Clinical Hypnotherapy - Peter Sergio Allegretti

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Title: “Hypnotherapy Works for Bowel Pain”
Date: 22/10/2003
Source: BBC News online

Hypnotherapy seems to be an effective long term treatment for irritable bowel syndrome, research finds.

IBS is a very common disorder affecting up to 15% of the population at any one time, but is difficult to treat. Researchers from Withington Hospital, Manchester, found hypnotherapy helped 71% of patients - and its effect lasted up to five years after treatment. The research, based on 200 patients, is published in the journal Gut.

The patients were given one hour sessions of hypnotherapy for up to 12 weeks. They were asked to assess their symptoms, quality of life and levels of anxiety and depression before and after treatment - and for up to six years after completing the course.

The majority of patients found that hypnotherapy reduced the severity of their IBS symptoms, and continued to do so for years. Even those who said the effect began to wear off with time, found that the deterioration was slight.

Hypnotherapy also seemed significantly to reduce levels of anxiety and depression - however, the effect here did begin to tail off slightly over time. But patients also said they took fewer drugs and did not need to see their doctors as often after they had had a course of hypnotherapy.

The researchers say the sustained improvements in most of the patients cannot be attributed to other treatments as fewer than one in 10 patients attempted alternatives after completing their hypnotherapy sessions.

Previous research has shown hypnotherapy to have a beneficial effect on IBS in the short term - but not over a longer period. Critics say hypnotherapy is an expensive treatment. But the researchers argue that the cost would be more than offset by a reduction in demand for prescription drugs.

Lead researcher Dr Wendy Gonsalkorale told BBC News Online: "While other studies have shown that symptoms have improved by the end of the course of treatment, the real significance is our finding that these effects are sustained after treatment sessions have finished, rather than patients just reverting back to their original state.

"We firmly believe that hypnotherapy should be available as a standard treatment for all patients with
IBS."

Dr Gonsalkorale said it was unclear what caused IBS, and why hypnotherapy should help.
However, she said the condition was possibly linked to problems with muscle movement, or to increased sensitivity of the gut lining.

She said hypnotherapy may help the patient to gain better control over the way their gut works by influencing the release of hormones, or the nerve links between the gut and the brain.
It may also alter the way that the brain responds to incoming pain messages.

"For some patients, psychological factors and stresses may play a role in triggering or at least exacerbating symptoms. "Whether or not they are the primary cause is still very debatable. Hypnosis can be used as a form of relaxation, to reduce stress. "But it is not the whole story by any means. We know also that the therapy alters the way patients think about their symptoms."

Dr Mark Cottrill, a trustee of the IBS Network and a GP in Wigan, told BBC News Online his practice had employed the services of a hypnotherapist to treat IBS patients for a short time.

"She proved extremely popular and within months she had a three to four month waiting list," he said. "But we had to end the sessions because we had no funding for them. It can cost £600 per patient and the money has to be found upfront."

Original Link: http://news.bbc.co.uk/2/hi/health/3207972.stm

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Visualising your digestive system as a river may not seem the most obvious way of treating an illness.
But that is exactly how hypnotherapists at a unique centre in Withington Hospital, Manchester, have been helping people with Irritable Bowel Syndrome (IBS).

The condition can leave people in constant discomfort and can cause severe pain. And it can prevent them from working or socialising normally. Dr Peter Whorwell, the gastroenterologist who founded the centre, devised the "river" concept.

The aim is to make the river flow smoothly. If there is a blockage or a flood, they are asked to visualise a way the problem can be solved. Sessions with a therapist, interspersed with home practice using a CD, are aimed at "retraining" a patient's gut and eradicating their problems. Since IBS affects everyone differently, the therapy is tailored to each patient.

So someone with constipation may visualise rocks which are blocking the river and have to be removed, while someone with diarrhoea may want to shore up the banks to prevent the river running so swiftly. The therapy has proved highly effective, with a recent study showing it had helped 71% of patients for up to five years after their course of treatment.

Vivien Miller, one of the team of hypnotherapists at the centre, said: "We are helping people control what's going on in their bodies, and telling them they can control their symptoms."

The centre is the only one of its kind in the UK and treats around 160 patients from across the country each year. IBS affects between 10 to 15% of the UK's population. Most will only have minor symptoms - but a fifth of them will suffer from faecal incontinence.

Patients are referred to the centre if they are experiencing severe IBS - where their lives are constantly affected by feelings of bloating, discomfort or constipation, or diarrhoea which can strike at any time. Dr Whorwell became interested in the potential of hypnotherapy for IBS patients over 20 years ago.

He kept his new interest under wraps from sceptical colleagues until research proved it was effective. "We had to stay in the closet to begin with and doctors can still be a bit sniffy about it."

He stresses the hypnotherapy he and his team use is nothing like the TV or stage hypnotists who make people dance like chickens or take their clothes off. "I give a lot of lectures to sceptical doctors. A lot of hypnotists take things very seriously and say they can cure anything. I don't.

"But IBS is a nuisance to treat. There are no treatments that are effective, so I thought we should try hypnotherapy." He added: "People are suspicious because they have seen stage hypnotists. "But you cannot be hypnotised against your will. And you won't act out of character while you're hypnotised."

Dr Whorwell is trying to spread the word to other doctors around the country. But he says many are still reluctant to use the technique. There are two theories for why hypnotherapy works for IBS. One is that by making people less anxious, it in some way makes the bowel less sensitive, thereby reducing symptoms.

Another suggests hypnotherapy may have an impact on a part of the brain which processes pain called the anterior cingulate cortex (ACC). One study showed patients could put their hands into boiling hot water without registering pain after being hypnotised, when they had earlier experienced intense pain. The hypnotherapy reduced the amount of activity in the ACC.

While many doctors may still be a little suspicious of using hypnotherapy, Dr Whorwell says patients have no such qualms. "They are falling over themselves to have the therapy, particularly the younger ones.

"Many are on antidepressants, because they have the effect of lessening pain sensations at low doses. But if you're 25 and you had the option of a long-term course of antidepressants or having hypnotherapy that will put you right, which would you choose?"

Original Link: http://news.bbc.co.uk/2/hi/health/3341093.stm

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Title: “Hypnosis 'can ease bowel illness'”
Date: 25/05/2007
Source: BBC News Online

Hypnotherapy could help people with severe irritable bowel syndrome (IBS), researchers say.

Doctors should consider using this and other "psychological" treatments such as antidepressants to help sufferers, King's College London experts say in the British Medical Journal.

However, a shortage of therapists could hinder this, they add.

Experts said there was growing evidence that IBS cases have psychological as well as biological elements.

IBS is a common and painful medical condition that has a wide range of symptoms, including regular abdominal pain, diarrhoea and constipation.

Conventional medicines prescribed for IBS often ease symptoms partially, or not at all.

Many scientists now believe that the cause in many cases is a combination of mental and physical factors, and that the drugs commonly used to tackle it may be aiming at the wrong target.

Patients with IBS are more likely to be diagnosed with depression.

Dr Ian Forgacs, a consultant gastroenterologist from Kings College, says that doctors are often reluctant to prescribe anti-depressants, especially in patients who, apart from their IBS, show no outward signs of being depressed.

He urged them to consider other forms of psychological therapy, including hypnotherapy, as an alternative in some cases.

"Patients with irritable bowel syndrome should be made aware of the existence of these treatments so that they can make informed choices," he said.

"Specifically, they should be made aware that using a psychological treatment does not mean that the disease is 'all in the mind'."

He found that one of the most effective treatments for IBS in research studies were so-called "talking therapies", such as cognitive behavioural therapy, particularly for people whose symptoms were causing them the most distress.

And severe cases of IBS could be improved by using hypnotherapy to target the links between the brain and the gut.

Hypnosis sessions concentrated on encouraging relaxation, then visualising the gut as a fast flowing river which is then imagined to be flowing more slowly and smoothly.

Dr Forgacs said that one obstacle to providing psychological therapies was a lack of the right specialists in some areas.

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Title: “Can hypnosis help to make you pregnant”
Date: 05/03/2002
Source: The Times

Some complementary therapists claim they can aid conception. Suzy Greaves investigates
One in seven women seeks medical help to aid conception. Inevitably, given this demand and the low success rates of conventional treatments for infertility (the IVF rate is 14 per cent) alternative practitioners have not been slow to offer therapies that they claim will increase fertility.

Dr Elizabeth Muir, a clinical psychologist who has specialised in treating infertility for seven years, uses hypnotherapy to help couples for whom there is no apparent medical reason why they should not have a child. Muir believes that the psychological issues surrounding pregnancy are not sufficiently well addressed for many women with fertility problems, and she claims a success rate of 45 per cent for her clients.
"Hypnotherapy works on the premise that the conscious and subconscious minds may be at odds with each other," she says. "I believe that while a woman might consciously want a baby, her subconscious may be stopping her from getting pregnant. Most women I see have psychosomatic infertility related to conflicts or unresolved issues about having a baby. A combination of counselling and hypnotherapy can remove these problems."

As with much alternative practice, there is no clinical evidence to support her claims. Lord (Robert) Winston, Professor of Fertility at the University of London and the director of the Infertility Unit at Hammersmith Hospital, is incensed by what he calls "wild claims of success".
"I have nothing against alternative or complementary therapy," he says. "Many of them will make you feel better, more confident, more relaxed. But there is no clinical evidence to show that they work as an effective treatment for infertility."

Muir explains that hypnosis affects the hypothalamus, the neural centre at the base of the brain linked to the pituitary gland and controls the flow of hormones in the body. The hypothalamus is sensitive to stress and acts as a bridge between the emotional and physical, turning emotional messages into physical responses that affect hormone levels.

A study by John Gruzelier, Professor of Psychology at Imperial College School of Medicine, revealed that self-hypnosis could strengthen the immune system by 48 per cent in six weeks. Muir's theory is also supported in studies by Dr Beth Domar, director of the Beth Israel Deaconess Behavioural Medicine Programme for Infertility in Boston, who examined the relationship between stress and infertility. Her studies documented the success of her mind/body fertility programme, which taught people how to relax and reduce tension.

In the first study, published in 1999 in the Journal of the American Medical Women's Association, 42 per cent of the 132 infertile women in the programme conceived within six months of completing it. In the second study, published in 2000 in the journal Fertility and Sterility, 55 per cent of the previously infertile women who met regularly in a mind-body programme conceived, compared with 20 per cent of the control group, who used no mind-body techniques and did not attend meetings.

