Chap: Hypnotherapy With Children

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Hypnosis is a state of inner absorption, concentration and focused attention. It is like using a magnifying glass to focus the rays of the sun and make them more powerful. Similarly, when our minds are concentrated and focused, we are able to use our minds more powerfully. Because hypnosis allows people to use more of their potential, learning self-hypnosis is the ultimate act of self-control….

Recent research supports the view that hypnotic communication and suggestions effectively changes aspects of the persons physiological and neurological functions. The American Psychological Association Division 30 states in their revised official definition [ 37 ]. The use of hypnosis in the treatment of a medical or psychological disorder or concern.

Trance is what happens when we engage in changing our minds. More recently theories and definitions have been proposed based upon neurophysiological research aimed precisely at identifying and describing the neurophysiologic correlates of hypnotic behavior, reported and observed hypnotic features and effects, now verified with the availability and use of functional MRI fMRI , PET scans, and related physiologic measures [ 39 , 40 ] etc.

Using brain imaging, cognitive neuroscientists have identified the power that suggestions have over attention functions and associated brain networks and their impact on physical and mental experience Raz, , [ 40 ]. Still, Amir Raz, a leader in the field of neurohypnosis, cautions about the common over-interpretation of fMRI findings. He notes that researchers are now using newer techniques combined with fMRIs in the goal of identifying brain regions associated with different cognitive functions [ 40 ] We await further exciting discoveries from these and other researchers.

While they provided stimulating food for thought, they did not reach a mutually agreed upon conclusion or provide a unifying definition [ 41 ]. Building on the preceding purposes delineated in the definition by Kohen and Olness, we would like to expand our conceptualization of clinical pediatric hypnosis as a tool to facilitate the evolution and refinement of self-regulation skills and capacities.

Children typically develop this capacity during infancy and childhood [ 43 ]. With appropriate clinical pediatric hypnosis training, child health clinicians can help children and youth to identify, discover, develop, and cultivate these capacities and other internal resources for their own benefit in managing and shaping their responses to a broad range of health and life problems, dilemmas, and challenges [ 42 ]. We wish to emphasize that we believe that the critical ingredients of the therapeutic hypnotic experience in children as well as in adults are focused attention to and absorption in imagination which includes a focus on multi-sensory imagery and a particular cultivation of that imagination on steps and strategies toward goals for resolution of problems and change of ineffective patterns.

Examples of possible specific goals include diminution or disappearance of undesirable symptoms, accurate discrimination of distorted thinking about situations and stressors, re-framing of perception of problems as solvable and conditions as manageable, building positive expectations, control of exaggerated reactivity, and creation and enhancement of the belief in the ability of the mind and body to work together to evoke and create desirable changes in outcome.

While this is not the forum for an expanded discussion of the similarities and differences between hypnosis and other self-regulatory activities, we are aware of other modalities that incorporate experiential learning and mechanisms for change. These activities share the goals of helping people to cultivate internal resources, to explore new possibilities, to accomplish physiologic, perceptual, sensory, and behavioral changes, and to facilitate mind-body communication and modulation [ 45 , 46 , 47 ]. How does it help me feel better… breathe easier? As described in the historical review, the beginning of a surge of clinical reports and clinical research in pediatric hypnosis began in the s and continues today.

This substantive increase may be causally related—and certainly temporally related—to the concurrent evolution of increased workshop training in pediatric clinical hypnosis during these decades as discussed above. In Kohen and colleagues published what remains today the largest clinical series of children children and youth treated with hypnosis for a variety of clinical problems, including enuresis, pain, asthma, habit disorders, obesity, encopresis, and anxiety [ 21 ].

In Olness, Uden and McDonald published their seminal research documenting the superiority of hypnosis training to medication in the treatment of juvenile migraine [ 49 ]. In appropriate search of physiologic correlates of the hypnotic experience in children, studies have been conducted describing changes found in peripheral skin temperature during hypnosis [ 50 ], in transcutaneous oxygen flux [ 51 ], cardiovascular changes in association with hypnosis [ 52 , 53 ], pulmonary function changes in children with asthma learning hypnosis [ 34 , 54 ].

