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Hypnosis and relaxation therapies
Andrew Vickers and Catherine Zollman
A wide variety of complementary therapies claim to improve health by producing relaxation. Some use the relaxed state as a means of promoting psychological change. Others incorporate movement, stretches, and breathing exercises. Relaxation and “stress management” are found to a certain extent within conventional medicine. They are included here because they are generally not well taught in conventional medical curriculums and because of the overlap with other, more clearly complementary, therapies.
Hypnosis is the induction of a deeply relaxed state, with increased suggestibility and suspension of critical faculties. Once in this state, sometimes called a hypnotic trance, patients are given therapeutic suggestions to encourage changes in behavior or relief of symptoms. For example, in a treatment to stop smoking a hypnosis practitioner might suggest that the patient will no longer find smoking pleasurable or necessary. Hypnosis for a patient with arthritis might include a suggestion that the pain can be turned down like the volume of a radio.
Definitions of terms relating to hypnosis
- Hypnotic trance—A deeply relaxed state with increased suggestibility and suspension of critical faculties
- Direct hypnotic suggestion—Suggestion made to a person in a hypnotic trance that alters behaviour or perception while the trance persists (for example, the suggestion that pain is not a problem for a woman under hypnosis during labour)
- Post-hypnotic suggestion—Suggestion made to a person in a hypnotic trance that alters behaviour or perception after the trance ends (for example, the suggestion that in the future a patient will be able to relax at will and will no longer be troubled by panic attacks)
Some practitioners use hypnosis as an aid to psychotherapy. The rationale is that in the hypnotised state the conscious mind presents fewer barriers to effective psychotherapeutic exploration, leading to an increased likelihood of psychological insight.
Relaxation and meditation techniques
One well known example of a relaxation technique is known variously as sequential muscle relaxation (SMR), progressive relaxation, and Jacobson relaxation. The subject sits comfortably in a dark, quiet room. He or she then tenses a group of muscles, such as those in the right arm, holds the contraction for 15 seconds, and then releases it while breathing out. After a short rest, this sequence is repeated with another set of muscles. Gradually, different sets of muscle are combined.
The Mitchell method involves adopting body positions that are opposite to those associated with anxiety (fingers spread rather than hands clenched, for example). In autogenic training subjects concentrate on experiencing physical sensations, such as warmth and heaviness, in different parts of their bodies in a learnt sequence. Other methods encourage deepening and slowing the breath and a conscious attempt to let go of tension during exhalation.
Visualisation and imagery techniques are somewhat akin to hypnosis: the induction of a relaxed state followed by the use of suggestion. The main differences are that the suggestions are visual and usually generated by patients themselves. In cancer treatment, for example, patients may be asked to think of an image which represents their immune system killing off cancerous cells. One patient might imagine immune cells as sharks and the cancer cells as small fishes being eaten; another might think of a computer game in which the cancer cells are “zapped” by spaceships.
Meditation practice focuses on stilling or emptying the mind. Typically, meditators concentrate on their breath or a sound (“mantra”) which they repeat to themselves. They may, alternatively, attempt to reach a state of “detached observation,” in which they are aware of their environment but do not become involved in thinking about it. In meditation the body remains alert and in an upright poition.
Yoga practice involves postures, breathing exercises, and meditation aimed at improving mental and physical functioning. Some practitioners understand yoga in terms of traditional Indian medicine, with the postures improving the flow of “prana” energy around the body. Others see yoga in more conventional terms of muscle stretching and mental relaxation.