A wise man once stated, “It is much easier to ignore the obvious than to renounce the traditional.” Thus thousands upon thousands of persons all over the world are hypnotized daily without harm and yet the method is considered dangerous simply because the “Svengali-Trilby” myth has been perpetuated for years.
However, an infinitesimally small number of dangerous sequelae following hypnotherapy have been reported. These isolated cases have been brought to the attention of the layman and the profession chiefly because of the ill-advised and promiscuous use of hypnosis by untrained and unqualified lay and medical hypnotists.13,14
This situation is certainly deplorable, and adequate precautions to avoid the misuse of hypnosis are indicated. Yet a sober and objective evaluation of these cases shows that it is not the hypnoses, but many other variables, such as psychotherapeutic mismanagement of the relationship and misdiagnosis, that are etiogenic. The lack of documentation, personal bias, operator attitude, and hearsay evidence, together with the necessary warnings against the unwarranted current use of hypnosis—all contribute to exaggerated claims that hypnosis is dangerous. It is safe to say that hypnosis is the safest of all psychotherapies. Deaths and considerable permanent damage have been reported with shock therapy, steroid administration, narcosynthesis, and hallucinogenic agents. Yet no one has ever died from hypnosis!
Another issue is made of the proper criteria for selection of patients on whom hypnosis can be used safely. This author firmly believes that the only real criteria are the training, the judgment, and the experience of the operator, and the motivation and the willingness of the patient to be hypnotized, provided there is, of course, a specific indication.
The British Medical Association has reported:
The dangers of hypnotism have been exaggerated in some quarters. The subcommittee is convinced, however, that they do exist, especially when it is used without proper consideration on persons predisposed constitutionally or by the effects of disease, to severe psychoneurotic reactions or antisocial behavior.2
The initial approval by the Council on Mental Health of the American Medical Association stated:
The surgeon, obstetrician, anesthesiologist, internist and general practitioner may legitimately utilize these technics within the framework of their own particular field of competence.1
Whereas the report stresses that all who use hypnosis should be cognizant of its complex nature, it points out that controversy exists as to the hazards of hypnosis. There were few dissenting voices to contend that hypnosis was a dangerous medical tool. Yet the American Psychiatric Association report,15 and the “Report on Training” issued by the Mental Health Council of the A.M.A.,12 while making many worthwhile recommendations on training, indicate that the minority opinion of the original 1958 A.M.A. report has been accepted. The reader is also referred an article on this subject, written by the author.9
The A.M.A. was queried about their stand. The question “Has the A.M.A. Committee on Hypnosis ever published officially any statement defining or implying the dangers in the use of hypnosis by physicians?” elicited the answer that it had not done so, nor had it authorized one, and that a member of the committee who states this is “expressing his own personal opinions.”
Platonov, an associate of Pavlov, who used hypnosis for over 50 years in over 50,000 cases, reported as follows in one of the most remarkable books written on hypnosis.
We have never observed any harmful influence on the patient which could be ascribed to the method of hypnosuggestive therapy, presumably leading to the development of an “unstable personality,” “slavish subordination,” weakening of the will, increase in suggestibility, pathological urge for hypnosis, etc.11
The author is in accord with Cheek, who has had a vast experience, when he states:
The mechanisms by which hypnosis can do harm are not different from the tools which Lady Macbeth used on her husband, which Cassius used on the honorable Brutus, which Iago used on Othello. We can do more harm with ignorance of hypnosis than we can by intelligently using the forces of suggestion.3
Julius Grinker long ago stated:
The so-called dangers from hypnotism are imaginary. Although I have hypnotized hundreds of times I have never seen any ill effects from its use. Bernheim, Liebeault, Ford, Wetterstrand, and a host of others who have practiced suggestive methods in thousands of instances have had similar experiences.7
Similarly, Pierre Janet, who at first opposed hypnosis and later became an ardent advocate, stated: “The only danger to hypnosis is that it is not dangerous enough.”
Words can be more devastating than bacteria. During a physical examination, for instance, symptoms can be produced by merely placing a stethoscope over a patient's heart and carelessly saying, “Humph.” The frightened and apprehensive patient is apt to ask, “What's the matter, Doctor, is there something wrong with my heart?” No amount of persuasion can convince this patient that his heart is perfectly normal. One would not indict the stethoscope or the physical examination as being responsible for the iatrogenic condition produced. But what was said and how it was done could be held culpable.
