The Practical Application of Medical and Dental Hypnosis

Milton H. Erickson, Seymour Hershman, Irving I. Secter

• Publisher: Routledge
• Year: 2014
• ISBN:
  9781317855460
• Edition: 1
• Topic: Psicología
• Subtopic: Hipnotismo

"During the past several years there have been ever-increasing numbers of physicians, dentists, and psychologists interested in hypnosis, both therapeutic and investigative. Reliable sources of clinical information and instruction were practically non-existent except for a few scattered individuals. To meet this need, to interest universities, and to stimulate medical and dental schools to an awareness of the importance of teaching clinical hypnosis, a group of experienced clinicians competent in teaching were formed. Throughout the United States, under the auspices of various professional societies and universities, this group conducted seminars on hypnosis.
"This book is compiled from the tape recordings of dozens of those seminars, and thus it contains the material as it was presented, with all the simplicity, directness, and effectiveness of the classroom presentation.
"It is no more, no less, than a comprehensive presentation of the material upon which thousands of clinicians throughout the United States have based the initiation and development of their successful clinical use of hypnosis."
-Milton H. Erickson, M.D. (1961)

1
	Outline of History and Theories of Hypnosis

Hypnotism is as old as time and probably originated when man first crawled out of the primeval mud. It has been employed for centuries in one form or another in all parts of the world. Primitive societies still use the “beat-beat-beat of the tom-tom” and ritualistic dances and tribal rites to induce a trancelike state similar to hypnosis. There are even several hundred references to the apparent use of hypnoticlike methods in the Bible. For instance, the laying on of hands to obtain cures was well known during the time of Christ.

The king’s “royal touch” or divine healing during the Middle Ages is another form of hypnosis. Receptive and suggestible individuals eagerly sought to have the godlike figure touch them and the hypnotic state was induced in a matter of seconds. In the Orient, yoga is still another form of hypnosis. Yoga uses breathing and postural exercises to effect physiologic responses in the body. The Greek and Egyptian priests used hypnosis over two thousand years ago in the treatment of various ailments.

Modern history

The modern history of hypnosis began with Franz Mesmer in 1773. Mesmer worked with the Jesuit priest, Maximilian Hell, who was the royal astronomer in Vienna. They used magnets in the treatment of several cases of hysteria. Hell thought that the magnet cured because of its physical properties, while Mesmer believed that the cures were produced by a redistribution of some sort of fluid, which he called animal magnetism to distinguish it from mineral magnetism. Later he abandoned the use of magnets, since his doctrine was continually misunderstood. Many people thought that he attributed his cures to mineral magnetism.

Mesmer later observed Father Gassner obtain cures by the laying on of hands and by making passes over the subject’s body. In 1775, Mesmer expressed the opinion that Gassner was using animal magnetism without knowing it. Gassner’s bishop soon forbade any further manipulation of this kind.

Mesmer then elaborated on Gassner’s technique. He postulated that a fluid circulating in the body was influenced by the magnetic forces originating from astral bodies. The theory sounded scientific at the time. It coincided with the discovery of electricity and advances in astronomy. Mesmer later contended that he, himself, had this force and that patients could be cured when the magnetic rays flowed from his fingers.

Public pressure forced him to leave Vienna, and he moved to Paris in about 1778. There, he developed a bathlike structure, or “bacquet,” lined with iron filings and magnets. When a patient entered the bath, he “recovered” from his ailment. Neurotics, neglected by their well-meaning physicians, flocked to Mesmer’s salon from all over Europe. He developed a large following with a very high percentage of cures. He also established a tremendous reputation that incurred the animosity of his colleagues. In 1784, the French Academy appointed a committee consisting of Benjamin Franklin, Lavoisier the chemist, Dr. Guillotin, the inventor of the guillotine, and others to investigate Mesmer.

The commission found that certain persons, supposedly very sensitive to animal magnetism and capable of experiencing convulsive reactions when they touched trees that had been magnetized by stroking, could not tell which trees in an orchard had been magnetized unless they saw the magnetizing performed. If they were told that a tree had been magnetized, they could have convulsions when they touched it. The commission declared that the effects attributed to animal magnetism were the results of imagination and denounced Mesmer as a fraud. He subsequently fell into disrepute. These scientists failed to recognize, however, that suggestion resulting in strong rapport was actually responsible for the so-called cures. Though Mesmer was discredited, he actually laid the foundation for modern dynamic psychiatry. His investigations led to a better understanding of the relationship of suggestion to psychotherapy.

Interest in Mesmerism was revived by Dr. Elliotson, Professor of Medicine at University College, London, the physician who, in 1838, introduced the stethoscope to England. Dr. Elliotson was asked to resign from his college and hospital appointments because of his profound interest in Mesmeric phenomena. After his resignation, he and others carried on their research on Mesmerism. They published their findings in a journal entitled Zoist.

