"Should the practice of hypnotherapy be restricted to
doctors?" Definitely not. Physicians cannot even
agree among themselves about hypnotherapy. There has been an
ongoing feud within medical circles since the beginnings
with [Dr] Mesmer.
In the early years of the
last century, surgeons were jeered at, even struck off their
registers, for daring to reveal they had operated hundreds
of times on patients with only hypnosis as an anesthetic.
Hypnosis in psychotherapy
fared no better. When Dr Ambroise Liebeault began to
practice hypnotherapy in 1860 he was ridiculed by his
colleagues - despite the cures his patient enjoyed.
Today hypnosis is widely
used by all kinds of medical personnel. In the 1950s both
the British and the American Medical Associations endorsed
hypnotherapy. However, a widespread belief among many
physicians, dentists and PhD psychologists, is that the use
of hypnosis should be restricted to themselves.
They accuse outsiders of
not having adequate understanding, training or ethical
standards to responsibly employ hypnosis, especially in
psychotherapy. Typical of this view is the following
accusation: "Stage hypnotists and other lay people, have
trifled with hypnosis for a long time, mainly for
sensational display. Many of them fancy themselves to be
hypnotherapists and advertise themselves as such. Physicians
and psychologists across the country have warned that the
irresponsible practices of these lay people endanger the
public interest, and attempts have been made to outlaw them"
(Brown & Fromm, 1986, p.147). Brown and Fromm are right to
be concerned about irresponsible practices but wrong to
imply that only physicians and psychologists behave in the
public interest.
Integrity is not something
that is conferred along with a medical or psychological
degree. If it were, 7% of psychiatrists and 12% of
psychologists would not have had sex with their patients nor
abused them in other ways such as enmeshing them in cults.
As for abuse specifically involving hypnosis perhaps the
most startling is murder. By a doctor. It is ironic that the
case is cited by psychologists who want to restrict the use
of hypnosis to professionals: "Some years ago, a
physician/hypnotherapist who was having an extra-marital
affair with a woman whom he wanted to marry hypnotized his
wife and suggested to her that she was developing a
headache. When the headache would become very severe, he
told her, she would swallow all the pills in the bottle he
had put in her lap. They would make her fall asleep, so she
would not feel the pain any longer. After a while she
reached for the pills and took them all. It was a lethal
dose." (Brown and Fromm, 1986, p.146).
Another example of
physician misuse of hypnosis is cited by a
lawyer/psychologist who first says, "While the evidence
appears overwhelming that hypnosis per se is a safe
procedure that carries little risk to a subject, no such
claim is made here with regard to the effect of ill-advised
suggestions that have been made to subjects. Usually such
suggestions are made by either lay hypnotherapists or
persons with no psychological training, practicing outside
the limits of their professional competence" (Udolf, 1981,
p.276). Udolf then condemns two such "foolish" and "idiotic"
suggestions by lay hypnotists. However, he does not condemn
an equally stupid suggestion made by a doctor: "...an
obstetrician, angered at a patient for not complying with
his suggestions for weight reduction, [told] her that if she
did not stick to her diet should kill her pet dog. While
this suggestion may have been given by the physician with
the intent of 'motivating' the patient, it probably resulted
from his own unrecognized countertransferences feelings in
response to this ego-bruising therapeutic failure. In any
event, it was followed by the patient's actually killing the
dog and her subsequent hospitalization with a diagnosis of
paranoid schizophrenia." Even if the number of professional
abusers is very small, it is still absurd for physicians and
psychologists to imply that their training or ethics makes
most of them immune to temptations of the flesh,
incompetence, and self-delusion.
Doctors and psychologists
are as frail as the rest of us. The supposed higher ethics
of the professionals is unmasked by their willingness to
lie. Many psychologists who shy away from the term
'hypnosis' nevertheless employ techniques (such as
progressive relaxation coupled with visualization) that are
virtually identical to hypnosis.
Such professionals
apparently have no ethical qualms about misrepresenting what
they do: "A certain number of subjects will be found who
could benefit from hypnotic treatment but who fear being put
into a trance and resist all attempts at reassurance. Such a
subject can be hypnotized without ever using the words
'hypnosis' or 'sleep' [sic] by simply referring to what you
are trying to attain as a 'deep state of relaxation"'. (Udolf,
1981, p.63). Other restrictors are proud to openly admit,
"We even lie to patients, and we believe that is OK too as
long as it is done for the purpose of helping them" (Citrenbaum,
et al, 1985, p.14). Given the controversial nature of
psychotherapeutic practice and the contradictions of its
various theories, how can this minority of practitioners
have the gall to insist that they are the only ones who know
how to use hypnosis? Especially when some research suggests
that two out of three trainee psychologists will be taught
by a therapist who is himself either ineffective or harmful?
(Cole, 1982).
