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.
As mindfulness methods have come to assume a more prominent role in mainstream clinical practice, the common mechanisms that underlie the efficacy of both GMM and hypnosis have become more apparent. To begin with, both involve two people: a guide, teacher, or therapist, who uses suggestion to focus then alter the awareness—cognitive, sensory, relational, and emotional—of a client or student, thereby promoting experiential learning. These alterations in awareness may give rise to dramatic and seemingly spontaneous shifts in perspective and even profound personal transformation as one’s self-definition expands. They may also yield what pioneering hypnosis researchers Theodore Sarbin and Ernest Hilgard called “believed-in imagination.” In fact, the science of clinical hypnosis is highly relevant to understanding how the methods of mindfulness may have even greater impact when used in a psychotherapeutic context.
The Power of Suggestion
Nevertheless, the very idea that GMM, just like hypnosis, incorporates active, directed suggestion to a client by the therapist strikes many mindfulness practitioners as tantamount to heresy, a betrayal of the “purity” of the practice itself. Mindfulness is typically introduced in the context of a therapeutic relationship by a clinician convinced of its merits, who directly says to the distressed client that “this will help,” and then begins the experience by conducting a guided mindfulness meditation. The GMM attempts to engage the client’s attention and help him or her focus on certain suggested experiences, whether they involve breathing, scanning the body, meditating on acceptance, awakening to the truth, or cultivating compassion. Finally, the point is made, either implicitly or explicitly, that this experience will have some lasting impact on the client’s well-being and that repeated practice will facilitate the desired effects. Is there any part of this process that does not rely on the use of suggestion to attain therapeutic results?
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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.
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.
A key to how this may occur can be found in the phenomenon of dissociation, which, simply defined, involves breaking a global, multifaceted emotional, sensory, and/or cognitive experience into its component parts. As soon as you suggest to someone that she focus on some specific stimulus, or experience a sense of detachment from some thought or feeling, you’re directly and indirectly suggesting dissociation—drawing her attention to this aspect of the experience, functionally separating it from the rest. When people speak about “parts” of themselves, as when someone says, “My head tells me this, but my heart tells me that,” or “Part of me cares, and the rest of me couldn’t care less,” they’re using the language—and suggested subjective reality—of dissociation.
During the experience of hypnosis, dissociation becomes especially evident when people respond nonvolitionally, that is, without conscious effort, to a suggestion. For example, a clinician might suggest a feeling of lightness or warmth in the client’s body, and that the client allow this experience to develop. Without being aware of expending any effort to respond, the client readily experiences lightness or warmth that seems to “just happen.” Typically, the first time a client has this kind of dissociative experience, he or she is truly amazed.
In GMM, dissociation similarly becomes evident when people can separate themselves from their usual frames of reference. When someone drifts off into serenity through a narrowed focus on just the physical experience of breathing, the accompanying sense of depersonalization can be a beneficial dissociative response. The ability to detach oneself from one’s thoughts—externalizing angry or self-destructive thoughts by seeing them, for example, simply as “clouds passing in the sky”—has great therapeutic potential as a critical step in building impulse control, frustration tolerance, and reality-testing skills.
Mindfulness seems to many like a mysterious, hidden, often spiritual source of energy; a kind of otherworldly magic that can grant profound gifts to those who are successful at eliciting it from the hoary depths. In fact, we’d understand mindfulness phenomena much better if we’d study the empirically demonstrated mechanisms of clinical hypnosis—a quite this-worldly form of “remote control.”
This blog is excerpted from "Suggesting Mindfulness" by Michael Yapko. The full version is available in the September/October 2011 issue, The Mindfulness Movement: Do We Even Need Psychotherapy Anymore?
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