Hypnotic Outcomes

The Ghost or the Machine?

2010-06-29T05:48:00.000-07:00

I was told a very tragic story this morning and I would like to share it in order that those reading this might find lessons in it. The grandson of a friend of mine, a lad in his mid-teens, had been experiencing crippling thigh pain for many weeks recently and his mother had taken him several times to Accident & Emergency at their local hospital. Each time they were sent away with nothing but painkillers, having been told there was nothing wrong and the lad was simply pretending to suffer pain in order to avoid having to go to school! The medical staff did not seem to take into account the mother's evidence that even when at home her son was lying on his bed constantly, crying with pain and unable to move without crutches.

Eventually, a blood test was carried out and it was discovered that the child had a serious infection in his femur. About thirty centimetres of femur was infected and it had also spread into his pelvis. Huge amounts of pus had to be drained away from the site of the infection. No wonder the boy was in agony. Needless to say, the patient, his family and the doctors were quite shocked. I am told that the boy will have to have a hip replacement but that it cannot be carried out until he stops growing so that won't be for several years yet. The doctors have almost run out of antibiotics to give him so there is no guarantee that the infection can be halted anyway. Furthermore, the painkillers he is on are so harsh on his digestive tract that there is the possibility of bowel damage. It is a sorry, tragic and very possibly unnecessary situation. I understand that the doctors have admitted fault and have said they will not evade legal culpability but obviously that is little comfort.

The situation reminds me of a famous case of the psychotherapist, Dr Michael Yapko. Yapko is a world recognised authority on brief and hypnotic psychotherapy and in his highly regarded text, Trancework, he provides a full transcript and commentary of 'The Case of Vicki'. This session is also available on DVD. Vicki was a woman in her forties, I believe, who Yapko saw for a single session, pain management intervention that was recorded in front of a master class group of hypnosis students he was teaching. It was the only way Dr Yapko could see Vicki before he left on a teaching tour and Vicki agreed to the session being observed and filmed. Those who have watched the video and read the transcript will know what a profoundly moving session it is. Vicki was a woman with a challenging past who had a lengthy history of psychiatric treatment (in a workshop I attended Dr Yapko speculated that Vicki's psychiatric history with misdiagnosed post-natal depression). Once admitted to the mental health system and mislabelled Vicki became lost in the psychiatric system and acquired a hefty medical file of psychiatric assessments which tragically provided the lens through which subsequent doctors would interpret her physical symptoms - to her cost. Vicki managed to get her life back on track through guts and hard work, went to college and amazed herself and her supportive therapists (colleagues of Yapko) with her determination and commitment to rebuilding her life. Then, tragedy struck again.

Vicki had been to doctors complaining of a number of physical symptoms which they dismissed as being psychosomatic in origin. It appears that proper medical investigations were not carried out. This went on for a long time and eventually Vicki made the supremely logical observation that "even hypochondriacs get sick" and refused to leave the medical clinic until a chest x-ray was performed. The doctors agreed (one can only imagine in the hope that the results would shut her up and get rid of her). The results of the x-ray were horrific - extensively metastised cancer through many parts of Vicki's system - undetected because the doctors had simply dismissed her physical symptoms as evidence of her mental instability! Vicki was given a very short life-expectancy forecast and the now humbled doctors offered her as much medication for pain as she could possibly have wanted. Vicki did not wish to spend her little remaining time in a drug-haze, however, and turned to Dr Yapko for help in managing her discomfort through hypnosis.

What can we learn from these stories? Well, firstly I want to say that I have enormous respect for the medical community and accept that situations like these are very much the exception rather than the rule. Secondly, I think it is in many ways encouraging that modern medicine accepts and recognises that physical symptomology can be generated by emotional and psychological factors. This reversal of Cartesian Dualism is broadly very desirable. It seems evident, however, that rushing to label physical symptoms as being psychosomatic without exhaustive medical examination has appalling risks that can cost people their health and perhaps even their lives.

I am left reflecting on the sublime wisdom in Vicki's words - "Even hypochondriacs get sick!" You can’t argue with that. And even if you suspect someone’s physical symptoms are psychologically generated there is no way to be sure until the full spectrum of medical investigation has been carried out. The fact that doctors seem to have failed to appreciate this may have cost Vicki her life and it may have crippled this young man for life whilst still in his teenage years.

