Physical (psychosomatic) Problems and Hypnotherapy

Lately I've been getting a lot of calls of people saying things like,

"I can't fall asleep at night and I've seen a bunch of doctors and nothing helps, even medication. Can you see me?" Or

"I get these terrible headaches but the doctors all say nothing is wrong with me. My acupuncturist/doctor/psychotherapist/neurologist told me to call you." or

"My hand isn't working right and nobody knows why and I've got a softball game in 3 weeks. When can you fit me in?"

These are psychosomatic complaints and they're a type of problem that hypnosis excels with. Today I thought I'd write about how I work with them.

Psychosomatic complaints: my definition

  • A problem that can't be medically explained or clearly diagnosed

  • Has a suspected or verified psychological element

  • Results in physical pain or other distressing physical problem or changes (“clinically significant distress”)

These include things like sleep problems, pain with no clear cause, injuries that haven't healed when they should have, unexplained paralysis or numbness, teeth grinding during sleep (nocturnal bruxism), irritable bowel syndrome, non-biological erectile dysfunction, vaginismus, fainting with no cause, and all sorts of other problems that make doctors say, "I don't understand. That shouldn't be happening."

I should say immediately that I only work with people who have gotten checked out by their doctor and no clear medical problem has been found. Often I'll even encourage second or third opinions. Many of the problems I've listed could have potentially significant medical consequences if not evaluated seriously. To give just one common example (I could give many from the above list alone): night time teeth grinding can be a symptom of sleep apnea and warrants a medical check and possibly a sleep study before pursuing hypnosis treatment.

The Purpose of a Symptom

Sometimes doctors will tell you, "The problem is all in your head." As if that's a helpful thing to say. Aside from ignoring much of the contemporary understanding of reality, such a statement ignores the actual purpose of the problem. "Purpose," you may be thinking, "we're talking about a migraine. What purpose could it be serving?"

I'd like to tell a story I heard once to illustrate.

Ignoring a Stone wall

Once upon a time, there was a civil engineer who was annoyed at a particular place in a road he had to take regularly where the road turned sharply to the right and avoided ahat appeared to be an empty field. After going for half a mile, the road turned back and resumed a path almost exactly where it had been going before. In front of the field, in the place where the road turned, was an old stone wall. A few times a year, cars would miss the turn and run into the stone wall. He decided he could fix this problem and prevent accidents.

So, the engineer convinced the town and the road crews to bulldoze the stone wall and build the road through the old field. The owner of the field was more than happy to sell that stretch of land, and by the end of the summer, they'd made a perfect straight road where there'd been a curve before.

In his excitement, however, the engineer failed to notice that the water table was particularly high in that section. When winter came, the road began to crack from all ice underneath it, and by spring, it was buckled and ugly. By the second spring, it was practically gravel and quite dangerous: many more cars skidded off the road than had missed the turn before, and by the third year, the stretch of road had practically disintegrated back into the marshy field around it. The town got so many complaints it opened up the old section again. Eventually motorists started putting rocks and boulders in the straight stretch of road to warn people away from going down that dangerous section, and eventually good Samaritans replaced the haphazard rocks and boulders with a proper country stone wall.

In the story, the civil engineer represents how we usually think. While perhaps an actual civil engineer would have consulted water tables or historical records before trying to build a road, when it comes to problems with our bodies and physical or psychological symptoms, we're rarely so thoughtful. The curve in the road and the stone wall represent symptoms: we don't know why they're there. They just are, and they do create problems: migraines, IBS, teeth grinding, fainting - whatever the problem - isn't without cost. But what the story is trying to illustrate is that they aren't random, just like the original road and stone wall weren't random. If there's no obvious physical reason for a problem, it behooves us to look deeper. And that's one of the things hypnosis treatment can do well.

Typically, purposes served by psychosomatic problems have to do with self-protection, interpersonal dynamics or other unconsciously tended areas.

