Over the past several centuries there have been multiple definitions of the word hypnosis. Yet these definitions too often reflect empirical observations rather than a true understanding the nature of hypnosis.
Looking at how history allowed the concept of hypnosis to evolve can provide at least a partial understanding of its essence. Unfortunately, the history of hypnosis normally starts off with an inaccurate myth. Many accord Anton Mesmer, MD, as the “Father of Modern Hypnosis” (Mesmer, 1980). Yet after reading his original works, it is fairly obvious that his activities can be more closely explained by the present practice of energy psychology and energy medicine rather than what is known as hypnosis today. Even though his patients responded to suggestion and many went into some type of altered state, this does not necessarily qualify him for his esteemed place in the history of hypnosis.Henry Munro, MD, discovered in the 1890s that a hypnotic state and specific suggestions allowed him to give reduced amounts of chemical anesthesia (1908). He came to realize that the number of deaths related to heart-stopping saturation – which resulted in deaths for one out of 400 surgery patients to whom ether or nitrous oxide was administered – could be stemmed by the use of hypnosis. This led him to encourage the founders of the Mayo Clinic to replicate his methodology. Munro’s “suggestive therapeutics” proved to be a very significant contribution to the history of hypnosis.
Sigmund Freud, MD, (1949) apparently rejected hypnosis. Some, including Elman (1964), felt that this was because he failed in his attempts to achieve efficient results. Freud then focused on psychoanalysis, which he based largely on the somewhat erroneous concept of the existence of an unconscious (or subconscious) mind. Until that point, the belief in a below-the-conscious-mind concept was not a factor in the development of hypnosis. However, Elman, Erickson, McGill, and the next several generations of hypnotists took up the subconscious mind mantra with blind obedience. (The term “unconscious” was coined by the German Idealist Friedrich Wilhelm Joseph Shelling in 1800. It is a philosophical term that has unfortunately been picked up by the scientific community. It has absolutely no basis in scientific methodology and thought. Rather, it is used to demark a limitation of investigation, which has been largely dissolved by modern neuroscience.)
David Elman’s study of several of the classical hypnotists led to his highly opinionated conclusion that hypnosis is a process not a state – as suggested by James Braid, MD, who coined the term “hypnosis.” Elman insisted that hypnosis is a process in which the “critical factor is bypassed and selective thinking was allowed.” Due to their heated rivalry and the differences in their direct versus permissive approaches, many practitioners overly focus on the belief that Elman’s and Erickson’s underlying theories contradicted each other. Upon exhaustive review of the works of both men, it is obvious that there are more similarities than differences.
While practically all modern hypnosis researchers intellectually straddle Freud’s subconscious mind concept and Erickson’s permissive hypnotherapeutic process, they are consistently failing to synthesize these beliefs with recent findings in neurology and the emergence of a growing volume of mind/body research. This is apparent from reviewing a vast multitude of research documented by the United States National Institutes of Health (NIH) (See PubMed). While the efficacy of hypnosis in the treatment of somatic and behavioral issues is supported, there is an almost universal belief that there is a lack of understanding about causation and a belief that additional research is warranted. However, many of the uncomfortable conclusions – which are echoed continually in the top two academic journals focused totally on hypnosis – are due to their insistence on defining hypnosis in terms of altered states, trances, and the subconscious mind. (Those two journals are the American Journal of Clinical Hypnosis and the International Journal of Clinical Hypnosis.)
Recent international neurological findings, to include advances in stroke treatment, the savant syndrome, neuro-plasticity, and mind/body literature (Doidge, 2007), clearly indicate that neuro-physiological changes occur when pattern resistance is reduced and substrates are inhibited. Transcranial Magnetics (TCM) investigators discovered (Walsh & Pascual-Leone, 2003) that this does not require trance. Also, it does not require the use of the mystical (and mythical) understanding of Freud’s subconscious mind. For instance, in an article on the Wisconsin Medical Society website, Treffert mentioned that when a “normal” person experiences an accident or illness that inhibits specific substrates, increased neural capabilities may result. He termed this the “acquired savant” or “accidental genius.” Additionally, Daniel Amen, MD, the Newport Beach child psychiatrist who pioneered the use of Single Photon Emission Computed Tomography (SPECT) scans as part of psychotherapeutic protocols, noticed that when a substrate is damaged or overactive it will affect the functioning of substrates nearby (2005). In summary, neuro-physiological changes occur without the use of trance or concentrating on subconscious mind concepts. (However, Amen does strongly believe in hypnosis as an intervention – even though his skill level or experience with hypnosis is not very extensive.)
The preponderance of recent research points to the fact that suggestions and imagery are effective in changing neuro-physiological patterns. And it is clear that once the interference of the left prefrontal cortex is negated, the efficiency of suggestions and imagery is enhanced. The presence of Synchronous Alpha or Theta brainwaves – otherwise considered an altered state or trance state – may create a situation where both the left prefrontal cortex resistance is mitigated and excessive anterior cingulate cortex (ACC) activity is reduced: thereby enhancing the function of nearby substrates. However, this is not a requirement for suggestion and imagery to impact transformation. Bypassing resistance and preventing or calming ACC hyperactivity can be achieved without an altered state.
To focus on understanding hypnosis as a state limits its usefulness. The utilitarian aspect of hypnosis lies in the realm of enhancing health, performance, and happiness through more effective use of the human mental faculty. Therefore, it is more useful and practical to consider hypnosis as a process. This must then focus on the ability for humans to employ the process of selective thought to create change. The application of imagination to selectively direct thoughts in order to affect neuro-physiological patterns should be the intent of both the clinician and an individual using self-help techniques. The success of this process will be found by increasing the efficiency of selective thought. It seems that this efficiency is indirectly correlated with the ability to increasingly negate resistance.
Compounding suggestions is one of the most potent tools for improving the efficiency of selective thought. This supports the fact that the tendency of human enterprise – down to the cellular level – is to adjust to new patterns once it becomes clear that resistance is futile. Newly developed patterns further ease our movement toward additional adaptations. The brain’s tendency to at least partially rely on newly formed patterns is the rationale behind the success of repetitive or compounded suggestions. This fully supports Hebb’s “use it or loose it” theory (1949) regarding the strengthening of neural pathways through repetition and the demise of unused networks. Therefore, if the term hypnosis is to be used in conjunction with this process, the following definition gains a high level of relevance and credibility:
Hypnosis is a process in which neuro-physiological patterns are transformed through increasingly efficient selective thought.
This definition does not use the concept of the subconscious mind or trance state. Also, it does not assume volition or will. Furthermore, this means that a phrase such as induce hypnosis is semantically incorrect.
This definition is much closer to that of David Elman, who insisted on the “bypass of the critical factor and allowance of selective thinking” approach (1964). Although he was relegated to obscurity once Erickson got the American Medical Association (AMA) to accept hypnosis and he founded his organization, in many ways Elman’s definition was ahead of his time. (Elman was a contemporary and friend of Freud’s nephew and was very vocal in his support of Freud’s concept of the subconscious mind.) Nevertheless, despite the fact that many find him less credible due to his involvement with stage hypnosis and his lack of either medical or psychology credentials, his lifelong study of the work of respected clinicians with those qualifications greatly contributed to the development of his knowledge.