In this chapter, arm levitation and miscellaneous technics of various types are described. These may be used in conjunction with sensory imagery or picture visualization technics. The levitation technics are best adapted to emotionally disturbed individuals who require more permissive approaches. As was mentioned earlier, the psychoneurotic has resistances to yielding his symptoms and therefore is often refractory to an authoritarian approach.
All levitation technics make use of the subject's ideomotor and sensory activities. The author's technic differs from those herein described2,14,16 in that the patient is motivated each step of the way. Moreover, the term “sleep” is never employed. The subject never realizes that he is being controlled at all times by carefully graded suggestions to deepen slowly the hypnotic state.
Levitation technics are initially time-consuming, but any posthypnotic suggestion or cue to reinduce hypnosis obviates the need for reinduction. Glove anesthesia is induced more readily than states requiring authoritarian technics. Watkins' progressive anesthesia technic, when combined with arm levitation, is excellent for those patients who for some reason must have anesthesia.14
THE ARM LEVITATION TECHNIC
The advantages of the author's modification of this technic are that the subject is not rushed, and he is convinced that the responses result from the operator's suggestions. It is time-consuming and frequently taxes the patience of the operator.
The verbalization is as follows: “Would you mind placing your hands on your thighs, and, if you please, just look down at your fingers, at your hands as they rest lightly on your knees. Perhaps you wouldn't mind pressing down real hard; if you will, just press down hard, just as hard as you can, as if you are pushing your knees and feet through the floor. Of course, this is impossible! Perhaps you can press a little harder and still harder. And, as you press harder and harder, become aware, if you will, that you are building up a great amount of tension in your fingers. Notice the tension building up in your fingers as you press harder and harder. Just keep pressing harder and harder. And, perhaps, you can feel an increased sensitivity in your fingertips. And notice, if you will, please, the texture of the cloth of your trousers. And maybe, as you keep pressing, you will notice the warmth of your body as it comes through the cloth of your trousers. And keep pressing, harder and harder. And, of course, you know that the opposite of the tension that you are building in your fingers is relaxation. So, any time that you might wish to relax, it is really so simple; all you have to do is just close your eyes and visualize, if you will, that one of the fingers on either the left hand or the right hand is getting lighter than all the others. Remember, the opposite of tension is relaxation; I am sure that you will agree to that. And if you really want to relax, one of the fingers on either the left hand or the right hand is getting lighter than all the others. And as it gets lighter than all the others, perhaps one of the fingers will begin to lift up in the air. And one of the fingers will begin to move on either the left hand or the right hand. Which finger will it be? Maybe it will be the little finger of the left hand, or perhaps it will be the ring finger of the right hand. It might even be the forefinger of the left hand. And I notice the forefinger of the right hand is beginning to lift. And it's lifting, lifting, lifting. And as it gets lighter than all of the other fingers, the other fingers of that hand can begin to lift. And very soon, if you wish, you are going to notice the most wonderful sensation—a floating, soothing sensation. The right hand is lifting in the direction of your face. Lifting, lifting, lifting. And perhaps you might be willing to give yourself the suggestions that ‘With each motion that my arm lifts upward, I will go deeper and deeper relaxed; my arm is lifting not because it has to, but because it wants to. I will soon reach a deep state, a deep state of relaxation.’ The right hand is now lifting, lifting, lifting, lifting, lifting! And perhaps you can visualize a balloon tied around your wrist, and now another balloon, three, four balloons are tugging at your wrist. And then you can visualize still another balloon. A red balloon, a blue balloon, and the arm is now lifting, lifting, lifting, lifting! And as soon as it touches your face, you might be willing to give yourself a suggestion that the moment any portion of your hand touches any portion of your face, that will be a signal, perhaps, for you to be willing to drop into an even deeper state of relaxation. As your arm lifts, you are going deeper and deeper relaxed.That's fine. You are doing just fine. You are really willing to learn, are you not? Hypnosis is a learning process. And if you learn these simple, elementary ABC suggestions, then you can learn other suggestions that are so necessary for complete mental and physical relaxation. And as the hand draws closer and closer to the face, just think of that wonderful feeling of relaxation that is going to come over your body.” (The subject touches his nose with the back of his palm; the arm drops limply into his lap as his head falls forward.) “You drop even deeper relaxed, way down, deeper and deeper … complete relaxation. That's right. And now I am going to lift this arm and you will go even deeper and deeper. And if you wish to go really deeper, just let it plop right in your lap with a resounding thud. Now I will let it go at the count of 3. Can't wait. 1 … 2 … 3 … plop.” (His arm drops to his lap.) “That's fine. Now, as long as your arms and hands remain in that position, you will go deeper and deeper relaxed. And as I raise your arm, it will get stiff and rigid.” (Catalepsy is induced by a deft stroke.) “Stiff and rigid; your arm is just as stiff and rigid as a bar of steel. Now it's rigid. And now, if you wish to go deeper, you may go still deeper by letting your arm drop even more relaxed into your lap. That's fine.”
