A wee while back, one of the guests on my podcast started a thread in a forum he runs at Facebook about his interview and discussion with me on my Hypnosis Weekly podcast. People discussed his views, his stance and those who had tuned in gave feedback and so on, as typically happens (one of the podcast’s aims is to stimulate debate, after all).
Another former guest to have featured on the podcast wrote the following comment on the thread once he had listened to the episode (please note, this is just a single sentence lifted from a very positive, fuller review):
“I enjoyed hearing you give ‘evidence based’ a good hard slapping and for all the correct reasons. I could almost feel Adam twitch as I know this is a thing of his?”
Hahahaha, this is very observant, I do often have to conceal the fact that I’d love to interject and refute elements of what my guests say, because I do have major differences with them on occasion, however, each episode is not about me, it is about my guests and about me allowing them to have their say, and also a major theme of the podcast is to embrace the diversity. I don’t think anyone would wish to be a guest on my hypnosis weekly podcast if all I did was highlight major flaws in things they have said according to what evidence suggests.
The comment had no ill-intention behind it as far as I was concerned but illustrates something that I feel strongly about within the field of hypnosis and hypnotherapy. Let me start to explain….
I posted this image and quote from Issac Asimov (whose books I love) on my business Facebook page back in January this year:
When I posted it, I also added these words:
Exchange the word “United States” for “field of hypnotherapy” in this Asimov quote – then visit popular hypnosis forums and experience for yourself how averse the majority of front line Hypnotherapists are to evidence base and responsibly researched due diligence when it comes to what they do.
This very week then, I had my eye caught by this utterly brilliant video clip featuring Barrack Obama that is doing the rounds of the internet and is entitled “Ignorance is not a virtue!” I’d love you to listen to these soundbites from that speech as they really articulate my own feelings with regards to the field of hypnotherapy, whereas Obama is referring to politicians and global impact of such mindsets:
To echo those opening words of Barrack Obama; “Facts, evidence, reason, logic, and understanding of science, these are qualities you want in” I would then interject and add my own completion of this sentence by adding the word “hypnotherapists.”
There is a fair amount of anti-intellectualism and sneering at evidence-based approaches within the field of hypnosis and hypnotherapy and often those who speak up and out against it really offer very weak and implausible arguments against the evidence, like they somehow know far better than researchers about research design, like they know far better than people who have studied at very high level for years and years and made major contributions, breakthroughs and advancements to our field.
Maybe it is just a trend apparent in society in general currently, in the book The Dumbest Generation, author Mark Bauerlein reveals how an entire generation of youth is being dumbed down with a seeming aversion to reading anything of ‘substance’ and an addiction to the drivel poured out via social media. I had better stop sharing Facebook memes here then, ahem…. Yet I think the vast majority of hypnotherapists are of a different generation and we cannot use this as an excuse.
Why is there this disturbing trend of anti-intellectualism in the hypnotherapy field then? Why is there such a chasm between frontline hypnotherapists and the academics and researchers within the field of hypnotherapy? Why do so many hypnotherapists attempt to replace intellectualising with ignorance and self-righteousness?
Journalist Charles Pierce, author of Idiot America, suggests the following perspective:
“The rise of idiot America today represents – for profit mainly, but also and more cynically, for political advantage in the pursuit of power – the breakdown of a consensus that the pursuit of knowledge is a good. It also represents the ascendancy of the notion that the people whom we should trust the least are the people who best know what they are talking about. In the new media age, everybody is an expert.”
There is much here that feels relevant to me within the field of hypnotherapy for sure. Many do have a financial interest in ensuring their own perspective is not questioned, for sure. Also the interest that keeps them being a revered expert with elevated status within the field. I mean who would respect those who are shown to be outmoded, outdated and superseded? It is in their interests to keep promoting what they deem to be the right way as the only way…..