For instance, suppose a young boy would lie awake every night as a child because his parents would fight after tucking him in. Sometimes they'd be particular violent and he felt he had to stay awake in case something really bad happened and he had to call the police or help. Imagine that the same boy has grown up and as an adult, has terrible trouble falling asleep and is filled with inexplicable dread of going to bed in general. The problems are so bad that regular doses of medication don't really help. The guy calls me one day and says "I'm having sleep problems." You see how the "sleep problems" serve a purpose?

Or suppose a young girl experiences subtle disapproval from her father whenever she does something, "un-lady-like." This extends as far as his disapproval when she signs up for advanced math classes, which her father judges harshly. Years later, her father dies and she finds herself feeling dizzy and anxious whenever she goes to her job, where she works as an engineer. She gets a cardio work up and monitors her blood pressure for a week and everything's normal. Could it be that her unconscious, galvanized by her father's death, is trying to keep some sense of connection to him?

Or, imagine a high school student who is getting bullied. He begins to get stomach aches before lunch, when he usually is harassed. Eventually the stomach aches are bad enough that he can't eat lunch at all. Even as an adult, in times of stress, he finds he can't eat. If he tries, he has almost immediate diarrhea and cramps, sending him to the bathroom. Aside from a diagnosis of IBS-D, he hasn't gotten any clear explanation or any relief from his doctors.

I realize I'm telling these stories a bit backwards — If you're dealing with a problem like this, there likely isn't a clear history to explain it: there's just diarrhea, or there's just sleeplessness, or grinding teeth -- just like in the story, where there's just a bend in the road and the stone wall. This is the nature of the way we relate to our unconscious minds in modern times. But even if there is a story of why the problem is there, it's not like knowing it fixes the problem. So let's move more into what to actually do to help things.

Specific ways I work with psychosomatic issues

Many of the same things that help other problems, such as anxiety, can help with psychosomatic complaints. For instance, anchoring and things that bolster a sense of inner strength and resources help many psychosomatic complaints. Mindfulness meditation and loving kindness practice are good easily accessible home practices. Likewise, specially tailored direct suggestions can be very helpful, as can the Turner Age Regression I talked about in my last entry.

Another approach I take with psychosomatic problems is called ideomotor finger signaling. It's a technique that allows for communication with the deep unconscious. To explain, let's clarify the goal. Suppose in the story I told earlier, the civil engineer could have consulted with the person who built the original stone wall. The two might have a conversation about water table and the hazards of building a road through that section, but also about the problems that are caused by the solution -- the accidents caused by having the sharp turn and the stone wall there. Ideally, they could come up with a better solution together than either could have on their own: maybe turning the road more gradually, or having a bridge there instead of a regular road. This is what we’re after. The best solutions to problems are the result of conversations between both our unconscious mind and conscious mind — or, you might say, all the parts of ourselves. Ideomotor finger signaling is a relatively easy way to facilitate that conversation.

Basically the ideomotor technique involves me training a client to listen in deep trance to the body's response when I ask yes or no questions and to use their fingers to non-verbally signal responses. The signals put language to a kind of deep gut feeling. Suppose you look at a menu at a restaurant -- you might have a gut feeling that you'd like one thing and not another. You look at the fajita description on the menu and some part of you says "yes!" and you look at the burrito description and it says, "no!" The part of you that is responding is usually your unconscious, and in a deep hypnotic state, it's your deep (somatic) unconscious. So if I ask, "Do you sense that the teeth grinding is somehow self-protective?" the client, who is in a deep trance, checks in with a kind of gut feeling and, if the answer is yes, one finger moves, if no, another finger does. (there are also fingers for "maybe," "I don't know," and "I don't want to say at the moment.") Moving a finger is easier than talking out-loud in trance states, and so require less practice. With a little bit of practice, though, the deep unconscious / body responds directly to the questions. This allows for a relatively unmediated conversation about the problem, and potentially a way to find a better solution.

There is much more I could say about this technique. If you're a clinician and want to read more about it, this book is a good place to start. The main author, Dabney Ewin, is a physician that has used ideomotor signaling with astounding results for decades.

Next I'll be talking about habit change and hypnotherapy.