In 1841, another English physician, James Braid, who had originally opposed Mesmerism, became interested in the subject. He stated that animal magnetism was not involved in the cures; that they were due to suggestion. He developed the eye-fixation technique of inducing relaxation and called it “hypnosis.” Since he initially thought that hypnosis was identical with sleep, he used the term hypnos from the Greek word for “sleep.” Later, after he recognized his error, he tried to change the name to monoeidism, meaning concentration on one idea. The term “hypnosis” has persisted despite the fact that it is technically a misnomer.

In 1845 James Esdaile, a surgeon, working in the back woods of India, performed hundreds of major and minor surgical procedures on natives under Mesmeric anesthesia. Esdaile’s book, Mesmerism in India,¹ published in 1850, describes over two hundred and fifty surgical operations, many of them extremely formidable ones, such as amputations of the leg, removal of huge scrotal tumors weighing from eighty to a hundred and twenty pounds, amputation of the penis, and other comparable surgery. He accurately described many of the phenomena of hypnosis as we know them. Even today this volume is a valuable scientific document. Like present-day investigators, he noted the diminution of surgical shock in his hypnotic patients. He or his native assistants mesmerized the subjects early in the morning and left them in a cataleptic state. Esdaile then went about his business, later returning and swiftly operating. His cases were all documented and observed by local dignitaries and physicians. When Esdaile returned to England and related his experiences, however, he was ridiculed and ostracized by his colleagues. He went to Scotland and eventually reported many more surgical successes. It is interesting to note that he remarked in his beautifully written book that it was difficult both to convince people of the validity of his work and to fight public opinion. These words are equally true today.

Concurrently, in Nancy, France, Dr. Ambroise-Auguste Liébault, a French physician, read about Braid’s work and became interested in hypnosis. In order to avoid being branded a charlatan, he worked without financial remuneration. His results were noticed by Hippolyte Bernheim, a famous neurologist, who taught at the medical school. Bernheim sent Liébault a patient suffering from sciatica, whom he had unsuccessfully treated for over six years. Liébault cured him with several sessions of hypnosis. This interested Bernheim in Liébault’s work and together they treated over ten thousand patients. Bernheim wrote the first scientific treatise on hypnosis, Suggestive Therapeutics, in 1886. This belongs on any reading list dealing with the historical development of hypnotism.

In France, hypnosis encountered a very serious obstacle in the person of Charcot, another French neurologist, who disagreed with Bernheim’s and Liébault’s ideas that suggestion was the important factor in hypnosis. Charcot contended that hypnosis was just another manifestation of hysteria. In a decade, he found only a dozen cases of “major hypnotism.” His experiments were performed mainly on three subjects who were hysterics. Charcot revived Mesmer’s theory of animal magnetism and a bitter controversy raged between the two schools of thought. History has proved that Charcot was wrong and Bernheim and Liébault correct. At this time many other famous scientists such as Broca, Heidenhain, Krafft-Ebing, and others became interested in the subject of hypnotism.

Freud heard of Liébault’s and Bernheim’s work and in 1890 came to Nancy. He had employed hypnosis with Breuer, a physician who was interested in using this technique on mentally disturbed individuals. Freud wanted to develop his own hypnotic techniques; he studied with Charcot and Bernheim. For his purposes, he found the cures too superficial and therefore abandoned the method. Freud’s rejection of hypnosis unfortunately retarded this field for over fifty years. There is some basis for the belief, however, that Freud developed his penetrating insights into human behavior and the workings of the mind from his early work with hypnosis. He found, too, that hypnotism was a very helpful tool for recovering buried memories.

Because of the tremendous incidence of shellshock among soldiers during World War I, Ernst Simmel, a German psychoanalyst, became interested in using hypnosis for the treatment of war neuroses. He developed a technique that he called hypnoanalysis. Here for the first time the use of hypnosis was combined with psychodynamic techniques. Hadfield and Horsley, working independently, and later Grinker and Spiegel during World War II, used barbiturates to induce a state of drug hypnosis (narcosynthesis) in order to bring traumatic material to the surface. During the last war hypnosis played a prominent part in the treatment of combat fatigue and other neuroses.

The merger of hypnotic techniques with psychoanalysis was one of the most important medical developments to come out of World Wars I and II. World War I revived a great deal of interest in hypnosis in the United States. Hull, a psychology professor at Yale, became interested in the experimental aspects of hypnosis. His data and observations are described in his book, Hypnosis and Suggestibility.¹ Since then many books have appeared on this subject and at present hypnosis is on the march. Several schools such as the University of California, Long Island University, Roosevelt University, Tufts University, and others are teaching hypnosis in this country. These are not enough, but at least a start has been made. It is gratifying that more physicians and dentists are becoming interested in this age-old science. Recently the British Medical Association, after a thorough investigation of hypnosis, decided that all medical students and physicians should be well grounded in the fundamentals of hypnotherapy, that hypnotherapy is a very valuable technique in the treatment of neuroses and for anesthesia in obstetrics and surgery. Similarly, the American Medical Association has recently endorsed the use of hypnosis by qualified medical practitioners.

