Hypnosis in the Management of Sleep Disorders

William C. Kohler, Peter J. Kurz

• Publisher: Routledge
• Year: 2017
• Print ISBN: 9781138062283
• eBook ISBN: 9781351666107
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Hypnosis in the Management of Sleep Disorders combines history and medical science to show that the use of hypnosis and hypnotic techniques is effective in the treatment of sleep disorders -- and that this is increasingly validated through modern tools (computers, fMRI images). Dr. Kohler and Kurz show readers that hypnosis and hypnotic techniques are not to be feared or avoided, but that their use can contribute to effective, non-intrusive, and cost-effective approaches to the treatment of sleep problems. This volume is a much needed reference for therapists and their patients alike on how hypnosis can be helpful in the treatment of certain sleep disorders.

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1   Introduction

This book was written for anyone interested in learning more about sleep and how an unappreciated, underused, and misunderstood technique – hypnosis – can be a medically sound and effective way to treat a number of sleep disorders.

The authors feel that hypnosis can be a non-invasive, important addition to the ways in which certain sleep disorders can be treated effectively and with fewer side-effects than other alternatives. Aside from the obvious benefits to the patient, greater usage will lead to a better understanding of hypnosis as a medical procedure, which will in turn lead to more scientific attention and focus on additional research.

Our most important goal is to provide an accurate and readable overview of the fields of sleep and the use of hypnosis in sleep medicine. The authors hope that this book will provide basic information useful to practitioners in the medical field as well as the interested general public. It is neither a “self-help” book nor a medical textbook. Rather than being an encyclopedic compilation of data and case studies the authors tried to offer a book that provides an easy-to-read but useful mix of historical and scientific background. To make the book readable, when needed our notes are at the end of each chapter, not disruptive to the flow of the text, yet easy to find in the context of each chapter and its major topic.

A second objective is to provide a useful, credible listing of references and resources for the reader who is or becomes more interested in one or all of these important – and very much related – topics. The reader who wants to learn more about aspects covered in the text can find them in the notes or through the resources sections at the end of the book (Appendix D).

This work should be particularly useful to those who are interested in or need a book on the new science of sleep and in new forms of treatment for certain sleep disorders. Dr. Kohler believes that hypnosis and hypnotic techniques should be at the forefront when considering treatment for sleep disorders. It may be a clarion call to professionals in the medical field, in the field of hypnosis, existing patients or others, perhaps, who have family members, friends or co-workers who could benefit from the treatment of sleep disorders through hypnotic techniques.

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At the turn of the nineteenth century, between 1890 and around 1920, several major developments and discoveries radically changed our understanding of the brain and the function of sleep. Dr. J. Allan Hobson, a professor and psychiatrist at Harvard Medical School, narrows the critical period even further:

If we were asked to identify the time frame in which the psychological and neuro-physiological study of the brain/mind took on its current “modern” form it would be the decade between 1890 and 1900. In that decade three important developments set the science of sleep and dreaming on its current course.

(Hobson and Wohl 2005)

In the following chapters this book will elaborate on these and other “important developments.” We will provide an outline of how, in a parallel course and affected by these developments, our understanding of hypnosis also changed significantly. This has led to the increased and effective use of hypnosis in the medical treatment of certain sleep disorders that will also be part of this book’s message.

In summary, the four messages the authors hope to convey to readers of this book can be stated as follows.

First, there is a new “science of brain” which continues to change and evolve as a result of unprecedented technical and related medical advances. This enhanced understanding of how the brain functions is interrelated with our understanding of other areas such as sleep, dreaming, and hypnosis.

Second, we now know more about sleep and its function and effect on human well-being than has ever been known before. Since the development of electroencephalographic technology (EEG) and the introduction of polysomnograms (PSGs) plus the discovery of rapid eye movement (REM) state sleep (in 1953), we have reached a new definition of sleep and of its many functions. We now know that sleep is not merely the “absence of wakefulness,” that the brain continues to be active at a very high rate even during sleep, and that sleep provides humans with numerous benefits far beyond just rest.

Third, these same instruments and a more sophisticated and accurate understanding of our brain and the nature of sleep have also clarified to a certain extent our understanding of the nature and function of dreaming.

