A History of Hypnosis In Medicine
© Davis Simons 2005-
reproduced with permission
The early years - pre 1600
Considering hypnosis in the context of the
contemporary state of knowledge, medicine and social change, we can
trace the importance of belief in healing right back to primitive
cultures. Since early history, priests and witch doctors have
attempted to bring about healing by inducing an altered state of
consciousness. This was often facilitated by rhythmic drum beats or
chanting, dancing and drugs, superimposed upon an elaborate ritual. (not
unlike the discos of today ! )
When man was searching for an explanation for the
inconsistencies of life he believed disease to be a Divine manifestation. The
Ancient Egyptians had their Temples of Sleep, and the Greeks their
Shrines of Healing, where patients were given curative suggestion
whilst in an induced sleep.
Hippocrates
(430 BC) was aware of the importance of harmony between mind and body, and
described the mind as the ‘seat of emotion’. It is possible to ascribe to
hypnosis many miracles described in the Bible, and later to the miracles and
cures ascribed to holy men, relics and shrines.
Between the times of the Romans and the sixteenth century
medicine was based largely upon folklore, and empirical remedies having little
scientific basis.
As dissection was frowned upon it was not possible except
in a few notable cases (eg Leonardo da Vinci circa 1500) to study
detailed internal anatomy until well into the sixteenth century.
Although Galen (170 AD) had described a
circulatory system it was not until 1628 that Harvey published his work on the
heart and the circulation of blood.
Chemical anaesthesia did not appear on the scene until the
mid-nineteenth century. Prior to this alcohol and opium had been used, but
surgery had been brutal and, of necessity, carried out at high speed. ( a
British surgeon, William Cheseldon, is reported to have removed a
stone from the bladder in 54 seconds !) The work of James Esdaile (see
later) should be viewed in this context. In addition to physical trauma and
shock, post-operative infection almost invariably followed surgery and accounted
for a huge mortality rate. Again we should view Esdaile’s extremely high
recovery rate in this context, and bear in mind the fact that it was not until
well into the nineteenth century that surgical asepsis became recognised as
being fundamentally important.
The development
of hypnosis
Paracelsus
elaborated the theory that the heavenly bodies exerted an influence
upon disease and healing, working through an all pervading universal
magnetic fluid.
Franz Anton Mesmer,
a very charismatic Viennese doctor, stated that man could influence this
magnetic fluid to bring about healing, and he established salons
where patients applied magnets to afflicted parts of their body.
Later he moved to Paris where he further developed his theory. It was
thought that a convulsive crisis was necessary for a cure to take place.
Louis XV1 set up a commission of
investigation, which included Benjamin Franklin, M. La Guillotin, and
La Voisier. Their conclusion was that magnetism coupled with
imagination produced a convulsive crisis, but magnetism alone did
not. Mesmer was discredited, but his Society of Harmonies
continued.
Le Marquis de Puysegur,
a member of the Society, decided that a crisis was not necessary. He believed
that the magnetic power was produced in his own mind and was transferred to the
patient via his fingertips. He found that he could produce a sleep in which
the patient would follow his commands - very authoritarian - and introduced the
terms perfect crisis and profound sleep.
John Elliotson,
Professor of Medicine at UCH, London, organised public clinical
demonstrations of a wide range of hypnotic phenomena, exhibiting
effects on voluntary and involuntary muscle, analgaesia, somnambulism,
hallucinations etc., which he attributed to the magnetism theory. On
his forced resignation he edited a journal, The Zoist, in which
he reported the work of...
… James Esdaile, a Scottish surgeon
working in India, who had performed several hundred operations quite painlessly
using hypnosis (mesmerism) alone as an anaesthetic. He or an assistant would
produce a state akin to suspended animation, now known as the Esdaile State,
by stroking the patient’s body for several hours. He recorded that fatal
surgical shock or post- operative infection occurred in only 5% o cases compared
with the then norm of 50%.
Case History: Gooroochuan Sha, shopkeeper
aged 40 - from Esdaile’s Records
Has got a
“monster tumour” (DS note: hypertrophy of the
scrotum) which prevents him from moving: its great
weight and his having used it as a writing desk for many years has pressed it
into its present shape. His pulse is weak, his feet swollen with fluid which
will make it very hazardous to attempt its removal.
