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For your Diary
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11th & 12th NOV 2006
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| A Brief History of Hypnosis in Medicine |
The Early Years - pre 1600
If we consider hypnosis in the context of the contemporary state of
knowledge, medicine and social change, we can trace the importance
of belief in healing right back to primitive cultures. Since early
history priests and witch doctors have attempted to bring about healing
by inducing an altered state of consciousness. This was often facilitated
by rhythmic drum beats or chanting, dancing and drugs, superimposed
upon an elaborate ritual.When man was searching for an explanation
for the inconsistencies of life he believed disease to be a Divine
manifestation. The Ancient Egyptians had their Temples of Sleep, and
the Greeks their Shrines of Healing, where patients were given curative
suggestion whilst in an induced sleep. Hippocrates (430 BC) was aware
of the importance of harmony between mind and body, and described
the mind as the 'seat of emotion'. It is possible to ascribe to hypnosis
many miracles described in the Bible, and later to the miracles and
cures ascribed to holy men, relics and shrines. Between the times
of the Romans and the sixteenth century medicine was based largely
upon folklore and remedies having little scientific basis. As dissection
was frowned upon it was not possible, except in a few notable cases
(e.g., Leonardo da Vinci, circa 1500), to study detailed internal
anatomy until well into the sixteenth century. Although Galen (170
AD) had described a circulatory system it was not until 1628 that
Harvey published his work on the heart and the circulation of blood.Chemical
anaesthesia did not appear on the scene until the mid-nineteenth century.
Prior to this alcohol and opium had been used, but surgery had been
brutal and, of necessity, carried out at high speed. (A British surgeon,
William Cheseldon, is reported to have removed a stone from the bladder
in 54 seconds !) The work of James Esdaile (see later) should be viewed
in this context. In addition to physical trauma and shock, post operative
infection almost invariably followed surgery and accounted for a huge
mortality rate. Again we should view Esdaile's extremely high recovery
rate in this context, and bear in mind the fact that it was not until
well into the nineteenth century that surgical asepsis became recognized
as being fundamentally important.
Development of Hypnosis - ongoing
1530
Paracelsus elaborated the theory that the heavenly bodies exerted
an influence upon disease and healing, working through an all pervading
universal magnetic fluid.
1765
Franz Anton Mesmer, a Viennese doctor, stated that man could influence
this magnetic fluid to bring about healing, and he established salons
where patients applied magnets to afflicted parts of their body. Later
he moved to Paris where he further developed his theory. It was thought
that a convulsive crisis was necessary for a cure to take place.
1784
Louis XVI set up a commission of investigation, which included Benjamin
Franklin, M. La Guillotin, and La Voisier. Their conclusion was that
magnetism with imagination produced a convulsive crisis, but magnetism
alone did not. Mesmer was discredited, but his Society of Harmonies
continued.
Le Marquis de Puysegur, a member of the Society, found that a crisis
was not necessary. He believed that the magnetic power was produced
in his own mind and was transferred to the patient via his fingertips.
He found that he could produce a sleep in which the patient would
follow his commands - very authoritarian - and introduced the terms,
"perfect crisis" and "profound sleep".
1837
John Elliotson, Professor of Medicine at UCH, London, organised public
clinical demonstrations of a wide range of hypnotic phenomena, exhibiting
effects on voluntary and involuntary muscle, analgaesia, somnambulism,
hallucinations etc., which he attributed to the magnetism theory.
On his forced resignation he edited a journal, The Zoist, in which
he reported the work of.
James Esdaile, a Scottish surgeon working in India, who had performed
several hundred operations quite painlessly using hypnosis (mesmerism)
alone as an anaesthetic. He or an assistant would produce a state
akin to suspended animation, now known as the Esdaile State, by stroking
the patient's body for several hours. He recorded that fatal surgical
shock or post operative infection occurred in only 5% of cases compared
with the then norm of 50%.
The British medical establishment rejected
these claims.
1841
James Braid, a Manchester doctor, saw a demonstration of mesmerism
by a French man La Fontaine, and applied the methods within his practice.
He found that patients having gazed at his bright lancet case would
enter a profound sleep, and in this state would accept his suggestions
aimed at cure. He assumed that staring at a bright object exhausted
the nervous system, and that the phenomenon was not to do with magnetism.
1884
In Nancy, France, Dr. Ambroise-August Liebeault, found that he could
bring about cures in this state simply by suggestion.
1886
He was joined by Professor Bernheim, from Paris, and together they
published 'De La Suggestion' in which they rejected the concept of
magnetism. They established the Nancy School, and set up the Animalist
Movement.
Around this same time Jean Martin Charcot was demonstrating his views
at the Salpetriere Hospital that hypnosis was a pathological state
akin to hysteria, the two phenomena being interchangeable. Following
conflict between the two schools, Bernheim's view was accepted and
Charcot discredited. However, two of Charcot's pupils were to have
a huge impact on psychological medicine.
