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Medical Hypnosis: An Underutilized Treatment Approach S

By Brian Alman, PhD

Abstract

Context: Use of hypnosis in medical practice has long been controversial, but recent developments in medical hypnosis--in particular, the understanding that the power of hypnosis resides mainly in the patient--have profound implications for treatment.

Objective: To illustrate and explain the therapeutically useful application of hypnosis in medical practice.
Design: Case series.

Setting: Department of Preventive Medicine at Kaiser Permanente Medical Center, San Diego.
Patients: Five outpatient Health Plan members referred to a department of preventive medicine for alleviation of physical, emotional, or behavioral symptoms.

Main outcome measures: Extent and duration of clinical recovery.

Results: Patients in all five cases had dramatically successful clinical outcomes after three or fewer intensive hypnotherapeutic sessions.

Conclusions: Medical hypnosis is an underutilized therapeutic modality which can be learned easily for everyday use in medical practice, especially when taking the medical history. In this era of emphasis on cost-effectiveness, both medical hypnosis and certain parahypnotic techniques (eg, closed-eye history taking) may be of special interest to physicians.

Introduction

Hypnosis is a state of highly focused attention (trance) in which external stimuli are disattended and suggestion becomes far more effective than usual.1 The fundamental usefulness of hypnosis in medicine and healing has been controversial for more than 200 years, ie, since Anton Mesmer produced the body of work now recognized as the beginning of clinical hypnosis. Does medical hypnosis work? If so, how? Does it produce real bodily healing at the physiologic level, or is its therapeutic effect merely the result of imagined comfort--and thus to be found in the mind only? These questions are reasonable and can best be addressed by clinical observation aided by modern technology.

The most clinically significant recent development in medical hypnosis is our understanding that the power of hypnosis actually resides in the patient and not in the doctor. This simple statement has profound implications because it implies existence of useful potential within each patient. The goal of modern medical hypnosis is to help patients use this unconscious potential--a revolutionary shift from the direction-focused, authoritarian therapeutic techniques of the past.

By contrast, modern medicine involves a highly rational belief system that minimizes the importance of autonomous therapeutic processes. This belief system has created an expectation that everything can be accomplished on a conscious and voluntary level, even though such voluntary efforts can sometimes obstruct natural healing processes. Notwithstanding this possible obstruction, a cumulative effect can be attained by simultaneously using the opposing concept that underlies modern medicine with medical hypnosis.

To support these statements and to illustrate the range of possible treatments, this article describes five patients who were treated with medical hypnosis after being referred to me from the Kaiser Permanente (KP) Department of Preventive Medicine in San Diego. Focusing on these five clinical examples presents the opportunity to answer three questions:
What is medical hypnosis?
How does medical hypnosis work, especially when no specific directions or suggestions are given?
When should medical hypnosis be used?

Discussion

Historically, medical hypnosis was identified with surgical anesthesia2 and with removal of symptoms. Medical hypnosis was defined as a state of heightened suggestibility in which something is done to a patient. From this interpretation--one in which hypnosis commands away the symptom--our definition has evolved to a subtler form that more effectively brings basic, long-lasting change. Because this description may seem undramatic to those who are familiar only with the commands of stage hypnosis--or with its often magical depiction in motion pictures--the distinction bears some elaboration.3

Medical hypnosis is quite different from the "command performance" of stage hypnosis, an activity that depends heavily on the practitioner's ability to quickly select from an audience those subjects who can be readily hypnotized.4 Stage hypnosis is also highly directed as to outcome ("You will sing like Frank Sinatra," "You will quack like a duck," etc). This directiveness can be dramatic and engaging, but it has limited utility. Unlike practitioners of stage hypnosis, physicians do not have the luxury of selecting subjects on the basis of perceived ease of outcome. In fact, for many patients, the problem is so complex that its resolution requires total dependence on unconscious processes occurring within the patient.5 For example, in none of the cases described were outcomes suggested; indeed, some outcomes were unanticipated. Research has shown that attempts to cure by specific direction and command have a high failure rate because of the unrecognized complexity underlying many patient problems.6

When we speak of medical hypnosis, we refer to a special type of interchange between two people--an interchange that involves trance. Trance can occur at many levels ranging from rapt attention with eyes open (entranced) to deep states that resemble somnolence. Whatever its depth, hypnotic trance has consistently been determined to have no relation to the state of sleep; hypnotic trance is physiologically a type of waking state. Moreover, just as an abdominal incision is itself not treatment but is instead the means through which surgical treatment may be done, hypnotic trance is not a treatment per se; instead, hypnotic trance is the framework in which treatment can more effectively be carried out. The goal is not to hypnotize someone; the goal is to accomplish a therapeutically valuable result during hypnotic trance.