Niravi Payne, a psychotherapist and pioneer of mind-body fertility therapy in America, believes that stress is only one of the factors that can prevent conception. "Our endocrine, immune and nervous systems are all intimately connected and influenced by every thought we think and every emotion we feel," she says. "When something significant happens in our lives, the emotionally charged experience gets stored in our brain. Memories and experiences are also simultaneously stored biochemically and electromagnetically in various organ systems. Negative emotional experiences can throw off the finely tuned hormonal balance necessary for ovulation and sperm production."

After four years of infertility, the actress Alex Kingston had a child after having IVF treatment. During the treatment, Kingston also worked with Payne. "One of my sisters is physically and mentally handicapped and I realised that I was holding on to a lot of fear about that," says Kingston. "With Niravi, I was able to release a huge amount of stuff I'd been holding on to without realising it."

Winston is not impressed. "It is unthinkable that you could come to me as a patient only for me to offer you a treatment that wasn't proven. I'd be struck off," he says. He is also concerned that if women rely on an unproved therapy and don't get pregnant, they are losing time during which, with orthodox medical help, they might conceive. Fertility decreases after the age of 35, he points out.

Doctors agree that people who try for a baby for a year or more without conceiving must seek medical advice. Complementary therapists make no claims to help with specific conditions such as damaged Fallopian tubes.

Publication Link: http://www.timesonline.co.uk

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Title: “Hypnosis 'doubles IVF treatment success rate'”
Date: 29/06/2004
Source: telegraph.co.uk

Hypnosis can double a woman's chances of getting pregnant after in-vitro fertilisation treatment, according to new research.

Scientists in Israel made the discovery after a group of 89 women were hypnotised while embryos were being transplanted into their wombs.

Their success rate was 28 per cent, compared with 14.4 per cent for another group of 96 women who did not undergo hypnosis. In both groups roughly the same number of eggs was obtained for IVF treatment, and the same kind of ovarian stimulation applied.

The women, all aged about 32, were first interviewed to test their susceptibility to hypnosis. Those selected underwent embryo transfer in the presence of a specialist therapist who sat with them throughout the procedure.

Study leader Dr Elihu Levitas, from Soroka University in Beer-Sheva, Israel, said embryo transfer, normally performed without anaesthesia, was often a highly stressful experience for women. Dr Levitas said there might be practical difficulties involved in making hypnotism routinely available to women undergoing IVF treatment.

But he added: "The bottom line is I think it's a good thing, it will work. Patients should be given the option if the facilities are available."
However, doubts about the research were raised at the conference by Dr Francoise Shenfield, an IVF specialist from University College Hospital, who is head of ethics at ESHRE.

She pointed out that the non-hypnotised women had been trying to become pregnant almost twice as long as the hypnotised women. The average pregnancy success rate for IVF clinics in the UK is about 25 per cent.

Original Link: http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2004/06/29/uivf.xml

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Title: “Complementary therapies to aid fertility”
Date: 16/08/2002
Source: Daily Mail

Scientific evidence shows that a variety of complementary therapies such as acupuncture, nutrition and even hypnotherapy can help boost fertility.

Here, we look at more alternative treatments said to help stimulate fertility

What is it? This therapy is based on the belief that the conscious and unconscious minds govern our health. Often used in conjunction with IVF, the hypnotherapist uses relaxation techniques to induce a 'trance-like' state and, during this time, makes suggestions or implants ideas.

How does it work? The idea is that our subconscious mind controls our biological functions such as our pituitary gland - the part of our body that controls our hormones. The hypnotherapist will make suggestions about improving your reproduction system - or ask you to imagine your egg is being impregnated with sperm and taking root in your womb.

Although, practitioners don't claim hypnosis cures infertility, they believe working in this way should allow your subconscious to absorb the message and encourage your reproductive system to work.

According to hypnotherapist John Butler, a lecturer in medical psychology at Guy's Medical School, it is an established fact that the subconscious mind can influence our biological systems. He points out that Dr Herbert Benson of America's Mind/Body Medical Institute first brought it to the public attention that hypnosis can influence body temperature, blood pressure, breathing and heart rate.

Is it effective? Although there is a lack of large-scale studies on hypnosis, a study by Dr Beth Domar published in the Journal of the Journal of Fertility and Sterility found that more than half of women receiving hypnosis conceived, compared to one-fifth of women not undergoing hypnosis.

How many sessions should I have? The first session should last from 60 to 90 minutes. The average number of sessions is at least six, depending on the person and their problem.

Original Link: http://www.dailymail.co.uk/pages/live/articles/health/womenfamily.html?in_article_id=133585&in_page_id=1799

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Title: “Chance to Dream: Body and Soul (extract)”
Date:27/11/2004
Source: The Times

Hypnotherapy: 'I found it useful being taught to hypnotise myself'

Insomniac: Jeremy Stannard, 31
Method: Hypnotherapy
Problem: I've had difficulty sleeping for five or six years, on and off. I have been down many of the recommended routes for insomnia other than sleeping pills, from lavender oil to hot baths, but, frankly, when my body decides that it's not going to go to sleep, its decision is final.

Treatment: I went for four sessions and the first thing the therapist David Samson did was to explain to me what hypnotism was: essentially extreme relaxation. He then hypnotised me using his voice and taught to me to hypnotise myself, using a technique which is fixing on an object or a relaxing scenario in the mind. He provided a CD with his voice on it, so that I could practise at home. You become more relaxed than you've ever been but stay conscious. Your eyes are shut and your head drops but you can hear what's going on.
Result: Just before I started the sessions, I began sleeping very well, passing out at night. So, the results of my sessions were never going to be dramatic.

Happily, I'm still sleeping well. What I found most useful was being taught to hypnotise myself. I see the techniques that I have learnt as a future weapon against insomnia.

Therapist: "Hypnosis works by altering our state of consciousness in such a way that the analytical left-hand side of the brain is turned off, while the non-analytical right-hand side is made more alert," Samson says. "The conscious control of the mind is thus inhibited and this allows the subconscious mind to be accessed. The subconscious mind is like the filing system in an office and contains all your experiences.

For insomniacs, if their subconscious mind retains hidden information of, say, a traumatic incident earlier in their life, this can prevent quality sleep. The only way that this 'bad information' can be removed is by re-programming the subconscious."

Publication Link: http://www.timesonline.co.uk

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Title: “Chronic pain sufferers increasingly turn to hypnosis”
Date:25/04/2006
Source: The News Journal (US)

Too many people spend their days suffering in pain. They fight through pounding headaches, cramping muscles and constricted limbs. Doctor visits and prescriptions don't stop the pain, which fatigues them, debilitates them, and keeps them from activities and people they love. Hypnotherapist Beth Keil believes it doesn't have to be that way. Through the use of hypnosis, she says, pain can be lessened or even eliminated.

"Our perception of pain is in our brain. It's not at the spot of the injury," said Keil, a registered nurse and co-owner of Delaware Hypnosis Partners, in Wilmington. "We can use hypnosis to create comfort and to decrease stress because when we're stressed, the fight-or-flight response turns on. When you can turn off that and turn on the endorphins, it's a natural painkiller."

Hypnosis has become increasingly popular as more people search for drug-free ways to relieve their pain. Hypnotherapist Colleen M. Stone said many of her clients spend years visiting doctors and trying different medications before they come to her for hypnosis. Her clients include patients with fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome and old injuries that haven't healed.

"The joke is that we're the last ones they come to, but the first ones they receive help from," said Stone, owner of Advanced Hypnotherapy of Delaware. "They usually come to us after trying everything else." The American Medical Association approved hypnosis as safe for use in medicine and dentistry in 1958. Over the years, it has been used to improve mood, reduce stress and eliminate bad habits, such as smoking. Some women use a natural childbirth method called HypnoBirthing to manage pain during labor and delivery.

A National Institutes of Health panel included hypnotherapy as one of several acceptable relaxation methods for treating chronic pain, especially for people with cancer. In Europe, thousands of patients in the last decade have used hypnosis as a replacement for or in conjunction with sedation drugs during surgery. Keil, who leads self-hypnosis programs for cancer patients at The Wellness Community-Delaware, said hypnosis allows patients to access the subconscious, where beliefs and habits are stored. While they are in a state of hypnosis, patients can replace their old beliefs about pain - such as the thought they must always be in pain - with feelings of comfort. They let go of the pain and feel relief.

During hypnosis, patients typically learn how to focus to get in touch with their subconscious mind, initially with the help of the hypnotherapist. Both verbal and nonverbal cues are used to bring patients into a state of hypnosis. People also can learn to hypnotize themselves by using the cues.

All forms of hypnosis can be considered self-hypnosis because they require the patient to be willing. "You decide where you want to go and how you want to get there," Keil said. "My expertise is in guidance as you go." When treating patients for pain, Keil requires approval from a doctor because some people need to be able to feel pain because of their particular medical condition.

While hypnosis is an option for some, it's not for everyone, said Dr. Philip Kim, medical director of the St. Francis Pain Center. Most studies have found that some patients can't be hypnotized, he said. Working with patients who are often in agonizing pain, Kim said he understands why many people want to find ways to increase their daily activity without relying heavily on pain medication. That's why people try exercise or minimally invasive procedures - like injections such as epidurals and even implanted pumps - to reduce their pain. Others try acupuncture or relaxation programs.

"I think there's a certain value for hypnosis," Kim said.

Stone said emotional stress contributes to the pain many people feel. "Emotional pain takes a toll on your body. It magnifies the physical pain," she said, adding that as people learn to release their pent-up emotional trauma, they feel pain relief.

For 30 years, Bonnie Carmine lived with the pain and discomfort of irritable bowel syndrome, a condition in which the bowel doesn't work as it should. The ailment disrupted her activities and caused her to retire early from her job with the Delaware Division of Parks and Recreation. She sought help from several doctors, but it wasn't until she tried hypnosis that she found relief. After about six hypnotherapy sessions with Stone, Carmine noticed a marked change. She felt more relaxed, more in control of her body. As time went on, she didn't need as much medication for her IBS.

Two years later, her symptoms are still relieved, although she does occasionally have painful episodes.
"For me, it's a mind-gut response," said Carmine, 61, of Milford. "It's not gone by any means, but I'm in the driver's seat."

Hypnosis, also referred to as hypnotherapy, is an altered state of consciousness. It is a normal state of aroused, attentive and highly focused concentration. The feeling has been compared to being so absorbed in a movie or novel you lose awareness of your surroundings.
Hypnosis allows patients to focus intently on a specific problem and its resolution while maintaining a comfortable state of physical relaxation. It also helps patients to enhance control over their body responses. It's usually achieved with the help of a hypnotherapist.
A 2002 report by the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health, found that more than 30 percent of adult Americans used imagery, biofeedback, hypnosis or one of five other relaxation techniques.

