Positive Health Online

Case Histories, Skin Conditions Diverse Approaches
My clients often surprise me, which I see as one of the benefits to me of my work as a therapist. One client who surprised me more than most was a 24 year old woman who came to see me hoping to achieve improvement in a skin condition, which had been diagnosed as eczema. She had this severely on her arms and hands, less severely on her face, and slightly on her chest. As with most people suffering from inflamed and flaking skin, she was burdened with itching, scratching and trying not to scratch, applying various products to her skin, changing and washing clothing, sleep disturbance from the irritation, and self-consciousness, particularly about her face. She reported having the condition since childhood and having noticed that its severity fluctuated with stress, she hoped that hypnotherapy would help her by reducing her stress and helping her to relax.

II usually have an anticipation of how things will go with a client, although I am always mindful of the advice of Fritz Perls, "Deal with what emerges", and I remain prepared to adapt to any surprises my clients spring on me. My anticipation with this client was that I would see her perhaps for four sessions, giving her a recording to listen to between sessions, and we would see some improvement over this time, which she could then continue on her own. I thought it likely that at some point, we would need to deal with emotions such as anger, frustration and resentment, which I have often found to be present with clients suffering from chronic, burdensome conditions, adding to their stresses.

My sessions usually last for a minimum of 90 minutes, giving me time to hear the client's story, ask her about her feelings on her condition and her hopes and aims in coming to see me, run some tests to see her responses to hypnosis, induce hypnosis, deepen the trance, and give her suggestions promoting her therapeutic aims. In this case, I used mostly 'oppositional' suggestions, such as that her skin would be cool, soft and supple. I recorded the hypnosis session and gave her the recording to take away and listen to. It so happened that she lived a long distance away and had arranged to have two sessions while staying in London for a few days. Therefore, four days later she came back for her second session. Her eczema had disappeared, the only trace remaining being a residual outline around the patches on her face. I was stunned, she was elated.

In the second session, I again induced hypnosis and gave her suggestions for well-being and continued improvement and good condition of her skin. She departed happily, and I never heard from her again. I generally find, in my profession, that no news is good news. Some happy clients write to tell me how well they are doing, but generally I only hear from clients if they seek further help from me or refer someone they know.

A more typical case was that of a 28 year old man who suffered from psoriasis on his legs and hands. He also reported having difficulty in sleeping and lacking in self-confidence. He hoped that hypnotherapy would help him with sleep and confidence, and did not focus on his skin condition, although he had noticed that it worsened with stress. I hypnotized him and gave him suggestions for relaxation, good sleep and confidence and gave him a recording of this. Ten days later, he came for a second session, reporting improved sleep, reduced stress and increased confidence. His skin condition was not much changed. At this session, he reported being troubled by feelings of anger and resentment. He wished to feel inner peace and calm, but this seemed to elude him. I hypnotized him and used the emotional disinhibition of the trance to investigate these feelings, developing a dialogue between conflicted elements within him, one of which was heavily critical of himself, and another heavily critical of others. When this dialogue had reached an emotionally intense pitch, I regressed him (i.e. asked him, in trance, to return to a time and place relevant to the feelings he was experiencing) to a series of scenes from his past associated with this inner conflict. The scenes he regressed to involved events from his family life, where his father was critical of him, and as he grew older, he in turn was critical of his father, against whom he harboured deep anger and resentment.  I then initiated a dialogue between himself and his father, asking him to imagine his father in front of him for this purpose, a technique known usually as Gestalt dialogue. In this process, he was able to achieve an expanded perception, using his present, more mature perspective to apply to his father's shortcomings the understanding and acceptance that he was not capable of as a child. He was able at a vivid emotional level to see that his continuance of the dynamics of reciprocal criticism within himself was only causing him harm and achieving no benefit.

This session lasted two hours, not uncommon when a procedure involving regression is required. The purpose of the procedure is to achieve an expanded perspective, and hopefully as a result the client chooses to set aside resentments and liberate their present and future from the grip of the past. These sessions are demanding for both client and therapist, as the client struggles through very real life choices in an intensive manner, and the therapist accompanies and guides them through this process, which requires great focus and attentiveness. This choice is the core of the therapeutic process and what the client chooses is not a foregone conclusion, otherwise it would not be a choice! Sometimes the resentments are so deep that the regression starts a process of change which may not result in an immediate choice to set them aside, but over a period of time the client manages to let them go. There is also no set model of how it is to be done - some clients choose a highly emotionalised liberation, others a quiet acceptance.

