by Tim Brunson, PhD
There are two major – yet substantially different – concepts regarding the implication of inhibition on the practice of clinical hypnotherapy. The first refers to a voluntary or involuntary diminishment of cerebral blood flow to one or more substrates. Through the use of hypnosis the inhibition of one or more substrates will precipitate an activation of other substrates. The result of such action serves to unleash the roles and capabilities of the activated substrate(s). Additionally, if such inhibition adversely affects the left prefrontal cortex, then the lessened influence tends to help intervention efforts.5 This is called the "substitution effect. "
The second type of inhibition is much different. This happens when some type of pattern-interruption or real or imagined sensory stimulus creates a level of numosity (i.e. wonderment) sufficient to release the inhibitory neurotransmitter dopamine. The adaptive reaction to the created frustration promotes a re-wiring of the brain's neurons.
Classical hypnosis used in the late 1800s and early 1900s focused on using monotonous speech and shocking the subject into a trance state. This was the technique used by Henry Munro, MD, (1908) when he taught "suggestive therapeutics" to thousands of medical doctors. It is plausible to assume that by boring the subject into a trance state the anterior cingulate cortex (ACC) is calmed, thereby empowering the right prefrontal cortex's ability to imagine. While this may have resulted in an inhibition of the left prefrontal cortex and thus reduced its interference, that probable conjecture was not the final step. By the hypnotic operator giving the sharp command "sleep!" the typical subject fell into a sudden somnambulistic state. Due to the success of that method, a tradition was formed. There was an assumption that hypnosis required a trance coupled with an authoritative command.
David Elman (1964) was heavily influenced by Munro, Bernheim (Bernheim, 1980), and others. However, he realized that there was a stark difference between the experience and nature of hypnosis. He was one of the first to realize that all operational hypnosis protocols included the fact that a person's resistance – which he called either the "critical factor" or "critical faculty" – had been reduced. Furthermore, he realized that this freed up the subject's ability to selectively think. Modern neurological findings indicate that these two concepts are synonymous with the inhibition of the left prefrontal cortex and an activation of the right prefrontal cortex – and specifically its R-OFC.
Elman's study of Bernheim led him to some other conclusions. First, Elman knew from his stage hypnosis experience that a subject's reaction would often be stronger after multiple suggestions. Then, after reading Bernheim, he noticed that the doctor claimed that his patients would go back into trance more easily during each successive visit. From this Elman developed his theory that by compounding suggestions during one session or visit, the same results could be achieved. In fact, his "hypnotic coma" technique is designed to take advantage of this factor.
The other significant Elman contribution was that of "waking hypnosis." He realized that the operator could obtain the same benefits without a trance induction. All that was needed was that the operator acts as if he had full confidence in his ability to create the results and that the nature of the suggestion not be contrary to the subject's belief system – to include not creating a fearful situation.
The dual conclusions here are that the resistance of the left prefrontal cortex can be mitigated without inducing a trance and that the intervention can be intensified due to a preference for pre-existing patterns (i.e. created by preceding suggestions) and by stimulating the brain through direct suggestions.
Despite the claims by the followers of Milton H. Erickson, MD, (O'Hanlon, 1987; Dilts et al., 1980) that his philosophy toward hypnotic interventions is quite contrary to those of Elman – his rival – once neuro-physiology is considered, there are more similarities than either would have admitted. Erickson's permissive and naturalistic approaches tend to mitigate left prefrontal cortex interference by creating frustration – which very much involves the dopanergic inhibition described in the previous section. This leads to the overwhelming and de-energizing of the left prefrontal cortex. Again, this inhibition – and the calming affect of the ACC – further enables the right prefrontal cortex and allows enhanced problem-solving participation by other nearby substrates, especially the two temporal lobes. Both versions of inhibition – substrate and neuronal – are obvious in an analysis of Ericksonian hypnosis.
By combining his exhaustive knowledge of Erickson's techniques with ideas generated by the emerging field of epigentics, Erickson protégé Ernest L. Rossi, PhD, (2002) proposed a new protocol that seems to better fit the results of modern neurological research. The protocol follows a 4-step approach: preparation, incubation, insight, and creation. The intent is to create a situation that uses the stimulative affect of numosity (i.e. the dopanergic response) to promote a naturalistic problem solving in the patient's brain. The protocol requires the patient to become vividly aware of some sensation (e.g. the current feelings of their hands), to think of a situation or problem state, and to allow their mind to "bubble up" an inspired solution. This idea came to Rossi after studying recent advances in genetics. His belief is that the stimulus created in this process actually has the potential for re-programming the patient's DNA – and thereby changing human nature. Nevertheless, Rossi is quick to claim that this is only a heuristic theory and warrants further research.
Regardless whether hypnotic protocols involve substrate inhibition or dopanergic stimulation, the implications on existing and potential protocols are clear. By understanding the mechanics of neural structure and dynamics together with an appreciation for mind/body integrative implications, the therapist can and will enhance the efficacy of hypnotherapy.
The International Hypnosis Research Institute is a member supported project involving integrative health care specialists from around the world. We provide information and educational resources to clinicians. Dr. Brunson is the author of over 150 self-help and clinical CD's and MP3's.
References:
Bernheim, H. (1980.) Bernheim's New Studies in Hypnotism. Trans. R. S. Sandor, New York: International Universities Press.
Dilts, R, Grinder, J., Bandler, R., & DeLozier, J. (1980). Neuro-Linguistic Programming: Volume I The Study of the Structure of Subjective Experience. Cupertino, California: Meta Publications.
Elman, D. (1964). Hypnotherapy. Glendale, California: Westwood Publishing Co.
Munro, H. S. (1908). A Handbook of Suggestive Therapeutics: Applied Hypnotism, Psychic Science. St. Louis, Missouri: C.S. Mosby.
O'Hanlon, W. H. (1987). Taproots: Underlying Principles of Milton Erickson's Therapy and Hypnosis. New York: W.W. Norton & Company.
Rossi, E. L. (2002). The Psychobiology of Gene Expression. New York: W.W. Norton & Company.
Posted: 10/29/2012
