The Uses of Hypnosis in Therapy

 

            Hypnotherapy has been used for centuries to treat a variety of physical and behavioral concerns. Hypnosis is best described as an altered state of consciousness whereby the subconscious mind is more open to suggestion and to retrieval of repressed information. Although it resembles other altered states, such as relaxation and meditation, it is indeed a unique state that distinguishes itself from other states in its tremendous potential for behavioral change, whether physical, emotional, or mental. There are numerous hypnotic methods or techniques, as well as applications. Once commonly used in attempt to cure individuals of such sexual behaviors as masturbation, homosexuality, and “excessive” sexual desire, its current applications in the field of sex therapy, tend to reflect our less sexually repressed, more sex-positive culture.

            Methods involved in hypnosis include induction techniques, information retrieval techniques, hypnotic suggestions, post-hypnotic suggestions, and self-hypnosis.  In a hypnotherapy session, induction techniques that help guide a person into a hypnotic trance or state are first employed. The focus is often on relaxation, going deeper, etc. Once a person is in a hypnotic state, hypnotic suggestions and post-hypnotic suggestions can be introduced. Suggestions are usually in the form of direct or indirect statements, intended to imprint desired information or behavior modification in the subconscious mind. Also, information pertinent to a client’s situation can be retrieved while in the hypnotic state. Past physically or emotionally painful sexual experiences or a sexually repressive upbringing, can be uncovered in hypnosis, and be valuable data for the therapist to work with. Self-hypnosis is a technique in which one puts oneself in a hypnotic trance and gives oneself hypnotic suggestions.

            Milton Erickson, highly influential in the field of hypnotherapy, developed and used such techniques as indirect suggestions, therapeutic metaphors, and confusion methods, including sensory overload and pattern interruption. Some other common methods employed are modeling, imagery training, self-talk, reinforcement for incremental improvements in hypnotic responsiveness, blocking out negative competing thoughts, direct suggestions, repetitions of suggestion, and motivation to be rid of bad habits. Some retrieval of information techniques include ideomotor responding, age regression, and ego state therapy.

            It is perhaps interesting to take a look back in time to see how the applications of hypnosis in sex therapy have changed. A1895 book entitled The Use of Hypnosis in Psychopathia Sexualis, by Von Schrenck-Notzing,MD,  gives us a peak at how sexuality was perceived, at least in the medical field in the Victorian era. While some of the applications of hypnosis presented in this book are still applied today, there are a few that would probably be considered by most, absurd, at least within the field of sex therapy. Masturbation, referred to as onanism or auto-sexual indulgence, excessive sexual desire, referred to as satyriasis, in men, or nymphomania, in women, and homosexuality, referred to as contrary sexual instinct or inversion of sexual feeling, were all considered to be psycho-sexual abnormalities or diseases that required some kind of treatment or intervention, and were believed to be potentially cured at least partially, through the use of hypnosis. Even a 1964 book, entitled How To Solve Your Sex Problems with Self-Hypnosis, by Frank Caprio, MD, while much friendlier in regards to masturbation, still considered some such cases to be neurotic, and considered all cases of homosexuality to be neurotic, offering readers hypnotic suggestions to overcome their neuroses, which today are no longer considered such.

            It is perhaps important to note here that sex therapy today is in different hands, and is no longer strongly influenced by the medical model, which is all about pathology. Thanks to Kinsey and other sex researchers, we now have a greater understanding and tolerance for the variety of ways people express their sexuality. Today, sex therapy is coming from a place of wanting to help people with their sexual concerns, not change them into “normal” people, although it would not surprise me to learn that some people still use hypnotherapy in such a way.

                        Applications of hypnosis in sex therapy today include the treatment of desire and arousal problems, inability to orgasm, ejaculatory issues, unwanted sexual proclivities or “paraphilias,” dysparenia, vaginismus, and even fertility issues. Woven into these issues are often body image issues, sexual self-perception issues, and sexual conflicts. Sometimes, hypnosis is used to help individuals or couples simply increase their sexual satisfaction.

            In his 1977 book Techniques in Behavior Therapy and Hypnosis, Arreed Barabasz discusses the use of hypnosis in helping women respond orgasmically to coitus without any manual stimulation. He specifically talks about the MacVaugh procedure, which entails actually inducing orgasm in the female while she is in a hypnotic trance, and is so achieved through a series of methods which include pubococcygeous exercises, viewing of explicit media in which women are taking an active role, and the suggestion of potentially stimulating sensations. Barabasz notes that he finds it to be more effective if, while under hypnosis, the woman produces her own list of sexually arousing stimuli, and he may also have her insert Ben-Wa balls prior to hypnotic induction.

