Hypnosis and Mind Body Interventions

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Hypnosis and Mind Body Interventions

• Joel Marcus PsyD
• Mind-Body Cancer Research Program
• Scott and White Clinic and Hospital
• Texas AM University System HSC College of
  Medicine

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Learning Objectives

• Identify specific clinical disorders that may be
  amenable to a Hypnotic Mind-Body Intervention
• Identify specific Hypnotic Mind-Body
  interventions that may be viable for clinical
  disorders
• Be able to describe a Hypnotic Mind-Body Stress
  reduction technique so that it would be
  acceptable for a pediatric or adolescent
  population.

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Any Concept of Health and Healing Which Does Not
Acknowledge the Power of Intangibles Such As
Love, Empathy, Caring, Compassion, Hope, Prayer
and the Power of the Mind and the Strength of the
Human Spirit, Is Sorely Lacking.
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Cogito, ergo sum Rene Descartes
I think therefore I exist
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What is hypnosis?

• Relaxation
• Mental Imagery
• Suggestion
• Hypnotic Phenomena
• Post-Hypnotic Suggestion

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Clinical Hypnosis
An altered state of consciousness characterized
by increased receptivity and involuntary
experienced response to which is multiply
determined by relationship, expectancy and trance
factors.
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Hypnosis is a multiple determined experience

• Relationship variables
• Transference
• Motivation and Expectancy
• Set a positive expectancy
• Determine Motivation
• Trance variables
• Dissociation
• Involuntary Responses

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What is Hypnosis?

• Purposeful altered state of consciousness
• Increased concentration and acceptance of
  suggestion which results in alteration of sensory
  and/or motor capabilities

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What is Hypnosis?

• Mental imagery is utilized
• Response is experienced in an involuntary manner
• Ex arm levitation

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Examples of hypnosis most people have experienced

• Everyday type trance
• Driving on a freeway and caught yourself briefly
  unaware of what you were doing
• So engrossed in watching a movie that you are
  unaware of surroundings and other people speaking

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Depth of Hypnosis
5 Refractory
45 Light Trance
55 Medium Trance
20 Deep Trance (Somnambulism)
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Individual Factors in Hypnosis

• Chronological Age
• Intelligence
• Imagery Ability
• Motivation
• Psychopathology

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High Hypnotizables
High hypnotizables in the hypnotic analgesia
conditions did not adopt deliberate strategies
for coping with cold-pressor pain, but they
nonetheless managed to reduce the pain to a very
considerable degree.
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Low Hypnotizables

• Low hypnotizables subjects in this condition
  also did not employ deliberate strategies of pain
  control, but unlike their high hypnotizable
  counterparts, they showed no attenuation of the
  cold-pressor pain.

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Hypnotic analgesia

• Hypnotic analgesia is quite dependent on
  hypnotic ability rather than on the deliberate
  use of cognitive strategies.

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Uses of Hypnosis

• Indications that Hypnosis might be useful in
  treatment.
• Stress management
• Chronic Stress
• headaches
• insomnia
• Periodic stress
• exams, etc
• Trauma therapy/post-traumatic stress
• Sudden death of a friend or loved one.

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Uses of Hypnosis

• Examples of indications for hypnotherapy
• Habit control
• Tics
• Tourette
• Weight loss / management
• Insomnia
• Irritable Bowel Syndrome

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Uses of Hypnosis

• Indications that Hypnosis might be useful in
  treatment.
• Reduction of anxiety and fears
• Improve Coping Ability
• Able to think and concentrate better
• Treatment of phobias
• Fears of flying, elevators, etc
• Dental work
• Receive care with less stress and strain

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Hypnosis today

• With the increased interest in complementary
  therapies, more patients are using mental
  imagery/relaxation
• The list of uses keeps growing...