Within the field of hypnotherapy, I often hear the louder dissenting voices claiming that their own purely subjective experience is somehow more correct than the formalised evidence. Often I hear that the results are all that matter, getting therapeutic results. However, understanding precisely how those results were achieved would enable effective measurement and correct replication.
That is the reason that expectation is often measured in hypnosis research for example, because the level of expectation is likely to effect the results that occur. Although the two have strong links, in order to measure the effects of hypnosis,w e have to take into account factors such as levels of expectation and be aware of how that might effect the results. Likewise, a huge number of other factors exist in a therapy room or classroom that have not been extrapolated or examined without bias and so making assumptions about how the results were gained may not be an effective way to teach someone else to get the same results; teaching based upon anecdote and exclusively based upon experience is not necessarily useful and is filled with lots of potential problems. That brings me nicely on to this….
Often I hear that practical skills are far more important than knowledge and academic understanding. In fact, I read recently on a website for a hypnotherapy training school that they do not cover much theory in class because they believe that practical skills are far more important and class should be used that way. They have obviously not noted that all of the most important surgeons, doctors, physicians, psychiatrists and psychologists in the world had to sit in lectures being taught the underpinning theory prior to practical applications.
Glibly referring to certain debates and discussions as ‘merely’ academic is a common thought, yet further evidence tends to suggest that correct understanding improves outcomes with hypnotherapy.
This all seems to make perfect sense to me, so why on earth does it not make sense to large swathes of the field of frontline hypnotherapists? Why is there such a sense of anti-intellectualism and not more adherence to evidence base?
Perhaps it is because so much myth, misconception and misinformation is invested in so heavily in this field and it is then mindlessly regurgitated without applying any critical thinking. Maybe it is because the evidence based message is being dismissed by those regurgitating the myth and misconceptions and their own authority leaves a firm impression upon those who willingly listen. Perhaps it is because it would involve us all having to read much more, research more and explore deeper which does not appeal to those who would rather lazily just do as they were taught. Maybe it is because people do not wish to admit that they do not know best, that it is an incredibly bitter pill to swallow to think that they notions they hold so dear are flawed and anyone suggesting as much deserves to be sneered at.
I think it is wholly irresponsible to sneer at the evidence base we have in this field, in the name of being responsible to our clients. I also do not think it is cool or clever to be anti-intellectual, especially if you are supposed to be a forward thinking responsible hypnotherapist.
I listen to a lot of audiobooks. In particular when running and training for running events. I am currently pausing my listening hours of textbooks and study materials and am indulging my love of fantasy novels and epic sci-fi. I am listening to a beautiful and brilliant book called Dawn of Wonder: The Wakening by Jonathan Renshaw and I am in love with it. In chapter 22 a group of boys training at an academy are gossiping and reflecting upon the coming days and a phrase was spoken that rang true with me and with the issues at the heart of this article; “speculation holds more wonder than fact.”
There it was – perhaps a sense of awe-inspiring wonder is causing the anti-intllectualism? Maybe that is it. Maybe the myth and misconception, the speculating about what hypnosis can and cannot do, the allure of the fantastical is why people in these fields reject sobering evidence base. I think they need to consider stopping being so starry eyed for a wee while though, especially if we want to gain credibility as a field. Who knows….
Let’s ensure the field of hypnosis does not turn into a typical US high school 80s movie scenario where the ‘jocks’ athletes and good looking cheerleaders refer to the well-educated as nerds, dweebs or dorks and attempt to belittle, dissociate, mock or angrily silent the voices of those who desire a more thoroughly educated life. Let’s not let the cult of ignorance and anti-intellectualism soak in to our field for another generation.
Anyhow, thank you President Obama, you proved to be some wonderful tonic to me, I’m going to go and replay that clip again, it feels like smelling salts being wafted under my nose….. Remember “ignorance is not a virtue!”
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I apologise for the length of this response and the rambling nature, it is a list of points that occurred to me rather than a series of arguments leading to a conclusion.
