The Discovery of Hypnosis: The Complete Writings of James Braid (2009)

The Discovery of Hypnosis

The Discovery of Hypnosis:

The Complete Writings of James Braid, the Father of Hypnotherapy

Foreword by Dr. Michael Heap
Edited with detailed prefatory essays by Donald Robertson
Published by the National Council for Hypnotherapy (NCH)

From the author: This is a major new publication which every hypnotherapist should possess. Just as you’d expect every psychoanalyst to have read Freud, every hypnotist should be familiar with the writings of James Braid, the founder of hypnotherapy. Braid’s writings are particularly relevant today with the growing emphasis upon evidence-based practice in psychological therapies. Contrary to popular misconception, which tends to confuse hypnotism with mesmerism, hypnotism actually originated as an early scientific critique of pseudoscientific Victorian therapies such as animal magnetism. Braid, as these writings clearly demonstrate, was an arch-sceptic and passionate empiricist, seeking a rational and common sense explanation for the phenomena of hypnotism.

Braid’s views help to powerfully counteract some of the most common misconceptions which undermine the confidence of clients and other professionals in hypnotherapy. Braid’s common sense approach makes hypnotism understandable and accessible, cutting through the confusion which followed in later decades. His ideas are surprisingly consistent with modern research on hypnosis and pre-empt certain aspects of contemporary cognitive-behavioural therapies (CBT). Braid’s writings even contain “forgotten” hypnotherapy strategies and techniques, which deserve to be revisited in modern times.

Available now from Amazon UK and Amazon.com

You can also browse the whole text online free-of-charge through Google books or visit our website and blog www.James-Braid.com

Some Reviews from Readers on Amazon

An Important Book for All Hypnotherapists – Paul Howard, hypnotherapist

This should be essential reading for all hypnotherapists, and for anyone with an interest in the history of psychology or psychotherapy. Most of Braid’s writings have been pretty much unavailable until now. 150 years on many of Braid’s ideas are still relevant. Braid’s writings show that hypnotism began as a thoroughly scientific therapy, based on criticisms of Victorian quack remedies.

Obligatory Reading – John O’Flynn, hypnotherapist

This quintessential work should be obligatory study for anyone in the field of Hypnotherapy. Donald Robertson unfolds the history of this most powerful therapy, through the words and works, the experiments and demonstrations, of Dr. James Braid, in a straightforward, deeply educational and most enlightening fashion. Excellently researched, it recounts the journey of a highly respected doctor who set out to debunk the follies of Mesmerism and found the jewel of Hypnosis. If you wish to simply understand hypnosis, or study the subject in depth, this is most certainly the book to have. I would go so far as to say, shame on anyone in the field of Cognitive Behavioural Hypnotherapy, who remains ignorant of what this book contains.

Fascinating – Tom Butler-Bowdon, self-help author

Braid was the first to put hypnotherapy on a scientific, rational footing, so today’s hypnotherapists have a lot to thank him for.

A Manchester surgeon, Braid discovered hypnotism reasonably late and like most doctors of his time considered stage hypnotists charlatans. It was only his physical examination of a hypnotised subject that convinced him an actual bodily change had taken place with non-mystical causes.

The Discovery of Hypnosis puts together Braid’s key writings and provides succinct commentary and historical context. This is an exhaustive survey and the editor has obviously mastered the material, revealing an underrated figure in the history of psychology and psychotherapy.

One of Robertson’s fascinating ideas is that Braid should not be considered simply the father of hypnotherapy, but the father of psychotherapy, given his early work into what is now called cognitive behavioural therapy.

Robertson’s clear writing style and to-the-point comments enliven the historical material, and the book itself is large and well laid out. Any hypnotherapist serious about their subject should have this book in their library. It is also a intriguing read for the layman.

Available now from Amazon UK and Amazon.com

You can also browse the whole text online free-of-charge through Google books or visit our website and blog www.James-Braid.com

What Braid Really Said: The Original Meaning of Hypnotism

What Braid Really Said: The Original Meaning of Hypnotism

Copyright (c) Donald Robertson 2009

For more information on the origins of hypnotism see my new book The Discovery of Hypnotism: The Complete Writings of James Braid (2009).

James Braid was the Scottish physician and surgeon who coined the term “hypnotism” and essentially founded hypnotherapy as we know it today, in opposition to the “animal magnetism” of the Mesmerists.  Fourteen years after discovering hypnotism, Braid wrote his last book on the subject, The Physiology of Fascination (1855), the text of a lecture to be read before the prestigious British Association.  By this time, Braid had come to define hypnotism as “the study of the reciprocal actions and reactions of mind and matter upon each other”, the key term here being “reciprocal” because hypnotism originally involved not only the power of the mind over the body but also the power of the body over the mind.

Braid carried out many ingenious experiments to test the claims of the mesmerists and convinced himself that their perceived effects were not due to animal magnetism or any special force or subtle energy transmitted by the mesmerist.  Instead,  he found that “the condition arose from influences existing within the patient’s own body, viz., the influence of concentrated attention, or dominant ideas, in modifying physical action, and these dynamic changes re-acting on the mind of the subject.”  Hence, although the terms “mesmerism” and “hypnotism” are often confused today, Braid was clear that he introduced the term “hypnotism” to distinguish his psychological and physiological theory from the supernatural theory of Mesmer and his many followers.  However, after over a decade of experimentation and clinical practice in hypnotism, Braid now proposed to modify his terminology. 

First, Braid rejects the notion that hypnotism refers to a single state of mind.  “This term has met with most favourable consideration from many able writers on the subject; still it is liable to this grave objection – that it has been used to comprise not a single state, but rather a series of stages or conditions, varying in every conceivable degree, from the slightest reverie, with high exaltation of the functions called into action, on the one hand, to intense nervous coma, with entire abolition of consciousness and voluntary power, on the other.”

