A Proposed Evidence Based Therapeutic Hypnosis Healing Support Protocol
For COVID-19 Patients
Following a published study from Liu et al. (2020), demonstrating the effects of progressive muscle relaxation on anxiety and sleep quality in patients with COVID-19, the author is proposing the design and use of a modifiable therapeutic hypnosis protocol for a hypnotic based progressive muscle relaxation technique, which includes additional hypnotic suggestion for mindfulness based mental relaxation and mind body healing.
The Proposed Evidence Based Therapeutic Hypnosis Healing Support Protocol for The Use with COVID-19 Patients using Hypnotic relaxation techniques have been widely used and studied for the treatment of a variety of acute and chronic physical and psychological conditions as an adjunct to conventional healthcare and medical treatment (Brugnoli, 2016; Castañeda & Krikorian, 2018; Eason & Parris, 2019; Flynn, 2018; Kendrick et al. 2016; Thompson, et al. 2019; Molina del Peral et al. 2017).
A unique and innovative randomised controlled trial (RCT) involving patients being treated in isolation at the Hainan General Hospital in Wuhan, Hubei, China from January 1 to February 16, 2020, demonstrated that by teaching Jacobson progressive muscle relaxation techniques to an intervention group of patients compared with a no-treatment control group, improved the sleep quality and anxiety associated with the patients being treated for COVID-19 in isolation. This is the first known study of its kind and the medical treatment and research team at Hainan General Hospital must be applauded for their dedication and efforts in carrying out this ground-breaking research during a time of a global viral pandemic.
The Jacobson progressive muscle relaxation technique (sometimes called progressive relaxation therapy) is a type of physical training therapy that focuses the patient on tightening and relaxing specific muscle groups in a sequence moving through various muscle groups of the body. It requires the patient to actively participate in learning the technique, by repeated contraction (flexion/tension) followed by relaxation of the specific muscles regions, with the result that the patient learns to recognise the difference between tension and relaxation sensations, therefore learning how to recondition the muscles to maintain a relaxed state. It requires active learning and repetitive and dedicated practice in order to establish the recondition responses, which ultimately reduces physical tension in the body. This technique was famously used by the behaviour psychiatrist Dr Joseph Wolpe (1915 - 1997) in his widely recognised systematic desensitisation technique (Batty et al. 2006; Lehrer, 2018; Morales & Tapia, 2020; Peris et al. 2020; Rabinovich, 2016; Seyyedeh, 2020) to treat phobias and other anxiety related conditions.
In contrast to the Jacobson progressive muscle relaxation technique, the therapeutic hypnosis progressive relaxation technique developed by Dr John Hartland (1901 – 1977) uses verbal hypnotic suggestion, where the progressive relaxation process is accomplished through mental thought processes following the instructions given by the (hypno) therapist (Debellemaniere et al. 2018; Jensen et al. 2009; Morrisson, 1988; Reid, 2016). It is a more passive process for the patient, who follows the guidance given to the patient by the therapist, so it does not require the patient to learn how to flex and relax their muscles. The hypnotic progressive relaxation process works by either mentally moving up or down through the body relaxing all of the muscles of the body, with complete body relaxation achieved in a matter of minutes. This technique is one of the most basic and safe hypnotic inductions taught and used for hypnotic relaxation, as it reconditions the physical sensations associated with the sympathetic autonomic nervous system response (Hammond, 2019; Kekecs, Szekely & Varga, 2016). This physiological response process is widely researched and applied to the treatment of a number of stress response related conditions, both physical and psychological (Flynn, 2018; Flynn, 2019; O’Toole et al. 2016; Sawni et al. 2017).
One of the great benefits of using hypnotic relaxation techniques, is that the hypnotic suggestions can be used to extend positive beneficial response to the mind and mental/psychological components of any presenting condition. By using a hypnotic progressive relaxation physical response process, combined with a mindfulness like meditative mental relaxation, we can extend the alteration or desensitisation of the sympathetic response and recondition the autonomic nervous system response to maintain a parasympathetic state (Flynn, 2018; Flynn, 2019; Hammond, 2019; Kekecs, Szekely & Varga, 2016) . Thereby, creating not only a physical relaxation response, but also a mental relaxation response, supporting a positive whole mind body (holistic) therapeutic state, which research has shown to support the body's natural immune response and healing processes (Hammond, 2019; Shakel et al. 2019). In addition, hypnotic suggestion supporting and promoting improved immune response and natural healing can be added into any treatment protocol once the body and the mind are in a relaxed and receptive state, as it is recognised that in this physical and mental hypnotic relaxed state the subconscious is more accessible and receptive to positive hypnotic suggestions given during this period, thereby amplifying the patient's own motivation, expectations and beliefs about improved health and well-being.
The author has developed a modifiable mindfulness process that can be delivered through a recording or directly face to face with patients, the recording may be a more appropriate delivery format, due to the highly infectious nature of COVID-19. The author will make this process available (upon request) to the general medical communities around the world, free of charge, as a contribution to promoting global public health under the current challenges we are facing. The process can also be used for anyone experiencing anxiety or concern associated with the acquisition of infection.
The author has extensive experience in treating thousands of patients using therapeutic hypnosis and mind body therapeutic approaches, working with hundreds of individuals every year. The author also teaches medical hypnosis to medical practitioners and medical students in UK medical schools, so has a wealth of knowledge and understanding in the use of therapeutic hypnotic suggestion for mind body healing. The author is a graduate of the USAF School of Aerospace Medicine, trained in preventive medicine and communicable and infectious disease control and worked in a hospital preventive medicine clinical setting for 6 years, most recently as a mind body therapeutic medical practitioner in private practice in London since 2013.