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Would you have surgery without an anaesthetic? Daniel Elkan is mesmerised by a woman who did

When Pippa Plaisted was told that she would need a fourth breast cancer operation, it was not the surgery that worried her most. Like many people, the idea of an operation did terrify Pippa, a 46-year-old personal trainer, but this procedure - to reposition an artificial valve attached to her breast implant, which had been inserted after a mastectomy -promised to be a straightforward 45-minute job. What Pippa was more worried about was the fact that the operation would require a general anaesthetic.

After each previous operation, Pippa, a mother of two, had reacted badly to the anaesthetic: "I'd be feeling dizzy and falling over for months afterwards. It would take me so long to feel well again, and it was getting worse each time."

With the operation only a few weeks away, she sought help from her hypnotherapist, Charles Montagu, a practitioner based in South Kensington, West London, to overcome her fear of the surgery. When Montagu heard about Pippa's difficulties with general anaesthetic, he suggested that hypnosis could be used to neutralise the pain of surgery, a technique known as hypno-anaesthesia, which, he believes, can be applied to most types of operations except those requiring deep invasive surgery, such as a heart operation. He believed that by entering a deep state of relaxation, known as deep trance, Pippa would be able to undergo the surgery without needing drugs at all.

The mechanism by which hypno-anaesthesia relieves pain is not yet precisely understood. One way is thought to be by the focusing of attention away from the source of pain. "All of our senses are selective," says Montagu. "If you are sitting down right now, you might not be aware of the chair that you are sitting on. But if you are in a boring lecture, you become very aware of the chair."

During surgery, hypnosis can be used to divert attention away from the area being operated on and focus it elsewhere, he says. Another way that it might work is by a reinterpretation of pain signals, according to the hypnotherapist Dr John Butler, who holds a PhD in medical science and lectures at the GKT School of Medicine in southeast London. "By instructing the brain to relax and to be unconcerned about pain, the pain signal can be reinterpreted as a non-distressing sensation," he says. "The pain signal is definitely received at the pain receptor; it travels up the spinal cord and into the brain. And that's all quite normal so far. But then, at a crucial point, it seems that the hypnotic activation in the brain re-routes the signal so that it gets understood as a harmless sensation."

The idea that hypnosis alone can be powerful enough to block out the pain of surgery may seem far-fetched. But research has provided clear indications that hypnosis can alter the brain's perception of pain. After deciding that she wanted to try hypno-anaesthesia, Pippa phoned her surgeon, Adam Searle, to ask if he would be willing to perform surgery under these conditions. To her relief, Searle thought it was worth a try. To act as a safeguard, and also for Pippa's reassurance, he arranged for an anaesthetist to be present in the operating theatre. Searle says: "My fear was that halfway through the procedure the hypnotherapy might not be as effective as hoped and we would have to call upon more conventional anaesthetics."

For hypno-anaesthesia to work, the patient needs to access a deeper state of trance than in an ordinary hypnotherapy session. To be sure of being able to reach the required state of trance on the day, Pippa had three hour-long practice sessions. Montagu would instruct her to focus her attention on her breathing, and then gradually count her down into a deeper and deeper trance.

To demonstrate how effectively pain could be blocked, Montagu -with Pippa's permission -pinched the sensitive skin on the inside of her arm hard. Pippa was amazed. Even though her arm was bruised, she had felt no pain. On the day of the operation, Montagu took Pippa through some of the relaxation techniques that they had practised. By the time the theatre was ready for her, Pippa was feeling confident: "I walked -or rather floated -down to the theatre, completely calm and in control."

In the theatre, Montagu stood at the head of the operating table, his thumb resting gently on Pippa's forehead. Within about ten minutes he had talked her into the required state of deep trance. The staff in the operating theatre couldn't help wondering what reaction Pippa would have to the first incision.
"There was a moment of anticipation that, when I put the knife in, this poor girl would sit up and run out of the room," Searle says. But, in fact, throughout the operation Pippa, despite being conscious and aware of her surroundings, felt no discomfort whatsoever. "The surgeon was cutting and sewing inside me, but I could not feel anything," she says. At each stage of the operation, Searle would gently reassure her that everything was going well, and tell her what was going to happen next.

To Searle's surprise, the hypno-anaesthesia had a remarkable physical effect. Pippa bled far less than would normally be the case in such an operation. He later learnt from a colleague, who is an anaesthetist, that reduced bleeding is a common characteristic of operations performed under hypno-anaesthesia.
Marie-Elisabeth Faymonville, an anaesthesiologist at Liege Hospital in Belgium, claims that anaesthetic drugs inhibit the natural tendency of blood vessels to constrict in response to an incision; secondly, patients knocked unconscious by anaesthetics have to breathe with the help of an artificial respirator. This puts pressure on the chest and, in turn, increases bleeding. In contrast, hypno-anaesthetised patients are conscious and breathe normally, and bleed less as a result. According to Searle, this made Pippa's surgery less tricky to perform: "The various layers of tissue are much more clearly visible if they are not bloody. It is easier to be accurate."

Pippa also believes that the hypno-anaesthesia helped to speed up her recovery from the surgery. "It was very much faster than it would have been. There was no bruising and I felt normal within a week. I didn't have any nausea or dizziness. But I was incredibly tired after the operation. You have to be very gentle with yourself; the body is doing all the work."

Although there are fewer than ten hypnotherapists performing hypno-anaesthesia in the UK, interest in the technique is growing fast. In Europe one method that is being routinely used in some hospitals is to combine local anaesthetic with hypno-anaesthesia. In this way, patients can avoid general anaesthetic without needing to enter such a deep trance.

The local anaesthetic blocks the pain signals coming from the area being operated on, while the hypno-anaesthesia relaxes the patient and, by reducing pain perception, makes the local anaesthetic work much better. Using this method, most patients do not need hypnoanaesthesia practice sessions before surgery.
For those who try hypno-anaesthesia, most people need only a few practice sessions to be able to access the required depth of trance. "It is rather like learning to drive; it varies from person to person," says Montagu. "Some people find it harder than others to let go and relax."

Pippa recommends it to anyone who thinks that they would benefit. "I think it is absolutely wonderful. People shouldn't be frightened of it because the power of the human body is enormous. It is about having faith in yourself and the power of your own mind."

HYPNO-ANAESTHESIA -the use of medical hypnosis in place of anaesthetic drugs to overcome pain -is based on the principle that the patient can be instructed to experience pain signals as harmless sensations. In this way, the patient does not need to be unconscious during surgery.

SUITABLE FOR most types of surgery, apart from heart, lung or brain surgery. With a few practice sessions, many people will be able to achieve the degree of relaxation necessary for the technique to work. For any surgical procedure that would normally require a general anaesthetic, an anaesthetist must be present during the operation by law. Hypno-anaesthesia is not without its risks -you should be confident that your therapist knows what he/she is doing.

COST Sessions are always private and cost from £60 an hour.

CONTACT There are few hypnotherapists in the UK who have experience of performing hypno-anaesthesia. Among those who have used hypnosis for a variety of operations normally requiring general anaesthetic is Dr John Butler, who can be contacted via the British Society of Hypnotherapists (020-7385 1166; www.hypnotism.org.uk), and Charles Montagu, who is co-founder of the Health Partnership (020-7589 6414) based in Central London. His hypnotherapy practice is taking bookings a year in advance. An initial 90-minute consultation costs £250, and then £150 is charged for 60-minute follow-ups.

FURTHER CONTACTS
The National Council for Hypnotherapy (0800 9520545; www.hypnotherapists.org.uk), or the British Society of Medical and Dental Hypnosis (07000 560309; www.bsmdh.org)

Publication Link: http://www.timesonline.co.uk

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Title: “Clinical Applications of Hypnotherapy”
Date: 08/1990
Source: Journal of Family Practice

Hypnosis has been used as a therapeutic tool for centuries, but only in the past 50 years have the clinical applications been delineated. As evident in the medical literature, the use of hypnosis by the medical community has increased, partly as a result of a growing awareness of hypnotherapy as an available treatment modality, and also as a result of major improvements in research methodology through strict standardization. Hypnotherapy, once considered to be limited to entertainment, has now proven useful in the treatment of a wide variety of medical illness.

Two cases of the use of hypnosis are presented. In the first case, hypnosis is used to alleviate pain in a gravid patient in sickle cell crisis. In the second case, hypnosis is used for desensitization of dental phobia in a 27-year-old women. The historical, theoretical, and clinical applications of hypnosis are reviewed. J FAM PRACT 1990; 31:180-184.

From the Family Practice Clinic, United States Air Force Medical Center, Scott AFB, Illinois. The views expressed in this article are those of the author and do not reflect the official policy or position of the Department of Defense or the United States Government Requests for reprints should be addressed to Mgf Eron Grant Manusov, MC, USAF, 1033 Woods Way, O'Fallon, IL 62269.

Hypnosis is widely used and accepted as an adjunct to treatment for pain control, habit disorders, symptom reduction, and many medical problems. Although in the past the application and effectiveness of hypnosis have been questioned by the medical community, the clinical disciplines that use hypnotherapy have grown to include the medical specialties, psychiatry, psychology, and social work. In the last 20 years over 100 review articles have been published by a diverse membership in both the American Journal of Clinical Hypnosis and the Journal of Clinical and Experimental Hypnosis, which are the respective journals of the American Society of Clinical Hypnosis and the Society of Clinical and Experimental Hypnosis. The International Society of Hypnosis is composed of individual members from more than 20 national constituent societies.

The use of hypnosis is widespread in various areas of clinical medicine, and family physicians are in an ideal position to address questions about the indications, misconceptions, and contraindications for the use of hypnosis. The physician's understanding of the history, theory, and clinical application can help guide the patient to this alternate therapeutic modality. Education in basic and advanced hypnosis can also enhance the family physician's armamentarium in diagnosing and treating many common ailments.

HISTORICAL PERSPECTIVE

Hypnosis has been a therapeutic tool for centuries. The Egyptians used "sleep temples" in which therapeutic suggestions were made, and kings were often thought to have healing powers. The clinical applications, however, have not been elucidated until recently. Acceptance by the scientific medical community has been limited by commercial exploitation, carnival sideshows, and controversy. The dispute was not whether the patient's symptoms improved, but whether the application was based on sound scientific theory. Hypnosis, however, which has been considered peculiar to regal powers, magnetism, and sleep, has in many cases proven effective. Researchers and clinicians have now introduced theories that are both acceptable and supported by scientific evidence.
The modern history of hypnosis begins with Franz Anton Mesmer. In 1766 Franz Mesmer, an Austrian physician, published a dissertation entitled "The Influences of the Planets on the Human Body." 1 Mesmer believed that all objects were subject to magnetic fields that directly influenced health and disease. Mesmer's techniques included elaborate theatrics with costumes, staring in his patient's eyes, and making "passes" over the body to employ his own magnetic field in the restoration of equilibrium to the patient's fluid.

