Speed Hypnosis Versus Meditative Hypnosis in Clinical Careby Gérard V. Sunnen, M.D.
© 2011 by Gérard V. Sunnen, M.D.
Hypnosis embodies special properties that can make it a potent therapeutic instrument in a spectrum of common clinical conditions. In the hospital, the unique properties of the hypnotic state can lend themselves to the mission of patient preparation for surgery and special procedures, for patient comfort without tranquilizers, and for rapid convalescence. In outpatient settings, hypnotic training can be applied to accelerating the resolution of symptoms, physical and emotional, as it can to developing individual talents, strengths, and aspirations.
Deep controversies continue regarding the very nature of hypnosis itself, and the mechanisms that yield diverse and sometimes dramatic phenomena such as regression in time, memory retrieval, profound relaxation, and anesthesia. In spite of these controversies, however, medical hypnotherapy continues on its expanding journey, integrating itself into many facets of patient care. Indeed, medical hypnosis is increasingly utilized because it has great pragmatic value as a healing agent.
While explaining hypnosis via psychological models of the mind often gets lost in theoretical labyrinths, new methods of investigation are opening avenues of observation and understanding as never before. Remarkably, central nervous system imagery is capable of showing the location, the activation, or the inhibition of neural networks in hypnosis, demonstrating the capacity of the mind to extend its reach far beyond its usual boundaries.
Clinical situations require judgment regarding the evaluation of patients for gauging the potential usefulness of hypnotic intervention. As important, is making a choice regarding the technique of hypnotic induction appropriate for that situation. Sometimes this choice needs to be arrived at with some urgency.
Speed Hypnosis: Indications and Methods
In medical practice, there is a massive need for anxiety control, and for pain control. Generally unappreciated, for example, is the intensity of stress experienced by patients awaiting operations. The apprehension of entering an unknown milieu, the uncertainty about outcomes, the patient’s forgotten and still unconsciously active memories of people who have sustained hospital related tragedies, all make for possible high anxiety pre-operative experiences.
Speed hypnosis refers to a body of specialized techniques designed to induce hypnotic states within short periods of times, sometimes in a matter of seconds. They are especially useful in situations of time pressure, where the milieu is busy and noisy such as in emergency rooms or pre-operative suites, or when the patient is experiencing acute stress, anxiety, fear, or pain.
Speed hypnotic techniques depend upon faith and respect of the patient for the hypnotherapist, and vice versa. The initial contact between the two may be short, often only a few minutes, or less. The stated and the subliminal message is clear: the therapist is there to alleviate fear, pain, and all the other negative emotions inherent in these dramatic situations, where at some level, the possibility of demise is understood. The other message is also communicated: the state of mind and body we are looking to reach quickly is calm, peaceful, relaxed, comfortable, all in a context of sensations of personal energy and force, existential tranquility, even optimism.
An important element in speed hypnosis is touch communication. Beyond verbal transactions between patient and therapist, touch can powerfully convey therapeutic intent. Touch, however, in kind and placement, is crucial to effectiveness. A clasping of the hands, or a touch to the shoulder or the forehead, is a beneficial and appropriate way to add intensity to the hypnotic communication.
The interpersonal contact in speed hypnosis is as intensely focused as possible. There can be direct eye contact in addition to touch communication. The verbal directives chosen carefully to correspond to the patient’s language usage are then spoken with calm and aplomb.
To illustrate a clinical situation involving speed hypnosis, the following case is presented:
A case of emergency cardiac bypass
A businessman was brought to the hospital via ambulance after experiencing chest discomfort and shortness of breath. At age 55, Fred had never been a patient in a hospital and was apparently in good general health. Tests showed major coronary artery blockages. One of the doctors who examined him had shown him a grave facial expression. He was scheduled to have surgery in a few hours.
The family called. Fred had become increasingly anxious, bordering on agitation. The family, in their concern, called for a consultation. Although tense, he did not desire sedatives or tranquilizers; to him they meant loss of self-control. He, however, was open to relaxation techniques including hypnosis. In his mind, from what he had seen and heard about, hypnosis could incite mental powers to the mission of relaxation and healing.