            Barabasz also discusses the use of hypnosis in the treatment of premature ejaculation in Techniques in Behavior Therapy and Hypnosis. He notes that his belief about premature ejaculation is that it is a learned response, often the product of positive reinforcement from a man’s early anxiety producing situations that favored his rapid performance, such as sex with a prostitute or in the backseat of a car. Phase one of the treatment for premature ejaculation begins with relaxation, and is followed by a visualization exercise in which he has intercourse with his spouse. This helps reduce the anxiety-producing value of the coital encounter, and therefore, removes the need for rapid ejaculation. Phase two involves in vivo desensitization, which essentially consists of a client gradually working toward the act of coitus over a period of amorous sessions, decreasing the anxiety incrementally. The basic suggestion underlying the first two phases is that the patient can expect to be “cured.” Phase three is where the overt hypnotic suggestions come into play. Barabasz offers in successive sessions and in this order the following post-hypnotic suggestions: “1) It will be easier and easier to be more relaxed and confident at each sexual encounter. 2) It’s easier and easier to enjoy intercourse, excited yet relaxed. 3) It’s easy to last as long as you wish.” (p. 79. Barabasz) In addition, clients are given daily self-hypnosis homework assignments, meant to reinforce the post-hypnotic suggestions.

            In an article out of Joseph and Leslie Piccolo’s 1978 book Handbook of Sex Therapy, the use of hypnosis, specifically the in vitro method and the in vivo method, in the treatment of vaginismus is discussed. The in vitro desensitization method they describe begins first with inducing deep relaxation, so far that hallucinations occur, if possible. Next an anxiety hierarchy is built, beginning with the weakest stimulus, being some pleasurable situation with the spouse, and ending with the strongest, being full intercourse. Over a period of six to eight sessions, this stimulus is incrementally introduced to the client while in a deeply relaxed state. After each session, the client is to reproduce whatever situation occurred in the hypnotic state at home with their spouse, in real life, as a way to reinforce the achievements. The in vivo method they describe involves first helping a client learn to relax through hypnosis, using a passive-permissive approach, noting that sometimes an active-authoritarian approach is necessary. Next, the client is taught the technique of self-hypnosis, which she can then practice at home. She is then introduced to Hegar dilators that she uses herself at home while under self-induced hypnosis. Eventually, the dilators are inserted by the therapist until the client can manage a dilator the size of a penis inside of her vagina, at which point she proceeds to have coitus with her spouse in the female superior position, while continuing to incorporate the self-induced relaxation hypnosis.

            Bernie Zilbergeld discusses the use of hypnosis, specifically result imagery, in the treatment of sexual problems in an article found in the 1986 book Hypnosis: Questions and Answers.  Zilbegeld considers that one’s self-image is often wrapped up with one’s sexual problems. Getting stuck on a negative sexual self-image becomes a self-fulfilling prophesy. The use of result or goal imagery helps a client alter his view of himself. The client is put into a relaxed state and made to imagine, over and over, having accomplished his goals and what his life is like now that he has done so. Hypnotic suggestions that Zilbergeld offers to men with erectile difficulty are: “You’re not trying to have an erection or have good sex or be a good lover. All those things are taken for granted. You are a confident, skillful, fully functional lover, with lots of pleasure and lots of good experiences behind you. You fully anticipate a wonderful time whenever you think about having sex with your partner and whenever you make or respond to the first sexual move.” Zilbergeld usually starts using result imagery near the beginning of  therapy, finding that focusing on the desired outcome, helps a client be more motivated through the rough spots in treatment.

            Carol Rinkleib Ellison discusses the use of trance in increasing the level of sexual satisfaction between couples in her article, also found in Hypnosis: Questions and Answers. Sometimes a couple does not perceive that they have a problem perse, but they wish to enhance their sexual interaction, and through a kind of altered state, Ellison calls the “intimate trance,” couples can experience a greater sense of connectedness and intimacy, that ultimately lead to greater sexual satisfaction. This kind of hypnosis could best be described as self-hypnosis, and involves many techniques and activities that assist the couple in attaining the “intimate trance.”  The techniques include centering, forming intent, sexual choreography, breathing exercises, touching exercises, and imagery for mutuality and merging.

            For all of its varied and complex applications, the use of hypnosis for pure relaxation seems to be the most universally valuable in sex therapy. The mere induction into trance is essentially deep relaxation. Relaxation, allows one to tune into the physical sensations in one’s body, focus on pleasure, and allow erotic energy to build. In fact, Bernie Zilbegeld considers that good sex is itself erotic trance.

References

 

Barabasz, Arreed. Techniques in Behavior Therapy and Hypnosis. South Orange: Power Publishers, Inc. 1977. pp. 169.

 

Biegel, Hugo. Johnson, Warren. Application of Hypnosis in Sex Therapy. Springfield: Charles C. Thomas. 1980. pp.327.

 

Caprio, Frank. How To Solve Your Sex Problems With Self-Hypnosis. New York: The Citadel Press. 1964. pp. 217

 

Hartman, William E. and Fithian, Marilyn A. Treatment of Sexual Dysfunction: A Bio-Psycho-Social Approach. New York: Jason Aronson. 1974.  pp 268.

 

LoPiccolo, Joseph. LoPiccolo, Leslie. Handbook of Sex Therapy. New York: Plenum Press. 1978. pp. 531.

 

Von Schrenck-Notzing. The Use of Hypnosis in Psychopathia Sexualis. New York: The Julian Press, Inc. 1895. pp. 320.

 

Zilbergel d, Bernie. Edelstien, Geral d. Araoz, Daniel. Hypnosis: Questions and Answers. New York: W.W. Norton & Company. 1986. pp. 489.