Altered 'state' of consciousness versus the 'nonstate' theory of hypnosis.

The notion of a hypnotic 'trance', an 'altered state of consciousness' or 'special state', emerged from what are referred to as the 'state' theories of hypnosis.  The premise of 'state' theory is that, through the actions of the hypnotist, the inducing of a 'trance' the 'unconscious' or 'subconscious' mind responds to suggestion. Cognitive Behavioural Hypnotherapy (CBH) holds a 'nonstate' perspective opposing the 'state' theory. This article aims to clarify, what the research evidence reveals and why CBH an evidenced based approach, proposes that a special state or 'altered state of consciousness' is an inaccurate explanation for what occurs in hypnosis.

     'State' theories derived from what is referred to as Mesmerism. Braid (1841, 1845) the father of the modern 'nonstate' theoretical perspective, demystified the superstition and deception of Mesmerism replacing it with an empirical theory. Through research efforts to settle, the 'state' versus 'nonstate' debate a superior understanding of hypnosis has emerged with practical implications for effective hypnotherapy.
 

The terminology of 'state' theory persists in everyday language.

     People frequently formulate ideas based on 'state' theory. I feel it is important to highlight at this point; the common use of 'state' terminology in language. Terms such as 'trance' and 'unconscious' are prevalent in everyday language. One might say that this is similar in a sense, to the way in which Freud and his theories, still commonly referred to when people talk about theories of psychology. I digress for a moment to clarify why exactly I refer to Freud in order to highlight this point. Whilst Freud is an important figure, in the sense that he stimulated research, his theories nonetheless are neither reliable nor valid. For instance, Freud's psychoanalysis on average took 1,300 sessions in 5 years, with significant percentage of the women's symptoms getting worse. I will let you be the judge of the effectiveness of Freud's theory and practice. Nevertheless, in everyday speech, Freud, his theories and associated terminology frequently referred to when people talk about psychology, as if his unfounded theories were somehow synonymous with valid psychological theories and findings. Freud's claims fuelled an abundance of research; leading figures in the area of psychology were determined to discredit and highlight the errors in his assertions and thus provided alternative rational, valid and reliable explanations and theories. 

     The point I am making is that often, as is the case with hypnosis, there are numerous false assumptions, which 'pop psychology', fad self-help books, cartoons and film makers, draw upon to captivate the audience. This serves to reinforce misconceptions and invariably certain terminology becomes embedded in language. As we are all very much aware, that for instance, in searching for a topic on the internet there is an abundance of grossly inaccurate information, some of which is frankly completely bizarre. This is definitely the case when people comment in the area of psychology, psychotherapy and hypnosis. There are very out of date views, opinions, terminology regarding the area of psychology, psychotherapy and hypnosis. This is more than ever apparent when people refer to 'trance' or 'altered state of consciousness'. While a popular and awe inspiring concept, there is no evidence to suggest such a theory.
 

     Research is vital in any field. Rigorous scientific research brings the area forward.
Where would any field or the integrity of any field of study be without adopting to important research findings?

 

     Prominent researchers examining the area of hypnosis discard the concept of 'altered state of consciousness' and 'trance'. Importantly, those psychologists and professionals who do not entirely reject the terms or use of terms such as 'subconscious' do so in a metaphorical sense or put forward an extremely diluted or weak version of what many people commonly believe the terms to represent.

     'The reality is that most of what is observed and experienced when hypnosis is said to be taking place (in the clinic, in the laboratory, on stage, on training courses, and so on)... can be satisfactorily explained provided we ground our explanations in a modern scientific understanding of the human mind, namely mainstream psychology and its related disciplines. Yet many writers have neither the knowledge nor the inclination to do this. I have lost count of the number of books I have seen which, on their covers, announce that their authors "at long last divest hypnosis of the mystery that has surrounded it" while between the covers they do the exact opposite, often by appealing to some magical entity called 'the unconscious mind', pop psychology, and oversimplified notions of the human brain'. (Heap, 2006: bold added for emphasis)

      'Nonstate' evidence based proponents hold that, through verbal or non-verbal direction, one invites, encourages and prompts the individual to enhance receptive mind-set; absorption, motivation, expectancy and imagination (Heap and Aravind, 2002). This contrasts starkly, with the 'state' assumption that responsiveness is predisposed and fixed. Authorities in the field of psychology and hypnosis view 'state' theory as reductionist, holding unsubstantiated assumptions. 

