THE PSYCHODYNAMICS OF HYPNOSIS. 13 October 2023
Hypnosis has had a chequered history over the years within the field of psychodynamics. The use of hypnosis for therapeutic purposes began in medicine in the 18th century. Yet during this time, hypnosis was regarded with suspicion by some professionals in the world of medicine, many physicians seeing it, erroneously, as Mesmerism which was regarded as disreputable.
However, the eponymous Viennese physician, Franz Anton Mesmer (1734-1815) was never a hypnotist in the true sense of hypnosis because he was an animal magnetist. He believed in animal magnetism. This is the belief in the idea of a magnetic fluid which can be used for therapeutic purposes. He experimented with metal magnets, stroking the body of his patients with the magnets to produce a trance. The animal magnetists held that magnets have universal influence on human beings. Mesmer later abandoned the magnets but he held on to the view of animal magnetism and never turned to hypnosis.
The use of hypnosis as a therapeutic tool was discovered by a British physician, James Braid (1795-1860). The only link between the use of hypnosis during the time of Braid and Mesmer’s work with his magnets was the belief by the physician that he was putting his patient to sleep. Mesmer was famous for saying to his patients, “Dormez!” (Go to sleep). They would go to sleep immediately on his command. On the other hand, Braid who coined the term ‘Hypnosis’ after Hypnos, the god of sleep in Greek Mythology, believed that his patients were at sleep during the therapy. The idea of patients ‘going to sleep’ during the therapy was part of the mystery and suspicion which was attached to hypnosis and created its sham image at the time.
Even today in the third century after Mesmer and Braid, there is still public fear and suspicion that hypnosis is a way of controlling a person’s mind and inducing him into sleep against his wishes or ‘planting’ some unwanted information in his mind. The wild magical claims of the hypnotists of today do not allay the fears and suspicions of the public.
For this reason, as a matter of professional ethics, the therapist who uses hypnosis as a therapeutic tool, should explain it clearly to the patient from the start. He should seek the patient’s approval or at least warn the patient in advance that he was going to use hypnosis before using it in the therapy. This is so as to avoid any problems later. For example, a patient may say that he consulted for psychotherapy, that he did not ask for hypnosis.
Hypnosis is a great therapeutic tool which has been used by psychotherapists and physicians since the days of James Braid. It is strictly a weapon for therapy but not the therapy itself although some hypnotherapists may disagree with this. Hypnosis helps a great deal to shorten the length of psychotherapy because it helps the client to relax and thus to focus the mind on the therapy.
The orthodox definition is that hypnosis is an altered state of consciousness. There is a slight ambiguation in the definition in respect of the mind/body problem. It raises the question about the state that is being altered, whether it is mental state or physical state. I shall return to this point before the end of this discussion.
As I use it in my own work, my working definition is that hypnosis is an accelerated learning technique which, by the use of deep relaxation and creative visualization, enables a person to achieve a heightened or a sharpened sense of awareness of the existing situation in his life in relation to his objectives towards the achievement of a desired goal or intention.
It is in the sense of ‘accelerated effects’ and ‘creative visualization’ in my definition above that the use of hypnosis can help an individual in the area of accelerated learning through the achievement of personal goals by directing the mind towards the desired objectives. For example, with the aid of deep relaxation and creative visualization, the technique of hypnosis can enable a person to boost sporting performance, or give up an unwanted habit such as smoking, overeating of unwanted high calorie foods, or to achieve a highly desired goal.
Some sports people such as athletes, boxers, swimmers, footballers, and others are able to boost up their sporting prowess and achieve a personal best (PB) performance with the use of hypnosis without the need to do something illegal by using banned drugs. Hypnosis can also help a person to read faster or do things better because it focuses directly on a particular need or desire of the individual. I have used hypnosis to help sports people to boost their performance and students to perform excellently at examinations.
However, the therapist must discuss the use of hypnosis with the patient and clear up all the myths surrounding hypnosis before he can resort to the use of hypnosis in any particular therapy. It is important for him to clear up all the myths so that the patient understands clearly what is involved in hypnosis. Many people feel unnecessarily alarmed about the nature of hypnosis and its therapeutic efficacy. There is public ignorance, on a wide scale, about hypnosis and at the same time great mistrust and hostility. I think that the mistrust and hostility may be due to two major factors: (a) hypnosis on stage and television and, (b) Freud’s role in the dispute between the French schools of hypnosis. I give explanation to these factors below.