Hypnosis for breast enlargement

2010-06-23T06:38:00.000-07:00

Yes, it might sound implausible, but there is a fair amount of research that shows that mind-body processes such as hypnosis can have the effect of increasing a woman's breast size without any need for surgical intervention. It has been the subject of articles by such hypnosis research notables as Milton Erickson and Theodore X. Barber and another researcher's work was featured in the Journal of Sex Research.

Obviously, any decision to opt for breast enhancement must be made by the individual woman concerned and I want to be very careful not to play upon individual insecurities. In my opinion our society places an undue degree of attention upon people's physical appearance as a measure of their worth and the 'phwooaarrr!!!' factor of 'bigger is better' in terms of women's bosoms is crude and sexist. People come in all shapes and sizes which can be beautiful in many different ways. Nonetheless, it is a simple fact that many thousands of women every year make the personal decision to undergo what can be expensive cosmetic surgery that is not without risk.

In light of this it is worth bearing in mind that Dr Peter Mutke, a researcher in psychosomatic medicine, conducted a study in which 20 out of 25 women achieved measurable breast enhancement after 10 weekly one-hour sessions of hypnosis. It seems, therefore, that hypnosis is well worth exploring as an option for breast enhancement. The advantages are as follows:

it is significantly cheaper (breast enlargement surgery can cost from £3,400 - £5,000, a course of hypnotherapy a mere fraction of that)
there is no risk of surgical complications or scarring and there is no risk of implants requiring remedial work at a later date
time away from work and home life to recuperate from surgery is not a factor
there is likely to be no physical discomfort
the results are likely to be fully in keeping with the aesthetics of your build as they are generated by your own mind-body
there is the mental satisfaction that you have achieved the change through your own relationship with your unconscious mind and this can be deeply empowering in other ways

All good reasons to give hypnotherapy for breast enhancement a very careful look before thinking of going under the knife.

What are the Italians doing right? And I'm not talking about football.

2010-06-19T08:47:00.000-07:00

Psychologist, Oliver James, has produced a fascinating study in his book, Affluenza. He looks at modern materialistic values and draws the interesting conclusion that the incidence of emotional distress/mental disorder seems very closely correlated with the degree of materialistic values - what he describes as 'selfish capitalism' - in different societies and nations. The more selfish capitalsim typifies a sociaty, he contends, the higher the levels of mental illness and distress appear to be.

In one of the appendices he produces a graph showing this correlation. He looks at the difference between incomes in the highest and lowest earners in different countries, what he describes as income inequality, and shows that the greater the income inequality between the top 20% of earners and the bottom 20%, the greater the incidence of emotional distress. Very interesting.

What strikes me as more interesting, however, is the outliers. As is often the case the examples that seem to buck the trend provide the greatest food for thought. Out of nine countries examined in the graph, Italy has the third highest income inequality and by James's argument should have a commensurately high level of emotional distress in the population. The fact is, however, that the graph shows Italy has the lowest level of emotional distress of any of the countries examines.

This begs many interesting questions which redound to "What other factors in Italian society are mitigating against the levels of emotional distress that we might otherwise expect to see?"

I haven't read the whole book and it may be that james provides some answers to this which I will update you on if they emerge but I was so struck by this anomaly that I wanted to share it straight away.

In the meantime if anyone has any thoughts on the matter please feel free to share with us.

Bloody Sunday, the Saville Enquiry and cognitive dissonance

2010-06-17T03:14:00.000-07:00

It has often been said that it is a foolish idea to publicly discuss religion and politics - perhaps even more foolish to discuss Northern Irish politics (from which religion is all but inseperable). I am going to take the chance and consequences be damned!

Firstly I would like to say that I have no particular allegiance to either of the cultural and political traditions in Northern Ireland and am delighted to see an inclusive peace process flourish that can move the province forward from the fear and suffering that engulfed it when I was growing up there. Nonetheless the recent publication of the Saville Report into the events of Bloody Sunday is an interesting illustration of the psychological phenomenon of cognitive dissonance. Those of you who have visited my website, www.hypnoticoutcomes.com, will have had the chance to read my review of the excellent book on the subject of cognitive dissonance, Mistakes Were Made (but not by me). It is, therefore, a concept through which I am filtering a lot of material at the moment.

