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Hypnosis in Children
Hypnosis can be used to strengthen a child's naturally ability to focus his or her concentration and
imagination to change symptoms, physiology, and behavior. It can be incorporated into all clinical
encounters in order to increase the physicians therapeutic rapport and positive expectancy.
I. Mechanism of Hypnosis
A. Hypnotic capacity is the ability to focus narrowly and intensify one's concentration and
perception while diminishing awareness of all other stimuli.
B. Examples of common hypnotic trance states include deep thought and prayer. The
person in hypnosis is more willful than in usual, less intense states of awareness.
Children often keep their eyes open and remain physically active in hypnosis.
C. All hypnosis is a form of self-hypnosis. The highly trained practitioner using the tool of
hypnosis is a facilitator.
D. The expressions guided imagery and imagination training are sometimes used to refer
to hypnosis. These may be useful terms for introducing concepts to children and their
families.
II. Clinical Benefits of Hypnosis
A. Children have been found to be able to use hypnosis to alter their responses to painful
stimuli, airway reactivity, brainstem evoked responses, and peripheral blood flow.
B. Hypnosis has been shown to reduce the frequency and intensity of childhood migraine
headaches more effectively than propranolol or placebo. Children with leukemia use less
antiemetic medication to reduce chemotherapy-induced nausea and vomiting when they
have been taught self-hypnosis.
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Pediatric Problems That Respond to Hypnosis
Anxiety associated with procedures or illness Nail biting
Attention deficit disorders Nightmares
Cerebral palsy Pain associated with acute problems (injuries, procedures)
Conditioned nausea and vomiting Pain associated with chronic disease (malignancy, hemophilia,
Diabetes mellitus sickle cell disease)
Dysfluencies Performance anxiety
Encopresis Pruritus
Enuresis Reflex sympathetic dystrophy
Facial tics Thumb sucking
Habitual coughs Trichotillomania
Insomnia
Migraine syndromes
III. Methodology
A. Language
1. Trained clinicians use language carefully in hypnosis. The tone, pace, and
semantics all must suggest confidence in the child's own ability, creating a sense
of positive expectancy. Words such as will and is are used (eg, You will feel
numbness beginning in your hand).
2. The child's or adolescent's own terms are used for the sensations and experience,
and The wording must give the young person a sense of mastery and control, such
as "I wonder if...,'' "You will discover...."
B. Steps in Hypnotherapy Method
1. Rapport. The first step establishes a therapeutic rapport by assessing and joining
in the young person's motivation and goals. This may be implicit: "I wonder if you
know how to keep this needle from bothering you?
2. Trance Initiation. The second step involves the initiation of a hypnotic trance. In
the context of a fearful experience, one might say: ''I bet this would bother you less
if you were in another place. Where would you rather be? Please tell me. Can you
imagine being there now? Good! When we start to do the needle poke you will be
surprised how easy it is to go there.'' Methods of trance induction help children
narrow their focus of concentration and absorb their imagination. Methods that are
intriguing, challenging, and fun that enhances the child's mastery and self-control
will work.
3. Therapy in Trance. This often follows from the trance initiation technique, as in,
"You will begin to notice that relaxed numbness in your back. See how your back
does not mind the needle touching you?
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4. Hypnotic Methodologies for Children
a. Reframing. Altering sensations: pain >> bother >> itch >> pecking like a little
bird.
b. Dissociation. Leaving the discomfort here while you "go" to another place; not
noticing it, as though it wasn't even there; where it won't bother you.
c. Healing Imagery. Using images of healing lights, beams, growing a healthy
garden, etc.
d. Trip Around the Body. Using a miniature "you" to travel around the body,
visiting healthy and problem areas, making repairs, and feeling the
improvement.
5. Ratification and Reflection. After the child is asked to "finish imagining for now,"
the experience should be reviewed. This helps the youngster confirm and
understand the experience.
IV. Practical Applications of Hypnosis
A. Hypnotic strategies can be blended into all pediatric encounters.
B. Inviting them to blow that fear away, as imaginary bubbles, provides an intriguing
challenge to children. The term "will not bother you" conveys the positive expectancy
required for the suggestion to be therapeutic.
V. Role of the Parents
A. The role of parents in hypnotherapy is pivotal because they: 1) often transmit their
anxiety to the child, 2) have great insight into their child's experiences, and 3) have
preconceptions about hypnosis that may either interfere with or aid their child's
therapy.
B. Parents can join with their child by focusing and relaxing. This, in turn, diminishes their
transmitted anxiety.