Condescension is rife
among restrictors. For example, they assert that only a
doctor or a psychologist would realize the futility of using
hypnosis to help an intoxicated person give up drinking (Getzlaf
and Cross, 1988).
The spreading of fear of
hypnosis by some medical people is a gross disservice to the
public. How many thousands of persons have consequently
steered away from the opportunity to harness this natural
tool for relaxation, self-control, problem-solving and
creative development? The restrictors claim that hypnosis
can be dangerous -- but not if it's in their hands. This
preposterous notion is belied by their own guidelines on how
to reduce risks. Because it is not hypnosis itself but the
unique interaction of the subject, hypnotist and environment
which yields the occasional unwanted effect, the guidelines
are quite properly concerned with these factors.
The most important of
which is the character of the hypnotist. "Significant
hypnotist risk factors are personal and professional.
Personal risk factors are:
" personality dynamics,
" verbal and non-verbal
behaviours and
" style and sexual
factors.
Professional risk factors
are errors or deficiencies in:
" history taking,
" screening,
" informed consent,
" observation,
" diagnosis,
[and] unclear, ambiguous
or confusing:
" suggestion,
" time and timing,
" word and imagery choice,
" interventions or lack of
them,
" debriefing,
" de-hypnosis and
follow-up." (MacHovec, 1988, p.63).
[emphases added].
There is nothing intrinsic
to being a doctor or a psychologist that automatically
eliminates the hypnotist risks listed by MacHovec. On the
contrary, the would-be restrictors themselves say that being
a medically trained person may in itself pose a risk! The
hypnotized client can be harmed by the professional's
habitual, non-hypnotic, ways of making suggestions or asking
questions (Brown and Fromm, 1988).
All the professional
factors can be learned and indeed, are often taught by the
'lay' hypnotists to medical and psychological practitioners.
The battle for restriction of who can use hypnosis is really
about power. Physicians want as much as they can grab. To
add hypnosis to their monopoly has nothing to do with
protecting the public, but everything to do with
aggrandizing physicians. Psychologists, eager to garner a
little prestige by cloaking themselves in medical rhetoric,
are being used by doctors. Doctors know disease, not health.
Yet they attempt to medicalise almost everything (e.g.
childbirth). Unlike psychologists they cannot make even a
pretense to expertise with the problems in living (shyness,
low self-esteem, phobias, bad habits, sexual and other
relationship difficulties, etc.) because these are rarely
medically based.
But the restrictors are
correct in suggesting "Ideally, associations of hypnotists
would protect the public from inappropriate use of hypnosis
and from claims that it will cure the incurable" (Getzlaf
and Cross, 1988, p.265).
"Lay" hypnotists are well
advised to require clients to have a thorough medical
check-up. This protects both hypnotist and client. If, for
example, your doctor tells you that your headaches are
caused by a tumour, the responsibility for choice of
treatment -- hypnotherapy and/or surgery -- rests where it
should: on you as an informed client.
References:
Brown, Daniel P., Fromm,
Erika (1986). Hypnotherapy and Hypnoanalysis. Hillsdale,
N.J.: Lawrence Erlbaum Associates.
Cole, David R. (1982).
Helping: Origins and Development of the Major
Psychotherapies. Toronto: Butterworths.
Citrenbaum, Charles M.,
King, Mark E., Cohen, William I. (1985). Modern
Clinical Hypnosis for
Habit Control. New York: Norton.
Getzlaf, Shelly B., and
Cross, Herbert J. (1988). Hypnotists Associations: A
Consumer's Confusion, The
International Journal of Clinical and Experimental Hypnosis,
XXXVI, 262-274.
MacHovec, Frank (1988).
Hypnosis Complications, Risk Factors, and Prevention,
American Journal of Clinical Hypnosis, 31, 40-49.
Udolf, Roy (1981).
Handbook of Hypnosis for Professionals. New York: Van
Nostrand Reinhold.
Bryan M. Knight, MSW, PhD writes in his book Health and
Happiness with Hypnosis: The spreading of fear of
hypnosis by some medical people is a gross disservice to the
public. How many thousands of persons have consequently
steered away from the opportunity to harness this natural
tool for relaxation, self-control problem-solving, better
health, and creative development! How much has such
ignorance unnecessarily added to the nation's medical bills!
The restrictors claim that
hypnosis can be dangerous - but not if it's in their hands.
This is an absurd notion. Hypnosis is not dangerous.
Unethical, ignorant, greedy or emotionally unbalanced people
are dangerous. And that can describe a doctor or a
psychologist just as well as it might describe a 'lay"
hypnotist. Good character or high morals have to do with the
kind of person you are, not with the degrees you've
accumulated. Apart from character defects, therapists'
errors in the use of hypnosis arise from inadequate training
about hypnosis; obviously such deficiency could apply to
anyone. (P 23)
