Hypnotized by skepticism

When hypnosis was first introduced to the European public more than a century ago, it was widely denounced by skeptics as a mere stage trick. Even when a hypnotized patient underwent surgery without anesthesia, showing no pain, the skeptics refused to believe anything more than a ruse was involved. The patient, they claimed, had obviously entered into an agreement with the surgeon to remain quiet through the operation!

I had assumed that such attitudes had long since faded. But while doing a little online research on Derren Brown, I came across some skeptical comments on hypnosis (which Brown is alleged to employ). The claim about Brown is that he practices "involuntary hypnosis" - hypnotizing his subjects without their knowledge or consent. I have no reason to think that involuntary hypnosis is possible. What surprised me, though, is that some skeptics still have their doubts about even conventional hypnosis.

Here is superskeptic James Randi:

... hypnosis is merely an agreement between the subject and the operator that they will fantasize together, nothing more. It may well have some limited value as a psychiatric tool, but it's not a "power," it's not a "force," it's a role-playing game, and only highly emotional persons will react as [a particular subject] did. She probably would have reacted to any suggestion, by anyone, that would produce imaginary events and the resultant trauma.

And here's Robert Todd Carroll of the Skeptic's Dictionary:

Most of what is known about hypnosis, as opposed to what is believed, has come from studies on the subjects of hypnosis. We know that there is a significant correlation between being able to be absorbed in imaginative activity and being responsive to hypnosis. We know that those who are fantasy-prone are also likely to make excellent hypnotic subjects. We know that vivid imagery enhances suggestibility. We know that those who think hypnosis is rubbish can’t be hypnotized.... [Many hypnotists dispute this claim - MP.]

If hypnosis is not an altered state or gateway to a mystical and occult unconscious mind, then what is it? [Psychologist Robert] Baker claims that what we call hypnosis is actually a form of learned social behavior.

The hypnotist and subject learn what is expected of their roles and reinforce each other by their performances. The hypnotist provides the suggestions and the subject responds to the suggestions. The rest of the behavior--the hypnotist’s repetition of sounds or gestures, his soft, relaxing voice, etc., and the trance-like pose or sleep-like repose of the subject, etc.--are just window dressing, part of the drama that makes hypnosis seem mysterious.

Now, if hypnosis is nothing but role playing, then it's hard to see how the surgery patient was able to get through his operation without "breaking character." But skeptics will object that the surgery experiment happened many years ago. (They seem to think that old data are somehow inherently unreliable. This saves them the trouble of actually looking at or responding to these data.)

So are the any contemporary uses of hypnotism in the context of surgery? It appears there are. A Google search for the terms "surgery" + "hypnosis" turned up "about 1,500,000 English pages."

Here's part of a 1998 article in NurseWeek:

Imagine having a lump the size of an orange carved out of your breast without anesthesia or feeling no pain as the surgeon drives a pin into the bone marrow of your fractured leg without a chemical pain reliever. Hypnosis, when used by properly trained healthcare professionals, can refocus patients’ minds and alleviate their pain.

Patients under hypnosis may still feel pressure or pulling, but healthcare professionals can use hypnosis to suggest that those sensations are good....

[T]he American Association of Nurse Anesthetists ... recognizes the technique as a valid form of analgesia....

In fact, studies have shown that patients undergoing hypnosis before, during, or after surgery need less pain medication and heal more quickly.

Here's the Harvard University Gazette:

Marie McBrown was invited to test whether or not hypnosis would help heal the scars from her breast surgery. Marie (not her real name) and 17 other women underwent surgery to reduce their breast size....

The pain and course of healing from such surgery is well-known, and a team of researchers headed by Carol Ginandes of Harvard Medical School and Patricia Brooks of the Union Institute in Cincinnati wanted to determine if hypnosis could speed wound healing and recovery....

The result was clear. Marie McBrown and the women who had undergone hypnosis healed significantly faster than the others. Those who received supportive attention came in second....

Four years ago, Ginandes and Daniel Rosenthal, professor of radiology at the Harvard Medical School, published a report on their study of hypnosis to speed up the mending of broken bones. They recruited 12 people with broken ankles who did not require surgery and who received the usual treatment at Massachusetts General Hospital in Boston. In addition, Ginandes hypnotized half of them once a week for 12 weeks, while the other half received only normal treatment....

The result stood out like a sore ankle. Those who were hypnotized healed faster than those who were not. Six weeks after the fracture, those in the hypnosis group showed the equivalent of eight and a half weeks of healing..

That's some mighty good role playing!

Finally, here's New Scientist magazine, with all emphases added:

As the surgeon's knife cut into her chest, 46-year-old Pippa Plaisted should have been in agony. The 45-minute breast cancer operation she was undergoing at the Lister Hospital in London would normally have needed a general anaesthetic. But Plaisted had not been anaesthetised, nor given painkilling drugs of any sort. Instead, hypnotherapist Charles Montigue stood at the operating table, his thumb resting on Plaisted's forehead, monitoring the hypnotic trance he had put her in minutes before the operation began. Eyes closed but awake, Plaisted could hear the surgeon calmly telling her, at each stage of the operation, what was going to happen next.... Astonishingly, the hypnosis succeeded in making her operation entirely pain-free. "The surgeon was cutting and sewing inside me, but I could not feel any sensation at all," Plaisted recalls....

In Liege Hospital, Belgium, anaesthetists routinely use a procedure that they call "hypnosedation".

They have found that when combined with local anaesthetic and much-reduced amounts of other analgesic drugs, medical hypnosis is an effective alternative to general anaesthesia. So far, the Liege team have used this technique in over 4800 major and minor operations. Now other hospital departments are beginning to follow suit.

Meanwhile, the Liege team are discovering that hypnosedation has some remarkable benefits. For a start, patients bleed less.... One reason for this reduced bleeding, [anesthestist Marie-Elisabeth] Faymonville says, is that anaesthetic drugs inhibit the natural tendency for blood vessels to constrict in reaction to an incision. Patients under general anaesthesia also have to be ventilated with a respirator. "This creates a positive pressure in the chest, which increases bleeding," Faymonville says. "In hypnosedation patients breathe spontaneously."

Because hypnotised patients are conscious throughout the operation they can even cooperate with the surgeon....

Hypnosedation also seems to improve recovery time. In 2000, Faymonville's team compared 20 patients undergoing thyroid surgery under hypnosedation with 20 patients undergoing the same surgery under general anaesthesia. Whereas the anaesthetised patients spent an average of 36 days recovering from the operation, those that had been hypnosedated returned to work after an average of only 10 days. The main difference, the team found, was a reduced level of inflammation in the hypnosedated group....

Neuroscientists are only just beginning to understand how hypnosis can reduce sensations of pain. In November, researchers at the University of Iowa in Iowa City published a study that used functional magnetic resonance imaging (fMRI) to compare the brain activity of hypnotised and non-hypnotised volunteers when they were exposed to painful heat. The fMRI images showed that brain activity in the two groups differed significantly. The response of their subcortical neural network, where pain signals start, was unaffected. However, there were remarkable differences in the higher parts of the pain network. Activity in the primary sensory cortex, the area responsible for feeling pain, was dampened down.

Once again, the skeptics are behind the curve. Trapped by a hopelessly rigid worldview, they simply cannot absorb new information - even when the "new" information in question is more than a century old. Meanwhile, the world moves on, leaving Robert Carroll and James Randi ever further behind.