Modified Arm Levitation
Christenson uses a levitation technic with sleep suggestions.2 He informs the subject that relaxation will deepen with each number he counts. Simultaneously, the more relaxed he becomes, the more his hand will lift; the degree of lifting will determine the degree of relaxation. The lifting, the relaxing, and the counting are all cleverly tied in, one with the other, and their interdependence is stressed. He cues the touching of the hand to the face to complete hypnotic relaxation. He also uses sleep suggestions. Wolberg's modification of Christenson's technic uses a more permissive approach.16
HANDLING OF RESISTANCE IN LEVITATION TECHNICS
It bears reemphasis that when resistance is encountered, one should switch technics. If what started to be a permissive technic, with arm levitation, seems not to be successful, say, “That's fine. You have done your part very well. Now you will raise your arm directly overhead.” Few patients will realize that the switch has been made. Because the ultimate goal is limb catalepsy, it is important to get the arm raised to the position where this phenomenon can be induced quickly. Expectation leads to hypnosis and, if that expectation is not instantaneously fulfilled, both the operator and the subject will be concerned. The time to switch to a different technic is before the patient senses that failure is inevitable. Thus the rapport is maintained.
Enlightened patients understand that a rather high order of concentration is necessary to achieve hypnosis and that it also requires more than a moderate degree of intelligence. Thus, if the operator emphasizes this point at some time during the induction, it becomes quite apparent to the subject that he is not utilizing his concentration to its fullest capacity. Some resistant patients may say, in the midst of an arm levitation induction, “I guess I'm no good, Doctor. My arm wouldn't go up. I just don't have what it takes.” Here, reassurance that the subject is intelligent and can concentrate is helpful. The operator can remark, “Perhaps you are trying too hard; I am sure that if you try again you will relax.”
When a subject's arm does not levitate, the operator can remark, “And as your arm remains comfortably in your lap, you can feel yourself going deeper and deeper relaxed with every breath you take. Deeper and deeper relaxed. Now I will raise your arm straight upward, and as it moves upward, you will become more relaxed.” (The arm is moved slowly to an upright position.) “Now, straighten the fingers, spread them apart. That's right. Spread them apart. That's fine. And now the entire right arm will continue to get stiff and rigid! Like a bar of steel! Stiff and rigid. Like a bar of steel. Stiffer and more rigid. Straighten out the fingers. Stiff and rigid.” (The arm is lightly stroked from the fingertips down to the shoulder.) “And now, if you wish to go deeper, just say to yourself, ‘I can't make a fist,’ and the more you really believe that you can't make a fist, the deeper relaxed you will go. And I notice that now you swallowed. That is a very good sign that you will reach a deep, deep state of relaxation. Go deeper and deeper. Real deep. Deeper and deeper. Way down. Deeper and deeper relaxed. That's right. Just close your eyes and let your eyeballs roll up into the back of your head.”
Resistance is often manifested by the subject's raising his arm too quickly. Here again, the operator must not be disturbed but, rather, should remark, “That's right. Your hand has reached your face. Now you can slowly allow your arm to fall toward your lap and, as it falls, you will go deeper and deeper. …”
Frequently, subjects do not close their eyes but keep them in a fixed and staring position. These individuals are in a somnambulistic state. The sophisticated hypnotherapist recognizes this immediately and proceeds with appropriate posthypnotic suggestions.
