Monday, August 29, 2011

On Hypnosis (Part 20/20)

Anxiety indicates that the defenses are under maximum strain and signals for the extra production of repressive chemistry. The system revs up to quell the Pain before control is completely lost. Anxiety is taxing enough but its suppression even more so, and the anxious person usually uses self-hypnotic techniques in order to control himself (though he may never identify them as such): "It'll be alright," "Don't worry, it'll turn out fine," "Take it easy," "Calm down," "Think positive." These are all hypnotic style suggestions. Very often they have to be repeated over and over to produce any effect, which gives us some idea of the energy needed to suppress and contain the anxiety.

Hilgard's discovery regarding the link between pain and anxiety parallels what we have learned about the effort involved in maintaining dissociation: feeling the Pain in its entirety is "easier" on the system than going through the labor of dissociating from it. In fact, it is not Pain alone that produces symptoms, but Pain together with its counteracting repression. Repression is responsible for the pressure the system is under leading to symptoms. It takes great physiological effort to keep Pain out of awareness, an ongoing internal struggle which is measurable through one's vital signs. Indeed, heart rate and blood pressure tend to decrease permanently after a period of releasing Primal Pain.

The fact that emotional pain registers as a physical entity, one which is imprinted throughout the system (indicated by the physiologic changes which occur as a result of its removal), is vital to our understanding of neurosis and hypnosis. This knowledge wrests neurosis from the abstract and even metaphysical realm created for it by its definition as a mental illness, from the realm of mechanics created for it by the behaviorist viewpoint, and at last, places it where it belongs in the very real and physical organismic processes.

Pain is not often thought of as anything other than the localized sensations caused by physical injury. When it is viewed on another level it is seen as an idea: as something that can be thought away, forgotten, or in some way mentally altered by psychological gymnastics (hypnosis, biofeedback, directive daydreaming). More recently we have coined the term "problem" to describe the affliction of neurosis. It then becomes a matter of unbalanced equations, malfunctioning machinery, and unsorted puzzles. Mental solutions are sought for mental problems and behavioral solutions are sought for behavioral problems.

Pain creates problems for those who suffer from it, but to become caught up in the treatment of each problem is to lose sight of the central issue: that only by dealing with the physical reality of repressed Pain does the nature and depth of the organismic disease known as neurosis become fully treatable.

As mentioned earlier, psychological mechanisms by which hypnotic states are induced are based on the innate defensive capabilities of the brain. Even more importantly, they are based on a pre-existing pattern of behavior that has been in constant and active use throughout the subject's life. Neurosis is the ongoing post-hypnotic state which is already operating when the hypnotist goes to work. The neurotic lives in a state of permanent dissociation from his pain. Hypnotic techniques take advantage of this situation without it being recognized. The already existing defense of dissociation gets an added boost from hypnosis. When translated back into neurological terms, this means that extra endorphins pour into the system. In other words, hypnosis helps the system function even more neurotically than usual.

"Pain," writes hypnotherapist Yapko, "is a warning sign that something is wrong. The various hypnotic approaches are essentially 'band-aids,' for while they may assist the client in being more comfortable, their healing abilities remain uncertain."[1]

As we shall see in the following chapters, the same can be said of the use of hypnotherapy as a psychotherapeutic tool. Hypnotherapy is anti-dialectic. It fails to take into account the complex interplay between imprinted Pain and repression in the development of problems such as smoking and drinking. Be it physical pain or psychological "problems," it takes the symptom as a viable force to be treated ex machina. It usually takes only one side of the dialectic process, working on the surface pain to the neglect of all else, manipulating it, changing its location, attenuating it by suggestion, but never...never... asking where it came from...and never...never...eliminating it.

