Hypnotized by skepticism

When hypnosis was first introduced to the European public more than a century ago, it was widely denounced by skeptics as a mere stage trick. Even when a hypnotized patient underwent surgery without anesthesia, showing no pain, the skeptics refused to believe anything more than a ruse was involved. The patient, they claimed, had obviously entered into an agreement with the surgeon to remain quiet through the operation!

I had assumed that such attitudes had long since faded. But while doing a little online research on Derren Brown, I came across some skeptical comments on hypnosis (which Brown is alleged to employ). The claim about Brown is that he practices "involuntary hypnosis" - hypnotizing his subjects without their knowledge or consent. I have no reason to think that involuntary hypnosis is possible. What surprised me, though, is that some skeptics still have their doubts about even conventional hypnosis.

Here is superskeptic James Randi:

... hypnosis is merely an agreement between the subject and the operator that they will fantasize together, nothing more. It may well have some limited value as a psychiatric tool, but it's not a "power," it's not a "force," it's a role-playing game, and only highly emotional persons will react as [a particular subject] did. She probably would have reacted to any suggestion, by anyone, that would produce imaginary events and the resultant trauma.

And here's Robert Todd Carroll of the Skeptic's Dictionary:

Most of what is known about hypnosis, as opposed to what is believed, has come from studies on the subjects of hypnosis. We know that there is a significant correlation between being able to be absorbed in imaginative activity and being responsive to hypnosis. We know that those who are fantasy-prone are also likely to make excellent hypnotic subjects. We know that vivid imagery enhances suggestibility. We know that those who think hypnosis is rubbish can’t be hypnotized.... [Many hypnotists dispute this claim - MP.]

If hypnosis is not an altered state or gateway to a mystical and occult unconscious mind, then what is it? [Psychologist Robert] Baker claims that what we call hypnosis is actually a form of learned social behavior.

The hypnotist and subject learn what is expected of their roles and reinforce each other by their performances. The hypnotist provides the suggestions and the subject responds to the suggestions. The rest of the behavior--the hypnotist’s repetition of sounds or gestures, his soft, relaxing voice, etc., and the trance-like pose or sleep-like repose of the subject, etc.--are just window dressing, part of the drama that makes hypnosis seem mysterious.

Now, if hypnosis is nothing but role playing, then it's hard to see how the surgery patient was able to get through his operation without "breaking character." But skeptics will object that the surgery experiment happened many years ago. (They seem to think that old data are somehow inherently unreliable. This saves them the trouble of actually looking at or responding to these data.)

So are the any contemporary uses of hypnotism in the context of surgery? It appears there are. A Google search for the terms "surgery" + "hypnosis" turned up "about 1,500,000 English pages."

Here's part of a 1998 article in NurseWeek:

Imagine having a lump the size of an orange carved out of your breast without anesthesia or feeling no pain as the surgeon drives a pin into the bone marrow of your fractured leg without a chemical pain reliever. Hypnosis, when used by properly trained healthcare professionals, can refocus patients’ minds and alleviate their pain.

Patients under hypnosis may still feel pressure or pulling, but healthcare professionals can use hypnosis to suggest that those sensations are good....

[T]he American Association of Nurse Anesthetists ... recognizes the technique as a valid form of analgesia....

In fact, studies have shown that patients undergoing hypnosis before, during, or after surgery need less pain medication and heal more quickly.

Here's the Harvard University Gazette:

Marie McBrown was invited to test whether or not hypnosis would help heal the scars from her breast surgery. Marie (not her real name) and 17 other women underwent surgery to reduce their breast size....

The pain and course of healing from such surgery is well-known, and a team of researchers headed by Carol Ginandes of Harvard Medical School and Patricia Brooks of the Union Institute in Cincinnati wanted to determine if hypnosis could speed wound healing and recovery....

The result was clear. Marie McBrown and the women who had undergone hypnosis healed significantly faster than the others. Those who received supportive attention came in second....

