From the archive, 22 April 1955: The medical value of hypnotism

The Guardian
22-04-2013
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From the archive, 22 April 1955: The medical value of hypnotism

The British Medical Association reports on the medical use of hypnotism

The seal of respectability is conferred on the ancient art of hypnotism in a report on the medical use of hypnotism, issued by the British Medical Association to-day. After collecting evidence from doctors and dentists for nearly two years a committee of three psychiatrists and a family doctor recommend that all medical students should be instructed in the possibilities, limitations, and dangers in hypnotism as a form of therapy.

They also feel that tuition in the clinical uses of hypnosis should be given to all medical postgraduates training as specialists in psychological medicine, as well as, possibly, to trainee anaesthetists and obstetricians. Research into the phenomena involved in hypnotism they recommend should be organised by university departments and the research foundations.

These recommendations arise out of the conclusion that hypnotism has a definite, if small, place in orthodox medicine. A somewhat similar conclusion was reached by another committee of the B.M.A. some sixty years ago.

The committee agree that the practice is sometimes the treatment of choice in certain psychosomatic disorders. Itching conditions of the skin are a case in point. But in such cases hypnotism is best regarded as a useful adjunct to other forms of psychiatric treatment. As one of the committee observed at a press conference yesterday, “It is a champion abbreviator of treatment” enabling the psychiatrist quickly to uncover hidden motives and to “put his own ideas across.”

When one recalls that major surgical operations were being performed successfully a hundred years ago with hypnosis taking the place of an anaesthetic, it is not surprising to find the committee acknowledging that the method has some use in surgery and dentistry where there is reason to avoid anaesthetics. A member of the committee said that as women in the advanced stages of labour are especially suggestible, it is usually possible by hypnosis to rid a woman of all memory of her accouchement. The process, however, is prolonged and boring for the doctor as well as depriving the woman of a sense of achievement at bearing her child.

Learning how to hypnotise is apparently quite simple, but a decision about who is a suitable subject is another matter. This decision, it is felt, should be left to the psychiatrist because of the dangers involved. Practitioners of hypnosis claim that the hypnotist cannot make the subject do anything that he would not ordinarily do. But, say the committee, where the patient is predisposed, either constitutionally or through disease, to severe psychoneurotic reactions or anti-social behaviour there is a danger that hypnosis may bring out these qualities. For that reason the commission of crimes, involving even danger to life, is not entirely to be ruled out.

The committee point out that hypnotism may involve the rapid or immediate development of a relationship between the hypnotist and subject of the same order and intensity as the relationship produced more slowly in the course of psychotherapy. The trained psychotherapist, however, must be aware of this relationship as part of the therapeutic process and recognise its potentiality for harm as well as being able to deal with it. But the application of the hypnotic technique without such knowledge and experience provides no control of the powerful emotions which may be released.

For this reason the committee believe that harm can be done by the application of hypnotism, especially when used by persons indifferent of the well being of the subject or ignorant of the morbid complications of the hypnotic state. They recommend, therefore, that the use of hypnotism in the treatment of physical and psychological disorders should be confined to persons subscribing to the recognised ethical code governing the doctor-patient relationship.

Rather surprisingly, however, they concede that this would not preclude the use of hypnotism by a suitably trained psychologist or medical auxiliary, of whose competence the medical practitioner was personally satisfied, and who would carry out, under medical direction, the treatment of patients selected by the physician.

Code of Ethics for Certified Hypnotherapists

Code of Ethics for Certified Hypnotherapists

1. Informed Consent for Therapy

1.1. When obtaining informed consent for therapy, hypnotherapists shall inform clients at the earliest feasible stage of the therapeutic relationship about the nature and expected course of therapy, fees, involvement of third parties, and limits of confidentiality. Ample opportunity shall be provided for clients to ask questions and receive answers.

1.2. When obtaining informed consent for treatments where established techniques and procedures are not widely recognized, hypnotherapists shall inform their clients about the developing nature of the treatment, potential risks involved, alternative treatment options that may be available, and the voluntary nature of their participation in the treatment. The primary consideration of hypnotherapists shall be the physical and mental well-being of each client. Hypnotherapists shall refrain from engaging in verbal, physical, or sexual abuse towards any client and shall not discriminate against clients based on race, religion, sexual orientation, age or gender identity.