Although the details of his methods are poorly documented, he did enjoy an immense success. His fame spread rapidly, and he treated large numbers of patients. His colleagues and local scientific societies, however, refused to acknowledge his achievements, and he ultimately retired to anonymity. Although his theories are now considered erroneous, his work did offer insight into the potential applications of hypnosis. The controversy also generated an impetus for other physicians to further study the elucidation of trance.

Despite the death of Mesmer, mesmerism continued to flourish. In 1784 King Louis XVI of France appointed a commission headed by Benjamin Franklin to investigate the claims of Mesmer's disciple, Charles D'Eslon. The focus of the commission was not the undeniable improvement of the patients, but rather to question the basic premise of the role of magnetic fluid in disease. The commission concluded that "the imagination is the true cause of the effects attributed to magnetism," 1 and once again the use of hypnosis fell into disfavor.

As with Mesmer, D'Eslon's success also waned, but the medical community continued the sporadic use of mesmeric treatment. In 1843 John Elliotson, a distinguished British physician well known for his introduction of the microscope to Great Britain, published a book entitled Numerous Cases of Surgical Operations Without Pain in the Mesmeric State. 1 He described in detail his personal use of the mesmeric state for the treatment of chorea and rheumatism. He also presented the work of his colleagues, who were able to perform such procedures as the painless release of contractures, incision of abscesses, and dental extraction. His arguments against the 1784 commission, however, lacked scientific basis. He contested that mesmerism was successful and therefore reasonable, but he could not support his statements with an acceptable theory. His contention was refuted, and mesmerism was banned from British hospitals.

A contemporary of Elliotson's, James Braid, introduced the term hypnosis derived from the Greek hypnos (sleep). Braid was also credited with the elucidation of the psychological aspect of hypnosis and the power the mind has over the body. He was impressed by the ease and rapidity with which trance could be induced, and fully recognized that the therapist did not transfer any magnetic, electric, or other physical force. His theory was close to the current understanding that the trance state is independent of the induction technique. His elucidation of the psychodynamic aspects of hypnosis were later adopted by Broca, Charcot, and Bemheim. 2 Other therapists, such as Freud and Bramwell in 1889, continued their investigations and empiric use until modem hypnotherapists, such as Milton Erickson and Karen Olness, refined the current clinical application of hypnosis. 1

The exact neuropathophysiology of trance is still unknown; however, theories by prominent physicians have offered insight into the psychodynamics of trance. The history of hypnotherapy has been filled with controversy, but the therapeutic success and the application of rigorous scientific methods to the use and research has greatly improved the acceptance of hypnotherapy by the scientific community.

THEORETICAL OVERVIEW

Simply speaking, hypnosis is an altered state of consciousness. Hypnotherapy, therefore, is the use of an altered state of consciousness, or trance, to reach a therapeutic endpoint. During the trance state there is a heightened concentration for the specific purpose of maximizing potential or changing cognition. Relaxation and imagery is used to obtain a fixed, narrowed attention with a high degree of concentration. The act of hypnosis is to induce a state in which the patient is receptive to therapy based on suggestion. Several particularly interesting characteristics of hypnosis include narrowly focused attention, dissociation, and primary process thinking. 1 These three attributes are used not only as objective factors for research purposes, but also as means to maximize the induction and deepening of a hypnotic state.
An example of a narrowly focused attention is the state of concentration required to be absorbed in a book, music, or television. A narrowly focused attention is one factor in a formal hypnotic induction that accentuates trance deepening. The subject is asked to focus attention to detail in imagery or fantasy. As the patient focuses inward, changes in cognition, such as feelings and interpretation, occur. A feeling of dissociation is often described, such as time and sensory distortion, that is similar to the dissociative process involved in fugue, amnesia, eating, and personality disorders. 4-6 Although common and generally harmless in the dream state and trance, dissociation, as the simultaneous development of subpersonalities and parallel memories that are in complete ignorance one of another, may result in many pathologic conditions. Hypnosis can be conceptualized as a controlled state of dissociation that is particularly useful in those pathologic conditions associated with dissociation. 7

Primary process thinking is the second factor intrinsic to hypnosis. It is a less complex or rudimentary form of thinking similar to dreaming. In trance logic, as in a dream, concepts such as falling up and being chased in slow motion are often accepted without question. Patients realize that the concept is against logic, but accept the incongruities. The subjective feeling is often described as knowing in the back of the mind that something is "not fight," but, because of a deep relaxed feeling, not being concerned about the conflict. Narrowly focused attention and primary process thinking can result in dissociation that can be either used in therapy or used to further hypnotic induction.

The trance state is a natural phenomenon and is often used by health care providers who have no formal training in hypnosis. Many physicians will change their tone of voice when interviewing children or patients in pain. The healing effect of touch and the physician's white coat are well described in the literature. Athletes, musicians, and scholars are also adept at trance utilization. A formal hypnotic induction, however, involves the patient sitting in a comfortable, quiet environment. The therapist may begin with progressive muscle relaxation, which can be followed by guided imagery. Eye closure often facilitates induction, and the patient is asked to first concentrate on each muscle relaxing and then is guided through a relaxing image such as a beach or outdoor scene. After a level of trance is obtained, specific suggestions are introduced. Hypnosis can be used in almost any environment, and induction and deepening techniques differ according to situation, patient, and therapist. In many situations patients who are experiencing acute pain, injury, and concerns about health are already in a frame of mind conducive to the use of trance.

Therapeutic intervention implies a change, and entering a trance alone does not signify a therapeutic endpoint. Once the patient has achieved a significant level of trance, the therapist may attempt change, ranging from simple suggestion to psychoanalysis. Although some uses, such as calming a frightened child in the emergency department, require minimal change on the part of the subject, more complex behavior patterns such as overeating or phobias require a complex therapeutic intervention. The results of the intervention, however, cannot always be attributed to hypnosis alone. Hypnosis may act as the therapy in itself, as in the application for pain control; however, in many cases hypnosis is used as a means to facilitate therapy. Combined with behavior modification, reassurance therapy, and psychotherapy, hypnotherapy has proven to be a useful adjunct to the treatment of many diseases.

CLINICAL APPLICATION

Illustrative Cases
Case 1. A 27-year-old woman presented to the Family Practice Clinic because of a severe dental phobia. As a child she had sustained an avulsion of the maxillary incisors, which required multiple surgical procedures. Over the previous 5 years, she had been unable to obtain either routine dental care or daily dental hygiene because of fear and an exaggerated oral sensitivity. Hypnotherapy was offered as a treatment option, and a combination of desensitization and suggestion was used to alleviate her fear. After a comfortable level of trance was obtained, she was told to imagine how great the feeling was as she walked out of a dentist office. In trance, after she was able to imagine herself having completed a dental examination, she was progressively led through the dental examination, beginning from calling for an appointment through the actual procedure. Ultimately after several months of hypnotherapy, she was able to care for her teeth and undergo dental examination. The desensitization, by slowly obtaining cognitive control over fears, resulted in the resolution of her phobia.

Case 2. A staff member of an obstetrics department requested an evaluation of and therapeutic intervention for a 28-year-old laboring woman in sickle cell crisis. Her pain had not responded to systemic opiates and conventional treatment. On initial presentation she was writhing in pain and unwilling to answer questions. Rapid pain relief was obtained with the use of glove anesthesia, a process by which the patient transfers the suggestion of analgesia, in a distribution in the area of a hand, to painful areas. She was asked to imagine her hand in an ice cold bucket of water. As she concentrated on the cold, numbing effect of the ice on her hand, the suggestion was made that she could transfer this cold, numbing sensation to any painful areas. She subsequently placed her hands on her knees and was able to obtain immediate relief with the suggestion. The patient rested comfortably and progressed through labor without further medical intervention.

The two case presentations are examples of clinical applications of hypnosis. The resolution of the dental phobia resulted from many trance sessions using desensitization of a fear that was secondary to earlier painful dental manipulations. The acute pain experienced by the patient in the second case is more dramatic and often requires only one session of hypnotherapy.
Hypnosis has been applied to the treatment of a wide variety of medical, psychological, and behavioral problems. Unusual or dramatic results are usually unsubstantiated by careful studies. 8 Hypnotherapy tends to be more effective in those medical conditions that have a clear-cut cause, and is less effective in cases complicated by psychodynamic or behavioral control. In these cases, a form of secondary gain or depression may complicate the treatment effectiveness and recovery.
Pain Control

One of the widest applications of hypnosis is pain control. Pain response is a perceptual phenomenon and refers to both physical (somatogenic) and psychological variables that include anxiety, expectations, attention, secondary gain, and various forms of psychopathology. 5 The specific application of hypnosis to pain control is well documented in the literature. 9-11 Erickson 12 reviewed 11 hypnotic procedures applicable to pain control. Wain 13 reported that 50% of patients referred to the Walter Reed Army Medical Center Pain Clinic received some form of hypnotic intervention. As demonstrated in the pain clinic, hypnosis is most useful in establishing cognitive control over symptoms. A patient who can demonstrate glove anesthesia or imagine a pain-free state can use hypnosis to obtain relief.

A trial of hypnosis is frequently indicated if the patient is interested. Often patients are enthusiastic about hypnosis as an adjunct to pain control, and when approached, volunteer readily for a trial induction. There are several hypnotic induction scales to determine susceptibility 13,14 ; however, indicators of susceptibility include a high degree of enthusiasm, an active ability to fantasize, a vivid imagination, and the ability to become engrossed in a book or movie. This information can provide a rapid assessment of hypnotic susceptibility in the office and is a useful guide for the potential use of hypnosis.

Obstetrics and Gynecology

The success of the Lamaze method of prepared childbirth, a method that is similar to hypnosis, relies on two approaches: (1) it serves to educate the parents about labor and delivery, so they may become informed participants; and (2) it prepares a woman to tolerate contractions with breathing, focusing, and progressive relaxation. 14 Hypnosis can improve pain control during labor with glove anesthesia, time distortion, and alleviation of fears and anxiety. Other potential uses of hypnosis in obstetrics and gynecology include relief of hyperemesis gravidarum, relaxation during gynecologic examination and procedures, relief of dysmenorrhea, and alleviation of menopausal symptoms. Should more conventional means of management fad, patients may benefit from hypnosis if a hypnotherapist is readily available upon patient request.

