Hypnotherapy: Gimmick or Reality?

Hypnosis was a controversial subject in medical, public, and legal debate in many European countries during the late 19^th century and the early 20^th century. The therapeutic properties of hypnotic suggestion were contrasted against the dangers of a mental state that made the patient powerless against the hypnotizer’s commands and will. Treatment with hypnosis had several risks, such as hysterical fits, induced nervousness, sexual abuse, criminal suggestions.¹

For critics, medical hypnosis was uncomfortably similar to “magnetic” treatments by lay healers, stage performances of “trance dancers,” and trance states of spiritualist mediums in occult séances. Also, simulation by a test person was considered to be a problem in evaluating the efficacy of the treatment.¹

Introduction

Albert Moll (1862-1939), a Berlin physician, established himself as an expert in hypnosis and suggestion therapy.¹

Hypnotizability is defined as the ability to enter a hypnotic state. It is a complicated behavioral phenomenon with social, cognitive, and biological components. In hypnosis, the patient attends to the hypnotist’s voice and ignores other thoughts and stimuli that may distract him or her.²

Hypnosis is a state in which a person appears to be asleep but can still hear, see, or respond to speech directed toward him or her. Hypnotherapy refers to hypnosis used for therapy. In the normal state, people’s brain waves are high-frequency alpha and uniform-frequency beta waves, regular and low-amplitude. When under light hypnosis, the brain waves become higher and the frequency becomes uniform, the amplitude of alpha.³

Advantages

Several clinical trials have demonstrated that gut-directed hypnotherapy is effective in adult patients with irritable bowel syndrome (IBS). Such patients reported less abdominal pain and lower symptom scores as compared to patients who did not receive hypnotherapy. Also, the effects were shown to last up to 7 years after treatment. In children, the effects have been shown to persist for 5 years.⁴

Hypnotherapy is used to treat:

• Depression
• Anxiety
• Sleep disorders
• Eating disorders
• Posttraumatic stress
• Compulsive gaming
• Phobias
• Habit control
• Fears
• Pain management³

Scientific research

The efficacy of hypnotherapy in reducing post-traumatic limb pain is unclear since only a single case has been reported in literature.⁵

Method

In gut-directed hypnotherapy, a hypnotic state is induced and the patient is guided to respond to suggestions for the control and normal functioning of the gut, as well as reduction of stress and strengthening of ego.⁴

Individual hypnotherapy consists of 6 sessions that run for 50-60 minutes each over a period of 3 months. 

• In the first session, hypnotherapists note down the full history of the patient. The child as well as the parents are explained how hypnotherapy works and how it helps reduce chronic abdominal pain. In this session, the child and the parents are told not to talk about the pain any longer.⁴

Then, a progressive relaxation and breathing exercise is introduced. The child is asked to imagine floating on a big cloud. Positive suggestions such as making the hands warm and placing them on the belly, imagining the warmth spreading through the abdomen are made to help decrease the discomfort.⁴

• In the second session, the progressive relaxation exercise is repeated and another exercise, called the “favorite place” exercise is introduced. This focuses on reducing stress and anxiety. 

• In the third session, a session that strengthens the ego is introduced. For primary school children, “the rainbow planet exercise” is used and for secondary school children, “the air balloon exercise” is selected. In this exercise, children choose colors from the rainbow for various needs such as tranquility, courage, health, and confidence.⁴

• In the fourth session, the “beach without worries exercise” is introduced. Children are encouraged to get rid of stress and more ego-strengthening suggestions are given. 

• In the fifth session, “the slide exercise” is done wherein children imagine sitting on a slide. Visualizations of a properly-working digestive system with food sliding through a bowel comfortably are encouraged. 

• In the final session, an evaluation of the previous three months is done. Any remaining issues are dealt with and the previous exercises are repeated.⁴

Gut-directed hypnotherapy is a valuable therapy for children with persisting IBS symptoms. However, it is not available to many suffering children because it is expensive and often not reimbursed by health insurance companies. 

In most countries, the number of properly-trained child hypnotherapists is very less. Hypnotherapy also requires heavy investments in the form of time and money by both parents as well as children due to work and school absences.⁴

Home-based hypnotherapy using self-exercises stored on a compact disc has been researched as an alternative and has been found to be effective in around 2/3 of the children tested. These children reported more than 50% reduction in abdominal pain. This option takes less time and costs less as compared to sessions with a hypnotherapist.⁴

Side effects

Hypnotherapy has been found to be safe and may lower the cost of medical treatment in patients with chronic pain.⁵

References:

1. Maehle AH. The powers of suggestion: Albert Moll and the debate on hypnosis. Hist Psychiatry. 2014 Mar;25(1):3-19. doi: 10.1177/0957154X13500596. PubMed PMID: 24594818; PubMed Central PMCID: PMC4067540.

2. De Pascalis V, Russo E. Hypnotizability, hypnosis and prepulse inhibition of the startle reflex in healthy women: an ERP analysis. PLoS One. 2013 Nov 22;8(11):e79605. doi: 10.1371/journal.pone.0079605. eCollection 2013. PubMed PMID: 24278150; PubMed Central PMCID: PMC3838345.

3. Li R, Deng J, Xie Y. Control of respiratory motion by hypnosis intervention during radiotherapy of lung cancer I. Biomed Res Int. 2013;2013:574934. doi: 10.1155/2013/574934. Epub 2013 Sep 4. PubMed PMID: 24093100; PubMed Central PMCID: PMC3777187

4. Rutten JM, Vlieger AM, Frankenhuis C, George EK, Groeneweg M, Norbruis OF, Tjon a Ten W, Van Wering H, Dijkgraaf MG, Merkus MP, Benninga MA. Gut-directed hypnotherapy in children with irritable bowel syndrome or functional abdominal pain (syndrome): a randomized controlled trial on self exercises at home using CD versus individual therapy by qualified therapists. BMC Pediatr. 2014 Jun 4;14:140. doi: 10.1186/1471-2431-14-140. PubMed PMID: 24894077; PubMed Central PMCID: PMC4060754

5. Mack P, Yam AK, Chin AY. Hypnotherapy: a forgotten modality in managing chronic post-traumatic upper limb pain. Ann Acad Med Singapore. 2013 Jul;42(7):361-2. PubMed PMID: 23949268.