The word “hypnotism” was originally an abbreviation for the term “neuro-hypnotism” meaning “nervous sleep”, as Braid puts it, or neurological inhibition, as we might put it today.  Braid never intended the term to imply that subjects were asleep in the ordinary sense of the word, and this turn of phrase caused much confusion among his patients.

I am well aware that, in correct phraseology, the term hypnotism ought to be restricted to the phenomena manifested in patients who actually pass into a state of sleep, and who remember nothing on awakening of what transpired during their sleep.  All short of this is mere reverie, or dreaming, however provoked, and it, therefore, seems highly desirable to fix upon a terminology capable of accurately characterising these latter modifications which result from hypnotic processes.  This is the more requisite from the fact that, of those who may be relieved and cured by hypnotic processes of diseases which obstinately resist ordinary medical treatment, perhaps not more than one in ten ever passes into the state of oblivious sleep, during the processes which they are subjected to.  The term hypnotism, therefore, is apt to confuse them, and lead them to suspect that, at all events, they cannot be benefited by processes which fail to produce the most obvious indication which the name imports. 

So, according to Braid here, as elsewhere, only 10% of his patients experienced complete amnesia during hypnotism, or anything which could be compared to a sleep-like state.  It may surprise many people to realise that this observation agrees with that of Bernheim and most other Victorian hypnotists.  Only a small minority of their patients entered the sleep-like state called “somnambulism” and it was not generally considered particularly important to the practice of hypnotherapy.

Braid apparently intended to continue using the established term “hypnotism” to refer to the subject of mind-body interaction in general, when speaking loosely, but to clarify that, strictly speaking, the term “hypnotism” should only be taken to describe a minority of subjects who experience profound amnesia during the process.

Let the term hypnotism be restricted to those cases alone in which, by certain artificial processes, oblivious sleep takes place, in which the subject has no remembrance on awaking of what occurred during his sleep, but of which he shall have the most perfect recollection on passing into a similar stage of hypnotism thereafter.  In this mode, hypnotism will comprise those cases only in which what has hitherto been called the double-conscious state ["somnambulism"] occurs; and let the term hypnotic coma denote that still deeper stage of the sleep in which the patient seems to be quite unconscious at the time of all external impressions, and devoid of voluntary power, and in whom no idea of what had been said or done by others during the said state of hypnotic coma can be remembered by the patient on awaking, or at any stage of subsequent hypnotic operations.  

Far from sleep, the essence of hypnotism was awareness.  Braid now defined hypnotism as a state of mental focus or concentration upon a dominant conscious idea.

Then, inasmuch as I feel satisfied that the mental and physical phenomena which flow from said processes result entirely from the mental impressions, or dominant ideas, excited thereby in the minds of the subjects, changing or modifying the previously existing physical action, and the peculiar physical action thus superinduced re-acting on their minds – and that, whether these dominant, expectant ideas existed in the minds of the subjects previously, or were suggested to them, after passing into the impressible condition, by audible suggestions or sensible impressions excited by manipulations of a second party – under these circumstances, I consider the following terms calculated to realise all the precision which we need desire on this point…

Braid proposed to use the term “monoideism”, and various cognate expressions, instead, meaning the concentration of the mind upon a single dominant idea or train of thought.  Braid borrowed the terms “ideo-motor reflex” and “ideo-motor reflex” from his friend Prof. W.B. Carpenter who proposed a theory of unconscious muscular action caused in a semi-reflex manner by certain ideas or images.  Braid added the concept of expectation and focused attention to this simple model of suggestion, to form the basis of his theory of hypnotism.

In order that I may do full justice to two esteemed friends, I beg to state, in connection with this term monoideo-dynamics, that, several years ago, Dr. W. B. Carpenter introduced the term ideo-motor to characterise the reflex or automatic muscular motions which arise merely from ideas associated with motion existing in the mind, without any conscious effort of volition.  In 1853, in referring to this term, Dr. [Daniel] Noble said, “Ideo-dynamic would probably constitute a phraseology more appropriate, as applicable to a wider range of phenomena.”  In this opinion I quite concurred, because I was well aware that an idea could arrest as well as excite motion automatically, not only in the muscles of voluntary motion, but also as regards the condition of every other function of the body.  [Braid had long recognised that hypnosis could either stimulate or depress nervous functioning in general.]  I have, therefore, adopted the term monoideo-dynamics, as still more comprehensive and characteristic as regards the true mental relations which subsist during all dynamic changes which take place, in every other function of the body, as well as in the muscles of voluntary motion.

To this he adds, “as a generic term, comprising the whole of these phenomena which result from the reciprocal actions of mind and matter upon each other, I think no term could be more appropriate than psycho-physiology.”  Of course, “psycho-physiology” means something like “mind-body” and Braid prefers it as an umbrella term for the many respects in which the mind and body inter-act reciprocally upon each other.  He concludes,

It must be obvious that these terms would comprehend every conceivable variety of phenomenon, according to the function of the part on which the dominant idea of the subject might be concentrated, and the liveliness of his faith.  Thus, let the mind of the subject be engrossed with the notion that he is to be irresistibly drawn, repelled, paralysed, or catalepsed, and the monoideo-dynamic or ideational condition of the muscles corresponding with this idea will take place, without any conscious effort of volition of the subject to that effect. 

