Monday, September 3, 2012

Nine years of numbness reversed with hypnosis

As I've mentioned in a previous post, hypnosis has been instrumental in helping me to overcome a dismaying numbness that my mind had created. And yet, how many people actually understand what hypnosis is? After all, some people seem to think it's just a way to make someone your zombie slave, while others say it's only an act.
` Of course, psychologists generally consider hypnosis to be a tool that can be used to change a person's perceptions, and which has a number of therapeutic and research applications. In this article I will cover only a few relevant hypnosis phenomena.

I had no real understanding of hypnosis until 2001, when I read a Scientific American article on the subject.  It explained that, while the Greek hypnos does mean 'sleep', one must contrarily be highly focused and alert in order to experience hypnosis. Although relaxation is commonly associated with hypnosis, I also learned that it can be induced while vigorously pedaling a stationary bike.
` The article covered some of the famous landmark experiments, such as blocking out the pain of plunging one's hand into a bucket of icewater. Part of it even covered the staff writers being hypnotized and made to experience such things as their hand seeming to 'levitate' by itself, and even the hallucination of a fly buzzing by one's ear.

Notably, at that point in time I was already recovering from a lifetime of post-traumatic stress disorder, and had thought that life could only get better from there. That all changed about two years later, when I experienced an even more traumatic incident than I could have imagined to be possible.
` After a long and astonishingly shocking ordeal, I couldn't remember who I was or even what I used to be like. Unfortunately, I had been wrongly prescribed several drugs, one of which caused my flashbacks to become increasingly vivid and more easily triggered, among other extremely terrifying, frustrating and embarrassing effects.

The panic attacks were soon joined by the alien feeling of "numb spots", one of them on my tongue where it touches the roof of my mouth. These spots would start out small, then spread, then slowly shrink again. One day, mental images of the terror were triggered so strongly that these spots expanded and multiplied, spreading from my fingers to my toes, and even my eyeballs.
` My neurologist advised that I was probably just hyperventilating, and that recovery was as simple as breathing into a paper bag. As it wasn't, I went to the emergency room, where precisely nothing was found to be wrong, other than these bizarre complaints.

Inevitably, I turned to The Mental Health Community For Poor People, where I was told that such experiencing of flashbacks meant that I was undeserving of treatment. I was shut out of therapists' offices when it was time for my appointment, was made to sing campfire songs with schizophrenics, and dozens of other surreal situations.
` This institutional abuse continued long after I'd moved to the West Coast and found myself thoroughly combing a mental hospital crowded with pungent hobos in the hopes that one of the jaded employees could or would help me.
` There, I could spend ten minutes telling someone about how some medication was so incredibly damaging to me, only to be shocked by the immediate response of, "Let me write you a prescription" for the exact same drug. Of course, if I didn't take it, that only meant I was too insane to know better.

For many years, I futilely complained about this absurd dance, yet some people told me to let these hack interns do the thinking and observing for me. Some others, however, encouraged me to escape this labyrinthine Morton's Fork.
` After all, a friend of mine told me that she had developed the same symptoms from a traumatic event and eventually recovered from them when she was sure that she was "ready to feel again." Therefore, it must be possible to recover from such a thing, right?
` By 2007, it was becoming clear to me that psychology classes and books had been far more useful to my well-being than talking to someone who thinks that 'being objective' means ignoring their subject. I was already doing most of my own mental health improvement, but would that be enough to resolve this particular difficulty? Was there any way at all?

A pivotal moment in class was learning of a malady called conversion disorder -- as in a "conversion" of anxiety into a bizarre deficit such as numbness, deafness, blindness, fits, paralysis, etc. Although it could last for years, I was relieved to know that it could be reversed with such treatments as explaining what causes the symptoms.
` Doubts kept nagging me about this, as I had already believed that an unconscious unwillingness to feel had caused this deficit all along, and five years had not been long enough to resolve it. Then again, I was still living in fairly stressful conditions, so perhaps the anxiety was staving off my courage to face this difficulty.

