Wall Street Journal
HEALTH: Hypnosis gaining respectability among doctors, patients
BY MICHAEL WALDHOLZ
Wall Street Journal
Hypnosis, often misunderstood and almost always controversial, is increasingly being
employed in mainstream medicine.
Numerous scientific studies have emerged in recent years showing that the hypnotized mind
can exert a real and powerful effect on the body. The new findings are leading major
hospitals to try hypnosis to help relieve pain and speed recovery in a variety of
illnesses.
At the University of North Carolina, hypnosis is transforming the treatment of irritable
bowel syndrome, an often-intractable gastro-intestinal disorder, by helping patients to
use their mind to quiet an unruly gut.
Doctors at the University of Washington's regional burn center in Seattle regularly use it
to help patients alleviate excruciating pain.
Several hospitals affiliated with Harvard Medical School are employing hypnosis to speed
up postsurgical recovery time. In one of the most persuasive studies yet, a Harvard
researcher reports that hypnosis quickened the typical healing time of bone fractures by
several weeks.
"Hypnosis may sound like magic, but we are now producing evidence showing it can be
significantly therapeutic," says David Spiegel, a Stanford University psychologist.
"We know it works, but we don't exactly know how, though there is some science
beginning to figure that out, too."
Hypnosis can't help everyone, many practitioners say, and some physicians reject it
entirely. Even those who are convinced of its effect say some people are more hypnotizable
than others, perhaps based on an individual's willingness to suspend logic or to simply be
open to the potential effectiveness of the process.
GOING MAINSTREAM
These days, legitimate hypnosis is often performed by psychiatrists and psychologists
though people in other medical specialties are becoming licensed in it, too. It can
involve just one session, but often it takes several - or listening to a tape in
which a therapist guides an individual into a trancelike state.
Whatever the form, it is increasingly being used to help women give birth without drugs,
for muting dental pain, treating phobias and severe anxieties, for helping people lose
weight, stop smoking or even perform better in thletics or academic tests. Many
health-insurance plans, even some HMOs, now will pay for hypnosis when part of an accepted
medical treatment.
Until the past decade, many traditional science journals regularly declined to publish
hypnosis studies, and research funding was scarce. That's changing. Spiegel, for instance,
is co-author of a widely referenced randomized trial involving 241 patients at several
prestigious medical centers. Published several years ago in the Lancet, a respected
medical journal, it found that patients hypnotized before surgery required less pain
medication, sustained fewer complications and left the hospital faster than a similar
group not given hypnosis.
Using new imaging and brain-wave measuring tools, Helen Crawford, an experimental
psychologist at Virginia Polytechnic Institute in Blacksburg, Va., has shown that hypnosis
alters brain function, activating specific regions that control a person's ability to
focus attention.
"The biological impact is very real and it can be quantified," Crawford says.
STAYING LEGITIMATE
Still, proponents say they typically spend a great deal of time dispelling commonly held
myths and answering skeptics. Hypnosis, they say, cannot make people do or say something
against their will.
Credible hypnotists don't wave a watch in front of their clients, as portrayed in many old
movies. People who enter into a so-called hypnotic trance are not, generally, put to
sleep. On the contrary, practitioners say, they refocus their concentration to gain
greater control.
Even so, the field continues to be hurt by quacks, says Marc Oster, president of the
American Society of Clinical Hypnosis. His group, along with the Society for Clinical and
Experimental Hypnosis, publishes research studies, conducts educational seminars for
health providers and certifies those who complete course work and meet other standards.
Oster suggests that people interested in hypnosis see a health provider licensed in a
medical discipline who is also certified by one of the hypnosis societies - someone
who "uses hypnosis as an adjunct" to a principal medical practice.
Researchers say that most people unwittingly enter into hypnosislike trances on their own
in everyday life. When reading a riveting novel or watching a film or TV, many people are
experiencing a trancelike state when they are so focused they become only vaguely aware of
nearby noise, conversation or activity.
In a dream, when someone imagines falling off a cliff and is startled awake by the
sensation of falling, they are triggering the same mental machinery that in hypnosis
allows the mind to influence the body, says Dabney Ewin, a psychiatrist at Tulane
University Medical School.
Katie Miley used self-hypnosis, taught to her by a Chicago-area psychologist, to help her
give birth "without being so anxious and without pain medication." For weeks
preceding the delivery, Miley, herself a psychologist, used tapes provided by the
therapist to practiced slipping into a hypnotic state. During the birth, and as suggested
by the therapist, she muted the pain by imagining the contractions "as a warm blanket
enveloping me," she says.
"It was weird," she says. "I was aware of everyone in the room and I was
interacting, but mentally my focus was elsewhere, and I just allowed the process to
unfold."
Some of the clearest clinically measured results come from using hypnosis to mute severe
and chronic pain - as the University of Washington's regional burn-treatment center
in Seattle is doing with burn patients.
Patients sent there must undergo frequent therapy to sterilize their damaged skin and get
new grafts. They must be awake and alert during the treatment, and even the most powerful
narcotics rarely diminish the intense pain.
CHANGING FOCUS
David Patterson, a psychologist at the center, induces a hypnotic trance with a typical
and relatively quick technique. Patients are told to close their eyes, breath deeply and
imagine they are floating. Through a variety of verbal suggestions, Patterson then helps
the patient imagine themselves elsewhere, away from the treatment.
"The pain is still there, of course, but patients simply don't experience it as
before," he says.
While relieving physical pain is one of the more common uses of hypnotism, it is also the
hardest to explain. Patterson and others report that hypnosis doesn't appear to act on the
body's natural pain-killing chemicals, the way drugs do. Instead, scientists believe,
through hypnosis a person can be trained to focus away from the pain, not on it as most
people usually do.
Many athletes often unconsciously use such a technique to play through severe pain,
concentrating their attention on the game or task ahead, instead of on their injury.
Hypnosis, in some form or another, has been used for more than 200 years. It began gaining
credibility as a medical tool in the early decades of the past century as psychiatry and
psychoanalysis began to show how the unconscious mind often rules daily life. Its
usefulness was cemented when combat physicians reported using it during World War II for
the wounded.
By 1958, as more doctors described their experiences in the war, the American Medical
Association certified hypnosis as a legitimate treatment tool. Few doctors employed it.
But in 1996, a National Institutes of Health panel ruled hypnosis as an effective
intervention for alleviating pain from cancer and other chronic conditions. These days, as
many people accept that stress can exacerbate illness, the potential curative power of
hypnosis is becoming more acceptable, too.
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