Kohen and Zajac recently described the efficacy of hypnosis for headaches in children and teens [ 57 ]. Subsequently Kohen reported an important follow-up survey demonstrating the long-term benefits of hypnosis for those who had originally benefited from learning hypnosis for relief of headaches and reported not only long-term sustained relief, but also the application of those skills to other areas of their lives [ 58 ].

Recently, Sugarman and colleagues have published an award-winning article describing new theories and promising research regarding the value of hypnosis and biofeedback with young people with autism [ 59 ]. In recent years the increase in use of clinical hypnosis with children has resulted in a plethora of publications for a wide variety of clinical problems.

For example, in preparation of the fourth edition of Hypnosis and Hypnotherapy with Children [ 2 ] the authors reviewed over newly published articles from the English, French, and German literature, published since the third edition in [ 18 ]. Additionally, we refer to the following Table 2 that highlights a broad range of applications.

The value of brain imaging in amplifying how hypnotic suggestions impact mental and physical experience is described by Lifshitz, Cusumano, and Raz [ ]. It is also noteworthy that Cochrane and other systematic reviews support the efficacy of pediatric hypnosis for various clinical applications, including Curtis et al.

The remainder of this paper offers several case vignettes to illustrate common applications of hypnosis and hypnotherapy in every-day child and adolescent health care. These case examples also demonstrate the nature and value of these empowering hypnosis strategies for children who previously struggled substantially before developing various self-regulation skills:. This was associated with poor emotional and behavioral self-regulation when frustrated and disappointed with his mistakes, which was particularly detrimental when playing his beloved sport, baseball.

As with all initial encounters with new patients, developing rapport with the child and parents is critical to the process and outcome of the treatment. While there may be some exceptions, the more formalized introduction of hypnosis per se and discussion and demystification of hypnosis may not take place until subsequent visit s.

Children in this age range are particularly receptive and responsive to hypnosis. He also kept a calendar to record his improving self-regulation skills, using a scale from 0 to 10 to indicate level of control over behavioral outbursts. Given his pronounced passion for baseball, the child and therapist made an agreement: Accordingly, sports terminology, the self-calming rituals of his favorite star ball players, and his capacity to focus his attention were incorporated into therapeutic suggestions. In this regard, J. While he imagined playing a close game, he was taught to pair or link a calming breath with the touch of the ball when pitching, bat when hitting, and base when running.

He was also told a metaphoric story about a boy who decided it was time to no longer feel like a loser by being tricked by curve balls inside his head that were stealing his attention, focus and control. First, he found a specialty coach to work with on his mental game during his spring training and he found immediate relief with the assist of calming breaths. Second, he taught himself to throw away any errors that were running around in his head, in order to quickly catch on to practicing new plays.

Third, he worked hard on drills to line up his new strategies in his mind. Before the end of his inner strength training, he struck out the old disappointment and frustration that had fouled up his game. He became a champion as a triple threat with his MVP—Most Valuable Playing—with full attention, focus, and self-control. Watch him keeping his eyes on the ball, instead of bawling! In subsequent sessions, the clinician reviewed his progress calendar and added other hypnosis experiences for him to listen to daily.

Within a number of weeks, this child showed significantly enhanced self-regulation of his emotions and behavior, both on and off the field. He became an athlete who shared his self-control strategies with his teammates. The day before his first visit he had a public tantrum at a local store when his mother said he could not get the toy he wanted. His mother reported that she was surprised that he had spontaneously come to her to apologize that same evening before bed. It is only okay or not okay how we get angry and how we act, not if we get angry. We are not allowed to hurt people or things when we get angry.

Almost as an after-thought Z. When he told the clinician that there was no problem with daytime wetting ever , the clinician purposely and dramatically showed pleasant surprise: At the second visit, Z. Then, I imagine or pretend there is a faucet or drain pipe in the side of that square. I turn it on and the angry feeling runs out of my thinking touching each next part while describing it down the side of my neck, down my shoulder on my either arm and down and around the bend at the elbow and all the way down into the palm of my hand holding palm upward until all of the angry feeling has filled up my hand.

