R RA AP PI ID DH HY YP PN NO OT TI IC CI IN ND DU UC CT TI IO ON N: :R R. .

K KM ME ET TH HO OD D

A Ab bs st tr ra ac ct t
Hypnosis based interventions are being increasingly used nowadays. The induction methods range from instant to lengthy ones. This paper describes a method of rapid hypnotic induction. Hypnosis is quickly induced through the method in a few minutes. The method is presented with detailed instructions for induction proper and the deepening techniques to enable an informed practitioner to utilise the method for accomplishing desired intervention. Key Words: Hypnosis, Hypnotic induction, Techniques of hypnosis, Deepening procedures for hypnosis.

I In nt tr ro od du uc ct ti io on n: :
The roots of hypnosis can be traced in ancient time. The Greeks had sleep temples where patients visited for their ailments. The priests used to put them to sleep before giving healing suggestions. Hypnosis as a formal phenomenon was identified by Franz Anton Mesmer (1734-1815), an Austrian physician. He is widely acknowledged as the 'Father of Hypnosis'. He believed that there was a quasi-magnetic fluid in the air we breathe and that the body' nerves somehow absorbed this fluid. He considered disease to be caused via a blockage of the circulation of this magnetic fluid in the blood and the nervous system. He formulated the theory of Animal Magnetism. Louis XVI (1784) appointed two commissions to investigate Mesmerism and its healing effects. Both the commissions disapproved his theory which led to decline of its popularity and practice. James Braid (1795-1860), a Scottish surgeon working in Manchester studied the phenomena and provided a physiological explanation. He coined the term hypnosis in 1843 and considered it as a type of sleep. James Easdaile (1818 - 1859), a colleague of James Braid, experimented with hypnotic anesthesia while serving the British East India Company in Calcutta,

India. His success resulted in lowering the surgical mortality rate to less than 5 percent in over 300 surgical operations. Jean-Martin Charcot (1825-1893), a leading neurologist and head of the neurological clinic at the Saltpetiere in Paris, used hypnosis to treat hysteria. He concluded that hypnosis was an induced seizure. Hippolyte Bernheim (1837-1919), a professor of medicine at the University of Nancy regarded hypnosis as a special form of sleep where the subject's attention is focused upon the suggestions made by the hypnotist. He emphasized the psychological nature of hypnosis. Breuer and Freud practiced age regression through hypnosis to treat hysterical symptoms during 1893-1895. They formulated their theory of unconscious determinants of symptoms. Sigmund Freud abandoned hypnosis and capitalized on free association. For the first three decades of the 20th Century, interest in hypnosis remained in decline, which was revived by Clark L. Hull, whose 1933 book entitled Hypnosis and suggestibility: An experimental approach was instrumental in rekindling interest in the topic. This renewal of interest was short-lived. Hull was forced to abandon the study of hypnosis and to turn his attention to learning theory. During World War II army psychiatrists successfully applied hypnotic techniques for treating traumatic neurosis. Serious laboratory investigations of hypnosis began in 1950s with the development of hypnotizability scales (Hilgard, 1965). Milton Erickson (1932-1974), a psychiatrist pioneered the art of indirect suggestion in hypnosis. He is considered to be the father of modern hypnosis. His methods bypassed the conscious mind through the use of both verbal and nonverbal pacing techniques including metaphor, confusion, and many others. He immensely influenced the practice of contemporary hypnotherapy. Hypnosis was officially recognized as a legitimate tool for therapeutic applications by British Medical Association in 1955 and American Medical Association in 1958. A division of the American Psychological Association (Division 30) is involved in the investigation and application of hypnosis in clinical and other areas.

D De ef fi in ni it ti io on no of fH Hy yp pn no os si is s: :
Hypnosis is a state of attentive, receptive concentration with a relative suspension of peripheral awareness (Spiegel and Maldonado, 1999; P. 1244). Hypnotic experience involves three main factors absorption, dissociation and suggestibility.