Another technic for handling resistance in the negatively suggestible subject is as follows:
“This hand is going to get increasingly light, but I am going to put my hand on it and hold your hand down. I will not allow your hand to come up. It keeps on getting lighter and lighter, but I force it down. You can sense the lightness as it is pushing up against my hand. I am in great difficulty trying to hold it down. In fact, it seems ultimately as if it would force my hand up in spite of my efforts to hold it down. You will prevail over me. I cannot keep your hand from rising into the air, and I cannot prevent you from relaxing. You go into a very deep relaxed state in spite of my efforts to stop you.”15 In this case the motivation to oppose the doctor is used in the actual hypnotic induction.
Often the arm may lift halfway and remain in a horizontal position. If this should happen, the following suggestions are valuable: “Your arm is now extended straight in front of you. You can move it upward, downward, or you can move it from side to side.” This confuses most individuals; they do not realize that there is no other direction in which the arm can move. If they still resist, invariably they will move the arm in one direction: up, down, or sideward. If so, quickly remark, “That's right, you are moving it in the right direction, just as I suggested. Now all you have to do is to move it upward [if that is the direction] until it is extended straight toward the ceiling.” If the arm moves downward, similar suggestions are made, ending with, “Return it to your lap or side” (where it inevitably must go).
COMBINATIONS OF TECHNICS
The sensory-imagery technics, with or without arm levitation, are excellent for the establishment of deeper hypnotic states. The principle of nearly all of them is to involve the subject in as many ideosensory activities as possible. Through this type of misdirection of attention, the suggestions of the operator are accepted more readily.
The technics of eye opening and closing, progressive relaxation, and tension and relaxation stress ideomotor activity, although ideosensory involvement is an essential feature of all these methods. Most technics of this type are ideal for the induction of children and also for handling the refractory individuals who state, “I doubt if you can hypnotize me because I have a strong mind.” “Playing a game” appeals to the former group, and the latter group is caught “off guard.” Nearly all of the technics can be used in various combinations, and the verbalization described can be altered to fit the needs of the subject and the operator.
The technics for tension and relaxation, hyperventilation, and catalepsy are dependent largely on physiologic effects to reinforce the psychological suggestions (the law of dominant effect).
The disguised technics are too numerous to mention. Many methods, such as transcendental meditation, the relaxation response, progressive relaxation, psychoprophylactic relaxation and natural childbirth, are disguised technics employing “waking hypnosis” or the alterations of awareness characteristic of hypnoidal states.
VISUAL IMAGERY TECHNICS
The Blackboard Technic
The blackboard technic appeals primarily to the subject's imagination and is an excellent method for developing amnesia.12 The individual is asked to see how well he can concentrate on all instructions. The following is the verbalization:
“Just visualize in your ‘mind's eye’ a blackboard in one of your high school classrooms. You are beginning to see it, are you not? When you do, nod your head to indicate that you see the blackboard.” (The subject nods his head.) “Now you may imagine that you are walking over to the blackboard. You are picking up a piece of chalk. Write the numbers from 1 to 10. You will see each number on the blackboard. After you have done this, you will let me know by nodding your head.” (The subject nods his head.) “Now, erase all of the even numbers. You see a smudge between each of the odd numbers. You do see it, do you not? All of the even numbers from 1 to 10 are now dropping out of your mind, are they not? You can see only the odd numbers, can you not?” (The patient nods his head, indicating that he is responding.) “You will remember now that when you are requested to count you will not be able to remember any even numbers. You are going deeper and deeper relaxed. Deeper and deeper relaxed with every breath you take, and with each breath that you take, all the even numbers are dropping out of your mind. And now, since all the even numbers have dropped out of your mind, you may find it difficult to count out loud.” (If the patient does not block, he may or may not be hypnotized. If he blocks but has not forgotten the even numbers, he may be in a light hypnotic state. Of course, if he is not able to remember the even numbers and merely counts “1, 3, 5, 7, 9,” then you can be fairly certain that he is in a deep state of hypnosis and is capable of developing posthypnotic amnesia as well as of following other suggestions.)