      According to research evidence, one can be trained to be a better hypnotic respondent. The significance of skills training, in addition to the impact of the therapist's skills and technique on responsiveness are fundamental research findings and crucial for the effective use of hypnosis in treatment. These findings are derived from 'nonstate' rigorous research investigation. Identifying with a role, (role of a hypnotic participant), found to result in physiological and psychological changes. This research evidence, conflicts with the 'state' assumption that somehow through the hypnotist's power the 'unconscious' responds to suggestion. Empirical research proposes that imaginal absorption (Barber, 1969), strategic enactment (Spanos,1991) identifying with a role or role enactment (Sarbin and Coe, 1972) and response expectancy or response set (Lynn and Kirsch, 2006), are psychological processes involved in hypnosis.

     Again I emphasis that 'trance' and 'altered state of consciousness' are outdated concepts. For instance, some writers claim that people in hypnosis experience a 'trance' or 'altered state of consciousness', which they consider to produce higher frequency of 'alpha' or even 'theta' brain waves on electroencephalogram (EEG) brain scans.  They propose that these findings suggest hypnosis somehow accesses the 'subconscious' or 'unconscious', a claim which is false and unreliable.

     In actual scientific research by leading researchers in the field, the results reveal that brain imaging changes which occur in the brain activity are far more complex than some authors of 'pop psychology' would have us believe. Rigorous, valid reliable research is vital in researching psycho-physiological phenomena. Changes occur in brain activity during hypnosis, however, the changes, which do appear on brain scans, are task specific. Putting it very simply for the sake of brevity, for instance, if a task in hypnosis, required increases in concentration levels therefore the area(s) of the brain utilised, thus appearing activated. The area(s) of the brain for instance related to speech or visual imagery activated if the task requires the individual visualise an image or talk about the image. In other words, the brain activity reflects the level of concentration or modality required as opposed to an 'altered state of consciousness.'

     Brain imaging technology does not support 'state' theory. Changes relate to the task performed by the individual and are variable; this is consistent with 'nonstate' theory. Adopting 'nonstate' approach hypnosis incorporated with cognitive and behavioural approaches to treatment. Mainstream psychological research is consistent with 'nonstate' CBH (Lazarus, 1997). 'Nonstate' CBH embraces the role of psychological and physiological factors, acknowledging that hypnosis inextricably interlinked with mainstream experimental, clinical, and neuroscience research investigation.

My point is quite nicely summed up in the following quote:
 

     'Very few topics in the whole history of mankind can have given rise to so many absurdities, misunderstandings and misconceptions. From the very beginning, the study of hypnosis has been tied up with fantastic conceptions like animal magnetism, the influence of the stars and similar tarradiddle. Even nowadays, popular conceptions of hypnosis are extremely confused and the journalistic reports in newspapers have done but little to clarify the issues involved.' Hans Eysenck, Sense & Nonsense in Psychology (1957)

     In conclusion, 'state' theory is invalid and unreliable. In contrast, 'non-state' theory is a common-sense approach, focusing on making meaning clear. A special state, an 'altered state of consciousness' popular concept, made increasingly popular in attempts to intrigue and enthral us in movies, books and on stage. There is an air of mystery about these concepts. Whilst entertaining theories, 'state' theories are inaccurate. These are ideas, which have actually, become embedded in language. They are however, found invalid, in an overabundance of research investigations. Leading researchers in the field have employed a 'nonstate' theoretical perspective. 'Nonstate' theoretical perspectives emphasises cognitive, behavioural and social processes, the conscious factors involved in ones responding to suggestion. CBH equips clients with valuable insight and long-term coping strategies, crucial to relapse prevention. This approach is absent from 'state' theories.