Absorption: Absorption is immersion in a central experience at the expense of contextual orientation (Hilgard, 1970; Tellegen, 1981). An individual involved in focal concentration tends to ignore peripheral psychomotor activity. Dissociation: Many routine, sensory experiences and emotional states may be dissociated. An individual may feel that his legs are no as much a part of his body as usual. Suggestibility: The suggestibility is enhanced in hypnosis. An individual accepts instructions relatively uncritically. He may even accept irrational directions.

M Miis sc co on nc ce ep pt tiio on ns s:
The term hypnosis is associated with numerous misconceptions in common mass and lay professionals as well. 1. Hypnosis is a type of sleep: The Greek root of the term hypnos means sleep. It has produced the most prevalent misconception. misconception. An individual under hypnosis is not asleep. The EEG pattern of hypnotized individual reflects alertness. Also one can not establish a dialogue with an individual while asleep which is a routine under hypnosis.

2. The ability to hypnotize is achieved throu through Sadhna: gh Sadhna : Some people believe that a hypnotist has to practice tratak or mantra siddhi to acquire the power to hypnotize. Hypnosis occurs naturally in everyday life while one is engrossed in a novel, movie and other routine activities. In a formal clinical clinical set up it is induced through suggestions. No Sadhna Sadhna Sadhna is required. Any person acquainted with the principles and procedures of hypnosis can induce it through suggestions. 3. A hypnotized person can be persuaded to perform any criminal/immoral act: The depiction of hypnosis in media and movies has created a widespread notion that an individual can be made to perform criminal or immoral acts through hypnosis. Since the person under hypnosis remains alert through out the procedure, he can not accept any instruction which violates his moral code. 4. An individual under hypnosis looses all the awareness of surroundings: Some persons may exit the hypnosis with a wrong feeling that nothing has happened to them since they were well aware of everything happening around around them. them. Probably they expect an experience similar to coma or generalized anesthesia. anesthesia. 5. A hypnotized individual may get struck and fail to exit exit: : It is impossible. If an individual is left as such without formal termination, either he shall come out of it it spontaneously or pass into natural sleep. 6. Hypnosis is dangerous: Hypnosis by itself is safe. Instead there are some contracontra-indications of the procedure like paranoid disorder in which the patient may misinterpret the procedure. 7. Only weak weakcan hypnotized: -minded people ca n be hypnotized : The experience of hypnosis depends on the hypnotizability, a trait, which is normally distributed. Therefore, some persons are easily hypnotizable and others require considerable repeated efforts. 8. One can be made to reveal his secrets: As the individual under hypnosis remain aware of himself and surroundings
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he can choose what to reveal and what to conceal. It never happens that he discloses any secret information unknowingly despite the deepest level of hypnosis.

H Hy yp pn no ot ti iz za ab bi il li it ty y: :
Hypnotizability is a trait which varies across individuals. The peak hypnotizability is found in late childhood which gradually decreases throughout adulthood. The assessment of hypnotizability is a helpful starting point for the use of hypnosis in treatment (Spiegel and Spiegel, 1987). Hypnotizability is assessed through standardized scales. For example, Stanford Hypnotic Susceptibility Scales (Hilgard, 1965; Weitzenhoffer and Hilgard, 1959; 1962); Hypnotic Induction Profile Spiegel and Spiegel, 1987), Stanford Hypnotic Clinical Scale (Hilgard and Hilgard, 1975).

Pre-hypnotic Preparation and Explanations:

This is an essential part in the whole process which follows gathering of background information and assessments. Rapport is to be established. Subjects concept of hypnosis is elicited. The misconceptions are corrected and he is reassured. It is to be stressed that hypnosis is a collaborative endeavor; nothing can be performed against his will. He will remain in a state of relaxed alertness and hear the therapists voice throughout. Hypnosis can be performed either in sitting or lying posture. The couch or bed should be comfortable. Pillow can be used as per the comfort of the subject. The place need be distraction free particularly the sudden sources of noise like telephone ring have to be avoided. No alarm clock should be present near the ears of the subject. Bright light should not fall directly on the eyes. If there are mosquitoes, a repellent is a must. The subject need be explicitly enquired about toilet needs. Hypnosis is not usually performed as a challenge to demonstrate the power of hypnotist. Have an observer be present while hypnotizing a person of opposite gender.

