What motivates professionals to learn and use hypnosis in clinical practice?

Redefining hypnosis: A narrative review of theories to move towards an integrative model

Hypnosis is an ancient mind-body intervention that has regained interest with the surge of research in the last decade documenting its clinical validity. Yet, theoretical controversies and misconceptions prevail among theorists, clinicians, and the general public, impeding the understanding, acceptance, replication, and use of hypnosis. Providing adequate information, which dispels misconceptions and promotes more balanced views, is warranted to facilitate the implementation and adoption of hypnosis in clinical and research settings. This review re-examines the conceptualisation of hypnosis throughout history and the theoretical controversies surrounding it while highlighting their meeting points and clinical implications. Despite dichotomies, a broad agreement appears across theoretical approaches regarding hypnotic analgesia effects, key components, and vocabulary. Further, theories highlight key factors of hypnotic responding. For instance, social theories highlight social and contextual variables, whereas state theories highlight biopsychosocial mechanisms and individual factors. Based on theories, the terms hypnotherapy or clinical hypnosis are recommended to refer to the therapeutic use of hypnosis in psychotherapeutic and medical contexts, respectively. This review concludes with a model that integrates various theories and evidence and presents hypnosis as a complex multifaceted intervention encompassing multiple procedures, phenomena, and influencing factors. This review intends to deepen our understanding of hypnosis, and promote its more rapid adoption and adequate implementation in research and clinical contexts, in addition to steering research towards evidence-based hypnotic practice. The review can have important research and clinical implications by contributing to advancing knowledge regarding hypnotic procedures, phenomena, and influencing factors.

Using hypnosis in clinical practice for the management of chronic pain: A qualitative study

BACKGROUND

Interventions used in chronic pain management do not routinely use clinical hypnosis (CH), despite evidence to suggest its effectiveness in improving pain outcomes. This study aimed to explore the beliefs and attitudes of clinicians' towards the implementation of CH in chronic pain management.

METHOD

We conducted a cross-sectional qualitative analysis following online CH training. Clinicians working in three tertiary pain clinics, were recruited to participate in the online training program and invited to focus groups following completion of the training to explore beliefs and attitudes towards CH and the training program.

RESULTS

We identified three themes regarding barriers and two themes regarding facilitators to implementation of CH. Barriers: (i) misconceptions about CH, (ii) reduced confidence in implementing CH, and (iii) concerns about integrating CH with current treatment frameworks. Facilitators: (i) change in knowledge and attitude following training and (ii) an openness to exploring the technique and skills. The online training program was evaluated as positive with two themes: (i) training structure and (ii) training credibility.

CONCLUSION

Successful implementation of CH requires the development of training programs that address existing misconceptions of CH, allow for knowledge and skills acquisition, and adapt to the contextual setting within which the intervention is implemented.

PRACTICAL IMPLICATIONS

Training of clinicians in the process and skills required to deliver clinical hypnosis for chronic pain should be supported to facilitate its successful implementation into clinical settings.

Demystifying hypnosis: Unravelling facts, exploring the historical roots of myths, and discerning what is hypnosis

BACKGROUND AND PURPOSE

Hypnosis, a mind-body treatment dating back to early human history, has regained attention in the last decade, with research suggesting its effectiveness for varied physiological and psychological ailments such as distress, pain, and psychosomatic disorders. However, myths and misconceptions have prevailed among the general public and clinicians, hindering the adoption and acceptance of hypnosis. It is important to distinguish myths from facts and discern what is hypnosis and what is not to enhance the understanding, acceptance, and adoption of hypnotic interventions.

METHODS

This narrative review traces the history of myths surrounding hypnosis in contrast to the evolution of hypnosis as a treatment modality. In addition to comparing hypnosis to other interventions with similar procedures and features, the review unravels misconceptions that have impeded the adoption and acceptance of hypnosis in clinical and research settings and presents evidence to demystify this intervention.

RESULTS

This review examines the roots of myths while presenting historical facts and evidence that support hypnosis as a treatment modality and alleviate misconceptions depicting it as mystical. Further, the review distinguishes hypnotic and non-hypnotic interventions with overlapping procedures and phenomenological features to enhance our understanding of hypnotic techniques and phenomena.

CONCLUSION

This review enhances the understanding of hypnosis in historical, clinical, and research contexts by disproving related myths and misconceptions to promote the adoption of hypnosis in clinical and research contexts. Further, this review highlights knowledge gaps requiring further investigations to steer research toward an evidence-based practice of hypnosis and optimise multimodal therapies embedding hypnosis.

Current Practices, Experiences, and Views in Clinical Hypnosis: Findings of an International Survey

An online survey of 691 clinicians who use hypnosis was conducted in 31 countries to gain a broad real-world picture of current practices, views, and experiences in clinical hypnosis. Among 36 common clinical uses, stress reduction, wellbeing and self-esteem-enhancement, surgery preparations, anxiety interventions, mindfulness facilitation, and labor and childbirth applications were the most frequently rated as highly effective (each by ≥70% of raters) in the clinicians' own experience. Adverse hypnosis-associated effects had been encountered by 55% of clinicians but were generally short-lived and very rarely judged as serious. The most common hypnosis approaches used were Ericksonian (71%), hypnotic relaxation therapy (55%), and traditional hypnosis (50%). Almost all respondents reported regularly using other therapeutic modalities alongside hypnosis. Among a range of client variables potentially affecting therapy, most clinicians rated hypnotist-client rapport (88%) and client motivation (75%) as very or extremely important factors for successful hypnotherapy. The majority of respondents had conducted hypnosis treatment via teletherapy, and 54% of those estimated it to be as effective as in-person treatment.