Reinforcing Neurosis with Hypnotherapy

As far back as 1958, the American Medical Association recognized the use of hypnosis by physicians and psychologists as a valid therapeutic modality.[2] Since then, hypnosis has become one of the most oft-used forms of therapy in pain management and psychotherapy .[3]
Given the established nature of hypnosis as a form of controlled dissociation, question s remain : Are changes in permanent or temporary? And if it is possible to effect permanent change in symptoms with hypnotherapy, is it desirable to do so, given the physiologic stress that results from maintaining the dissociation
Whenever we consider hypnosis we must understand that however sophisticated the explanation, it is still repression that is at its core; a matter of narrowed perception; a constricted perceptual field. Just as it is possible to make a person unaware of physical pain, it is possible to dissociate him from feelings of anxiety, low self-esteem, and depression. Someone can think his emotional problems have vanished when they have not. A person can believe that his feelings of inferiority have been resolved even while he admonishes his children to be the best in everything. While the hypnotic reality constructs one world -- "I feel relaxed," "I am not compulsive anymore," "I feel worthwhile," "I want the best for my kids" -- the actual physiologically engraved reality (necessarily) constructs another world of referred tensions, substituted symptoms, and projected emotions. The first logical extension of this fact is that applying hypnosis in psychotherapy means utilizing the same dissociative conditions of consciousness that characterize neurosis. The second logical extension is that hypnotherapy reinforces rather than resolves neurosis
Utilizing key neurotic mechanisms to treat neurosis is at the very least contradictory. But before examining this hypotheses, let us take a look at how two prominent hypnotherapists apply their views of hypnotherapy to their patients.

Different Views of Hypnotherapy: The Ericksonian Approach

Despite his death in 1980, Milton H. Erickson's approaches to hypnosis have swept the field. "Ericksonian Hypnotherapy" is a recognized area of specialization for therapists, and Ericksonian training centers and foundations exist across the country. Psychotherapists from other specialties -- psychoanalysis, behaviorism, gestalt, etc. -- also draw from Ericksonian methods.
Erickson led the field in developing a vast array of techniques that were often highly innovative, and sometimes shocking and incomprehensible. Several of his colleagues spent much time and effort studying and observing his techniques, trying to find out what he did and how he did it. Foremost among them was psychologist Ernest Rossi. Rossi was with Erickson during much of the last decade of his life and wrote several books (with Erickson as co-author) that attempted to systematize and conceptualize Erickson's hypnotic approaches. The only relatively simple part of Erickson's work was his theory of the "conscious and unconscious minds," but how he applied that theory clinically with patients remained highly unusual and virtually non-reproducible. The crux of Erickson's viewpoint is the belief that the "unconscious mind" can heal the patient without the "conscious mind" ever being involved. According to Erickson, the conscious mind is often a barrier to healing, In his view, the unconscious mind and its reception of repressive suggestions can do, as h e demonstrated, is aid in the job of repression, so that symptoms are brought under control. "You will forget. You will not feel pain. You won't have migraines anymore .,"
In the hypnotic trance state, the conscious mind can be bypassed and the unconscious mind given free rein. According to Erickson, the conscious mind contains the "learned limitations" and "negative life experiences" that prevent us from enjoying ourselves and using our given potentials. The unconscious mind, on the other hand, contains the answers and untapped potentials for us. In Erickson's view, by bypassing or "depotentiating" consciousness, the unconscious is allowed to solve and heal. This does not mean that consciousness is kept out entirely, for it may be brought in at the end in a very secondary position:

The patient doesn't consciously know what the problems are, no matter how good a story he tells you, because that's a conscious story. What are the unconscious factors? You want to deal with the unconscious mind, bring about therapy at that level, and then translate it to the conscious mind...One tries to do hypnotherapy at an unconscious level, but to give the patient an opportunity to transfer that understanding and insight to the conscious mind as far as it is needed.[4]
In other words, consciousness may be included in therapy, but it need not be. It certainly is not to be trusted, since "the patient doesn't consciously know what the problems are, no matter how good a story he tells you..." Hypnotherapy is effective when it occurs on an unconscious level, and may then be brought into consciousness, but only "as far as it is needed."

[1]Yapko, Trancework, p. 276.
[2]_American Medical Association: Medical use of hypnosis. Journal of the Medical Association 1958, 168: 186-189.
[3]54% of 1,000 respondents to a recent survey agreed that "hypnosis can be used to recover memories of actual events as far back as birth." 97% felt hypnosis is a worthwhile tool for psychotherapy. (Yapko, M., Suggestibility and Repressed Memory of Abuse: A Survey of Psychotherapists' Belief. American Journal of Clinical Hypnosis, 36 (3), 1/94, 163-171.
[4]Milton H. Erickson, "Hypnotic Approaches to Therapy." In The Collected Papers of Milton H. Erickson on Hypnosis, Vol. IV, pp. 76-95. Edited by Ernest L. Rossi (NY: Irvington), 1980. Originally published in The American Journal of Clinical Hypnosis, 1977, 20, 20-35.