THEORETIC DANGERS FROM MEDICAL HYPNOTHERAPY
Seldom considered also is the fact that disturbed subjects can fabricate material as well as “acting-out” behavior in and out of hypnosis if they desire either to please or displease the experimenter. This can lead to dangerous conclusions on the part of the therapist. Moreover, it is not so easy to change behavior by hypnosis. If it were, a team of hypnotherapists could be sent into our penal institutions to hypnotize every hardened criminal into becoming a lawabiding citizen. This just could not be done. Thus, if wanted changes are difficult to obtain by hypnosis, certainly unwanted changes are not going to occur.
Not to belabor this point, in the usual doctor-patient hypnotherapy relationship, it is extremely difficult to hypnotize a patient without his consent or to induce untoward behavior in a subject from hypnosis per se. It is conceivable, however, that an unscrupulous physician, under the guise of giving vitamin B injections, could make an addict out of a patient by repeatedly giving him morphine and telling him that it was vitamin B. Likewise, through very devious and circuitous routes, it is theoretically possible to engraft an experimental conflict, covered over by an amnesia, in a somnambulist, and to give him posthypnotic suggestions to commit an amoral act. This “contrived” situation admittedly does not apply, however, in the doctor-patient relationship.
Wolberg states:
Employed by a reasonably trained professional, within the context of a structured therapeutic program, with proper awareness of limits of its application and with appropriate timing … the dangers inherent in its use are few or nonexistent, if it is skillfully employed by a responsible operator.18
Weitzenhoffer believes that there is no foundation for the belief that hypnosis weakens the will, leads to overdependency or causes neuroticism.16 This author is in complete accord with this statement. The incontrovertible fact is that it is doubtful if, when properly used, there is another modality less dangerous in medicine than hypnosis. Yet there is no medical technic which makes a better “whipping boy” than hypnosis!
The supposed dangers from hypnosis can occur with therapy at nonhypnotic levels. Already emphasized is the sense of omnipotence and grandiosity that some therapists feel after obtaining spectacular results. Some of these therapists have psychopathological problems or oversell the method, and this leads to dissillusionment.17 Motives on the part of the physician using hypnosis should be evaluated.10There are no dangers unique to hypnosis.6,4 However, Crasilneck and Hall theorize that organic pain may be suppressed, thus obscuring the diagnostic picture.5 In dealing with hundreds of patients, the author has never encountered this complication. Admittedly, it is possible to overlook a dangerous organic deficit, but this too occurs at nonhypnotic levels. A fuller explanation of complications and precautions in the use of hypnosis is given in Chapter 21.
REFERENCES
1. A.M.A. Council on Mental Health—Committee on Hypnosis: Training in Medical Hypnosis. Report approved by Council on Mental Health, February, 1960.
2. British Medical Association: Medical Use of Hypnotism: Report of Subcommittee Appointed by Psychological Medicine Committee, British Medical Association. Br. Med. J., 1:1019, 1955.
3. Cheek, D.B.: Hypnosis: an additional tool in human reorientation to stress. Northwest Med., 6:177, 1958.
4. Conn, J.H.: Is hypnosis really dangerous? Int. J. Clin. Exp. Hypn., 20:61, 1972.
5. Crasilneck, H.B., and Hall, J.A.: Clinical Hypnosis: Principles and Applications. New York, Grune & Stratton, 1975.
6. Friedman, J.J.: Psychodynamics in hypnosis failures. Psychosomatics, 2:1, 1961.
7. Grinker, J.: Quoted in Quackenbos, J.D.: Hypnotic Therapeutics. New York, Harper, 1908, p. 109.
8. Janet, P.: Psychological Healing. London, Allen & Unwin, 1925.
9. Kroger, W.S.: It is a wise hypnotist who knows who is hypnotizing whom. West. J. Surg. Obstet. Gynecol., 69:132, 1961.
10. Nesbitt, W.R.: The dangers of hypnotherapy. Med. Times, 7:597, 1964.
11. Platonov, K.: The Word As a Physiological and Therapeutic Factor. Moscow, Foreign Languages Publishing House, 1959.
12. Plunkett, R.J.: Medical Use of Hypnosis. J.A.M.A., 168:186, 1958.
13. Rosen, H.: Hypnosis and self-hypnosis in medical practice. Maryland Med. J., 6:297, 1957.
14. Rosen, H., and Bartemeier, L.: Hypnosis in medical practice. J.A.M.A., 175:128, 1961.
15. Ross, M.: Regarding Hypnosis: a Statement of Position by the American Psychiatric Association, February 15, 1961.
16. Weitzenhoffer, A.M.: General Techniques of Hypnotism. New York, Grune & Stratton, 1957, p. 424.
17. West, L.J., Deckert, G.: Dangers of hypnosis. J.A.M.A., 192:9, 1965.
18. Wolberg, L.H.: Hypnoanalysis. New York, Grune & Stratton, 1945.