In brief, contrary to popular misconception,

1. Braid opposed hypnotism to mesmerism, they are not the same thing.
2. Only 10% of Braid’s subjects felt as if they were asleep or unconscious, and this was not essential to hypnotism.
3. Far from being a passive state like sleep, hypnotism was defined as a variety of states revolving around focused conscious attention and heightened expectation.
4. Hypnotism was not simply a theory of the power of suggestion but of the reciprocal power of psycho-physiology, of the mind and body inter-acting in both directions.
5. In addition to verbal suggestion, therefore, Braid emphasised what he termed “muscular suggestion”, in which subjects changed their body posture or facial expression to evoke mental states.

I hope these brief comments will encourage some hypnotists to read Braid’s work more closely and rediscover the true nature of the original hypnotism, because many of the misconceptions about hypnotherapy which abound today are the result of confusing hypnotism and mesmerism, and a “return to Braid” would allow us to set the record straight in a way that can only benefit our clients.

AD: Diploma in Cognitive-Behavioural Hypnotherapy (UK College)

Diploma in Cognitive-Behavioural Hypnotherapy

In my opinion, Don is one of the leading authority figures in the art of hypnotherapy and self hypnosis of his time. I would have no reservations at all in recommending him to whoever wishes to broaden their understanding of these fascinating disciplines.  (Frank Forster, Chair of AICH)

Do you want to become a professional hypnotherapist? Call the UK College now on freephone 0800 195 9809 to order a prospectus. Save 10% on the total cost of training, when paying in full before 31st October, and receive a free copy of our new book The Discovery of Hypnosis.* You can also book online on our payment page. You can reserve your place by paying a deposit and fees can easily be split over ten, monthly, interest-free payments.

The UK College of Hypnosis & Hypnotherapy is one of the country’s leading accredited hypnosis training schools. We have been established since 2003 and specialise in evidence-based and cognitive-behavioural approaches to clinical hypnotherapy.

This course can’t be improved; Donald, you are pure perfection.  I loved it! Thank you.  (Itai, Psychologist, London)

External Accreditation

People who wish to practice as hypnotherapists normally complete a diploma training approved by one of several independent professional bodies. Our diploma in cognitive-behavioural hypnotherapy is externally accredited by the National Council for Hypnotherapy (NCH) and the General Hypnotherapy Register (GHR), the two largest independent bodies in the field. Unlike most other courses, this diploma is also externally accredited by multiple professional bodies, including the Hypnotherapy Society, Hypnotherapy Association, and Register for Evidence-Based Hypnotherapy and Psychotherapy (REBHP).

The diploma is a Level 4 award issued by NCFE, a leading Government-recognised national awarding body who provide external quality assurance to verify that students are trained and assessed to adequate standards and in accord with the official National Occupational Standards (NOS) for hypnotherapy.

I thoroughly recommend this training, it’s excellent. (Vanessa, Hypnotherapist, Surrey)

Course Syllabus & Assessment

The diploma training is based upon a standard one-year diploma training which has been condensed into divided into three seven-day intensive stages. These can be spread out or close together, depending upon the needs of individual students. There are many dates to choose from, the first stage usually runs about six times each year. The total number of classroom hours, however, remains the same as a typical one-year diploma course.

Training focuses on practical face-to-face classroom exercises and group learning with rigorous online assessment following completion of the classroom training. Stage one focuses on the core skills of a hypnotherapist whereas stage 2 deals with behavioural psychology and interventions in hypnotherapy and stage 3 addresses cognitive concepts and techniques. The whole training provides a thorough grounding in modern cognitive-behavioural hypnotherapy.

Full details of the diploma training, including prices, dates, locations, and course syllabus, can be found on these pages.

I liked the relaxed, peaceful, gentle atmosphere, and sense of humour.  Don, you know your thing very well!  (Gosia, Intuitive Coach & Trainer, London)

Diploma Trainers

We have a variety of associate trainers who specialise in areas such as sports hypnosis, medical hypnosis, applied relaxation, and deliver components of the diploma training.

The main trainer on the diploma course is Donald Robertson, the College principal and founder. Donald is well-known as a proponent of cognitive-behavioural hypnotherapy through his talks and writings. He is also a published authority on the origins of hypnotherapy and the editor of The Discovery of Hypnosis, the Complete Writings of James Braid (2009). Braid coined the term “hypnotism” and was the founder of hypnotherapy as it’s known today. Donald is also the author of the forthcoming books The Philosophy of CBT and The Practice of Cognitive-Behavioural Hypnotherapy, due for publication by Karnac in 2010. Donald is an accredited Senior Clinician Hypnotherapist (NCH) and registered psychotherapst (UKCP/EAP).

* Terms and condition apply. The advertised discount applies to payment received in full for all three stages of training before October 31st 2009. This offer applies to bookings for course dates before 31/12/2010. This offer cannot be combined with any other discount or special offer.

Online Preview of The Discovery of Hypnosis, The Complete Writings of James Braid, The Father of Hypnotherapy (2009)

The Discovery of Hypnosis on Google Books

The Discovery of Hypnosis:
The Complete Writings of James Braid, the Father of Hypnotherapy (2009)

Published by The National Council for Hypnotherapy (NCH)
Edited with commentary by Donald Robertson
Foreword by Dr. Michael Heap

You can now browse a free online copy (limited preview) of the complete writings of James Braid with Google Books.  James Braid coined the term “hypnotism” in 1841 and was, essentially, the founder of hypnotherapy as we know it today.  See our website www.James-Braid.com for more information on Braid’s life and work.

Google Books: The Discovery of Hypnosis: The Complete Writings of James Braid

Review by Tom Butler-Bowdon, author of Fifty Self-Help Classics

Braid was the first to put hypnotherapy on a scientific, rational footing, so today’s hypnotherapists have a lot to thank him for.

A Manchester surgeon, Braid discovered hypnotism reasonably late and like most doctors of his time considered stage hypnotists charlatans. It was only his physical examination of a hypnotised subject that convinced him an actual bodily change had taken place with non-mystical causes.