Effectiveness of hypnosis on pain and anxiety in dentistry: Narrative review

Hypnosis presents an auxiliary adjunct in medical, dental, physiotherapeutic, and other clinical fields. This narrative review verified the effect of hypnosis in the control of pain and anxiety in dentistry. It presents the importance and effectiveness of hypnosis to aid dental procedures. It´s use in dentistry allows a wide range of applications such as sedation, analgesia, anesthesia, and hemostasis to facilitate treatment and improve the experience of dental care for dental patients. A discussion about the regulation of hypnosis in dentistry in Brazil, the attributions of dentists qualified in hypnosis, as well as the benefits of application based on evidence of hypnosis in dentistry, and the need for certification by hypnosis practitioners due to the possible risks inherent to the use of hypnosis are presented. Hypnosis is useful in the management of pain and anxiety in dentistry, when the dental practitioner is adequately experienced in this modality and the patients are carefully selected.

Attitudes Toward Hypnosis Based on Source of Information and Experience With Hypnosis

Attitudes and beliefs toward hypnosis are relevant in promoting hypnotic responses, in predicting the efficacy of interventions that include hypnosis, and in reducing iatrogenic effects in hypnotized individuals. The goal of the present study is to test the impact of previous knowledge about hypnosis and past experiences being hypnotized on attitudes and beliefs about hypnosis. A sample of 1,977 Portuguese students participated in the study; they responded to the Valencia Scale of Attitudes and Beliefs Toward Hypnosis-Client Version (VSABH-C) on two different occasions (test-retest method). Significant differences were found (p ≤ 0.001) on participants' attitudes and beliefs about hypnosis depending on the source of knowledge about hypnosis. Results also showed significant differences (p ≤ 0.001) in the multivariate profile analysis of the scale's factors based on whether participants had a previous history of hypnosis and depending on who hypnotized them. Participants who reported no previous knowledge about hypnosis or who acquired their knowledge from nonscientific sources scored significantly higher in the negative factors (fear, memory, magical, and marginal), therefore reporting more negative beliefs. Likewise, these participants scored lower in the positive factors (help, control, collaboration, and interest). Participants who had been previously hypnotized showed higher scores in the positive factors. In addition, when hypnosis had been utilized by a psychologist, these scores were even higher. However, some participants who had been previously hypnotized scored high in some of the negative factors (memory and magical), which indicates that some professionals using hypnosis are fostering some misconceptions about hypnosis.

A Pragmatic Guide to the Setting up of Integrated Hypnotherapy Services in Primary Care and Clinical Settings

Despite the continued debate and lack of a clear consensus about the true nature of the hypnotic phenomenon, hypnosis is increasingly being utilized successfully in many medical, health, and psychological spheres as a research method, motivational tool, and therapeutic modality. Significantly, however, although hypnotherapy is widely advertised, advocated, and employed in the private medical arena for the management and treatment of many physical and emotional disorders, too little appears to be being done to integrate hypnosis into primary care and national health medical services. This article discusses some of the reasons for the apparent reluctance of medical and scientific health professionals to consider incorporating hypnosis into their medical practice, including the practical problems inherent in using hypnosis in a medical context and some possible solutions.

Impact of a preoperative conversational hypnotic session on propofol consumption using closed-loop anesthetic induction guided by the bispectral index: A randomized controlled trial

OBJECTIVE

The automated administration of propofol in a closed loop could be used to objectively evaluate the nonpharmacological anesthetic action of hypnotherapy. The objective of this study was to evaluate the impact of a conversational hypnosis session on the consumption of propofol for anesthetic induction.

DESIGN

A randomized, usual care-controlled, single-center, patient-blind trial.

SETTING

Tertiary care center in France from November 2012 to December 2013.

PARTICIPANTS

Adult patients scheduled for a surgical procedure under general anesthesia.

INTERVENTIONS

Before surgery, patients were randomized with a computer-generated random list for a preoperative conversational hypnosis session or for usual care. The conversational hypnosis session was conducted and individualized by the therapist with an academic degree in hypnosis in a quiet environment. Anesthetic induction was automatically performed by propofol without opioids and was assisted by the bispectral index in a closed loop.

OUTCOME

Primary endpoint was the propofol dose required for anesthesia induction, defined as a Bispectral index less than 60 for at least 30 seconds.

RESULTS

The study included 48 patients in the hypnosis group and 49 patients in the control group. No difference in propofol consumption to obtain anesthesia induction was observed between the groups (total dose: 138.6 [67.5] and 130 [47.9] mg, P = .47; adjusted dose: 2.15 [1.09] and 1.95 [0.66] mg/kg, P = .28, for the hypnosis and control groups, respectively). Hetero-evaluation of arm movement during propofol injection (no reaction: 98% and 74%; P = .004, in the hypnosis and control groups, respectively) and face reaction at venous access placement (no reaction 59% and 30%; P = .017, in the hypnosis and control groups, respectively) were lower in the hypnosis group. No adverse event was reported.

CONCLUSIONS

No difference in propofol consumption was observed in this study designed to evaluate the effect of a hypnotic conversational session on anesthesia induction using an automated tool for propofol administration.

A Short Profile of Hypnotherapy Licensure in Israel

In Israel, only physicians, dentists, and psychologists who complete an accredited licensing process may practice hypnosis. This study examines the characteristics of hypnotherapists compared to nonhypnotherapists in the same discipline. All hypnotherapists in Israel were compared to nonhypnotherapist health professionals. There are more subspecialists among hypnotists, and the most common specialties were psychiatry, pediatric dentistry, and clinical psychology. These findings imply self-sorting of hypnotists as a result of the regulation in Israel. Licensure of hypnotherapists could be useful in other countries by comprehensive follow-up of all licensed hypnotists and by improving public and health professional perceptions of the field and its relevance to clinical practice.