Although most practitioners receive their training in hypnotherapy or relaxation as a part of their academic training, the American Society of Clinical Hypnosis and the Society for Clinical and Experimental Hypnosis maintain training programs as well as a registry of practitioners (see previous box). Training in teaching relaxation techniques is provided through various routes from self-teaching and apprenticeships to a number of short courses. Many yoga centers also teach relaxation and offer courses to train yoga teachers.teachers.
In the everyday trance of a daydream or movie, an imaginary world seems somewhat real to you, in the sense that it fully engages your emotions. Imaginary events can cause real fear, sadness or happiness, and you may even jolt in your seat if you are surprised by something (a monster leaping from the shadows, for example). Some researchers categorize all such trances as forms of self-hypnosis. Milton Erickson, the premier hypnotism expert of the 20th century, contended that people hypnotize themselves on a daily basis. But most psychiatrists focus on the trance state brought on by intentional relaxation and focusing exercises. This deep hypnosis is often compared to the relaxed mental state between wakefulness and sleep.
Hypnosis can be defined as a procedure during which changes in sensations, perceptions, thoughts, feelings or behaviour are suggested. Hypnosis can be used to amplify whatever it is about therapy that makes it therapeutic. It permits a wide range of choices regarding where and how to intervene in the patient's problems. In this paper, we set out to examine the rationale of using hypnotherapy to manage various types of sleep disorders, and to explore the techniques, strategies and hypnotic scripts employed by various hypnotherapists. We also examine the research data available on the efficacy of hypnosis in the treatment of sleep disorders. Acute and chronic insomnia often respond to relaxation and hypnotherapy approaches, along with sleep hygiene instructions. Hypnotherapy has also helped with nightmares and sleep terrors. There are several reports of successful use of hypnotherapy for parasomnias, specifically for head and body rocking, bedwetting and sleepwalking. Hypnosis is a specialised technique, not a therapy itself, and should be used as an adjunctive intervention within a complete psychological and medical treatment package. Most of the literature is limited to case reports or studies with such a small sample that at times it is very difficult to interpret the results. There is a major placebo effect, so uncontrolled trials are of limited value. It is hard to perform a randomised, double-blind, controlled trial to evaluate hypnotherapy given that cooperation and rapport between patient and therapist is needed to achieve a receptive trance state.
Pierre Janet originally developed the idea of dissociation of consciousness from his work with hysterical patients. He believed that hypnosis was an example of dissociation, whereby areas of an individual's behavioural control separate from ordinary awareness. Hypnosis would remove some control from the conscious mind, and the individual would respond with autonomic, reflexive behaviour. Weitzenhoffer describes hypnosis via this theory as "dissociation of awareness from the majority of sensory and even strictly neural events taking place."
Around 1900, there were very few preoperative anesthetic drugs available. Patients were naturally apprehensive when facing surgery. One out of four hundred patients would die, not from the surgical procedure, but from the anesthesia. Dr. Henry Munro was one of the first physicians to use hypnotherapy to alleviate patient fears about having surgery. He would get his patients into a hypnotic state and discuss their fears with them, telling them they would feel a lot better following surgery. Ether was the most common anesthetic at that time, and Dr. Munro found that he was able to perform surgery using only about 10% of the usual amount of ether.
Published, controlled studies of the use of hypnosis to cure warts are confined to using direct suggestion in hypnosis (DSIH), with cure rates of 27% to 55%. Prepubertal children respond to DSIH almost without exception, but adults often do not. Clinically, many adults who fail to respond to DSIH will heal with individual hypnoanalytic techniques that cannot be tested against controls. By using hypnoanalysis on those who failed to respond to DSIH, 33 of 41 (80%) consecutive patients were cured, two were lost to follow-up, and six did not respond to treatment. Self-hypnosis was not used. Several illustrative cases are presented.
A person with depression experiences a wide variety of emotions. According to the University of New Hampshire, hypnotherapy can help a person learn to reduce and/or better control feelings of anxiety, stress, and sadness. Hypnotherapy is also used to treat negative behaviors that could be worsening a person’s depression. These behaviors may include smoking and poor eating and sleeping habits.
"Never in my life have I felt so close to peace and to God as I did during your course. You gave me the most fantastic tool anyone could ever find... you taught me to be able to go deep within myself to find the answers and find myself. Now my only objective is to help people with what you have taught me, so they may also find that wonderful world that comes from inside...."
Hypnotherapy is used for nonmedical patients as well as those who wish to overcome bad habits. Hypnotherapy has been shown to help those who suffer from performance anxiety, such as in sports, and speaking in public. In academic applications, it has also been shown to help with learning, participating in the classroom, concentrating, studying, focusing attention span, improving memory, and helping remove mental blocks about particular subjects.
Meditation practice focuses on stilling or emptying the mind. Typically, meditators concentrate on their breath or a sound (mantra) they repeat to themselves. They may, alternatively, attempt to reach a state of “detached observation,” in which they are aware of their environment but do not become involved in thinking about it. In meditation, the body remains alert and in an upright position. In addition to formal sitting meditation, patients can be taught mindfulness meditation, which involves bringing a sense of awareness and focus to their involvement in everyday activities.
For several decades Braid's work became more influential abroad than in his own country, except for a handful of followers, most notably Dr. John Milne Bramwell. The eminent neurologist Dr. George Miller Beard took Braid's theories to America. Meanwhile, his works were translated into German by William Thierry Preyer, Professor of Physiology at Jena University. The psychiatrist Albert Moll subsequently continued German research, publishing Hypnotism in 1889. France became the focal point for the study of Braid's ideas after the eminent neurologist Dr. Étienne Eugène Azam translated Braid's last manuscript (On Hypnotism, 1860) into French and presented Braid's research to the French Academy of Sciences. At the request of Azam, Paul Broca, and others, the French Academy of Science, which had investigated Mesmerism in 1784, examined Braid's writings shortly after his death.
The central theoretical disagreement regarding hypnosis is known as the "state versus nonstate" debate. When Braid introduced the concept of hypnotism, he equivocated over the nature of the "state", sometimes describing it as a specific sleep-like neurological state comparable to animal hibernation or yogic meditation, while at other times he emphasised that hypnotism encompasses a number of different stages or states that are an extension of ordinary psychological and physiological processes. Overall, Braid appears to have moved from a more "special state" understanding of hypnotism toward a more complex "nonstate" orientation.
In the 1950s, Milton H. Erickson developed a radically different approach to hypnotism, which has subsequently become known as "Ericksonian hypnotherapy" or "Neo-Ericksonian hypnotherapy." Erickson made use of an informal conversational approach with many clients and complex language patterns, and therapeutic strategies. This divergence from tradition led some of his colleagues, including Andre Weitzenhoffer, to dispute whether Erickson was right to label his approach "hypnosis" at all.