The Discovery of Hypnosis puts together Braid’s key writings and provides succinct commentary and historical context. This is an exhaustive survey and the editor has obviously mastered the material, revealing an underrated figure in the history of psychology and psychotherapy.

One of Robertson’s fascinating ideas is that Braid should not be considered simply the father of hypnotherapy, but the father of psychotherapy, given his early work into what is now called cognitive behavioural therapy.

Robertson’s clear writing style and to-the-point comments enliven the historical material, and the book itself is large and well laid out. Any hypnotherapist serious about their subject should have this book in their library. It is also a intriguing read for the layman.

Tom Butler-Bowdon, author of 50 Psychology Classics: Who We Are, How We Think, What We Do; Insight and Inspiration from 50 Key Books

Braid’s Theory of Hypnotic Suggestion

Braid’s Theory of Hypnotic Suggestion

Excerpt from The Discovery of Hypnosis: The Complete Writings of James Braid (2009) edited by Donald Robertson.

Contrary to common misconception, Braid appreciated and employed the technique of verbal suggestion in hypnosis.  Moreover, he considered suggestion essential to the practice of hypnosis and utilised an array of suggestion methods.  Braid clearly distinguishes between suggestions given by the hypnotist and those arising from within the subject, e.g., due to expectant ideas, which we would now call “autosuggestion”.

            In Magic, Witchcraft, etc. (1852), Braid acknowledged that in addition to those “fully” hypnotised, many subjects were “partially” hypnotised, and that others did not respond to the induction at all.  Nevertheless, they could be influenced by a variety of suggestive factors which he claimed were essential to the production of phenomena even in susceptible hypnotic subjects.  In one passage alone, he lists the following six factors, which I have labelled using more contemporary terminology, supplying Braid’s description in quotes, 

1. Spoken Verbal Suggestion.  ‘The patients hear the ideas suggested when uttered in a language known to them.’  Braid clearly recognises that changes in voice tonality have a profound effect upon verbal suggestions, and refers to this several times in his later writings.
2. Written Verbal Suggestion.  ‘When they see them written (which is sufficient to affect many).’
3. Role-Modelling or Imitation.  ‘When they can see, by ordinary vision, the movements made in their presence which it is intended they should be forced to imitate, through the power of sympathy and imitation.’
4. Mental Association.  ‘When they feel sensible impressions, associated with certain ideas or previous feelings.’  For instance, the subject may hear a piece of music which reminds them of sad feelings; or sense the hand passes of the Mesmerist, and by association, imagine being a child once again, soothed by its mother’s touch.  Note that the Victorian concept of psychological association was a subjective precursor of the later physiological theory of conditioned responses pioneered by Pavlov’s laboratory research.
5. Muscular Suggestion.  ‘When they feel sensible impressions […] which call subjacent muscles into action.’  For instance, when the body posture or facial expression (“Anatomy of Expression”) is manipulated so as to evoke the corresponding idea or state of mind.  For instance, the hypnotist may firmly grasp and briskly straighten a subject’s arm in such a way as to suggest that it should become stiff and cataleptic.  Alternatively, by clenching a subject’s fist and furrowing his brow, Braid would evoke feelings of aggression, etc.  In fact, this was the form of suggestion primarily employed by Braid in Neurypnology (1843), and used by him as the basis of his radical re-interpretation of phrenological phenomena.  This notion, perhaps surprisingly, has many parallels in modern therapy, e.g., the notion of “acting as if” in George Kelly’s work and subsequent cognitive-behavioural therapy.
6. Focused Attention.  ‘Direct attention to the special organs of sense, which excites ideas corresponding with the functions of these different organs, or arouses former ideas arbitrarily or accidentally associated with such and such sensible impressions.’  As in the experiments on attention, debunking the Reichenbach phenomena, which show that prolonged or focused attention, can, by itself, lead to hyperacuity or create spontaneous hallucinatory sensations.  Several modern studies have likewise shown that merely asking subjects to stare at a wall, or even sit with their eyes closed and contemplate their experience, tends to evoke a flow of surprisingly unusual experiences.

At the start of Hypnotic Therapeutics (1853), Braid again writes of ‘suggestions received through words audibly uttered in his hearing [verbal suggestion], or ideas previously existing in his mind [autosuggestion], or excited by sensible impressions made by touches or passes of the operator [association], which direct the attention of the sleeper to different parts [focused attention], or excite into action certain combinations of muscles [muscular suggestion], and thereby direct his current of thought’.  To a large extent, Braid’s common sense philosophy of hypnotism and suggestion can be seen as deriving from the three basic laws of psychology adopted in his writings: the law of sympathy and imitation, the law of habit and association, and the ideo-dynamic response, which might be termed the “law of dominant ideas”.

Hypnotherapy Practitioner Diploma (HPD) Version 2: Proposals for Improvements

Proposals for HPD Revision & Improvement

Reproduced from the NCH publication The Hypnotherapy Journal, Issue 3 Vol. 9, Autumn 2009

Donald Robertson & John Harrington

 

In accord with NCFE’s guidance, now that it’s been in use for several years, NCH have been reviewing the existing Hypnotherapy Practitioner Diploma (HPD) award in an attempt to make necessary updates and improvements.  We have already developed a draft document which clearly shows how the existing HPD learning outcomes might be merged into a smaller set of more generic outcomes.  NCFE have changed their standard format for the specification of learning outcomes since the original HPD was designed and they have advised us that a qualification of this kind would typically be comprised of 20-30 outcomes, whereas the existing HPD has about 86 individual outcomes.  Some of the Version 1 HPD outcomes were quite “high-level” and generic, whereas others become much more concrete and specific.  This created some inconsistency in the award which seemed to complicate the assessment process, e.g., one learning outcome seems to be trying to cover the whole history of hypnosis theory, and could be evidenced by a long essay-type answer.

