By Ran D. Anbar, MD
Note: This article was reprinted with permission of the author.
You can read the original article here.
Even when patients cannot relax with hypnosis, the subconscious can respond.
Since all hypnosis is self-hypnosis, if a patient is uninterested, it does not work. Two years after I first started using hypnosis in my clinical practice, I reviewed the case histories of all the patients to whom I had taught hypnosis techniques. Over 80 percent of them experienced an improvement in their symptoms.
What was common among the remaining patients is that they expressed ambivalence about hypnosis, perhaps because they did not believe they had an issue that required therapy, were unwilling to make an effort to improve or take responsibility for their problem, or their parents had forced them to meet with me.
After that review, I learned not to offer hypnosis therapy until a patient expressed a strong interest. Since then, nearly all my patients who have used hypnosis have reported at least some improvement.
For instance, a 16-year-old girl was referred to me with fainting spells at school without a diagnosed medical cause. I told her that she could learn how to use hypnosis to help herself, but she said she was uninterested because it seemed it would take too much effort to learn how to self-regulate. I told her that she could return when she was ready.
Three days later she was back. I asked her why she came back so soon, and she told me that she had fainted again and thought about what I had said. I taught her how to calm herself with hypnosis and immediately her fainting episodes resolved.
I believe that if I had urged her to learn how to use hypnosis at her first visit it likely would not have worked for her, as she was not invested at that moment. In that event, it is likely she would have concluded that hypnosis could not work and would not have taken the opportunity to benefit from it.
Low Hypnotizability
In the hypnosis research literature, it is stated that 10 to 20 percent of individuals are “low hypnotizable” throughout their lives, meaning that they would find hypnosis more difficult to work for them (Kekecs et al., 2021). However, while at first it was thought that low hypnotizable individuals could not use clinical hypnosis effectively, more recently it has been understood that most such patients can respond well when hypnotic approaches are individually tailored for them.
Early in my experience with hypnosis, in my role as director of a cystic fibrosis (CF) center, I offered instruction in hypnosis techniques to all my patients with CF. There are many applications for hypnosis in dealing with a chronic disease, including control of discomforts associated with the disease and its treatments, as well as dealing with existential questions relating to having a terminal illness.
One of my 15-year-old patients with CF gained no benefit from being taught about hypnosis. He said he was unable to visualize and could not even bring himself to relax when I suggested that he allow his body to relax one muscle group at a time. At that time, I thought he was “low hypnotizable,” and thus would never be able to use hypnosis effectively.
Six years later, the same patient asked me to teach him hypnosis to help him with his depression. This time hypnosis techniques worked well for him. Thus, I learned that at 15 this patient apparently lacked motivation to help himself, and yet at 21, when he became motivated, hypnosis worked fine.
Interactions With the Subconscious
Recently, I worked with four young adult patients who were unable/unwilling to use hypnosis. The first one dealt with body dysmorphia and did not like the asymmetry of her face, which was imperceptible to a casual observer. She said that when I taught her how to use hypnosis as a way of calming and feeling better about herself she did not believe she deserved to feel better, which was part of her psychopathology.
The second and third reported that they could not feel more relaxed after the use of hypnosis and progressive relaxation. One of them complained of fast breathing that could last for days, without an identifiable physical cause, and the other had been diagnosed with depression. Neither of them had responded to extensive medical and psychological therapy previously.
I wondered if in these cases there was a reason their subconscious minds prevented them from improving. One of them verbalized that he was afraid that if his symptoms improved he would be asked to take on normal responsibilities, and that he might fail at keeping up with the demands of life.
The fourth had developed difficulties swallowing after choking on a piece of food. Typically, in the case of patients who are afraid of swallowing, learning how to use hypnosis to relax while swallowing resolves the issue. However, she said she hated relaxing and could not follow my instructions about using hypnosis to relax.
Notably, with each of these four patients, I was able to speak with their subconscious through muscle testing, which helped address their issues. For instance, instead of focusing on their presenting complaint, therapy could be focused on their core dysfunctional issues that involved learning to be more accepting, nonjudgmental, and supportive of themselves. In so doing, all four patients made clinical progress.
Thus, I learned that even when patients are unable to use hypnosis for relaxation or comfort, subconscious exploration (which involves a hypnotic state) can still be feasible and therapeutically useful.
When patients are unresponsive to hypnosis-mediated relaxation or subconscious exploration, they can be offered alternative approaches such as psychodynamic therapy, cognitive or dialectical behavioral therapy, breathing techniques to help with self-calming, progressive relaxation techniques, biofeedback, or yoga, or they can be encouraged to take better care of their physical and mental health through getting adequate sleep, exercising, eating a well-balanced diet, and cultivating a good social life.
Takeaway
Although relaxation achieved with hypnosis can be helpful for many patients, for others, including “low hypnotizable” individuals, hypnosis sometimes can be used to allow therapeutically fruitful interactions with their subconscious.
