Hypnosis and Mind Body Interventions

1. Hypnosis and Mind Body Interventions Joel Marcus PsyD Mind-Body Cancer Research Program Scott and White Clinic and Hospital Texas A&M University System HSC College of Medicine

2. 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.

3. 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.

4. “Cogito, ergo sum” Rene Descartes I think therefore I exist

6. What is hypnosis? • Relaxation • Mental Imagery • Suggestion • Hypnotic Phenomena • Post-Hypnotic Suggestion

7. 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.

8. Hypnosis is a multiple determined experience • Relationship variables • Transference • Motivation and Expectancy • Set a positive expectancy • Determine Motivation • Trance variables • Dissociation • Involuntary Responses

9. What is Hypnosis? • Purposeful altered state of consciousness • Increased concentration and acceptance of suggestion which results in alteration of sensory and/or motor capabilities

10. What is Hypnosis? • Mental imagery is utilized • Response is experienced in an involuntary manner • Ex: arm levitation

11. 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

12. Depth of Hypnosis

14. Individual Factors in Hypnosis • Chronological Age • Intelligence • Imagery Ability • Motivation • Psychopathology

20. 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.

21. 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.

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

24. 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.

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

26. 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

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

28. 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 Indications for Hypnosis with Children

30. Hypnotherapy for Management of Symptoms • Assess the patient’s symptoms • Introduce hypnosis as a mind-body intervention • Empower the patient • Set specific goals and expectancy • Assess hypnotizability as a part of the process

31. 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

32. 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

33. 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...

34. 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.

35. 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

36. "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. • .

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

38. "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

41. 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.

42. 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.

43. 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.

44. 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.

46. 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).

47. 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

48. 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.

50. 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)