A hypnosis session consists of an interview, entrance, intervention and exit from the trance, although depending on whether one works with classical or Ericksonian hypnosis, somewhat different steps are identified.
“Depending on the personality of each patient, their ability to connect with themselves is trained by performing suggestion tests so that they can disconnect from the conscious message even if the psychologist is speaking. This implies that the person does not rationalise the language”, details Belmonte, pointing to relaxation and visualisation as strategies for the patient to relax physically and mentally. Subsequently, certain techniques will be used to facilitate that mental state which, depending on the theoretical current applied, for some people may be a more or less dissociative state of consciousness. In contrast, for others, it would be similar to the conscious state, although more hypervigilant.
“Once in that state, the therapeutic part is introduced in a way that allows reaching the unconscious part of the person working with their language: how they would like to feel, how they would like to stop being in a certain way or how they would build the process to achieve it. The patient has his hypnotic process that implies, on the part of the hypnotist, a cadence, a tone of voice, and an adjustment to the person, accompanied by background music. All this is recorded, and the patient listens to it. As changes are seen, hypnosis is adapted to the person. That would be self-hypnosis. “It’s like doing psychotherapy, but in a non-rational way, without going through the filter of reason,” Belmonte argues.
Sessions are 45 minutes. The first is evaluation and understanding of what is happening to the person, whether they want to work on it or how. Later they go on to “train” the hypnotic state. The hypnosis process lasts approximately half an hour, using the first part of the time to talk about the evolution between sessions and the last minutes to exchange sensations about the current session. The number of sessions required to achieve good results depends on many variables. However, if hypnotic work is understood to be suitable for the intervention, an average between two and six sessions is usually required.
“It is always combined with psychotherapy and, in some cases, pharmacological treatment. We start with the interview and psychotherapy sessions and include hypnosis work in certain sessions, although certain cases can be addressed directly with hypnosis. It depends on the previous symptomatology of the person and how it is adapted in the different areas of life (work / academic, leisure / free time, partner, creativity and social)”, the psychologist.
Are there people more likely to be hypnotised?
According to Belmonte, the most confident personalities and less tendency to control are more hypnotisable and women more than men. As the years go by, the ease of entering a hypnotic state decreases, with the interval between 9 and 12 years is the age in which there is greater suggestibility. But this psychologist affirms that, in general, hypnotizability is related to intelligence. “To be hypnotised requires an average intelligence and a medium-high cultural level if we talk about psychological work with hypnosis, which is not the same as being hypnotised at the level of a show, which is the use of hypnosis on TV”.
On the other hand, not everyone accepts hypnosis as psychological therapy, and those unaware of the process are afraid of what might happen. “If the patient requests it, they usually have no difficulty understanding it, but when I raise it in the context of therapy, some people show reluctance or mistrust. In those cases, psychoeducation about hypnosis can be done to demystify and understand it.”
In which psychological disorders is hypnosis most effective?
The range of applications of hypnosis is increasingly wide. This tool is used in conversion symptoms of all kinds, such as paralysis; conversion crises, such as pseudo-neurological alterations (which are not). It is also used to manage the concentration, but as long as difficulties with the attentional pole are ruled out.
On the other hand, hypnosis can complement treatment for anxiety and depression, in anxiety for residual symptoms, which are often conditioned by physical symptoms (dizziness, laziness), or for the psychological part of depression, since the neurochemical part is treated with antidepressants.
In the field of pain, there is a lot of scientific evidence of the usefulness of hypnosis, both for psychosomatic and psychogenic pain (which is not understood from the medical point of view but encourages the person to travel through multiple consultations to understand why it hurts). Head, back, etc., if “you have nothing”), such as for real chronic or acute pain. “In both types of pain, hypnosis is quite useful as an apprenticeship of the mind that helps to modulate the painful sensation in another way,” adds Belmonte, explaining that conversion or psychosomatic symptoms mean converting emotional symptoms into physical symptoms such as paralysis of the legs, fainting, deafness or stiffness, among others.
Hypnosis in eating disorders
Working with hypnosis is not recommended if the patient does not trust the tool or in cases of epilepsy or psychotic spectrum disorders. A newer approach is to eating disorders.
The expert affirms that in serious disorders such as anorexia nervosa that restricts food, has body distortion, with vomiting and cognitive dysfunction at that time, hypnosis would not be applicable. “Before approaching hypnosis, the psychiatrist puts the appropriate drugs to work on the awareness of the disease and the symptom at a behavioural level. Later, when the patient is more functional and her pathology more controlled, she can already set specific goals such as better relating to her body. All of this is built through a metaphor,” says Belmonte.
Hypnosis does have a place in eating disorders when the most acute symptoms (vomiting, dietary restrictions, binge eating) are managed, when the patient is aware of the disease and when she is receiving treatment voluntarily. Hypnosis can improve general self-esteem, body self-concept and anxiety in this favourable situation. And more specifically, it helps to reintroduce forbidden foods, prevent relapses, associate foods with positive sensations, to admit adequate satiety suggestions, reduce hyperactivity, body distortion, body image, and even an improvement in intake by deconditioning fear.
keys to hypnosis
- Hypnosis is a psychological tool that enhances other treatments.
- All hypnosis is self-hypnosis.
- One does not lose consciousness, nor does one fall asleep.
- Nobody can manipulate your mind in a hypnotic state.
- It should only be applied by healthcare professionals who understand the human mind.
- Hypnosis per se does not cure any mental illness.