Have you every wondered where the idea of 'healing energy' comes from? Click here to read 'healing energy vs experimentation.

Another article which may interest you Is Hypnosis a Distinct Form of Consciousness? Written by Lilienfeld and Arkowitz (2009). To see excerpts Click here.

Is Hypnosis a Distinct Form of Consciousness?

Featured in Scientific American Mind Magazine

Scott Lilienfeld and Hal Arkowitz (2009) summarises research on hypnosis. Lilienfeld is a psychology professor at Emory University, and Arkowitz is a psychology professor at the University of Arizona.

'... investigators have sought to uncover distinct physiological markers of hypnosis. Under hypnosis, EEGs, especially those of highly suggestible participants, sometimes display a shift toward heightened activity in the theta band (four to seven cycles per second). In addition, hypnotized participants frequently exhibit increased activity in their brain's anterior cingulate cortex (ACC).

Yet neither finding is surprising. Theta activity is typically associated with states of quiet concentration, which frequently accompany hypnosis. The ACC is linked to the perception of contradictions, which many hypnotized participants experience as they imagine things-such as childhood experiences in the present-that seem to conflict with reality. [...]

Fueling the perception of hypnosis as a distinct trancelike state is the widespread assumption that it leads to marked increases in suggestibility, even complete compliance to the therapist's suggestions. Nowhere is this zombielike stereotype portrayed more vividly than in stage hypnosis shows, in which people are seemingly induced to bark like dogs, sing karaoke and engage in other comical behaviors in full view of hundreds of amused audience members [...]

Before beginning their shtick, they prescreen audience members for high suggestibility by providing those people with a string of suggestions. They then handpick their participants from among the minority who comply.

We agree with Lynn and psychologist Irving Kirsch of the University of Hull in England, who wrote in 1995 that "having failed to find reliable markers of trance after 50 years of careful research, most researchers have concluded that this hypothesis [that hypnosis is a unique state of consciousness] has outlived its usefulness." Increasingly, evidence is suggesting that the effects of hypnosis result largely from people's expectations about what hypnosis entails rather than from the hypnotic state itself [...] Although hypnosis poses fascinating mysteries that will keep scientists busy for decades, it seems clear that it has far more in common with everyday wakefulness than with the watch-induced trance of Hollywood crime thrillers'. (Scott Lilienfeld and Hal Arkowitz, 2009 bold added for emphasis)

Stage Hypnosis

Thought provoking, mystifying and amusing, comedy stage-hypnosis, frequently perceived as an excellent form of entertainment. Stage hypnotists, commentators and researchers have served to illustrate a number of factors, specific to stage performances, providing valuable insight into the illusion and deception involved in stage hypnosis. Often people equate hypnotherapy with stage-hypnosis, formulating ideas of hypnosis and hypnotherapy based on perceptions of stage-hypnosis. I feel it is very important to demystify hypnotherapy and thus, I believe it is therefore necessary to demystify stage-hypnosis. This article aims to give a brief overview of the deception and misdirection involved in stage performances, as opposed to hypnosis or psychology. Indisputably, stage-hypnosis contains trickery and conspiracy and differs greatly from hypnosis used in the professional context of a clinical setting.

     Misleading and persuading the audience that the hypnotist has a source of power, that they somehow acquired the skill of telepathy through training, undeniably involves creating an illusion. Many stage performers refer to themselves as illusionists. Hypnosis is therefore, not an accurate description for much of what is occurring on the stage. Ormond McGill, who was originally a magician, wrote New Encyclopaedia of Stage Hypnosis, which is an excellent read for those of you who find the topic of stage hypnosis interesting. Paul McKenna refers to New Encyclopaedia of Stage Hypnosis, as 'truly a goldmine of information'. The book cleverly outlines the abundance of tricks used in stage hypnosis. It contains numerous examples of tricks used by stage-hypnotists commonly referred to as 'hypnotrix' or 'fake hypnosis' which entail misleading the audience and 'sleight of hand'.