Foundational Theories of Medical Hypnosis

Dr Milton Erickson--physician, psychotherapist, teacher, and arguably the consummate medical hypnotherapist of the 20th century--emphasized the need for practitioners to individualize their approach to hypnosis.9 Erickson believed that the hypnotherapist must understand, evaluate, accept, and use the unique aspects of each patient. Erickson's often-extraordinary results occurred precisely because they activated and further developed what was already within the patient instead of trying to impose from the outside an element that might be unacceptable for that individual's personality. Although easy to describe, this process is difficult to accomplish without extensive practice. To understand what can be accomplished in medical hypnosis--and to obtain a detailed explanation of the underlying concepts--I suggest you read "The February Man."10 This monograph provides a verbatim transcript and detailed explanation of one remarkable case in which Dr Erickson definitively treated the patient in four sessions, during which the patient believed that she was merely providing background information as the prelude to treatment.

In Dr Erickson's approach, all symptoms are viewed as signals. In this approach, the hypotherapist asks, "What is this patient trying to tell us with a headache, chronic fatigue, or recurring, stress-related skin disorder?" Some patients may present through their own imagery a metaphor about their emotions that ultimately helps expand the patient's conscious understanding.11
How Hypnosis Works

That medical hypnosis works is clear from the case examples given and from extensive clinical and experimental literature. However, the mechanisms of hypnosis and reasons for its effectiveness raise vastly more complex questions. Nonetheless, this situation is not different from that of aspirin, which was used effectively for more than half a century without anyone understanding how or why it worked. Like uses of hypnosis, some of aspirin's uses have been discovered only recently--and more may well be found. The five cases described in this article illustrate only our current understanding that the power of hypnosis resides in the patient.9,12 The power of hypnosis certainly need not originate in commands; indeed, none were given to our patients. Moreover, enhanced physiologic function (as in Case 1) must be interpreted as resulting from release phenomena, because biologic functions cannot be inserted. This interpretation implies existence of a wealth of material in the patient's unconscious that can be used in healing. This wealth of material is what current medical hypnosis techniques attempt to stimulate.


disadur dari group facebook "Clinical Hypnotherapy & Transpersonal Psychotherapy (2)"

Gunawan CHt

Smoking in Public Places ???

Smoking in Public Places
Should be Banned???*

*(you can answer by your self after read this one)

Smoke..smoking..smoker..

Some people like smoke very much. After they take a meal, in the free time, when they try to killing their time, when somebody get stress and so on..and so on.. ; means ; they smoking every time. Furthermore (if we don't want to say 'the worst'), they smoke everywhere. On the street, in their own room, in somebody room, in dining room, open area, closed area, by them self, in front of the other (including not smoker one), with or without looking the other (they pleased or no about it) and so on..and so on..

The other side, some people doesn't like smoking. They hate smoke ("it can kill you slowly", they said) and they hate smoker also ("it because sometimes they didn't care about the other", they adding). And the rest of the people felt fair enough for this, as long as the smoker care about the other.

Referring to the scientist research; such as a doctor, dentist and a chemistry scientist; they said that the smoke which spread out from the mouth of the smoker containing some danger substances. For the examples are ; first, CO2 or Carbon dioxide can make a hole in somebodies lung. It will make him/her felling pain when they take a breath. The second is nicotine. It can make your teeth become yellow, make your throat itchy and irritated and nicotine can make you get a hypertension also.. Third, tar (hydrocarbon aromatic). It is almost cause the same effect with nicotine. Not only the tree substances above, they said that cigarette contain a substance that usually can use as a fuel for a rocket, such as a nitrogen and methanol (amazing isn't it???). Of course it very danger substance if somebody consume it.

Not only the substances that was very terrific, but also the effect of the smoke. It can cause some diseases if somebody sniff it in a long time. Let we say; a cancer, tuberculous (TBC), breathing disturbances, lung disease and any other disease that can't be write one by one in this article.

The worst is... "NOT ONLY the smokers who can get the effect, BUT ALSO the other around the smoker effected, even can be worst", the doctor said. Why? It's because the smokers spread out the toxin, and the spread toxin has a lot of substances that have a danger one and it sniffed by the other people around the smokers. So if somebody smoking between 10 person around him, the smoke can affected to all people in that room. It's mean that 1 person who smoke can make 11 peoples get the diseases. What kind of diseases are they anyway? It's a lot of diseases.. (just check it out, please..!!)

(this is for active smokers)

(...and this is for passive smokers)

So.. what will be happen if someone free to smoke in public area? it can affect to a large amount of people around there.. diseases seed are spread everywhere. Bacterias and many of viruses can fly and stick freely everywhere.. means that we have to be alert with the diseases that spread everywhere..

