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
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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?
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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
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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 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
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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.htm
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Hypnotic Induction by Age
• Age 4-6
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Favorite Place
Flower Garden
Mighty Oak Tree
Story Telling
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Hypnotic Induction by Age
• Age 7-11
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Action Imagery
Coin Drop Induction
Arm Lowering
Flying Blanket
Science Fiction Imagery
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Hypnotic Induction by Age
• Age 12-18
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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
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Anxiety Reduction
Relaxation
Suggestion
Perceptual Alteration
Dissociation and Imagery
Self-Hypnosis
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Research and Child Hypnosis
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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 nonpharmacologic 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
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Pain
Phobia
Tic or Tourette’s
Insomnia
Mind-Body Research
Learning Objectives
• Identify specific Hypnotic Mind-Body
interventions that may be viable for clinical
disorders
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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
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