Then I roll it up into a tight fist, take a deep breath and hold it, then as I blow out I throw it away!! At the next visit he and his parents reported considerably fewer tantrums and much more cooperation. He asked about getting dry at night. Therefore, he has to remind them before he goes to sleep because he is going to be asleep. Brain, you have a choice: His parents were astounded, and he was very proud.

She was also highly motivated to get rid of several large warts on her knees. She was tired of always wearing pants to cover them for fear of being teased. The evaluation showed that her fear of injections met criteria for a Specific Phobia, given her excessive and developmentally inappropriate level of fear reactivity regarding the procedure. She begged loudly for a delay, tried to hide in the corner of the exam room, cried and screamed in protest when the nurse approached her. Given her panic symptoms of high psychophysiological and emotional reactivity, K.

She was urged to practice this new skill several times a day. Now notice how easily you deepen your sense of calmness by using your belly breathing and self-hypnosis when the nurse comes in to give the medicine that keeps you healthy. She had already been taught about the blood vessels underneath the warts.

She heard a few ideas used by other children, such as a rope and lasso, a knife, a detour. Within a few moments her dominant handmade slashing gestures, as if she held a knife. Such ideomotor gestures are common during hypnosis. Upon return the warts were notably smaller, and she indicated readiness for the needed immunization. Two weeks later she returned again, wearing a lovely skirt, and proudly announced her successful experience with that immunization procedure.

The warts were gone. She was referred by one of her two pediatric neurologists for help with chronic, daily, severe headaches. A detailed history was taken, revealing headaches since early childhood that increased in frequency, duration, and severity over time. There was a very strong family history of migraines.

Interventions included multiple medication trials, and a recent three-month intensive inpatient rehab program that involved a comprehensive and multi-modal approach: There was no mention of hypnosis. During the initial visit, the typical assessment scale to measure pain severity scale was also used therapeutically. Surprised with the question: As with most patients with chronic recurrent pain, the clinician introduced the possibility of change while simultaneously assessing motivation through the use of embedded suggestions with carefully selected wording in the following questions:.

The clinician also asked W. Of course had she said she did need to know the reason, additional and alternative clinical approaches would have been the appropriate next step. At the end of this visit the clinician again evoked positive expectations when telling W. At the second visit, training in hypnosis and self hypnosis began with viewing a couple of videos of youngsters both talking about and doing self-hypnosis. A few years ago, I worked with a year-old young woman, with migraine problems, who rode horses.

And, of course, when it got to zero it stayed there. Whichever works best for you is the best for you. By the middle of the following school year she was substantially improved. Nine months after the first visit, W. While the foregoing cases are representative of common conditions and common responses to hypnotic interventions, it is essential to note that not everyone responds so positively and so quickly.

Like any strategic therapeutic intervention, positive rapport is essential to good clinical work, and ongoing re-evaluation, flexibility, and engagement in brainstorming with patients and families are fundamental to ultimate progress, problem resolution, and healing. As with any clinical intervention, treatment with clinical hypnosis is not without obstacles or roadblocks. There are a few absolute contraindications to the utilization of hypnosis with children, and several more relative contraindications [ 2 ].

Analogously, though hypnosis can be a very helpful tool in treating posttraumatic stress disorder PTSD , clinicians who learn hypnosis yet have no specialized training in treating children with PTSD should not start offering hypnosis for PTSD. Quite the contrary, even the case illustrations noted carry the notable caveat that the involved experienced pediatric clinicians were very well trained in pediatric clinical hypnosis before they began to apply these skills in their clinical work.

It is our hope and intention that the foregoing will serve as a stimulus for further study, inquiry, and most importantly, for appropriate clinical skill development through training by licensed health care professionals. Pediatric-specific didactic presentations and experiential learning through supervised practice by licensed pediatric professionals are essential to the development of the expertise required to help children and families help themselves through the learning of self-hypnosis in fostering self-regulation abilities and other internal resources, as well as symptom reduction.