Finally, lets back to the first sentence in this article. Smoking in Public Places Should be Banned.

are you agree with this statement or not ???

you can answer by you self..

*information collected from many sources

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Waiting a baby...

"Waiting is a boring thing.. bikin pusing bikin garing.." (The Changcuters in The Tarix Jabrig)

---------------------------------------

Yeah..waiting is a boring thing...

just like when i have to waiting my baby delivered... it seems so long.. "where is the baby?.. why don't you come yet???"... it have been 2 days since doctors prediction..

but..waiting with patient will get a sweet result...

Alhamdulillah..

Monday, 15th September 2008 at 08.29 pm (wib)...finally..she's come to this world....

uhhhhh... happy to see.. normal born and safe..eventhough she is so small (with 2,6 kg / 47 cm), but she's so cute.. nice and sweet girl..

we give her name... Kanzha Septara Zenobia Nugroho.. its mean "Beloved child that can be trust, able to endure and earnestly..", "Septara" mean that she was born on September and "Nugroho" is her fathers last name..

i love you my little kid.. thanks my wife, for delivering our baby...

Thanks GOD, thanks ya Allah for your gift that you gave to me and my family.. give her the best in her life, make her a girl / women with a gold in her hearth and beautiful in her face.. and make her useful and devoting to her country, religion and her parents... amin...

The International Day

in indonesia:

Masih inget kerja keras kita selama 3 harian? sudah selayaknya kan kita masuk majalah, hehehehe....

in english:

still remember our hardwork in 3 days? its deserve to us to be "a covermag guys", hehehehe....

The Psychology of STRESS

It might seem like a simple concept. We toss the word around every day. Stress. But what does stress really mean? Is it the same thing as physiological arousal? Is is the same thing as “workload”? Is it any different from anxiety or unconscious anger? Is it the cause of trauma? Is it anything at all? Is it just a “myth”? [1]

Change
Let’s begin with the concept of change, because life is a process of change. Therefore, anything that involves change contains within it the “demand” that we adapt to it, in one way or another. Graduating from school can be as demanding as starting school, and starting a new job can be as demanding as losing a job.

How we perceive the change really determines how we manage to adapt to it.

If the perception is positive, we generally embrace the change with open arms and relief. And the story essentially ends there.

If the perception is negative—that is, if the change challenges our stamina or resources—the body will automatically—and dramatically—respond to this perceived threat with a variety of physiological responses.

Physiological Responses to Change

Early in the 20th century, Walter Cannon’s research in biological psychology led him to describe the “fight or flight” response of the Sympathetic Nervous System (SNS) to threats.[2] Cannon found that SNS arousal in response to a perceived threat involves several elements which prepare the body physiologically either to take a stand and fight off an attacker or to flee from the danger:

• Heart rate and blood pressure increase
• Perspiration increases
• Hearing and vision become more acute
• Hands and feet get cold, because blood is directed away from the extremities to the large muscles in order to prepare for fighting or fleeing.

Hans Selye [3] first popularized the concept of “stress” in the 1950s. Selye theorized that all individuals respond to all types of threatening situations in the same manner, and he called this the General Adaptation Syndrome (GAS). He claimed that, in addition to SNS arousal, other bodily systems such as the adrenal cortex and pituitary gland may be involved in a response to threat. For example, chemicals such as epinephrine (adrenaline) may serve to focus the body’s attention just on immediate self-preservation by inhibiting such functions as digestion, reproduction, tissue repair, and immune responses. Ultimately, as the threat wanes, Selye suggested, body functions return to normal, allowing the body to focus on healing and growth again. But if the threat is prolonged and chronic, the SNS arousal never gets “turned off,” and health can be impaired. With a continuously suppressed immune system, for example, a person would be more vulnerable than usual to infection—which is one explanation of why some individuals get sick so often.[4]

And, regardless of whether Selye was right or not, psychology, as well as medicine and popular culture, have accepted the concept of “stress” as an unpleasant fact of life.

Reducing Physiological Arousal

Physiological arousal can be uncomfortable and distracting in situations that might feel threatening but don’t involve an actual threat. Fortunately, this sort of arousal can be reduced by practicing some form of relaxation. A basic relaxation technique such as Progressive Muscle Relaxation (PMR) consciously helps muscles to relax, and, because muscle tension is one of the triggers of arousal, the PMR process, by decreasing muscle tension, essentially tells the body that the perceived danger is over and that systems can return to normal. More advanced forms of relaxation, such as autogenics and prayer, cause muscle relaxation through mental imagery.

Hence these forms of relaxation don’t just help to turn off the physiological symptoms of arousal—in the imagination they can actually change one’s view of change, so to speak, so that a change isn’t perceived as a threat in the first place. This is why the benefits of advanced relaxation techniques extend beyond their physiological benefits and can lead to enhanced performance, greater self-esteem, and serenity of mind.

