Basics

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.

Active Aging, Specializations

Hypnotherapy in Later Life: Part 2

Life Review

While philosophers make much of reason, the most complex parts of the mind evolved to help us create communities.

Community starts with the family – we look at our parents’ faces and find comfort or distress. Sometimes those responses are instinctive: when we smile, blood is forced into the brain and we feel happy. Perhaps intuitively we understand then that it is good when our parents smile. They are happy and reward us with their attention.

But other expressions seem arbitrary. Why make a raspberry, for example?

Well it turns out that not everybody does. Thus comes the problem of community: we wander away from the family and encounter other ways of relating. Rather than a raspberry, another person may snort to show disdain. It is the social center of the brain that allows us to see past the differences to build trust.

Eric and Joan Erickson studied personal growth to social maturity. Their “Stages of Development” recognize that what we learn at an earlier stage supports our success at later stages. In the early stages, however, society expects us to accomplish each stage by a certain age. That means that even if we have not mastered an earlier stage, we will be forced to move into the larger social setting as shown in the table. It’s expected of us.

Age Partner Issue Success
0-1 Mother Will the world provide for me? Trust
2-3 Parents Can I control myself? Autonomy
4-5 Family Can I control my environment? Initiative
6-12 School Can I succeed? Industry
13-22 Peers/Father Will society accept me? Identity
23-35 Lover/Spouse Can I be emotionally responsible? Intimacy
35-55 Workplace Can I be socially responsible? Generativity
55-65 Society Does life have meaning? Integrity

When the shift to larger concerns occurs too soon, we can feel like an alien, like we “don’t fit in.” Sometimes that’s not bad. We’ve all heard of children that were “precocious” – mature beyond their years. But most often it’s a problem for us – we say and do things that are inappropriate, making others uncomfortable and suffering their rejection.

The fulfilled life closes without regrets. Most of us muddle through, surrounding ourselves with people that don’t mind our quirks. At every step we do the best that we can and often find friends at hand when we need help. When that doesn’t happen, we are left with a trauma – and the regret that comes with it.

A good way to think about trauma is a muscle cramp. We strain against some force (like a heavy weight) and the muscle contracts until it gets tired and stops. If we are forced to hold the muscle at that position (perhaps by our own stubbornness), eventually it begins to cramp. Because the muscle tissue tears during a cramp, the effects can last for weeks or even years. During that time, we shift its burdens to other muscles. Those muscles become stronger, but that very strength can cause twisting of the posture that can itself become disabling.

I had several muscle injuries when I started yoga in my fifties, and posture problems to go with them it. While it was painful and frustrating, with discipline and patience they have healed. I learned to relax the compensating muscles so that my posture straightened, and then stretched and strengthened the original muscle.

Having done this work, I find that I move with greater grace and dignity. People stop to tell me how wonderful my posture is.

I spend all this time on muscle cramps because as regards social growth a similar opportunity is available to seniors after retirement. With the pressures of daily life behind them, they can revisit painful experiences in the past and apply their adult wisdom to heal them.

This is the opportunity of life review. The first goal is to prevent social trauma from affecting the choices we make in the present. But as the earliest social traumas ripple down through the rest of our lives, they affect our intimates as well. Our traumas infect others, and theirs infect us. Life review branches out to encompass others. Guided by the Stages of Development and other frameworks for personal growth, we attain insight that leads us toward forgiveness.

On my own journey, I eventually realized that all the people who hurt me were “doing as was done unto them,” looking all the while for someone strong enough to show them how to heal.

Retirement living also drives social change. We leave work and search for new ways to serve our community. Friends and partners retire, move away to be with family, or leave us behind when they die. No longer finding satisfaction is maintaining a large residence, we seek to simplify. One side-effect is to find ourselves in close contact with others in facilities designed to stimulate the formation of new friendships and romantic interests.

In recognition of these facts, Joan Erickson suggested a ninth stage of development in which all the earlier stages were revisited. That occurs in retirement. What better opportunity to revisit old wounds and gaps to heal and strengthen our spirits? And find deeper fulfillment in the years that remain! A sensitive and compassionate therapist bears witness to those capacities, ensuring that we recognize and celebrate new growth.

The power of hypnotherapy is always to give courage to the subconscious mind that seeks safety. With gentle and persistent encouragement, it comes forward to reveal depths of experience that are known to few, as we’ll consider in our next post

Part 1 | Part 3

Relationships, Specializations

Loss and Grieving

To know loss is to confront change.

People, pets, homes and jobs are not just things – they are the backdrop for our behavior. When we first acquire them, we are conscious of learning to adapt to their presence. Over time, those changes become automatic behaviors managed by the subconscious, woven together as a pattern for our life. Remove one element and the pattern vibrates. It may be a trivial disruption, such as when we lose a penny. Or it may be a near-collapse, such as when we lose a child.

