Medical Hypnosis and Physiology

Source: Tracework by Yapko, 2005. Traditional medicine has long recognized the "placebo effect". In some instances, a patient's positive belief that he or she is getting an active drug when she is really getting no drug at all, only a sugar pill resembling a drug, will generate the same level of therapeutic effect as if the patient has been given an active drug. Conversely, a negative expectation can foster a "nocebo" effect, a negative therapeutic effect. A person's expectation and attitudes can obviously have profound effects on mental and physical experience. With this growing recognition of the influence of client's expectancy on both physical and psychological treatments, there is a growing use of hypnosis and hypnosis-related techniques. Psychologist Irving Kirsch, Ph.D., has evolved a specific socio-cognitive model of hypnosis, known as the response set theory, which heavily emphasizes the role of expectancy in treatment (1985, 2000). In fact, Kirsch detailed considerable evidence that much of the positive effects of hypnosis is due to positive expectations on the part of the client, and Kirsch has even come to refer to hypnosis as a "non-deceptive placebo", unlike the sugar pill clients are fooled into believing are active drugs (1994). There is a considerable body of empirical evidence attesting to the power of expectations in both psychological and medical conditions ( Harrington, 1997). Given a foundation for appreciating how expectancy can influence physiology and behavioral responses, is hypnosis only a placebo? Certainly there is some truth in that perspective, if that's all hypnosis was, it would still be worthy of intensive study. After all, the need to engage clients in their treatment is vital to enhancing treatment effects and minimizing a sense of victimization and even depression when such reactions delay or even prevent recovery (Lynch, 1999; Yapko, 2001). In general, hypnosis can be useful adjunct to more traditional medical treatments for several reasons, the first of which relates to the mind and body relationship and the role of the mind (attitudes and related emotions) in medical disorders. "Miracle cures" that defy current medical understanding, which have evolved out of the patient's refusal to give up, are not uncommon in literature. Pragmatically speaking, why not encourage ---or at least permit "miracles"? Why place limitations on the patient that he or she would not place on him or herself? A second reason for making use of hypnosis in the medical context is because of its emphasis, by its very nature, on the responsibility of each person for his own health and well-being. Use of hypnosis gives people a direct experience of having control over internal experiences, whether pain or distress. Finding resources of comfort or the ability to shift perceptions of their body within themselves is a dramatic experience, and allows a new and higher level of responsibility for patient's own well being. Specific applications of hypnosis in medical contexts are greatly varied, but can generally be described as a way of attaining a significant degree of control over physical process. One possibility is the reduction or elimination of pain without the use of medication (Chaves, 1993; Montgomery, DuHamel, & Redd, 2000). Pain management is one of the more sophisticated uses of medical hypnosis, and is applicable to the patient in both chronic and acute pain. Hypnosis is commonly used in the treatment of anxiety and stress disorders, and is considered to be the most effective treatment ( Schoenberger, 2000). Teaching the medical patient techniques for preventing negative stress whenever possible, techniques for identifying stress well before it reaches a level where it is likely to cause debilitating symptoms, and techniques for relaxing and managing stress positively are all elements in teaching a hypertensive patient to manage his or her condition positively and responsibly. Hypnosis in the treatment of serious diseases, as an adjunct, not a replacement, for more traditional approaches, has demonstrated the necessity of addressing the emotional needs while using the mental resources of the patient as a part of the treatment....Hypnosis doesn't replace other treatments, it adds to them. .

My Take on Personality Development

Part of human personality is predisposed. Hereditary is an important component in personality development. This is especially true for children. Physiology structure and functioning are inherited from our parents. It plays a large role in response tendencies and dispositions. Some children are naturally shy, cautious, fearless, outgoing, musically inclined, intellectually predisposed, etc. It can then be said that there is a part of human personality that is predetermined. Yet,human nature cannot be solely held responsible for personality development. How we nurture our children and ourselves is just as significant in its contribution. Children as well as adults need human connection. We need to feel loved. We need human interaction. As such, personality development is dynamic. As we learn which behaviors are most effective in obtaining our needs, we unconsciously fine tune ourselves in order to control results. When we make cognitive connections between how people react to our words and actions biological changes occur in our brain and neural synapses. Like a rubber band that has the ability to expand and contract, everyday encounters facilitate or hinder biological change within us which directly affects personality and its development.

Since I believe that genetic make up sets up the stage for personality development, I cannot completely claim the blank slate concept. What I can say is that some individuals have a leg up on developing healthy psychological functioning more than others. Individuals who are not so genetically lucky need a more caring and facilitating environment to make up for their so called genetic deficiencies. However, I do think that the blank slate illustration is effective in portraying the role of the environment in the personality development process. If two children, one genetically disadvantaged and the other of better genetics, were placed into an equality nurturing environment one can almost conclude that the child with better genetics will come out with the healthiest psychological functioning. Yet, if the genetically advantaged child was placed in a nurture deficient environment and the other child who is genetically disadvantaged into a room full of caring and nurturing adults, ultimately it is the genetically disadvantaged child who will psychologically strive.

The role of hereditary make up is an important contributor to personality. It is the starting point of every individual. But, it is the environment that will ultimately determine how far or limited that personality can develop. An individual may initially be limited by heredity but if one exposed one's child or oneself to enriching human interactions and situations, then biological changes will occur. This will further enable more positive psychological functioning.

I do not believe that perfect healthy psychological functioning exists or can be attained. I believe that every individual experiences doubt and psychological disturbance frequently in their lifetime. Sometimes, this psychological disturbance is so severe or debilitating that it is necessary to reach out for help. This is where we, therapists, come into play. This belief ties in to my prior statement that points out the dynamic and ever changing nature of personality development. As such it goes through cycles of lows and highs. The question of how low or high is a matter of how well one has learned coping and adjusting mechanisms.

Humans are social animals. Learning how to maneuver oneself socially is the key to maximizing psychological health . Being confident in a variety of social interactions yields social approval. In a society were social approval is necessary for prosperity and maybe even survival, one feels most healthy when one is socially received and comfortable.

Human nature is a result of both physiological makeup and environmental factors. Although genetic predisposition can be considered the starting point in personality development, introduced environmental factors will further mold personality via the process of learning. Environment influence and physiological changes will consequently and continually occur and influence each other. Thus, human personality is dynamic and ever changing. It adjusts according to the events of one's life.

Maximum and minimum levels of psychological functioning is also dynamic. Thus, the lows and highs experienced are normal and to be expected. I believe the best indicator of psychological health is in how well a person is able to cope and adjust to life changes.

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