...He became insensitive on the fourth day of
mesmerising...two men held the tumour in a sheet moving it forward at the same
time and I removed it by a circular incision, expedition being his only safety.
After
tying the last vessel he awoke.
The loss
of blood had been so intense that he fell into a fainting state
Tumour
weighed 80 lbs.
Patient did well post operatively.
The British medical establishment rejected Elliotson’s
claims for the efficacy of Mesmerism.
James
Braid, a Manchester
doctor, attended a demonstration of mesmerism by a Frenchman
M.La Fontaine, and applied the methods within his practice.
He discovered that patients, having gazed at his bright
lancet case, would enter a profound sleep, and in this state
would accept his suggestions aimed at cure. He assumed that
staring at a bright object exhausted the nervous system, and
that the phenomenon was not to do with magnetism. His
treatise coined the word Neurypnology
(literally ‘nervous sleep’, from Hypnos, the Greek
god of sleep. This was the first use of the word
hypnosis..
In Nancy, France, Dr. Ambroise-August
Liebeault, found that he could bring about cures in this state simply by
suggestion.
He was joined by Professor Bernheim,
from Paris, and together they published ‘De La Suggestion’ in which they
rejected the concept of magnetism. They established the Nancy School, and
set up the Animalist Movement.
Around this same time Jean Martin
Charcot was demonstrating his views at the
Salpêtrière Hospital
that
hypnosis was a pathological state akin to hysteria, the two phenomena
being interchangeable. Following conflict between the two schools, Bernheim’s view was accepted and Charcot discredited. However, two of
Charcot’s pupils were to have a huge impact on psychological medicine.
Josef Breuer and Sigmund Freud
developed the application of hypnosis beyond the mere suggesting away of
symptoms, and changed the approach to the elimination of their apparent
cause. Breuer found that in hypnosis patients would often recall past
events and in talking about them would experience an emotional outpouring,
subsequently losing their symptoms. This he called his talking cure, (we
would now refer to this emotional state as an abreaction). Freud was also
looking at the dynamics and history of illness, but after earlier work
with Breuer he left hypnosis in favour of his work in what was later give
rise to psychoanalysis.
During the Great war the Germans
realised that hypnosis was of value in the immediate treatment of
shell-shock, allowing soldiers to be returned rapidly to the trenches. A
formularised version of hypnosis, autogenic training, was devised by a
German, Dr. Schultz.
Martin Orne
was born in 1927 in Austria. His family moved to the USA and in due course Orne
qualified as a psychologist before obtaining a medical degree and becoming a
psychiatrist.
As an undergraduate at Harvard he
launched a bombshell with a paper dispelling many of the myths associated with
the use of hypnosis for age regression. He proposed that the adult under
hypnosis is not literally reliving his early childhood but presenting it from
the perspective of adulthood. The repercussions of this were to continue to rage
many years later in the controversy surrounding false memory syndrome.
Further repercussions occurred from his conclusion that in crime investigation
hypnosis could encourage witnesses to confabulate or "remember" things they
could not actually have seen or experienced. As a result of his expertise in
this field Orne was often called as an expert witness in high profile cases, for
example testifying on behalf of Patricia Hearst, the heiress.
Dr Orne also had a particular
interest in the study of multiple personality disorders, and again was able to
display his skills as an expert witness in a number of nationally important
cases.
His high profile and his term as President of the
International Society of Hypnosis were instrumental in promoting hypnosis as a
respected and respectable skill within psychology and medicine as well as within
the legal field.
Milton Erickson,
(1901-1980)
brought up on a farm in Wisconsin, was doubly qualified
in psychology and psychiatry. He was apparently dyslexic, tone deaf and colour
blind, being able to see only the colour purple.
Like Clark Hull before him, Erickson contracted polio
as a very young man, and was immobilised for many months, and physically
debilitated for the rest of his life. He is quoted as saying that his physical
limitations had made him more observant, and certainly his powers of observation
were legendary.
It is not possible adequately to describe the life and
impact of Milton Erickson in this short space. Literally thousands of books and
papers have been written about him and his work, and his modus operandi
has been copied and distorted by a plethora of practitioners under the guise of
Ericksonian techniques.
Erickson perceived from his own experience that, in
contradiction to the then current view, people responded in individual ways to
induction, and could also vary in their degree of trance and the extent to which
they would follow the hypnotist's suggestion. From this he developed the
inspiration that the therapist should enter the patient’s world and let
them slide into trance with whatever that patient presents at that time.