A As ss se es ss sm me en nt to of fS Su ug gg ge es st ti ib bi il li it ty y: :
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Suggestibility is one of the three main factors of hypnosis. Simple Simple clinical test of suggestibility can be run to have an approximate idea about the subjects capacity to experience hypnosis.
Ask the subject to sit comfortably on the chair and rest his hands on the arm of the chair. Tell him to hold a pen or similar object gently between index and middle finger of either hand and close his eyes. Give suggestions that his fingers are becoming loose and light, the gap between fingers is widening. widening. The grip is loosening. Repeat the suggestions a few times. times. The actual widening widening and drop indicates suggestibility.

R Ra ap pi id dH Hy yp pn no ot ti ic cI In nd du uc ct ti io on n( (R RH HI I) ): :
There are numerous methods for hypnotic induction. The interested reader is referred to an excellent resource Advanced Techniques of Hypnosis and Therapy: Selected Papers of Milton H. Erickson by Erickson (1967). The RHI incorporates components of three classes of hypnotic induction procedures eye fixation, relaxation and confusion. The script for RHI method is as under:

Be calm, quiet and comfortable. Concentrate on my voice. Whatever I say that will occur naturally and spontaneously. You do not have to speak or node. Keep your eyes open. You may choose any point slightly above the eye level to stare on. Mentally inspect your body. Let all the tension and tightness in the body be released. Allow few moments to adjust your body. Now gently focus on your abdomen. With inhale it rises and on exhalation it shrinks be aware of your legs both the legs are loose and light focus on your arms and hands both the arms and hands are loose and light visualize your abdomen inside and outside it is loose and light focus on your chest it is loose and light visualize your back relaxation is spreading in lower and upper back focus on your neck both back and front side of neck is loose and light focus inside your mouth everything inside mouth is loose and light focus on your face the face is loose and light your eyes are becoming very light lighter and lighter after a few moments your eyes shall shut down automatically your forehead is loose and light your head is loose and light. (if eyes are not closed yet) your eyes have become extremely light I shall count five to one in reversed order at the count of one the eyes will be closed automatically five four three two three four ONE. (In some relatively less hypnotizable subjects quick repetition of instructions may be required).

D De ee ep pe en ni in ng g:
As the subject closes his eyes deepening instructions are given.
Now imagine that it is a night time look at the sky innumerable stars blinking in the sky full moon shining in the sky with passage of time your are passing deeper and deeper into sleep (60 seconds pause). pause).

Now I shall count five to one whatever I say let it happen naturally and spontaneously spontaneously Five with every breath you are going deeper and deeper into sleep Four your depth of sleep is increasing ten times Three you shall continue to hear my voice throughout you will come back in a better than before condition when I ask ask you to do so Two in future, whenever, I count five to one you shall instantly pass into deepest level of sleep One with passage of time you shall continue to go deeper and deeper into sleep.

A As ss se es ss sm me en nt to of ft th he eD De ep pt th ho of fH Hy yp pn no os si is s: :
There are two ways to assess the depth of hypnosis subjective and objective: S Su ub bj je ec ct ti iv ve e:

Ask the subject what is the depth of your sleep light, medium or deep. Ask the subject to imagine a 12 point scale where One indicates very mild sleep and 12 is the deepest level of sleep. Let him rate the depth of his sleep on this scale.

