Hypnosis within medical and psychiatric settings

Hypnosis is becoming an increasingly established practice within medical and psychiatric settings; perhaps one of the best-known users of hypnotic techniques was Sigmund Freud, himself. However, it has had a rather unfortunate history in the popular world of entertainment. This, coupled with a certain aura of mystique which has surrounded the practice of hypnosis, has engendered a general feeling of suspicion towards it. Nevertheless, it is reassuring to note that hypnosis cannot make people do anything they do not want to do — the cooperation of the subject is essential.

In the clinical setting, hypnotic techniques may be used in a number of ways, e.g. psychoanalysis, facilitation of behavioural / attitudinal change, relaxation induction and to treat psychosomatic conditions. The method considered here, 'autogenic training', was evolved in the 1920s by Schultz and Luthe from hypnotic techniques used in the medical setting. Although clinically standardised hypnotic induction methods are available, autogenic training provides a self-help alternative. After a period of training this can be used independently by the client. Only the first six basic exercises are described here; these are aimed at achieving generalised relaxation. More advanced stages involve visualisation, fantasy and problem-orientated suggestion, ultimately focusing upon deep psychic conflict and trauma. Consequently, specialised training should be sought in order to practise the technique; this is especially important in view of the fact that the advanced stages of the technique are essentially a psychoanalytical procedure. The use of autogenic training with clients suffering from psychosis is inadvisable.

The process by which techniques based on hypnosis achieve their effects are not clearly understood. However, the element of suggestion is thought to be the key factor.

Given the proper training of carefully selected clients, autogenic training may be one of the more powerful ways of inducing relaxation. There are, however, certain disadvantages. Firstly, it is not suitable for more disturbed clients, e.g. those suffering from any form of psychosis. Secondly, as specialised training is required, the technique is less accessible for many therapists. Thirdly, careful selection of clients is also important due to the high levels of cognitive discipline required. Clearly this technique is best presented in the later stages of treatment, when acute anxiety has abated and the client has already achieved some skill in the more basic relaxation techniques.