1890
Josef Breuer and Sigmund Freud developed the application of hypnosis
beyond the mere suggesting away of symptoms, and changed the approach
to the elimination of their apparent cause. Breuer found that in hypnosis
patients would often recall past events and in talking about them
would experience an emotional outpouring, subsequently losing their
symptoms. This he called his talking cure, (we would now refer to
this emotional state as an abreaction). Freud was also looking at
the dynamics and history of illness, but after earlier work with Breuer
he left hypnosis in favour of his work in what was later to give rise
to psychoanalysis.
1914-18
During the Great War the Germans realised that hypnosis was of value
in the immediate treatment of shell-shock, allowing soldiers to be
returned rapidly to the trenches. A formularised version of hypnosis,
autogenic training, was devised by a German, Dr. Schultz.
Post 1945
After the second world war the work of Milton Erickson in the U.S.A.
was to have an enormous influence on the practice and understanding
of hypnosis and mental processing. He recognised that hypnosis is
a state of mind that all of us are entering spontaneously and frequently
as part of our normal behaviour pattern. He utilised this phenomenon
in conveying his suggestions in a covert way, by an exciting and innovative
use of language.
Following Erickson, Richard Bandler and John Grinder, amongst others,
have studied and codified his subtle techniques in the development
of neurolinguistic programming, ( N.L.P. ) which currently has a very
high profile not only within medicine, but also within business organisations
and industry.
Hypnosis is currently seen as a tool rather than as a cure in itself.
It is used in simple relaxation techniques for nervous dental and
medical patients; as an adjunct to chemical sedation and anaesthesia;
as relaxation therapy in the handling of stress and related disorders;
in obstetrics and antenatal care; in the management of intractable
pain, cancer and terminal illness; as an adjunct to psychotherapy,
and in the management of a wide range of phobic, anxiety and other
medical and psychological problems.
Hypnosis is a constantly evolving and ever
changing field.
Martin Orne was born in 1927 in Austria. His family moved to the USA
and in due course Orne qualified as a psychologist before obtaining
a medical degree and becoming a psychiatrist.
As an undergraduate at Harvard he launched a bombshell with a paper
dispelling many of the myths associated with the use of hypnosis for
age regression. He proposed that the adult under hypnosis is not literally
reliving his early childhood but presenting it from the perspective
of adulthood. The repercussions of this were to continue to rage many
years later in the controversy surrounding false memory syndrome.
Further repercussions occurred from his conclusion that in crime investigation
hypnosis could encourage witnesses to confabulate or "remember"
things they could not actually have seen or experienced. As a result
of his expertise in this field Orne was often called as an expert
witness in high profile cases, for example testifying on behalf of
Patricia Hearst, the heiress.
Dr Orne also had a particular interest in the study of multiple personality
disorders, and again was able to display his skills as an expert witness
in a number of nationally important cases.
His high profile and his term as President of the International Society
of Hypnosis were instrumental in promoting hypnosis as a respected
and respectable skill within psychology and medicine as well as within
the legal field.
Ernest Ropiequit Hilgard (1904-2001) was appointed Professor of Psychology
at Stanford Ca in 1933. His major early interests were in learning
and motivation, and two of his textbooks, Theory of Learning (1948)
and Introduction to Psychology (1953) became classics.
In the 1950s he and his wife Josephine, Professor of Clinical Psychiatry
at Stanford became pioneers in bringing to hypnosis the discipline
of scientific study. Hilgard recognised a need in research for a standard
by which to measure depth of hypnosis and hypnotic susceptibility,
and the Stanford Hypnotic Susceptibility Scale which he devised in
1959 is still in wide use today.
In 1957 they established the Stanford Laboratory of Hypnosis Research.
Here they experimented with hypnotic pain reduction and two books
in particular, Hypnosis in the Relief of Pain (1975) and Divided Consciousness
(1977), became landmarks in the objective study of hypnosis.
Hilgard further developed Janet's earlier work on dissociation into
his theory of neodissociation, posing three stages of consciousness
within hypnosis; the distorted reality, the hidden observer and the
observing consciousness. This model, when brought together with the
then contemporary Pain Gate Theory of Melzack and Wall, gave an elegant
paradigm which remains just as fresh today, to explain the way in
which hypnotic interventions can be so effective.
John Hartland was a psychiatrist, a member of the BSMDH, and editor
of the Journal of Medical Hypnosis. His comprehensive textbook on
clinical hypnotherapy, Medical & Dental Hypnosis was published
in 1966. Hartland described straightforward techniques for ego, employing
direct suggestions of a general nature, aimed at increasing the patient's
self confidence. The book, now in its fourth edition, became a 'bible'
for the medical or dental student of hypnosis.
The study of psycho-neuro-immunology (PNI), the conduits through which
our emotions and thoughts may affect our health came into prominence
in the 1980s, and a major influence in this study remain Dr Ernest
Rossi. In his early years Rossi worked with and co-wrote many papers
with Milton Erickson, and is editor of Erickson's collected papers.
In 1986 he published a major book, The Psychobiology of Mind-Body
Healing. His painstaking research into psychobiology and state dependent
learning has resulted in a large number of publications in which he
describes the mind-body pathways, and applies hypnotic techniques
in utilising these pathways to bring about healing.
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