     'Most laymen...believe that in demonstration of stage hypnotism the subjects behave in a very special way because they are in a special state ("hypnotic trance"). In fact, much of the lore about "hypnotic trance" seems to derive from the performances that are observed in stage hypnotism. However, appearances are at times misleading and especially in so in the case of stage demonstrations' (Barber et. al., 1974).

     One example of a common and well-known ploy used in stage hypnosis consists of, requesting participants adhere to instructions they receive via a microphone. The participant listens to the instructions of the voice via the microphone such as, 'Blink! Now blink again, great! And blink again and now close your eyes please'. The supposed hypnotist on the stage, in an authoritarian and domineering tone (which cannot be heard by the participant) is suggesting 'your eyes are heavy, extremely heavy, you try to keep them open, but you will fail to do so...' Thus, the hypnotist suggests he has control over the participant mind. This is just one version of what is commonly referred to as 'private whispers'.

     Another tactic used by stage hypnotists as a convincer is the 'human plank' (full body catalepsy). This trick presented as supposedly hypnotising the subject, so that their entire body is rigid. The tactic consists of the participant suspended between two chairs and a man or woman standing on their chest. Hypnosis is a completely inaccurate explanation for what actually takes place during this particular performance. This trick can be demonstrated by placing any individual, (even a petite woman) in the correct required position, between two supports or props and they will in fact, be able to bear the weight of another person on their chest. For example, a petite woman is likely to hold a weight of approx 250lb. The weight, which one can support, obviously varies depending on the individual. Sceptics have demonstrated the trick, in order to demystify stage hypnosis. Such tactics involve using the human body's capabilities. This ploy among similar tactics, referred to among stage hypnotists, as 'self-working'.

     It is also noteworthy to mention that, those who volunteer to participate in stage performances give permission to the hypnotist. In other words, as one might say, they are up for the laugh. Barber et. al., 1974, published an important and influential review of stage hypnosis. They proposed that successful stage hypnosis requires the selection of hyper-suggestibility or heightened suggestibility in participants, using specific techniques and then selecting from this sample those who are extroverted, in a large audience statistically there are likely to be approximately 10% suitable volunteers.

     Successful stage performance relies on willing volunteers from the audience; however, they also frequently incorporate plants or stooges. Stage-hypnosis tactical use of plants or stooges, as 'volunteers' acting as role-models, encouraging and motivating the others on the stage, as well as placing a demand on the volunteers to go along with the show. It therefore, has to be said that there are some elements of psychology involved in stage performances. The psychological factors contributing here include peer pressure, the significant influence of the imagination, in addition to, the prevailing demand characteristics of the stage and the audience. All of these components are integral to the stage performance.

     An important factor, highlighted in various stage performances, is the occurrence of amnesia in participants. Notably, regarding hypnotherapy it in fact a disadvantage to experience amnesia. A professional hypnotherapist wants their clients to remember what was suggested. If one experiences elements of amnesia, the professional therapist will address this issue. Therapy is of benefit when one is capable of remembering what went on during hypnosis and can take the insight gained and skills learned with them outside the therapy session. It has been found that the vast majority of people are fully conscious while in hypnosis. 5% of the population do however, report an element of amnesia. Thus, 95% of the population are aware and experience a full recollection. Stage hypnotists use methods to select the small number of people who do experience amnesia for their performance (exploring the various methods used by the stage performers is beyond the scope this article). The stage hypnotists delude the participants and audience by informing them that through their power that the individual will forget everything that went on during the performance.