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Indications for Hypnosis with Children

• Pain Management
• Dealing with Anxiety
• Tension and Migraine Headaches
• Coping with Painful Medical Procedures
• Insomnia

• Bedwetting
• Habit Control
• Irritable Bowel Syndrome
• Post-Traumatic Stress
• Habits
• Psychosomatic Distress

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Hypnotherapy for Management of Symptoms

• Assess the patients symptoms
• Introduce hypnosis as a mind-body intervention
• Empower the patient
• Set specific goals and expectancy
• Assess hypnotizability as a part of the process

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Hypnotherapy for Management of Symptoms

• Match suggestions and Imagery to the patients
  symptoms and personal preferences
• Teach Self-Hypnosis
• Provide adequate follow-up
• Involve the family and other medical staff as
  needed

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Process of a Hypnotic Induction Intervention

• Focus of attention
• Stare at a spot.
• Suggestions for eye closure
• Your eyes can feel heavy as they stare at the
  spot...
• Relaxation
• The Wave of Relaxation

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Process of a Hypnotic Induction Intervention

• With hypnosis, we quiet the mind and relax the
  body, then add mental imagery - the conscious
  creation of vivid, meaningful pictures in the
  mind is a powerful way to help bring about what
  one wants to achieve
• Any imagery is appropriate
• Use imagery that the patient finds enjoyable
• Its VERY hard to feel tense when you are in your
  favorite place...

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Trance

• Deepening Trance
• Deepening the trance state often involves
  metaphors to do with progression and often
  descent. e.g counting up or down, descending
  stairs, visualizing each of the chakras in turn,
  following a path leading somewhere tranquil.

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Process of a Hypnotic Induction Intervention

• Positive suggestions for goal achievement
• All the things that the patient wants to
  accomplish
• Ego strengthening
• you're doing a great job
• Alerting

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"Principles of Suggestion"

• Law of Concentrated Attention - whenever
  attention is concentrated on an idea over and
  over again, the idea tends to spontaneously
  realize itself.
• .

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"Principles of Suggestion"

• Law of Reversed Effect- the harder you try to
  will yourself to do something, the less chance
  you have to succeed.

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"Principles of Suggestion"

• Law of Dominant Effect - a strong emotion tends
  to replace a weaker one. Attaching a strong
  emotion to a suggestion tends to make the
  suggestion more effective

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Focusing Attention

• During the trance state there is a heightened
  concentration for the specific purpose of
  maximizing potential or changing understanding
  and experience. Relaxation and imagery is used to
  obtain a fixed, narrowed attention with a high
  degree of concentration.

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Fading

• Fading -also called distraction, or redirection
  of attention, used with pacing and leading
  provides the conscious the opportunity to take
  hold and be accepted when they are not being
  subjected to conscious and critical analysis.

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Pacing

• Pacing The process of gaining rapport through
  feeding back some or all of a client's observable
  verbal or nonverbal behavior. Pacing can be fully
  direct, partially direct, or indirect. Successful
  pacing builds sufficient rapport that will allow
  the therapist to make more direct, leading
  statements. Unsuccessful hypnosis, or
  insufficient trance depth are almost always the
  result of insufficient pacing.

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Leading

• Leading Providing the client with information in
  the form of instructions that relate to
  furthering the trance experience or implementing
  a therapeutic goal. Leading can be direct or
  indirect. Direct leading can be implemented in
  deeper trances with more profound levels of
  dissociation. Indirect leading is called for when
  clients are in less profound states of
  dissociation or lighter trances. Leading will
  fail without sufficient pacing.

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Variation in voice

• Typically, a light trance state is evidenced by a
  general relaxing of muscle tone and posture, a
  visible change in facial tension, a slower rate
  of breathing, fluttering of the eyelids, a
  decrease in the tempo of speech and voice volume,
  and a shift in language use which might include
  metaphorical or body-based descriptions of
  internal states (Gilligan, 1987 p. 125).

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Trance phenonomen

• The trance state is natural and often
  experienced, both clinically and in everyday
  life. The use of formal induction, directed
  suggestions which typically include the words
  "deeper" and "relax," are not necessary to induce
  deep trance states. Instead, the use of language
  patterns, muscular relaxation, and the focusing
  of concentration can be used in a naturalistic
  manner to induce trance

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Personal Imagery and Experience

• Visualization and imagination are closely related
  to the unconscious mind. Imagery has been
  described as the language of the unconscious. The
  key to successful use of imagery is to be as
  creative and imaginative as one can.
• Use personal memories and experiences and fill
  ones images with colors, sounds, aromas, textures
  and tastes to be as real and as absorbing as they
  can be. Keep visualizations positive and
  personally appealing to be a powerful tool in
  hypnosis.