Four years ago, Ginandes and Daniel Rosenthal, professor of radiology at the Harvard Medical School, published a report on their study of hypnosis to speed up the mending of broken bones. They recruited 12 people with broken ankles who did not require surgery and who received the usual treatment at Massachusetts General Hospital in Boston. In addition, Ginandes hypnotized half of them once a week for 12 weeks, while the other half received only normal treatment....

The result stood out like a sore ankle. Those who were hypnotized healed faster than those who were not. Six weeks after the fracture, those in the hypnosis group showed the equivalent of eight and a half weeks of healing.

That's some mighty good role playing!

Finally, here's New Scientist magazine, with all emphases added:

As the surgeon's knife cut into her chest, 46-year-old Pippa Plaisted should have been in agony. The 45-minute breast cancer operation she was undergoing at the Lister Hospital in London would normally have needed a general anaesthetic. But Plaisted had not been anaesthetised, nor given painkilling drugs of any sort. Instead, hypnotherapist Charles Montigue stood at the operating table, his thumb resting on Plaisted's forehead, monitoring the hypnotic trance he had put her in minutes before the operation began. Eyes closed but awake, Plaisted could hear the surgeon calmly telling her, at each stage of the operation, what was going to happen next.... Astonishingly, the hypnosis succeeded in making her operation entirely pain-free. "The surgeon was cutting and sewing inside me, but I could not feel any sensation at all," Plaisted recalls....

In Liege Hospital, Belgium, anaesthetists routinely use a procedure that they call "hypnosedation".

They have found that when combined with local anaesthetic and much-reduced amounts of other analgesic drugs, medical hypnosis is an effective alternative to general anaesthesia. So far, the Liege team have used this technique in over 4800 major and minor operations. Now other hospital departments are beginning to follow suit.

Meanwhile, the Liege team are discovering that hypnosedation has some remarkable benefits. For a start, patients bleed less.... One reason for this reduced bleeding, [anesthestist Marie-Elisabeth] Faymonville says, is that anaesthetic drugs inhibit the natural tendency for blood vessels to constrict in reaction to an incision. Patients under general anaesthesia also have to be ventilated with a respirator. "This creates a positive pressure in the chest, which increases bleeding," Faymonville says. "In hypnosedation patients breathe spontaneously."

Because hypnotised patients are conscious throughout the operation they can even cooperate with the surgeon....

Hypnosedation also seems to improve recovery time. In 2000, Faymonville's team compared 20 patients undergoing thyroid surgery under hypnosedation with 20 patients undergoing the same surgery under general anaesthesia. Whereas the anaesthetised patients spent an average of 36 days recovering from the operation, those that had been hypnosedated returned to work after an average of only 10 days. The main difference, the team found, was a reduced level of inflammation in the hypnosedated group....

Neuroscientists are only just beginning to understand how hypnosis can reduce sensations of pain. In November, researchers at the University of Iowa in Iowa City published a study that used functional magnetic resonance imaging (fMRI) to compare the brain activity of hypnotised and non-hypnotised volunteers when they were exposed to painful heat. The fMRI images showed that brain activity in the two groups differed significantly. The response of their subcortical neural network, where pain signals start, was unaffected. However, there were remarkable differences in the higher parts of the pain network. Activity in the primary sensory cortex, the area responsible for feeling pain, was dampened down.

Once again, the skeptics are behind the curve. Trapped by a hopelessly rigid worldview, they simply cannot absorb new information - even when the "new" information in question is more than a century old. Meanwhile, the world moves on, leaving Robert Carroll and James Randi ever further behind.

Comments

[Darryn]

Absolutely spot-on as usual Michael.

There was a documentary here a few months ago that was entirely a LIVE hernia operation with hypnosis alone as analgesic and anaesthetic. The fellow operated on was frightened of general anaesthesia and went down this route. Forget Big Brother, this is what reality TV's about!

