Article on Hypnosis to Quit Smoking Fails to Tell the Whole Story.

WebMD Article on Hypnosis to Quit Smoking Fails to Tell the Whole Story.

by James Hazlerig, MA, Certified Hypnosis Practitioner

First off, kudos to the WebMD team for the things they got (mostly) right:

One, clients experiencing hypnosis are typically aware of their surroundings. As we hypnosis practitioners like to say, “People in hypnosis look asleep, but they don’t feel asleep.” However, it should be noted that everyone responds differently, and some clients do experience spontaneous amnesia.

Two, the article is close to accurate when it says hypnosis can’t make you do anything against your will. It would be more accurate to say that hypnosis can’t make you violate strong moral convictions. (Actually, numerous psychological experiments have shown that many people will violate moral convictions without any hypnosis being involved at all.) But I believe the authors would agree with me when I say that hypnosis can’t help you quit smoking if you don’t want to quit smoking.

(As an aside, the article is completely off when it blithely says that stage hypnotists claim you can be made to do things against your will. With only a few exceptions, most modern stage hypnotists make a point of reassuring their audiences that hypnosis CANNOT make them violate their own will or morals. But we can forgive the WebMD team for not being well-versed in the reality of stage hypnosis, it’s a common condition, even amongst well-educated people.)

Sadly, the accuracy of the WebMD article takes a nose-dive with its simplistic description of smoking cessation hypnosis, when these words appear:

During hypnosis for smoking cessation, a patient is often asked to imagine unpleasant outcomes from smoking. For example, the hypnotherapist might suggest that cigarette smoke smells like truck exhaust, or that smoking will leave the patient’s mouth feeling extremely parched.

The technique described there, called Aversion Therapy, is only one of many approaches used by hypnotic smoking cessation specialists, and in truth, it is no longer one of the most popular approaches.

There are several reasons why most hypnosis practitioners don’t use Aversion Therapy:

For one, most hypnosis practitioners joined the profession because they are compassionate individuals who love to help and empower people, so we tend not to favor methods that involve torturing our clients.

Secondly, most smokers don’t care how bad a cigarette tastes; they’ve been smoking cigarettes that taste terrible for years. Likewise, smokers don’t care how bad a cigarette makes them feel; no smoker enjoyed the first cigarette, yet they all kept right on smoking.

The article goes on to describe Spiegel’s method for getting people to quit smoking with hypnosis, which basically involves giving direct suggestions that smoking is bad for you and you should quit if you want to live.

Again, that’s one of many approaches a hypnosis practitioner who specializes in smoking cessation might use: it is by no means the only one, nor the most common or most effective one. Much like the aversion techniques, pointing out that cigarette smoke is poisonous is rarely effective on its own; if that were the case, the Surgeon General’s warning would have ended smoking long ago.

Both Dr. Spiegels (a father and son team), by the way, are hypnosis researchers, not clinicians, so it’s no surprise that their method focuses entirely on direct suggestion, which is the hypnotic technique best-suited to laboratory experiments but not generally considered a first-line approach by hypnosis practitioners who actually help clients stop smoking.

Actual hypnotic quit smoking specialists often tailor the approach to the individual client and therefore use a variety of techniques, including but by no means limited to indirect suggestion, guided imagery, amnesia (forgetting to smoke), negative hallucination (the suggested inability to smell cigarettes), mindfulness, autogenic training, progressive muscle relaxation, and anchoring.

Again, the writers at WebMD have as little first-hand experience with hypnosis as your average journalist or psych major, so they can be excused for presenting a very limited and overly-simplistic view of hypnosis for quitting smoking.

For example, they can be forgiven for quoting the oft-repeated but utterly inaccurate idea that one in four people cannot be hypnotized. This idea is based on experiments into “hypnotizability,” conducted by such researchers as the Spiegels and Ernest Hilgard, which like so much scientific research has been misinterpreted so often that it has achieve urban myth status.

The flaw in virtually all “hypnotizability” research is largely in the conclusions drawn from it. In research of any kind, it’s important to minimize the variables. One important variable in any hypnotic interaction is the skill of the hypnosis practitioner, and the practitioner’s ability to adapt and customize suggestions to the individual client.

However, in hypnosis research, exactly the same suggestions are delivered to every volunteer, typically either read in a monotone by a completely untrained grad student or simply played on a cassette tape. Under those conditions, between one in four and one in twenty people do not then respond to generic suggestions. From that, the researchers concluded that some people cannot experience hypnosis.

Now, to put this in layman’s terms, the equivalent would be to serve lukewarm Big Macs to one hundred people, see that ten of them refused to eat it, and then announce that ten percent of the population is “immune to food.” In other words, it’s ridiculous.

