Hypnosis "Useful in medicine, dangerous in court." U.S. News & World Report, December 12, 1983. (Inverview)

Hypnosis "Useful in Medicine, Dangerous in Court"

Controversy over the use of hypnosis has been laid to rest in the medical community, but in solving crimes hypnotic techniques can lead to "a terrible miscarriage of justice."

Q Dr. Orne, why is the use of hypnosis spreading?

A The technique has been accepted by the American Medical Association, the American Psychiatric Association and the American Psychological Association. In addition to many encouraging clinical reports, there is now a growing body of research which helps clarify the nature of hypnosis and supports its use in a variety of areas.

We know that hypnosis has many useful applications in medicine, such as in the treatment of pain. It can lower an individual's level of arousal, and it helps in the treatment of stress. It is effective in the treatment of some forms of asthma and in certain skin disorders. It can even help modify the response of the body's immune system. Hypnosis is also used in psychiatry in a variety of ways: In the context of psychodynamic therapy, to uncover feelings and memories; in the context of behavioral approaches, to facilitate imagery. It is particularly effective in the treatment of anxiety and phobias.

Q Why then is hypnosis considered controversial?

A The medical uses of hypnosis are not controversial; what is controversial is the use of hypnosis in questioning suspects and witnesses to solve crimes.

There is a common misconception among laymen and in the law-enforcement community that people who are hypnotized must tell the truth. That is not so. Even deeply hypnotized people are capable of resisting suggestions and therefore capable of lying if they choose to. A person can also fake hypnosis in a way that can't readily be detected except by special tests.

As a paper published in Science magazine in October clearly indicates, memory obtained under hypnosis is less reliable -- not more reliable -- than normal recall prior to hypnosis. In a real-life situation, this is all the more a problem because the hypnotized person is responsive to suggestions and may translate his own beliefs or those of the hypnotist into pseudo memories.

Q Can hypnosis be dangerous?

A If hypnosis is used to create pseudo memories, it can be extremely dangerous in the courtroom. If you use hypnosis to convince a jury that an innocent man is guilty, it can lead to a terrible miscarriage of justice.

For example, I was involved in a case where a man was suspected of firing at two sailors. One sailor was wounded slightly. At the lineup, the victim said of the suspect, "No, he looks like him, but he wasn't the guy." But he also saw the



witness identify the suspect as the assailant. After two hypnotic sessions, the victim became convinced that the suspect really was the guy. On the basis of that testimony, the suspect was charged with attempted murder. Weeks later it turned out that the suspect had an ironclad alibi and was completely innocent.

Q But doesn't the hypnotic effect on the mind wear off?

A Certainly. Many of the effects of hypnosis wear off rapidly. Typical posthypnotic suggestions do not tend to persist over long periods, but hypnosis can permanently distort memory if the hypnotized subject comes to believe that he has remembered something that had not actually occurred. Such a pseudo memory may persist like any other memory even though it can be totally false. In the case I just described, the victim may well spend the rest of his life believing that the suspect had shot him. Two years after the event he wrote a letter to the newspaper Stars and Stripes complaining that "a guy nearly killed me and they let him go on a technicality."

Q Can hypnosis cause actual physical or mental harm?

A Like all therapeutic techniques, hypnosis has certain risks. Used in competent hands for appropriate reasons, hypnosis is very effective.

It is most important to make an accurate diagnosis before treatment. Hypnosis, for example, can relieve headache pain. If the headache is due to a brain tumor, you must still treat the tumor. Just because you've obtained relief from pain doesn't mean the underlying disease has been cured. It's also important that the person who does hypnosis is competent. With hypnosis you can uncover painful feelings and buried experiences, such as memories of a sexual assault. This is very useful in psychotherapy, but it requires a well­trained therapist to help the person deal with these very powerful emotions. It is not enough to tell the patient "all is well" and try to pour the genie back into the bottle. To do so may cause the patient even more difficulties.

Q Just what is hypnosis?

A Hypnosis is a state or condition where the subject focuses his mind on the suggestions of the hypnotist so that he is able to experience distortions of memory or perception. For the time being, the subject suspends disbelief and lowers his critical judgment. A good way to think of it is that your mind becomes so focused that you really get into a fantasy. You become so absorbed in what you are thinking that you begin to experience it as reality. One may conceive of hypnosis as a believed-in fantasy brought about through the use of the subject's imagination.

Q What are some of the uses of hypnosis in general medicine?

A Dramatic results have been achieved in the relief of asthma and some other allergies. This is because hypnosis can at times modify the body's immune system and block some of the allergic reaction. Hypnosis can be quite effective in arresting intractable hiccups and treating some forms of severe insomnia. One of the more interesting uses is in the treatment of certain kinds of warts and some skin disorders.

Hypnosis is also being used on an experimental basis to treat burn victims. What leads to the greatest damage and


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pain for these patients is not the burn itself but the body's reaction to the burn that causes inflammation and swelling. Research now under way suggests that it may be possible to hold back the body's response to burns through hypnosis and thereby reduce the painful swelling.

Q Can hypnosis bring relief from pain?

A It is very effective in the control of pain. Children with leukemia, for example, must undergo a painful procedure to obtain bone-marrow specimens to assess their condition. With hypnosis you can relieve the anxiety associated with the anticipation of pain and help these children to tolerate this procedure relatively comfortably.

