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Hypnotherapy: hype or healing?

Hypnotherapy: hype or healing?

Susannah Baron believes in the latter. Rhona MacDonald finds out why

"Hypnotherapy is not mystical or magical. It is an altered state of consciousness where the body is relaxed and open to suggestions," explains Susannah Baron, specialist registrar in dermatology and hypnotherapist. She explains further: "There is a door between your conscious and subconscious mind. Hypnotherapy can open that door wider when you are relaxed so when a positive suggestion is made, it can change your pattern of behaviour quite quickly." However, she is quick to point out that it is not a panacea for every ailment: "Hypnotherapy can only help people if they want to make that change. You can only help them to help themselves. It is a tool rather than a cure."

This sounds relatively non-threatening and a far cry from stage performers who use hypnotherapy for entertainment value. Susannah explains: "We all go in and out of an hypnotic trance all the time. That's what daydreams are."

Hypnotherapy can only help people if they want to make that change.

But how can this power of positive suggestion and daydreams be used in medicine? Susannah is already using it in her own specialty with her eczema patients: "I ask them to remember a time when their skin felt good, what it felt like, and what they were doing. For example, I take them back to the beach and describe the feeling of the sun on their skin when it felt healthy and not itchy. I also ask them what their skin stops them from doing now and what they would like to do, then, through the power of suggestion, take them there." According to Susannah, it is all about direct suggestions, ego strengthening and stress management. People with skin disorders often have a negative body image and so they get themselves into a vicious cycle where their stress and negative emotions can drive their skin condition. This is where self-hypnosis can help. Susannah explains: "It is reasonably simple. I teach them self-hypnosis. Once patients are in a quiet place and feeling relaxed, such as just before bed, I ask them to take themselves in their minds to somewhere they want to be. Then I ask them to imagine that their skin is cool and clear."

But does it work, and how can you fit hypnotising patients into a busy outpatient clinic? Susannah admits that it is difficult to find the time to fit it in and insists that the way forward is robust research: "It is difficult for the medical profession to accept if there is no good evidence, and so I am planning to do a pilot study on ten adults and ten children with eczema, which hopefully will lead on to a randomised controlled trial."

It is difficult to imagine what the placebo will be for hypnotherapy, the thorn in the side of many complementary or alternative treatments, especially acupuncture, but Susannah is pretty positive: "There has been a lot of work already with irritable bowel syndrome (IBS) with fantastic results. Research with a large number of patients has shown that hypnotherapy (in group sessions) is cost effective in managing IBS and improving quality of life." Maybe eczema will be next.

Unsurprisingly, some of her colleagues are sceptical about her work but others are supportive and interested and Susannah stresses the importance of practitioner regulation. She has trained through the medical diploma at the London College of Clinical Hypnosis which is specifically for doctors. It involves one weekend a month for six months and a written and practical exam. But of course the best training is often on yourself, and Susannah is a living testament to how it can help.

In October 1998, she received a diagnosis of Hodgkin's lymphoma. She recalls: "To try to improve the terrible spinal headaches that I had from the intrathecal methotrexate, I went to see an aromatherapy masseuse who had been recommended to me. She gave me an insight into complementary medicine. Despite being a sceptic and a scientist, I thought why not. I did not stop the chemotherapy but conventional medicine treats only the part of you it can see is sick. Complementary medicine takes a more holistic approach and tries to treat all of you. It can give you that edge and sometimes that's what you need to survive.

Susannah was already interested in hypnotherapy and had started to train in it before she got ill, so it naturally was included in her complementary therapy. She still uses self-hypnosis regularly to maintain her wellbeing and has been clear of cancer for three years. However, she says: "There are so many different treatments out there and so many claims. It makes sense that different things work for different people. Do things that make you feel better."

Rhona MacDonald, Editor

racdonald @bmj.com

This article was first published in BMJ CAREERS on 3 May 2003 and is reprinted by the kind permission of the publishers.

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