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Theoretical Framework for Hypnosis Summary: Theories of hypnosis are remarkably limited in detail When I first started reading about Hypnosis I was surprised how little of any book was devoted to the theory of the subject. A typical book would have one chapter devoted not so much to the theory as to various theories; seldom come down on the side of one to the exclusion of all others; and then never actually use the theory in the rest of the book! As an example we may take that classic work Hartland's Medical and Dental Hypnosis. This book classifies theories as follows. I have added names of one or more people associated with each theory that may be familiar to the reader.
More recently a few books have appeared which are devoted entirely to theory. For example, the book entitled What is Hypnosis? (Ed. Peter L.N. Naish, Open University Press, 1986) consists of six different perspectives by leading names in the field. The summary at the end of the book notes that no definitive theory of hypnosis can be offered, but that "it is possible to conclude with a list of characteristics which roughly define our current views.
Next let us compare our field with other fields that have some agreed theories. Suppose that you are interested in steam engines, for example, then as well as practical work you will learn a good deal of theory. You will have to learn how steam pressure varies with temperature, for example. You will learn how much load you can pull up a certain incline with a given power. You will learn how the power is related to such things as the bore of the pistons that you are using, and the diameter of the wheels. There is a LOT of theory that exists which enables you to answer questions such as, "This engine is not working. What can be done about it?" or "Can you design the best engine for these conditions?" And the answers will NOT be simply of the form, "Weeelll now. You might try such-and-such?" or "How about twiddling the thingummy?" They will involve asking quite precise questions about such things as steam pressure, temperatures, water capacity, weights, pistons and so on: in other words the component systems of the whole thing. But when I started working as a hypnotherapist I could find effectively no help given by any theoretical approaches, such as they were. The books always seemed to dwell on successes, but I often found that a recommended approach did NOT work. Why not? As far as any theory went the answer might be presented as, "The subject was clearly not 'deep' enough." or "The suggestions were not getting through to the subconscious" and so on. These sentences seem to convey information. But when you start to examine them meaning evaporates considerably. They are the equivalent of what would happen if my car did not work and I asked someone what was wrong with it, and he said, "The engine is not functioning." That really only puts into slightly more technical sounding language something I already know. Suppose I then asked, "Well, WHY is the engine not working" and got the reply, "It is simply that the combustion process is not activating." This, again, is little more than a technical paraphrase of my "The car does not work". Such phrases as, "We are in a zero power production situation", "I diagnose a hiatus in the ongoing automotive processes" and so on ad infinitum are simply yet more ways of saying the same thing: "The car does not go"! What I am expecting a real engineer to reply is, "I don't know yet, but these are the things I am going to check out. First I am going to assess the electrical system. I will check that the battery is charged. I will then see if there is a spark at the plugs. If not then I will check the points and the high tension circuits...." and so on. I would then know that the engineer understood the underlying systems and the principles on which they worked, and I would have confidence in him for good reason. Did I find anything like that in hypnosis texts? Perhaps I missed reading the right book... And so I did not have a theory that could tell me either where I was going wrong or how I could improve, or put any detail into my understanding of what was going on. Over ten years or so of full-time practice I gradually put together a way of thinking about our subject that I hope will recommend itself to new readers as it has to those who have read my book 'Principles of Hypnotherapy'. This is now freely available to download from my web site , but I would like here to give an introduction and summary of the rationale behind this work. A systems approach, arising from James Braid's work One starting point is James Braid's seminal work in the 1840s in which he disentangled Hypnosis from many of the ideas of mesmerism or animal magnetism: Neurypnology or the Rationale of Nervous Sleep considered in relation with Animal Magnetism (which can also be read in full on the web site above). One of the key things that Braid observed was the way in which he was able to "depress" or "prodigiously exalt" the activity of groups of nerves. And it is this feature that I would like to suggest as a starting point for a discussion of the phenomena of Hypnosis. Let us first generalise it a little using a more modern language and observe that in the field of Hypnosis we commonly observe increases and decreasing in the activity of a great variety of subsystems of the central nervous system (which includes the brain), and hence of connected organs. A few simple examples of these will serve to show how many of the phenomena with which we are all familiar can be classified in this way. We might be working on the nervous system connected to the main muscles of the body and either reduce their activity to produce complete relaxation or to increase their activity to produce complete rigidity. We might be working on the sensory nervous system and reduce the activity to the point of anaesthesia or increase the activity to the point that it can be reporting a touch when there is not one. We can be working on the visual cortex (with the eyes closed) and decreasing its activity to the point where everything seems black, or increasing its activity in often specific ways so that a wide variety of images may be seen. More briefly still we can find hypnotic techniques leading to increases or decreases in the sense of heaviness, or pain or emotions of all kind, or sleepiness or sensitivity to smells or tastes or sounds or sense of balance. The range is enormous, and the complexity of the systems we are dealing with is also. But the most simple and practical way of summarising the phenomena of our field is that we are interested in naturalistic ways of activating or inactivating any specific subsystem of the central nervous system. NO OTHER SCIENCE SHARES THIS BROAD INTEREST. There are many people whose interests cause them to focus on one system or another. A speech therapist, for example, will be interested in the small parts of the nervous system involved in voice production. Antenatal classes will focus on inactivating anxiety and stress but also on being able to activate pelvic muscles when the time comes. Athletics coaches will focus on activating appropriate muscle groups and so on. By contrast the hypnotherapist has a range of techniques that enable changes in virtually any subsystem of the human being. Archetypal "script" analysed Next I will present an outline hypnotic "script", of a kind that almost all practitioners will be familiar with. After each sentence I am going to describe its purpose in systems terms, so that it should become apparent how the hypnotist is selectively acting on a variety of systems in the subject.