When the loss is great, we may be overwhelmed and seek to avoid change. Most directly, we may deny the loss. We might imagine that the loved one will walk through the door any second, or that after the tornado we’re at the hotel on vacation. When denial becomes a permanent condition, the sufferer should be referred to a licensed mental health professional.

Another strategy is to cultivate dependency. We may expect other people to care for us, take refuge in pleasant experiences, or consume substances (food and drugs) that boost our energy and mood.

Healing begins when we discard denial and dependency to accept that we need to change our lives. Specializing in behavior change, a hypnotherapist can help with that journey.

The mind is always seeking health, and so hypnotherapy works with the mind. In planning therapy for loss, then, we should understand how the mind responds to loss. I cover two accepted frameworks for loss before offering my own perspective.

Kubler-Ross

Elizabeth Kubler-Ross broke ground with her study of how terminally ill patients dealt with loss and grief. In the popular formulation, the process follows five stages, but the middle three stages can become a whirlpool. The stages are:

  • Denial
  • Anger
  • Depression
  • Bargaining
  • Acceptance

We’ve already discussed denial and its helpmate, dependency.

Anger is the natural reaction to the realization that there is no answer to “Why?” It can be focused on the self for past misbehavior (such as cigarette smoking) or toward others (the tobacco companies). In the grief process, anger is important because it breaks down neural pathways. It is a mechanism used by the mind to get rid of behaviors that no longer serve us. In the context of a broken heart, this is clearly necessary: we need to stop acting like we did when we had a romantic partner and prepare ourselves to seek a more fulfilling relationship. In the case of a terminal illness, anger prepares us to accept that life as we knew it is going to end.

If the loss is due to illness, persistent anger also has dangerous consequences: it stimulates the sympathetic nervous system, which increases inflammation in our tissues. This can inhibit healing or even stimulate metastases.

Depression is a term in psychology used when we are unable to respond to the world. In severe cases, that manifests as avoidance. The highly depressed person can end up hiding in a darkened room. It is more severe than denial because while in denial we can at least function. What is different is that while in depression we are recovering from the mental disorder created by anger and gathering energy to create a new life.

After anger has softened our old behaviors and depression has allowed us to gather strength, we begin bargaining. This can take two forms. The less helpful is whining: “Dear God, what do I need to do to make this cancer go away?” Whining often loops back into anger and depression. The better is imagining: “If I heal from cancer, I will commit more of my time to charitable work.” Imagining builds new behaviors to replace those erased by anger.

Imagining prepares us to move forward to the last stage: acceptance. Acceptance is a great gift. It is the ability to take life one day at a time, savoring every moment and opportunity, while trying to enrich the experience for ourselves and others. Having achieved that wisdom, you will hear people say that getting divorced (or sick with cancer or arrested or…) was “the best thing that ever happened to me.”

Trujillo

Through his teaching and trauma response work, Timothy Trujillo has developed tools to aid those trying to recover from loss. Where Kubler’s focus is practical (“This is how people grieve”), Trujillo offers a metaphor for healing. Trujillo starts every therapy with the mind/body connection, establishing that it is possible to feel good.

The table elaborates the physical metaphor for psychic healing:

Stage Physical Healing Psychic Healing
Whole    
Injury    
Hemostasis Stop bleeding Separation from trauma
Inflammation Clear damage, fight infection Release old behaviors
Proliferation Repopulate with new cells Evolve new behaviors
Remodeling Cells organize as tissue Reconstruct relationships
Adaptation Compensate for lost function Deal with unexpected consequences
Recovery Return to normal

The power of this metaphor arises from the fact that often recovery from psychic trauma is impeded because the wound is projected into the body, causing discomfort to persist. In emphasizing the body’s natural healing powers, the client associates increased physical comfort with psychic healing. In effect, the conscious mind no longer interferes with the subconscious effort to restore balance and harmony.

Confronted by traumatized communities, Trujillo captured this psychological transition as a hypnotic script titled “The Five-Minute Miracle” (https://timothytrujillo.com/projects/five-minute-miracle).

Beyond Healing

If we have a wonderful relationship that falters and fails, do we want to release those cherished memories and behaviors? Or do we want to learn from the failure and expand our vision of future possibilities? Not just sexual satisfaction, for example, but also children and society?

Loss and wounding both have negative connotations. We have seen that at the end of grieving, we achieve a positive resolution – but the steps along the path are dreary, to say the least. With physical wounds, we can be awed and humbled by our natural healing powers, but in most cases after recovery we are less capable than before the injury. The metaphor suggests that the mind will also lose function during grieving. Why should we accept that?