     'Stage hypnotists are showmen first [...] none have any special power or knowledge placing them above other hypnotists. Their greater success is most often more apparent than real. Their one advantage is that they can select the subjects they work with, as well as what they do with them. (Weitzenhoffer, 2000: 401, author's italics)

     It is important to remember that frequently stage-hypnotists have training in stage magic consisting of skilled illusion, in many cases 'smoke and mirrors' and 'sleight of hand' (Barber et al. 1974). There are numerous strategies and indeed the list is extensive of tactics stage hypnotists use to convince their audience of their magical telepathic 'power'. Attempts to associate their performance with hypnosis and classifying it as such seems to be for the purposes of creating an air of mystery and distracting the audience from what is actually occurring on screen or on stage. It is largely therefore, for commercial publicity.

     'Go to any large bookshop nowadays and you will most likely find that their shelves are liberally stocked with books about hypnosis and its numerous applications. Pick out any such book at random, open it anywhere and look anywhere on the page. The chances are that what you are reading is plainly wrong, is misleading, is questionable, has little support, or requires significant qualification for it to be accepted as a valid statement.' Heap, 2006

     In conclusion, stage hypnosis involves a combination, in varying degrees, of optimising physiological and psychological phenomena, creating an illusion and misleading the audience. Marketing these forms of entertainment, as hypnosis is a method used in an attempt to deter scepticism, whilst endeavouring to provide a more plausible explanation and intrigue their audiences. This invariably leads to great confusion and misunderstanding regarding the professional practice of clinical hypnotherapy. The benefits and application of clinical hypnotherapy are vast. Evidenced based clinical hypnotherapy is an extremely effective intervention in aiding clients in achieving relief from anxiety and stress. Hypnosis used in a professional context enables one to discover inner strengths, to gain insight, clearer perspective and self-awareness. Unfortunately, chiefly due to the attention and media coverage which stage performers receive, too frequently, people begin to equate hypnotherapy with stage-hypnosis, or base their perception and attitudes towards hypnosis on misinformation provided on screen on or in the content of 'pop psychology' books. I therefore believe that, it is the task of those in the field of psychology, psychiatry and psychotherapy who use hypnosis in treatment plans, to draw attention to the misinformation provided on stage, on screen, in new age therapies and 'pop psychology' books.  In highlighting the validity and effectiveness of evidenced based clinical hypnotherapy we raise awareness of this effective method used in treatment plans, which can potentially aid one, in coping with life's difficulties, develop psychological resilience, well-being and achieve long-term gains.

For more information, specifically addressing the performances of Celebrity Mentalists and Illusionist see Spectacular Psychology or Silly Psycho-babble? by Simon Singh This includes excerpts from his article on Derren Brown.

Spectacular Psychology or Silly Psycho-babble?

by Simon Singh

Published in The Daily Telegraph.
Derren Brown ... But is he a genius of psychology or merely a skilled magician?

'His mass appeal relies on his uncanny ability to predict and control human behaviour. He can read your mind, tell if you are lying, plant ideas in your head and mess with your subconscious. The audience is told that this is all down to Derren's stunning understanding of psychology. However, I now believe that his amazing demonstrations of mind reading and mind control are little more than clever magic tricks.

So why is this a big problem? Let's take an example. In one TV show [...] a boxer and a woman (Derren's assistant) face each other. He places his hands under her arms, hoists her easily into the air and returns her to the ground. Next Derren stares into the boxer's eyes and defies him to lift the woman, having apparently sapped his strength. Sure enough, the boxer finds it impossible to lift her off the ground.

Derren says in narration, "Some athletes use the mind to try and improve stamina and strength, can I use my mind to take it away?", clearly implying that this is a psychological effect, presumably the power of suggestion. Although the power of suggestion can affect people, I am convinced that it does not explain this dramatic demonstration. In fact, this stunt is most easily explained using GCSE physics.

If the woman stands 4 inches from the boxer, then the boxer can lift her. If she stands 8 inches away, then the force required to lift her doubles. It is the physics of levers. Nobody notices that she moves a few inches back or forth, but the results are very dramatic. [...]