  1. An email comment:
    "Hi Art,
    Thank you so much for republishing your 20 excellent and pedagogic articles on Hypnosis. It has been for me a much-needed education which has taken my understanding on the human conditions a few steps forward.
    When I look back and see my life in a development and survival perspective, I think that I have used self-hypnosis as an important tool. Already in my teens I replaced my father's authority with other authorities, gurus, authors, etc. (fortunately often with a democratic, intellectual touch even though, objectively seen, there also were elements of enlightened despots). With these father substitutes, I had constant debates in my head, and I let them tell me how to act in many critical situations.
    In this manner I always have had a few "hypno therapists" to pull out of my hat. And You, Art Janov, became over the years one of them. A fascinating thing is that when I look back at those who have meant something to me and “acted” as my hypno therapists, they coincide in much with my father; strong, good looking, intelligent role models, who have been able to “show me the way”. These gurus/hypnotists “showed” me an unconditional respect and support. That way, I avoided my fathers conditional treatment.
    One of the countless memories of “self hypnosis” is when I in the mid 90ies went through my most difficult and revolutionary primals, which definitely turned my seizures into birth primals. Being under tremendous pain with my body starting to “move by itself”, recalling memories from the reptile brain, Art Janov was with me in my mind, telling me: “Go with the feeling Jan, go with it!! I went straight into a feeling of horror between life and death, and I came out, as liberated human being after a struggle which often lasted 1-2 hours.
    Without your education about what was going on and without my ability to use you as a “hypno therapist” it would never have been possible to feel that humiliating, terrifying pain. I’m still flabbergasted what I put up with.
    The fantastic conclusion: IT HAS BEEN WORTH EVERY SECOND OF THE EFFORT!
    The self-evidence and the lack of hesitation in your primal theories combined with your personal appearance established the unconditional support which created and gave me mental guidance to let out and live the pain."

  2. the writer of the above letter raises an interesting point re the importance Art's personal appearance in the early success of primal therapy; having been a devotee of Freud in college, when The Primal Scream first appeared in bookstores, i naturally grabbed it up and read it; i think the eye-catching graphic on the cover helped too; but what really sold me on the book, and it's contents, was when i saw Art on the Dick Cavett show for the first time; what a great looking guy, with the curly rock star hair and the mod clothes, and his utterly relaxed and coherent manner and speech; he just seemed so real; the only other person who had same qualities, for me, was when Floyd Patterson, the boxer, was a guest of Cavett's; go figure.


Review of "Beyond Belief"

This thought-provoking and important book shows how people are drawn toward dangerous beliefs.
“Belief can manifest itself in world-changing ways—and did, in some of history’s ugliest moments, from the rise of Adolf Hitler to the Jonestown mass suicide in 1979. Arthur Janov, a renowned psychologist who penned The Primal Scream, fearlessly tackles the subject of why and how strong believers willingly embrace even the most deranged leaders.
Beyond Belief begins with a lucid explanation of belief systems that, writes Janov, “are maps, something to help us navigate through life more effectively.” While belief systems are not presented as inherently bad, the author concentrates not just on why people adopt belief systems, but why “alienated individuals” in particular seek out “belief systems on the fringes.” The result is a book that is both illuminating and sobering. It explores, for example, how a strongly-held belief can lead radical Islamist jihadists to murder others in suicide acts. Janov writes, “I believe if people had more love in this life, they would not be so anxious to end it in favor of some imaginary existence.”
One of the most compelling aspects of Beyond Belief is the author’s liberal use of case studies, most of which are related in the first person by individuals whose lives were dramatically affected by their involvement in cults. These stories offer an exceptional perspective on the manner in which belief systems can take hold and shape one’s experiences. Joan’s tale, for instance, both engaging and disturbing, describes what it was like to join the Hare Krishnas. Even though she left the sect, observing that participants “are stunted in spiritual awareness,” Joan considers returning someday because “there’s a certain protection there.”
Janov’s great insight into cultish leaders is particularly interesting; he believes such people have had childhoods in which they were “rejected and unloved,” because “only unloved people want to become the wise man or woman (although it is usually male) imparting words of wisdom to others.” This is just one reason why Beyond Belief is such a thought-provoking, important book.”
Barry Silverstein, Freelance Writer

