Laurence I. Sugarman

Symptoms as solutions: hypnosis and biofeedback for autonomic regulation in autism spectrum disorders.

The Autonomic Dysregulation Theory of autism posits that a phylogenetically early autonomic defect leads to overarousal and impairments in language and social engagement. Cognitive rigidity and repetitive behaviors manifest as mitigating efforts. Focusing on the implications of this premise may provide more productive therapeutic approaches than existing methods. It suggests that self-regulation therapy using hypnosis and biofeedback should be highly effective, especially for young people. Hypnotic strategies can utilize restrictive repetitive behaviors in trance as resources for comfort and control. Biofeedback training can be tailored to focus on autonomic regulation. The authors develop this theory and describe methods of integrating hypnosis and biofeedback that have been therapeutic for people with autism. Directions for future research to validate this approach are discussed.

Reorienting Hypnosis Education

The legacy model of professional clinical hypnosis training presents a restrictive frame increasingly incompatible with our evolving understanding of psychobiology, health, and care. Emerging science recognizes human experience not as disease and diagnosis, but as manifestations of individual, uniquely-endowed, adaptively self-regulating systems. Hypnosis is a particularly well-suited discipline for effecting beneficial change in this paradigm. Training in clinical hypnosis must progress from the current linearly-structured, diagnosis-based, reductionist model toward a more responsive, naturalistic, and client-centered curriculum in order to remain relevant and accessible to clinicians beginning to integrate it into their practices. To that end, this article extends Hope and Sugarman’s (2015) thesis of hypnosis as a skill set for systemic perturbation and reorientation to consider what those skills may be, the principles on which they are based, and how they may be taught. Parsing a clinical vignette reveals how incorporation of novelty and uncertainty results in less restrictive and more naturalistic hypnotic encounters that, in response to client-generated cues, elicit psychophysiological plasticity. This disruptive hypnosis education and training framework extends the utility and benefit of applied clinical hypnosis.

Mapping the Domain of Hypnosis

This bothers me still. It was 1998 and I was walking a corridor of the University of Rochester Medical Center when I came upon Bob Ader. Bob is the father of psychoneuroimmunology, the founder of the Rochester Center for Mind–Body Research, and a valued colleague, mentor, and friend. As usual, he stopped there in the hallway, asked me what I was up to, and gave me his full attention. I told him proudly that I was a new diplomate of the American Board of Medical Hypnosis. He paused, smiled, and then began to laugh, hard. He became red-faced. He began to cough. He supported himself, hand to the wall, and took deep breaths to quell the fit. I had mixed feelings. I was a bit concerned about his health. He evidently found my achievement hilarious. He regained his composure and wiped his eyes. I stared, then asked, “What?” He replied, warmly, “Well are you a diplomate in a field that doesn’t exist?” Bob died in 2011. This still bothers me. Despite the ensuing explosion of mind-stretching evidence supporting the resonance between psychological, neurological, and physiological processes that has emerged since that encounter—spawned, in part, by Bob’s work—we still do not know what the domain of hypnosis, distinct from its many components, is. It is no wonder that hypnosis tends to be largely disregarded by the mainstream of health care research and practice. Hypnosis has been defined variously, and often simultaneously, as a state, trait, procedure, process, therapy, sociocognitive construct, and everything we do with those in our care. This confusion is commonly manifested in word usage. The same person may refer to hypnosis as a process (e.g., I do hypnosis); a changed state of consciousness (e.g., You are in hypnosis); in adjective

Learning Clinical Hypnosis Wide Awake: Can We Teach Hypnosis Hypnotically?

Conversational hypnosis has been promoted as both more congruent with mechanisms of psychobiological change and more feasibly integrated into clinical care than the more dominant, ritualistic, hierarchical, induction-based Standards of Training in Clinical Hypnosis. Further, it has been argued that, in teaching the legacy standard, clinical hypnosis training lacks pedagogical integrity. This article builds on these premises by piloting a mixed-methods approach to studying the pedagogy and participant evaluations of two professional education events that focused on conversational hypnosis. Results indicate that this is an effective methodology for studying the impact of teaching hypnosis hypnotically and fostering wider integration of hypnosis into health and care.

Functional Symptoms in Young People: Conceptualizations, Definitions, and Approaches

All health conditions incorporate and exhibit the interplay of psychophysiological factors, which become significant in functional disorders. Functional disorders are a subset of health conditions for which conventional medically based evaluations do not reveal structural or physiological abnormalities to account for the presenting symptoms. As such, they challenge clinicians to shift from models based on mind–body duality, and the primacy of externally applied therapies, and to work instead with the reality of psychophysiological phenomena. By recognizing functional groupings of these conditions and by developing appropriate therapeutic approaches, clinicians can help young people and their families to grow, change, and move toward well-being. In so doing, clinicians invest in their young patients’ resiliency and self-efficacy, enrich and solidify patient/provider relationships, and increase clinician satisfaction in practice.