I think it is a difficult topic for various reasons. One is that there is no general consensus about what hypnosis is and yet people from every approach and no approach can elicit hypnotic phenomena. It is difficult to agree on what would constitute evidence when we cannot agree as a profession what it is that we are using/doing.
Another factor is the disconnect between the academics,the procedures that make sense to them and the lay hypnotherapists who may have no background in psychology and neuroscience and not necessarily accept that hypnosis fits within those contexts. I suspect the disconnect has negative consequences both ways, for example Kirsch has apparently had no success duplicating the alleged success gained by nlp advocates using the ‘fast phobia cure’. It would be interesting to know how an nlp trainer would critique Kirsch’s technical ability with this process (or whoever did it for him).
There is no bar to entry into learning hypnosis other than financial. Of the training courses that I have seen information about the emphasis is mainly on learning some techniques and applications of those techniques, and possibly quite rightly because the people taking those courses want to use those skills to help people and earn an income. I can understand, though not agree with, those associations that have barred hypnosis training to those with prior medical qualifications and who therefore do have the relevant professional background.
Another issue in my opinion is that reflective practice is optional. On the one hand you have people like Gary Turner who seem to be researching and testing everything that stands still long enough to be grabbed, on the other you have people with, perhaps, too much skin in the game, to much of a vested interest / vested disinterest to interfere or re engineer their cash cow.
Another issue is the framework within which evidence based research occurs. Is this a level playing field? Are therapies decided to be more evidence based because there is more research available on a particular therapy, or are therapies judged more evidence based after comparative and equal assessment? I suspect it is the former.
I also wonder about the scope of evidence based research. To what extent does it assume/ assess a particular model in the design of the research. For example, if I test a particular procedure, such as a regression technique aimed at reducing trauma, what am I actually getting data about? Is it only the end result? How do I measure that? Is ‘feeling better’ enough? A six month/one year follow up? Perhaps that tells me about the procedure and studies other other procedures for the same condition could give me comparative effectiveness information. I don’t think they can speak to the validity of the underlying model. Does that matter? I think it does because it gives me information about what works, and if a technique from a model that I think is pants, is effective, then maybe I will look again and see what might be useful to me. I am sorry, this is a long way around saying that getting information/evidence about results is valuable even thought the model the technique come from is less accessible to assessment through an evidence based approach.
So, all in all I think deriding an evidence approach is about as much sense as planning to close the (US) Patents office in the 1800’s was, a mistaken idea based on mistaken beliefs. However, I do not think evidence based research and procedures are without flaw. What they do provide is our best possible guess as a very divided profession, about what (may) work, and thus the foundation for moving forward as an individual therapist and a profession.
Thank you Richard, some incredibly valid and thought-provoking points made, greatly appreciated.
Best wishes to you, Adam.
A large many hypnotherapists are not from academic or professionally regulated backgrounds and are therefore not fully conversant with the need to be evidence based and to be held accountable to a professional body. For the profession to go forward and to be respected and recognised there must be a regulation council or body that require sound academic understanding and skills just as is required from medicine or psychology.
With regards to some hypnotherapists’ claim of ‘gut feelings and instinct’ when working with clients, there is interesting scientific evidence for this.
Diamond (1974,1977) regards therapeutic hypnosis as a “dual phenomenon” occurring within the context of an intense, interpersonal relationship (Diamond 1983)
Kushner (1962) purports ” the hypnotic state is not an anomaly of human behaviour that results from some technical manipulation or suggestion per se but it develops in a naturalistic way of an interpersonal relationship “.