1.3. Hypnotherapists shall strictly adhere to the boundaries of their training and expertise in the practice of hypnotism, ensuring compliance with all applicable local laws. Hypnotherapists shall not diagnose, treat, or prescribe for clients in matters pertaining to medical or mental health conditions. Their aim shall be to facilitate clients’ natural restorative and coping abilities, and refraining from making any therapeutic claims. Hypnotherapists shall abstain from providing hypnotic services to clients who exhibit behavior, appearance, or statements that warrant evaluation by a licensed healthcare professional. Services may only be rendered to such clients following evaluation and approval from the licensed healthcare professional.

2. Therapy Involving Couples or Families

2.1. When agreeing to provide services to multiple individuals with a relationship (such as spouses, significant others, or parents and children), hypnotherapists shall take reasonable steps to clarify, at the outset, (1) who among the individuals are clients and (2) the nature of the hypnotherapist’s relationship with each person. This clarification shall include the hypnotherapist’s role and the likely uses of the services provided or the information obtained.

2.2. If it becomes apparent that hypnotherapists may be required to assume potentially conflicting roles (such as serving as a witness for one party in divorce proceedings), they shall take reasonable steps to clarify, modify, or withdraw from such roles as appropriate.

3. Group Therapy

When providing services to multiple individuals in a group setting, hypnotherapists shall clearly describe, at the outset, the roles and responsibilities of all parties involved, as well as the limits of confidentiality.

4. Providing Therapy to Those Already Receiving Mental Health Services

When considering whether to offer or provide services to individuals already receiving mental health services elsewhere, hypnotherapists shall carefully assess treatment issues and the potential client’s welfare. These issues shall be discussed with the client or another legally authorized person on their behalf, in order to minimize the risk of confusion and conflict. Hypnotherapists shall consult with other service providers when appropriate and proceed with caution and sensitivity to the therapeutic concerns.

5. Sexual Intimacies with Current Therapy Clients/Patients

Hypnotherapists shall refrain from engaging in sexual intimacies with current therapy clients.

6. Sexual Intimacies with Relatives or Significant Others of Current Therapy Clients/Patients

Hypnotherapists shall avoid engaging in sexual intimacies with individuals they know to be close relatives, guardians, or significant others of current clients. Hypnotherapists shall not terminate therapy to circumvent this standard.

7. Therapy with Former Sexual Partners

Hypnotherapists shall not accept individuals with whom they have engaged in sexual intimacies as therapy clients.

8. Sexual Intimacies with Former Therapy Clients

8.1. Hypnotherapists shall refrain from engaging in sexual intimacies with former clients for a minimum of two years after the cessation or termination of therapy.

8.2. Hypnotherapists shall not engage in sexual intimacies with former clients/patients even after a two-year interval, except in highly exceptional circumstances. If such activity occurs after the two-year period has elapsed and there has been no sexual contact with the former client/patient, hypnotherapists bear the burden of demonstrating that no exploitation has taken place. This assessment shall take into account all relevant factors, including (1) the duration of time since therapy ended, (2) the nature, duration, and intensity of the therapy, (3) the circumstances of termination, (4) the client’s personal history, (5) the client’s current mental status, (6) the potential adverse impact on the client, and (7) any statements or actions made by the therapist during therapy that may suggest or invite the possibility of a post-termination sexual or romantic relationship with the client.

9. Interruption of Therapy

When entering into employment or contractual relationships, hypnotherapists shall make reasonable efforts to provide an orderly and appropriate resolution for the continuity of client care in the event that the employment or contractual relationship ends. The welfare of the client shall be of paramount consideration.

10. Premature Termination of Therapy

10.1. Hypnotherapists shall terminate therapy when it becomes reasonably evident that the client no longer requires the service, is unlikely to benefit from it, or is being harmed by its continuation.

10.2. Hypnotherapists may terminate therapy when they are threatened or otherwise endangered by the client or by another person with whom the client has a relationship.

10.3. Unless precluded by the actions of clients or third-party payors, hypnotherapists shall provide pre-termination counseling or coaching, and suggest suitable alternative service providers prior to terminating the therapy.

11. Advertising

Hypnotherapists shall maintain honesty and truthfulness in all forms of advertising. They shall consistently provide accurate information regarding their titles and degrees when communicating with the general public, media, and within the scope of their profession.