Hypnosis is an altered state of mind, usually accompanied by some or all the following:
1
Increases in the intensity of focal concentration as compared with peripheral awareness
2
Changes in perception, memory and temporal orientation
3
Alternations in the sense of control over voluntary motor functions
4
Dissociation of certain parts of experience from the remainder
5
Intensification of interpersonal relatedness, with an increase in receptivity and suspension of critical judgement.
Individuals capable of experiencing some or all of these changes associated with a shift into the hypnotic trance state may learn to employ them as tools in facilitating therapeutic change. This applies especially to people with disorders which involve the psychosomatic interface.
Hypnosis is not sleep but rather a shift in attention which can occur in a matter of seconds, either with guidance or spontaneously. Highly hypnotizable individuals are more prone to intensely absorbing and self-altering experiences, for example when reading novels or watching good films. All hypnosis is really self-hypnosis. Under guided conditions, hypnotizable individuals allow a therapist or other person to structure their own shift in attention. However, not everyone can be hypnotized. Research using a variety of standardized scales indicates that hypnotizability is highest toward the end of the first decade of life, and declines slowly through adulthood and more rapidly late in life. Approximately two-thirds of the adult population is at least somewhat hypnotizable, and about 5 per cent are extremely hypnotizable. Among psychiatric patients, this capacity for hypnotic experience has been shown to be higher in certain disorders, such as dissociative and post-traumatic stress disorders and lower in others, such as schizophrenia. In general, the capacity to experience hypnosis is consistent with good mental health and normal brain function. Neurophysiological studies of hypnotized subjects indicate brain electrical activity consistent with resting alertness.
Hypnosis has been used successfully as an adjunctive tool in the treatment of a variety of psychiatric and medical conditions, including the control of pain; anxiety and phobias; habits, especially smoking; and in the treatment of acute and post-traumatic stress disorders. .When used in treatment, the hypnotic state provides a receptive and attentive condition in which the patient concentrates on a primary treatment strategy designed to promote greater mastery over the symptom. Some individuals with dissociative fugue states and multiple personality disorder are treated with hypnosis because their high hypnotizability becomes a vehicle for the expression of symptoms. Dissociative amnesias can be uncovered, and shifts between different personality states can be facilitated with the goal of teaching the patient greater control over these transitions in states of mind.
All psychotherapies are composed of interpersonal and intrapsyphic components which facilitate change. Hypnotic trance mobilizes focused concentration, demonstrates the ability to change both psychological and somatic experience, and intensifies receptivity to input from others. This makes the hypnotic state a natural tool for use in psychotherapy and a fascinating psychobiological phenomenon.
David Spiegel
Stanford University
Further reading
Fromm, E. and Nash, M.R. (eds) (1992) Contemporary Hypnosis Research, New York.
Spiegel, H. and Spiegel, D. (1987) Trance and Treatment: Clinical Uses of Hypnosis, Washington, DC.
