Reading - Part 5

The Efficacy of Hypnotherapy

In the 1840s Scottish neurosurgeon, James Braid coined "Hypnotherapy". At that time, in India, British surgeon, James Esdaile, practiced hundreds of scrotal and abdominal operations, adopting hypnosis as the only anaesthetic. It was unfortunate timing that he reported his research dissertation on hypnosis to London Royal Society just as chemical anaesthetics were discovered. The technique was not agreed on by the medical establishment.

These days, whilst an increasing number of people are asking about private practitioners, the level of studies within the hypnotherapy field is meaningful enough that it remains on the fringes of medicine. In a report on alternative and complementary medicine in 2000, the Science and Technology Committee of the UK’s House of Lords has given hypnosis a bad reputation by putting it in the "poor research/regulation" category. In other words, the therapies were unlikely to enter mainstream medicine without substantial changes.

If you research the PubMed database using the term "hypnotherapy," you find 11,518 hit- words, so there are plenty of studies out there. However, most of the researchers are not satisfied with the gold standard of a Randomised Controlled Trial (RCT) instead of taking the frame of reviews or case studies. Only 91 relevant RCTs conducted in the world have worked in the past four years. The researchers propose that hypnotherapy can be an effective treatment for pain control, irritable bowel syndrome, anxiety disorders and smoking cessation.

There is clear evidence that hypnosis has psychological and physiological effects. That’s why Peter Whorwell at the University of Manchester has researched the efficacy of IBS (irritable bowel syndrome) surgery for gastrointestinal modulation with hypnotherapy and possible immune function support. But even though IBS is one of the best-covered areas, the action with mechanism is not clear and the Cochrane Collaboration from assessing clinical trials has criticised the size and quality of the studies.

In spite of the evidence that hypnotherapy reduces pain, anxiety and stress, there are a couple of reasons why few trials have been done. From these stages, hypnosis’s usage doesn’t aid its image. Also, it has the same problems as other "talking" therapies. Alternative funding should be built up, as the drug companies do not benefit from funding expensive studies.

But, one of the biggest obstacles to hypnosis being considered on a more scientific basis is the therapists themselves. Its effects are a result of a unique interaction between the practitioner and the patient. The expectation is similar to that of a drug and therefore should follow the same trial testing criteria. However, this argument is not helpful.

I strongly believe that whilst meeting with a living, breathing person, it is hard to decrease the process of clinical hypnosis and to receive YES or NO responses that are able to be reliably repeated in other conditions. However, for hypnosis to be considered medical, it should be measurable, replicable and vigorous. Actually, we need to model a body of clinical evidence in order to adapt to the medical profession.

With standardising protocol used, we demand quantitative measures of the effects on the patient, so studies can be compared. Ideally, researchers would have access to state-of- the-art brain scanning equipment. In reality, we are able to get simple biochemical markets of hypnosis and after-effects under suitable usage.

Coming out of such studies in England, Ursula James founded the Medical School Hypnosis Association with her colleagues. According to Complementary Therapies in Clinical Practice, she explains schemes to bring medical professors and students together with hypnotherapists to operate coordinated national trials and build up a large body of evidence from research replicated at multiple locations. Most of all, one of the first questions is whether clinical hypnosis is able to decrease stress. That is an important component potentially in an illness. We work towards using standardised questionnaires to calculate lifestyle, stress and depression and to measure various stress hormone levels in saliva samples taken from case applicants.

If we are able to present that there is a decrease in stress, we hope that hypnosis will be supplied to patients to treat their condition. With a wide range of usages, it could open up study into other areas including decreasing the thoughts of pain and improving recovery times.