Hypnosis
From charlatans to medical care
IT CAN be used for hypnotic preparation toward birth; emotional adjustment and behavioral problems in the young; bedwetting; training children with serious illness to hypnotize themselves to reduce pain and anxiety; lack of concentration on studies; conflicts with parents; trichotillomania [hair pulling], fear of heights, flying and other phobias; difficulties with military service; relationships; stress; coping as grandparents; adjustment to aging and much more. However, Livnay admits that there are limitations: getting people to kick the smoking habit using hypnosis, for example, is “very complicated and can easily not succeed,” he says.
Hypnosis, derived from hypnos, the Greek word for sleep, is defined as a “special psychological state with certain physiological attributes, resembling sleep only superficially and marked by a functioning of the individual at a level of awareness other than the ordinary conscious state.” A leading founder was Franz Anton Mesmer, an 18th-century German doctor who suggested that there was a “natural energetic transference” that occurred between all animated and inanimate objects that he called “animal magnetism.” His theory was later called “mesmerism,” and “mesmerized” has long been accepted in the English language.
“He believed in ‘magnetic fluid’ that people had to balance against their illness,” said Livnay. “Mesmer made a special bathtub with rods immersed in it to treat mass hysteria. He was thrown out of Vienna and went to France, where five investigative committees were set up, one of them headed by the American statesman and inventor Benjamin Franklin. But none of them found the device made any difference. They realized that hypnotism was connected to imagination and the power of suggestion.”
Performers claiming to hypnotize subjects, often “stooges,” gave hypnotism “a bad name” for centuries.
The great psychiatrist Sigmund Freud went to study hypnosis in France, said Livnay. “He was very rigid and saw that after hysterical blindness was ‘cured’ in a patient, the condition returned. He didn’t know what
Hypnotism has been practiced for thousands of years, and for most of that time it was associated with magic, witchcraft, meditation, charlatans and entertainment. Only in the past century have the medical and psychological benefits of hypnotherapy been documented, scientifically proven and significantly utilized to treat a gamut of problems from stuttering, bruxism (teeth grinding) and phobias to painful childbirth, anxieties and psychiatric diseases. But the layman retains many misunderstandings and myths about hypnotism, and large numbers of people who could benefit have no access because the treatment is not included in the basket of health services.
There are 250 active members in the Israel Society of Hypnosis, chaired by clinical psychologist Dr. Udi Bonstein. Nearly 50 percent of licensed hypnotherapists are clinical psychologists like him, about 30% psychoanalysts/psychiatrists and the rest dentists. All of them have to take and pass a special hypnotism course to be licensed.
The society would like to see other professionals, such as nurses, clinical social workers, midwives and physiotherapists join, but the law would have to be changed – a very complex process.
Dr. Shaul Livnay , a Swiss-born, France-raised and American- and Israeli-trained senior clinical psychologist, licensed supervisor and trainer of hypnosis who has integrated hypnotherapy into his practice for the past 30 years, recalled its background and explained its uses.
In an interview last week with The Jerusalem Post, he said: “I have used it on many hundreds of patients for matters of parental guidance, treatment of children and adolescents, help for adults in their 20s through 50s and through retirement.” to do after the trance ended. Freud had a flirtation with hypnosis, and turned it eventually into free association, but sometimes disliked it because he thought he was not good at it. He also felt uncomfortable when patients stared at him, so he always sat behind the patient, whom he put on a couch. He always preferred that arrangement when dealing with patients.” ONE OF the most veteran licensed hypnotherapists in Israel, Livnay attended his first hypnosis conference in Jerusalem in 1988. “I felt freed, much more open to patients when I learned it. I began to use it with other techniques, and today I am an integrative therapist.” Asked whether all patients can be “inducted” (urged) into a trance, Livnay said about 10% are not susceptible to it at all, 10% are “always in a trance,” while the rest have to be inducted. “We conduct tests and use scales to determine who can do it. There is no correlation to age, sex, culture, religiosity or other factors.” Hypnosis, which is a kind of psychotherapy, was in 1892 recognized by a committee of the British Medical Association, the body of experts evaluated the nature and effects of hypnotherapy and decided that it is “frequently effective in relieving pain, procuring sleep, and alleviating many functional ailments.”
Only in 1955 did the BMA officially approve hypnotherapy, and stated that in the previous century that it could be “of great service in the treatment of patients.” The American Medical Association followed with a commission in 1958 that decided “hypnosis has a recognized place in the medical armamentarium and is a useful technique in the treatment of certain illnesses when employed by qualified medical and dental personnel.”
There is no such thing, said Livnay, as doing only hypnosis. “It is a tool to use within your specific specialty. For example, it can be used on pregnant women to affect the fetus. Babies emerge very calm. Most courses for childbirth include hypnosis without saying so.