Quotes for "Life Before Birth"

“Life Before Birth is a thrilling journey of discovery, a real joy to read. Janov writes like no one else on the human mind—engaging, brilliant, passionate, and honest.
He is the best writer today on what makes us human—he shows us how the mind works, how it goes wrong, and how to put it right . . . He presents a brand-new approach to dealing with depression, emotional pain, anxiety, and addiction.”
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Art Janov, one of the pioneers of fetal and early infant experiences and future mental health issues, offers a robust vision of how the earliest traumas of life can percolate through the brains, minds and lives of individuals. He focuses on both the shifting tides of brain emotional systems and the life-long consequences that can result, as well as the novel interventions, and clinical understanding, that need to be implemented in order to bring about the brain-mind changes that can restore affective equanimity. The transitions from feelings of persistent affective turmoil to psychological wholeness, requires both an understanding of the brain changes and a therapist that can work with the affective mind at primary-process levels. Life Before Birth, is a manifesto that provides a robust argument for increasing attention to the neuro-mental lives of fetuses and infants, and the widespread ramifications on mental health if we do not. Without an accurate developmental history of troubled minds, coordinated with a recognition of the primal emotional powers of the lowest ancestral regions of the human brain, therapists will be lost in their attempt to restore psychological balance.
Jaak Panksepp, Ph.D.
Bailey Endowed Chair of Animal Well Being Science
Washington State University

Dr. Janov’s essential insight—that our earliest experiences strongly influence later well being—is no longer in doubt. Thanks to advances in neuroscience, immunology, and epigenetics, we can now see some of the mechanisms of action at the heart of these developmental processes. His long-held belief that the brain, human development, and psychological well being need to studied in the context of evolution—from the brainstem up—now lies at the heart of the integration of neuroscience and psychotherapy.
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In Life Before Birth Dr. Arthur Janov illuminates the sources of much that happens during life after birth. Lucidly, the pioneer of primal therapy provides the scientific rationale for treatments that take us through our original, non-verbal memories—to essential depths of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.
Gabor Maté MD, author of In The Realm of Hungry Ghosts: Close Encounters With Addiction

An expansive analysis! This book attempts to explain the impact of critical developmental windows in the past, implores us to improve the lives of pregnant women in the present, and has implications for understanding our children, ourselves, and our collective future. I’m not sure whether primal therapy works or not, but it certainly deserves systematic testing in well-designed, assessor-blinded, randomized controlled clinical trials.
K.J.S. Anand, MBBS, D. Phil, FAACP, FCCM, FRCPCH, Professor of Pediatrics, Anesthesiology, Anatomy & Neurobiology, Senior Scholar, Center for Excellence in Faith and Health, Methodist Le Bonheur Healthcare System

A baby's brain grows more while in the womb than at any time in a child's life. Life Before Birth: The Hidden Script That Rules Our Lives is a valuable guide to creating healthier babies and offers insight into healing our early primal wounds. Dr. Janov integrates the most recent scientific research about prenatal development with the psychobiological reality that these early experiences do cast a long shadow over our entire lifespan. With a wealth of experience and a history of successful psychotherapeutic treatment, Dr. Janov is well positioned to speak with clarity and precision on a topic that remains critically important.
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His new book “Life Before Birth: The Hidden Script that Rules Our Lives” shows that primal therapy, the lower-brain therapeutic method popularized in the 1970’s international bestseller “Primal Scream” and his early work with John Lennon, may help alleviate depression and anxiety disorders, normalize blood pressure and serotonin levels, and improve the functioning of the immune system.
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“Life Before Birth: The Hidden Script that Rules Our Lives” is scheduled to be published by NTI Upstream in October 2011, and has tremendous implications for the future of modern psychology, pediatrics, pregnancy, and women’s health.