There is no definite dividing line between a normal waking state and a hypnotic or trance state.
Examples of alterations in consciousness occur frequently and most people experience some of them. Both children and adults can become so absorbed in daydreaming that they lose track of what is going on around them. Some people consciously use daydreams to divert themselves from certain aspects
of their existence. When someone is concentrating intently on a work project, the hyper-focusing that
aids the work may also shut out noises and other distractions. Someone who is absorbed in an activity may, when the activity ends, need to take a moment to reorient to the external world
What hypnosis is not: Sleep. Adults who are hypnotized often prefer to have their eyes closed. This
is not necessary in order to have a deep trance state. In fact, many children prefer to have their eyes open and even to walk around during hypnosis. While in hypnosis, one's attention and concentration
is more focused. During sleep, this is not usually the case. EEG patterns during hypnosis and during sleep differ. Hypnosis is intense focused concentration, with the partial or complete exclusion of awareness of peripheral phenomenon. Some feel that individuals who are able to become intensely absorbed in an activity or daydreaming make the best hypnotic subjects. Hypnotic or trance states can occur spontaneously both inside the therapy room and in every day life.
Indications for Medical Hypnosis
Pain: Some clients worry that if hypnosis helps their pain that it means that the pain in "all in my head." Actually, that is true because ALL pain is mediated through the brain. Pain-related to surgery or medical conditions such as shingles can respond well to hypnosis. I usually work with the client to build in safeguards so that he or she will be alerted to any change or increase in the pain.
Habit Disorders: Hypnosis has been shown to be effective for bruxism (repetitive teeth grinding) I have used it successfully to help individuals stop smoking. For individuals with alcoholism or other chemical dependencies, I strongly suggest that if they are seeing me for hypnosis, they also attend 12 step meetings.
Nausea and other Conditions in Pregnancy: I have had good results using hypnosis to attenuate nausea associated with cancer chemotherapy. An added benefit in one individual was the ability to learn to dilate small veins prior to a needle stick. "Morning sickness," nausea associated with pregnancy, can range from mildly annoying to medically dangerous. Pregnant women often wish to avoid medication unless absolutely necessary. I do not see hypnosis, in isolation, as a substitute for childbirth preparation classes such as Lamaze or Bradley. However, it can work in combination with these approaches. Women with anxiety disorders, who wish to avoid medication during early pregnancy, can often use these techniques to decrease anxiety and minimize panic attacks
Relaxation: Almost by definition, hypnosis induces a state of relaxation. This can be short term, as when used to interrupt panic. When used with self-hypnosis, a motivated individual can often achieve longer-term results.
Anxiety states: Hypnosis can help anxiety disorders in more than one way. It can directly decrease anxiety and panic by inducing a state of relaxation. The therapist can also use the hypnotic state to help the client focus more clearly on issues that might be causing the anxiety. Often the use of fictional stories, used as metaphors, can give the client a new way of looking at his or her problems. Story telling is more permissive than direct suggestions. It gives the client a chance to accept or reject the suggestion without feeling that he is being "non-compliant."
Interruption of strong emotional state: Individuals in crisis are often more susceptible to suggestion.. Susceptible individuals may actually dissociate spontaneously during a trauma or crisis. This tendency may be used therapeutically in emergency situations.
Some, such as the Speigels, feel that each individual has an innate capacity for achieving trance state. They see this capacity as relatively stable over time. They suggest that there may be inheritability of this capacity. Thus, they do not use deepening techniques as much as other clinicians. They do note that expectations and rapport with the therapist can influence the success of the hypnosis.
Milton Erickson emphasized less a biologically determined capacity for hypnosis. He attempted to find metaphors suitable for each individual. He also would use deepening techniques. He felt that individuals who seemed to have a limited capacity for trance could still achieve trance states with proper technique. Many clinicians approach their hypnotic work from a middle ground. It is useful to get a sense of the client's capacity to easily achieve trance. However, much can be done to deepen and enhance the trance state. Additionally, a great deal of productive work can be done while an individual is in a light trance state.
The induction is essentially a ritual that helps formalize a transition to a more focused state of consciousness. Deep or light trance states can occur spontaneously. The formal induction process serves to organize and structure the process so that the trance state can be more efficiently used in therapy. There are a wide variety of types of hypnotic inductions. Some therapists tend to use a particular type of induction most of the time. Others vary the type of induction depending on the personality type and preferences of the client. Brief induction techniques can be more practical because the client can often learn to use it himself in "real world" situations.
I will often teach clients how to use self-hypnosis so that they can gain more control over the process. They can use it between sessions as boosters. Often I teach them a long induction for when they have time and a shorter induction for quick use in crisis situations. Individuals who have difficulty doing
the self hypnosis may benefit from hypnosis tapes. I will often make up custom tapes for certain clients.
Contraindications for Hypnosis
This is a controversial subject. Different clinicians have varying opinions about the appropriate uses
of hypnosis. I tend to be more conservative than some other experienced clinicians. Most licensed clinicians agree that they should not use hypnosis for public entertainment. It is not a good idea to try to induce hypnosis in a client who does not want it. One should not use hypnosis to try to achieve goals other than the client's wishes. Generally, it would be difficult to use hypnosis in this way. However, there have been reports of manipulation of ambivalent clients in hypnotherapy and other forms of therapy.