Attention Deficit Disorder

Medical vs.


Reasons for Medical Hypnosis


   Habit Disorders



   Anxiety States



Hypnosis in children and adolescents–special



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What is Hypnosis?

There is no definite dividing line between a normal waking state and a hypnotic

or trance state. Examples of alterations in consciousness occur frequently and

most people experience some of them. Both children and adults can become so

absorbed in daydreaming that they lose track of what is going on around them.

Some people consciously use daydreams to divert themselves from certain aspects

of their existence. When someone is concentrating intently on a work project,

the hyperfocusing that aids the work may also shut out noises and other

distractions. Someone who is absorbed in an activity may, when the activity

ends, need to take a moment to reorient to the external world

What hypnosis is not: Sleep. Adults who are hypnotized often prefer to have

their eyes closed. This is not necessary in order to have a deep trance state.

In fact, many children prefer to have their eyes open and even to walk around

during hypnosis. While in hypnosis, one’s attention and concentration is more

focused. During sleep, this is not usually the case. EEG patterns during

hypnosis and during sleep differ. Hypnosis is intense focused concentration,

with the partial or complete exclusion of awareness of peripheral phenomenon.

Some feel that individuals who are able to become intensely absorbed in an

activity or daydreaming make the best hypnotic subjects. Hypnotic or trance

states can occur spontaneously both inside the therapy room and in every day


Individuals may feel disappointed and say, “I didn’t feel like I was under

hypnosis.” They expect their eyes to close automatically and expect to feel a

floating or tired state. Despite this, within a few days, their target symptoms

seem to get better. This may actually be good hypnotic treatment. Individuals

experience trance in their own way. Many, particularly children, do not close

their eyes or even remain seated, during the hypnosis. Some people may continue

their work consciously or unconsciously after they leave the session. Other

individuals consider medical hypnosis a failure because they have unrealistic

expectations or goals. While hypnosis may be the primary treatment of choice for

certain symptoms and disorders, it is often appropriate as an adjunct to other

biological or psychotherapeutic techniques


Medical versus Amateur Hypnosis

When I explain hypnosis to a new patient, I often have to explain how my

procedures differ clinically and ethically from amateur stage hypnosis. Stage

hypnosis depends on a certain amount of peer pressure and a given individual’s

conscious or unconscious wishes to perform. Frequently it is not done with

consideration for the subject’s needs or vulnerabilities. I see hypnosis as a

specific medical or psychological procedure that should be done within the

context of a therapeutic relationship.

Recently a clinician from another state asked for advice about branching out

from clinical hypnosis to hypnosis for public entertainment. I advised her to

avoid this completely. It is important for licensed mental health practitioners

to use care in determining the appropriate venue for hypnosis.


Indications for Medical Hypnosis


Some patients worry that if hypnosis helps their pain that it means that the

pain in “all in my head.” Actually, that is true because ALL pain is mediated

through the brain. Pain related to surgery or medical conditions such as

shingles can respond well to hypnosis. I usually work with the patient to build

in safeguards so that he or she will be alerted to any change or increase in the



Habit Disorders

Hypnosis has been shown to be effective bruxism (repetitive teeth grinding) I

have used it successfully to help individuals stop smoking. For individuals with

alcoholism or other chemical dependency, I strongly suggest that if they are

seeing me for hypnosis, they also attend 12 step meetings.


Nausea and other Conditions

in Pregnancy:

I have had good results using hypnosis to attenuate nausea associated with

cancer chemotherapy. An added benefit in one individual was the ability to learn

to dilate small veins prior to a needle stick. “Morning sickness,” the nausea

associated with pregnancy, can range from mildly annoying to medically

dangerous. Pregnant women often wish to avoid medication unless absolutely

necessary. I do not see hypnosis, in isolation, as a substitute for childbirth

preparation classes such as Lamaze or Bradley. However, it can work in

combination with these approaches. Women with anxiety disorders, who wish to

avoid medication during early pregnancy, can often use these techniques to

decrease anxiety and minimize panic attacks.



Almost by definition, hypnosis induces a state of relaxation. This can be short

term, as when used to interrupt panic. When used with self-hypnosis, a motivated

individual can often achieve longer-term results.


Anxiety states

Hypnosis can help anxiety disorders in more than one way. It can directly

decrease anxiety and panic by inducing a state of relaxation. The therapist can

also use the hypnotic state to help the patient focus more clearly on issues

that might be causing the anxiety. Often the use of fictional stories, used as

metaphors, can give the patient a new way of looking at his or her problems.

Story telling is more permissive than direct suggestions. It gives the patient a

chance to accept or reject the suggestion without feeling that he is being




of strong emotional state

Individuals in crisis are often more susceptible to suggestion.. Susceptible

individuals may actually dissociate spontaneously during a trauma or crisis.