The Television Technic
The television technic is a form of the picture-visualization technic that is excellent for the induction of children. They close their eyes and visualize a favorite television program. As soon as they say they have “turned on the TV” and are seeing the scenes changing, the operator remarks:
“You will pay more and more attention to the television screen. Keep looking at it. As you are looking at it, you will notice that your right arm will begin to lift up into the air by itself. That's right. It is beginning to lift. It is lifting, lifting, lifting. Higher and higher. Just keep looking at the picture. Your arm is lifting still higher. Listen to everything that is said and, as you keep looking at the screen you are getting very, very tired. And now your arm is raised straight toward the ceiling. If you wish, you can go deeper relaxed. Just say to yourself, think to yourself, ‘My arm is getting stiffer and stiffer. Rigid!’ And, if you wish to go deeper, slowly allow your arm to fall, and as it falls, you too will go deeper and deeper.” (The same deepening procedure is used as in the blackboard technic.)
THE EYE OPENING AND CLOSING TECHNIC
In performing the technic of eye opening and closing, the following verbalization is used:
“Would you mind fixing your eyes on a spot directly above your forehead? Keep looking at a spot directly above your forehead. As you keep looking at that spot, perhaps you would not mind opening and closing your eyes.” (The eyes open and close.) “That is right. The more you open and close your eyes, the more you will be able to relax.” When the lids begin to droop, the operator suggests: “Your lids are very tired now. If you keep them closed, you will relax. You may now let your eyeballs roll up into the back of your head and, as your eyeballs remain in this position for a few seconds, notice how your lids are sticking tighter and tighter together.” If the subject is unable to open his eyes, this indicates success—manifested by furrowing of the brows and trembling of the lids. The lid catalepsy can be made more complete by saying, “If you really wish to go deeper and deeper relaxed, you will notice that your lids are really stuck tightly together. Your eyes can only be opened with difficulty.” This does not leave the operator “out on a limb” and, in fact, he has not challenged the subject. The rest of the verbalization follows a standardized direct technic.
For resistant individuals who keep their eyes open, I remark: “You see, your eyes remain open; you cannot close your eyes. If you do close your eyes, you will certainly go deeper and deeper relaxed.” Most subjects do not realize that eventually they must close their eyes; when this occurs, they attribute it to hypnosis instead of fatigue of the eyelids.
THE PROGRESSIVE RELAXATION TECHNIC UTILIZING THE HANDCLASP AND THE POSTURAL SWAY
When handclasp and postural sway methods are to be employed in the performance of the progressive relaxation technic, the subject is asked to close his eyes tightly; a light touch on the lids is usually sufficient to give the impression that they are sealed tight, especially if the operator remarks, simultaneously, “Your eyes are locked tight, glued together, tightly, very tight.” The operator now takes the subject's hands and clasps them together, saying, “If you really wish to go deeper relaxed, you will think, ‘I cannot open my eyes and I cannot unclasp my hands no matter how hard I try.’” Simultaneously, he is gently swayed around and around, and it is suggested, “If you really wish to go still deeper, just imagine that you are on a boat, and the waves are rocking you deeper and deeper relaxed.” The operator can easily discern the degree of relaxation by the ease with which the subject sways. At this point, he remarks, “Your body is relaxing still more and you feel as if you could go into a deep, deep sleeplike state, almost like nighttime sleep. If I ask you to open your eyes, you will see everything that I suggest nothing else.” This is accomplished by slipping from ideomotor to ideosensory suggestions. Since belief is invoked with each suggestion, as the result of conviction, sensory reality becomes unreality. Because he is convinced that the relaxation, the eye closure, and the inability to open the fingers were due to the operator's suggestions, the subject will readily develop sensory hallucinations. This is a good technic for developing somnambulists.
THE HYPERVENTILATION TECHNIC
In the hyperventilation technic, the subject is asked to close his eyes. He can be rocked to and fro as in the postural sway technic, with his eyes tightly closed. The following verbalization is used:
“Your eyes are tightly closed together. Take a deep breath and hold it. Hold it as long as you can. Take another deep breath and hold it! Now inhale deeply. Let all the air out of your lungs. Do it again. That is right. With each deep breath you take, you will notice that your head will get lighter and lighter. You are getting very light-headed. The longer you hold your breath, the more light-headed you get.” This is kept up, together with suggestions that he will continually go deeper and deeper as he gets more and more light-headed. Naturally, the subject is not aware that he is getting light-headed because of the hyperventilation. He thinks that all the sensations are due to the operator's suggestions.
