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Mind-body therapy methods of ideodynamic healing in hypnosis
The Arts in Psychotherapy,
Vol. 17, pp. 282-284.
@ Pergamon
Press plc, 1990. Printed in the U.S.A.
0197-4556/90
$3.00
+ .OO
BOOK REVIEW
Mind-Body Therapy Methods of Ideodyncmic Heaiing in Hypnosis Ernest L. Rossi & David B. Cheek iNew York: W.W. Norton & Company,
Hypnosis and hypnotherapy suffer from many myths. Traditional hypnotic theory, based on the idea that suggestion and overt and/or covert conditioning are the basic mechanisms of cure, evokes images of the patient’s mind submitting to the will and to the powerful, superior information and skill of the therapist. The highly directive and charismatic hypnotist ultimately leads the inadequate patient to health. Thus most therapists, scientists, and the general public hold a dim view of hypnotherapy that is, according to the authors of the present text, unfair and inaccurate. Ernest Rossi, who has written extensively on the work of Milton Erickson, has compiled the work of another major contributor to the field of clinical hypnotherapy, that of David Cheek. Together they integrate research findings in the fields of neurology, endocrinology, psychosomatic medicine, and molecular biology with Cheek’s long clinical experience to advance several basic hypotheses regarding the fundamental nature of and the value of therapeutic hypnosis. In doing so they hope to provide a dramatic contrast to traditional hypnotic theory and dispel many of the myths of the directive, omnipotent hypnotist. The basic thrust of the book is as follows: During periods of emotional and/or physical stress, information is encoded at deep psychobiological levels by the release of hormones and “messenger molecules.” That information becomes state-bound or state-dependent to that particular psychological and physiological state of stress. The problem is that these memories, bound as they are to those stress states, are not accessible during “normal” non-stress periods by the
1988, 519 pages, $34.95)
verbal processes of conversational psychotherapy. David Cheek’s technique of ideodynamic signaling, employed during a hypnotic state, apparently bridges the gap between the physiological and verbal levels. The effectiveness of ideodynamic signaling is based on the idea that unconscious gestures and movements indicate deeper levels of feeling than are reflected in speech. Conversational psychotherapy and conversational hypnosis for that matter, according to Rossi and Cheek, deal only with information that is available to normal memory at the verbal level. Using ideodynamic signaling, the hypnotherapist can thus access and reframe those state-dependent memories and true healing can take place. The ideodynamic method involves the patient’s use of a hand-held pendulum or the lifting of fingers. In either case, the “inner mind,” which often knows what has been forgotten or what was never known consciously, will direct the movement of the pendulum or select the appropriate finger to indicate a “yes, ” ‘&no,” “I’m not ready to answer yet,” or “I don’t know” response. The pendulum reflects slight body movement in these responses. In much the same way, a designated finger will move as the subject (unconsciously) thinks and feels yes, no, not ready to answer, or don’t know to questions by the therapist. Cheek’s observations of many of his patients whose unconscious muscle response-usually a definitive lifting of the finger-would often seem to contradict a spoken answer, indicated that feelings at variance with those expressed consciously certainly did exist. Rossi and Cheek point to two reasons why ideodynamic signaling is so effective: (a) because the 282
BOOK REVIEW method accesses many psychobiological levels of state-bound information (memory, learning, and behavior) that verbal processes cannot reach and (b) (and it is here that they hope to challenge the traditional views of the directive hypnotist) because it allows the patient to rely on his or her own inner resources. In other words, the skill of the hypnotist is in facilitating the patient’s inner work, not in programming the patient’s mind with dominating suggestions that work the “magic. ” This usually means that the patient’s inner resources are being integrated for problem solving and for healing. This process, according to the authors, is found in that “ever active and eager part of the inner mind, that, like a creative child, is still flexible enough to receive, explore, and develop a few generative clues and guidelines that are offered by the therapist” (p. 78). Two questions were raised for me on the point of “inner work.” For one thing, it is not clear to me how we know that the inner mind is performing these functions during hypnotic states. Certainly one could point to the successful results and conclude that an integration of inner resources did occur. However, that skirts the issue, and implies a pragmatic view of the process that the authors, in their detailed description of the theory of state-dependent physiology, seem to wish to avoid. The second question is over the meaning of “generative clues and guidelines” used by the hypnotherapist. How much of this technique is different from the stereotypical view of the directive hypnotist? How can we be sure that the movements of hypnotized patients are not responses to the implied demands from the therapist and do indeed represent true unconscious thought? The question is raised by the authors and, it seems, not fully resolved. They make an analogy between the doctorpatient and coach-athlete relationship to illustrate the positive, optimistic fighting spirit that is elicited in the patient by the doctor’s use of raising expectancies. However, as with the coach-athlete relationship, the doctor-patient dynamic may be characterized by many unconscious forces that work against the objective improvement of the patient. In addition, as with an athlete, a patient may feel obliged to respond optimistically and give what is sought by the hypnotherapist, in other words to outwardly comply. Under calm circumstances, “permissive” hypnosis is possible. But, claim the authors, “authoritative commands are necessary during an emergency” (p.310). And, as in sports, this reliance on extrinsic motivation does not always lead to satisfactory results. But Cheek