A brief history lesson for those not familiar with Ulster history. 'Bloody Sunday' was a seminal incident in the history of Northern Ireland that occurred on the 30th January 1972 in Northern Ireland's second city of Derry (Unionists would have called the city Londonderry - even place names in Northern Ireland can have political significance - I use the term Derry as it is shorter and much more commonly used nowadays by both traditions). Derry was experiencing considerable civil unrest at the time, as was the entire province. The historic tensions between Protestant and Catholic were at crisis point and the British Army had initially been sent in to keep the two warring factions apart. Although initially warmly welcomed by the Catholic population of Northern Ireland, a series of incidents had caused relationships between the Catholic population and the British army to sour and the previous months had been characterised by considerable violence and loss of life. Some time before, in response to the civil unrest, the Stormont Government had imposed internment without trial - a measure enacted with grossly disproportionate force against Catholic communities. As a result of this many men were taken from their families and placed in internment camps without having the opportunity to know what they were charged of or to challenge their detention. The outrage and sense of injustice this caused was considerable. This fresh injustice was coupled with a sense that Catholics in Northern Ireland had been treated as second class citizens in many other ways and a fledgling Civil Rights movement was founded to campaign against the perceived discrimination. A number of Civil Rights marches had taken place as a result and some of these had been attacked by Loyalist crowds who perceived the Civil Right movement as being a cover for Republican agitation. These attacks, which in some cases it was claimed had been facilitated by the police, led to rioting and a wave of tit-for-tat violence. Whatever the exact course of events was and wherever blame lies, it is clear that by the 30th January 1972, tensions in the province were at fever pitch. This was the date upon which it had been decided to hold another Civil Rights march in Derry, protesting against internment and other injustices. The Stormont Government had banned all such parades so the march was technically illegal. The protesters planned to proceed nonetheless.

Against the advice of the police commander in Derry, the 1st Battalion of the Parachute Regiment was sent to Derry to deal with any rioting that might develop. This unit of crack, 'shock' troops had gained a reputation for a particularly tough, some said brutal, response to civil disorder. On the day of the march the army had blocked the planned route of the parade with barricades and the organisers re-routed the march to avoid these obstacles. It had been planned at a senior military level that the Civil Rights march should be allowed to pass by but that an arrest operation would be undertaken against any rioters who took advantage of the demonstration to create trouble. The commander of the Parachute Regiment on the ground was ordered, however, not to enter the overwhelmingly Catholic/Nationalist Bogside area of Derry as the potential for serious clashes was too high. As the day progressed and skirmishing broke out between rioters and security forces this order was disregaded and units of the 1st Battalion of the Parachute Regiment entered the Bogside. The military's intention of allowing rioters and demonstrators to separate from each other before interventions were made had not been accomplished at this time and there were many civilians in the area who had planned merely to attend a peaceful, if illegal, parade.

What happened next was a matter of great dispute at the time. The Army claimed that they had come under gun and petrol bomb attack and had fired to defend themselves and engage legitimate targets. Local people and many journalists claimed that the Army had opened fire without any provocation. Everyone agreed, however, that by the time the shooting had finished the Parachute Regiment soldiers had fired over 100 live rounds at those in the area and that thirteen people, including a number of teenagers, had been shot dead. A fourteenth man wounded on the day died some months later. A similar number of people were wounded but not fatally. The impact of a British military unit on British territory (even if sovereignty was disputed by some) shooting dead over a dozen civilians was felt globally. The grief of the victims was exacerbated by the subsequent government commissioned report, constructed by Lord Chief Justice Lord Widgery, which effectively exonerated the Parachuted Regiment soldiers and implied that many of the victims may have been handling guns or explosives that day and effectively brought their fate on themselves. The distrust, bitterness and anger created that day lingered long in Northern Ireland's memory.

Scroll forward 38 years and a second enquiry reports on the events of Bloody Sunday. Chaired by Lord Saville, a senior judge, the enquiry has taken 12 years in total and had cost almost £200 million. The recently published findings effectively reversed Widgery's conclusions, exonerated the victims and stated that there was no justification for any of them being shot. It also concluded that the Parachute Regiment soldiers were the first to open fire that day - a fact long the subject of dispute.