 

3.3 How the models and concepts in your area of practice have evolved and developed, how these tend to change with time and the similarities and differences between different versions.

 

Whereas others focus down upon very specific areas of practical concern which require a small amount of very specific evidence, e.g.,

 

15.4      When to touch the client and when not

 

For the sake of consistency, we’ve tried to subsume more specific issues under a simpler set of broader headings and set the learning outcomes at similar levels of abstraction.  We’ve also tried to minimise jargon, and to substitute theoretically-biased terminology with more generic language.  The “range” (explanation) of each outcome can then be used to provide further specification where needed.  Organising the HPD in a more structured way makes it much easier to read the document and work with the outcomes.  We can now outline the learning outcomes more simply in a single-page document, which provides a clear outline of what must be covered on an HPD training.

            There were also some typographical errors and minor corrections made, and some proposals for additional outcomes which seem to have been missing from the original HPD.  Version 2 of the HPD will be quality-assured by NCFE as meeting the same standard of competence, but easier to read and implement and hopefully as generic and “streamlined” as possible, to make it easier for different training schools to implement.  (To be clear, the number of outcomes has no bearing on the volume or level of work required for the award, which will remain the same.)  Below is the current draft, which is very much under discussion, and has been developed with advice from NCFE on the wording, etc.  The whole award pack provided for students and trainers will be much more comprehensive, hopefully, this is just the list of learning outcomes. 

            We are publishing these proposals at an early stage for the sake of transparency and to encourage NCH members to consider them and comment, especially trainers, who may have to implement them in relation to their existing courses.  We promise to acknowledge any feedback received and will be happy to discuss any comments or suggestions.  This is not a “final draft” until we’re satisfied everyone has had a reasonable and bona fide chance to comment.  According to NCFE, the original HPD was not formally mapped against the National Occupational Standards for Hypnotherapy published by Skills for Health, although it was very closely based upon them.  However, the Version 2 will be systematically mapped against the NOS, we hope, in a manner approved by NCFE.  There is some indication that the National Occupational Standards for Hypnotherapy will be revised themselves next year, in accord with recent revisions which have made other CAM NOS more generic.  The plus sign (+) Indicates an outcome which was previously absent from the HPD, or not clearly stated, but has been proposed for inclusion in version 2.

 

UNIT 1: ASSESS & PREPARE CLIENT (INITIAL CONSULTATION)

1.         Assess the suitability of clients for treatment.  (Contra-indications, motivation, circumstances, nature of problem, etc.)

2.         Interview the client to assess their needs.

3.         Build rapport and a sound working alliance.

4.         Assess hypnotic susceptibility.

5.         Provide a rationale and explanation for hypnotherapy treatment.

 

UNIT 2: PLAN & DELIVER HYPNOTHERAPY TREATMENT

6.         Design a treatment plan and agree it with the client.

7.         Employ hypnotic inductions and related techniques.  (Deepeners, tests, emerging, etc.)

8.         Deliver hypnotherapy treatment.

9.         Teach and assign homework techniques.  (Self-hypnosis, CDs, etc.)

 

UNIT 3: EXPLAIN HYPNOTHERAPY THEORY

10.       Explain the main therapeutic approaches used in modern hypnotherapy.

11.       Evaluate the elements of psychopathology relevant to the practice of hypnotherapy.

12.       Evaluate the factors which might help or hinder the working alliance.

13.       + Explain and evaluate the nature of hypnosis.

14.       + Explain and evaluate the principles of effective hypnotic suggestion.

 

UNIT 4: EXPLAIN ETHICAL & PROFESSIONAL ISSUES

15.       Evaluate the key elements of the NCH or UKCHO codes of ethics and practice.

16.       Explain the scope and limits of your sphere of competence as a hypnotherapist.

17.       Explain the role of CPD and reflective practice in maintaining professional standards.

18.       + Evaluate the benefits of different forms of clinical supervision.

19.       Evaluate the role of confidentiality in hypnotherapy

20.       Evaluate the legal issues relating the practice of hypnotherapy.  (Criminal and civil law.)

21.       Evaluate the risks attached to hypnotherapy treatment in general and specific interventions.

22.       Evaluate common ethical dilemmas in the practice of hypnotherapy.

Hypnotic Sleep Therapy: Some Basic Instructions

Hypnotic Sleep Therapy: Some Basic Instructions

Copyright (C) Donald Robertson 2008

This is an excerpt from the Coping with Noise self-help workbook from the chapter on improving sleep…

It helps if you can try different methods that other people have found helpful and pick the one that appeals to you, or seems to work best.  Try using the techniques you’ve already learned first of all, or the methods below, if they appeal to you.  Many different relaxation techniques are known to be effective, but you have to practice most of them regularly to get the most benefit.  The most important thing, therefore, is probably that you pick a simple technique that you feel comfortable using, and are willing to use every day for a few weeks or more. 