Hypnosis on Stage and Television
The first factor is the general concerns of the public about the use of hypnosis by stage and television performers. These performers make members of the audience do silly things for entertainment purposes. This has occasioned a misunderstanding of the role of hypnosis for therapeutic purposes. Those using hypnosis for entertainment on television and on stage are entertainers, not therapists. However, these ‘entertainers’ seem to cause alarm and public fear by giving the impression that hypnosis is just a form of magic show, that they have some magic ‘power’ over the subject, that they can control the subject and put some kind of magic spell on him and make him do silly things on command. They make believe that they can influence the subject by their ‘power’.
Because of these false claims, some patients fear that their mind may be controlled by the therapist using hypnosis and that they may be made to do or say silly things against their will. An honest and genuine therapist who is using hypnosis for therapeutic purposes does not have magical ‘power’. He does not pretend that he has such ‘power’ because he is guided by the code of ethics of professional practice and his major concern is to help his patients. It is his job to reassure his patient that the therapeutic use of hypnosis is to help the patient generally to attain personal well-being, obtain relief from illness, or achieve success in self-improvement. The therapist must help his patient to understand that the therapeutic use of hypnosis does not degrade or deride an individual, or control a patient’s mind.
In suggestion therapy such as practised by Josef Breuer and Sigmund Freud in 1895, some patients may be more suggestible than others. This does not mean that the suggestible subjects are in any danger or that they are in any way, servile, gullible, stupid or less intelligent than non-suggestible subjects. It is quite the reverse, really. Suggestibility does not mean gullibility because hypnosis is a consent therapy and, as a result, the suggestions which the therapist gives to the patient should always be dictated by the expressed intentions of the patient.
In hypnosis a suggestible subject is one who fully understands his own intentions for seeking the therapy and accepts the suggestions because they are dictated by his own intentions. In short, he is a person who knows what he wants to do and goes ahead and does it with the help of the therapist. This is basically the purpose of the therapy, that is, to obtain help from the therapist whose job it is to render such help by giving the necessary positive suggestions. Suggestible subjects do extremely well in their therapy such as for giving up smoking, or losing weight.
The so-called non-suggestible subject is one who thinks he understands his own intentions for seeking therapy but questions, doubts, and refuses the suggestions dictated by his own intentions. In short, he is a person who thinks that he knows what he wants to do but refuses to do it anyway! This is basically the opposite of what therapy is about – he comes to the therapist to seek help but refuses the help given to him. He is like the patient who consults with a physician for a certain physical disorder but when the physician prescribed the medication required to treat the symptom, he refused to take it because he believes that the medication will damage his health!
The so-called non-suggestible subject is a person with dishonest intentions and an underlying negative framework which induces him to doubt or question the suggestions given to him. He is a person with a conflict and he has reasons to hide his true intentions and present a dishonest facade during therapy. The non-suggestible subject fails miserably in his therapy but he will always explain away his failure in a woeful defence mechanism: he would say that his mind was too strong for the therapist to control!
It should be clear from the foregoing that suggestibility is neither a defect nor a weakness on the subject nor of hypnosis in general because the suggestions always follow the intention, wish, or desire of the subject, that is, what he wills to do. As mentioned above, the reason for this is that hypnosis is a consent therapy. Thus, it is inconsistent to question or doubt the help suggested by the therapist based on the intention declared by the client. The patient is able to relax with hypnosis because he has given his consent to the therapy willingly by requesting it and declaring his intention. His mind is disposed towards the desired therapeutic objective, that is, his motive or intention for wanting the therapy.
Here is a simple illustration to clarify the points raised above. Suppose that a patient has consulted with weight problem, because he wants to lose weight. This is the patient’s declared intention and the reason why he has sought therapeutic help. The therapist then questions the patient about his usual diet, snacks, and others, and acting with this information in obedience to the patient’s motives and intentions, he gives positive, tried and tested, suggestions for weight loss. Here, a suggestible patient will follow the suggestions because they are dictated by his intentions and he will lose weight accordingly, progressively, effortlessly because he has a motive and an intention to lose weight. The so-called non-suggestible patient will doubt and question the suggestions and fail hopelessly to lose weight because he has anxiety problems which make him present dishonest intentions or make him doubt his own intentions.
It is never, ever, true to say that the therapeutic use of hypnosis is a means of controlling anyone’s mind because genuine treatment with hypnosis is a consent therapy. There are no magic shows in the therapeutic use of hypnosis and it is utilized for positive effects, to help patients achieve their desired objectives. The patient is always fully in control under the therapeutic use of hypnosis. Any suggestions other than the patient’s declared intention will be repugnant to the patient under hypnosis and he will not react to it. Thus, his mind cannot be controlled to do what he does not want to do.