So why is this relevant to cognitive dissonance? Well, I am looking at the responses of a number of people to the Saville Report. It is clear that the Prime Minister David Cameron has been able to accept and endorse the findings of the Saville Report as have most other mainstream politicians. Even the Chief of the General Staff of the British Army has done the same whilst placing the events of Bloody Sunday in the context of the overall distinguished service of Briish Forces in Ulster. There is little surprise about this in terms of dissonance theory. Le me recap briefly on what dissonance theory invloves. Originally postulated by social psychologist, Leon Festinger, dissonance theory suggests that when we hold two conflicting bodies of information, belief systems or sets of evidence both of which are important to us, we enter an uncomfortable state called cognitive dissonance. Effectively, we are unable to comfortably reconcile the evidence with what we wish to believe. Festinger concluded that when in such an uncomfortable state human beings engage in remarkably creative, often implausible and generally odd juggling of the facts in order to try and achieve some reconciliation with the facts. For example a smoker who believes him or herself to be an intelligent person nonetheless knows that smoking is a stupid behaviour. To reconcile this he or she might say "I enjoy smoking", "I don't believe all the stuff about the health risks" or "I could quit any time I wanted to." I recall seeing an interview with the late singer, Freddie Mercury, in which he claimed that he smoked in order to give his voice a husky quality which suited his singing style. A man who beats his wife and is deep down ashamed of the fact may attempt to convince himself that his wife actually enjoys it therwise she wouldn't keep provoking him to do it.

In their book Mistakes Were Made (but not by me), the authors look at dissonance theory in the context of law enforcment and explore how prosecutors and law enforcement personnel reconcile themselves with incontrovertible evidence that they have wrongly convicted someone. Their conclusions are alarming. They cite a number of telling cases such as that of Thomas Lee Goldstein, a college student and ex-Marine who was convicted of murder in 1980. There was no forensic evidence linking Goldstein to the crime, no motive and most eye-witnesses had described the murderer as being of a different ethnic origin. The evidence against Goldstein was a statement by a notoriously unreliable prison informant and heroin addict with a police record as long as your arm. This informant had testified in ten other cases that cell-mates had confessed to him their part in crimes. He had received a reduction in his prison sentence as a result of testifying - a fact he denied under oath. The only other evidence was an eye-witness who only agreed to identify Goldstein after falsely being told Goldstein had failed a lie-detector test. Goldstein remained in prison for 24 years before being released by a judge for the furtherance of justice. How did the District Attorney's office respond to the increasingly obvious fact that Goldstein was innocent? They refiled the murder charge against him and set bail at $1 million! It took months more for the newly filed charges to be dropped. They simply could not reconcile their belief that they were decent, hard-working officers of justice with the clear evidence that they had wrongly convicted an innocent man and stolen 24 years of his life. They had to try to convince themselves that he was guilty.

Tavris and Aronson describe many other such cases of dissonance reducing behaviour including prosecutors who continued to maintain the guilt of someone they had convicted even when newly available DNA testing showed the convicted person to be innocent. They quote a classic 1932 publication by Yale law professor, Edwin Borchard, which looked at sixty-five miscarriages of justice. These included eight murder convictions where the alleged murder victim subsequently turned up alive and well. Despite this, they point out, one prosecutor still felt able to tell Borchard "Innocent men are never convicted. Don't worry about it, it never happens."

Back to the Saville Report - what does dissonance theory tell us about the responses to the findings? I suspect they were quite predictable in the main. David Cameron was able to accept and endorse the findings of Lord Saville because, although declaring himself a patriotic supporter of the British Army, he had never been wedded to the notion that they were infallible and had acted correctly in Derry that day. By his own statement in the House of Commons he observed that Bloody Sunday was something he had learned about rather than lived through. He did not have a vested emotional involvment in a particular position so there was no significant conlict experienced when Saville's findings were revealed and no dissonance to resolve. The same goes for the Chief of the General Staff of the British Army, Sir David Richards, who served in Northern Ireland earlier in his career but was a soldier with the Royal Artillery. Being from a different unit may have made it easier for him to take a balanced look at the Saville Report findings (as might admirable personal qualities, of course). A number of Unionist politicians, who might traditionally have sided with the official Widgery version of events seem to have side-stepped commenting on the actual overt conclusions of the Saville Report and instead focused their attention on the inordinate length and expense of the enquiry. Others gave passing, almost grudging acknowledgment to the findings whilst refocusing attention on the suffering of others in the Troubles (which is, of course, undeniable). It is interesting to speculate upon the possible dissonance experienced by such politicians upon learning that the British Army which they had long championed had in fact quite clearly been aggressors on Bloody Sunday and that the victims who they had long claimed were terrorists and criminals were, in fact, (with one possible exception) wholly innocent.