283
reports successful results, so in matters of critical life-threatening situations, does the end justify the means? The authors seem to imply this, but at the cost of dismissing important questions. Another unsettling aspect of the work described by Rossi and Cheek is their seemingly naive assumption and/or belief that a “simple recognition” by the patient of counterproductive feelings, such as guilt or a defeatist belief system, will permit the patient to remove that factor. No further elaboration is made, and the reader is left wondering if this is again part of that “inner work” process described earlier. In any case, the failure to describe the process by which resistance is overcome undermines the reader’s understanding of and confidence in the authors’ work. Rossi and Cheek devote a good deal of time in the world of biochemistry and molecular biology. As a therapist concerned with the emotional life of my patients, I found these sections to be too technical and inappropriate for a text on therapy. The reason the authors give for presenting this material is their hope that clinicians, in reading it, will construct “a strong belief system.” This strong personal belief in the theory and practice of the ideodynamic method will then make for more effective therapy. To be honest, wading through this highly technical material seemed to elicit the opposite response from this reader. In fact, the same response was elicited after encountering the same point-“we can reach deeper levels of unconscious thought with the help of ideomotor responses than is possible under usual circumstances with conversation” -made all too frequently throughout the text. The most moving, and consequently the most valuable, sections of the text were Cheek’s fascinating case studies. As a gynecologist/obstetrician, he has had the opportunity to work with many women experiencing various difficulties at various stages of pregnancy. These include dealing with the psychodynamics of blood pressure, clotting, and hemorrhage during menstrual and pregnancy cycles, and with the muscle tension and contraction during normal and premature labor, and during abortion. The cases apparently illustrate the profound bodily effect of seemingly simple questions using ideodynamic methods, and the powerful, natural inner healing responses of the human spirit. They were captivating and most inspiring. To his credit, Cheek expands on the significant factors in his therapeutic work that may make his hypnotic interventions that much more effective. The
284
BOOK REVIEW
most salient features, he admits, are his position of doctor as healer, his patients’ extreme state of dependency during an emergency situation, and the biological near-certainty of successful birth in the face of psychological difficulties. As tediously technical as the theory, the case histories were full, rich, and warm. Despite the fact that he presents verbatim accounts with suggestions as to how to proceed, Cheek’s technique cannot be reduced to mere steps in an induction. His warmth and personal concern and caring come through very clearly through the numerous interviews, and it would be unwise to follow these accounts cookbook style. Cheek’s extensive clinical experience and his profound sensitivity have enabled him to make many pertinent observations and suggestions concerning patients in critical situations. He points out that simple, direct reassurance is rejected and often implies the exact opposite to the patient, as if it were being offered indiscriminately without regard to the individual needs. Cheek elaborates on additional valuable aspects of patients’ responses during critical periods. A valuable point is about the concrete, literal thinking of people during naturally occurring hypnoida1 states that emerge during emergencies and at other times. Interestingly, as Cheek and Rossi point out, much of the classical phenomena of hypnosis were originally discovered as spontaneous manifestations of altered states in everyday life. This places a responsibility on those authorities involved with the emergency care of people, and would include surgeons and anesthesiologists who must be made aware
of the possible interpretations and misinterpretations that their patients, while under general anesthesia, may have of careless conversation in the operating room. Cheek’s ideodynamic approach seems, by his own estimation, to be most suitable and effective in emergency (accidents, wars) or high-performance life situations (birth, sex, sports, drama, creative and artistic work). These stressful situations reactivate traumatic and stress-related problems that Cheek’s approach can then access and reframe. Despite the apparent smugness of the hypnotherapist in dealing quickly and effortlessly with patients’ problems (‘ ‘The typical psychoanalyst who is involved with the tedious unraveling and lengthy working through” . . .p. 380), the authors point out that it is unlikely that the approach will replace lengthy restructuring and remedial work necessary in some psychotherapy. Rossi and Cheek acknowledge that the actual psychobiological processes in the healing of patients are not yet known. Their theoretical vision has yet to be tested through the use of applied experimental controls. Their speculations, apparently consistent with current well-known scientific understanding of these processes, await further research. In the meantime they present us with fascinating accounts of what appears to be mind-body healing.