His third session was two weeks later. He reported feeling lighter, as though burdens had lifted from him, sleeping better, feeling relaxed and confident, and to his surprise, his skin much improved.  I hypnotized him again, and gave him suggestions for ongoing maintenance and improvement in all respects. I haven't heard from him since.

I have felt it worth while to give these case histories in relative detail, as I find that many people have only a very vague idea of what transpires in a hypnotherapy session. Both of the cases quoted are straightforward, the first one particularly so, but I hope that the account provides a basis of understanding of the goals and methodology involved. I am aware that the aims of resolution of inner conflicts, letting go of long-held negative patterns of thinking and their replacement by more productive thinking patterns are common to many forms of therapy. Many accounts of therapeutic interventions describe "epiphanies" or moments of vivid expanded perception, and related turning points where the client makes a choice to change at a profound emotional level. Because this deep emotional level is often not straightforward to access in normal thinking and conversation, and its contents are often not immediately obvious even to its owner, it has the technical name of the subconscious.

Hypnotherapy Treatment Approaches
Because the subconscious is not straightforwardly accessible to consciousness, many methods have been developed in therapy to attempt to gain access to the power of the subconscious - it might be regarded as 'therapeutic gold'. This is the level of the brain which packs such a punch it can induce an otherwise rational and competent adult to avoid actions such as using lifts, travelling on trains and/or planes, leaving their homes, or an almost infinite range of other actions, at great inconvenience and limitation to their lives. It is also implicated in many physical complaints which appear to result from, or are exacerbated by, emotional stress. Among such complaints are various types of skin inflammation, digestive disturbances, sleep disturbance etc.

Among the methods of therapy which have been developed to gain access to the subconscious are methods involving drama of some kind such as role plays or Gestalt dialogues, analysing the contents of dreams, bodywork and many others. Looked at from the point of view of a hypnotherapist, it appears that these depend for their effects on a trance being entered into, triggered by a willing opening of consciousness to the subconscious contents. Crucial to this acceptance is a willingness to trust the therapeutic partner, the therapist, and the formation of the therapeutic alliance. The formal use of hypnosis is a powerful accelerator and facilitator of this trust, setting out clear steps and boundaries for the client and therapist to follow.

I am sometimes asked if people have to 'believe in' hypnotherapy in order for it to work, which always amuses me. Provided you are prepared to believe you have a central nervous system and are willing to operate it in the light of the knowledge gained by over two hundred years of clinical and experimental hypnotherapy, any outcome you achieve with hypnotherapy you demonstrate and experience for yourself, 'blind' faith is not required.

Modern hypnotherapy is a sophisticated approach which allows clients who are capable of rapid change, such as the two clients mentioned above, to gain the benefit of their capability. I don't have to spend many sessions allowing them to get used to me and gradually forming an alliance. They have sought me out because they are ready to change and believe that hypnosis can help them to do this. Using hypnosis enables them to benefit from their capacity to change. Others are not ready to change so rapidly, and the flexibility of hypnotherapy allows them to come for sessions periodically, using recordings and self-hypnosis in between to consolidate changes made in stages.

Trance disinhibits constraints on performance of many faculties of the brain, not only access to emotions and significant memories of the past. Memories of formally learned items such as study materials are also facilitated, and abstract reasoning and logic are enhanced by the ability to focus intently in response to directions, free from confusion and conflict. The same process enhances performances of many kinds, in sport, for instance, music, acting or other fields. In the 'choice' phase of hypnotherapy work, where the client has become aware through their vivid memories of the past, how they have constructed a version of the world and their own place in it which is now not serving them well, the enhancement of their logical power is put to use to reconstruct a more accurate and productive view of themselves and their capabilities.

The basic methods and principles of hypnosis are relatively simple to learn. For a therapist, the sophistication arises from the variety of individuals you see and adapting the methods to suit each one. However, there is great benefit to be gained from learning the methods and principles for yourself and using them as part of a self-help system for self-understanding and change. I find teaching people to do this immensely rewarding, as they discover for themselves the extent of the creative powers in their own minds, gaining resources to see them through crises and challenges in their lives. Also, for a therapist of any kind, the practice of self-hypnosis is a powerful method of generating and sustaining the emotional resilience required for giving their clients the intense attention and focus that they need and deserve.