The emergency suite was noisy and filled with patients. In its large space the cacophony of beeping monitors and the hurried pace of the personnel challenged the senses. The curtain surrounding his bed once parted revealed Fred, pale, half propped up, slightly sweating, looking hyperalert. His wife held his hand. Connected to multiple tubes and sensors, the oscilloscope’s green waves displayed his cardiac activity, annoying beeps accompanying each peak.
Distress was conveyed by his eyes, along with a hopefulness to be well and a subdued plea for assistance. Asked if he would like to feel calm, relaxed, comfortable, unbothered by interruptions, somehow magically detached from all the commotion, with a sense of peace, energy and good optimism, he nodded with a half smile, unequivocally in the affirmative. Asked if he desired hypnosis to achieve this, he was equally agreeable.
I took his hand; it was clammy. Then, gently raising his arm, with our hands clasped and eye contact maintained, I touched his forehead with the other hand. As Fred’s eyes closed, three consecutive mini-handshakes signaled his entry into hypnosis. After deepening suggestions, hypnotic affirmations for global relaxation began.
His body, previously spring-wound, gradually sank comfortably into the bed. Peacefulness in breathing became evident as chest and abdominal respirations flowed together. Head muscles relaxed and facial features smoothed out. Deepening directions continued and the electrocardiogram’s beeps became less frantic. Then, post-hypnotic affirmations followed, for rapid relaxation and for entering another state of mind, with lightness and detachment, as if floating around his own body.
If he could relax or even sleep before the procedure, his vital energies would recharge, so he was told during his hypnotic trance. And during the procedure itself, he would remain calm, unperturbed, in harmony within himself, with a steady blood pressure and easy, flowing respirations. Indeed, remaining active during operations, the unconscious mind remains sensitive to post-hypnotic affirmations, and to their beneficial influence.
Fred came out of the hypnosis treatment looking remarkably peaceful. He smiled, and then slowly said a few words of greeting as if was returning from a dream. He then promptly fell asleep. Awakening shortly before the start of the procedure some three hours later, he communicated his unusually relaxed state, saying, with an ethereal look and slightly nodding his head, ”I’m looking forward to this, I’ll have a new heart.”
As is common in these hypnosis-assisted medical procedures, the process took a shorter time than usual. The patient’s calm and physiological stability made the process move in ways that increased the probabilities of operative success.
Meditative Hypnosis: Indications and Methods
Meditative hypnosis represents, in contrast to speed hypnosis, another polarity in the spectrum of clinically useful hypnotic techniques. As the name implies, meditative hypnosis refers to a fusion of ancient techniques of meditative practice, with methods gleaned from the (relatively) more recent science of medical hypnosis. This fusion of both disciplines allows for clinical interventions not possible with either discipline utilized alone.
Meditation is concerned with the expansion of the territory of consciousness. Via the practice of steady focused attentiveness, pathways of consciousness are made to project into selected dimensions of mind and body, gradually claiming ever-greater jurisdiction for the domain of self in the matrix of the body. In this model, awareness expands its essence, and its executive functions, into neural networks that normally function automatically, below conscious levels.
Meditation, in this perspective, involves mental and physiological processes that bypass the domain of what is psychological. As such, true meditative practices are mostly non-verbal, seeking to move beyond the mental networks of language. The ultimate goal of meditation, in its highest form, is the experiencing of a state yet poorly described or studied, that may be called the experience of pure consciousness. Pure consciousness represents a direct and ongoing perception of aliveness, disconnected from all other functions of mind.
Medical hypnosis, by contrast, refers to a body of techniques utilized to assist in the physical and psychological care of patients, via the involvement of their own (and unique) cognitive processes. In order to therapeutically alter cognition, hypnosis makes dedicated use of language, heavily relying on verbal communication.
Meditative hypnosis draws concomitantly upon the capabilities of meditation and the capacities of medical hypnosis, to optimally achieve clinical objectives. Utilized together, that combination makes for the most efficient, effective, and rapid personal transformations possible.
In the case of anxiety conditions, for example, meditative techniques subdue stress reactions by directing awareness into the autonomic nervous system networks. The very mechanisms of stress are thus steadily reversed, and the process of creating relaxation becomes a new skill. Hypnosis, applied concurrently within the meditative experience, modulates patient-specific cognitive systems to encourage all manner of relaxation dynamics.