Gerard F. Shaw, Ed.D. Psychotherapist in private practice New York City
Vol. 17, pp. 282-284.
@ Pergamon
Press plc, 1990. Printed in the U.S.A.
0197-4556/90
$3.00
+ .OO
BOOK REVIEW
Mind-Body Therapy Methods of Ideodyncmic Heaiing in Hypnosis Ernest L. Rossi & David B. Cheek iNew York: W.W. Norton & Company,
Hypnosis and hypnotherapy suffer from many myths. Traditional hypnotic theory, based on the idea that suggestion and overt and/or covert conditioning are the basic mechanisms of cure, evokes images of the patient’s mind submitting to the will and to the powerful, superior information and skill of the therapist. The highly directive and charismatic hypnotist ultimately leads the inadequate patient to health. Thus most therapists, scientists, and the general public hold a dim view of hypnotherapy that is, according to the authors of the present text, unfair and inaccurate. Ernest Rossi, who has written extensively on the work of Milton Erickson, has compiled the work of another major contributor to the field of clinical hypnotherapy, that of David Cheek. Together they integrate research findings in the fields of neurology, endocrinology, psychosomatic medicine, and molecular biology with Cheek’s long clinical experience to advance several basic hypotheses regarding the fundamental nature of and the value of therapeutic hypnosis. In doing so they hope to provide a dramatic contrast to traditional hypnotic theory and dispel many of the myths of the directive, omnipotent hypnotist. The basic thrust of the book is as follows: During periods of emotional and/or physical stress, information is encoded at deep psychobiological levels by the release of hormones and “messenger molecules.” That information becomes state-bound or state-dependent to that particular psychological and physiological state of stress. The problem is that these memories, bound as they are to those stress states, are not accessible during “normal” non-stress periods by the
1988, 519 pages, $34.95)
verbal processes of conversational psychotherapy. David Cheek’s technique of ideodynamic signaling, employed during a hypnotic state, apparently bridges the gap between the physiological and verbal levels. The effectiveness of ideodynamic signaling is based on the idea that unconscious gestures and movements indicate deeper levels of feeling than are reflected in speech. Conversational psychotherapy and conversational hypnosis for that matter, according to Rossi and Cheek, deal only with information that is available to normal memory at the verbal level. Using ideodynamic signaling, the hypnotherapist can thus access and reframe those state-dependent memories and true healing can take place. The ideodynamic method involves the patient’s use of a hand-held pendulum or the lifting of fingers. In either case, the “inner mind,” which often knows what has been forgotten or what was never known consciously, will direct the movement of the pendulum or select the appropriate finger to indicate a “yes, ” ‘&no,” “I’m not ready to answer yet,” or “I don’t know” response. The pendulum reflects slight body movement in these responses. In much the same way, a designated finger will move as the subject (unconsciously) thinks and feels yes, no, not ready to answer, or don’t know to questions by the therapist. Cheek’s observations of many of his patients whose unconscious muscle response-usually a definitive lifting of the finger-would often seem to contradict a spoken answer, indicated that feelings at variance with those expressed consciously certainly did exist. Rossi and Cheek point to two reasons why ideodynamic signaling is so effective: (a) because the 282
BOOK REVIEW method accesses many psychobiological levels of state-bound information (memory, learning, and behavior) that verbal processes cannot reach and (b) (and it is here that they hope to challenge the traditional views of the directive hypnotist) because it allows the patient to rely on his or her own inner resources. In other words, the skill of the hypnotist is in facilitating the patient’s inner work, not in programming the patient’s mind with dominating suggestions that work the “magic. ” This usually means that the patient’s inner resources are being integrated for problem solving and for healing. This process, according to the authors, is found in that “ever active and eager part of the inner mind, that, like a creative child, is still flexible enough to receive, explore, and develop a few generative clues and guidelines that are offered by the therapist” (p. 78). Two questions were raised for me on the point of “inner work.” For one thing, it is not clear to me how we know that the inner mind is performing these functions during hypnotic states. Certainly one could point to the successful results and conclude that an integration of inner resources did occur. However, that skirts the issue, and implies a pragmatic view of the process that the authors, in their detailed description of the theory of state-dependent physiology, seem to wish to avoid. The second question is over the meaning of “generative clues and guidelines” used by the hypnotherapist. How much of this technique is different from the stereotypical view of the directive hypnotist? How can we be sure that the movements of hypnotized patients are not responses to the implied demands from the therapist and do indeed represent true unconscious thought? The question is raised by the authors and, it seems, not fully resolved. They make an analogy between the doctorpatient and coach-athlete relationship to illustrate the positive, optimistic fighting spirit that is elicited in the patient by the doctor’s use of raising expectancies. However, as with the coach-athlete relationship, the doctor-patient dynamic may be characterized by many unconscious forces that work against the objective improvement of the patient. In addition, as with an athlete, a patient may feel obliged to respond optimistically and give what is sought by the hypnotherapist, in other words to outwardly comply. Under calm circumstances, “permissive” hypnosis is possible. But, claim the authors, “authoritative commands are necessary during an emergency” (p.310). And, as in sports, this reliance on extrinsic motivation does not always lead to satisfactory results. But Cheek
