, constrained by models of “typical” behavior that can hinder treatment of deep psychological disorders. Ericksonian therapy has the flavor of surgery, with behaviors added or removed in various states; Kappasinian therapy tends toward overall integration of the hypnotic and waking experience under processes controlled by the client’s subconscious.

As a client seeking support, you are encouraged to understand your therapist’s approach. Appreciate that hypnosis is a tool employed in several practical styles. Don’t be afraid to explore alternatives. Your comfort with the therapeutic method is an element essential to successful change.