What is “Stress”?

Given what we know about the physiology of arousal due to perceived threats, and given what we know about relaxation techniques to diminish that arousal, what can be said about the concept of “stress”?

Well, actually, not much.

A person could, for example, experience a job loss and respond to its perceived threat not with healthy problem-solving but with anger. This anger may be conscious or unconscious, but as long as it persists a state of physiological arousal will be maintained. In addition, perhaps this unfortunate person will experience a Major Depressive Episode or will develop an Anxiety Disorder.

In traditional terms it could be said that this person is under intense stress. In fact, because of Selye’s influence, psychology and medicine have tended to regard “stress” as if it were some “thing” that could destroy our health and happiness even against our wills.

But it could just as well be said that the person in the example has simply failed to accept change in a healthy, adaptive manner.

So maybe “stress” isn’t any “thing” at all. Maybe it’s just a descriptive term that our culture uses to normalize unconscious anger, a fear of love, a lack of forgiveness, a desperate clinging to a vain identity, and an absence of a spiritual life. Maybe “stress” is just a convenient myth to shift responsibility for life away from ourselves and onto something so vague that everyone can love to hate it.

But those who accept the discipline of a relaxation technique are at least taking a positive step—not to fighting “stress,” but toward living responsible lives.

--> http://www.guidetopsychology.com/

Quiz VS My Concentrate

Today.. we've got our first quiz...
you know? i can't concentrate all day.. actually since yesterday.. that was since i tried to get a permission to go home.. You know what? the principle just permit me for a day !!! one limited day !!!
Of course it's shocking me.. i can't imagine how can i goin' home just for a day???? i try to get my permission for waiting my baby birth.. my first baby guys...!!!!

i think it's too cruel.. for me my self, my wife and for my child of course..!!!

THAT'S WHY... i can't concentrate all day.. i can't even closed my eyes last night..
and consequently.. i can't doin' my quiz right..

Malam Ngobrol Indonesia - Australia

Pretty cool huh...

Tonight I've been invited to the Indonesian - Australian Chatting Night (malam ngobrol)... in the Chief of Defense Attache house on Purnawarman Street 144 Jakarta.

I never imagine before that I will attended to the party like that.. It quite fun... we can learn more about australian people.. try to speak so much (in english of course).. and they talking in Indonesia language.. and it happen.. we understand each other.

Wow..

it is so impressive.. we learn each other.. different country and speak in the opposite language..hahaha.. we chatting a lot, eat a lot, drink a lot and sing a lot.. all together.. It is quite fun mate.. I really enjoy this night..

Thanks God.. for everything that you've been gave to me..

Alhamdulillah...

Thanks GOD

Thanks GOD...
Finally I can make my own blog.. I never dream to make my own blog... actually, since I posted in Supadio Air Force Base, it is difficult to get an internet connection.. I have to go to the uptown to get an internet connection. Mean..I have to drive for 15 km from my home..

Thanks GOD...
You give me a chance to take a study in Jakarta, although just for 3 months. Mean, I can learn to make a kind of blog like this one.. Coz I think that I will never try to make something like this if You never give me a chance to come here.

Thanks God...
Eventhough that my blog is still not perfect...not good enough.. and may be not proper to anyone who know about internet system or the other blogger, but I still thanks to You.. I know my blog is still the simple things.. coz I am a beginner here..

So God...
Give me a lot of courage and curiosity to make it better..

And God..
thanks a lot for your kindness..

How to be a good LEADER..

We know that there is a lot of worker / employee has been retired in the last two years. Referring to the research, they are quit from his/her work not only because of the job...but it's because of their supervisor.

So, if you are supervisor / senior or superior, be wise to them. Give them 'the high motivation' to catch their own career. Do not ever kill their creativity, because it is the important one that can make your unit Strong.

To motivate your employee / subordinate not enough by pushing 'em to motivate their behavior. But you must keep doing to "Do Not Killing" their spirit.

Here are some tips for you to be a good leader :

Do not seeing your sub ordinate like a tools. As a superordinate / manager / leader, you have a right to use your subordinate to get your purposes. But if you don't pay any attention or any respect to them, you will lost your sympathy.

Do not criticizing your subordinate in front of the other. That will be embarrassing your subordinate, even-though that everything you say is true. When somebody get embarrassed in front of the other, his/her spirit will be decrease quickly.

Do not unfair to one or some of them. Discrimination behavior can be very easy to make a jealousy feeling. Then, it will be disunion in your unit.

Do not ever and ever doubt your own decision. If it happen, it will make your team confuse and they will doubt your ability. So that, just careful if you wanna take a decision. Think it couple time and be wise to them.

Have a nice try... :)