Hypnosis as an effective method of Complementary and Alternative Medicine (CAM) has been the subject of controversy over the course of an interesting history which has led to the long lasting dichotomy between ‘lay’ and ‘professional’ hypnotists Despite some scientific validation and legitimate uses, the fundamentals of how hypnosis works is poorly understood and lacks a sufficient theoretical framework to be fully scientifically embraced. As hypnosis developed over the centuries, conflicts have arisen as to whether or not the practice of hypnosis is ethical. The question of the ethical validity of hypnosis takes two forms. There is a question of whether hypnosis has valid use within the medical profession. This is a more straight-forward question, and while hypnosis has yet to gain mainstream acceptance in medicine, it is increasingly accepted as a valid treatment for certain indications when done by physicians or other medical professionals. The second question, which is more controversial, is whether hypnosis has a valid use by lay practitioners. Here, I explore a brief history of hypnosis to outline how this second question came to be relevant. Understanding the historical origin, progression, and uses of hypnosis will help to illuminate some of the current perceptions of hypnosis.
Henriette Gezundhajt gives a thorough account of the origins of hypnosis. While the term “hypnosis” wasn’t created until 1843 by surgeon James Braid, methods sufficiently similar or nearly identical to hypnosis have been around since ancient cultures such as the Egyptians, Romans, Grecians, and Druids. These methods were used with religious practices for healing and enlightenment, but in the Middle Ages, were generally denounced as demonic or occult. In 1529 a Swiss alchemist, Paracelsus, was the first to associate health and disease with the presence of a heavenly magnetic fluid. This idea was adopted over 200 years later by a priest and astronomer, Father Maximillian Hell, who successfully used magnetism to cure ailments in ritualistic procedures. Studying under Father Hell, the physician Franz Anton Mesmer, coined the term ‘animal (animate) magnetism’ asserting that “a universal fluid is present in everything in the universe and more especially affects the nervous systems of humans.” Disease and ailments were attributed to an imbalance in these fluids and were cured by restoring the proper balance to this distribution of fluids and magnetic vibrations. Mesmer used a drum filled with bottles of specially magnetized water to induce convulsive and curative trances in ritualistic group ceremonies with a very authoritative approach. The king of France ordered Mesmer to be investigated in two separate investigations (led by Benjamin Franklin). Though the efficacy of his methods was not questioned, the existence of magnetic fluids was denied and Mesmer retired. Some of his students noticed that whether or not a magnetic fluid exists, trance can be conducted without it. One student, the Marquise de Puysegur discovered a “magnetic sleep” by accident, later finding a calm relaxed state was often better for healing than convulsions. Puysegur emphasized the importance of rapport, intention, and attention as the main components of healing, which remain the fundamentals of hypnosis today (Gezundhajt 2007).Around the same time, Father Johann Joseph Gassner relieved symptoms thought to be caused by possession by conducting exorcism rituals which first enhanced the symptoms of his subjects, and then caused them to disappear through exorcistic instructions. Subjects were instructed on how to behave thereafter, similar in many ways to how hypnosis is conducted today (Gezundhajt 2007). Magnetism was forgotten during the French Revolution, until Joseph Deleuze, of the French National History Society outlined methods of suggestion in an instructional book, Practical Instruction in Animal Magnetism. At the same time the monk Abbe Faria, introduced oriental hypnosis to Paris and started the imaginationist movement. He saw the presence of a fluid to be an illusion, and that external forces were not necessary to bring about a state that came from within, coining the term “lucid sleep”. Magnetism was again investigated by a commission with the Academy of Medicine in France where it was thought to be nothing more than boredom and imaginations, but agreed it could be therapeutic so long as it was only used by physicians. Due to controversy with the finding, a second commission was issued and discredited magnetism altogether in France, leading to its spread to other countries (Gezundhajt 2007).
Mesmerism was first introduced to America by the Marquis de Marquette, of the French Royal Court, however Mesmerism did not take hold in America. Both George Washington and Benjamin Franklin rejected the Marquis’ agenda to bring Mesmerism to America. Despite the rebuke from leadership, mesmeric societies across America were established, some of which flirted with fringe movements such as phrenology and spiritualism, doing healing work and advancing the movement, making contributions to both the art and its acceptance (Gravitz 1994).
John Elliston, a physician in London and student of Abbe Faria, was a pioneer in using magnetism as a form of anesthesia in surgery, but was forbidden to practice magnetism at the University Hospital as he was competing with the inventors of chloroform. His acquaintance, James Esdaile was a surgeon from Scotland, stationed in India in 1845, who promoted magnetism, performing thousands of operations using only mesmerism for anesthesia. Given his success, he was given a hospital in Calcutta by a Government committee, but it was shut down by detractors. A second hospital opened in 1848, and Esdaile published a manual for using magnetism in surgery, adding the use of chloroform to appease detractors, but he still received opposition from predecessors and the Church (Gezundhajt 2007).
Charles Lafontaine was a Swiss magnetizer who performed demonstrations for entertainment purposes. Lafontaine was banned from performing in Italy as the cures he was performing were considered to be “blasphemous imitations of the miracles of Christ”. His demonstrations were witnessed by Scottish Surgeon James Braid and although he was skeptical at first, Braid became convinced after a second demonstration. Braid coined the term hypnosis in 1843 and moved away from mesmerism into the era of hypnosis, thinking it was a form of sleep resulting from exhaustion of the eye muscles from extended attention. Attempted to rename to “monodeism” once he realized it wasn’t necessary to induce sleep to have hypnotic phenomenon, but the new name did not take and it has been known as hypnosis ever since (Gezundhajt 2007). Braid thought hypnosis should be limited to use by physicians and dentists as a powerful adjunct to other therapies, although interestingly he learned it from someone who was not a physician.