The uses of hypnosis for pain control and anesthesia are well documented in the literature. The first documented use of hypnoanesthesia in surgery was in 1829, when a mastectomy was performed by Jules Cloquet in Paris. 15,16 The early application of hypnosis in surgery was successful because it was effective, it had a low incidence of side effects, and there was a lack of chemical anesthetics. The therapists were innovative and contributed greatly to the widespread use of hypnosis in surgery. Currently there is still a role for hypnoanesthesia, if used by a qualified hypnotherapist and in appropriate circumstances, such as with patients who are unable to use regional or general anesthesia.
Preoperative relief of apprehension, reduction of the amount of chemical anesthesia, and a reduced length of hospitalization are also reported effects of hypnosis and can enhance the armamentarium of both surgeon and anesthesiologist.

The role of psychologic factors in dermatologic disease is well known, and emotional stimuli often cause exacerbation of many skin diseases. Although the exact pathophysiology is not understood, stress and its effect on the immune system may play a significant role in the onset and course of dermatologic disease, psoriasis in particular. Hypnotherapy and progressive relaxation have been used successfully in the treatment of psoriasis exacerbation and have a role in many other dermatologic diseases. 17-19 Hypnosis is also valuable for the treatment of long-lasting psychological problems such as low self-esteem and reduced self-confidence associated with scars and acne.

Children respond to a large number of hypnotic induction techniques and show a remarkable skill for dissociation and trance logic. The young respond best to different inductions, and specific items may measure different dimensions according to the age of the patient. The heightened degree of hypnotizability in children affords many therapeutic options. The therapist, however, needs to approach the child according to age and level of cognitive development.

Children generally have more hypnotic talent than adults, and as pain control relates to hypnotizability, it is not surprising that children are extremely adept at hypnotherapeutic pain control. 20-22 The advantages include the enhancement of self-confidence, participation in the healing process, increased daily activity, and reduction of side effects. Hypnosis can be used as an adjunct to other treatment modalities, such as chemotherapy, or to reduce the acute pain and fear that may accompany an emergency department visit. Improvement of physician-patient rapport and the alleviation of fears and anxiety are also important clinical applications often used by clinicians not formally trained in hypnosis. Other uses of hypnotherapy include treatment of enuresis, behavioral difficulties, learning disorders, and nail biting. 3

Hypnosis can be applied to the behavior control of habits such as smoking and obesity. Since habitual behavior is multifactorial, success is enhanced by a program that combines behavioral modification, physical modification, and group therapy. If hypnosis, however, is directed toward individual belief systems, significant change can occur with therapy. 23-25 Other applications in general medicine include the treatment of cephalgia, stress-related disease, and insomnia, and the maintenance of patient's morale. Although outside the usual practice of family physicians, hypnosis is also effective in the treatment of eating disorders, in sexual counseling, and in psychotherapy.

Hypnosis can be a valuable asset in the treatment of disease. Although the list of applications presented in this article is not exhaustive,* it does demonstrate the potential use of hypnotherapy in the treatment of many illnesses. The formation of the American Society of Clinical Hypno
sis and the Society of Clinical and Experimental Hypnosis has not only provided a forum for discussion and education about the many applications of hypnosis, but has standardized scientific research, resulting in a better acceptance of and interest in hypnosis. If the therapist and patient have a realistic endpoint, hypnosis in many cases can enhance both treatment options and effectiveness.

* Further information and location and dates of future training may be obtained from the American Society of Clinical Hypnosis, 2250 East Devon Avenue, Suite 336, Des Plaines, IL 60018.
References
1. Tinterow MM: Foundations of Hypnosis: From Mesmer to Freud. Springfield, Ill, Charles C Thomas, 1970
2. Evans FJ, Pettinati HM: Hypnosis. Carrier Letter No. 85. Belle Mead, New Jersey, Carrier Foundation, January 1983
3. Olness K, Gardner GG: Hypnosis and Hypnotherapy with Children. Philadelphia, Grune & Stratton, 1988
4. Sanders S: A brief history of dissociation. Am J Clin Hypn 1986; 29:83-85
5. Spiegel D: Dissociating damage. Am J Clin Hypn 1986; 29:123-131
6. Gruenewald D: Dissociation: Appearance and meaning. Am J Clin Hypn 1986; 29:116-121
7. Torem MS: Dissociative states presenting as an eating disorder. Am J Clin Hypn 1986; 29:137-142
8. Mott T: Guidelines for writing case reports for the hypnosis literature. Am J Clin Hypn 1986; 29:1-6
9. Wain HJ: Hypnosis on a consultation liaison psychiatry service. Psychosomatics 1979; 20:678-&9
10. Kroger WS: Clinical and Experimental Hypnosis. Philadelphia, JB Lippincott, 1976
11. Hilgard ER, Hilgard J: Hypnosis in the Relief of Pain. Los Altos, Calif, Kaufmann, 1975
12. Erickson M: An introduction to the Study and Application for Pain Control. New York, Springer-Verlag, 1966
13. Wain HJ: A quick method for screening pain patients for hypnotic treatment. in Caycedo A: Medical Sophrology. Barcelona, Spain, 1975
14. Spiegel H: Manual for Hypnotic Induction Profile, revised. New York, Soni Medica, 1973
15. Johnson JM: Teaching self hypnosis in pregnancy, labor and delivery. Med Care Nurse 1980; 5:98-101
16. Gravitz MA: Early uses of hypnosis as surgical anesthesia. Am J Clin Hypn 1988; 30:201-208
17. Surman OS, Crumpacker C: Psychosocial aspects of herpes simplex viral infection. Am J Clin Hypn 1987; 30:125-131
18. Tenzel JH, Taylor RL: An evaluation of hypnosis and suggestion as treatment for warts. Psychosomatics 1969; 10(9):252-257
19. Winchell SA, Watts RA: Relaxation therapies in the treatment of psoriasis and possible pathophysiologic mechanisms. J Am Acad Dermatol 1988; 18:101-104
20. Olness K, Gardner GG: Some guidelines for uses of hypnotherapy in Pediatrics. Pediatrics 1978; 62:228-233
21. Gardner GG: Hypnosis with children. Int J Clin Exp Hypn 1974; 22:20-28
22. Andolsek K, Novik B: Use of hypnosis with children. J Fam Pract 1980; 10:503-507
23. Rabkin SW, Boyko E, Shane F: A randomized trial comparing smoking cessation programs utilizing behavior modification, health education or hypnosis. Addict Behav 1984; 9:157-173
24. Feldman J: The work of Milton Erickson: A multisystem model of eclectic therapy. Psychotherapy 1985; 22:154-162
25. Citrenbaum CM, King ME, Cohen WI: Modern Clinical Hypnosis for Habit Control. New York, WW Norton 1985
Suggested Reading Andolsek K, Novik B: Use of hypnosis with children. J Fam Pract 1980; 10:503-507 Crasilneck HB, Hall JA: Clinical Hypnosis: Principles and Applications. New York, Grune & Stratton, 1985
Haley J: Advanced Techniques of Hypnosis and Therapy. New York, Grune & Stratton, 1967
Kroger WS: Clinical and Experimental Hypnosis. Philadelphia, JB Lippincott, 1976 Olness K, Gardner GG: Hypnosis and Hypnotherapy with Children, Philadelphia, Grune & Stratton, 1988

Publication website: http://www.jfponline.com/

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Giving patients a form of hypnosis helps them cope better with the pain and anxiety of minor operations, doctors have found.
Patients instructed in self-hypnotic relaxation had less pain, needed less pain-killing drugs and had better control over their blood pressure.

Elvira Lang and colleagues from Beth Israel Deaconess Medical Centre, Boston, USA, studied 241 patients, a third of whom received self-hypnotic instruction.

Doctors are keen to cut the quantity of sedatives and narcotics patients need, as they can cause various physical problems during operations.

The techniques in the study included telling the patient to relax all their muscles one by one, and count backwards from 100. Some patients were also told to roll their eyes upwards, breathe deeply, and concentrate on a sensation of floating. They were also told to focus on a "safe and pleasant" experience.

All the patients in the study, whether receiving hypnosis or simply standard treatment, were given access to self-controlled painkilling drugs during the operations. The procedures involved were not major "open" operations, but involved the insertion of probes into blood vessels. Despite the time it took to instruct patients in the techniques, the fact that patients under hypnosis were less restless meant that they actually spent less time - 17 minutes on average - in the operating theatre.

However, it is not clear whether the patient benefits found in the study were the result of actual hypnosis or simply deep relaxation triggered by the techniques. Dr Peter Wallace, a consultant anaesthetist from the Western Infirmary in Glasgow, said that anything which reduced the need for drugs would be welcome.

He said: "The concept of relaxation techniques for patients undergoing this sort of procedure is well-established. "I'm not sure whether there is any real difference between thes and hypnosis, but certainly, the results here in terms of reduced need for sedatives is quite remarkable."

However, the president of the Royal College of Psychiatrists, Professor Leo Strunin, said that many hospital departments carrying out these procedures were too stretched to spare the time to teach such hypnosis techniques.

He said: "The problem is that they are so unpredictable - they may work for some people but not for others." The research was reported in the Lancet medical journal.

Original Link: http://news.bbc.co.uk/2/hi/health/728092.stm

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All doctors should know how to perform hypnotherapy on their patients, according to a US expert.
Professor David Spiegel, of the Department of Psychiatry and Behavioural Sciences at Stanford University, said the therapy had been shown to help patients deal with pain, and could potentially be used in many other situations, such as helping people cope with long-term illnesses.

Professor Spiegel told BBC News Online: "We have more and more people living with these illnesses who need help coping with them, and hypnosis is a safe and effective way to teach people how to manage their own response, how to take the edge off their pain, how to think through their anxiety and not let it overwhelm them."

The Stanford scientist made his comments at the annual meeting of the American Association for the Advancement of Science in Boston.

He teaches self-hypnosis to help people manage their symptoms themselves.

"If they have pain, I'll have them imagine they're doing to the part of their body that hurts what they actually do in the real world when it hurts, whether it's using a bag of ice cubes or applying heat."

Professor Spiegel said studies had shown hypnosis did help patients. In a study of women with breast cancer his team is due to publish later this year, those given support plus self-hypnosis had half the pain of those not given that combination.

His team has also found evidence that the brain's reaction can be changed under hypnosis.

A study of people classed as highly receptive to hypnosis looked at how colour was processed in their brains.

They were shown patterns, either in colour, or in shades of grey. But if they were hypnotised to see colour, when in fact they were looking at the grey pattern, they believed they were seeing colour and their brain reacted as if that were true.