I didn't know it yet, but that class also taught me a potential solution -- and now we are back to hypnosis. This text is actually based on my abbreviated notes from a class lecture on the subject:
Hypnosis is when your attention is highly focused and you allow someone else to guide you through some inner experience. It can help to alter one's perception to the point that one can have surgery under hypnosis and not feel pain. [More on that shortly.]
When subjects are hypnotized to see the color on a pattern 'drain away', the color-processing areas of their brains 'turn off', and they report that the color has gone away. When they are given a suggestion to see color on a black-and-white version of the pattern, those areas of the brain activate despite having no color to process. [See Kosslyn 2000].
From this and other examples, I learned that hypnotism was powerful enough to alter one's subjective experience dramatically, and had made a connection between it and my condition. I might have actually pursued this line of thinking if I hadn't spent most of my college years living in continually overwhelming "survival situations" (which is why I don't recommend living in run-down conditions with assorted whack-jobs...).
` It wouldn't be until my return from The Amaz!ng Meeting 2012, after the insanity (and police visits) had a chance to drain away from my life, that I met an actual hypnotherapist. His entire job is to help people change their less-than-useful perceptions and various bad habits, or, as he puts it, "telling them to just stop doing that."

I had long assumed that a seemingly unconscious decision to not feel is actually a bad habit, so if that was my issue, he might know how to help. Then again, if this was just a habit, then why couldn't I seem to just stop doing that after almost nine years?

Curiously, while I was at TAM 2012, I asked skeptical activist and neurologist Steven Novella whether my condition sounded more like nerve damage than a kind of dissociation. The best way to determine that, he said, would be to undergo a battery of neurological tests.
` L Dean Poppe, a psychologist to whom I should have been going all along, agreed with this plan. However, now that I knew a hypnotherapist, there was a far simpler option for no money at all -- discover whether hypnosis helps. If I recovered, then finding a lack of nerve damage would only be a side effect.

My skeptical instincts prompted me to learn even more about hypnosis before trying it out. Already, I had known that hypnosis may not technically be a distinct state of consciousness per se, but rather more like a "highly-suggestible mode" where one person's words can become another person's subjective reality.

Let me repeat that -- one person's words can become another person's subjective reality, and this is not limited to here-and-now illusions: People from the Skeptic community may be familiar with the way in which hypnosis can be used to create or expand false memories of alien abductions or past lives, or, tragically, abuse by innocent family members.
` Not only can hypnosis cause color or pain to fade away, but even the entire hypnotist can "go invisible" while the hypnotee looks around quizzically. Other "harmless party tricks" include temporarily forgetting one's name, or being unable to remove one's hand from one's snooker table.
` Just think of the amount of mischief that can be achieved with this ability! Not surprisingly, such surreal mind-bending is sometimes capitalized on as hidden camera entertainment, as street hypnotists such as Derren Brown have demonstrated. Some of these stunts are so incredible that they will have to be the subject of a future post.

Also worthy of mention is my previous assumption that people will "snap out of" hypnosis if they are told to do something they find ostensibly immoral. The hypnotist I met, Robert Schryvers, tells me that, "of course, they might be guided into doing something conspicuously immoral if it is suggested that they are doing something quite different. And mayhem may mirthfully ensue."

It is, then, no wonder that some people will tiptoe away as soon as one mentions their personal interest in hypnosis. (Yes, I've actually seen this happen.)
` What these people might be more terrified to know is that they themselves ordinarily go into a 'trance' every day, when absorbed in driving, reading a book, watching a movie, or being "in the zone". Egads!
` Robert tells me that trance is not necessary for hypnosis to occur, although this bit of dissociation helps the hypnotic suggestions to seep in more fully.