Around the same time, French Neurologist Jean Martin Charcot, was conducting experiments on hypnosis and presenting experimental and observational finding to the Academy of Sciences. Charcot recognized different stages of hypnosis, categorizing them as lethargy, catalepsy, and somnambulism, concepts which are still in use today. Charcot’s experiments were not well conducted and he was generally shunned, but his hypnosis methods were carried on by his pupils, Josef Breuer, and Sigmund Freud. Freud and Breuer collaborated to use hypnosis in the treatment of hysteria. Freud grew to dislike hypnosis and focused on using dissociation without hypnosis, and after Charcot’s death, hypnosis was not really rediscovered until after World War I (Gezundhajt 2007) and was used after World War II for psychotherapeutic hypnosis in treating psychogenic war casualties, in dentistry, and in obstetrics, earning endorsement from major national medical associations (Upshaw 2006).
Despite these endorsements, hypnosis has had varied acceptance among medical practitioners in the last 50 years as Mark Weisberg outlines. Despite the initial revival of hypnosis after WWII, the technological and pharmaceutical advancements of the 1950’s made “low-tech” interventions seem antiquated, unscientific, and extraneous, thus undermining the traditional hallmarks of medicine up until that time. As the low-tech “unscientific” methods were cast off by mainstream medical practitioners, they were adopted by alternative practitioners, giving birth to the “alternative therapies industry” in the 1950’s. These alternative practitioners were viewed as ineffective, unethical, and fraudulent, and carried a certain level of stigma (Weisberg 2014). Pop Culture in the early 20th century portrayed hypnosis negatively. Books like Trilby, The Manchurian Candidate, and The Search for Bridey Murphy portrayed hypnosis as a form of mind control and it had a strong tie with spiritual seekers (Upshaw 2006). Along with lay practitioners of hypnosis, stage hypnotists also perform hypnosis for entertainment purposes, giving a certain impression about what hypnosis is, furthering the notion of a loss of volition and a sense of obedience to the whims of the hypnotist. While hypnosis is more accepted today, these views still remain to some extent.
Despite this stigma, professional medical hypnosis societies were established during this time, but hypnosis was not widely utilized, and few medical professionals were trained in the technique. In the 1960’s alternative practitioners established national schools for lay hypnosis, and the modern tensions between lay hypnotists and health professionals was born. Efforts to restrict lay hypnosis by medical professionals were unsuccessful as state regulatory bodies considered it an unfair restraint of free trade. (Weisberg 2014). In the 70s and 80s, law enforcement began to use hypnosis in investigations, and hypnosis was seen with skepticism and it was noted false memories could be implanted, leading to its exclusion and limits on its use in the courts, tarnishing its reputation unnecessarily (Upshaw 2006). While the efficacy of hypnosis has largely been accepted, it has failed to gain traction in medical practice due to religious concerns, supernatural characterizations, lack of access to scientific explanations, the availability of other effective treatments, negative media coverage, or concerns about hypnosis and the fallibility of memory (Weisberg 2014). Technological advances such as MRI, fMRI, and PET, gave a new dimension to hypnosis, taking it from a verbal intervention to an intervention understood on a non-verbal level. The National Institutes of Health (NIH) issued a report in 1996 endorsing hypnosis for certain indications, leading it to be accepted by some insurance providers and Medicare. However, the mechanisms by which hypnosis works, and the theoretical foundations are still in dispute with two dominant schools of thought; state theories, which consider hypnosis to be a special state of consciousness, and non-state theories which consider hypnosis to simply be part of socio-cognitive mechanisms which are already understood. These theories will be discussed in depth in the next section. The historical dichotomy between the physiological and psychosomatic became more integrated as it was understood that the mechanisms interacted and played a legitimate role in healthcare, leading to an integration of conventional and alternative treatments in health care utilizing treatments from both realms (Weisberg 2014). In many ways the story of hypnotherapy follows the struggles experienced by clinical psychologists. Clinical psychologist fought for legitimacy in the early years of the profession, were thought to lack the skills necessary to work with clients, were thought to be illegitimate charlatans, and inefficacious (Benjamin 2005). Clinical psychology gained acceptance as it was able to demonstrate competence, efficacy, and professionalism.
Benjamin, Ludy T. 2005. “A Hisotry of Clinical Psychology as a Profession in America (and a Glimpse at its Future).” Annual Review of Clinical Psychology 1-30.
Gezundhajt, Henriette. 2007. “An evolution of the historical origins of hypnotism prior to the twentieth century: Between spirituality and subconscious.” Contemporary Hypnosis 24 (4): 178-194.
Gravitz, Melvin. 1994. “Early American Mesmeric Societies: A Historical Study.” American Journal of Clinical Hypnosis 37 (1): 41-48.
Upshaw, William. 2006. “Hypnosis: Medicine’s Dirty Word.” American Journal of Clinical Hypnosis 49 (2): 113-122.
Weisberg, Mark B. 2014. “50 Years of Hypnosis in Healthcare.” Chap. 14 in The Handbook of Behavioral Medicine, by David I. Mostofsky, 251-274. John Wiley & Sons, Inc.