As briefly noted earlier, starting in , a cadre of multidisciplinary faculty of licensed health care professionals began teaching what has become the longest-running pediatric clinical hypnosis workshop training in the United States, sponsored by the Society for Developmental and Behavioral Pediatrics SDBP. Over the past 4 years over child health professionals with graduate degrees have availed themselves of the NPHTI skill development workshops. These past participants, representing over forty states in the U. NPHTI is a rapidly growing professional organization open to inquiries from licensed professionals with advanced degrees and would be pleased to welcome qualified applicants to future training.

Hypnosis and Hypnotherapy With Children | Taylor & Francis Group

We are grateful to our colleagues whose research and publications cited herein make this endeavor so exciting, and to the children and families with whom we are privileged to work and teach. Each author contributed two of the case reports, and contributed to, reviewed, and approved the text of the manuscript. National Center for Biotechnology Information , U.

Journal List Children Basel v. Published online Aug Author information Article notes Copyright and License information Disclaimer. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license http: This article has been cited by other articles in PMC. Abstract This review article addresses the process, intention, and therapeutic value of clinical hypnosis with children and adolescents.

Introduction The review that follows is designed to be a panoramic snapshot of the current state of the art, science, and clinical practice of child hypnosis and hypnotherapy. The field of pediatric hypnosis has blossomed in many ways and directions over time: From the use, writings, and research by a select group of clinicians, i. From apprenticeship learning at the bedside of highly specified hypnotic techniques to the richness of multi-modal and multi-sensory training within a group setting, based on research about adult learning and skill acquisition, emphasizing the multiple paths toward similar clinical goals.

Book Review: Using Hypnosis with Children

From definitions based on the fixed views and narrow theoretical concepts of a few to the fertile exchange by many within a global community. From precise suggested commands applied rigidly to all patients to open-ended, permissive, and individualized suggestions utilizing the specific needs, resources, and interests of each child or teen. From making conclusions and generalizations about the hypnotic experience based solely on behavioral observation to incorporating double-blind research studies evaluated in Cochrane reviews and state-of-the-art neuroimaging to correlate with the varying types of hypnotic behavior.

Open in a separate window. Definition Over the past three decades professionals have proposed a variety of theoretical definitions based upon controlled clinical laboratory research [ 36 ]. Wide Spectrum of Applications As described in the historical review, the beginning of a surge of clinical reports and clinical research in pediatric hypnosis began in the s and continues today.

Category Examples Key References 1. Case Presentations The remainder of this paper offers several case vignettes to illustrate common applications of hypnosis and hypnotherapy in every-day child and adolescent health care. These case examples also demonstrate the nature and value of these empowering hypnosis strategies for children who previously struggled substantially before developing various self-regulation skills: Case of Anxiety 7.

Fear of Shots and Embarrassing Warts K. As with most patients with chronic recurrent pain, the clinician introduced the possibility of change while simultaneously assessing motivation through the use of embedded suggestions with carefully selected wording in the following questions: Contraindications and Caveats While the foregoing cases are representative of common conditions and common responses to hypnotic interventions, it is essential to note that not everyone responds so positively and so quickly.

Contraindications There are a few absolute contraindications to the utilization of hypnosis with children, and several more relative contraindications [ 2 ]. Hypnosis should not be utilized for entertainment. As we have discussed and illustrated, hypnosis is a very effective clinical tool; and often may have powerful and dramatic positive effects on medical and mental health.

We strongly advocate against the use of hypnosis for public entertainment as is seen commonly during high school graduation parties. Hypnosis should only be used by clinicians trained in the appropriate use of hypnosis and hypnotherapy and within the scope of their clinical practice.

Of course it would be appropriate for those professionals to teach their clients how to use self-hypnosis WHEN they go to the dentist. Hypnosis should not be used to treat a condition for which there is already a fundamentally appropriate, acceptable, accessible, and effective treatment.

One example might be strep throat. Of course, however, one might well learn self-hypnosis to help allay anxiety or discomfort associated with having a throat culture; or learn methods of control of anxiety, discomfort, and return of normal bodily functions pre- and post-operatively for an appendectomy. Hypnosis should be tailored to the developmental level and capacities of the individual child. Designing a hypnosis session to address clinical anxiety for a six-year-old would be very different for a nine-year-old.