Professor Spiegel said that studies showed hypnosis was a distinct psychological state, and it was not simply that the person under hypnosis was adopting a role suggested to them.

He added: "People who are hypnotised see what they believe. They don't just tell you that's what it is - it actually looks that way to them."

He is still looking for a "brain signature" which will show what happens in the brain when people are hypnotised.

Original Link: http://news.bbc.co.uk/2/hi/in_depth/sci_tech/2002/boston_2002/1825175.stm

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Melinda Stevens takes her trances with Paul McKenna
I have a fear of public speaking. No exotic phobias for me. No apple cores, rubber bands or words containing the letters “th” or “ph”. Just plain old public speaking.

But when the hypnotist Paul MacKenna starts telling me it’s “the most common fear there is”, I can’t help feeling a bit upset. After all, nobody wants to be average; nobody wants to be a 2.2 kids, blue-estate-with-cupholders boring Norma, when they could be a 6.8 kids, penny-farthing-with-bells-on visionary. Anyway, he’s meant to be helping me get over my phobia, not telling me how mediocre it is.

Which is why, halfway through our session, I ask if I can swap. “Look,” I say, “maybe I don’t need this public-speaking thing as much as I thought I did. I never give speeches, I don’t read in church and I’m sure I’ll get better in interviews with time. What I really want to do ...” I pause, “... is write a jolly good book.”

This may sound silly, but it’s what Paul does. Not only can he help you overcome your fears, but he can propel you towards your desires. He tells me about two scriptwriters who, after a session with him, were catapulted from the mire of writer’s block into Tom Hanks-starring, Sam Mendes-directing movie nirvana. So I am seduced. As I relax on my chair — a leather- effect lounger that squeaks like a brood of piglets — and Paul talks mellifluously of rewiring my neural pathways, I envision a new Pulitzer prize-winning life in a gloriously lonely garret.

Within seconds, however, I realise that I’m not quite ready for hefty reprogramming. It might bust a fuse or two and, at 30 years old, I’m not inclined to buy a new set. I apologise and squeak about uncomfortably in my seat. We go back to the public-speaking issue.

Paul asks me to envision my fear — or “Mrs Fear”, as he likes to call her. I imagine Mrs Fear to be round, small and grey, with a mouth that flops all over the place like uncooked pastry. Before I know it, I find myself answering questions on Mrs Fear’s behalf. It’s embarrassing, but I can’t help myself. I feel like I’m on a very bad episode of Trisha.

Soon, Paul is asking me to stare at a place on the wall, and he counts down as I close my eyes. I comply without resistance, much to my annoyance. At first I hear Paul speaking to me in a voice so deep it appears to be dragging along the ocean floor of the Pacific. But soon afterwards, he sounds very far away.

After 10 minutes that feel like two, Paul wakes me up. He asks me to imagine being in a throat-closing, hyperventilating, jelly-legged public-speaking situation again, and, try as I might, the adrenaline overkill appears to be playing hopscotch elsewhere. But I need to test it properly.

And here beginneth the frustrating part of the tale. I don’t work in an office, so I can’t make an announcement. I am not a churchgoer, so I can’t wing in to a random parish to read the lesson. I am not part of a local amateur-dramatic troupe, or a resident expert at the Royal Geographical Society. For a while, I convince myself that talking very loudly in the pub is proof enough of McKenna’s mystical powers.

Then I receive a phone call from The Sunday Times, who aren’t letting me off that lightly. I’m to hold forth on a subject of my choice from a soapbox at Speaker’s Corner, then write about the experience for your benefit. How do I feel? Cool as a cucumber.

Original Link: http://www.timesonline.co.uk/tol/newspapers/sunday_times/style/article830622.ece

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A 27-year-old virgin, terrified of sex, found satisfaction through hypnosis

It wasn’t until she tried to make love to her boyfriend for the first time two years ago that Sarah Dewsbury realised she had a problem.

Just as the couple were about to have intercourse, Dewsbury — a 27-year-old virgin at the time — found herself terrified of being penetrated. “I suddenly became very frightened and tensed up,” says Dewsbury, now 29, and a designer from Surrey. “It was a completely involuntary reaction. However much I tried to relax and however much my boyfriend tried to help, I couldn’t control it.”

Dewsbury did not realise she was suffering from vaginismus, a condition affecting 1 to 2 per cent of women. Sufferers’ fear of penetration causes the muscles around the vagina to suddenly spasm and contract. Although Dewbury’s boyfriend had not had this problem with his previous girlfriends, he was patient and the issue brought the couple closer together. But after six months without any improvement, their relationship was becoming strained.

Dewsbury’s GP referred them to Relate, the relationship counsellors, where a sex therapist gave her exercises to become comfortable with her body. But after a year of treatment nothing had changed. “The discussions with Relate were helping but they were not solving the problem; it was so fixed in my head that there was no way round it,” she says. With the couple increasingly desperate, Relate suggested they try hypnotherapy. A friend put them in touch with Marcia Degun-Mather, an experienced hypnotherapist and psychologist specialising in sexual disorders.

From her initial assessment, Degun-Mather felt Dewsbury’s vaginismus had several causes: poor sex education, ignorance of her body, and a fear of having her hymen broken. Each painful attempt at intercourse reinforced her anxiety. After an assessment, she introduced Dewsbury into a state of deep relaxation. Degun-Mather then began a technique known as progressive muscle relaxation, with emphasis on the pelvic muscles. The next step was to replace her negative beliefs about sex with positive ones.

While under hypnosis, Dewsbury was asked to imagine feeling confident and calm about various sexual scenarios: first, touching herself, being touched by her boyfriend, and finally, having intercourse with him. With each scenario, Degun-Mather gave Dewsbury statements to repeat to herself so that when carrying out the actions, she would have the positive feelings — a technique called post-hypnotic suggestion.

A vital component was to practise self-hypnosis at home to maximise the effect, according to Degun-Mather. Dewsbury was asked to listen to an audio-tape of the session once a day, and she also had to masturbate.

The hour-long sessions were held fortnightly over four months. After the seventh session Dewsbury’s boyfriend attended. Degun-Mather found that he’d expected Dewsbury to get turned on like his previous girlfriends, and this put pressure on her. Degun-Mather assured him that there was no need to worry or hurry.

The following weekend, the couple had a hotel break in Stratford-on-Avon. The first evening they were finally able to go all the way. At first, Dewsbury didn’t realise they had achieved penetration: “I know it sounds mad,” she says. “But I just hadn’t known what to expect.” One year on, the couple are still impressed. “It is not until you try hypnotherapy that you realise how powerful it is,” Dewsbury says.
“Fortunately we have never had a repeat of the situation. But, like all couples, sometimes one of us doesn’t fancy sex and the other one does!” The couple believe the problem strengthened their relationship. “Not many couples go through such intimate and complicated things,” says Dewsbury. “We had to decide to stick with each other and then work through it.”
Sarah Dewsbury is not her real name
HEALING WITH HYPNOSIS
What is it?
Hypnosis is a state of enhanced relaxation in which the deeper parts of the mind become more accessible.
Suitable for
Helping stress-related conditions, pain and overcoming phobias.
WHAT'S THE EVIDENCE? by Dr Toby Murcott
Is hypnosis an effective treatment for vaginismus?
Hypnosis is one method of treating vaginismus but it is normally used with other techniques such as behavioural therapies and pelvic floor exercises. Carole Clifford, a counsellor, psychosexual therapist and hypnosis practitioner, says that hypnosis is only one tool and should not be seen as a cure in itself. When properly applied, says Clifford, hypnosis can encourage relaxation and reduce anxiety — helping women to change their thinking and adopt new patterns of behaviour.
Is there any research?
One US paper, published in 1980, describes the clinical treatment of 71 women over a nine-year period, all but three of whom found the approach effective. Sarah Dewsbury’s experience fits into this category. While these cases build a picture of the treatment they are not equivalent to well-conducted clinical trials. A review of research into sexual dysfunction, published last month by the Cochrane Collaboration, says that case studies are encouraging but there is insufficient evidence from clinical trials to draw any conclusions about the effectiveness of hypnosis for vaginismus.
What’s the evidence for hypnosis?
Phyllis Alden, a consultant clinical psychologist at the Hope Hospital in Salford, has considerable experience using hypnosis for a number of different conditions and says it is difficult to study in classic clinical trials. Treatments vary from patient to patient yet clinical research requires a consistent treatment that can be applied in the same way to different individuals. However, the International Society of Hypnosis is working on a new assessment of hypnosis which it hopes will offer better scientific validation of the technique.
How do I know if hypnotherapy is the right approach for me?
Both Clifford and Alden are emphatic that treatment for vaginismus must be by professionals who are qualified in the treatment of sexual problems. While hypnosis might be the right tool, that decision can only be made with a suitably qualified expert. Your GP can often refer you, and some hypnotherapy is available on the NHS. Carole Clifford also recommends contacting the British Association for Sexual and Relationship Therapy, HYPERLINK "http://www.basrt.org.uk" www.basrt.org.uk, the nationwide specialist charity that accredits sexual and relationship therapists.
How widely accepted is hypnosis?
Hypnosis is recognised as a clinical technique by the British Medical Association and the American Medical Association. There is, though, an important distinction between medical practitioners who use hypnosis and hypnotherapists who are not medically qualified. Be sure to check the qualifications of any therapist.

Original Link: http://www.timesonline.co.uk/tol/life_and_style/health/complementary_medicine/article623782.ece

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Alison Kirwan, 32, a general manager who lives in London, gave up smoking using hypnotherapy
I had been smoking between 10 and 20 cigarettes a day for about 16 years when I quit last August. I wanted to give up because I didn't want to look old and have loads of wrinkles. I was also starting to worry about my health.

I had tried to give up twice before. Once, when I was 26, I'd managed to last six months by going cold turkey. But then one night in a pub I had too many drinks and told myself there would be nothing wrong in having JUST one cigarette. One led to another and, before I knew it, I was back to smoking full time again.

Last year, I decided to try hypnotherapy. My session lasted two hours. The hypnotherapist recorded it on a CD which I had to listen to later if I felt I was weakening. I was also given a mantra which involved tapping my face, shoulder, arm and hand, at the same time as repeating something positive such as: "I completely accept myself. I don't need a cigarette." It worked and I haven't smoked since.

Although it didn't take away the cravings, the advice and mantra took my mind off wanting a cigarette. But I did lapse once. I'd had a few drinks with smoking friends, my willpower was faltering and the mantra didn't seem to be working. I ended up offering to light cigarettes for my friends - and I could take a few sneaky drags. Next day, I felt bad that I'd smoked, which made me more determined to give up.