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Dissociation

• "... A process whereby specific mental contents
  (memories, ideas, feelings, perceptions) are lost
  to conscious awareness and become unavailable to
  voluntary recall..." (16th ed. Merck Manual)

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Setting the overall goal

• Hypnosis can be used as a tool for patients to
  achieve goals such as smoking cessation, weight
  control, stress management, self esteem, pain
  management and goal setting

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Reinforcement of Response

• While suggestions remain with some individuals
  indefinitely, others may need reinforcement
• Reinforcement occurs whenever drive is reduced,
  leading to learning of whatever response solves
  the client's problem. Thus the reduction in need
  serves as reinforcement and produces
  reinforcement of the response that leads to it.
• http//www.sonoma.edu/users/d/daniels/hullspence.h
  tm

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Hypnotic Induction by Age

• Age 4-6
• Favorite Place
• Flower Garden
• Mighty Oak Tree
• Story Telling

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Hypnotic Induction by Age

• Age 7-11
• Action Imagery
• Coin Drop Induction
• Arm Lowering
• Flying Blanket
• Science Fiction Imagery

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Hypnotic Induction by Age

• Age 12-18
• Sports Activity
• Deep Breathing
• Hand Levitation
• Adult Oriented Induction
• INDIVIDUALIZATION

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All Hypnosis Is Self-hypnosis

• Response to hypnosis is largely determined by the
  persons talent or ability to use the mind-body
  connection. The goal of hypnosis is to empower
  the patient.

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Pain Control and Child Hypnosis

• Anxiety Reduction
• Relaxation
• Suggestion
• Perceptual Alteration
• Dissociation and Imagery
• Self-Hypnosis

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Research and Child Hypnosis

• Pain Management
• Psycho physiological Processes
• General Medical Problems
• Chemotherapy Distress
• Acute Pain

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Evidence for Pain Reduction

• Integration of behavioral and relaxation
  approached into the treatment of chronic pain and
  insomnia. NIH Technology Assessment Panel on
  Integration of Behavioral and Relaxation
  Approaches into the Treatment of Chronic Pain and
  Insomnia. JAMA, 1996, Jul 24-31, 276(4) 313-8.
• Syrjala, KL, et al. Relaxation and imagery and
  cognitive-behavioral training reduce pain during
  cancer treatments a controlled clinical trial.
  Pain, 1995 63 189-198.
• DePalma, MT. Psychological influences on pain
  perception and non-pharmacologic approaches to
  the treatment of pain. Journal of Hand Therapy,
  1997 10(2)183-191.
• Urba, SG. Nonpharmacologic pain management in
  terminal care. Clinics in Geriatric Medicine,
  1996, May, 12(2) 301-11.

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Learning Objectives

• Identify specific clinical disorders that may be
  amenable to a Hypnotic Mind-Body Intervention
• Pain
• Phobia
• Tic or Tourettes
• Insomnia

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Learning Objectives

• Identify specific Hypnotic Mind-Body
  interventions that may be viable for clinical
  disorders
• Distraction
• Going to a favorite place
• Seeing a Movie in your Mind
• Reframing the sensation
• Pain to pressure

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Learning Objectives

• Be able to describe a Hypnotic Mind-Body Stress
  reduction technique so that it would be
  acceptable for a pediatric or adolescent
  population.
• The general every day trance experiences
• Getting ready to and falling asleep
• Watching a movie and ignoring everything else
• daydreaming

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The End
Proceed to the Post Test 1. Down load the post
test 2. Complete the post test 3. Send the post
test to Dr. Sandra Oliver
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Post test

• 1. Which of the following are considered
  hypnosis
• A. Relaxation and mental imagery
• B. Suggestion
• C. Mental
• 1. A and B
• 2. B and C
• 3. A and C
• 4 All of the above

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Post test

• 2. Hypnosis is dependent on which of the
  following
• A. Motivation
• B. Negative Expectancy
• C. Association
• D. Voluntary Responses

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Post Test

• 3. Hypnosis is least utilized in
• A. Stress management
• B. Pain management
• C. Employee management
• D. Weight loss management

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Post test

• 4. With hypnosis, to bring about what you want
  to achieve you
• A. Excite the mind
• B. Relax the body
• C. Create obscure mind pictures
• D. Take control of the patient

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Post test

• 5. Hypnotic induction of a 7-11 year old
  includes which of the following
• A. Sports Activity
• B. Deep Breathing
• C. Science Fiction Imagery
• D. Adult Oriented Induction

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Post test

• 5. The general every day trance experiences
  includes all except
• A. Getting ready to and falling asleep
• B. Deep sleep
• C. Watching a movie and ignoring
  everything else
• D. Daydreaming