Brookside Center for Counseling and Hypnotherapy
Possible Dangers and Complications
by Maurice Kouguell, Ph.D., BCETS.
Is hypnosis in any way dangerous?
The following is a presentation of the review of the literature and reported individual cases. The reader will have to decide what conclusions to draw from the following study. The literature points out some complications that can arise from the use of hypnosis and it seems that all established writers and researchers do suggest the importance of the knowledge of the working of the mind and applying the rule: THAT IF A PERSON CANNOT TREAT A PROBLEM WITH NON-HYPNOTIC TECHNIQUES, HE SHOULD NOT TREAT IT WITH HYPNOSIS. This is taken from Clinical Hypnosis by Crasilneck and Halls, one of the standard recognized textbooks on hypnosis. The same authors report also that hypnosis can, under certain circumstances, be dangerous not only to the client but also to the hypnotist and to the idea of hypnosis itself.
Dangers and Complications of Hypnosis
While the hypnotic trance itself may occur comfortably and easily, Dr. Thurman Moct reports complications occurring:
To take this further, in Hypnosis Complication: Risks and Prevention, a research article by MacHovec, in The American Journal of Clinical Hypnosis, 1988, he lists about 50 complications associated with hypnosis and reports that this is only a partial list. The author grouped the complications into five categories:
Dr. MacHovec defines hypnotic complications as unexpected unwanted thoughts,
feelings or behaviors during or after hypnosis which are inconsistent with agreed goals
and interfere with the hypnotic process by impairing optimal mental functioning with no
prior incidents or history of similar mental or physical symptoms.
Summary list of complications associated with hypnosis:
anergia and fatigue antisocial acting out anxiety, panic attacks attention deficit body/self-image distortions comprehension/concentration loss confusion coping skills, impaired decompensation, psychotic-like delusional thinking depersonalization depression de-realization dizziness dreams drowsiness, excessive sleep fainting fear of fearfulness guilt headache histrionic reactions identity crisis insomnia irritability medical emergencies memory impaired, distorted misunderstood suggestion nausea, vomiting obsessive ruminations over dependency personality change phobic aversion physical discomfort, injury psychomotor retardation psychosis regressed behaviors sexual acting out sexual dysfunction somatization spontaneous trance stiffness, arm or neck stress, lowered threshold stupor symptom substitution tactile hallucinations traumatic recall tremors weeping, uncontrolled
The same researcher described risk factors as most frequently involving repressed materials or unconscious needs; personality dynamics such as resistance, regression, secondary gains, misunderstood suggestions, attitudes and expectations. He also adds the risk factor to the hypnotist, which he describes as falling into two categories:
1. Professional risk factors related to a deficiency or weakness in education, training or knowledge, skill, ability or experience, which impair judgment or proficiency
2. Theoretical bias which limits awareness of other factors or dynamics.
Kleinhauz, M and Beren, B., in an article entitled Misuse of Hypnosis: A Factor in Psychopathology, published in the American Journal of Clinical Hypnosis,talk about a client who came for smoke ending and became extremely agitated and depressed and experienced suicidal thoughts. In my own practice, and I have mentioned this at some of my workshops, I had worked with a man who came for smoke cessation and after he was relieved from the habit, he went into a severe depression. He was one of the cases that prompted my own feeling about the importance of an assessment prior to any hypnotic protocol.
Four Case Studies
Kieinhauz and Eli, reported four cases of "deleterious effects of hypnosis used in the dental setting."
In the literature, authorities have been urging caution in the use of hypnosis for over 100 years. As far back as 1887, Bjornstrorn cautioned of the possible injuries and fatal effects. Janet, one of the forefathers of hypnosis, in 1925, recommended that awakening should be postponed if a morbid symptom of any sort should intervene during the hypnotic state. Weitzenhoffer warned about special care in avoiding the adverse effects of hypnosis and related those to the competency and integrity of the practitioner. In 1961, Meares expressed concern about premature termination. Also, Weizenhoffer warned against inappropriate symptom removal before symptoms are suggested away some of the functions they serve should be determined.
Side Effects of Hypnotism
Numerous mild side effects occur during a hypnotic induction and at times these mild reactions might also occur following a post hypnotic suggestion.
Dr.Thurman Mott reports numerous mild side effects occur during inductions. These are usually not reported and have not been studied systematically; however, although they do occur usually during the first induction, they might be expected to reoccur with psychiatric patients. The most common of these side effects during the induction could be the increase of anxiety frequently related to fears of loss of control and excessive crying and sobbing. At times patients feel dizzy and develop various degrees of nausea during the induction. Spontaneous regression to a traumatic event or period of life, although rare, does happen.
In my own practice, one of my clients during an interview, went into trance with her eyes open and relived spontaneously an earlier sex abuse experience. Most of the side effects can usually be alleviated quickly by discontinuing the induction or by proceeding with the induction and usually the side effects will disappear as the hypnotic state deepens. An appropriate technique should be applied.
The concern of symptom substitution was one danger of hypnosis reported by many
practitioners. Symptom substitution currently, because of the better training of
hypnotists, has been replaced by symptom modification which then permits the patient to
retain the symptom if it is dynamically important to do so.
Patients under hypnosis tend to accept suggestions concretely, if not literally and this might result in adverse reactions which may come as a surprise to the therapist.
For instance, Crasilneck and Hall in their text Clinical Hypnosis: Principles and Applications, discuss the case of a burned patient. While working on improving the patient's nutrition, the patient was given the suggestion that he could eat everything on his plate. One day the patient became ill and vomited on his plate and was later discovered eating the vomitus.
Masking physical pathology could also be a very delicate outcome of hypnosis where the patient has pain because of a physical condition and is now completely controlled by hypnosis. The reason for the physical discomfort is now totally overlooked thus creating other problems. Dr. Fromm, in her book Values in Hypnotherapy: Theory, Practice and Research, describes hypnosis as a state of decreased vigilance resulting in a vulnerability which involves dangers if a patient is in the hands of a poorly trained incompetent therapist using hypnosis. She states, Most of the complications related to hypnosis occur when hypnosis is misused and these complications may be prevented by the following:
Hypnosis must be used permissively, allowing patients to determine when
hypnotherapy is used. Guidelines and methods for working with severely disturbed patients
are discussed by Murray-Jobsis in Clinical Hypnosis: A Multidisciplinary Approach
and by Baker in A Hypnotherapeutic Approach to Enhance Object Relatedness in Psychotic
Patients in the International Journal of Clinical and Experimental Hypnosis 29.136-
In summary, hypnosis, when properly used, is one of the safest tools in the healing profession. As clinicians using hypnosis to help with treatment we need to be aware of the adverse effects when hypnosis is misused. It is necessary for any organization and any training program to promote not only the teaching of safe hypnotic techniques but also the restrictions of the use of hypnosis to the areas of competency of the practitioner.
As health care professionals in the public eye we work with habit control
frequently, it is not safe to assume that anyone coming for smoke ending or weight loss is
simply coming with that symptom alone. Anyone we see for hypnosis is coming with a whole
baggage of attitudes, difficulties, adjustments reactions and so on. Some assessment
technique needs to be used and I will take the liberty here to suggest to the reader
becoming acquainted with my books Human Figure Drawings:
A Screening and Evaluative Tool in Hypnosis and DAPTH: Accessing the Unconscious in the Practice of
Hypnosis and Counseling which are both simple and accessible in this regard.
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