Light to medium hypnosis usually appears, even if no other suggestions are given. As long as the regular and deep breathing is maintained, the subject will remain relaxed and hypersuggestible. The operator must be on guard for syncope produced by hyperventilation. Usually hypnosis is achieved before signs of this occur. The literalness with which such suggestions as “Breathe deeper and more rapidly” are followed is indicative of relaxation; a person in syncope develops shallow respirations and is unaffected by any type of suggestion. If fainting should occur, the hyperventilation is terminated automatically. The associated carpopedal spasm and muscular twitching are more awesome than serious. However, they are a good indication against further use of this technic. Catalepsy and deepening are produced as with other conventional technics.
THE DISGUISED TECHNIC
A disguised technic, which can also be used as an induction procedure, is performed in the following manner: If a small child or an adult with an extensive laceration of the thigh is seen and you wish to induce a hypnotic state without having anyone, especially the subject, know it, just place a towel over the subject's eyes and say: “Now close your eyes and keep them tightly closed! If you really wish to go into a nice state of relaxation so that you won't feel any discomfort, just relax. You will go deeper and deeper with each breath you take. The more you relax, the less it is going to hurt you. Now, here comes the first stitch.” (Gently place the needle on the edge of the wound without pressure.) Now you say, “See, stitch number 1 didn't hurt, did it? Stitch number 1 is a ‘hallucinated’ stitch.” (This is misdirection.) “You are going deeper and deeper relaxed. Here comes stitch number 2. That's fine. You are relaxing wonderfully. You are going into a deeper and more pleasant state of relaxation. The more you relax, the less discomfort you will have. There, I just put in stitch number 2.” (Again there is only light pressure against the wound.) Stitches 3, 4 and 5 are “put in” in a like manner. When the patient develops rigidity or limb catalepsy, and the breathing gets slower, deeper, and more regular, you can be fairly certain that the hypnotic state has been induced. Now, stitch number 1 can be painlessly inserted. (This is a nice, naturalistic approach for induction of hypnosis.)
Evans obtains hypnotic phenomena merely by “teaching relaxation.”5 Hartland uses a similar technic.6
“BLOOD PRESSURE” METHOD
The author has used a blood pressure apparatus to induce hypnosis by a nonformalistic approach. The method is as follows: The cuff is placed around the arm and is inflated to produce a pressure sensation. Then, as it is slowly released, the operator remarks: “You feel yourself going deeper and deeper relaxed. You can hear the air escaping and feel the pressure relaxing around your arm as you become deeper and deeper relaxed. Now close your eyes. …”
MECHANICAL TECHNICS
Any steady, monotonous sound has a tendency to induce relaxation. Any regular sound, such as the ticking of a watch, a metronome, or a clock, the constant falling of drops of water, or even listening to the heartbeat (a stethoscope is placed in the subject's ears) will induce hypnorelaxation. The operator must explain how and why the sounds will induce relaxation. He can suggest that the eyes will be opened and closed alternately with every sound of the watch or beat of the metronome or the heart.
A small microphone can be used to amplify and conduct the subject's own heart and respiratory sounds to his ears.10 The rhythm of the heartbeat acts as a monotonous fixation stimulus, and the monotonic effect of the breath sounds serves as a conditioned stimulus for sleep. A verbalization technic also can be employed with this method. Another variation is to use intermittent visual stimuli, such as is provided by a flashlight, which can go on and off in synchrony with the metronome. Counting backward or forward is also helpful with either of these technics.
Passes of the hands over the face and the body often fit the expectancy of the subject. Frequently they facilitate induction. A rotating mirror or a brightly colored fish lure can accomplish the same effects. All of these technics can be combined with appropriate suggestions for relaxation. There are many other devices, such as hypnodisks and tape and record players, which can induce some degree of hypnosis in susceptible individuals. Recordings are valueless unless rapport with the operator is established first. However, as yet there is no device per se that is 100 per cent effective in inducing hypnosis. Invariably a standard verbalization technic is necessary.