Hernia removal is no mild painless thing, it should be said, but the guy felt no pain throughout, and was up and walking minutes after being stitched up. He claimed only to be aware of being worked on, and nothing in the way of discomfort or pain. The subject's mother was on hand throughout the thing, and constantly expressed bewilderment to the interviewer at how this was not employed more routinely.

They also featured a Belgian hospital (presumably the one you mention in your piece) where operations are routinely conducted with hypnosis and mild sedation as the only form of pain control. One woman they featured had I believe a large mass in her neck, painlessly removed.

On the discussion panel was an anesthesiologist who expressed visible nonchalance, even scorn, at the notion that hypnosis could have a role in surgery.

I think it's desperately sad that this remarkable state has been trivialised for over a century, despite visibly successful use in surgery since Esdaile and in psychotherapy since Milton Erickson. Erickson was really an extraordinary person I'd encourage you to take the time to look into.

Just discovered Channel 4 has the entire video on its site! Do check it out. http://www.channel4.com/more4/event/H/hypnosurgery/hypnosurgerylive.html

[Michael Prescott]

The Channel 4 link didn't quite come through, so here it is, along with related material. Thanks, Darryn!

[jimbo]

While googling around in response to this, I came across Randi approvingly quoting "The Amazing Kreskin" to the effect that "hypnosis does not exist" (which seemed odd to me based on what little I remembered about Kreskin, but on furthur reading it seems Kreskin is denying that there is such a thing as a "hypnotic state", not that suggestion can't do what it so obviously does. Seems like splitting hairs, to me. But then I came across this interview:

http://littleegyptmagic.com/kreskint.htm

Here's an interesting bit:

"On to the tough questions. I note that, like Ricky Jay, Kreskin performs primarily for the lay public. We never hear of him performing at the Magic Castle, or at magician's conventions. I ask to what extent that is a deliberate disassociation.

Well, you ask the question, you get the answer. It goes like this: Since 18, Kreskin has claimed to be legitimate. Working as a "magician" would compromise that stance. He also feels that most modern magicians are unwilling to accommodate that stance. Along with his friend the late Bob Lund, he deplores a lack of spirituality among magicians. [I didn't have time to ask if he is aware of the philosophies of theologian-magicians such as Eugene Burger and Robert Neale, or of Jeff McBride's Mystery School.] He says that, despite his debunking of sham spiritualists, Houdini believed in telepathy, as did Robert Houdin and Thurston, and that Kellar believed in precognition. At Seton Hall, Kreskin majored in psychology and minored in religious philosophy. He feels that modern magicians believe that God is dead and that they have taken his place, that one must be an atheist to become a card-carrying magician. This also led into a disapproval of modern magic clubs [we are back on a track I can relate to better]. He noted that in its early days the S.A.M. was a somewhat clandestine organization of professionals. Today it's different. The pointed analogy is that there is no way the American Medical Association would consider having a plumber as its president, but a "magician's" society wouldn't hesitate."

[alanborky]

Robert Todd Carroll's remark, "We know that those who think hypnosis is rubbish can’t be hypnotized..." alerted me to the fact in some ways ARCH skeptics like himself resemble those Gnostics of yore who believed this world was a kind of illusion created by a false - evil - god, the Demiurgos, making it our duty to break free of the magic spell he used to convince us this level of existence was the only reality; only in Carroll's case, he's playing for the other side, so to speak, hence HE's trying to save the rest of us from nefarious 'magic spells' capable of deluding us into believing in IMAGINARY additional orders of existence; and though he'd probably dispute the implication of religious zeal on his part, if he and his fellow 'believers' are really so convinced of their point of view why waste so much time and energy trying to convince the rest of us we're wrong? For instance, if I were to tell you Liverpool FC are the greatest football club in the history of the Universe, you'd of course be unable to dispute this, because as we all KNOW - as Carroll or Randi might say - this is a stone cold PROVEN scientific FACT; but if, hypothetically, you were to then insist it was Spurs or - God forbid! - Man U, whilst I might be concerned for your mental welfare, I wouldn't otherwise be bothered because, as we all KNOW, my point of view is a scientific FACT; but if I were instead to suddenly start arguing the toss that the fact the Hindu equivalent of Adam is called MANU is just a coincidence, you might be forgiven for wondering if I was actually as certain as I claimed to be.