Other theoretical positions viewed from a systems perspective Next I am going to outline how this systems approach relates to other theories. The important point to realise is that it does NOT nullify them: it does not say that they are totally wrong. All these theories have, after all, been produced by intelligent men observing real phenomena, and have useful things to say. What it does do is to provide a framework within which the other theories may be located, assessed and compared, essentially by noting the systems that they focus on. Thus the psychoanalytic approaches can be seen as primarily focussing on rather complex mental systems that might be labelled Id, Ego and Superego, or Adult, Parent and Child, or simply The Child Within. By contrast the behaviourist approaches would focus on quite simple systems in which stimulus and response reactions are also simple: simple posthypnotic suggestions take this form. Suggestion theories would be seen as noting that very often there can be a direct link between the activation of an idea in the brain and the activation of muscular or other systems which realise the idea. The pathological theory of Charcot - that hypnotic phenomena are best seen as a manifestation of hysterical disorder - has never received much approval from others, though in fact some of his work is relevant to the treatment of problems today. For example the way in which some of his female patients would act out an original trauma is quite close to modern practice of allowing trauma victims to relive the experience. Dissociation theories can be seen as drawing our attention to the fact that very often there exist two quite complex systems in the brain that do not communicate with each other. Sleep theories tell us that we can, as in sleep, inactivate the greater part of all neurological systems and still have a few active. Role playing theories draw our attention to well-attested fact that from childhood we can copy: an image of someone doing something (an activity of the visual system) will activate a surprisingly accurate reproduction of it (in the muscular system). This extends to copying sounds, emotions and so on. In the adult these patterns can be evoked by simply activating the idea of copying a remembered behavioural pattern. Actors are particularly good at this, but it is undoubtedly the case that some element of this can arise in much hypnosis, especially in groups where it is always easier to produce a given effect on someone if someone else has produced it first. Atavistic Regression theories are based on the idea that hypnosis involves (in systems language) the elimination of more modern, adult or logical systems of thought and their replacement by more primitive, childlike, suggestible or irrational systems. Again there are conditions and subjects for which this is a valuable way of looking at things, but equally it is hard to see ALL hypnotic phenomena as being most usefully seen from this perspective. Neurophysiological theories tend to observe patterns of activity and brain waves (such as alpha waves) or to focus on particular parts of the central nervous system (such as the reticular activation system). There seems substantial evidence that hypnotic techniques can, as might be expected, affect the functioning of subsystems of the brain in many ways (as measured by temperature changes, PET scans, etc.) But there is no evidence of ONE subsystem or ONE brain wave pattern being either necessary or sufficient for the production of hypnotic phenomena as is suggested by proponents of this approach. A variant of this is hemispherical dominance: the idea that hypnosis is based on reducing the activity of the dominant hemisphere (normally the right) and increasing the activity or dominance of the other hemisphere. Now our systemic approach can accommodate this as a possibility; and one that may actually be usefully attained in some individuals at some times, as a result of hypnotic procedures. However there is, again, no evidence that this accounts for ALL hypnotic phenomena. There are in fact yet other theoretical approaches, as detailed in my book, but this very quick trip through Hartland's list is enough to establish a general principle. That is that a systems approach combines simplicity with generality, and that it gives us a framework in which to place any particular hypnotic theory or phenomenon, and hence to compare, contrast and relate them if we choose.. Developments of a systems approach It is one thing to be able to label phenomena and theories, but we would naturally like a theory to do more for us than this. Here I will merely outline how starting from this basis enables us to understand a lot more of what is going on in hypnosis. It has to be an outline because it turns out that a full development of the consequences of looking at our subject in this way takes a full book to expound: which is a characteristic of a theory which has some real content and meat. But it is important to notice that it does not invalidate anything that any current hypnotist is doing. Neither does it come up with any new specific technique which is supposed to be a magic cure-all for one or all problems. It is simply the kind of material that exists in most other sciences: a conceptual or theoretical framework which makes it easier to teach, explain and analyse. What we are aiming at with a given technique becomes clearer. At any given time, as in the example of the above induction, we will be more exactly aware of what system(s) we are working on and what we are aiming at: typically an activation or inactivation. Are we aiming to activate a visual memory? with or without activating emotions? (if it was traumatic then the first recall is often better without emotion); are we