I return to my illustration with weight problem to clarify the point. Suppose further that as the patient consulted with weight problem, a deviously unscrupulous therapist goes on to give the patient the suggestion to rob the bank across the road! Now the idea of robbing a bank is remote from the patient’s declared intention, it is not the idea in his mind and not the reason why he has sought the therapist’s help. Thus, the suggestion will not take hold in the unconscious mind and, because it is devious to the patient’s intention, the suggestion will be repugnant to the patient and he will not consent to it. Such therapy will, therefore, fail but it fails because hypnosis gives control to the patient.
Now the upshot of all this is that there is no reason for the general fear of hypnosis in therapy because the therapeutic use of hypnosis is not a means of controlling a patient’s mind or making people do what they do not want to do. It is a positive means by which the patient achieves success in doing whatever he wishes to do or in avoiding whatever he wishes to avoid. It helps the patient to concentrate his mind on a desired objective thus making that objective easily achievable. This is entailed in my working definition of hypnosis given above.
There is nothing in hypnosis for the patients to be worried about because drugs are not involved in it and no frightening weapons are used in it today. A trained professional practitioner working with hypnosis today does not swing a pendulum in front of his patients. He does not insult his patients with a snap of his finger to command them to fall under his ‘power’ and obey him. He does not say “You are under my power” and he does not say “Go to sleep”.
He does not say “Go to sleep” because the patient has not come to the consulting room to sleep. This is not his intention for seeking the therapy. Where the consulting problem is insomnia, the therapeutic objective will always be to enable the patient to sleep at home at his regular bedtime in his own bed or in his usual place of sleep. The therapist always treats his patients with respect because his primary objective is to help them to be relaxed and be comfortable, not to make them subservient to a dictatorial command with the snap of the finger. Thus, a professionally trained hypnotist does not insult his patients with a demeaning snap of the finger to extort obedience.
In order to make the patient comfortable and relaxed the therapist speaks to him in a calm and soothing tone of voice, with a confident and positive manner. He focuses his attention on the patient’s mind and body and attempts to get the patient to feel mentally and physically relaxed so that he can focus deeply on the therapy and be in a receptive mood to participate in it. In hypnosis the patient’s participation is crucial. Thus, it is obvious from my discussions here and what I have said above about James Braid and Franz Anton Mesmer, that hypnosis is not sleep.
The patient under hypnosis is expected to know what is going on. He can hear what the therapist is saying to him and he is able to engage in conversations with the therapists during analytic sessions. However, it happens sometimes that, some patients get so relaxed under hypnosis that they fall asleep during therapy. As I have pointed out above, this does not suggest that the therapeutic objective with hypnosis is to put patients to sleep. In hypnoanalysis the session is considered unproductive if the patient slept through it. This is because falling asleep renders the patient incapable of observing the technical rules of free association and incapable of participating productively in the therapeutic conversation.
Freud’s Role in the Dispute between the French Schools of Hypnosis
The second factor which I think is responsible for the hostility, mistrust, and the reason why many people are unnecessarily alarmed about hypnosis concerns Freud’s later reactions to hypnosis. Ironically Freud, the man who helped to popularise the use of hypnosis in psychotherapy, was also the man who helped to discredit hypnosis as a therapeutic tool. Freud practised the use of hypnosis effectively during the period before his creation of psychoanalysis until the eventful scene with his amorous patient.
For those people who have read Freud’s later, psychoanalytic, comments on hypnosis, for example in his Five Lectures on Psychoanalysis (Freud 1910a), delivered at Clark University, Worcester, Massachusetts, USA, there is fear that hypnosis might not lead to complete cure. I think that two events influenced Freud’s decision to give up on hypnosis after he had used the technique effectively for the treatment of his patients and found that “it was highly flattering to enjoy the reputation of being a miracle-worker” (Freud 1925d SE 20 P17) with his use of hypnosis.
The first event concerns the great dispute in the late 1880’s and early 1890’s between the two famous French schools of hypnosis where Freud learned and perfected the technique of hypnosis. These are the Salpetriere Clinic and school of hypnosis in Paris led by professor Jean Martin Charcot (1825-1893) and the great Nancy school led by professor Hyppolyte-Marie Bernheim (1840-1919).
This dispute is over the physiological and psychological perspectives of hypnosis and it is the same Cartesian controversy about the distinction of mind and body, or the physical and the mental. This dispute is rightly seen as a continuation of the old quarrel between the fluidists who insisted upon the physical element in hypnotic phenomenon and the animists who held that imagination was the essential factor.