Typically, developing toddlers and those children with significantly impaired intellectual and language abilities and limited capacity for internal absorption would benefit from repetitive sensorimotor stimuli known to induce a calmer, steadier state of comfort, such as rhythmic rocking, patting, swaying, or music. Acknowledgments We are grateful to our colleagues whose research and publications cited herein make this endeavor so exciting, and to the children and families with whom we are privileged to work and teach.

Author Contributions Each author contributed two of the case reports, and contributed to, reviewed, and approved the text of the manuscript. Conflicts of Interest The authors declare no conflict of interest. A Study of the Sexes in a Changing World. Hypnosis and Hypnotherapy with Children.

Hypnosis and Child Therapy. Treatment of incontinent boys with non-obstructive disease. Hypnosis and the adolescent drug abuser. Norms of hypnotic susceptibility in children. Hypnotherapy in the management of childhood habit disorders. The use of self-hypnosis in the treatment of childhood nocturnal enuresis. A report on forty patients. Hypnosis and non-hypnotic techniques for reduction of pain and anxiety during painful procedures in children and adolescents with cancer. The effectiveness of behavioral intervention for reducing nausea and vomiting in children and adolescents receiving chemotherapy.

Hypnotherapy of Pain in Children With Cancer. Lehrbuch der Kinderhypnose und hypnotherapie. Hypnosis and Hypnotherapy with Children ; Olness, K. No Fears, No Tears 29 min. Children Coping with Pain 46 min. A hypnotic pain reduction technique for children in acute pain.

Self-regulation of salivary immunoglobulin A by children. Hypnosis in Pediatric Practice: Imaginative Medicine in Action. Metaphorical Tales for Pediatric Problems. More Metaphorical Tales for Pediatric Problems. Therapeutic Hypnosis with Children and Adolescents. National Pediatric Hypnosis Training Institute. Behavioral outcomes in a prospective, controlled study. Applying hypnosis in a preschool family asthma education program: Uses of storytelling, imagery and relaxation. Relaxation-imagery self-hypnosis in Tourette syndrome: Experience with four children.

Current Models and Perspectives. Dissociation of sensory and affective dimensions of pain using hypnotic modulation. In hindsight, Baking Time highly illustrated her point. The children did not blink; they were completely absorbed in their imaginations. Their hands vigorously stirred imaginary mixes as if they were holding real bowls.

1. Introduction

They gladly washed their hands in the imaginary sink — and, as I later discovered, they carried this attitude with them when they had to wash their real hands in the bathroom. I can support this with my firsthand experience. As I read Lyons and started to recall the absence of tantrums about hand washing, I realized what a positive impact the hypnotic game had on my students. Lyons addresses hypnotism for pre-teens and teens, too. She highlights the key differences in developmental thinking among various age groups, and explains how those differences affect the style of hypnosis one should use.

Pre-teens may be more resistant, she writes, due to new awareness and underdeveloped coping skills. They will inevitably require different types of induction and discussion than a five-year-old. Teens, meanwhile, can more easily tap into their imagination with their eyes closed, whereas small children can be playful with their eyes open.

Lyons lists these types of differences throughout each chapter. To help serious hypnosis practitioners, Lyons addresses specific challenges: In one chapter, on parents as allies, she offers techniques in parental management and involvement. Having parents as allies in child therapy is likely no different. This book is full of useful strategies for opening dialogue, managing child and parent expectations, creating a safe working space, induction games, and helping children create useful coping strategies for all types of situations blood draws, insomnia, depression, and so on.

While it does contain a few spare examples, this is not a step-by-step guide for those just starting out in hypnotherapy. There are no complete templates to work with, and, while Lyons contends that each session must be tailored to each child, this means the book may need a more instructive companion for those starting out in the field.

Despite this omission, however, Lyons seems to provides clinicians with a near-complete text to help navigate the various facets of hypnotherapy. Even as a former pre-k teacher, I learned a lot about what hypnosis looks like in young minds. Using Hypnosis with Children: Creating and Delivering Effective Interventions W.

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