You might ask, "What's the harm? Leave the poor guy alone. It's only a bit of fun."

There are three problems. First, any TV performer has a contract with the audience. In this case, Derren's contract is based on a claim to perform effects based on psychology, but this is simply not the case. Often his psychological explanations are bogus. Viewers are left with a false understanding of psychology[...]

Derren says, "Giving explanations, which we do some of the time, is not about patronising people. It's about playing to people's intelligence." It is actually about misleading people. [...]

The second problem is that Derren's show taints the science of psychology. He makes statements about psychology and what can be achieved with the human mind, but they directly contradict scientific knowledge.[...]

The third [...] taints factual television ... misleads and appears to elevate magic to the level of science. [...]

Of course, magic does involve the science of psychology. But Derren implies he is using a branch of psychology distinct from the psychology of, say, magical misdirection [...]

Please do not misunderstand me. I do love magic. I merely hate it when magicians pretend to be psychologists. By the way, I apologise to magicians for revealing the poker trick, but in my opinion Derren only brings magic into disrepute. Giving away one secret seems like a small price to pay to highlight the problem.

My fear is that this is the start of a nasty trend. Reality magic is becoming increasingly fashionable, but TV execs need to be honest with their audience in terms of what they are actually delivering.

Finally, I suppose I should put my money where my mouth is. Derren performed two stunts on This Morning. If he can repeat them - read my childhood thoughts and replicate a drawing that I make - then I will happily donate �1,000 to charity. Derren, if you are happy to accept the challenge, then just contact the Telegraph offices.'

NOTE: Published in The Daily Telegraph newspaper on 5 June, 2003. Derren has yet to accept the challenge.

'Healing energy' versus Experimentation

Mesmer (1778) suggested that a force or healing energy 'animal-magnetism' or 'magnetic-fluid' was in the human body. He proposed that this could channel into another human being. In doing so, it could be channelled from a distance or even without the subject's awareness. The basis is that one individual holds inherent power and influence over another (the subject). This view, completely disputes the role of the participant and suggestion. This contrasts starkly, with evidence based hypnotism, often referred to as 'non-state' theory of hypnosis, which acknowledges the participant's role and the influence of verbal and non-verbal suggestion. Originating with James Braid evidenced based hypnosis, acknowledges the involvement of conscious factors in ones responding to suggestion. Braid's experimental research dismantled Mesmerism, undoubtedly producing findings which influences are apparent in modern 'nonstate' evidenced based therapy.

     In 1841, Braid attended a public presentation by Lafontaine a popular French Mesmerist. Initially Braid attended due to cynicism, assuming that mesmerism was based on trickery and conspiracy. On observing the mesmerist, Braid noted a number of phenomena, including anaesthesia and the subject's inability to open her eyelids (eyelid catalepsy). Accepting the phenomena yet critical of 'animal-magnetism' standpoint, the observations reaffirmed his scepticism and served to spark Braid's determination to challenge Mesmerism. Braid then attended performances with the objective of examining and uncovering the rational principles behind what were actually occurring. In other words, Braid searched for reliable and valid evidence. Braid through his persistence in investigating hypnosis by means of empirical research, is regarded as the founder of the modern 'nonstate' theory of hypnotherapy. The frequent confusion of hypnosis with mesmerism is common in everyday language, largely due to the assumption that Mesmer was the founder of hypnotism. On this note, stage hypnotists frequently add to these misconceptions in order to present their magic act and trickery under the guise of hypnosis and psychology.

     Braid (1841) conducted experiments initially aiming to uncover the physiological causes of the phenomena he witnessed. He conceived the term 'neuro-hypnotism', abbreviated to 'hypnotism' referring to the 'sleep' taking place in the nervous system. Later (1855) Braid documented the psychological influences of suggestion. Braid proposed the term 'monoideism'. This view suggests that through direction from the hypnotist, the individual focuses attention on a single dominant stimulus. Receiving empirical support, this is the perspective, developed in modern Cognitive Behavioural Hypnotherapy (CBH). Through verbal and non - verbal direction from the therapist, the participant focuses sustained attention on a dominant feeling, thought, behaviour or image. The therapist invites, encourages and prompts the client to enhance absorption, motivation, expectancy and imagination.