In short, such is the intensity under which this particular argument can be conducted, it sometimes seems to me as if both sides have a strange fear Reality is being secretly reformatted before our very eyes and whoever wins the argument will get to determine the new parameters under which Reality will thereafter be conducted.

(P.S., keep up the blogs, because while I sometimes disagree with you, [I actually thought 'Fight Club' was good, though missing the first half hour of it might have something to do with that...], I quite like the meandering and delving course your interests take and, aboveall, your ability to observe things like changes in yourself over time, [as in your observations of the different ways you would've reacted to Robert Anton Wilson at different periods of your life], plus your ability to admit it when you think you're wrong, [eg. over waterboarding]).

[Glen Raphael]

"They seem to think that old data are somehow inherently unreliable."

Old data /are/ inherently unreliable when it comes to any situation where deliberate trickery might have been involved. Every magician knows that the trick the audience /remembers/ seeing is vastly more impressive than what actually happened. We have "old data" to support sightings of bigfoot, the loch ness monster, UFOs, and so on. Once enough time has passed, it becomes nearly impossible to determine whether the person who made such a claim was (a) a truthful observer of a real event, (b) a truthful observer who was fooled by a hoaxer or magician, or (c) an unreliable witness who accidentally or deliberately misinterpreted what was claimed to be seen.

Memories are fallible and written accounts can be forged or changed. A magician knows that you simply /cannot trust/ a layman's eyewitness account - or even a scientist's eyewitness account - of a magic act; it's not unreasonable to extend the same logic to old accounts of possibly related phenomena.

[Michael Prescott]

Depends on the case. Bigfoot sightings etc. were not obtained under controlled conditions. In the case of, say, the 1908 Naples sittings with Eusapia Palladino, there were three experienced investigators knowledgable about conjuring, who had exposed scores of phony mediums and who took every conceivable precaution against fraud. We have minute-by-minute stenographic records of the sittings and detailed analyses written immediately afterward. Can there be doubt as to what happened? Yes ... but not reasonable doubt.

[alevangel]

Thanks for an excellent analysis of the hypnotism question. For the record, Randi et al. have (as usual) cherry-picked the psychological press for their "version" of hypnosis. There are two very active schools of thought: (1) hypnotism is a learned socially-conditioned behavior (the socio-psychological view), and (2) hypnotism is an altered state of consciousness characterized by signficant alterations in neural processing (the bio-psychological view). Igorning the bio-psycho view doesn't make it go away -- it only makes the skeptics appear ill-informed and biased.

In 2000, Kosslyn et al. (Kosslyn, S. M., Thompson, W. L., Costantini-Ferrando, M. F., Alpert, N. M., & Spiegel, D. (2000). Hypnotic visual illusion alters color processing in the brain. American Journal of Psychiatry. 157, 1279-1284) demonstrated that the hypnotized person's mentation was dramatically different from the non-hypnotized "simulator" who pretended to be hypnotized. This was the HARD data that psychologists had been awaiting for a century to show that hypnotism was "something more" than just putting on an act. The data have continued to pile up since then, if Randi and friends would bother to read it.

Anita Evangelista

[Alexander Glockner]

I'm curious: who's trivializing - the "skeptics", or Mr. Prescott, Ms. Evangelista, and company?

"Nothing but role playing"? "Just putting on an act"?

Agreements - for instance, marriage or adoption - change behavior and "mentation" all the time. They lead people to perform both everyday kindnesses they wouldn't otherwise do and extreme behaviors such as running into burning houses, lifting some/all of an automobile, and tolerating intense physicial and/or psychological pain.
So why not an ability to reduce pain in surgery, or change blood flow while healing? Heaven knows the hypnotizees are motivated...