Trance is especially important during one of the most powerful and constructive uses of hypnosis -- hypnotic anesthesia. [Told you I'd get to this.] Though this may seem surprising, it's not new: According to Wobst [2007, in Anasthesia & Analgesia], hypno-anesthetic had been used for various different surgical procedures from the 1830s until about 1860, when chemicals such as ether and chloroform became more popular.
` Hypnosis was then taken as good only for amusement and hucksterism until the 1950s, when it became recognized again as a useful form of anesthetic, and: "In 1958 the American Medical Association endorsed the use of hypnotism by physicians while condemning hypnosis for entertainment."
` This is understandable -- after all, something so powerful should not be taken lightly -- although this writer opines that street hypnosis is fascinating as well as entertaining. More important was the realization that if I can 'hypnotize' myself not to feel, then someone should be able to help me undo the damage.

After all, it truly is amazing how hypnotized patients, in the face of scalpels and stitches, can report little or no pain, as their heart rate and muscles remain relaxed. Because they are conscious, such patients don't need to be given antibiotics, nor help with breathing or any other bodily function.
` Often -- not always -- patients are given a chemical local anesthetic along with the hypnosis. Local anesthetic blocks the stress response of the body (moreso than hypnosis), whereas general anesthesia doesn't (which isn't pleasant to learn first-hand*).
` This stress-blocking effect allows the wounds to heal faster and hurt less, which means the patients require less medical care afterwards. This is why, for example, the Cliniques Universitaires St. Luc in Belgium uses local and hypno-anesthesia together so often.
` I know this from reading about a 2011 study from this hospital (as reported in Science Daily) which found evidence that cancer is also less likely to spread if local anesthesia (with hypnosis) is used when removing it. Even if that turns out not to be true, the aforementioned health benefits are more than enough to keep the practice going strong.
"There is still a lot of debate around the exact mechanism that allows hypnosis to reduce pain perception," says Professor Roelants," but what it absolutely clear is that it does so. The result is that one third of thyroidectomies and a quarter of all breast cancer surgery carried out at the UCL hospital are performed under local anaesthetic with the patient under hypnosis."
Hypnosis is also extremely useful when patients are deathly allergic to general anesthesia, yet will be just as dead without surgery. My psychologist, Dr. Poppe, explained to me one such situation at a V.A. hospital in which he helped to keep a patient out of pain as surgeons removed an intestinal obstruction.

This powerful psychological pain relief generally starts with rendering the patient's hand impervious to pain via hypnotic suggestion and then 'spreading' this ability by touching the hand to the part of the body that needs this effect. Examples of this process litter YouTube, from informal demonstrations of "see, pinching doesn't hurt this person" to a UK television special called HypnoSurgery Live.**
` Sensationalistic as this may seem at first glance, it is rather impressive that this works predictably well enough to record a half-hour hernia operation on live television. With some hypnosis practice, Dale (the patient) was feeling fine all the way through, even without the use of any chemical pain relief!

