Michael Yapko • June 18, 2015 • from PsychotherapyNetworker
If you talk to mindfulness practitioners about the similarities between guided mindfulness meditation and hypnosis, they tend to react with various degrees of indignation, if not downright revulsion, as if to say, “Don’t get that icky hypnosis all over my nice mindfulness!” Mindfulness practice, they aver, is rooted in the ancient wisdom traditions of the East, dedicated to developing self-understanding, serene acceptance of life’s trials, and spiritual growth. Free of religious dogma or orthodoxy, presumably it imposes nothing, but simply elicits an inner “awakening” of people’s “true selves” and helps them “cultivate compassion,” “awaken from the trance of unworthiness,” and, of course, “attain enlightenment.” Who wouldn’t want to experience these lofty states of mind?
Hypnosis, by contrast, is commonly considered a crass theatrical stunt—an occasion for a hypnotist to exert mind control over a passive subject. In this distorted view, hypnotists impose their will on easily led people, as epitomized in a cheesy Las Vegas stage show where the slick, manipulative hypnotist makes a row of volunteers believe and act as if they were playing musical instruments or pantomime over-the-top lascivious behavior. If mindfulness is symbolized by the Buddha, his soft gaze turned down in serene contemplation, hypnosis is too often represented by Svengali, his fierce eyes fixed on his prey.
But a closer look at the processes, goals, and outcomes of both mindfulness and hypnotism reveals that they share fundamental similarities of purpose and practical knowledge. Within the framework of a trusting therapeutic relationship, attuned therapists now regularly employ Guided Mindfulness Meditation (GMM) in the same way I was trained to use clinical hypnosis. Today’s mindfulness-oriented therapists, like clinicians practicing hypnosis, teach clients self-regulation strategies, such as how to use their breath and employ guided imagery to shift attention and experience the deep power of accepting what’s unchangeable or inevitable.
GMM practitioners could significantly improve their clinical work and produce more focused and effective interventions if they drew upon the findings reported in thousands of studies already done by hypnosis researchers about the many complex personal and interpersonal factors influencing people’s ability to respond meaningfully to suggestion. But to do so, they first need to strip away the philosophical abstractions, Eastern mystical spirituality, and romantic exoticism that currently infuses the entire discussion of mindfulness.
The Power of Suggestion
To acknowledge the inevitable role of suggestion in mindfulness is to acknowledge the principles and methods of clinical hypnosis. Hypnosis encompasses the study of how to compose and deliver suggestions that engage the client’s attention, foster a deep experiential absorption, and “spontaneously” elicit different kinds of empowering subjective experiences, such as analgesia or anesthesia for pain management or increased bodily and sensory awareness. Hypnosis, like mindfulness, encourages awareness and acceptance, especially an awareness of the personal resources one can bring to bear on a situation. Virtually all of the modern neuroscience of clinical hypnosis, like that of mindfulness, focuses on attentional processes and directing focused attention in clinically useful ways. When a mindfulness practitioner talks about “attention without intention” and tells the client to “let go of goals” and “stop being a human doing and instead be a human being,” he or she is paradoxically suggesting a new goal of having no goals.
Whatever the client’s experience from either GMM or hypnosis, the therapist’s actively directed suggestions lead the way. If mindfulness-oriented clinicians want to be effective in the work they do, it’s important that they strive to better understand how their methods—their suggestions—are structured and delivered, and discover what role the quality of their suggestions plays in the clinical results they obtain.
Dissociation: The Driving Force
Both GMM and clinical hypnosis use suggestive methods to elicit beneficial, nonvoluntary responses—suspension or amelioration of pain, “spontaneous” feelings of compassion, acceptance, or transcendence, and so on—that can’t simply be willed. During a course of meditation, a wide range of responses can seem to arise as if from nowhere. For example, a mindfulness practitioner has the client focus on her breath by suggesting that she “become aware of the breath, the rise and fall of the chest, the warm or cool temperature of the air,” and the client’s breathing may slow down, even though the practitioner hasn’t suggested that she slow her breathing down. The client says it “just happened.” Similarly, a person undergoing GMM reports an “amazing transformation of my anger to forgiveness” or proclaims “my self-hatred turned to self-love.” These aren’t responses you can consciously generate on demand. They’re nonvolitional but subjectively powerful. It’s not surprising that a client will have the feeling that something “magical” just happened.
When people don’t understand the mechanism behind something that seems extraordinary, they can too easily conclude it’s magic or divinely inspired. Even those practitioners of hypnosis who aren’t well grounded in the science of hypnosis can resort to global philosophies such as “trust your unconscious to know the meaning of the metaphor” or “trust your unconscious to know what to do when the time is right.” When people don’t recognize their participation in co-creating some experience, they may conclude it’s the “inner sage” or “the Buddha within,” and have little or no insight about the role suggestion played in eliciting the hypnotic phenomenon that seemed so unexpected.
Clinicians who use guided mindful meditations need to become more aware of what they’re doing, how and why these experiential processes work, and how they can improve their own practice of these powerful methods. The field of clinical hypnosis has gone far in explaining the key structural factors underlying GMM and hypnosis: the skilled application of suggestions to a client who is in an attentive and receptive dissociated state. Understanding this can benefit not only mindfulness practitioners, but therapists and even other health care professionals. After all, every therapeutic intervention you can name, whether medical or psychological, will necessarily involve some degree of skilled—and suggestive—communication with an individual within the context of a therapeutic alliance.