This tendency may be used therapeutically in emergency situations.


Psychotic Disorders:


do not use hypnosis as the primary treatment of schizophrenia or bipolar

disorder. However, I occasionally will use hypnosis to interrupt an intense

emotional state while waiting for other medical treatments to take effect. One

must use caution when using hypnosis with these individuals, but hypnosis is not

absolutely contraindicated.



Hypnosis can be a useful part of exploratory psychotherapy. The therapist often

makes use of metaphorical stories to help the patient develop another way of

looking at certain situations.



Some, such as the Speigels, feel that each individual has an innate capacity for

achieving trance state. They see this capacity as relatively stable over time.

They suggest that there may be inheritability of this capacity. Thus, they do

not use deepening techniques as much as other clinicians. They do note that

expectations and rapport with the therapist can influence the success of the


Milton Erickson emphasized less a biologically determined capacity for hypnosis.

He attempted to find metaphors suitable for each individual. He also would use

deepening techniques. He felt that individuals who seemed to have a limited

capacity for trance could still achieve trance states with proper technique.

Many clinicians approach their hypnotic work from a middle ground. It is useful

to get a sense of the patient’s capacity to easily achieve trance. However, much

can be done to deepen and enhance the trance state. Additionally, a great deal

of productive work can be done while an individual is in a light trance state.

Hypnotic Induction

The induction is essentially a ritual that helps formalize a transition to a

more focused state of consciousness. Deep or light trance states can occur

spontaneously. The formal induction process serves to organize and structure the

process so that the trance state can be more efficiently used in therapy. There

are a wide variety of types of hypnotic inductions. Some therapists tend to use

a particular type of induction most of the time. Others vary the type of

induction depending on the personality type and preferences of the patient.

Brief induction techniques can be more practical because the patient can often

learn to use it himself in “real world” situations.

Self Hypnosis

I will often teach patients how to use self-hypnosis so that they can gain more

control over the process. They can use it between sessions as boosters. Often I

teach them a long induction for when they have time and a shorter induction for

quick use in crisis situations. Individuals who have difficulty doing the self

hypnosis may benefit from hypnosis tapes. I will often make up custom tapes for

certain patients.

Hypnosis and Children

Children are actually more easily hypnotized than adults. They may become bored

with a slow adult-type progressive relaxation induction. If one expects to see a

hypnotized child lie still with his eyes closed, one may conclude that the child

is incapable of trance.


When children experience pain, they may not understand what is going on. Thus,

the pain may be complicated by anxiety. Hypnosis along with sensitive, age

appropriate explanations, can result in good pain relief. In severe or chronic

pain, the psychiatrist may want to coordinate treatment with other medical


Anxiety Disorders

In separation anxiety, hypnosis can compliment a comprehensive approach which

may also include specific family guidance, psychotherapy and sometimes

medication. The hypnosis may help decrease the child’s anxiety during separation

by helping him or her to carry an internalized representation of a parent with

them. In reactive anxiety, (anxiety directly related to stress) hypnosis may be

the treatment of choice and further treatment may not be necessary.


Cognitive psychotherapy can help a child or adolescent with OCD as it can an

adult. Hypnosis can be an adjunctive treatment.


I do not use hypnosis as a primary treatment for AD//HD or learning disorders.

Primary treatments for this condition include parent training, medication,

educational intervention, psychotherapy, and the use of support groups. Hypnosis

can sometimes augment these treatments by improving self-esteem, anxiety, and


Behavior disorders.

When one is treating a child or adolescent, the goals of the parent and school

may be different from those of the child. In such situations, control issues may

be prominent. When I use hypnosis in such situations, I emphasize the permissive

nature of the trance state. I do not try to use the hypnosis to make a child do

things he does not want to do. I try to use the hypnosis to help the individual

focus on the positive things he or she wants to achieve. The trance state may

help the child or adolescent break out of an oppositional stance by encouraging

him or her to think of creative solutions.


Contraindications for Hypnosis

This is a controversial subject. Different clinicians have varying opinions

about the appropriate uses of hypnosis. I tend to be more conservative than some

other experienced clinicians. Most licensed clinicians agree that they should

not use hypnosis for public entertainment. It is not a good idea to try to

induce hypnosis in a patient who does not want it. One should not use hypnosis

to try to achieve goals other than the patient’s wishes. Generally, it would be

difficult to use hypnosis in this way. However, there have been reports of

manipulation of ambivalent patients in hypnotherapy and other forms of therapy.

There are a number of specific patients who I might feel would benefit more from

another type of psychiatric intervention. In such cases, I will discuss a range

of treatments and their potential risks and benefits. Hypnosis is one of a

number of psychiatric treatment techniques. The person doing the hypnosis should

first be a well-rounded clinician with knowledge of psychiatric diagnosis and