Hypnotic Treatment of Somatic Symptoms

Hypnotic Treatment of Somatic Symptoms

Hypnotic Treatment of Somatic Symptoms:

Globus Hystericus and Migraine Headache

In two recent cases, I witnessed skill in developing receptivity to self-hypnotic suggestion help clients alleviate somatic symptoms that were debilitating and dangerous. In the first case a forty-eight year old married woman with adult children who still routinely demanded parental assistance in the form of time and money had developed a choking response every time she tried to eat food. This problem had generalized to a fear of eating, and as a result she had lost twenty pounds by the time I first saw her. She appeared quite gaunt and anxious and was quite willing to cooperate with any procedure that might help restore her ability to eat, although she was clear about her reluctance to risk the terrifying throat constriction that even compromised her ability to breathe.

She was intrigued but skeptical about the idea of learning self-hypnosis. In demonstrating the direct and practical approach of hand levitation by simple direct request, I offered this learning as an interesting new skill requiring some focus and concentration, and offering a sense of powerful collaboration with one's unconscious resources, separate from outside influence or demand. She was surprised and pleased when she readily developed a satisfactory hand levitation response to one simple direct self-suggestion. She also showed a trance-like receptivity to the interpretation I offered that the choking response contained an important message from her unconscious that must be heeded: There are some things you're just not going to swallow anymore. It was clear from her attentive, thoughtful demeanor, her fixed gaze, and her slow, rhythmic nodding that she was reorganizing attitudes and orientations in a way meaningful to her. We discussed the error of making the response too concrete and disallowing food to enter her body. She chose the second phrase as a mantra to repeat at mealtime: But it's essential to allow healthy, life-giving, nutritious food into my body to fuel me so that I can really enjoy my life. From the first session she determined that whenever her throat would begin to tighten, she would first express gratitude to the "symptom" for reminding her to set limits on the inappropriate and intrusive demands of her adult children and her unappreciative boss at work, and second use her hypnotic mantra to relax her throat and remind her body to accept nutrients. Currently her diet has expanded to include a variety of foods she at first doubted she'd try again. She still has not eaten any lettuce. (Do you suppose "let us" is what her children used to say?)

In the second case a thirty-two year old woman was finally divorcing her husband of ten years after repeatedly forgiving his dishonesty with family finances. But her migraine headaches were acting up, now occurring almost daily for two months when she came to my office. I asked her if she was interested in trying a technique I had read about but never taught, using hypnotic suggestion during the aura of a migraine to prevent the onset of a full-blown attack. The technique is described in Hypnosis and Suggestion in the Treatment of Pain by Joseph Barber. It consists of training the client to recognize aura as the moment blood vessels in the head are constricting, and hypnotically preventing the rapid dilation of the vessels, the full-blown migraine phase. One theory suggests the dilated vessels press against the nococeptive system, each heartbeat translated as an iteration of the pounding pain migraine sufferers experience. I suggested to the client that a good way to test her ability to hypnotically control constriction and dilation of blood vessels would be to change the temperature of her hands. Not psychologically or subjectively, but to actually raise the temperature of one hand by dilating the vessels, and to lower the temperature of the other by constricting the vessels. We linked this to the height the hands would rise in her hand levitation experience, and as in the first example used only direct self-suggestion to achieve the desired result.

She was able to confirm the objective change in temperature of her hands by touching them to her face and noticing the difference. Her confidence was heightened and her skill demonstrated. We developed the self-suggestion for use during auras, During the next seven hours very slowly dilate the capillaries, veins and arteries to their normal size. She was delighted to report no further migraines at her next appointment, and in the three months since has experienced several auras, but only two migraines, a 90% reduction in symptoms.

Her enthusiasm for her newfound skill was so great that during her second session she admitted having tried and succeeded at "leg levitation." "It was hard, and it took a while to develop, but I could feel the muscles twitching and organizing, and eventually my leg just lifted off the ground all by itself. It was really exciting to know how responsive my unconscious is to my requests."