The mirror neuron system is thought to be an essential aspect of the neural basis for empathy. By perceiving the expressions of another individual, the brain is able to create within its own body an internal state that is thought to “resonate” with that of the other. Therapists can perceive and understand not only the inherently social nature of the brain of another but that their own bodily shifts may serve as the gateway toward empathic insights into the state of the other person. Perceptions of another’s affective expressions may alter our own somatic and limbic states through a prefrontal process of interoception, interpretation, and attribution
When we interact with another person our brain and bodies are no longer isolated, but immersed in an environment with the other person. We become a coupled unit through continuous moment-to-moment mutual adaptation of our own actions and the actions of the other (Konvalinka et al 2010) (De Jaegher et al 2010)
This dynamical interactive process has been shown to result in an alignment of behaviour (Richardson et al 2007, Schmidt & Richardson 2008), posture (Shockley et al 2003), autonomic nervous system (Muller & Lindenberger 2011) respiration (McFarland 2001) cardiac rhythms (Konvalinka et al 2011)
Neural rhythms (Dumas et al 2011; Hasson et al 2012)
Tronick et al (1998) points to the enhanced and adaptive potential that is inherent in the collaboration of two minds in the dyadic relationship of therapy. When two minds attend to one another an intersubjective field is created where one is able to collaborate with another mind.
A major challenge for neuroscience is to provide an explanatory framework that accounts for both the subjectivity and neurobiology of hypnosis. Neural correlates of have been uncovered but there remains an explanatory gap in our understanding of how to relate neurobiological and phenomenological features of hypnosis. An adequate conceptual framework is still needed to account for phenomena that have a first person subjective – experiential or phenomenal character that is neuro biologically realised and are describable and reportable.
Thank you Linda, some excellent points made, lots to think about here.
Best wishes to you, Adam.
I am all for evidence based research, especially in the field of neuroscience and neuroplasticity. Without theses advances, hypnosis would be viewed by academics and scholars as being unsubstantiated and lacking any true validity (not to say that such opinions are any more important). Evidence-based research is bringing hypnosis out from the dark ages and I am all for the further clarity that is bringing to the field.
I agree with you Matthew. Sadly, I think the field still lacks clarity and continued proliferation of myth and pseudoscience does prevail. The vast majority of the field still use the notion of an ‘unconscious mind’ to explain hypnosis, think hypnosis guarantees veracity when used with regression, and still conceptualise hypnosis in ways that have been proven to be flawed by most research. The field still thinks that the two most important authors are Erickson and Elman, yet both contribute little to the empirical and research backed understanding of hypnosis, and we still have primetime TV shows depicting hypnosis as something it is quite clearly not….. Hopefully, more people will read blogs like this one, find the right books, and study with the right colleges (I hear the Anglo European College of Therapeutic Hypnosis are excellent!) instead of being lured into recycling the misinformation by the heavily marketed aspects of this field, and we may start to truly progress.
Best wishes to you, Adam.
A thought I had as I was reading this post.
I love sleight of hand magic – cards, coins, that sort of thing.
As I was growing up I was fascinated at the apparent powers of the magicians. “How do they do that?” I began reading and researching the tricks I would see. I was now learning the mechanics. (Full disclosure: I never learned to be a magician I’m just a fan.)
On learning the mechanics I lost my wonder. “Oh, that’s how it’s done.” The ‘magic’ disappeared for a time.
However, sleight of hand is still magical to me. In the hands of a master magician those tricks retain their magic. I can know 100% what is being done (i.e. the palm here, the swap there) but still be awestruck at the beauty of the performance. And I can still be fooled, left scratching my head. I know that something was done at some point but have no clue what exactly.
My point? I had a similar path in my fascination with hypnosis. It seemed a super power to be wielded over the subject. Over time I learned the mechanics and the ‘magic’ disappeared…for a time.
Now that I am doing a deep dive into the evidence based learning of hypnosis (i.e. I’ve just begun earning a diploma through Adam’s online college course) I am finding that my awe of the process is being rekindled. A big part of this is learning the evidence that suggests how much is capable through self-hypnosis and the choices of the subject in the hetero-hypnosis process.
Hope this added to the conversation. Cheers.
There is so much magic to be found in the ‘ordinary’ and so much magic to be discovered in the results we help create. I just struggle a bit with presenting this field in magical terms from the start. Begin sober, then let the results create the magic and the awe 🙂
Best wishes, Adam.