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ARTICLES
HISTORY OF HYPNOSIS: AN OVERVIEW
Ancient Egypt:- ‘sleep temples’ (temples of healing) 5th Century BC, spread in the 4th century to Greece (Trikka- temple of Asklepios) and then later to Rome (temple of Aesculapios Tibur Island).
Birth of modern Hypnotism regarded as the work of Franz Anton Mesmer. He did his doctoral thesis on the effects of the magnetic fields of the planets on the human body (1). He drew heavily on theories of the tides, and the effects of gravity and magnetism on the human body, an extension of Newtons theories. His first letter on the subject ran into several reprints (2).
He had observed the exorcisms performed by Father Johann Gassner in the early 1770’s. In the spirit of the enlightenment he had trouble believing that Fr Gassner was actually exorcising demons, and looked for another explanation. He believed that the metal cross that Fr Gassner was carrying was magnetising the patients and curing them. He was a friend of Haydn and Mozart, and there is a Mesmerism Scene in Cosi fan Tutti.
Mesmer used magnets and electrodes to effect his cures, but preferred to use his hands. He believed he possessed animal magnetism and developed therapeutic sessions based on séances. He cured a young girl of what seems to have been hysterical blindness and became very unpopular with the local medics in Vienna, was accused of magic and had to flee. He set up a very successful practice in Paris, and similar clinics sprang up all over France. His later treatments involved ‘magnetising’ vats of acid with poles sticking out of it, and trees. The patients would hold the magnetised objects and fall into convulsions.
Louis of France sent a committee to look at Mesmers’ work, and their report makes fascinating reading (3). The negative conclusion of the report damaged Mesmers’ credibility. He was possibly consoled by the fact that one of the committee was later executed by an invention of one of the others (Lavoisier was sent to the Guillotine!). Mesmers’ work was expanded by James Braid, a Manchester surgeon, who coined the word hypnosis, from the Greek hypnos-sleep, and by Charcot and his theory of somnambulism and cures of hysterical illnesses. Charcot lectured and demonstrated to Freud and ?Jung, so directly influencing the Viennese school of analytical psychotherapy. Freud was a trained hypnotist, but later rejected hypnotism as a useful tool, which seems a little unfair as Freud himself was not a successful therapist, and many patients spent years in therapy with him (psychoanalysis) with no improvement. Freuds idea was that you should bring everything to the attention of the conscious mind for insight to cure all. Despite no real evidence for this therapeutic model it is still very dominant today.
Hypnosis has had one more titanic figure this century, Milton Erikson. Erikson was a hypnotist, with a unique style. He often used indirect hypnosis procedures, suggesting things to the patients without doing any formal induction. Indeed probably all good physicians use elements of suggestion in that a ‘warm and friendly ‘ doctor is the most important factor in the placebo effect. Erikson’s methods were observed by John Gordon and Richard Bandler in LA in the 60’s and this produced the NLP movement.
Probably the other most significant worker in the field this century was Pavlov, who demonstrated that hypnosis worked through a process of inhibition, using a classic Stimulus – Response paradigm (4). Pavlov postulated when an organism is responding to one stimulus there will be reciprocal inhibition of incompatible stimuli and responses. This of course we are all familiar with as reciprocal inhibition of muscle groups. However if we accept that cognitive stimuli can be equally or more powerful than physical stimuli, we see the application of Pavlovs ideas to Hypnosis. Pavlov observed that if two stimuli are paired in close contiguity, then they become associated so that on later occurrence of the first stimulus the reaction to the second occurs. In his classic experiment this was of course the bell and the taste of food (production of saliva). Pavlov, however, recognised the power of words as cognitive stimuli. If in the classic experiment, we replace the physical stimuli with the sentence which shows the equivalent cognitively we get ‘Every time you hear the word bell you will find the taste of food in your mouth’ this sentence contains the two cognitive stimuli, and the physical response to the second (sense of taste of food). Alfred Barrios recently gave a fascinating update on this theory (5).
State vs non state. Current Theories.
From the report of the Kings commissioners to very recently, there has been a raging debate about whether Hypnosis is a real state or a product of imagination or social pressure. All attempts to find neurological correlates of the trance state were unsuccessful. Many researchers forcefully dismissed the state theory (6) (7).