James Braid’s Method of “Sleep at Will”

The physiologist and physician Dr. Edmund Jacobson concluded after many decades of research, conducted at leading universities in the USA, that relaxation of the facial muscles, eyes and voice were particularly conducive to sleep and relaxation.  It’s certainly true that people tend to find this kind of technique useful, and similar approaches have been used for over 150 years.  James Braid, the Scottish surgeon who invented hypnotism, wrote in 1843 of a method for inducing “sleep at will.”  Braid observed quite simply that by relaxing, focusing on the idea of falling asleep and fixing one’s attention on an unexciting image or sound, sleep tended to be induced.  He recommends a number of ways of doing this, but a modern account might read as follows, 

1. Focus your gaze.  Stare at a point on the ceiling and keep your eyes glued to the spot.  Make them feel tired and sleepy, without straining them too much.  Close them slowly when they begin to feel tired.  This shouldn’t take more than a few minutes, if you really imagine your eyes feeling tired.  Alternatively, close your eyes and imagine you’re staring up at an image, like a star in the sky.
2. Relax your breathing.  All the while, act relaxed, lie still, and let your breathing become shallow and steady, as relaxed as possible.  Make your body comfortable, and try to feel as pleasantly relaxed as you can throughout the whole process.
3. Focus your mind on sleep.  All the while, keep your attention fixed upon on the idea of falling asleep.  Don’t try to force yourself to sleep, that won’t work.  There’s a knack to focusing on an idea in a relaxed, pleasant and passive way.  Forget about absolutely everything else for a while.  Have faith, believe you can do it easily and expect to drift off to sleep.
4. Rest and repeat.  When your eyes close, continue to relax for a few more minutes.  If you’re still not falling asleep then fix your gaze again and repeat the process as many times as is necessary and you will fall asleep eventually.  It’s unusual to have to repeat it more than 3-4 times, though.

As Braid observed, this kind of technique tends to become much easier with practice, as you get the knack of doing it and your body starts to respond out of habit.  

Conscious Autosuggestion

Braid also recommends repeating a monotonous phrase, like a lullaby.  This technique was popularised in the 1920s by the French pharmacist Emile Coué, renowned as the father of modern self-help.  Coué developed a technique which he called “conscious autosuggestion.”  These are his instructions for insomniacs,

Having settled themselves comfortably in bed they will repeat (not gabble) “I am going to sleep, I am going to sleep,” in a quiet, placid, even voice, avoiding of course, the slightest mental effort to obtain the desired result.  The soporific [sleep-inducing] result of this droning repetition of the suggestion soon makes itself felt; whereas, if one actually tries to sleep, the spirit of wakefulness is kept alive by the negative idea, according to the law of converted effort.  Insomnia indeed affords a striking demonstration of the disastrous effect of the exertion of the will, the result of which is just the contrary of the one desired.  (Coué, 1923: 31-32)

Coué’s law of “converted effort” or “reversed effect” is also known as the principle of “paradoxical” effect.  It refers to the fact that in many ordinary situations, the more effort we make to do something, the more we may achieve the opposite.  One notorious example of this is sleep.  The more we try to force ourselves to fall asleep, the more we tend to become tense and alert, and to keep ourselves awake.  It’s well-known that when people who suffer from insomnia are asked to try to stay awake as long as possible, paradoxically, they tend to fall asleep more quickly.

            In the 1970s, Herbert Benson, another scientist who became a well-known authority on relaxation techniques, developed a similar method called the “Benson method” for inducing what he termed the “relaxation response.”  Benson compared many popular relaxation and meditation techniques, and found that although most worked, and produced measurable physiological signs of relaxation, there was little difference between them.  They all seemed equally effective, although some were more complicated than others, so he tried to develop a simplified approach that worked as well as the existing ones, but was much easier to learn.  Benson’s method simply requires that you sit still with your eyes closed and repeat any word or short phrase over and over for about 20 minutes.  Benson found that the most important aspect of the technique was the client’s attitude toward distraction.  People who try too hard to relax, or worry about their mind wandering, etc., tend to remain tense, but people who say “So what?”, shrug off distractions, and patiently return to the monotonous exercise, tend to relax more easily and more deeply.  Benson’s method is used both to overcome stress and to help people fall asleep.  It’s really just a modern variation of the old method introduced by Braid and popularised long ago by Coué.

The Hypnotic Symbol Suggestion Technique

The Symbol Suggestion Technique in Hypnotherapy

Copyright (c) Donald Robertson, 2008-2009

A.E. van Vogt was a popular science fiction influenced by General Semantics, who co-authored a serious textbook on clinical hypnotherapy.  This excerpt serves to illustrate the technique of symbol suggestion in circulation among hypnotherapists as far back as the New Nancy School.  This simple technique can be used in self-hypnosis training and resembles the use of techniques in other models of therapy, such as collapsed coping statements in CBT. 

Mechanics of Auto-Suggestion

(Excerpt from Cooke & van Vogt, The Hypnotism Handbook, 1956) 

In formulating suggestions for the patient to use in auto-hypnosis, the following rules apply:

1. Write it. Write the suggestion out in accordance with the laws of hetero-hypnotic therapy […]. Writing forces us to crystallize our ideas. It makes us analyse the problem that we are facing, and is an aid to clear thinking.

2. Symbolise it.  Give it a key word or idea, a code word. By definition, then, the symbol represents the entire formulation, exactly as in a trans-oceanic cable code a nonsense word may represent a complex sentence or idea. Select a simple word, preferably (but not necessarily) one that carries out the implication of the entire suggestion. For example, a therapy typed out single space and occupying a page which is designed to help a patient overcome feelings of inferiority could be symbolized with the word, “Confidence.”

3. Edit it.  Read the written suggestion to insure that it complies with the basic laws. Revise it. Reconstruct it. Expand it. Condense it. Recopy the revised version and destroy the first draft.

4. Read it aloud.  Before hypnotizing yourself, carefully read the entire suggestion to your self aloud. When in the presence of others where reading might be impossible, the suggestion can be read silently but very carefully. Reading aloud is preferable because it compels the uttering of every word. In reading silently, we are accustomed to scanning and skipping. When a suggestion has been properly edited, every word is important.

5. Hypnotise yourself.  Use the particular method that has been taught you.

6. Think the symbol. Or whisper it to yourself. […] You have given yourself the suggestion fully and forcefully as a pre-hypnotic suggestion. You have, so to speak, loaded the gun. When you think the symbol, you are merely pulling the trigger on a gun which is already loaded.  An alternate method […] is to roll the paper containing the suggestion and hold it in one hand or tape it to the hand. The presence of the paper, which has been previously read, serves as a trigger.