The author helped to assay the brain wave synchronizer, an electronic instrument designed to induce various levels of hypnosis, probably by photic stimulation of the brain waves. The instrument should always be used in conjunction with a tape recording or a verbal induction and dehypnotization technic. It definitely increases receptivity to suggestion and has been tested clinically on many subjects, including obstetrical patients attending group hypnosis prenatal training classes. The apparatus induced light to deep hypnotic levels in over 90 per cent of the subjects. Hypnotic response is more readily produced if a favorable “mind-set” is created. Therefore, to some extent, the expectant attitude created by the structured situation enhances the hypnotic response, but about 30 per cent of the subjects, who had received no explanation or verbalization and who had no knowledge of what the brain wave synchronizer would do, were hypnotized to various degrees ranging from light to deep stages. The apparatus has excellent potentialities for deepening a previously fixed hypnotic level and for facilitating and speeding up hypnotic induction, which often can be time-consuming, especially in refractory subjects. A distinct advantage is that no physical connections or attachments are placed on the patient. The author has noted that refractory subjects with whom little rapport exists often are easily induced by the apparatus.
All mechanical technics depend to a degree on expectancy and rapport. The prestige factor is very important. If a subject expects to be hypnotized by a device and has confidence in the person who controls the instrument, then hypnotic relaxation can be induced readily in a susceptible subject.
OTHER TECHNICS
Two other technics are mentioned only to be condemned. The carotid sinus method, which is achieved by pressure on the carotid artery, is dangerous, as it may stop the heart. In the shock technic, a subject is caught off guard by the command, “Go to sleep, deep, deep sleep,” accompanied by a snap of the fingers and a very authoritarian approach. Both of these methods smack of the entertainer, who uses them because of their dramatic appeal.
A “lullabye” technic, in which a monotonic rhythm is employed, has been described.8 Writing technics can be utilized to induce hypnoidal states.3 Grunts and subverbal cues have been employed to induce hypnosis.11 Pantomime induction has already been described.4 There is a specific technic for deaf mutes through an interpreter.1,7 The author has on many occasions performed this technic in the course of seminars in foreign countries where there is a language barrier. Telephone hypnosis has been resorted to on patients when the author was never seen. One striking case was the cessation of intractable hiccups, achieved in a single telephone session.9 The author has often demonstrated a technic whereby patients go into hypnosis without a spoken word. However, a positive mind-set and reward inducement must be established a priori. In teaching seminars, for instance, the suggestion can be made that those who wish to remember better what has been taught will do so if they go into hypnosis. The operator leaves the room and then merely raises the arm, which immediately becomes cataleptic. This illustrates that the capacity to enter into hypnosis is more a function of the subject and his willingness to have his perceptual responses altered. However, I have never used this technic in a clinical setting, as it is too dramatic and theatrical.
For a verbatim transcript of other excellent technics of all types, the reader is referred to the Syllabus on Hypnosis and the Handbook of Therapeutic Suggestions of the American Society for Clinical Hypnosis. A study by Myron Teitelbaum, replete with technics of hypnotic induction, is also recommended.13
DRUG HYPNOSIS
It has been the author's experience that a drug seldom induces hypnosis by itself. However, some of the tranquilizing agents, such as the phenothiazine derivatives, can be helpful in decreasing central autonomic reactivity while maintaining a good cortical arousal pattern. Meprobamate preparations and phenobarbital often relax and facilitate induction in patients with musculoskeletal tensions.
Patients who are insusceptible to hypnosis are seldom made more suggestible by narcotics. On numerous occasions, the author has used sodium amytal or pentobarbital intravenously, carbon dioxide and nitrous oxide, ether, scopolamine, and Trilene with equivocal results. This may be due to personal bias against drugs. It is difficult to assay the value of drugs for facilitating hypnosis with any degree of accuracy unless double-blind studies are utilized.
The success of all hypnotic technics depends upon the strength of the interpersonal relationship. When one operator cannot hypnotize a subject, a successful induction is not precluded by another one; his personality and approach may appeal to the patient or may fit in with the latter's need.
The nuances of induction technics are learned by experience. The manner in which the arm is slowly being lifted, for example, is often indicative of whether or not the individual is going into hypnosis. Frequently, light stroking or the deft touch which reinforces a psychological suggestion by a physiologic effect instantaneously facilitates catalepsy. One can feel muscles that develop rigidity as they are stroked; the increased tonicity often cannot be simulated.
An induction procedure can be initiated with the subject's eyes tightly shut. The only reason for initial eye fixation is that the heaviness heightens the belief that other “suggested” phenomena will result. No one aspect of induction is as important as the dictum “Belief of hypnosis leads to hypnosis.” Therefore, one must never arouse a critical attitude or resistance by using “loaded” words such as, “You are going to lie there perfectly still as if dead.” To a hypochondriac, this would interrupt the necessary concentration for achieving hypnosis.