Current developments

In 1956 a committee of the American Medical Association met to consider how hypnosis could be integrated into medical teaching and reported their findings in the Journal of September 13, 1958.² A number of other leading medical journals have also published articles on hypnosis. There are now several journals devoted exclusively to the experimental and clinical applications of hypnosis, (1) The American Journal of Clinical Hypnosis, (2) British Journal of Medical Hypnotism, and (3) The Journal of Clinical and Experimental Hypnosis, and two journals in Spanish.

It is interesting to note that from time immemorial hypnosis has masqueraded under a multiplicity of labels. At the turn of the century there was the Janet method of relaxation, the Pierce method, and the DuBois method. More recently, there was Jacobson’s progressive relaxation. At present, autoconditioning and autogenic training are very popular in Germany. Other convenient labels for hypnoanesthesia are the Russian Psychoprophylactic Relaxation and Read’s Natural Childbirth.

It is believed that the approach of the faith healer embodies various forms of hypnotic suggestions. References to this method of relaxation are noted in the literature.

Theories

Some brief mention should be made concerning the various theories of hypnosis. In an operational definition, hypnosis may be viewed as an increased susceptibility to suggestion, as a result of which sensory and motor capacities are altered in order to initiate appropriate behavior. The difficulty with most theories is that they do not separate the trance induction process from the actual phenomena resulting from the hypnotic state. They are different entities. In hypnosis, the concern is with a segment or phenomenon of behavior that cannot be separated from the total realm of human behavior. Whether done consciously or unconsciously, man has used suggestion and/or hypnosis long before he was ever aware of it. Hypnosis is a part of everyday life. Many persons have been hypnotized thousands of times, although they may not have recognized this fact. For example, a fisherman sitting in his boat and fishing for several hours may find that the shimmering and dancing of the water lulls him into a sort of reverielike state. A man may glance at his watch and make the statement, “My goodness, have I been here for six or eight hours? Why, it seemed like only three or four to me.” Any repetitious visual, auditory, tactile, olfactory, or gustatory sensation can induce a state of increased susceptibility to suggestion. Verbal and nonverbal stimuli can readily produce relaxation when the stimulus is repeti-tiously maintained. Many a person has memories of sitting in a classroom while the professor droned monotonously on and on. He may recall that there were times when his eyes got very heavy and his head began to nod, and he actually went into a hypnoidal state. This often merged into actual sleep. Awareness can fluctuate up and down the entire broad spectrum of consciousness.

Hypnosis and susceptibility to suggestion play an important role in everyone’s life, especially in advertising. A radio or TV commercial, repeated over and over again, can eventually become a conditioned stimulus ultimately affecting behavior toward the desired response.

In some individuals, the hypnotic state may be an atavism, analogous to the inanimate state of catalepsy commonly observed in frightened animals when they “freeze to the landscape” in order to escape detection. The presence of a highly evolved cortex in the human now makes unnecessary the various instinctive defense mechanisms, unless the individual is subjected to inordinate fear or danger. In some the atavistic tendency is closer to the surface than in others. It accounts for the fact that some individuals are readily hypnotizable while others are not.

Schneck likewise believes that the state of hypnosis is a return to a very primitive level of psychophysiologic functioning and is present in all living animals, especially the human.

Hypnosis can be observed throughout the animal kingdom. A snake hypnotizes a bird by its sinuous movements. In turn a snake can be hypnotized by stroking. Strangely enough, snakes are deaf. All of us have seen pictures of or heard about the flute player who “charms” the snake into a sort of hypnotic-like state. Actually, it is his to-and-fro motions that cause the induction of a hypnotic-like state in the snake. Animal hypnosis has been well described. Anyone who has ever been on a farm knows that he can place a chicken on the ground and draw a line next to the eye closest to the ground, and the chicken will develop a tonic immobility of the limbs. A butcher who puts a chicken’s head under its wing can observe the immediate extensor rigidity of the chicken’s limbs. The chicken lies immobile. This is a form of animal hypnosis.

It is important to emphasize that hypnosis is not a state of sleep. This is evidenced by electroencephalographic studies and tests of reflexes, circulation time, and blood pressure, which reveal themselves as identical to the waking state but different from the sleep state of the same individual. Both hypnosis and sleep are altered states of awareness. One may merge into the other. The closing of the eyes, often associated with hypnosis, is used to blot out visual stimulation; as a result, there is concentration on the operator’s verbalizations. This is a common phenomenon. Music lovers at a concert who wish to concentrate put their heads back and close their eyes to hear better.

At present, conditioned reflexology, which is yet another term for hypnosis, is very popular in the Soviet Union. Pavlov, the great Russian physiologist, is probably as well known to the Russian scientists for his research on hypnosis as he is for his work on conditioned reflexes. Pavlov says it is true that words and ideas acquire a conditioned meaning for us. Conditioning is only a part of hypnosis, however, and both this concept and Pavlov’s idea of cortical inhibition are really too simple to explain the hypnotic phenomenon. Pavlov also erred in his assumption that hypnosis was a modified form of sleep.

Another theory propounded by Ferenczi, the psychoanaly...