“Even though hypnosis has a strong influence on many patients, it doesn’t mean that I use it on everyone. Some come only for hypnosis, for anxiety or psychosomatic problems, for example. It then takes six to 12 sessions. I tell them it’s part of therapy, even a major part, but never the whole treatment.”
But many people have “more complex problems. Hypnosis for these conditions usually shortens the number of psychotherapy sessions they need,” he says. However, he continued, if a person is very unstable “and an untrained therapist opens him up with hypnosis, he could go into psychosis. Untrained people have been sued for harming patients. There was a famous case a few years ago of a Florida high-school principal who tried to help pupils suffering from test anxiety, and a suicide was the result.”
The left brain hemisphere, he explained, controls reasoning and language. The right brain deals with imagery and imagination. “Inducing a hypnotic trance means that the patient leaves the generalized reality orientation and begins to drift, using free associations. He closes his eyes, concentrates and uses his imagination.”
Hypnotists used to use crystals as a pendulum to wave in front of the patient’s face. “We may use it to test the person’s ability to go under or do some investigative work. But today we often use individual colorful marbles; patients choose one and smile, because they have a warm feeling as they associate it with their childhood. When they touch it, it’s so relaxing. Induction can also be verbal. It can take a few seconds to a few hours to get there.”
There are several myths about hypnosis. “One,” says Livnay, “is that the therapist is in control. In fact, the patient is always in control. He might decide to give up conscious control of his left brain and open up the right hemisphere, but the therapist cannot control him like a puppet. A trance can not be used to force a patient to abandon his morals and principles.”
Another myth is that if a patient is inducted, there is a danger that he won’t be able to wake up. Most people close their eyes and become immobile, so they look asleep. But they are still conscious. Some patients fear they will lose their memory, said Livnay, “but they always remember what happened and remain in control during the induction, hearing the therapist and being de-hypnotized.
“If a stage is skipped, and the therapist claps his hands but all stages have not been performed, the patient may go out a bit mixed up and return to reality by themselves. Yet they may be frightened. The hypnotist must make sure to test the patient to ensure that he has ‘come back’ properly. Unless I’m working on a person suffering from insomnia, in which case I put them on a couch or they sit on a lounge chair with their feet up, I have people sit on a regular chair in front of me.”
Although he is not observant himself, he has ultraOrthodox patients, who he says learn about his service by word of mouth. “I recently treated some yeshiva students who had all kinds of problems caused by their intensive study. I used hypnosis to get them to relax. Teenagers are complicated, but I got a whole slew of problems yeshiva students who came to get relaxed.”
Phobias are very common. “People are afraid of small or large places [claustrophobia and agoraphobia] or of getting into a plane. There are some people, mostly women, who drive perfectly well in the city and never had an accident but are petrified by the idea of driving on intercity roads.”
Hypnotherapy is very useful for pure medical purposes, including preparing and calming patients before surgery so they are more cooperative with their doctors, Livnay said. For this purpose, many surgeons have learned to do hypnosis themselves.
Some hospitals are strong advocates of hypnosis; Hadassah University Medical Center in Jerusalem’s Ein Kerem, for example, has a hypnosis unit headed by Dr. Eitan Abramovich.
“With hypnosis, recovery takes less time,” said Abramovich, “and there is less bleeding and less need for anesthesia and pain killers. There was a Scottish surgeon back in the 19th century who performed over 5,000 operations using hypnosis; 500 of them involved major surgery, all without anesthesia. But this use was largely replaced by modern anesthesia.
“I have a colleague in Turkey who performed a hysterectomy on a highly motivated woman. He put her into a trance, and a curtain was placed in front of her. Fully conscious but with no pain, she talked to the surgeons about a recipe she had made.”
Hypnotherapy can help patients with skin conditions; psoriasis has a major psychosomatic element. So does irritable bowel syndrome; hypnosis is almost the treatment of choice. It can give cancer patients getting chemotherapy some relief from nausea. For pain, hypnosis can help no less and probably more than medical marijuana, Livnay said. “But the technique cannot be used on psychotic or other severely disturbed patients.”
Stroke patients, people with tinnitus (chronic ringing in the ears), hypertension, or those with kidney failure who are on dialysis also can benefit from hypnotherapy. Many dentists use it to pull teeth, make fillings, treat bruxism and a gag reflex in their patients – or a complete dental phobia. One health fund, he concludes, “has had a hypnosis unit in its dental service for many years.” DR. UDI Bonstein, a physician who studied hypnotherapy at Tel Aviv University Medical School and has practiced it for 15 years, said he would like to have a day at the Israel Society of Hypnosis national conference next May opened to physicians and other professionals who are interested. But some doctors are “still leery, especially as the therapy is not provided by the health funds free, so they don’t want to take the risk and establish a hypnosis institute. If it were included in the basket of health services, many more would do it. And it should be taught to medical students in their final years of studies.”