Is Hypnosis Moving Closer to Mainstream Medicine?

Throughout the developed world, people are increasingly turning to hypnosis for a variety of reasons, from stopping smoking to alleviating the pain of cancer treatment. It’s surprising, therefore, that there is little consensus among medical professionals about what hypnosis is, let alone whether it’s effective for these purposes.

The word hypnosis is derived from Hypnos, the Ancient Greek god of sleep, and was coined by James Braid (1795-1860), the first person to conduct formal medical research on the subject. In fact, however, hypnosis bears little relation to true sleep, and is more accurately described as a state of highly focused attention. James Braid himself later realised this, and attempted to change the name to monoideaism, but the catchier hypnosis had stuck. Subjects under hypnosis remain conscious throughout the process. Andrew Barrett, a London based practitioner, told me: “People [who come to me] are vaguely aware [of what hypnosis is] but apprehension is based on what they see on TV such as Derren Brown or Paul McKenna. The initial fear is ‘will I be in control?’ I give them a taste and then they feel more comfortable and we can get down to real work.” Approximately 95% of subjects can be hypnotised to some degree, although many cannot attain the deep, trance-like states often associated with hypnosis.

Jenny Fenfham, who used hypnosis for help managing anxiety, remembers, “[The hypnotist] told me to think of a door. He told me to open the door and to go inside, to imagine a room on the other side. He asked me to see what was in this room and to throw away what I didn’t want.”

Perhaps the fundamental dividing line in the hypnosis debate is between those who argue that it is an “altered state of consciousness” and those who insist that supposedly “hypnotised” patients are in fact subconsciously acting out a role. It has long been universally accepted that, contrary to popular perception, it is not possible to hypnotise someone against his (or her) will. While this does not invalidate the notion of an altered state, it does leave open the possibility that the subject simply wants to be hypnotised and therefore behaves in the way he believes a hypnotised person should behave.

This latter explanation is often given for the bizarre behaviour exhibited by subjects in stage hypnosis: that, since people believe that they are not responsible for their actions, their inhibitions are removed. The Hypnotherapy Association comments, “Entertainment hypnosis relies on compliance, expectation from the audience and perception of what the audience expects. In fact, if you should choose to go to an entertainment hypnotist, you are going with the express intention of having fun and being asked to do silly things.”

One might hope that modern brain imaging techniques such as EEG (Electroencephalography), PET (Positron Emission Tomography) and fMRI (functional Magnetic Resonance Imaging), which allow activity in different parts of the brain to be measured, might provide a definitive resolution to this so-called “state/non-state” argument. Instead they have made the question itself seem ill-defined since, while patients under hypnosis do show changes in cerebral activity, so do patients asked to complete or imagine various activities. The American website Skepdic comments dryly: “One might as well call daydreaming, concentrating, imagining the colour red, or sneezing altered states, since the experience of each will show electrical changes in the brain and changes in brain waves from ordinary waking consciousness.”

Nevertheless, brain imaging has provided us with some tantalizing hints. A 1998 study in patients pre-screened for their ability to suffer auditory hallucinations under hypnosis scanned their brains using PET under four conditions: when a tape was playing, when it was not playing, when they were asked to imagine hearing the tape, and when they were under hypnosis and told that they were hearing the tape. One region of the brain, activated when they were hearing the tape but inactivated (initially) when they were not hearing the tape, was found to be activated by hypnotic suggestion that the tape was playing despite remaining inactive when they simply imagined hearing it. In other words, their brains were fooled into genuinely believing they were hearing it.