Monitoring EEG
Hypnotherapy and Development of a Monitor
Hypnosis can be a powerful agent in the treatment of many psychosomatic disorders and psychological complaints such as agoraphobia and anxiety states and as an adjuvant to anti-smoking therapy.
The general view is that it is not possible to assess depth of hypnosis without resort to eliciting hypnotic phenomena such as hand-arm levitation or compliance with test post-hypnotic suggestions. Dr Mark Griffiths started to practise hypnotherapy in 1960, but he was frustrated at the lack of an objective indicator of hypnosis until the collaboration with Professor Alan Preece in the early 1980s. The first paper was a comparison of the EEG effects in the subjectively similar deep hypnosis and sedation with nitrous oxide, a technique used to this day by dentists and called "Relative Analgesia". We noticed that when a subject in deep hypnosis was invited to tell a lie there was a lessening of the relaxed state shown by suppression of the alpha rhythm. The research was presented to the Forensic Psychiatry section of the International Association of Forensic Sciences on the basis that a) nitrous oxide could be used to enhance hypnosis for applications such as crime scene recall and b) it was an excellent lie detector. The lack of a suitable commercially available EEG monitor may explain why this has never been taken up.
Hypnosis in pain management
By 1993 the transputer PC based version was developed enough for Mark Griffiths to offer a "product" to the Pain Management Centre of the BRI under the direction of Dr John Alexander. Some of the patients had difficulty in achieving a depth of hypnosis for therapy to be effective so nitrous oxide sedation was used until the patient was sufficiently adept. Later enflurane was used with excellent results. The manager of the Centre, Sr Jacqueline Gannon conducted two audits in sequential years that showed that there was a significant improvement in quality of life for the patients (about 40 in number). This service for patients lapsed due to lack of funds, but Dr Peter Grainger continues to use the equipment for his private hypnotherapy clinic.
There are considerable problems in conducting research in hypnosis, notably the virtual impossibility of "blinding" the patient or the operator. Many aspects of medicine that involve quality of life and other emotive aspects share this problem; however, assessment tools are under development.
Exhibitions
The EEG monitor (TM20) was exhibited at a Technology Transfer Fair in Durham in 1996. Under the auspices of the IPEM it was one of five medical devices to be selected to represent the UK at a Research and Innovation Fair at the M,O,C in Munich in 1997, also the Tomorrow's World Live Exhibition at the National Exhibition Centre in February 1998 and later that year in Durham again. Alan Preece won the IPEM manufacturer's prize for the TM20 in 1999.
Hypnosis in the medical/dental press
There are very few journals that have anything interesting to say about hypnosis, most of it is anecdotal and relates case histories (and how good the writer is). The psychological research journals are more erudite, but the articles are not always about hypnosis per se.
Practitioners of hypnosis
Hypnotherapy is practised by doctors, dentists, clinical psychologists and unregistered hypnotists who can be found in the "Yellow Pages". There are two main societies in the UK, the British Society for Medical and Dental Hypnosis (BSMDH) - mainly doctors and dentists - and the British Society of Experimental and Clinical Hypnosis (BSECH) - mainly psychologists. Neither is very large, the BSMDH has about 1200 members.
The International Society of Hypnosis has further details.
Related therapies and altered states of consciousness
All the relaxation techniques that we have been able to test - meditation, autogenetic training, aromatherapy - have shown that generation of a strong alpha rhythm appears to be the major EEG effect. Many psychological therapies have a relaxation component, the most notable being cognitive behavioural therapy (CBT). This has received considerable prominence in recent years and seems to be a highly effective non-drug technique for a wide range of problems (1). The basis of therapy is the modification of the patient's beliefs, expectations and negative thoughts. The distinction between CBT and hypnosis seems to be semantic rather than practical, so the market for an EEG monitor could be extended into this area. As in hypnosis, the monitor can provide objective feedback to the therapist as to whether the patient has attained a therapeutically useful state of relaxation and information about the positive and negative effect of suggestions. Counsellors dealing with post traumatic stress, bereavement and cancer would benefit from an EEG monitor for the same reasons.
Aromatherapy is a particularly interesting area of development with implications for controlling panic attacks and sports performance. The memory of odours, good and bad, is exceptionally long lasting, probably a lifetime. It is possible to link the smell of a blend of aromatic oils, or a commercial perfume, to a state of relaxation, calmness and personal control. Dr Tim Betts at Birmingham University has been helping people suffering from epilepsy by training them to recognise the initial warning signs of an impending seizure and then linking their choice of perfume to a state of relaxation so that they can ward off the actual attack.
Reference
(1) Fortnightly review: Cognitive behaviour therapy - clinical applications, Simon J Enright BMJ 1997; 314: 1811.
