Amanda, a 39-year-old architect, became stricken with a familiar feeling of fear as she walked to meet a friend to watch a movie. Her anxiety began to intensify as she approached the local cinema, and would not subside until the film was over, and she had taken in almost nothing of the plot.
Amanda suffered from a phobia of sitting among large groups of people and feeling trapped – often categorised as a form of anthropophobia. What if her friend had not booked aisle seats to allow for a quick exit? What if other patrons decided to sit behind, next and in front of her?
Amanda had dealt with similar thoughts since her early teens, and over the years they had become intrusive to the point that even the suggestion of a night at the cinema or theatre caused a sleepless night. It also deprived her of many social occasions, as she began to use avoidance techniques to make sure she wouldn’t have to endure a group situation. She had to do something about it, and that’s when she called a hypnotherapist.
Amanda was joining thousands of people across the UK by choosing to have her mental health treated by hypnosis. It's use as a therapeutic treatment (where patients focus on a specific problem while in a trance-like state) is on the rise, and reports of its efficacy are increasingly impressive - but it's far from a new technique. Hypnosis as a healing tool has been a feature in many cultures for centuries; ancient relics from Egypt depict something similar to hypnosis, while social historians have noted practices resembling the trance state used by Aboriginal Australian, Native American, and Hindu cultures. But in reality, these practices bear little resemblance to the work of modern hypnotherapists, and the practice of hypnosis in general has become enveloped by unhelpful myths that mask its true use, especially in behavioural and clinical psychology.
"Before scientists and clinicians had started to explore its usefulness as a therapeutic tool for psychiatry, hypnosis was already popular in circuses and magic shows, which led to many myths. Some of these myths still exist today."
“There are so many misconceptions and so much misinformation about hypnosis,” says Dr Renzo Lanfranco. “A lot of it has been perpetuated by the media, and continues to be.” Renzo is a former practising psychologist from Chile who completed his PhD is Human Cognitive Psychology and Neuroscience at Edinburgh in 2020. He now works as a postdoctoral researcher at the Karolinska Institute in Stockholm.
He goes on: “This is a problem that started four centuries ago when hypnosis became popular in Europe. Before scientists and clinicians had started to explore its usefulness as a therapeutic tool for psychiatry, hypnosis was already popular in circuses and magic shows, which led to many myths. Some of these myths still exist today. For example, that hypnosis is the same as sleep; that the person who gives the hypnotic suggestions - the hypnotist or hypnotherapist - gains control over the hypnotised person; that events remembered during hypnosis are more accurate; and so on.”
Having said that, Renzo believes we have come along way since those primitive days of circus tricks and sideshows. In fact he traces the modern development of hypnosis as a mode of therapy back to crucial work carried out in the mid 19th century by a University of Edinburgh graduate.
“James Braid was a major figure in the history of hypnosis,” he says. “Many historians have argued that it’s only thanks to him that hypnosis entered the world of science and medicine at all. Braid knew about hypnosis being used in circuses and as part of occult practices, so he was rightfully sceptical about it. But he was curious too, and used scientific experiments that he conducted at home to explore hypnosis and its effects - which is remarkable considering the fact that he lived over 150 years ago.”
Braid was a Kinross-shire-born surgeon who studied at the University as part of an apprenticeship. After watching a demonstration of mesmerism - the theory set out by German physicist Franz Mesmer whereby healing of the human body could be achieved by harnessing a type of “animal magnetism” within the universe – he decided to conduct his own independent research on the subject. In fact, it was Braid who popularised the term ‘hypnosis’, derived from the Greek word for ‘sleep’, and he stressed that his work was based on the fact that while hypnosis did indeed resemble a kind of sleep, it was also related to the workings of the human brain and accessing the unconscious state.
“This alone was a big step,” says Renzo. “Because older concepts like ‘mesmerism’ –- were tainted by esoteric beliefs that external and supernatural forces were at work. Braid brought science and rationale to the subject.
“He was also a pioneer of using hypnosis for pain management and I would say that we are still following the principles that he set out back then.”
"Of all the information that reaches our senses, only a portion gains access to our conscious awareness. What happens with the other pieces of information? Can they still affect the way we think, feel, and behave?”
Of course, today we know much more about consciousness, cognition, and the brain, and the technology exists to study phenomena that Braid could only have dreamt about. But, says Renzo, the rigour of experiment and scientific framework was first laid by him:
“Braid was the first clinician to have published clinical reports of patients being treated with hypnosis-induced analgesia. Both scientifically and clinically, he was a pioneer in the field and was a crucial figure in hypnosis becoming an accepted phenomenon of study by science and medicine.”
And that is what fascinates Renzo and drives his research, over 150 years later.
“As a clinical psychologist, your main objective is to diagnose and treat people who suffer from psychiatric ailments,” he says. “The better you understand the patient’s history, symptoms, social system, and cognitive processes, the better you will be able to help them through therapeutic tools such as cognitive behavioural therapy.
“Working with patients who suffered from schizophrenia or some severe personality disorders made me very interested in their brain processes. A big question for me was the nature of consciousness. Of all the information that reaches our senses, only a portion gains access to our conscious awareness. What happens with the other pieces of information? Can they still affect the way we think, feel, and behave?”
When Renzo began his research (first at Cambridge and then at Edinburgh) there were already studies indicating that even at an unconscious level, psychiatric disorders can bias the way a person processes information.
“I became so intrigued about what was happening at the brain level,” he says. “Our ability to help people who suffer from psychiatric disorders is also limited by our understanding of how these basic mental functions work. Today, my fields of research are around those functions: consciousness, emotion processing, body ownership (how we feel that our body belongs to us), and face processing (how we detect and recognise faces and their social information). Hypnosis has intrigued me from the very beginning of my clinical career so studying it scientifically has been very motivating. The ability to use words to suggest changes in people’s perceptual experience can be amazingly useful in my research and to ultimately help patients.”
"We need clinical hypnosis training to become more mainstream in psychology and psychiatry programmes."
Indeed, the use of hypnosis for a number of disorders is growing. For example, within pain management, hypno-birthing (training in self-hypnosis to decrease pain and stress during labour and delivery) is now being used in the NHS. However, people experience hypnosis in very different ways and its efficacy varies from person to person.
“We need more research to understand these individual differences,” says Renzo. “And we need clinical hypnosis training to become more mainstream in psychology and psychiatry programmes – even though thousands of papers have been published on the matter, and there are academic journals entirely focused on hypnosis research and clinical utility, it is still rather uncommon to find clinicians that have been trained in hypnotherapy. Educating the broader public on these topics is also a challenge for the future, but a necessary one.”
As for people like Amanda, the 39 year old architect with a fear of large groups, hypnotherapy is offering an increasingly popular way to overcome phobias, bad habits and anxiety, with the British Society of Clinical Hypnosis estimating that 1 in 18 people in the UK have used hypnosis as a form of therapy. And for Renzo the potential scope of its use is reason enough to keep researching:
“Hypnosis is a such an interesting phenomenon because it allows us to study how the brain monitors reality in a way that other techniques don’t. It’s intriguing and exciting, and there's no doubt that it has a promising future for therapy and clinical care.”
Main image: by Giorgio Trovato on Unsplash.
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