by Tim Brunson, PhD
In 1953, in what is probably the most famous cartoon quotation, Pogo stated that "We have met the enemy and he is us." No other utterance so closely conveys my misgivings and concerns about the struggle between the clinical approach to hypnotherapy and the rather idealistic one, which is too much en vogue in contemporary practices. My initial training and the numerous certifications previously received from four well-established international hypnotherapy associations clearly stated that I possessed clinical credentials. Yet upon further reflection and after being challenged in 2006 by a group of medical doctors to reconcile my accomplishments with relevant scientific literature, I started questioning how my colleagues – and even those in the medical and psychology professions – were using the word clinical in regards to hypnotherapy. This pondering continued during my successful efforts to complete a PhD dissertation on neurology and hypnosis. During that process I was expected to clarify, validate, and cite my various statements and claims. Many of my concerns emanate from those efforts.
There are two significant trends within the hypnotherapy community. The first is what I call "idealism," which fits quite well with spiritualism and the smorgasbord of New Age beliefs that have become increasingly popular since the 1960's. The second is a desire to move hypnotherapy back into the more scientific arena first proposed by the 19th Century French physician Ambroise-Auguste Liébeault, who I consider to be the father of clinical hypnotherapy. Frankly, I believe that the latter must triumph over the former if hypnotherapy is to survive as a relevant endeavor.
Additionally, it is somewhat of an irony that most hypnotherapists and many other practitioners within the non-medical and psychological fields generally take an idealistic approach – although they frequently self-apply the clinical label. Meanwhile medical and other psychology-licensed practitioners regularly conduct what they call clinical activities all the while basing their approaches to hypnosis predominantly on idealistic myths. However, it should not be lost on readers that the latter group has superior cultural and legally-sanctioned authority. And, they frequently lead efforts to prevent the former from using the clinical moniker. Truthfully, this seems like a kettle-calling-the-pot-black situation. Unfortunately, the success by the second group stems largely from the first's refusal to comply with scientific expectations.
To understand the foregoing it is helpful to explore the meaning of idealism, clinical, and even the term science. Idealism refers to ideas or thoughts, which are based solely on beliefs and devoid of any verification through observation or rationality. This is best described as a faith-based approach. Another way of saying this is that an idealistic practitioner believes in their statements and activities regardless of the lack of any substantial validation through scientific processes. On the other hand, the word clinical actually means observed or observable. A judgment such as a diagnosis, which is confirmed through observation, would qualify as a clinical one. Thus a practitioner cannot claim to be involved in a clinical practice unless his or her methods are backed up by empirical observations, which if adequately substantial would be considered to support evidence-based conclusions.
For an endeavor to be scientific, three essential elements must be present. First, there must be a proposition, which is normally called a hypothesis. Second, there must be a series of empirical (i.e. clinical) observations designed to confirm or dispute the hypothesis. (This is why a clinical process is also a scientific one.) And third, the results of the observations must be filtered through a logical process such as deductive or inductive reasoning. Obviously, idealism meets the first required element. However, it fails when it comes to the other two and thus must be considered faith-based or pseudo-scientific. The clinical approach is the only one of the two that meets all three elements. Therefore, in order to justifiably consider oneself to be a clinical hypnotherapist, the principles upon which a practice are based must be scientifically valid. Otherwise, at best the practitioner is merely a "consulting hypnotist."
Of course, the key difference between idealism and clinical is the quantity and quality of the observations. If the number of observations is too few and therefore statistically insignificant, any of the resulting conclusions or beliefs should be considered dubious and therefore idealistic. To the contrary, numerous documented cases and/or published and replicated research would be on the other end of the credibility spectrum and thus justifiably be considered as being clinical.
Therefore, idealistic practitioners almost always promote conclusions that are bereft of sufficient clinical trials or observations. For instance, saying that hypnosis can stop a smoking habit or substantially reduce symptoms of fibromyalgia sufferers remains at the idealism level until a significant number of observations are made. Fortunately for all hypnotherapy practitioners – regardless of their complementary licensure – scientific research validating these two applications and many others are abundantly present in the medical literature.
So at this point you are probably wondering why I feel that the idealism/clinical distinction is important. Obviously, a procedure (i.e. idea) is being followed and the desired results are more often than not being achieved. To say it another way, this is a condition that is called efficacy or efficacious. This means that there is a relationship between the hypnotist's actions and the achievement of a positive result. Shouldn't this be sufficient considering that the client/patient's foremost interest is in achieving progress toward their goals and intentions? Even though answering this question in the positive is all that matters to many hypnotherapists, in our society a failure to follow scientific/clinical protocols could produce inconsistent results, increase legal liability, and give our critics even more ammunition for their efforts to restrict our activities.
Let's explore this further. What if a practitioner decided to pursue a hypnotic procedure for which there was insufficient clinical experience? (Attorneys would probably say that the legal liability would be considerably higher should the procedure result in harming the client.) Would related statements to a client or patient be classified as clinical or idealistic? For instance, if I were to tell a patient that hypnosis could achieve a certain result knowing that there is absolutely no evidence supporting it, would I truly be living up to my clinical hypnotherapist credentials? I think not. Don't forget that when you make a statement and imply that it is clinical, there had better be something to back it up. Otherwise, your comments are rather fraudulent. Remember that advice that is not backed up with a significant body of evidence is NOT clinical – it is idealistic.