The strange side effect of hypnotherapy is that, because I asked the hypnotherapist to target the ageing aspect and smell of cigarettes, every time I smell smoke, I feel sick.

Whenever I see someone smoking, I see them as old. It all helps to put me off the weed. It cost me about GBP 200 to give up smoking - money well spent.

Publication website: http://www.express.co.uk

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Title: “How one in five have given up smoking”
Date: 31/10/1992
Source: New Scientist

Hypnosis is the most effective way of giving up smoking, according to the largest ever scientific comparison of ways of breaking the habit. Willpower, it turns out, counts for very little.

Smokers are coming under increasing pressure to quit. Earlier this month the Institute of Actuaries published the results of a study it commissioned which showed that the mortality rate for smokers is twice as high as for non-smokers, and that, on average, a smoker dies 6 years earlier than a non-smoker. Surveys suggest that three in four smokers would like to give up, according to the antismoking campaign Action on Smoking and Health (ASH).

To find the most effective way to give up smoking, Frank Schmidt and research student Chockalingam Viswesvaran of the University of Iowa carried out a meta-analysis, statistically combining the results of more than 600 studies covering almost 72 000 people from America, Scandinavia and elsewhere in Europe.

By combining the results from so many separate studies, the meta-analysis enables the real effectiveness of each technique to be picked out from the statistical 'noise' that often blights studies involving smaller numbers of subjects.

The results, published in the current issue of the Journal of Applied Psychology, show that the average success rate for all methods was 19 per cent: that is, only about one in five smokers is likely to succeed using methods covered by the study.

Patients told that they had serious cardiac disorders, and so a clear incentive to stop immediately, had the highest quitting rate, at 36 per cent. But for most smokers the most effective technique was hypnosis, in which smokers go into a state of deep relaxation and listen to suggestive tapes. The analysis of treatment by hypnosis, which included 48 studies covering over 6000 smokers, gave an average success rate of 30 per cent for this method.

'Combination' techniques, combining, for example, exercise and breathing therapy, came second with a success rate of 29 per cent. Smoke aversion, in which smokers have their own warm, stale cigarette smoke blown back into their faces, achieved a 25 per cent success rate, followed by acupuncture at 24 per cent.

The least successful method turned out to be advice from GPs, which appears to convince virtually no one to give up. Sheer willpower proved little better, with a success rate of only 6 per cent. Self-help, in the form of books or mail-order advice, achieved modest success - around 9 per cent, while nicotine gum was a little better at 10 per cent.

'We found that involvement of physicians did not have as big an impact as we expected,' said Schmidt 'We speculate that the reason is that it is the content of the treatment that matters, and not the status of the person giving it.'

David Pollock, director of ASH, said he was surprised by the success of hypnosis, which anecdotal evidence had suggested was not very effective. One organisation not surprised by the results is the British Society of Medical & Dental Hypnosis. Christopher Pattinson, the society's academic chairman, said that current hypnosis techniques are a far cry from their popular image of music-hall tricks involving swinging fob watches. The latest relaxation techniques achieve success rates of up to 60 per cent from a single session, he said.

Richard Doll, the epidemiologist who carried out the pioneering studies of the risk of smoking, said that the apparent success of hypnosis and the high quitting rate of patients with heart disease backed his own observations. He added, however, that he was somewhat surprised by the low success rate of those who resorted to willpower alone: 'The majority of people find it not too difficult to give up,' he said. 'The only way to succeed is to want to do it enough. You have got to really appreciate what the risk is. I smoked and gave up without too much difficulty.'

Original Link: http://www.newscientist.com/article/mg13618450.700-how-one-in-five-have-given-up-smoking-.html

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Title: The Wacky World of Smoking Cessation (extract)
Date: 11/05/2007
Source: Times

Our writer probes the weird and wonderful treatments available to would-be quitters

Hypnotism: “Liiieeee baaaack. You are getting very sleeeeeepy?.” Hypnosis has come a long way from the creepy practitioner dangling a pocket watch pendulum in front of your lids. Now it more closely resembles a standard therapy session, where you are asked questions such as, “There was a time in your life where you did not give the slightest thought about smoking. Do you remember what it was like then and how you felt about smoking?”, and digging deep into what emotional impulses you harbour that make you need the smelly sticks.

Hypnotherapists say that a crucial element is that the smoker has to truly want to give up smoking, otherwise cracking open the psyche can have the opposite effect: solidifying your resolve to light up. At the session, be prepared to chat a bit and then lie back and through imagination exercises have your unconscious exposed and gently prodded towards the conclusion that smoking is yucky. Sure, you knew that before, but did your id?

Original Link: http://www.timesonline.co.uk/tol/life_and_style/specials_/smoking_ban/article1777920.ece

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Title: “Could hypnotism or patches help you give up smoking?”
Date: 06/01/2003
Source: Daily Mail

Are you trying to give up cigarettes for good? Here, in the second part of our guide to stop-smoking techniques, two testers report on hypnosis and nicotine patches.

HYPNOSIS
Tester's name: Liz Stout
Age: 30
Profession: Beauty writer
How long a smoker?: 15 years
How many cigarettes smoked a day?: 15 to 20
Why you want to give up: I had always promised myself I would stop by the time I was thirty, so had no choice!

What you have to do: Liz says: 'Annie likes to speak to people over the telephone before she arranges a session to find out a bit about them and make sure that they really do want to kick their smoking habit. There is little point going to see a hypnotist about smoking unless you really want to give up - it just won't work.

'I went to see Annie one evening after work for a session that lasted about an hour and a half. It started off with a really informal chat about the procedure and Annie explained that they key thing to do was to relax. She encouraged me to 'go with the flow' during the actual hypnosis and not to worry about how I was feeling.

'She pointed out that my mind might wander off to thinking about other things - like what I was going to have for dinner - but that I shouldn't worry. As long as I followed her instructions and relaxed, she would be able to access my sub-conscious mind. Spooky!'

How easy was it?: 'The hypnosis was an entirely pleasurable experience and I was conscious throughout. I simply laid back in my chair and let myself drift off until I felt completely relaxed and comfortable. During the session, Annie asked me to imagine that one of my hands felt tingly and it did, which was an amazing sensation. Afterwards, Annie pointed out that if my mind could make my hand feel tingly at will, it could definitely steer me away from the deadly fags.'

Did it work?: 'Yes! From the moment I said goodbye to Annie, I have never, at any point, craved a cigarette. Stopping has been easy, it's quite astonishing. I'd tried to give up so many times before this and it had been a torturous experience, ultimately followed by a visit to the newsagents for a packet of 20.

'I feel like I never smoked in the first place and although I don't mind other people smoking around me, I sometimes feel I want to tell them how mad they are. I feel so much better - my skin is healthier and I have loads more energy. As part of the treatment, Annie also worked on my presumption that giving up would mean piling on the pounds. Since stopping five months ago, I have not gained any weight.'

Would you recommend it to others?: 'Definitely. It has changed my life! However, I think it's important to add that hypnotism doesn't work for everyone. I do have friends who haven't enjoyed the same success as me. But I think if you want to kick this horrible habit, anything is worth a try.'

Original Link: http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=153666&in_page_id=1774

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Title: “Weight Loss: It’s All in the Mind”
Date: 16/08/2005
Source: The Express

Your health – Hypnotherapy tackles the reasons for overeating, re-programmes attitudes to food and is virtually effortless, say fans of the latest way of slimming, by Madeleine Bailey

We all know how to lose weight - cut back on fat and burn more calories. But if it's so simple, why are 65 per cent of men and 57 per cent of women overweight, according to British Heart Foundation figures? Most weight-loss experts emphasise that the key to successful slimming is ditching diets in favour of long-term healthy eating habits.

Clinical hypnotherapist Georgia Foster, who runs workshops helping people tackle the psychological reasons for overeating, says diets are bad for our emotional health.

"Diets create stress by placing unrealistic demands on people. Most are restrictive, so we feel deprived and give in, " she explains. "Every time we fail, this reinforces our belief that we'll never succeed, knocking our self-esteem and leading to a damaging pattern of dieting and overeating." Georgia should know. She struggled with these problems for 16 years, until she became a psychology student and specialised in hypnosis in the mid-nineties.

After seeing how hypnotherapy helped people to build self-esteem and break bad habits such as smoking, she devised her own self-hypnosis techniques to combat overeating, and went from 11st 7lb to nine stone in 18 months. "I began losing weight without trying. I realised I was only eating when I was hungry, not when I was depressed or stressed, and that I was gradually being drawn towards healthier food. I then started using the same techniques in clinical practice and found they worked well on clients who had issues with food."

Georgia believes overeating is a habit that builds up over the years to help us deal with difficult emotions. We all have an "inner critic", which reminds us of our past failures in a misguided attempt to protect us from further pain.

According to Georgia, hypnotherapy works by reprogramming the mind out of such negative thinking.
"The subconscious can't tell the difference between reality and imagination, so visualising yourself as a slim person who eats healthily fools it into believing you've succeeded. It will then act accordingly and stop trying to 'protect' you from failure by sabotaging your weight-loss efforts, " explains Georgia.

She claims that during her eight-week Weight Less Mind workshop (one day a week), clients lose on average between seven and 18lb. But most importantly, she says, six-month follow-ups have revealed continued weight loss and a permanent change in their behaviour.

Publication website: http://www.express.co.uk

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"Woolfrey explained that how we feel about ourselves is key to why and what we eat. Hypnosis reaches the unconscious mind to change those beliefs" What is it? Eight 90-minute sessions of hypnotherapy.
Does it work? Although I eat well and exercise regularly, I work from home and nip into the kitchen for snacks. I also socialise nearly every night and late meals and alcohol usually feature.

Initially, I was sceptical of hypnotherapy. It sounded like hocus-pocus and I didn't like the thought of someone reprogramming my mind. At the first session, though, my misgivings faded. Tricia Woolfrey explained that the sessions would be about getting to why I ate what I did. Hypnotherapy at the end of each session would remind my subconscious to think positively.
Before we began, she asked about my diet, exercise and emotional relationship with food. Then, with soft music in the background, she put me into a state of hypnosis (which felt like the moments just before falling asleep) and talked about ways to improve my life and lose weight.

As the weekly sessions progressed, I became more confident in her ability to help me and I came out of each session very motivated. She drummed into my head how healthy I'd feel if I snacked on fruit, ate less at night and drank more water.

She became the angel at my shoulder, reminding me of my goals. At each session she evaluated my diet, exercise and emotions (how I was dealing with stress).
It was getting to the heart of emotional issues that helped me. As Woolfrey explained, how we feel about ourselves is the key to why, and what, we eat.