The author would like to thank Dr. Alyx Taylor, Senior Lecturer Physiology, AECC University College, Bournemouth, Dorset, BH5 2DF, for her valued contribution to the proposal.
Mr. Tod A. Cury, BSc, PGCert (Dist), PDCHyp, PDCBHyp, GQHP, FHEA
10 Harley Street
Batty, M. J., Bonnington, S., Tang, B. K., Hawken, M., & Gruzelier, J. H. (2006) Relaxation strategies and enhancement of hypnotic susceptibility: EEGneurofeedback, progressive muscle relaxation and self-hypnosis. Brain Research Bulletin 71 (2006) 83–90.
Brugnoli, M. P. (2016). Clinical hypnosis for palliative care in severe chronic diseases: a review and the procedures for relieving physical, psychological and spiritual symptoms. Ann Palliat Med, 5(4), 280-297.
Castañeda, E., & Krikorian, A. (2018). Current Applications of Clinical Hypnosis in Latin America: fi Systematic Review of the Literature. Avances en Psicología Latinoamericana, 36(2), 269-283.
Debellemaniere, E., Gomez-Merino, D., Erblang, M., Dorey, R., Genot, M., Perreaut-Pierre, E., Pisani, A., Rocco, L., Sauvet, F., Léger, D., Rabat, A., & Chennaou, M. (2018). Using relaxation techniques to improve sleep during naps. Industrial Health, 56, 220–227.
Eason, A. D., & Parris, B. A. (2019). Clinical applications of self-hypnosis: A systematic review and meta-analysis of randomized controlled trials. Psychology of Consciousness: Theory, Research, and Practice, 6(3), 262.
Flynn, N. (2018). Systematic Review of the Effectiveness of Hypnosis for the Management of Headache. International Journal of Clinical and Experimental Hypnosis, 66(4), 343-352.
Flynn, N. (2019). Hypnosis and Medicine: An Historical Examination. Current Trends in Clinical and Medical Imaging, 3, 1-7.
Hammond, D. C. (2019). Integrating Clinical Hypnosis and Neurofeedback. American Journal of Clinical Hypnosis, 61(4), 302-321.
Jensen, M. P., Barber, J., Romano, J. M., Molton, I R., Raichle, K. A., Osborne, T. L., Engel, J. M., Stoelb, B. L., Kraft, G. H., & Patterson, D. R. (2009). A Comparison of Self-Hypnosis Versus Progressive Muscle Relaxation in Patients With Multiple Sclerosis and Chronic Pain, International Journal of Clinical and Experimental Hypnosis, 57(2), 198-221.
Kekecs, Z., Szekely, A., & Varga, K. (2016). Alterations in electrodermal activity and cardiac parasympathetic tone during hypnosis. Psychophysiology, 53(2), 268-277.
Kendrick, C., Sliwinski, J., Yu, Y., Johnson, A., Fisher, W., Kekecs, Z., & Elkins, G. (2016). Hypnosis for acute procedural pain: a critical review. International Journal of Clinical and Experimental Hypnosis, 64(1), 75-115.
Liu, K., Chen, Y., Wu, D., Lin, R., Wang, Z., & Pan, L. (2020). Effects of progressive muscle relaxation on anxiety and sleep quality in patients with COVID-19. Complementary Therapies in Clinical Practice, (39), 101132.
Molina del Peral, J. A., Mendoza, M. E., Díez González, L., Llanes Basulto, Y., & Capafons, A. (2017). Clinical Hypnosis: assessment of its effectiveness and the quality of the investigation of it in Medicine. Revista del Hospital Psiquiátrico de La Habana, 13(3).
Morales, A. M., & Tapia, B. P. (2020). Hypnosis as a therapeutic tool applied to a case of ornitophobia. Ajayu, Vol 18, No 1, 2020. 121-151.
Morrison, J. B. (1988). Chronic Asthma and Improvement with Relaxation Induced by Hypnotherapy. Journal of the Royal Society of Medicine, 81(12), 701-704.
O'Toole, S. K., Solomon, S. L., & Bergdahl, S. A. (2016). A meta‐analysis of hypnotherapeutic techniques in the treatment of PTSD symptoms. Journal of traumatic stress, 29(1), 97-100.
Peris, T. S., Storch, E. A., & McGuire, J. F., Eds. (2020). Exposire therapy for children with anxiety and OCD: Clinician's guide to integrative treatment. Academic Press, London.
Rabinovich, M. (2016). Psychodynamic Emotional Regulation in View of Wolpe’s Desensitization Model. The American Journal of Psychology, 129(1), 65-79.
Reid, D. B. (2016). Hypnotic Induction: Enhancing Trance or Mostly Myth?. American Journal of Clinical Hypnosis, 59, 2: Hypnotic Induction Techniques.
Sawni, A., & Breuner, C. C. (2017). Clinical Hypnosis, an Effective Mind–Body Modality for Adolescents with Behavioral and Physical Complaints. Children, 4(4), 19.
Schakel, L., Veldhuijzen, D. S., Crompvoets, P. I., Bosch, J. A., Cohen, S., van Middendorp, H., ... & Evers, A. W. (2019). Effectiveness of stress-reducing interventions on the response to challenges to the immune system: a meta-analytic review. Psychotherapy and psychosomatics, 88(5), 274-286.
Seyyedeh, Z. S. (2020). Non-Pharmacologic Therapies, Multiple Sclerosis, Stavros J. Baloyannis, IntechOpen, DOI: 10.5772/intechopen.86288.
Thompson, T., Terhune, D. B., Oram, C., Sharangparni, J., Rouf, R., Solmi, M., ... & Stubbs, B. (2019). The effectiveness of hypnosis for pain relief: A systematic review and meta-analysis of 85 controlled experimental trials. Neuroscience & Biobehavioral Reviews 99, 298-310.