His mum, meanwhile, watched in amazement and wondered how it was possible for someone to both know he's being cut into, and yet not feel any fear nor suffering. In a way, it's simple -- you only need to focus very closely, which is what is really meant by "going deeper and deeper into hypnosis."
` David Spiegel describes this experience in a 2004 ScienCentral article on using hypnosis for procedures such as deep brain stimulation: In hypnosis, you can see in great detail what you are focusing on, while not being as aware of your surroundings, as though "looking through a telephoto lens."
"So it's like getting so caught up in a good movie that you forget you're watching the movie, you enter the imagined world. That's what a hypnotic state is like. You wake up and pay attention in a highly focused way. So the parts of the brain that are involved in attention, the frontal cortex, for example, are turned on when you're hypnotized."
As soon as the live HypnoSurgery is finished, Dale gets to his feet and describes his feelings of euphoria and empowerment with controlling the pain, which he maintains now that the hypnosis session is over. Even though he could feel the manipulation of his innards, he says it was an 'intense tickling' at worst.
` He has no pain or nausea, nor mental fogginess, he's just clear-headed and walking around, ready for some tea and a ham sandwich. Not only is this a remarkable medical feat, such experiences can help people to feel more empowered in their lives. To use another quote from the ScienCentral article:
"And to those who think of being hypnotized as losing control, Spiegel says, "hypnosis is a way of enhancing people's own control over their bodies and their consciousness. It's not a matter of me putting the whammy on someone and saying, 'Go do this.' It's a matter of teaching them how to restructure their approach to their problem and manage it better."
So, how does one put a person in control of something they didn't think they had much control over? (Management of severe pain is only one example of this.) Restructuring a client's approach is most of what Rob the hypnotherapist does, in the form of cognitive reframing -- that is, shifting people's mental "frames" around.
` In other words, he uses various methods of quickly getting clients looking at their situation in a different way. According to the classic psychological work, Change [Watzlawick, Weakland and Fisch, 1974], the meaning of 'reframing' is... change the conceptual and/or emotional setting or viewpoint in relation to which a situation is experienced and to place it in another frame which fits the 'facts' of the same concrete situation equally well or even better, and thereby changing its entire meaning.
So, what exactly does that mean? One good illustration that comes to mind is from a well-known hypnotist (Igor Ledochowski): If one sees an ambulance speeding down the street with its sirens wailing as it runs a red light, it is then easy to assume that it's on its way to a medical emergency.
` On the other hand, if a sports car follows the ambulance through the red light, one might think the driver to be acting very rashly and selfishly. This interpretation of the facts seems rather straightforward until one takes a closer look:
` Let's say the back doors on the ambulance fly open and one can see several college students having an ambulance-theft party. Meanwhile, a closer look into the sports car reveals a man with a medical situation; his wife (presumably) is in the passenger seat, visibly pregnant and injured.
` Taking this information into account, we re-frame how we see the same situation -- the driver of the ambulance is the irresponsible one, rather than the driver of the sports car. It isn't reality that has changed, it's having a different (and importantly, more accurate and useful) perception of what's happening.

This is why, Robert says, his job isn't to hypnotize people per se, but rather, to un-hypnotize them from certain limiting beliefs they've adopted. Leading people around their mental obstacles can only be achieved with a more accurate view, both of the world and their own minds.
` Logically, if my real problem was a belief that kept me from consciously registering nerve impulses, then there should be a way to convince me that it's wrong. After all, if hypnotists can convince people whether getting nylon muscle stitches is searingly painful or just tickly, then hypnosis could be used to convince me whether or not I can fully sense, say, my own lips pressing together.

As one might guess, my personal reframing sessions are not exactly the simplest to react to, so let's look at a more prosaic example: Luckily, I've saved my notes about how reframing is done from Rob's presentation at the meeting where I met him, so let's use those to explore how this works:

First off, Rob generally works with helping clients to change their ways, such as finding out how easy it is to quit smoking. He asks his clients whether discovering this ease would be acceptable to them, and as they agree, he's already re-directed their "tunnel" of reality.
` He then asks why they smoke cigarettes. A common answer is that it helps them to relax. "So," he might say, "you must be smoking all night when you're asleep, right?" (Albeit in a more gentle tone.) Soon enough, he leads the people to consider whether or not being able to relax without smoking would be alright for them to do.
` Another reason he might hear is that smoking is important in a client's social life. Because nonsmokers have bad social lives, right? Or maybe it's the nicotine? Because you get up in the morning really craving that first patch, don't you?
` Though there are other addictive chemicals in cigarettes, many people who smoke will tell you that the ritual is more important than the physical addiction. "So, if you learn to do a different ritual," he might ask, "would that be okay?"

Now that Rob has loosened up the client's limiting beliefs, he finds a hypnotic induction that works well for that person and suggests, for example, imagining a future time in which it is so wonderful to be free of cigarettes and to not have any desire for them whatsoever.
` Although the conscious therapy helps, hypnosis is better at changing the more powerful unconscious processes behind one's undesirable habits. This is important because changing behaviors is easier when both conscious and unconscious processes are working together rather than in conflict.
` This seems to account for the paradoxical situation where clients could walk into hypnotherapy claiming to lack the willpower to quit by themselves, afterwards lose all desire for cigarettes, and yet not credit the hypnosis! They are literally not conscious of the changes, proclaiming something like, "I just don't feel like smoking anymore all of a sudden, for no particular reason."
` Such is is the irony of working with people's non-conscious processes.