283
reports successful results, so in matters of critical life-threatening situations, does the end justify the means? The authors seem to imply this, but at the cost of dismissing important questions. Another unsettling aspect of the work described by Rossi and Cheek is their seemingly naive assumption and/or belief that a “simple recognition” by the patient of counterproductive feelings, such as guilt or a defeatist belief system, will permit the patient to remove that factor. No further elaboration is made, and the reader is left wondering if this is again part of that “inner work” process described earlier. In any case, the failure to describe the process by which resistance is overcome undermines the reader’s understanding of and confidence in the authors’ work. Rossi and Cheek devote a good deal of time in the world of biochemistry and molecular biology. As a therapist concerned with the emotional life of my patients, I found these sections to be too technical and inappropriate for a text on therapy. The reason the authors give for presenting this material is their hope that clinicians, in reading it, will construct “a strong belief system.” This strong personal belief in the theory and practice of the ideodynamic method will then make for more effective therapy. To be honest, wading through this highly technical material seemed to elicit the opposite response from this reader. In fact, the same response was elicited after encountering the same point-“we can reach deeper levels of unconscious thought with the help of ideomotor responses than is possible under usual circumstances with conversation” -made all too frequently throughout the text. The most moving, and consequently the most valuable, sections of the text were Cheek’s fascinating case studies. As a gynecologist/obstetrician, he has had the opportunity to work with many women experiencing various difficulties at various stages of pregnancy. These include dealing with the psychodynamics of blood pressure, clotting, and hemorrhage during menstrual and pregnancy cycles, and with the muscle tension and contraction during normal and premature labor, and during abortion. The cases apparently illustrate the profound bodily effect of seemingly simple questions using ideodynamic methods, and the powerful, natural inner healing responses of the human spirit. They were captivating and most inspiring. To his credit, Cheek expands on the significant factors in his therapeutic work that may make his hypnotic interventions that much more effective. The
284
BOOK REVIEW
most salient features, he admits, are his position of doctor as healer, his patients’ extreme state of dependency during an emergency situation, and the biological near-certainty of successful birth in the face of psychological difficulties. As tediously technical as the theory, the case histories were full, rich, and warm. Despite the fact that he presents verbatim accounts with suggestions as to how to proceed, Cheek’s technique cannot be reduced to mere steps in an induction. His warmth and personal concern and caring come through very clearly through the numerous interviews, and it would be unwise to follow these accounts cookbook style. Cheek’s extensive clinical experience and his profound sensitivity have enabled him to make many pertinent observations and suggestions concerning patients in critical situations. He points out that simple, direct reassurance is rejected and often implies the exact opposite to the patient, as if it were being offered indiscriminately without regard to the individual needs. Cheek elaborates on additional valuable aspects of patients’ responses during critical periods. A valuable point is about the concrete, literal thinking of people during naturally occurring hypnoida1 states that emerge during emergencies and at other times. Interestingly, as Cheek and Rossi point out, much of the classical phenomena of hypnosis were originally discovered as spontaneous manifestations of altered states in everyday life. This places a responsibility on those authorities involved with the emergency care of people, and would include surgeons and anesthesiologists who must be made aware
of the possible interpretations and misinterpretations that their patients, while under general anesthesia, may have of careless conversation in the operating room. Cheek’s ideodynamic approach seems, by his own estimation, to be most suitable and effective in emergency (accidents, wars) or high-performance life situations (birth, sex, sports, drama, creative and artistic work). These stressful situations reactivate traumatic and stress-related problems that Cheek’s approach can then access and reframe. Despite the apparent smugness of the hypnotherapist in dealing quickly and effortlessly with patients’ problems (‘ ‘The typical psychoanalyst who is involved with the tedious unraveling and lengthy working through” . . .p. 380), the authors point out that it is unlikely that the approach will replace lengthy restructuring and remedial work necessary in some psychotherapy. Rossi and Cheek acknowledge that the actual psychobiological processes in the healing of patients are not yet known. Their theoretical vision has yet to be tested through the use of applied experimental controls. Their speculations, apparently consistent with current well-known scientific understanding of these processes, await further research. In the meantime they present us with fascinating accounts of what appears to be mind-body healing.
Gerard F. Shaw, Ed.D. Psychotherapist in private practice New York City