There is evidence that this dispute influenced Freud’s dissatisfaction with hypnosis. He was torn between his intellectual allegiance to Charcot and Bernheim both of whom had taught him different methods of the clinical use of hypnosis. It seems in this instance that his intellectual convictions would favour the psychological viewpoint of the Nancy School on account of his decision to remain on psychological grounds in therapeutic issues (1900a PFL4 PP684-685). However, Freud’s attitude wavered between the two adversaries in the dispute, sometimes supporting Charcot, at other times Bernheim.
Freud used hypnosis in the treatment of his patient Emmy von N around 1889-1890 and he provided the review of August Forel’s book on hypnotism in 1889 (Freud 1889a). He also provided the German translation to Charcot’s book on hypnosis and two of Bernheim’s books on hypnosis and psychotherapy and these German translations were published between 1888 and 1892; indeed, during the period of the hypnotic dispute. Many theorists who took sides with Charcot and his assistant Joseph Babinski in the dispute felt, erroneously, that the way to make hypnosis respectable and scientific was through a description of its nature in a quasi-neurophysiological language.
In the controversy of last century, the essential element of Theodore Barber’s (1969) polemics on hypnosis is a resurrection of the old dispute. Although I am not aware of any documented evidence of Freud’s feeling that he has betrayed the trust of Charcot and Bernheim in switching sides between them in their dispute, it can still be argued that if Freud had any personal worries of this sort, the best way to appease the situation was to give up on hypnosis and decline support to both parties.
However, recalling the great controversy some forty years later in a letter to A. A. Roback, Freud admitted that in the question of hypnosis he took sides against Charcot, though not wholly with Bernheim, “…over the question of hypnosis I sided against Charcot, even if not entirely with Bernheim” (Freud 1960a, P394).
The issues in the old dispute does, indeed, confound current controversies in experimental psychology about state and non-state hypnosis. The real issue of contention is whether the subject under hypnosis is in a physiological state or in a psychological state of mental awareness. You can see from this that there is, strictly, no such thing as a non-state hypnosis.
The second event concerns the much more publicly acknowledged reason for Freud’s dissatisfaction with hypnosis and his consequent abandonment of the technique. This is his own admitted incompetence in the induction of deep, somnambulistic, level of hypnosis which resulted in his trip to Nancy in the summer of 1889 to perfect this technique with Bernheim and Liebeault.
He started to use hypnosis in his therapeutic practice in 1887 shifting gradually from neurology to psychopathology dealing initially with hysteriform conditions using suggestion therapy. As a result of what he learnt at Nancy from his observation of Bernheim and Liebeault and how they treat their patients by suggestion under deep hypnosis, he took it as a general rule of therapy that a necessary requirement for an effective therapy lies in the ability of the therapist to put his patients under deep, somnambulistic, level of hypnosis.
Not finding himself able to do this, he quickly gave up the use of hypnosis on the next available opportunity of a therapeutic problem and then blamed the failure of some of his therapies on hypnosis. The embarrassingly unwelcome embrace by his amorous patient which was made even more unpleasant by the unexpected intrusion of his servant into the consulting room at the inconvenient moment (Freud 1925d SE 20, P27) was decisive in his giving up completely on hypnosis and effecting a complete break from the cathartic method.
Freud felt that the incident with the amorous patient was the fault of hypnosis, that it was not for his physical charms that the patient threw her arms round his neck. He felt that he knew enough about hypnosis and that he should discontinue with the technique. From then onwards he began to condemn hypnosis. “I was modest enough not to attribute the event to my own irresistible personal attraction, and I felt that I had now grasped the nature of the mysterious element that was at work behind hypnotism. In order to exclude it, or at all events to isolate it, it was necessary to abandon hypnotism” (ibid.).
Ironically, and interestingly, Carl Jung, who was once Freud’s side kick, mimicked Freud in these experiences. Jung used hypnosis at the beginning of his private practice and, also like Freud, enjoyed the reputation of being a miracle worker with hypnosis treatment. Jung also abandoned the use of hypnosis on account of an apparently successful treatment of woman whose miraculous recovery baffled and frightened Jung. Like Freud, he blamed the incident on hypnosis (Jung 1995 PP139-140).
Thus here, the trouble is that uninitiated people who have watched hypnosis used on stage or on television to degrade volunteer participants and deceive members of the audience, and those who have read the later statements of Freud and Jung on hypnosis may be worried about its safety and efficacy. The therapist needs to draw the attention of his clients to the therapeutic value of hypnosis and reassure them about the safety of hypnosis before he can use it effectively in their treatment.