     Notably, the principle of mesmerism is that one is somehow controlled by the mesmerist's power therefore, self-mesmerism does not exist. Braid introduced the term self-hypnosis. Through teaching effective use of self-hypnosis in CBH, the client is capable of self-hypnosis, which the client is capable of conducting between sessions eventually becoming a life skill. The capacity of one to induce self-hypnosis is contrary to the basic principles proposed in mesmerism. This is a significant aspect of modern empirically support CBH protocols, crucial to effective treatment interventions and reducing relapse.

     Benjamin Franklin (1784) investigated the claims of Mesmerism, concluding that 'animal-magnetism' was unsubstantiated; instead suggesting that the 'trance' observed was as a result of subjects 'imagination' 'belief' and 'expectation'. Liebault (1866), purportedly influenced by Braid, proposed a perspective on hypnotism utilising direct suggestion. Bernheim (1884) an advocate of Liebault, also recognised Braid's work on the phenomena of suggestion. Apposing mesmerism, in addition to physiological theories, Bernheim concluded that psychology and suggestion were integral to hypnotism. The British Medical Association (1895) dismissed mesmerism and supported hypnotherapy, its associated phenomena and therapeutic applications, regarding hypnotherapy as a conventional medical intervention. These events were hugely influential in research and development of hypnotherapy. Cognitive, behavioural and social processes including the role of the participant, focused attention, attitude, expectation, motivation, and their interconnection with suggestibility, highlighted by Braid and subsequent followers. The benefits of empiricism and subsequent findings are apparent in modern CBH.

     In conclusion, evidence based theories are derived from Braid's critique of mesmerism and subsequent attempts to replace it. Braid, through his persistence in investigating hypnosis through empirical research is laregly regarded as the founder of modern 'non-state' theory of hypnotherapy. 'State' theories are derived from mesmerism. Through the attempts to analyse and demystify mesmerism, Braid was the first to propose a physiological and psychological theory, on the 'trance' presented in mesmerism. His investigation in the area and his theories on hypnosis stimulated a large amount of research, which is fundamental to evidence based practice, contributing to a superior understanding of hypnotherapy, effective treatment outcomes and relapse prevention.

To read more on the importance of evidence-based practice please click here.

Evidenced Based Practice.

'...effective therapy depends far less on the hours you put in than on what you put into those hours'. (Lazarus, 1997)

The foundations of hypnotherapy were built on Braid (1851) empiricism. Critical of the Mesmerists healing energy 'animal magnetism' explanation, Braid conducted experiments to uncover the rational principles behind what was actually occurring in Mesmerism. He searched for valid reliable evidence. The role of evidence-based practice began with Braid, who is largely recognised as the founder of 'nonstate', evidenced based hypnotherapy. Evidence-based practice is of great significance today in practice of hypnotherapy for effective treatment outcomes and reducing relapse. To read more on the unsubstantiated concept of 'healing energy' please click here.

     The empirical base of modern therapy is evident in the integrating of hypnosis and cognitive behavioural therapy (CBT). Alladin, 2008 refers to numerous empirical investigations including meta-analysis, which found increased effectiveness in incorporating hypnosis with CBT. Taking an evidenced-based approach it is the responsibility of the therapist to be knowledgeable in what constitutes as reliable and valid evidence, drawing on the most recent and pre-eminent evidence available.

     Whilst research on various therapeutic protocols uncover effectiveness, dismantling research is essential in distinguishing between the components, which are  contributing to treatment outcomes and those, which are excess to requirements. Numerous investigations have dismantled therapies uncovering the elements, which were unnecessary; uncovering the components which are used essentially to market the therapy but have no significant benefit to clients.  One example, which clearly highlights this point, is the research conducted by Nezu and Perri (1989). Their cognitive dismantling of Eye Movement Desensitisation and Reprocessing (EMDR) treatment of Post-traumatic stress disorder (PTSD), found treatment equally effective, with or without the use of eye movement, from which it derived its name. Therefore, the eye movements, which the therapy specifies as an integral component, found obsolete.