wanting to reduce analytical activity in the brain to increase suggestibility? What systems are active that are getting in the way? and so on. We can build inductions with more precision. Many inductions touch on all manner of systems, as we have seen above, and usually there is no rationale given for which and why. If we have in mind a specific goal for an induction, in terms of the systems that we went inactive and those we want hyperactive then an induction will suggest itself. If, for example, we want to use hypnosis specifically to change the emotional response to the image of a spider then our goal is to have an active visual system (albeit with the eyes closed) and a completely calm or inactive emotional system. Consequently there is probably not much point spending a lot of time on such things as finger levitation, leg relaxation and work on other systems that are not directly involved. Diagnosis becomes clearer because we naturally start from any presented systems or systems and start to ask questions such as, "What system is the symptom in?" "What system, if any, is activating the symptom system?" "What would be a result of reducing the activity of the symptom system?" In practice competent practitioners are doing something like this in any case, instinctively. But doing it more consciously leads to a more complete picture. Furthermore it enables diagnosis to be taught methodically. (And I have yet to see ANY other book on hypnotherapy that deals with diagnosis at all.) Patterns become quickly revealed. In particular the existence of loops, and their importance becomes clear. A typical loop is the following vicious circle that arises in so many people. A feeling of (say) a rapid heart beat arouses an activity in the cognitive system: "that is dangerous", this in turn activates emotional (affective) systems to respond to the supposed danger; this in turn activates the autonomous nervous system to increase the heart rate, and then the loop is closed as this is thought to be "even more dangerous". In ordinary language this is a vicious circle. When a diagnosis is made in systems terms then such loops leap out at you when they exist. Failures can be analysed. If a given expected change does not take place then we can begin to explore methodically. A favourite induction which relies heavily on visualisation may well fail in a given person because their visual cortex is very poorly activated by the verbal system. Whether this happens or not can be established by question and answer. For example if an induction aiming at physical relaxation does not achieve its goal we may analyse the component parts of the induction. "Was the auditory system responding to the words, or was there too much distraction from internal dialogue?" "If that was OK, did the words have any direct effect on the muscular system?" "Did the suggested images actually activate pictures in the visual system?" "If they did, then did these pictures in turn arouse the desired feelings of relaxation?" "If not, why not, and what pictures would be more appropriate?" And so on. It should be clear that this process is far closer to what I expected of the competent automotive engineer who has a detailed idea of what he is doing and dealing with. Experimental work becomes more precise and clear. A lot of experimental papers involve at some point saying "the subject was hypnotised", which is really a very vague statement indeed: there are so many different ways of hypnotising people and the results vary so much. For example hypnotic techniques may lead to either hyperacuity of touch or anaesthesia. At the very least the systems approach should encourage the experimenter to monitor and comment on the condition of some key systems that are supposedly affected. A practising hypnotherapist will know that it is highly relevant whether a subject is visualising vividly or not. Many experimenters will not even ask a subject whether there is any visualisation! So at the very least I would suppose that there has been some questioning or measuring of such basic things as muscle tone (muscular system), changes in heart rate (cardiovascular system), ratings of emotional arousal (affective system), amount of visualisation (internal visual system), amount of felt resistance (psychological defensive system), amount of inner talk (cognitive or rational system) and amount of distraction by surrounding sounds (auditory system). Each of these can have a significant effect on how a subject responds to anything else that is involved. Experimentalists often seem to treat "hypnosis" as if it were a pill: "give the patient one dose of my script per week". Most practising hypnotherapists know that this is a remarkably ineffective way of doing things, and will automatically change the content and timing of their approach to suit the client involved. Finally the systems approach makes LEARNING easier. I hope that the examples above will make it clear that this approach gives the teacher and students a language and a conceptual structure rich enough to explain in detail what is happening in the field of hypnosis so that if a student asks "Why?" it is possible to give an intelligent answer. Conclusion
An outline has been
given of a way of thinking about the field of hypnosis which will enable
it to be placed conceptually on a level with many other sciences which
have used a systems framework to great effect. It is hoped that this will
expand its credibility to people in other specialties who have found its
scientific credentials rather limited. It has already found a warm response
from many practising hypnotherapists who find that it helps them to make
sense of what they have been doing, and doing well for decades.
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