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What are the risks or dangers of hypnosis?

Author: Todd I. Stark

From the Hypnosis FAQ by Todd I. Stark

Web version, revision 2. Last update: February 16, 1997.

The risks of using hypnosis for change are roughly the same as
those for other forms of psychotherapy. Competently performed
hypnosis in itself has virtually no risk or danger. Even
incompetently performed hypnosis usually has only a very minimal
risk. Skillfully utilized suggestion by a malicious or unethical
hypnotist, or hypnosis used with a particularly vulnerable person
has some possible real psychological dangers associated.



Hypnotists in the process of psychotherapy (hypnotherapy)
sometimes momentarily lose control during hypnosis because they
encounter psychological needs or problems in their clients that
catch them by surprise. If they are not well trained to deal with
such events, there is a possible risk of exacerbating existing
problems, or a remote chance of creating new problems. Hypnosis
often involves vivid imagery which seems very real to the client,
and intense emotion which is very real to the client. The
hypnotist may even get caught up in the fantasy, or at least the
emotion of it. One leading medical hypnotist (Meares, 1961)
listed the following potential areas of difficulty that the untrained
or
poorly trained hypnotist may confront,
most of which are common to all forms of psychotherapy :




  1. The situation may be deliberately misused to meet
    ulterior needs (e.g. seduction of trusting female
    clients)

  2. The interaction may enhance negative aspects of the
    hypnotist's personality, or create dependence of the
    client on the hypnotist

  3. Traumatic confrontation with previously unacknowledged
    memories

  4. Precipitation of a latent psychosis

  5. Substitution of one symptom for another

  6. Panic reaction, or creation of traumatic fantasy

  7. Complications due to misunderstandings

  8. Difficulty in arousing the client, and problems caused by
    incomplete alerting.



The last category is an interesting example, because it is
unique to hypnosis, and sounds like the sometimes voiced fear of
"getting stuck in a trance." The media inspired
scenario is that the hypnotist dies during hypnosis and their
client never wakes up because they never get the commands to
awaken.



No, you can't possibly get stuck in a hypnotic trance.
However, a hypnotist can (rarely) get stuck trying to end a
hypnosis session ! This is not because the client has lost
control of hypnosis, but because the hypnotist has lost
control
to the client, who has decided
that they need to stay "out of it" for a while longer.
The same principle applies to most problems infrequently
encountered in hypnosis. The client, for their own reasons, is
exercising their own control over the situation, their own
psychological needs are coming to the surface.



The hypnotic "trance" is passive simply because
hypnotized people find it more comfortable to remain still, not
because they are immobilized by forces outside their control.
They are fully capable of waking at any time, or moving at any
time, if they are uncomfortable with what the hypnotist is
suggesting to them. Hypnotized people do what they feel they need
to do at the moment, which usually means cooperating with the
hypnotist. However, this cooperation, or trust, can be broken
during hypnosis, without ending the hypnotic session. The relaxed
state of passivity will remain as long as the client is
comfortable with it.



Hypnotic trance, like all "states of consciousness"
is not turned on and off as if by a switch, it is a dynamic
experience maintained by a number of continuously changing
psychological and physiological variables. Left alone, without
instructions to end hypnosis, we naturally either rouse fully or
fall asleep. Like other psychological states, hypnotic trance
varies continuously over time due to changing physiological and
psychological factors.



What of the valid concern that it may be temporarily
difficult to alert someone from hypnosis
? I say temporarily,
although this has been reported to last as long as 12 days
(Williams, 1953). It is important for the hypnotist to realize
that that their client is attempting to control their own
behavior. Understanding the reason for this kind of defensive
reaction may be a key step in their therapy.



For those interested, a good list of "horror
stories" about dangers in hypnosis is available
(MacHovec,1986). Robert Baker ("They Call It Hypnosis")
calls MacHovec's book "a collection of cases of
individuals who suffered from various sorts of personality and
emotional disorders prior to hypnotherapy, and then after
hypnotherapy blamed the therapy for their problems.
" The
object lesson here seems to be that hypnosis is safe when the
hypnotist is properly trained to deal with the problem at hand
.
To help people recover from bad habits or improve their golf
swing requires less specialized psychological training than
dealing with more acute problems.



Even a safe procedure like hypnosis can help precipitate a
serious problem in some people, if used for generally
psychotherapy without adequate knowledge of both psychotherapy
and hypnosis (Frauman, Lynn, & Brentar, 1993; Kleinhauz &
Eli, 1987; Judd, Burrows, Dennerstein, 1985; Kleinhauz &
Beran, 1984; Orne, 1965; Rosen, 1957; Rosen & Bartemeier,
1961).



Clinical data on hundreds of inductions gathered by E.R.
Hilgard showed that hypnosis is a safe procedure, and that there
are virtually no negative consequences associated specifically
with hypnosis (Hilgard, Hilgard, & Newman, 1961). The
only adverse effects found were temporary headaches or discomfort
reactions upon attempting induction. These seemed to be
correlated with previous negative experiences with general
anesthesia.



In spite of the safety of hypnotic induction, there are strong
psychological forces at work during therapy that must be
respected when hypnosis is used as a tool for change. If an
unexpected situation is encountered, and the hypnotist panics or
behaves irresponsibly, there is a very real risk in some cases of
existing psychological problems becoming exacerbated. Several
years later, Hilgard added that :




"On the whole, hypnosis is not at all dangerous ...
Still, there are some people who have a very slight hold on
reality and for whom too much playing with fantasy might
conceivably release tendencies toward psychotic behavior that
they have shown under other circumstances as well. If such
discordant behavior follows hypnosis, the hypnotist is likely
to be blamed for it, even though there can usually be found
many instances of similar behavior by the subject prior to
any attempted hypnosis." (Hilgard, 1971)




This is why hypnosis should not be considered a casual
interaction, but an intimate communication that should be used
with some respect. Just as it would be irresponsible to do other
sorts of psychotherapy without training, hypnosis used
irresponsibly can have unexpected and even unfortunate results
with people who already have underlying serious problems (Coe and
Ryken, 1979) (Hilgard, 1974). Since these sorts of problems
sometimes go undiagnosed for years, they sometimes arise quite
surprisingly in therapy.



The general rule is : don't let someone treat something
with hypnosis, if they aren't qualified to treat it without
hypnosis.
In other words, training in hypnosis alone does
not qualify someone to treat psychological problems
. Treating
psychological problems involves inherent risk, and the capacity
of hypnosis to reproduce a variety of psychological conditions
makes it possible that a hypnotist can trigger a problem that
they never suspected exists

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