I refer a simpler, positive model. Like Trujillo, I recognize the connection between mind and body, but would emphasize that it goes both ways. The reason we say the old lover’s name is because we remember them when our cheek is kissed. We have associations between physical sensation (the kiss) and old behaviors (saying their name).

The first step in recovery from loss, then, should be creating space within the self. This can be done many ways, but all involve intense physical exertion with focused attention. Shaking our fist at the sky is one example, as is a long, wracking cry. Other methods are possible: I use Sunday dance celebrations to create space within myself; others might go rock climbing. The point is to be aware that we are consciously creating these sensations of exhaustion within ourselves.

The next step is to rest until our energy recovers. Finally we imagine what we can do with this new awareness and energy. That inevitably collides again with loss: we would like to have dinner with lost spouse, but that’s not possible. So we return to creating space inside ourselves, resting and imagining until we have established that it is myself that needs dinner.

How is this space inside created? In my view, it is from the heart. When I weep or dance, I have the sense of something inside bearing witness to me and my loss. If I allow it, it flows from that deep inner source and enters the situation as it is to bring healing – not just to myself, but to everyone that will accept it.

A Hypnotist’s Support

How is this model facilitated by hypnotherapy? When anger (or other negative emotions) are entrenched, I start with a hand clasp induction; otherwise a simple eye fascination suffices. Complete awareness of the self is built through a long progressive relaxation starting at the feet with particular attention paid to expansion around the heart to allow the emanation of light. Gathering all the resources of the being and the represented potential, the progressive passes up the neck and over the back of the head to rest over the forehead, above the prefrontal cortex where all planning is done.

From there the therapeutic strategy depends upon the specific needs of the client. Those in deep grief often need to establish resources in the subconscious landscape through free-form therapeutic imagery. That work leads to reconstruction of their self-image. Those seeking to implement behavioral changes may have fear responses to clear using desensitization.

Between sessions, breathing meditation and mindfulness reinforce personal boundaries. Dream therapy can be used to assess the readiness to change, to release resistance, and to focus subconscious attention to find constructive solutions to specific behavioral problems.

Basics

Personal Development: Table of Contents

While we are all unique, life imposes certain facts upon us. We are born, grow, learn, create and relate to those around us. Each opportunity builds upon those that come earlier.

For the fortunate, life becomes deeper and richer with age. For others, life is a rut that can’t be escaped. In either case, just as a map guides a mountain climber, so a basic map of personal development guides our growth to maturity.

This blog series builds a road map around the relationship between the conscious and subconscious mind – the relationship managed most directly through hypnotherapy. The mind divides in childhood to soften conflict between the self and the world. Unfortunately, that division generates internal conflicts. Which creates conflict with the world, leading to conflict with the self, and on and on until we realize that we need to include others in our circle of concern. As harmony is rebuilt, the mind reunites, and we enter the realm of spiritual experience.

Part 1: Change Matters – Unlike most animals, humans make their most important changes in the mind.
Part 2: Theory of Mind – Explaining why the mind is divided between conscious and subconscious.
Part 3: Path to Maturity – Laying out the steps toward maturity and the roles characteristic to each stage.
Part 4: Survival (dependent) – We are social creatures: survival depends upon partnership. The first partnership is with our parents. When family experience is painful, hypnotherapy can help limit the impact on our adult lives.
Part 5: Sex (hedonist) – The sexual urge drives us out of the home and into peer relationships. Again, many of us have work to do as adults to heal the damage caused in those chaotic years.
Part 6: Exchange (consumer) – Euphoria and fear control our preferences, but also bias our behavior when we expect one more than the other. That bias arises in infancy, making it hard for us to adjust our patterns when they cause problems.
Part 7: Healing and Trust (healer) – When we come to accept that our bias is our problem, sympathy for ourselves extends to include others, and we begin the work of building relationships around trust. This is the sweet-spot for hypnotherapy.
Part 8: Truth (partner) – Life involves many relationships, and only in honoring the truth are we able to sustain true partnerships. Hypnotherapy allows us to smooth over any rough edges carried forward from the past.
Part 9: Creativity (inventor) – In the security of partnerships, we get to choose both who we want to be and what we wish to accomplish. Sustaining harmony is the challenge, as trauma disrupts everyone’s plans. Hypnotherapy helps both with harmony and healing.
Part 10: Imagination (liberator) – This final post looks (somewhat speculatively) at the final step into maturity. The barrier between conscious and subconscious dissolves, and we enter a realm of spiritual development that is qualified by our ability to sustain harmony in the realm of ideas.