If M. Mesmer had no other secret than how to put the imagination into motion effectively, for health purposes, would not that still be a marvelous blessing? If the medicine of imagination is best, should we not practice the medicine of imagination?

—From the original scientific investigation of animal magnetism commissioned by King Louis XVI of France (Franklin et al., 1784)

Hypnosis has been available to dentistry for centuries, yet it is underutilized and widely misunderstood. This chapter describes the essential nature of hypnosis and recommends applications that should be learned and used by every competent modern dental practitioner. The subject is too vast and complex to be covered in a short chapter such as this; consequently, the goal of this chapter is to introduce hypnosis, dispel inhibiting myths, and provide a map along with encouragement for exploration. Recommended readings are provided at the end of this chapter.

A proper understanding of hypnosis can enhance the experience of both provider and patient, and dental personnel who fail to apply basic hypnotic principles are letting their patients down.

A Brief History of Clinical Hypnosis

Hypnosis has a storied past, filled with mystery and misunderstanding. Hypnotic practice has suffered by being caught between implausibly exaggerated claims and overwrought skepticism. The literature on hypnosis is littered with reports such as Ewin’s (1992) study titled “Hypnotherapy for Warts (Verruca Vulgaris): 41 Consecutive Cases with 33 Cures” and Willard’s (1977) purportedly successful research on “Breast Enlargement through Visual Imagery and Hypnosis.” Nonetheless, it has survived over the centuries while many other nonphysical forms of healing have not. The American Medical Association officially endorsed hypnosis as a treatment modality in 1958, recommending its inclusion in mainstream medical training (Wester, 1987).

While trance was exploited by ancient healers, the modern history of clinical hypnosis begins with the Viennese physician, Anton Mesmer. Mesmer studied gypsy and religious healing practices and became intrigued with the “laying on of hands” which seemed to produce medical results. His work in “animal magnetism” was eventually discredited when a distinguished panel of investigators, including Benjamin Franklin, Antoine Lavoisier, and Dr. Joseph Guillotin, acknowledged that Mesmer had achieved positive physical outcomes. They found, however, that his “cures” (including “crises” and convulsions) were not the result of animal magnetism or the influence of heavenly bodies, as Mesmer had claimed, but “that this new agent may be only the imagination itself, the power of which is so great that it is little understood.” (Franklin et al., 1784).

The “father” of clinical hypnosis was a Scottish physician named James Braid (Kroger, 1977). He replaced the concept of animal magnetism with his term “hypnosis,” derived from the Greek word for sleep, hypnos. This turned out to be an unfortunate naming, as comparisons of hypnosis to sleep are inaccurate and misleading. Interest in medical applications of hypnosis was great in nineteenth-century Europe, where Bernheim, Charcot, Janet, and Freud all conducted extensive explorations into its usefulness. Unfortunately, Freud discarded hypnosis, partly because it bypassed the very resistance and defenses that his approach was designed to explore. Hypnosis did not fit his theoretical view, and Freud’s powerful influence dampened collegial interest. Janet was prophetic at the time, however, when he said, “If my work is not accepted today, it will be tomorrow when there will be a new turn in fashion’s wheel which will bring back hypnotism as surely as our grandmother’s styles” (Kroger, 1977, p. 4).

The physical and psychological trauma of two world wars accelerated interest in hypnosis, and military doctors returned home from battlefields motivated to continue their study of trance and healing.

The next wave of interest in hypnosis was generated in the second half of the twentieth century by the charismatic and somewhat eccentric psychiatrist, Milton Erickson. His innovations and publications excited a generation of physicians, psychologists, and dentists, and his views shaped the way that modern clinical hypnosis is understood. Erickson understood hypnosis more broadly than his predecessors, and he eventually focused on the ways that humans influence each other subconsciously, both in and out of formal trance states. Zeig (1987) observed, “To Erickson, hypnosis was not merely a trance state within a person; it was a special context for communication …” (p. 394). Erickson actually caused a paradigm shift in the ways that hypnosis is understood and practiced, and those changes are described later in this chapter.

The Nature of Hypnosis

Hypnotic interventions can add to clinical practice in the following ways (Holroyd, 1987):

• enhanced rapport
• increased suggestibility
• positive use of attention and awareness
• utilization of dissociation
• access to the mind–body relationship
• use of imagery
• responsiveness to the doctor’s messages.

Since patients and doctors typically fail to avail themselves of the benefits of hypnosis due to misconceptions, it is wise to begin with those. A multitude of myths and misunderstandings blur our ability to take advantage of something that is inexpensive (or free), generally harmless, relatively easy to do, and filled with potential benefit. Here are four important problematic myths.

Defining Hypnosis and Using It

Novices think exclusively about trance when they think of hypnosis, but there are other ways to define hypnosis that open the door to widespread and efficient application in dental care. There exists no single, well-accepted definition of hypnosis. Carol Erickson reported (personal communication) that her father, Milton, once said, “I’ve been doing hypnosis for fifty years, thinking about it for fifty years, and I still don’t really know what it is.” In fact, as Lynn and Rhue (1991) observe in their book on theories of hypnosis, “There is no question that hypnosis has eluded a single, simple definition.”

What follows is a description of a “map” of hypnosis. An outline of this map can be found in Table 6.1. This description is quite basic in nature, and the map is not the territory.

Forms

It is useful to divide hypnosis into two forms: trance and nontrance.