 

Symbol Suggestion in The New Nancy School

Charles Baudouin explained how various methods in yoga, such as repetitively chanting the Hindu sacred syllable AUM, can be seen as means of inducing a state of relaxed concentration similar to hypnosis. 

Let us return to autohypnosis, as described earlier in our own text.  Since it can be induced by immobilising the attention on a mental state, why should we not choose, for this mental state (in preference to the bead-telling or to the counting), the very idea which is to be the object of the suggestion?  There is, in fact, no reason to the contrary, provided that the idea fulfils the requisite conditions, provided that it holds the attention rather than that the attention holds it.  We must be able to think of it mechanically; ere long in spite of ourselves, as if we were obsessed by it; in the same way as that in which we listen to the sound of water running.

                A very simple means of securing this is to condense the idea which is to be the object of the suggestion, to sum it up in a brief phrase which can readily be graven on the memory, and to repeat it over and over again like a lullaby.  The state of hypnosis thereupon ensues, with the effortless contention characteristic of the condition.  We pass unawares into the preliminary stage of hypnosis.  Relaxation occurs without our noticing it; reverie is neutralised by the presence of an idea which makes around itself a mental void.  The states we have analysed above are now synthesised into a single state which shares the characters of them all; which exhibits phases recalling now one, now another; but which differs from each.  This condition is one of pre-eminent autosuggestibility.  If we graft it upon a condition of spontaneous outcropping, as upon the morning and evening states bordering upon sleep, we shall obtain maximum results.  But it may also be usefully attained during the waking hours.  This method of repeating a phrase has often been recommended by American writers. […]

                Let us add that, to prevent the mind from wandering, it may be well to repeat the phrase aloud, or at least to sketch its pronunciation with lips and tongue as we utter it mentally.  This motor accompaniment favours the acquirement of the habit we wish to form; gives it a certain solidity; and acts as a leash or leading string whereby, without effort, our thought is guided towards its object. (Baudouin, 1920: 151).

The technique also resembles, in some respects, the “Relaxation Response” method made famous by Herbert Benson in his research upon comparative relaxation and meditation techniques, and widely-employed in the field of stress management.

The National Council for Hypnotherapy (NCH)

The National Council for Hypnotherapy

The National Council for Hypnotherapy (NCH) is the largest not-for-profit hypnotherapy organisation in the UK, with almost 2,000 members at present.  It is a member of the UK Confederation of Hypnotherapy Organisations (UKCHO).  The NCH publish The Hypnotherapy Journal, edited by Rob Woodgate, one of the best and widest-circulation hypnotherapy periodicals in the country.  It holds an annual hypnotherapy conference, probably the largest in the country, and runs regular low-cost continuing professional development (CPD) workshops for its members and other hypnotherapists.  I am the current research director on the NCH committee and provide regular monthly research snippets on the main NCH website below.

www.hypnotherapists.org.uk

The NCH also have a very active “fan” page on Facebook where we post a constant stream of articles, research, video clips, etc., and where our members frequently contribute comments and chat.  Click on the link below to visit the site or become a “fan” and receive regular updates through Facebook.

The National Council for Hypnotherapy Facebook Page

National Council for Hypnotherapy

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Evidence Against the Doctrine of Symptom Substitution

Evidence Against the Doctrine of “Symptom Substitution”

One traditional criticism levelled at hypnotherapy by psychoanalytic therapists was that its benefits must be temporary unless it attempted (as in regression) to “get to the root” of the problem by analysing its remote childhood causes.  This theory was first propounded by Freud, on the basis of a tiny handful of cases, 

[Hypnosis] could be employed in certain cases only and not others; with some much could be achieved by it, and with others very little, one never knew why.  But worse than its capricious nature was the lack of permanence in the results; after a time, if one heard from the patient again, the old malady reappeared or had been replaced by another. (Freud, 1920: 157)

Indeed, Freud and his followers tended to argue that any therapy which attempted to directly remove symptoms without analysing their unconscious root cause, in the so-called “Oedipus Complex”, would lead to temporary improvement while leaving the client vulnerable to relapse and deterioration.  As all symptoms, on the original psychoanalytic model, were viewed as disguised representations of unconscious complexes, new symptoms were expected to occur which would symbolise repressed material in different ways a “return of the repressed.”

            In fact, this was merely a supposition made by Freud, an objection based on theory rather than observed facts.  However, it was not until the introduction of behaviour therapy that hypnotherapy found its first major ally in disputing this hypothesis.  However, as Marks rightly points out, it seems absurd that this presupposition is confined to psychotherapy which is symptom-focused whereas nobody seems to “fear the dragon of symptom substitution” when prescribing common psychiatric medication, such as tranquilisers (Marks, 1981, p. 237).  In cases where medication is used to remove symptoms, there is clearly no evidence of new substitute symptoms erupting from the unconscious mind in symbolic form, contrary to the prediction made by psychoanalytic theory.  Hence, in the opening salvos of the “psychotherapy wars”, Eysenck announced that contrary to the assumptions of Freud, symptom substitution was essentially a myth.