I think these two remarkable cases are wonderful examples of the utility and power of self-hypnosis taught as a vehicle for client-centered empowerment, with the clinician as expert coach, not operator or trance-inducer. Flowing with and facilitating the healing process allows so much more creativity and enthusiasm to emerge in the room than attempts to control or script it.

The Radically Empirical Hand-Levitation Induction

How I talk about hypnosis with clients changes depending on the kind of relationship we have and the goal of the work, but I often start with what is typically considered an "advanced" induction, and have been as surprised as my clients to notice that every client who tries has been successful at developing hypnotic hand-levitation using only direct self-suggestion on the first try. Part of my "training monologue" developed while working with a particularly skeptical client a couple years ago.

"It might surprise you to learn that much of what has been taught about hypnosis over the years is superstition and tradition. Having had a lot of training myself, I'm under the influence of these limiting beliefs. But you're in a good position to take a radically empirical approach to exactly what limits there are, and aren't, to the applications of self-hypnosis in your life. So take everything I teach you today as a point of departure for your own explorations and investigations into your abilities to develop hypnotic experience and receptivity -- to your own suggestions.

While essentially consisting of a very simple, straightforward demonstration of hand-levitation by direct self-suggestion, this "technique," or, more accurately, approach to teaching clients to discover and develop their unique abilities in self-suggestion, features some talking about what self-hypnosis is and how it can be helpful that includes the following principles:

Try simple, direct suggestion first. "Self-hypnosis is the development of a more cooperative relationship between your conscious intention and your unconscious mind. I don't want to be manipulated or ordered around, so I figure my unconscious works the same way. I treat that relationship like I would one with another person. I make my requests simple, direct, and respectful, and I express gratitude when my request is honored. I'd like to ask my unconscious mind to lift my arm so that my client can see a demonstration of hand-levitation by self-hypnosis."

Let the unconscious do the work. "Now you wouldn't be impressed with me just lifting my arm, and you wouldn't be impressed if nothing happened. The trick, the skill, the discipline involved in mastering self-hypnosis is to make the request skillfully and then get out of the way and allow it to happen. You don't want to try and make it happen, and you don't want to stop it from happening. You want to allow it to happen."

Utilization and amplification of minute changes. "It's different every time I do this, but it usually starts with a little tingling sensation in the palm of my hand, and then I notice my hand very gradually leaving my leg. If you notice, there's no trembling of my fingers like there is if I try to hold them still on purpose."

I invite the client to ask their own unconscious in the way they feel will be most effective, out loud or silently. I suggest direct, respectful request. While we wait, we may talk about something else, notice the subtle changes beginning, explore their curiosity or skepticism. Usually something happens fairly quickly and we have something to notice and talk about, which builds their enthusiasm and confidence in their hypnotic skill.

Hypnosis as a skill to master and enjoy. "Isn't it more enjoyable to know that it's your growing relationship with your own unconscious processes that allows your arm to lift automatically, rather than how clever or tricky I am at producing a trance state in your consciousness?" "Once or twice a year I meet a client whose skills at self-hypnosis and self-suggestion leave me in the starting blocks. I can never predict beforehand who that's going to be. But whether you're unusually gifted at learning these skills or just a regular person, I can guarantee you will get better the more and the more regularly you practice."

Hypnosis as relational. “Like I said, hypnosis is a relationship, not just one-way influence. In addition to being grateful (literally saying ‘Thanks!’) when your unconscious mind chooses to do something you’ve asked, it’s also important to listen to what your unconscious is telling you. We really like it when people listen deeply to what we are trying to say, and so do our unconscious minds. That’s a great way to facilitate cooperation and mutual trust. If you develop this skill, you’ll probably prevent a lot of stress and symptom formation as well, because you’ll get the message before it needs to become as ‘loud’ as a symptom.”

I want to emphasize that the most important aspect of how I teach self-hypnosis to clients is my comfort and confidence with this approach: it fits well with my style of relating with my clients, and being experience-based, it has integrity. To me it's important that the principles of client-centered self-determination and locus of control are observed, and I get excited being part of a process where clients gain skill and mastery over their own experiences and a deeper sense of connection with their physical and mental processes. I encourage you to discover what works for you and your clients that may share some of these principles and attributes.