Objective: Chertok (1966, P. 102) provided following objective symptoms of various depths of hypnosis:
Depth Objective Symptoms Relaxation Fluttering of lids Closing of eyes Complete physical relaxation Catalepsy of eyes Limb catalepsy Rigid catalepsy

Light Trance

Anesthesia (Glove) Partial amnesia Posthypnotic anesthesia Personality changes Simple posthypnotic suggestions Kinesthetic delusions, complete amnesia Ability to open eyes without affecting trance Bizarre posthypnotic suggestions Complete somnambulism Positive visual hallucinations Positive auditory hallucinations, posthypnotic Systematized posthypnotic amnesia Negative auditory hallucinations Negative visual hallucinations, hyperesthesia

Medium Trance

Somnambulistic Trance

U Ut ti il li iz za at ti io on no of fH Hy yp pn no os si is s: :
Hypnosis in itself is not therapeutic. Psychotherapeutic interventions can be performed under hypnosis. The common forms of therapeutic utilization of hypnosis involves posthypnotic suggestions, cognitive restructuring, behavioral intervention, age regression and life regression.

T Te er rm mi in na at ti io on no of fH Hy yp pn no os si is s: :
It is necessary to formally terminate the hypnosis. The sample termination instructions are described below:

Now it is time to come back to the normal state of awareness in a few moments your mind will be prepared when you feel prepared let me know I shall count One to Five upward at the count of Five you shall be back to the normal awareness in a better than before condition there shall be no ill effects or signs of discomfort One your complete body is coming back to the normal state of awareness Two your mind is coming back completely to the normal state of awareness Three your body is back Four your mind is 100% back to the normal and alert level Five your body and mind are back perfectly in a better than before condition.

Additional Instructions for Difficult Termination:

(a) (c) Repeat the above instructions. Tell the subject he has two options either to continue to sleep for one long very very long minute or exit right now.

(b) Allow rest for a few minutes

C Co om mp pl li ic ca at ti io on ns s: :
A few subjects may report headache, heaviness, pain or weakness after termination. In such cases, repetition of termination instructions may be needed. Reverse any instruction such as lightness or analgesia induced during hypnosis. Counting coupled with instructions for termination may be used freely. If the symptoms still persist, tell him to sleep for a few hours, the symptoms will disappear.

C Co om mm mo on n I In nd di ic ca at ti io on ns s I In nt te er rv ve en nt ti io on ns s: :
(a) Dissociative disorders

f fo or r

H Hy yp pn no os si is s

B Ba as se ed d

(b) Post-traumatic stress disorder

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(c) Insomnia (d) Obesity (e) Pain disorders (f) Substance use disorders (g) Psychosomatic disorders (h) Generalized anxiety disorder and phobias

C Co on nt tr ra a-i in nd di ic ca at ti io on ns so of fH Hy yp pn no ot th he er ra ap py y: :
(a) Paranoid disorder (b) Obsessive-compulsive disorder (c) Suicidal depression

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B BI IB BL LI IO OG GR RA AP PH HY Y
Chertok (1966) Hypnosis. London: Pergamon Press. Erickson, M.H. (1967) Advanced techniques of hypnosis and therapy: Selected papers of Milton. Erickson Edited by Haley, J. New York: Grune & Stratton. Hilgard, E.R. (1965) Hypnotic susceptibility. New York: Harcourt, Bruce & World. Hilgard, J.R. (1970) Personality and hypnosis: A study of imaginative involvement. Chicago, I.L., University of Chicago Press. Spiegel, D. and Maldonado, J.R. (1999) Hypnosis. In R.E.Hales, S.C. Yudofsky and J.A. Talbott (Eds.) Textbook of Psychiatry, Vol. II. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd. Spiegel, D. and Spiegel, H. (1987) Forensic uses of hypnosis. In I.B. Weiner and A.K.Hess (Eds.) Handbook of Forensic Psychology. New York: Wiley. Tellegen, A. (1981) Practicing the two disciplines for relaxation and enlightenment: Comment on Role of the feedback Signal in Electromyograph Biofeedback: The Relevance of Attention by Qualls and Sheegan. Journal of Experimental Psychology, 110, 217-226. Weitzenhoffer, A.M. and Hilgard, E.R. (1959) Stanford Hypnotic Susceptibility Scale, Forms A and B. Palo Alto C.A. Consulting Psychologists Press. Weitzenhoffer, A.M. and Hilgard, E.R (1962) Stanford Hypnotic Susceptibility Scale, Form C. Palo Alto C.A. Consulting Psychologists Press.
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