Don’t take my word on this: Understand that the so-called “Hypnotizability Scales” are widely rejected by many degreed hypnotic clinicians. Andre Weitzenhoffer, who pioneered the hypnotizability research with Ernest Hilgard, wrote in 1980, “The Stanford Scales and similar instruments are found to have failed to take into account essential features defining traditional hypnosis and suggestibility and to have created confusion in the scientific inquiry into hypnotism.”

Again, I think we can forgive the WebMD writers for having only a passing acquaintance with hypnosis, no more than that of the average psychologist or medical doctor. After all, none of those people are hypnosis specialists.

The writers at WebMD then take a cursory glance at the research related to quitting smoking with hypnosis, and they do make the accurate assessment that it is mixed. They cite one article supporting hypnosis for smoking cessation, mention a “handful” of articles supporting Spiegel’s method, and then quote the American Cancer Society’s website as saying that “reviews that looked at studies of hypnosis to help people quit smoking have not supported it as a quitting method that works.”

Now, I may not write for WebMD, but I am surprised that the writers there don’t have enough time to do their own survey of the research. If they had, they might have found some interesting things:

For instance, they might have found that in 1992, the Journal of Applied Psychology published a meta-analysis of over 600 studies involving of 72,000 individuals. According to reports in The New Scientist (1992), the study found hypnosis to be three times as effective as the patch and fifteen times as effective as simply deciding to quit.

Or they might have come across a 2005 study in the Journal of Nursing Scholarship that showed people who quit smoking using guided imagery, a popular hypnotic technique, were twice as likely to remain smoke-free after one year.

Perhaps they might have found the Texas A&M study that showed an 81% success rate for quitting smoking with hypnosis, and a 48% success rate at remaining smoke-free after one year.

So it is true that some studies have mixed results. It’s easy to cherry-pick the studies that either support or don’t support the use of hypnosis for stopping smoking. However, it is irresponsible to not bother looking.

It’s interesting that the WebMD article on nicotine gum says nothing about the research on its effectiveness (or lack of effectiveness). If it did, perhaps WebMD would cite the 1994 article that indicates that Nicotine Replacement Therapy is helpful for only about 15% of the population (with the patch being helpful to fewer than one in ten).

WebMD goes on to state, completely accurately, that hypnosis is not approved by the American Medical Association (AMA). The full story is that in the late 1950s, many medical doctors were learning hypnosis, and the AMA at that time made an official statement recommending that all doctors should be trained in the use of hypnosis. Unfortunately, that did not happen, and most doctors know no more about hypnosis than the average layperson. (I’m fine with that, I want my doctors to be experts in what they do, not in what I do.) As WebMD states, the AMA rescinded that opinion in 1987. What WebMD doesn’t mention is that the AMA rescinded that entire class of opinions in 1987; the organization got out of the business of offering such opinions. So it’s not that the AMA decided it didn’t trust hypnosis. The AMA simply no longer makes that kind of evaluation.

The final section of the WebMD article is titled “How to Find a Hypnotherapist.” It should more accurately be titled, “How Members of an Elitist Minority in the Hypnosis Community Want You to Find a Hypnotherapist.”

See, the leadership of the American Society of Clinical Hypnosis
, which is made up mostly of medical doctors, psychologists, and counselors who practice hypnosis, want you to believe that only their members are qualified. It’s worth pointing out that a medical professional can enjoy the ASCH stamp of approval after 20 hours of hypnosis training, in other words, two-and-a-half days of sitting in a classroom.

In contrast, the International Medical and Dental Hypnotherapy Association requires a minimum of 180 hours, nine times the ASCH requirement, for certification. The American Council of Hypnosis Examiners requires 500 hours for certification, twenty times the ASCH requirement. But ASCH leadership maintains that you should prefer a nurse who dabbles in hypnosis over a hypnosis specialist.

ASCH, the only organization consulted by the WebMD writers, urges smokers to ask hypnosis practitioners, “Would you be qualified to help me quit smoking without using hypnosis?”

This is a bit like asking welders if they would be qualified to glue metal together instead of using a welding torch. This is a bit like asking your personal trainer if he is also a medical doctor. This is a bit like saying to a yoga instructor, “You know, maybe only a licensed health care professional should be teaching me meditation techniques.”

Again, we really can’t blame the writers at WebMD for talking to representatives of only one hypnosis organization. They really can’t be blamed for not seeking a statement from only one organization.

After all, the average writer at WebMD knows no more about hypnosis than your average medical doctor, counselor, or therapist, that is to say, virtually nothing.

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