     'One need not kowtow blindly to "science". Still we must recognise that there is an implicit contract between practitioners in psychology and psychiatry and the clients who seek their help. This involves the assumption that the techniques of mental health specialists are based on scientific grounds. [...] In this sense, it is a very profound responsibility of the clinical practitioner that he be in position to show some of the ties between what he practices and the background of formal theory that makes up the body of knowledge in his field'. (Singer, 1974: 5)

     Evidence-based practice employed in Cognitive Behavioural Hypnotherapy (CBH) draws on theory and methodology derived through rigorous empirical research. Providing the client, with the best standard of treatment available to them, requiring that the therapist continually update ones understanding of various important developments in psychotherapy, hypnosis, psychology and related fields. Evidence-based practice refers to the therapist using therapeutic techniques, which are supported by reliable, valid and comprehensive interpretation of rigorous research findings. In sum, those techniques, which lack support in research, are not employed. Findings from well-designed empirically validated research are the bases for the techniques utilised at Northwest Therapy and Hypnosis The well-being and best interests of the client of paramount concern.

For information on your therapist, Click here.

Brief Therapy

'...effective therapy depends far less on the hours you put in than on what you put into those hours'. (Lazarus, 1997)

Through rigorous research, the effective methods and techniques which facilitate long-term therapeutic benefits, are uncovered. Research additionally highlights methods and strategies, although commonly used by practicing therapist, nevertheless revealed as ineffective and unnecessary. In brief therapy, those techniques, which lack support in research investigations, are not employed.

     Research in any field moves the area forward. Empirical investigation allows for successive development in the field of psychology, psychotherapy and hypnosis. Evidence-based practice thus, crucial in the provision of effective therapy. The importance of which cannot be underestimated. Establishing an evidence-based approach to the practice of therapy demands the therapist guided and informed by stringent criteria of empiricism, in researching, utilising treatment procedures and protocols.

     Cognitive Behavioural Hypnotherapy, (CBH) is an integrated approach. Employing empirically supported or informed techniques with the welfare, functioning and safety of the client of principal concern. This involves the therapist studying and investigating evidence-based theory. Providing the client, with the best standard of treatment available to them.  It requires the therapist continually maintaining and updating their understanding of various important developments in psychotherapy, hypnosis, psychology and related fields. This comprehensive approach is vital to effective treatment and long-term gains form therapy.

     Applying the knowledge of the stringent criteria of empiricism and its strengths, in selecting the most appropriate empirical research, tailoring techniques and protocol to the client, accounting for individual differences, preferences and needs of the client, is integral to the role of a therapist. In other words, adopting a multi-faceted approach incorporating clinical research, clinical experience, client needs and preference is crucial to effective treatment outcomes in therapy. In the incorporation of these factors, therapy efficiently conducted in a brief period of time.

     Arnold A. Lazarus has written well over 200 articles in addition to 16 books on the topic of therapy and the practice of psychotherapy. He is widely regarded internationally as an authority in the field.

     'Good therapy is precise. A session should contain no unnecessary psychological tests, no protracted or redundant methods, no needless techniques, no prolonged silences, and as little dilatory rhetoric as possible. This requires not that the therapist gloss over important details, nor that he or she forgo thoroughness for sake of brevity, but that every intervention tell'. (Lazarus, 1997)

     Extensive research has clearly illuminated that when therapy is evidence based and thorough it can be effectively conducted in a brief period of time. In particular, comparing brief therapy to older, outdated longer forms of therapy, evidence based brief therapy is comprehensive; it is systematic with successful treatment outcomes, including effective strategies for relapse prevention.