Many children can go even deeper into fantasy and actually go on a mental trip in a spaceship, imagining that he or she is flying to the moon with Buck Rogers. The child becomes so absorbed in the fantasy that he or she is no longer aware of any pain during the bone-marrow aspiration. In the same way, hypnosis can be used in dentistry so that the patient becomes oblivious to a tooth being drilled.

Q What about cancer pain?

A We have had good success in relieving cancer pain through suggestion under hypnosis. Ironically, the fact that we can suggest a pain away doesn't mean that the pain was an imaginary symptom. Quite the reverse: It is generally more appropriate to suggest away a pain due to clear-cut physical reasons, such as a tumor, than one that has a psychological basis. When the pain is emotionally rooted, simply suggesting away the pain is not generally the treatment of choice -- though hypnosis may be used in the context of the psychotherapeutic or behavioral treatment that is indicated.

Q And headaches?

A Headaches are a very complex issue. Simple headaches are relieved as effectively by placebo -- inert medication -- as they are by aspirin or hypnosis as long as the person believes that the remedy works. A true migraine is a different story. Placebos and nonprescription painkillers have less effect, but hypnosis is very helpful with some migraines.

Q Can hypnosis help control heartbeat, blood pressure -­ even bleeding?

A By inducing a state of relaxation, hypnosis and self­hypnosis can often slow down the heartbeat and lower blood pressure. Here again it's important to make a diagnosis to determine that there aren't underlying causes for these conditions that may need treatment.

Dentistry has had some success in controlling bleeding through hypnosis. In a number of cases, hypnosis has apparently slowed the bleeding of hemophiliacs during dental procedures and decreased the need for many blood transfusions.

Q What are some of the psychiatric uses of hypnosis?

A We use hypnosis to uncover thoughts and feelings of which an individual may not be aware. This is effective in dynamic psychotherapy and forms the basis for hypnoanalysis.

Hypnosis has achieved good results in patients with a variety of anxiety disorders. It is also effective with many specific phobias: Fear of flying, fear of driving, fear of going out of the house, fear of insects, fear of snakes, fear of dentists, and so on. Through hypnosis and self-hypnosis, one learns to master these fears. Conditions such as aphonia, which is the inability to talk, blindness due to psychological reasons and posttraumatic stress reactions are other examples of conditions readily treated with hypnosis.

Q Can hypnosis help a person gain more self-confidence and be more productive?

A Hypnosis can improve your self-esteem by encouraging you to see yourself as capable and to rehearse certain tasks in your mind with the moral support of the therapist. What the therapist is doing here is using hypnosis to duplicate a situation where we gained self-confidence as children by mastering certain tasks with the support of our parents. Again, learning to use self-hypnosis and thereby to administer appropriate suggestions to oneself is particularly helpful for many individuals.

Q What about hypnosis to overcome addictions such as smoking, overeating or abuse of alcohol or drugs?

A Generally speaking, hypnosis is not very effective in treating disorders of self-control. It won't make you do something that you can do voluntarily if you would put your mind to it -- but that you really don't want to do for a variety of conscious and subconscious reasons.

In getting people to stop smoking, the success rate with hypnosis has not been dramatic. It's more a help in controlling the discomfort associated with quitting rather than in quitting itself. For people trying to lose weight, hypnosis is only moderately and occasionally effective. For control of drugs and alcohol, hypnosis is virtually useless. In most cases of alcohol and drug abuse, there are complex psychological reasons that prevent the mind from responding to hypnotic suggestions for self-control. Finally, hypnosis has very little use in the major psychoses. It is rarely, if ever, the treatment of choice for severe depressions, mania or schizophrenia.

Q Why do some people appear to be more responsive to hypnosis than others?

A The better you are at becoming totally absorbed in a fantasy, the more responsive you'll be to hypnosis -- if you want to respond. Children, especially under the age of 13, fantasize easily and are readily able to be hypnotized. As we grow older, we don't let our imaginations wander quite as much, and it is somewhat more difficult to suspend disbelief. The ability to respond follows a normal curve and tends to be higher among artists and many creative scientists. After the age of 60 we tend to lose some of our flexibility of thinking, and the ability to be hypnotized is generally decreased.

Q Can a person be made to do something while hypnotized that he or she would not normally do?

A No. You can't get people to do under hypnosis what they really don't want to do.

Q What kind of doctor is able to do hypnosis?

A It is easy to learn the technique of hypnosis. What is essential, however, is that the psychiatrist, psychologist, general physician or dentist be trained to treat the condition without hypnosis as well. You should be wary of any physician or psychologist who uses hypnosis to treat all his patients. Just as you wouldn't go to a doctor who uses penicillin with everybody, you wouldn't want to go to a doctor who uses hypnosis for everybody. A good physician is one who determines what ails you and then selects the best remedy. To use hypnosis appropriately, it should be one of many tools in the doctor's therapeutic armamentarium.

The preceding paper is a reproduction of the following interview (Hypnosis "Useful in medicine, dangerous in court." In U.S. News & World Report, December 12, 1983.). Copyright 1983 U.S. News & World Report, L.P. Reprinted with permission.