Another relevant issue is that a clinical hypnotherapist – like any other scientifically-oriented practitioner – should be extremely concerned about the issue of causation (i.e. etiology). What causes your idea to manifest the desired results? You apparently know that there is an efficacy. But, do you know the etiology? And, most important to the current discussion is whether the etiology is also scientific. That is to say, I may have a theory that the Sun will rise every morning and can clinically verify my hypothesis and have it sufficiently concurred with by my colleagues. However, when I begin claiming an etiological theory, which says the cause of the daily movement of the Sun is due to a god riding his chariot, unless I can further substantiate this though clinical observations, I have reverted back to the realm of faith-based idealism. This is where most hypnotherapists – and numerous lay hypnotherapists within the licensed medical and psychology communities – absolutely fail.
For centuries anyone interested in the power of the mind to influence mental or physical healing has had ample opportunities to clinically verify the efficacy of hypnotherapy. However, the lack of understanding regarding the etiology of hypnosis is where we fail to act as clinicians. For instance, many may feel that chakra balancing, Reiki, and energy medicine/psychology are effective. Nevertheless, until these interventions are adequately backed by evidence using a scientific approach and a causal theory reasonably confirmed – which I firmly believe will eventually happen – they are not clinical healing modalities. They are still in the rather idealistic realm.
And, here is our most glaring failure. Ever since Friedrich Schiller, an18th century philosopher who incidentally was called a German Idealist – not a German Clinician – stated that there must be something else in addition to conscious awareness, there has been a very popular myth concerning the unconscious or subconscious mind. This concept almost immediately crept into the scientific realm and clearly eroded the credibility of many clinicians. The problem is that the unconscious mind has never been clinically verified. Sigmund Freud attempted to describe it. However, his statements as to the nature and behavior of the unconscious mind are only idealistic theories. Unfortunately, his mantra was later taken up by Milton H. Erickson, who then provided its path into the world of hypnosis and Neuro Linguistic Programming (thanks to Bandler and Grinder).
The unconscious mind myth is a tremendous blunder within the medical, psychology, and hypnotherapy professions. When I attend a conference sponsored by an institution or one of the auspicious hypnotherapy associations, or review a professional book for a respected New York publisher, I am appalled by frequent statements lauding the power of the unconscious mind. I extend these feelings to what I experience when the speaker or author makes completely unsupported statements explaining the nature of the unconscious mind. These include phrases like, "Your unconscious mind will...", "Your unconscious mind does...," and "Your unconscious mind wants...." Where did they get this? Obviously, it did not come from using scientific methods. Last weekend I was briefly watching a very popular female evangelist on TV. She was making the exact same statements albeit replacing the words unconscious mind with God. She was doing just what I expected her to do. After all, she is an evangelist. I expect her to make faith-based comments. However, I would object if I heard her calling herself a clinical evangelist. Why would I feel any different when I experience the same coming from one of my colleagues?
Other than my obsession about being honest and accurate, why am I concerned with the idealistic nature of many hypnotherapists? The reason is that we are increasingly becoming a threat to ourselves. Idealism-oriented hypnotherapists are more and more involving themselves with physical (e. g. medical hypnotherapy) and mental issues, which have traditionally been the sole concern of other licensed professionals. The fact that we are getting significant results – often at times when others feel inept – threatens not only the traditional establishment's credibility but also their livelihood. Still, the clinical weakness within hypnotherapy is frightening. [Note: Licensed "clinical" psychologists can get away with being idealistic (e.g. the followers of Freud, Jung, and Woodman). They are sanctioned by the state as licensed practitioners.]
It is at this point that I see us becoming our own worst enemies. Many of my colleagues, who call themselves clinical hypnotherapists, follow a rather unscientific approach. This is especially true when it comes to their explanations as to why they are successful and some of their other rather spurious claims. This gives those who are threatened by their accomplishments the ammunition with which to challenge them legally and in front of legislative bodies. There already has been an insistence by one state that hypnotherapists cease using the label clinical hypnotherapist and begin calling themselves consulting hypnotists. And, almost yearly there are attempts by various US state legislatures to clamp down on the activities of hypnotherapists. This is truly becoming rather bothersome. Unfortunately, collective efforts to counter these moves have either been unsuccessful or only resulted in a temporary stay. At best this allows us to continue operating in our current under-regulated, non-clinical, and too often a low standards manner.
Conversely, I see that the only way that we will truly benefit society at large is if we clean up our act. If we are to survive as an identifiable group, our only option is to move from idealism to a sound scientific/clinical foundation exactly as is expected of the medical and psychology professions. Our failure to do so will result in our eventual demise or our being relegated back to the New Age arena where some of our fellow practitioners would apparently feel more comfortable.
Regardless, my efforts to find and promote the scientific credibility of hypnotherapy have led me to a couple of very important observations. First, I see that recent discoveries within theoretical physics and those involving the human brain point to unquestionable conclusions about unlimited human potential when it comes to health, happiness, and self-actualization. Secondly, hypnotherapists – especially those who are knowledgeable as to the entire spectrum of hypnosis arts and sciences – are uniquely suited to assist this next stage in human evolution. Whether we will survive to do so will largely be our choice.
Tim Brunson is a practicing clinical hypnotherapist. He is the founder and the Executive Director of The International Hypnosis Research Institute. He is the primary developer of Advanced Neuro-Noetic Hypnosis, has written and produced 18 courses, and has written and recorded over 150 self-help and clinical CD's, which are available through www.TimBrunson.com.
Posted: 11/22/2011