From a practical standpoint, no one technic is superior to any other, but, rather, the technic used must fit the needs of the subject at that particular time, his personality, and, most importantly, the ongoing relationship manifested by his behavior. If the patient believes that you are going to hypnotize him, then nearly any approach, formal or nonformal, will be successful. As a matter of fact, nonformalistic technics, as utilized by spiritualistic healers, are extremely effective, inasmuch as criticalness is reduced. Moreover, any technic which uses breathing exercises and a religiousphilosophic approach, such as Yoga and Buddhist meditation, is effective for similar reasons.
An extremely authoritarian type of induction is seldom as efficacious as the permissive approach. Use of the patient's total experiential background, with all his feelings, ideas, and attitudes, allows him to decide what he wishes—not what you wish! This places the onus or responsibility for achieving the phenomena of hypnosis upon the patient's shoulders.
When using hypnosis in a child, always talk to him at his own intellectual level. If possible, make the induction procedure a sort of game. Use his imagination to “look” at a TV program. Get him to play a role in it or have him resort to some type of daydreaming fantasy. Imagery technics are more effective if the ideas are incorporated into the child's imagination. Let him think that he controls the situation by having him decide if he wishes to play baseball while getting an injection; there will be less discomfort if he is engrossed in the ball game. Most children go into hypnotic states readily through such naturalistic technics, especially if ideomotor and ideosensory involvement is fully utilized.
REFERENCES
1. Alderete, J.F.: The induction of hypnosis through an interpreter. Am. J. Clin. Hypn., 10:138, 1967.
2. Christenson, J.A.: Dynamics in hypnotic induction. Psychiatry, 12:37, 1949.
3. Coulton, D.: Writing techniques in hypnotherapy. Am. J. Clin. Hypn., 8:287, 1966.
4. Erickson, M.H.: Pantomime techniques and hypnosis and the implications. Am. J. Clin. Hypn., 7:64, 1964.
5. Evans, F.J.: An experimental indirect technique for the induction of hypnosis without awareness. Int. J. Clin. Exp. Hypn., 15:72, 1967.
6. Hartland, J.: The general principles of suggestion. Am. J. Clin. Hypn., 9:211, 1967.
7. Isasi, A.: Dos casos de sofrosis en sordomedos. Rev. Lat. Am. Hypn. Clin., 3:92, 1962.
8. Klemperer, E.: Techniques of hypnosis and hypnoanalysis. Int. J. Clin. Exp. Hypn., 17:137, 1969.
9. Kroger, W.S.: Hypnotherapy for intractable post-surgical hiccups. Am. J. Clin. Hypn., 12:1, 1969.
10. Kubie, L.A., and Margolin, S.: A Physiologic method for the induction of states of states of partial sleep, and securing free association and early memories, in such states. Trans. Am. Neurol. Assoc., 10:136, 1942.
11. Meares, A.: A System of Medical Hypnosis. Philadelphia, W.B. Saunders, 1960.
12. Moss, A.A.: Hypnodontics—Hypnosis in Dentistry. Brooklyn, Dental Items of Interest, 1952.
13. Teitelbaum, M.: Hypnosis Induction Technics. Springfield, III., Charles C Thomas, 1969.
14. Watkins, J.G.: Hypnotherapy of War Neuroses. New York, Ronald Press, 1949.
15. _______: Introductory Lectures in Medical Hypnosis. New York, The Institute for Research in Hypnosis, 1957, pp. 40-41.
16. Wolberg, L.R.: Medical Hypnosis. vol. I. New York, Grune & Stratton, 1948.
ADDITIONAL READINGS
Hamner, A.G., and Arkins, W.J.: The role of photic stimulation in the induction of hypnotic trance. Int. J. Clin. Exp. Hypn., 12:81, 1964.
Kroger, W.S., and Schneider, S.A.: An electronic aid for hypnotic induction: a preliminary report. Int. J. Clin. Exp. Hypn., 7:93, 1959.
Sadove, M.S.: Hypnosis in anesthesiology. III. Med. J., 124:39, 1963.