Finally, also on a parallel track of rapidly occurring new discoveries is our understanding of hypnosis and the effectiveness with which hypnotic techniques can be used in the medical treatment of patients. This track is affected and influenced by the parallel developments in the fields of mind, sleep, and dream science.

Our hope is that this work will reach a wide audience and, therefore, will stimulate additional interest, foment more research, and for many more patients will lead to better treatment.

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Recent advances in our understanding of how the brain functions have been so rapid and numerous that it is difficult to keep pace in our understanding of what has been discovered and what these discoveries mean. The historical background we will cover, our concomitant current understanding, and the practical results from which we benefit today are only a beginning.

The pace of new developments is accelerating and the findings and consequences are – literally – mind boggling! With the technological advances of the last decades – particularly in computer science, optics, and radiology – valuable and unique research constantly results in major, at times surprising, new findings. This research is no longer limited to a few distinguished and well-known academic and scientific centers. The major research and academic centers of Western Europe, Japan, and North America will continue to amaze us with their new and astonishing discoveries and surprising announcements. But valuable – routine as well as extraordinary – research is going on throughout the world. And, equally importantly, it is shared and dissipated to all corners of the globe, more rapidly and in greater numbers than ever in human history. The authors believe that this will continue at what may become an even faster pace.

The authors also believe that this will introduce a new era – an exciting new future – in the treatment of sleep disorders. As we unlock the scientific mysteries of the brain, of sleep, dreaming, and hypnosis, the authors believe that the results that Dr. Kohler has already seen will be enhanced, leveraged, and multiplied through the better use of already existing as well as through the future use of yet unimaginable tools and techniques.

But first, before we dive into the new science of sleep and a more detailed discussion of why and how hypnosis is expected to become an effective way to treat numerous diseases – including sleep disorders – we will explore in more detail the very basic topics of what is sleep? And what is hypnosis?

Reference

Hobson, J. Allan and Hellmut Wohl. 2005. From Angels to Neurones: Art and The New Science of Dreaming. Special Edition. Fidenza: Mattioli 1885.

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2 What is Sleep?

I don’t understand what you say, replied Sancho; I only know for sure that as long as I’m asleep I have neither fear nor hope, neither work, nor glory; and praise be to whoever invented sleep, the very cloak that covers all human thoughts, food that removes hunger, water that drives away thirst, the fire that warms the cold, cold that tempers heat, and the universal currency with which all can be acquired, the weight and balance which makes a shepherd the equal of a king and the fool the same as a wise man. According to what I’ve heard, there is only one thing wrong with sleep and it is that it’s like death; there is very little difference between the sleeping person and the dead.

(Cervantes, 2010, Don Quixote, Part II, Chapter LXVIII)¹

All of us “know” what sleep is. This state called sleep may be mysterious and its purpose may be puzzling, but all humans experience it for periods of more or less the same length of time and within quite predictable, cyclical intervals. Yet we struggle when asked to describe and to define it. Why? After all, since recorded history there is evidence that healthy humans spend around one-third of their lives in this state – sleeping. Whether in Africa, Asia, Europe, everywhere on earth and now also in space, today as thousands of years ago, females and males, young and old, tall, short, overweight or thin – for all sleep is a most essential and universal need and practice.

Imagine how this would look to very different outside visitors observing us for the first time, perhaps imaginary aliens from another planet: regularly, everywhere, animals stop at predictable intervals, assume an apparently inactive, passive state, and do not emerge for an equally predictable, specific period. This is precisely how our ancestors began to study sleep and in their notes or drawings left us a record of their varied conclusions, often based on very careful observation but always tinted by their environment, their philosophies of life and death, and, of course, a fertile imagination.

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What is Sleep? Attempts to Depict, Describe, and Define

But what really is sleep? The truth is that we still don’t know. Because it is so universal, essential to life, and predictable, also because for millennia it has been almost exclusively a nighttime event, many easy conclusions and superficial definitions emerged. We could only see the outward results of something we labeled sleep. We were not able to “touch” or otherwise document any hard physical evidence of how such a state came about. Interestingly, several cultures have used and continue to use the exact same word for “sleep” and “dreaming.” One example is Spanish, illustrated by the great Cervantes in his story of the adventures of Don Quixote and his squire, Sancho Panza. The Spanish equivalent of the English “sleep” is sueño, as is “dream.” Consequently it is impossible for a translation into English of the passage quoted at the beginning of this chapter to reflect completely the nuances which Cervantes observed and knowingly inserted. The comparison Sancho makes when describing the “only fault” or negative aspect of sueño – that “it’s like death” – could be a reference to either or both “sleep” and “dream” (Oxford Spanish Dictionary 2003, 780).²

At the beginning of the twenty-first century we know more than we have ever known about the brain and the states of sleep, dreaming, and hypnosis, but even so we have only begun to scratch the surface. The four are related and intertwined and the more we learn about each the more we are awed by how one touches the other. It is precisely the rapid exchange of new discoveries and information in each of these sciences that propels and accelerates the phenomenal progress we now see in our understanding of each.