How about the return of symptoms?  I have made a thorough search of the literature dealing with behaviour therapy with this particular point in view.  Many psychoanalytically trained therapists using these methods have been specially on the outlook for the return of symptoms, or the emergence of alternative ones; yet neither they nor any of the other practitioners have found anything of this kind to happen except in the most rare and unusual cases.  […] relapses occur, as indeed one would expect in terms of learning theory under certain circumstances, but they quickly yield to repeat treatment. […] Nor would it be true that alternative symptoms emerge; quite the contrary happens.  The disappearance of the very annoying symptom promotes peace in the home, allays anxieties, and leads to an all-round improvement in character and behaviour. […] Once the symptom is removed, the patient is cured; when there are multiple symptoms, as there usually are, removal of one symptom facilitates removal of the others, and removal of all the symptoms completes the cure.  (Eysenck, 1960: 12-13)

Even when psychoanalysts turned to the empirical evaluation of this theory, their own results were negative,

Mowrer, having accepted, as we have seen, Freud’s conclusion with regard to the meaning and function of symptoms, was considerably embarrassed by his own empirical finding that “symptomatic” treatment of enuresis was not only 100 percent successful with regard to the symptoms, but was not followed by symptom substitution in a single case!  (Yates, 1958, in Eysenck, 1960: 22)

Likewise, when Azrin and Nunn carried out direct habit reversal treatment with over 300 subjects, they reported remarkable success in breaking habits such as nail-biting, hair-pulling, stammering and tics, of the kind traditionally treated by Freudian psychoanalysis.  However, despite changing the habit symptoms directly, without attempting to interpret their “unconscious root”, they found no evidence whatsoever of symptom substitution (1977: 32).  Freud himself forwarded no evidence whatsoever for this theory other than anecdotes based on his own limited clinical experience with a small sample of clients.  It is inconsistent with the clinical experience of most modern therapists.  However, it has seeped into popular culture and you will find many clients who have internalised this view in the form of a superstition or a “myth” about therapy.

            Behaviour therapists passionately argued that symptom substitution was a superstition and only likely to occur if the client had been led to expect it to happen.  Of course, in some cases clients may solve one problem while neglecting another, but it is rare that this would lead to new symptoms.  Lazarus carried out a detailed follow-up study of 112 clients who were treated by him using behaviour therapy.  He could find indications of symptom substitution in only five or six cases (5%) and even these were classed as “tenuous.”  Similarly, Kroger & Fezler confidently assert that there is “no evidence” that psychodynamic symptom substitution exists (1976: 79).  Even Weitzman, a psychoanalytic therapist, in an article openly critical of behaviour therapy, accepts,

It has been pointed out, from both camps, that analytic theory requires that symptom substitution or recurrence must attend a symptomatic treatment which, by definition, does not affect the dynamic sources of the symptoms.  The evidence is rather impressive that neither substitution nor recurrence typically follows treatment by systematic desensitization.  When occasional recurrences are reported, they are described as being of low intensity and, apparently, never catastrophic. (Weitzman, 1967: 301)

Drawing on evidence from reviews by behavioural researchers including Bandura, Lazarus, Paul and Wolpe, Rimm & Masters conclude,

Reviews of empirical findings (including case histories and controlled experiments) indicate that the evidence is overwhelmingly against symptom substitution. (Rimm & Masters, 1974, p. 10)

Evidence from behaviour therapy unequivocally demonstrated that this psychoanalytic theory was false, and that people did improve as a result of direct symptom removal, without analysis of their past.  Indeed, the results of behaviour therapy were often much quicker and more reliable than anything that could be hoped for from psychoanalytic approaches.  As one behavioural hypnotherapist, explains, 

Once these changes start to occur, they will become self-perpetuating.  You will realise you can cope with what once seemed formidable problems, and so you will approach other situations with far greater expectations of success.  The therapeutic effects of hypnosis and self-hypnosis are undoubtedly ongoing and permanent.  (Jackson, 1990: 30)

Indeed, as Freud himself had originally stated (1895), when any symptom is removed clients will generally develop more ego-strength, growing in confidence in a way that tends to make them improve across the board in other areas of their life.  For example, when people successfully quit smoking, it is rare (though not impossible) for them to substitute some other negative behaviour.  Most people feel more empowered and tend to improve in other areas of their life as well, creating a kind of positive “domino effect.”

            The notion of “symptom substitution” is a particularly insidious one as it discourages clients from making practical changes that are well within their sphere of control.  This is most notable in depressed clients who typically suffer from a lack of initiative and motivation and are further de-motivated by the excuse that the myth of symptom substation offers.  They may complain that there is “no point” fixing one problem until they have solved their “underlying” character problem.  In most cases, this is not a realistic goal, however, and it is many small changes which improve the quality of life for most people.  Notably, psychoanalysis has been blamed for worsening the condition of some depressed clients.  Likewise, after reviewing relevant outcome data from a wide range of independent studies, Bandura was tempted to speculate that the predictions of “dire consequences” resulting from symptom substitution were little more than scare-mongering by psychoanalytic therapists, attempting to stifle innovations in symptom-focused treatment (Bandura, 1969, p. 48).

            The distorted “grain of truth” in the theory of symptom substitution, as Eysenck (1960: 13) notes, is that where the client suffers from an (autonomic) emotional reaction and their (psychomotor) behaviour is reconditioned without addressing their underlying mood, they may relapse or seek another behaviour to alleviate their inner distress.  For example, someone who bites their nails to cope with stress may relapse or begin grinding their teeth instead if this habit is suppressed directly, unless they are also alleviated of the emotional arousal associated with stress, e.g., by desensitisation therapy. 

Thus, there is no axiom of behaviourism which precludes the substitution of one maladaptive behaviour for another.  But from a practical point of view, it is a phenomenon only rarely observed. (Rimm & Masters, 1974, p. 10)

This is a far cry, moreover, from the Freudian notion of “symptom substitution” due to unconscious dynamics, and only a seriously incompetent therapist would attempt to remove a self-comforting habit without also addressing the associated emotions.  It isn’t a question of removing the symptom and its cause, but rather one of removing all of the symptoms from a mutually inter-dependant and self-maintaining cluster.