He wrote with great authority on techniques of trance
induction, experimental work exploring the possibilities and limits of the
hypnotic experience, and investigations of the nature of the relationship
between hypnotist and subject.
A major innovation in Erickson’s therapeutic technique was
that effective treatment was not necessarily dependent upon the formal induction
of trance. He believed that his patients had problems because they were out of
rapport with their unconscious minds, and that by using trance to reduce the
demarcation between the conscious and unconscious minds the patient could regain
rapport with his unconscious, and thus access his own resources. In addition,
and crucially, his almost uncanny use of the power of language and
imagery, of
metaphors
(often based on his own life), confusing statements, surprise and humour would
cut instantaneously through to the patient’s own experience and comprise a major
part of his vast range of therapeutic tools.
The fact that Erickson became a cult figure would not have
pleased him, any more than the fact that therapists attempting to use aspects of
his technique within ‘Ericksonian Therapy’ were often ignoring the intuitive and
observational skills that the man had possessed which over-rode mere technique.
Ernest Ropiequit Hilgard
(1904-2001) was appointed Professor of Psychology
at Stanford Ca in 1933. His major early interests were in learning and
motivation, and two of his textbooks, Theory of Learning (1948) and Introduction
to Psychology (1953) became classics.
In the 1950s he and his wife
Josephine, Professor of Clinical Psychiatry at Stanford became pioneers in
bringing to hypnosis the discipline of scientific study. Hilgard recognised a
need in research for a standard by which to measure depth of hypnosis and
hypnotic susceptibility, and the Stanford Hypnotic Susceptibility Scale which he
devised in 1959 is still in wide use today.
In 1957 they established the
Stanford Laboratory of Hypnosis Research. Here they experimented with hypnotic
pain reduction and two books in particular, Hypnosis in the Relief of Pain
(1975) and Divided Consciousness (1977), became landmarks in the objective study
of hypnosis.
Hilgard further
developed Janet's earlier work on dissociation into his theory of
neo-dissociation, posing three stages of consciousness within hypnosis; the
distorted reality, the hidden observer and the observing consciousness. This
model, when brought together with the then contemporary Pain Gate Theory of
Melzack and Wall, gave an elegant paradigm which remains just as fresh today, to
explain the way in which hypnotic interventions can be so effective.
John
Hartland was a
psychiatrist, a member of the BSMDH, and editor of the Journal of Medical
Hypnosis. His comprehensive textbook on clinical hypnotherapy, Medical & Dental
Hypnosis was published in 1966. Hartland described straightforward techniques
for ego, employing direct suggestions of a general nature, aimed at increasing
the patient's self confidence. The book, now in its fourth edition, became a
'bible' for the medical or dental student of hypnosis.
Following
Erickson, Richard Bandler and John Grinder, amongst
others, have studied and codified his subtle techniques in the development of
neurolinguisic programming, ( N.L.P. ) which currently has a very high
profile not only within medicine, but also within business organisations and
industry.
The study of
psycho-neuro-immunology (PNI), the conduits through which our emotions and
thoughts may affect our health came into prominence in the 1980s, and a major
influence in this study remains Dr Ernest Rossi. In his early
years Rossi worked with and co-wrote many papers with Milton Erickson, and is
editor of Erickson's collected papers. In 1986 he published a major book, The
Psychobiology of Mind-Body Healing. His painstaking research into psychobiology
and state dependent learning has resulted in a large number of publications in
which he describes the mind-body pathways, and applies hypnotic techniques in
utilising these pathways to bring about healing.
Hypnosis is currently seen as a tool
rather than as a cure in itself. It is used in simple relaxation techniques for
nervous dental and medical patients; as a first line in acute ward admission;
as an adjunct to chemical sedation and anaesthesia, as well as being an agent in
its own right; as relaxation therapy in the handling of stress and related
disorders And medical conditions; in obstetrics and antenatal care; in the
management of intractable pain, cancer and terminal illness; as an adjunct to
psychotherapy, and in the management of a wide range of phobic, anxiety and
other medical and psychological problems.
Is hypnosis dangerous?
Not nearly as dangerous as Medicine,
Nursing and Dentistry…that’s why we spend so long learning how to do them
properly !
© David Simons, 2005 - reproduced with permission
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