The Therapeutic Value of Hypnosis
There are three main areas in which hypnosis can be used in therapy. The first is in the area of pain control by suggestion. Here the patient is guided into a state of deep relaxation which sets him free from distractions and enables him to attain a sharpened sense of awareness of his objectives in relation to the elimination of pain.
The therapist gives positive suggestions for the elimination of pain. He may suggest amnesia to the feeling of pain, he may also give a post-hypnotic suggestion for the continuing elimination of pain. The technique of pain control is particularly useful for the relief of pain for those suffering from painful degenerative diseases such as arthritis (osteoarthritis and rheumatoid arthritis), where no orthodox treatment is effective except for the administration of pain killing drugs which may produce alarming side effects.
The control of pain by post hypnotic suggestions can also be used for painless childbirth, an area where conventional anaesthetics can be dangerous for both mother and baby. I have personally dealt successfully with a number of cases in this area. This entails teaching the expectant mother the technique for the control of pain, under hypnosis, so that she can apply it on the eventful day, under the supervision of a midwife, instead of the use of conventional epidural. For more information on this refer to Mind Castles (Maurice-Nneke 2002).
James Esdaile (1808-1859), a Scottish surgeon, used this method of pain control to perform surgical operations in India between 1843-1846 and established the value of hypnoanaesthesia. He performed over 300 operations including the removal of tumours, cancerous growths, and about 19 amputations without the patients feeling any pains whatsoever.
His post hypnotic suggestions were that the patients would not develop any infections or septic conditions. The importance of Esdaile’s work can be best appreciated by taking into consideration the fact that it was done before the French microbiologist Louis Pasteur (1822-1895), the English baron Joseph Lister (1827-1912), and others drew attention to bacteria in the aetiology of diseases and to infections as a result of unsterilised instruments and virulent organisms.
The second area in which the use of hypnosis is of value concerns the treatment of chronic diseases which are not easily responsive to orthodox medication. In such cases hypnosis can be used to allay sufferings especially where the patient suffers from symptoms of irritability, depression, and certain mental disturbances. Such problems as nervous exhaustion, insomnia, neuralgia, and others, can be treated with hypnosis.
The mental aggravation and nervous irritation by symptoms of rheumatoid arthritis, osteoarthritis, and similar symptoms can often be dramatically relieved in therapy by the technique of hypnosis. Treatment by hypnosis can often produce good and permanent results in the problem of nervous twitches, and nervous mannerisms.
The third area in which hypnosis is of value is in the treatment of mental and emotional problems. Because of their connection with emotional and other psychological problems, the problems of smoking, overweight and underweight, can be treated successfully with hypnosis where the patient is genuinely disposed to be healed. Long repressed memories or experiences are more easily accessible under hypnosis than under orthodox medication.
The repressed experiences can be recalled under hypnosis without the emotional upheaval that could result if they were recalled by other means. In the treatment of emotional problems and psychoneuroses today, the therapy can be conducted with a combination of the use of hypnosis and free association in a technique known as hypnoanalysis. Freud did not practice hypnoanalysis. He used the cathartic method during the period of his collaboration with the respected Viennese physician and experimental physiologist, Dr Josef Breuer. Freud used free association in psychoanalysis after his abandonment of hypnosis.
What do you think about the use of hypnosis for the treatment of patients?
REFERENCES
BARBER, Theodore X. 1969. Hypnosis: A Scientific Approach. V N Rheinhold, New York
BREUER, Josef and FREUD, Sigmund. 1895. Studies in Hysteria. Penguin Freud Library 3
FREUD, Sigmund. 1960a. Letters of Sigmund Freud 1873-1939 (Edited by Ernst L Freud)
FREUD, Sigmund. 1925d. An Autobiographical Study. Standard Edition Volume 20
FREUD, Sigmund. 1914d. On the History of Psychoanalytic Movement. SE 14
FREUD, Sigmund. 1910. Five Lectures on Psychoanalysis. Standard Edition Volume 11
FREUD, Sigmund. 1900a. The Interpretation of Dreams. Penguin Freud Library 4
FREUD, Sigmund. 1889. Review of August Forel’s Hypnotism. Standard Edition Vol.1
JUNG, Carl Gustav. 1995. Memories, Dreams, Reflections. Fontana Press
MAURICE-NNEKE, Antony. 2023. Lose Weight Now. Amazon. Available to Buy Now.
MAURICE-NNEKE, Antony. 2003. The Psychodynamics of the Unconscious. Available to
buy now. Go to Order Form
MAURICE-NNEKE, Antony. Mind Castles. 2002. Available to buy now. Go to Order Form.