Robert adds that although one session may be enough to elicit long-term change, the research shows that adding more sessions is more effective. Not only does this reinforce the suggestions, but it reminds clients that they are the ones really in control.
` This control is most conspicuous in situations such as when a client fails to bring cigarettes along on a weekend camping trip. While relaxing in the woods far from home doesn't evoke cravings, the habit may threaten to resurface once it's time for the first school break on Monday.
` In other cases, some clients have "pretended" that they aren't so successful in quitting, even when they are. If someone tries to tell him something like, "Bad news, I'm having setbacks because I'm experiencing cravings!" Rob re-frames it:
` "All you're dealing with is cravings?" he might say, although more warmly. "Well done! That means that you're doing a good job of not playing with cigarettes! Just keep doing that for a couple more days and the cravings will pass -- you're 90% of the way there, so you're practically home-free!"

But wait, you say, if smoking cessation is that easy, then why do some doctors say it's harder than quitting heroin? The answer is simple -- ask yourself whether you've heard of anyone having collapsed in a puddle of their own vomit and urine, hallucinating and sweating, perhaps dying, because they quit smoking cigarettes?
` Heroin definitely has the worse withdrawal symptoms, so how could people fail more at quitting cigarettes? It may be that people aren't given heroin breaks at work, plus heroin is more damaging and looked-down upon in society, so there is a greater incentive to stop.
` Again, with cigarettes, or any other tobacco product, one's frame of mind seems to be a larger factor in habitual use than physical addiction. And, Rob says, if you can use reframing well in communications, solving problems, or psychotherapy, then you are most of the way to your goal already.

The frames that had to do with this numbness of mine were very deep-seated, of course, and so a few sessions of reframing were necessary before I was most of the way to my goal. What was so important about maintaining this mental blockage? What reason did I have to tune out useful sensory messages that my body was picking up on? As far as I could tell, there were none.
` Rob also walked me through imagining the trauma backwards, in black and white, and with silly sound effects, thus toning down my emotions toward it. He also helped me to imagine that I could raise and lower the amount of sensation that I could feel in my left hand.

As I was in a mild hypnotic "trance" at this time, the sensation in my hand actually changed. Slowly, my hand became more numb, and then sensation flooded back into it, more than had been there before. It felt almost as though the sensation in my hand stopped facing inward and began reaching toward any stimulus "out there".
` At last, the sensation has been flickering back into the former "numb zones", sometimes restored more than other times. Because I'm not used to them, normal sensations takes some amount of practice, just like learning any other maneuver.
` I'm currently best at feeling fine textures when I concentrate on them, pretending that the sensation is almost "pouring out of" my hand like some sort of liquid. Similarly, since my sense of taste is also affected, I sometimes meditate on what food tastes like, as though it is infused with some sort of "energy field" that my taste buds are "tuned into".
` Also, notably, my attitude and approach to related traumas have also changed: Instead of feeling an imprint of helplessness in the face of terror, these fluctuating regions of sensation remind me that I have much more control over myself than I had previously suspected.

From what I can tell, the return of these sensations is real, but even if it were illusory I would be just as amazed because the experience of them is just as real. Indeed, just the change in my attitude has been well-worth the effort!
` This is not, Robert notes, the same thing as "treating" the problems that people "have", such as craving sugar or tobacco. This is more like restructuring people's feelings and perceptions about the processes that cause their problems, but that alone can be enough to solve them.

This leaves open a question of whether or not there is an important difference between eliminating a problem and eliminating one's experience of it, but I shall tackle that another day. For now, I'm just glad to know that something as strange as constructive mind-bending really are real, and can be used in helping people to feel whole again.

*I know this personally, thanks to medical abuse, and freely admit that this is part of the reason why I think the hypnosis option is so attractive.

**The show also includes some history of anesthetic and hypnosis, an apparent demonstration of using hypnosis to induce pain, as well as to take it away during a dental implantation and a thyroid growth removal, so there's lots more to see besides Dale and his innards.

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