When I was a college student, I learned hypnosis and self-hypnosis. Years later when I was a surgical intern, I removed a small tumor from a patient's arm using hypnosis because he said he was allergic to the anesthetic. At first, I was hesitant to use hypnosis for a surgical procedure without anesthetic drugs, although I had read the literature that many operations had been performed with hypnosis alone. However, it went very well, and it impressed me very much. It was a personal step toward trusting hypnotic anesthesia. This was the pivotal point in my career.

My internship was in medicine and surgery, and then I did my residency in psychiatry. I began to apply hypnosis to psychiatric problems. My current specialty is hypnotherapy, which uses hypnotic trance in combination with traditional psychotherapy. Hypnotherapy is sometimes used to find out why a change is not occurring--that is, if there is a "block." It can facilitate the translation of an insight into change as well as the discovery of the insight itself. The individual is more apt to be able to work through insights--to translate them into internal changes--in the trance state than in the normal waking state.

Patients who are physically ill often need to gain a psychodynamic understanding of their situation. Hypnotherapy is used not only for removing symptoms or for giving direct suggestions. Hypnotherapy also has to do with the patient's interpretation and image of the situation, which involves a deeper level of understanding and change.

One of the problems in this field is that there is no formal training for medical hypnosis. One has to find one's own way. There are no institutes of medical hypnosis. There is varied training, and one has to find one's own mentors.

Throughout my hospital-based career, I have seen the need for relaxation training, with or without hypnosis, for hospitalized patients. Giving patients medication is not the answer to help them adjust to the hospital situation at all. Taking the time to talk with patients, explaining procedures, and paying attention to their mental state is more important. I have found that relatively little time is spent paying attention to patients' mental state. Their physical state and their basic needs are taken care of. However, if patients indicate that they are having anxiety, they are given tranquilizers. Sedating patients doesn't create positive moods and affects that aid healing. I see the role of hypnosis in the hospital as helping to allay patients' fears and anxieties. Usually, hospitalized patients are placed in a passive, dependent role. Not only do patients need to be involved in the decision-making process with regard to their care. They also need to become a force for healing themselves.

In the future, more work needs to be done not only with patients, but also with health professionals. Hospital personnel often do not see the value of helping patients through nonorthodox techniques. Nurses, physicians, and surgeons may be ignorant of or biased negatively against these techniques. These treatment personnel must be educated with regard to the value of hypnosis. For example, the surgeon mentioned in the preceding article, who called to ask me about the hypnosis for the woman who underwent a bronchoscopy, later referred several hospitalized patients to me because he saw how effective hypnosis had been in this one case.