A case of meditative hypnosis: liberating emotional creativity
A filmmaker knew that he desired more out of his work. Now in his early 40’s, he had enjoyed some successes but, in an opinion shared by his friends, he was clearly falling short on his creativity. His main film characters consistently failed to achieve optimal emotional color. Consequently, on viewing his work, audiences came away with less than anticipated visceral impact. What, he asked, were possible causes for this failure to achieve the dramatic levels he desired?
There was no doubt that much of this emotional inertia took root in the years intertwined in his family dynamics. Coming back to the present time and somewhere in the initial conversation, he was asked to describe the salient emotions experienced in his daily life. What emotions did he notice most, and which the least? How intense were these emotions and how were they integrated into his work? And finally, a question that surprised him: what are the physical locations of the feelings as they are experienced in the body, and can they be described in detail?
After a period of concerted reflection, he finally came upon a thought that, to him, seemed revelatory. The most persistent and ongoing emotions he experienced in daily life, unfortunately, belonged to the anxiety spectrum. Indeed, anxiety can be experienced in myriad forms. In fact, when other emotions expressed themselves as, for example, anger or intimacy, unwanted tensions invariably colored them. As to the location of emotions in his body, he made wide gestures drawing a swath in the air encompassing his chest, throat and abdomen, accompanied by descriptions connoting vague and pervasive sensations he could best describe as a “tightening vacuum.”
A meditative technique that can be called “body traveling” showed him how to project awareness into his nervous system networks, beginning with those circuits involved with respiration. Indeed, recognized for millennia, the respiratory process is a good starting point because we now appreciate that its innervation is both voluntary and automatic. From there, he traveled to other territories of his internal universe, each time extending the control of his inner self ever further. Then, upon encountering the outer edges of his awareness of his anxiety, he took the courage to foray deeper. Ultimately he had a revelatory experience. Knowing factually full well that it was he who created stress in the first place, the technique permitted him to perceive the very experience of the mechanisms that resulted in his feelings of stress. He understood experientially that anxiety belonged to him, and that he was its ultimate creator.
Hypnosis, utilized within the meditative state, speaks to areas of the mind that are anchored in verbal cognitive spheres. Successions of various anxiogenic scenarios gleaned from his daily life were presented in the context of the meditative experience. Hypnosis enhances imagery. Relived in the imagination, each life scenario was reprogrammed in the framework of new perspectives embodying emotional relaxation and personal mastery.
As anxieties receded, he was able to give ever-freer expression to the rich emotional palette of his inner life. This he applied directly and successfully to his art.
Speed hypnosis, and meditative hypnosis, encompass extremes of a spectrum of clinical techniques that extend the practice of hypnotic intervention ever further into contemporary psychotherapeutic practice.
Emergency medical situations that are marked by the presence of high psychological tension, fear, anticipatory anxiety, and pain can be ideal candidates for a recourse to speed hypnosis. Often, patients in these situations are in states of psychological shock and highly receptive to assertive hypnotic intervention. Speed hypnosis, as all forms of medical hypnotherapy, requires the consent of the patient. Once obtained, a variety of procedures may be used, predicated upon several factors, mostly having to do with the physical condition of the patient.
As illustrated above, the actual psychological preparation of the patient in speed hypnosis may be significantly compressed to include only a statement about the intended goals of the process. The induction itself is short to ultra short, often spanning only seconds in nominal time. If the patient is to undergo operative procedures, even those requiring general anesthesia, post-hypnotic affirmations are administered that invoke physiological resilience and harmony during the intervention itself. These affirmations will tend to stabilize functional parameters such as blood pressure, respiration and heart rate, to increase probabilities of positive outcomes. Indeed, even during general anesthesia, the unconscious dimensions of the mind remain active, automatically lending their influence to the mission of survival, health, and recovery.
Meditative hypnosis, by contrast, embodies a self-actualizing approach, allowing the patient to determine the direction of therapy. The hypnotherapist in this situation functions as a guide to apply techniques of meditation, thus allowing for the progressive inner knowing of one’s neural networks. Conditions such as anxiety, for example, in any one of its myriad forms, can yield to the steady push of expanding self-awareness into neural networks. Hypnosis, utilized within the context of meditative states, and via separate mental mechanisms, greatly accelerates desired therapeutic action.