The Franklin Commission investigating Mesner didn't say that all of Mesner's patients weren't better; they said that some weren't, and that Mesner's explanations for his techniques didn't explain his successes.
Randi and Carroll don't say that some of the anecdotes cited aren't true; they say that the state hypothesis is unnecessary, and that learned social behavior suffices. (As the Franklin Commission suggested with different words, perhaps.)

Doubting the state of hypnosis is not the same as doubting the anecdotes.

Is a parent dying while trying to save an adopted child role playing or just an act?
I don't think so - it's a combination of learned social behavior (a definition of kinship) with other behavior (the rescue attempt) which is part learned and part hard-wired. Not unlike reduced bleeding, I assert.

Please stop trivializing the learned social behavior hypothesis.

(Note to Mr. Prescott: if hypnosis is a state, then there's a very good chance that involuntary hypnosis is possible. If only "conventional" hypnosis is possible, then the learned social behavior hypothesis is more in line with Occam's razor.)

[Alexander Glockner]

Doh! That will teach me to use the "Preview" button...my bad use of whitespace, and:

It's "Mesmer", of course.

And "Franklin Commission" was not the group's official name, but Ben was a member. See, for instance, http://en.wikipedia.org/wiki/Mesmer

[Bruni Brewin]

As a practising Clinical Hypnotherapist I really don't care what the skeptics think or how they class the phenomenan of hypnosis.

I am just amazed at what might be classed as 'impossible' (whilst in our normal 'conscious' thinking mode) is able to be achieved (whilst we are in the 'sub-conscious' or altered trance state mode).

An 80% success rate was attained over 250 unselected people who all suffered from irritable bowel syndrome (that medication was not able to assist). This was achieved in teaching people how to use their minds to alter the functioning of their gut through the use of hypnosis. The study was well documented - refer to the Department of Medicine, University Hospital of South Manchester,Manchester, United Kingdom, by Wendy M Gonsalkorale, Lesley A Houghton and Peter J Whorwell. My own practice using these methods substantiates this success.

I have also taught a client to change his arrythmia through the use of hypnosis. Having the prospect of having not only a pacemaker but also a constrictor placed in his chest to stop his heart from going as fast as 200 beats per minute and varying down to 30 beats per minute, believe me this client is a firm believer of hypnosis. He is now 8 years down the track with no arrythmia and no implants in his chest.

Often these 'so called miracles' occur when all else 'conventional' or main stream has failed. After all, isn't that when you look 'outside the square' to find answers not available in more conventional methods? And no, the above mentioned client did not come with false expectations. Sure he came with hope, but he also came with a skepticism that he would be able to be hypnotised.

Dr Linda Edwards, (Edwards L. (MD); ‘What is depression?’ DepressioNet: www.depresionet.com.au, cited Sept.7, 2006) states the benefits of hypnotherapy as being a powerful tool for accessing the subconscious.

Edwards states that the subconscious is a non-ordinary state of consciousness and that the human psyche is far more amenable to positive change, healing or beneficial reprogramming when we are in an hypnotic state compared to when we are in our usual beta state of consciousness (our thinking mode). Edwards recommends the work of psychiatrist Dr Stanislav Grof who has written numerous books and research articles on the healing power of non-ordinary states of consciousness. Dr Edwards states there is documented evidence that hypnotherapy compares very favourably with the most popular forms of therapy. Her comments are supported by Dr Alfred A Barrios, (Barrios, A.A. (MD) Psychotherapy, 7(1) (the psychotherapy journal of the American Psychiatric Association) who has reported the following success rates:

Hypnotherapy 93% recovery after 6 sessions (about 1.5 months)

BehaviourTherapy 72% recovery after 22 sessions (about 6 months)

Psychotherapy 38% recovery after 600 sessions (about 11.5 months)

If people would just stop debating what hypnosis is or is not, and rely on the research results and then give it a go for themselves with an open mind, they might suprise themselves at what they can achieve.

Regards, Bruni Brewin - President of the Australian Hypnotherapist's Association