Hypnosis reaches the unconscious mind to change those beliefs. While I was hypnotised, she emphasised positive things, making me build a picture of how I wanted to look and feel. After eight sessions, I am more aware of exercising and eating well. I last saw Woolfrey three weeks ago, but my mind is still set.

Weight loss 9lb (4kg)

Original Link: http://www.timesonline.co.uk/tol/life_and_style/health/healthy_eating/article406992.ece

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As millions start New Year diets that probably won't work, we challenged four yo-yo dieters to see if hypnosis is the answer ...

Can hypnosis be the key to successful dieting? Even the best diets fail without willpower but some experts say that going into a trance can help you discover why you overeat - and how to conquer your bad habits.
FEMAIL sent four sceptical women to hypnotherapist Monica Black and charted their progress over six weeks. Here they tell Wendy Sloane whether they lost weight, and Monica explains how it all works. . .

Lousie Moran, 26, is an accounts manager who lives in Clapham, south London, with fiance Darren, 34, a businessman.
Number of sessions: 6
Height 5ft 3in
Pre-hypnotherapy weight: 11st 6lb
Post-hypnotherapy weight: 10st 10lb
Total weight loss: 10lb

She says: Recently I'd fallen into the habit of working through lunch then working late. I'd come home from work around 10.30pm and drink three glasses of wine while I cooked something high-carb, quick and satisfying.Very quickly the weight crept on, and within a year I'd put on over two stone. I tried several diets but found them difficult. When I'm on a diet I want to be able to eat normally, but I become so obsessed that I reduce my intake way too much, eating only fruits and vegetables. When I start eating normally again, the weight piles back on within a few days.

I was sceptical about hypnotherapy. I analyse things too much and am too aware of what's going on around me to be easily swayed. I couldn't see myself going into a trance-like state, but I thought I'd give it a go - the only thing I had to lose was the weight.

At the first session, Monica and I talked about what I ate. I buy loads of healthy food, I love fresh fish and vegetables and never buy crisps
or chocolate, so I couldn't understand why I was piling on the pounds.
But talking my week through with Monica make me realise the food usually goes off because I never have time to cook it. Instead, I tuck into a bowl of chunky chips at the pub then come home and have spaghetti.

When I lay on Monica's couch she made me take deep breaths and concentrate on my body. I had to relax myself, including my tummy, feet and legs - until I could fully let go. At that point, I thought I'd be passed out cold, so when she asked me if I was 'under', I lied and said 'yes' even though I didn't think I was.

She focused on me eating chunky chips or spaghetti, telling me not to eat them and suggesting healthier alternatives such as olives.
I thought concentrating on these two foods wouldn't make any difference.
Just to prove her wrong, on the way home I bought a packet of sweets.

I was saying: 'Monica's tried to hypnotise me but here I am eating sweets.' The second week we discussed my eating habits again. I told her how, in a nice restaurant, I had been too uncomfortable to tell the waiter I didn't want the sauce or breadcrumbs. So we worked on my confidence, remembering three times in my life I had felt especially confident.
I didn't see the point of this. I am a confident person generally, so why was she making me tap into past memories to make myself confident?

However, by the third session, I'd lost 7lb. I was amazed when I got on the scales. But looking at my food diary, I realised I hadn't eaten chunky chips, spaghetti or bread since session one. I just hadn't fancied them. Instead, even though I have never been a protein person, every meal I'd eaten had been based around protein. My dress size has shrunk from a 14 to a 12.
Monica has told me to give myself 20 sit-ups when I'm asleep. It doesn't mean I'll be jumping up and down in my bed when I'm asleep, it means my stomach will contract my muscles without me knowing it.
She 'told' my stomach to do this, and of course I've no idea if my body is doing it, but my stomach is flatter.
Even though the results speak for themselves, I'm still not sure I believe in hypnotherapy - I think it's more to do with the power of suggestion, and that you'd have to keep going to the sessions for it to keep working.

Helena McCarthy, 42, is a businesswoman who lives in Little Venice, north London. She is single.
Number of sessions: 6
Height: 5ft 7in
Pre-hypnotherapy weight: 13st 6lb
Post-hypnotherapy weight: 12st 4lb
Total weight loss: 16lb

She says: I've always been a yo-yo dieter. When I was younger I suffered from anorexia, so my weight has always been an issue. When I recovered I weighed 10 stone, and remained a size 10 for years. But seven years ago I broke up with a boyfriend and was made redundant twice in one year, and ballooned to a size 18. I've never been a really big eater but I'd always eat too quickly. Monica said that mine wasn't a food issue but an emotional one: while some people are obsessed with food I was just eating the wrong things too quickly.

I'm always skipping meals then eating something horrible like a huge greasy fry-up which I wolf down and then feel ill afterwards. It means I always get indigestion.

For me, hypnotherapy was a last ditch attempt, as I had tried to many different fads in the past. Atkins made me feel ill and constipated, the GI diet meant I had to change everything in my fridge. I found WeightWatchers and Slimming World dreadful - parodies of the ones you see in TV comedies.

Monica and I had a long conversation about my eating patterns, as I lay with my eyes closed. When she said: 'You will not be able to open your eyes,' I thought 'Yeah, right' but then I tried to open them and couldn't. I very quickly went into a hypnotic state, and later was amazed at how refreshed and full of energy I felt.

She talked to me a lot about how and when to eat, such as that I should take a bite, put my knife and fork down, and count for 20 seconds before I take another bite. She said that when I eat too much I override my brain which is telling me I'm full.

Now I realise when I have hit the satiation point and should stop eating.
I'm not worried I'll slip back into anorexia as I still eat well - I am now more in control.
At each session, we'd discuss how my week had gone and help build my self-esteem. Now my eating habits have totally changed. I couldn't even finish a sandwich today. Before, I was buying salads and extra things to put in them because they were too small.
Now I can't finish them all, and my need for lots of food has lessened.
So far I've lost more than a stone.
I'm still not where I want to be, but everyone is commenting on how well I look. I'd like to lose another 2st 4lb, and I know I can do it. I plan to keep seeing Monica maybe once a month because the hypnotherapy has changed my life.

Nicola Gregson, 34, is a marketing director who lives near Hitchin in Hertfordshire. She is married to Mark, 39, a catering director, and they have a 20-month-old daughter, Tulip.
Number of sessions: 2
Height: 5ft 4in
Pre-hypnotherapy weight: 13st
Post-hypnotherapy weight: 12st 2lb
Total weight loss: 12lb
She says: Food has always played a big role in my life. I have travelled all round the world doing cookery courses, in India and Thailand. But lately my life has become chaotic, juggling home-life with long hours at work, and eating the wrong kinds of food at the wrong times of the day.
I had started putting on weight about a year before I got pregnant. I had always been a comfortable size 14, then I ballooned to a size 18. I never ate chocolate and biscuits but I like full-fat cheeses, meats and pasta.
My husband and I would share a bottle of wine every evening, which definitely added to my weight gain.
I've never even tried to diet before, let alone hypnotherapy, so visiting Monica was new territory. During the first session I tried to remain open-minded, but thought she'd tell me off for liking my food so much.
Instead, we talked about my eating habits for about an hour, then I lay down. I could hear things going on around me, but I was relaxed and able to take in what you hear.
We talked about the triggers that I have for eating, going right back to when I was a child and was told I couldn't leave the table until I'd finished, through to why I comfort eat as an adult. It was common sense really, but made me think again about what I was eating, and why.
I felt empowered and understood at last why I ate the way I did and what triggers, such as stress, made me eat certain foods.

I started implementing Monica's suggested changes in the way I eat. It was easy. Now, I eat smaller portions at better times of the day instead of stuffing myself hours after I've skipped a meal. I've lost 12lb in six weeks. I'm not worried I'll put the weight back on. My whole philosophy has changed and I don't want to eat that rubbish any more.

Joanna Denman, 51, is a support worker for people with dementia.
She lives in Fulham, West London, is divorced and has one daughter, Gemma, 21, and a son, Oliver, 17.
Number of sessions: 6
Height: 5ft 9in
Pre-hypnotherapy weight: 15st
Post-hypnotherapy weight: 14st 4lb
Total weight loss: 10lb

She says: When I went back to university in my 40s, I was going through a painful divorce. It was very stressful and I started drinking. After a while things calmed down but when I packed the alcohol in, food took its place. I'd eat too much at lunchtime then go home and eat a lot again.

The weight quickly started to pile on. I've never been on a sensible diet although I've had issues with my weight for years. I knew that the only way to lose weight and keep it off was to change my mindset.
When it came to hypnotherapy I had ideas of entertainers making people jump around pretending to be a monkey, but thankfully, it was nothing like that.

What Monica did was give me very positive messages and mantras to repeat about my goals in life while I was in an almost sleep-like state - which makes it easier for them to get through.

She has given me insight into the triggers that set off my binge-eating, helping me to understand how I eat more when I'm tired or stressed. So now I take a step back from the fridge, breathe deeply, try to relax and pinch my fingers together to make me focus. I stand quietly for a minute, then if I realise I'm not really hungry, I make myself a cup of tea and sit down.

I have completely stopped overeating and have a greater feeling of wellbeing. I still enjoy food but have stopped using it as a crutch. When I now go food shopping, I am always thinking of what I want to eat and how to make healthy choices. I want to nourish my body rather than abuse it. These are subtle messages I give to myself, rather than tearing around trying to stuff my face.
I've still got miles to go as I reckon I was at least three stone overweight. But this has given me a kick-start, and even my children have noticed that my stomach has shrunk. When you're in your 50s and start putting weight on slowly, it can so easily get out of control.

Hypnotherapist Monica Black says: It's amazing how many people are sceptical of hypnotherapy because they immediately think of stage hypnotists and people going around clucking like a chicken.

But clinical hypnotherapy is different. The client is in control the whole time and the hypnotherapist cannot make somebody do something against their core beliefs.

That means we can't make anyone go out and rob a bank, but similarly we can't make someone lose weight if they don't want to. For weight loss, it's necessary to look at the client's lifestyle: why do they overeat? Do they comfort eat, or eat when they're bored or stressed? We then address the issue. If they eat when they are stressed we give them coping mechanisms such as relaxation exercises, or teach them acupressure points on the body which aids calming. If they eat when they're bored, we help them find a hobby.
But only people who are prepared to alter their lifestyle and want to lose weight will be successful. They need to be open to suggestions I make while they are under hypnosis.

I use coaching and hypnotherapy to motivate people to change their relationship with food. It also changes their attitude about themselves, and gives them confidence and self-esteem.

Publication link: http://www.dailymail.co.uk

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