Interesting examples of dissonance-reducing behaviour are more apparent in the anonymous comments of a number of Parachute Regiment soldiers who served on the day. I have read newspaper comments on the Report from Paras who claim that they can scarcely remember the events of the day but who still aver that they had come under gunfire and brick and bottle attack despite the comprehensive report of the Saville Enquiry concluding that no such provocation was encountered. One of the observations in Saville's report was that a number of soldiers appeared to have deliberately lied about events in their contemporaneous reports and also in their testimony to his enquiry. I am led to reflect upon the chapter of Mistakes Were Made entitled Memory, the Self-justifying Historian. Was such inaccurate testimony deliberate deception or a scarcely conscious attempt to reshape memory to avoid cognitive dissonance? What inner conflict would it have generated for a soldier who had signed up to serve his country, who truly believed that the IRA were an evil incarnate, to find out that the men he had shot down were not in fact terrorists but were innocent bystanders? Is it possible that the vagaries of memory over the years were subtly recruited to soothe a tormented conscience? Is it possible that on the day, having realised the magnitude of what had happened, soldiers got together and colluded with eachother under the comforting self-justification that "the guys we shot were probably terrorists anyway, they just weren't carrying weapons today"? Who knows? It is not beyond the bounds of possibility, Tavris and Aronson note exactly such behaviour amongst police officers who, convinced of the guilt of a suspected criminal, may plant a little bit of evidence just to 'help the process of justice along'. They justify such behaviour by telling themselves that the guy is a crook anyway and that it would be a travesty if he got off scot-free just because he wasn't carrying the drugs that day, or whatever. If such forces were at work in the minds of Parachute Regiment soldiers might it have been easy, in mentally reconstructing the events of the day, to confabulate having heard gunshots, having seen someone carry something that looked like a gun and such like and actually come to believe this enhanced memory as it eases a nagging sense of guilt? It is an explanation - it might not be the right one.

Another well known military commentator for a UK tabloid claimed that Saville had got it wrong because he did not understand the stress and tension that soldiers encountered on the streets of Derry. How such stresses would justify the shooting of about thirty civilians, many of whom were attempting to flee is not explained. I suspect that the cognitive dissonance experienced in these perspectives may be readily easily explained. Someone has put his life on the line day and daily against an 'enemy' he perceives as being wholly and inexcusably evil. The evidence of an exhaustive enquiry shows that he or those very like him were the 'enemy' that day. How do you reconcile that? Simple - discredit the enquiry by claiming that they just couldn't understand the context in which events evolved. It is always interesting, of course, to look at exceptions to what might be expected. General Sir Mike Jackson, former head of the British Army has publicly apologised for the events of Bloody Sunday despite being present as an officer in the Parachute Regiment on Bloody Sunday. His example of honesty and candour is encouraging. Acknowledgments of wrong were also forthcoming from a former officer who served in Northern Ireland, Colonel Richard Kemp and a former Para, Tony Clarke. One solicitor representing soldiers during the enquiry has commented that Lord Saville cherry-picked evidence and could just as easily come to the opposite conclusion. Fit that perspective into dissonance theory as you please!

As I stated in the opening, my intention in this blog has not been in any way to be political or make political statements. Northern Ireland has had a very tortured history with examples of great courage and egregious wrong on both sides. The British Army and the police force took a huge number of casualties in a horrendously difficult set of circumstances in a uniquely challenging role. As did the communities they operated in. It is wonderful to see the situation moving forward and I hope the Saville findings will have a healing effect for all concerned on all sides of the community. Rather my purpose in blogging this is to encourage readers to notice examples of dissonance theory in their everyday life and this seemed a great example. It is a powerful way of understanding human behaviour and when we see it at play it gives us the oportunity to understand where people are coming from and perhaps give them room to reach an accomodation with the facts rather than having to deny them. If you would like to read the review of Tavris and Aronson's excellent book, Mistakes Were Made (but not by me), which has stimulated my thinking here, it is still available on the Homepage of my website www.hypnoticoutcomes.com.

Thanks for reading.