Most definitions of sleep are incomplete, inadequate, or outright inaccurate. Because our understanding of the scientific basis was missing until very recently, such definitions have always been circumstantial, without the benefit of the neurological and physiological information which we began to amass during the past century or so. In defining sleep, the Oxford English Dictionary (OED) reflects the difficulty in attempting to be complete, precise, and accurate. In defining “sleep,” even the Compact Edition fills a beginning page, moves through two additional pages, and finishes at the end of the fourth page. The next word – “sleeper” – begins two full pages of additional English words beginning with some form of “sleep” (sleepiness, sleepwalker, finally stopping at “sleepy”). The most significant first definition of sleep (the noun) is:

1. a. The unconscious state or condition regularly and naturally assumed by man and animals, during which the activity of the nervous system is almost or entirely suspended, and recuperation of its powers takes place; slumber, repose. Also, a similar state artificially induced, as hypnotic (or magnetic) sleep.

(Oxford English Dictionary 2014, “sleep”)

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Adding: “The word is further applied to the more inert condition of certain animals during hibernation.” The verb “to sleep” is defined primarily (1.a.) as “To take repose by the natural suspension of consciousness; to be in the state of sleep; to slumber.”

Dictionary definitions are not always accurate. The authors (WCK and PJK) believe that by the end of this work the reader will find this first definition to be inaccurate and oversimplified. It is interesting to read OED’s fourth definition related to what appears to be a universal linkage of “sleep” with “death” and dying: “4. Fig[urative] a. “The repose of death” (Usually with qualifying terms or phrases). To put to sleep, to kill, esp. painlessly.“ Another version by OED offers the following: “4. A state compared to or resembling sleep, such as death or complete silence or stillness” (Oxford English Dictionary 2014, “sleep”).

As will be mentioned in later pages, our departure from waking consciousness at regular intervals for hours of “sleep” leads to major changes in brain wave activity and many physiological functions. Significant differences occur during the two major sleep stages, which will also be defined later. Sleep is a period of reduced motoric activity and of decreased responsiveness to external stimuli. But we have learned through modern scientific studies and with the help of modern techniques that the activity of the brain continues at a very high level even during sleep. However, first, let us look at sleep as most of humanity saw it for thousands of years, through the eyes of artists, storytellers, and writers.

What is Sleep? Artists and Writers Search for an Answer

For thousands of years, roughly until the beginning of the twentieth century, our understanding of sleep was entirely through perspicacious observation and inspired, talented depiction through words and art. Such works of art, literature, and philosophy have been created since the beginning of recorded history. The phenomenon of sleep has always been of great inter...

Table of contents

• Cover Page
• Hypnosis in the Management of Sleep Disorders
• Title
• Copyright
• Dedication
• Contents
• Preface
• Acknowledgments
• Author Biographies
• In Memoriam Dr. William C. Kohler
• 1 Introduction
• 2 What is Sleep?
• 3 What is Hypnosis?
• 4 A Brief History of Medical Hypnosis
• 5 The Selection and the Mechanics of Hypnotizing a Patient
• 6 A Brief History of Recent Developments in the Treatment of Sleep Disorders
• 7 The Successful Use of Hypnotic Techniques in the Management of a Dozen Sleep Disorders
• 8 Case Studies from Dr. Kohler’s Practice
• 9 The (Very) Exciting Future
• Appendix A: “Sleep Patterns in 2-Year-Old Children” An article by Kohler, Coddington, and Agnew. Pediatrics. 1968
• Appendix B: “The Treatment of Sleepwalking with Hypnosis” Poster by Kohler, Presented at World Association of Sleep Medicine Congress. 2011
• Appendix C: Glossary
• Appendix D: Resources
• Index