Through the ‘90’s a number of very elegant experiments by John Gruzelier, professor of neurophisiology at Imperial College London demonstrated the neurophisiological correlates of hypnotic phenomenon (8). He has demonstrated that there is inhibition of the left frontal cortex, by the process of fixation and release contained in the classical hypnotic induction. In turn this inhibition removes the normal inhibitory effect of the left hemisphere on the right. Processing abilities of the right hand are decreased and of the left are static or increased , while measures of visual design generation are improved. Certain tasks involving signal detection show facilitation of the motor response to simple signal detection, but the inhibition of the motor response to error detection and processing. This inability to respond to errors, indeed the loss of the EEG wave which shows errors are detected gives a fascinating clue to the point at which hypnosis affects the brain, splitting the cognitive and executive control functions, suggesting a suspension of executive control which perhaps is then handed to the hypnotist, and errors (ie cognitive dissonances) in the hypnotists suggestions are not processed under hypnosis. All these experiments had relaxation control groups listening to a similar amount of verbal material and were very well conducted. He has also demonstrated changes in the theta wave patterns that are specific to Hypnosis and do not happen in relaxation or sleep (9). Theta waves represent the communication between the hippocampus and the cortex, and represent the integration of memories using past patterns and experiences. The state/non state debate is probably an irrelevance now. Whether there is anything special about hypnosis does not really matter, it is a very powerful tool which can help many people. It is probably a very powerful extension of normal neuro-physiological effects. I find that Pavlov’s theory combined with Gruzelier’s work explains adequately all the phenomenon of Hypnosis.
Hypnosis in General Practice.
There has been very little work done in General Practice on using Hypnosis as a tool, but given the similarities to the placebo effect it is an ideal tool for use in these circumstances. One of the most important factors in the effectiveness of hypnosis is the trust and credibility of the hypnotist. Given the high standing of GP’s we start with a huge advantage over Psychologists or Psychiatrists, who are regarded with suspicion. People are much more ready to suspend criticality with us and be affected by the messages and I think they respect our holistic approach to medicine much more than we imagine. I have completed a 2 ½ year clinic evaluation of referrals from our LHCC (generously funded) of 400 referrals and the outcomes, particularly for panic and anxiety are very good. It was published in 'Contemporary Hypnosis' in 2004 (10) see 'resources'.
(1) Dissertatio physico-medica de planetarum influxu in corpus humanum. 1766(2) Sendschreiben an einen auswartigen Artz. 1775(3) Report of the commissioners charged by the king with the examination of animal magnetism. Benjamin Franklin, Majault, Le Roy, Sallin, Jean Sylvanian Bailly D’Arcet, De Bory, Joseph Guillotin & Anton Lavoisier. Skeptic Magazine 1784 (4) Pavlov I.P (1923) the identity of inhibition with sleep and hypnosis. Scientific monthly, 17, 603-608(5) A Theory of hypnosis based on principles of conditioning and inhibition. Alfred A Barrios Contemporary hypnosis (2001) vol 18 No 4 2001 pp 163- 203.(6) Barber t.X (1979) Suggested hypnotic behaviour: the trance paradigm versus an alternative paradigm. In E. Fromm and R.E Schorr, Hypnosis : developments in research and new perspectives. 2nd ed New York: Aldine 217 -271 (7)Wagstaff G. F (1984) The enhancement of witness memory by Hypnosis: a review and methodological critique of experimental literature. British journal of Experimental and Clinical Hypnosis 2, 1, 3-12 (8) Gruzelier J 1998 A working model of the neurophisiology of hypnosis: a review of the evidence. Contemporary hypnosis vol 15, No 1 pp 3-21 (9) Williams J Gruzelier J 2001 International journal of Clinical and experimental hypnosis vol 49 no 3 185-20 (10) Dobbin A, Faulkner S, Heany D, Selvaraj S, Gruzelier J (2004) Impact on Health Status of a hypnosis clinic in General Practice. Contemporary Hypnosis vol 21 no 4 pp 153-160
Williams J Gruzelier J 2001 International journal of Clinical and experimental hypnosis vol 49 no 3 185-20