Like puppets, the hypnotist makes people sink to the floor asleep or forget their own names. Completely devoid of will, they are paraded on stage, exposed. Afterwards, they remember nothing. Or hypnotised patients lie in a deep trance on a couch, without control, at the mercy of the therapist. This is the image that comes to mind for many when they hear the word hypnosis. Influenced by stage hypnosis or films.
But clinical or medical hypnotherapy involves something completely different. Put simply, its aim is the exact opposite of exposing or being at the mercy of others. It is intended to strengthen. «Hypnosis is mental self-efficacy training,» says Anna Bewer Silvestri. She is a paediatrician in Thalwil, Canton of Zurich, and has been using hypnosis in her daily practice since 2018.
If someone does not want to, hypnotherapy does not work.
Caroline Maroni, psychotherapist
She came to this conclusion because she was increasingly confronted with children for whom she had no satisfactory solution with her training as a paediatrician: daytime wetting, functional stomach aches or headaches – i.e. pain for which there is no organic cause – or school anxiety, for example.
Trust is very important
Hypnotherapy is suitable for children and adolescents for precisely this reason, but also for sleep disorders, problems with emotional regulation, general anxiety or learning blocks. The prerequisite for this is that the child themselves wants to change something about the situation.
«Hypnotherapy doesn't work if someone doesn't want it to,» explains Caroline Maroni, psychotherapist and president of the Swiss Society for Clinical Hypnosis and Hypnotherapy (GHYPS). Parents and children also need to trust her, says Anna Bewer Silvestri. That's why she only treats children she knows from her practice with hypnotherapy.
So how does a therapy session like this work? «It's very individual,» says Eva-Maria Albermann, a specialist in psychiatry and psychotherapy in Winterthur, Zurich. And that was the groundbreaking aspect when American psychiatrist Milton H. Erickson developed hypnotherapy in the mid-20th century: rather than the therapist telling the client what to do according to a standardised procedure, the client finds the solution for themselves.
Despite the individual approach, a few basic principles can be defined. First, the child sets their goal. Anna Bewer Silvestri invites the children to write a letter of motivation and bring it with them to their first session. In it, they should write down what they would like to change. For example: «I want to get along better with my teacher» or «I want to have dry underpants». Preschoolers paint or draw their goal, such as a happy child on the toilet, because they want to learn to go there.
We focus attention on what the child can already do.
Caroline Maroni, psychotherapist
Focus on resources
This is followed by what is known as a resource assessment. Together with the therapists, the children discover their strengths, interests and skills. This is because hypnotherapy focuses on resources, not deficits.
«We focus attention on what the child can already do,» says Caroline Maroni. As an example, she tells the story of a young girl who had binge eating episodes. We'll call her Lea. Caroline Maroni started by talking to Lea about everything she had already done to avoid binge eating and control her weight.
«Lea realised that she was very competent. She already exercised, didn't keep sweets or snacks at home and often had her cravings well under control.» Eventually, they discovered that she ate uncontrollably when she was home alone and feeling lonely. The next step was to find a solution. This was done under hypnosis, i.e. in a trance.
A completely natural ability
But what exactly is trance? «It is a state in which we are completely focused on something and block out everything around us,» explains Eva-Maria Albermann, who leads training courses for the Swiss Medical Society for Hypnosis (SMSH).
Children have a natural ability to go into a trance. All parents are familiar with this scenario: dinner is ready, you call your child, but they don't hear you because they are engrossed in play. That's when they are in a trance. Children therefore respond particularly well to hypnotherapy or hypnotherapy – the terms can be used synonymously. «The depth of the trance is not decisive for the effectiveness of the therapy,» explains Caroline Maroni.
Induced trance
Anna Bewer Silvestri lets the children draw and play during hypnosis, and takes them on imaginary or physical journeys. For the latter, the children lie down on a large sheet of paper and the paediatrician draws them. The children then look at themselves from the outside and continue to paint their self-image until it is the way they want it to be.
Older children and adolescents can be guided into a so-called induced trance, just like adults. To do this, they sit or lie down comfortably and focus on a point in the room or on their two outstretched index fingers. The therapists use a gentle voice to guide the young people into a deep state of relaxation until their fingertips touch and their eyes close.
Anchoring a sense of security
Once the children are in a trance, Anna Bewer Silvestri lets them travel in their minds to their safe place: «This is the place where they feel comfortable and can be themselves.» This could be the football pitch, the North Pole or their own bed. In this place, the children work out the solution to their problem.
For example: A child finds a hole in his bladder and repairs it. A boy who loves football now sees his teacher as a referee. He no longer picks fights with her because she could show him the red card and send him off the pitch. Or a teenager who is being bullied builds herself a protective suit. When others tease her, she can slip into the suit in her mind.
The fairy question
Eva-Maria Albermann sometimes asks the children the fairy question: «Imagine that a fairy comes to you tonight, brings you a wonderful magic potion, and tomorrow all your problems are gone. How will you get up? What will you wear? What will you have for breakfast? How will you get to school? How would you react if someone annoyed you?» She asks lots of specific questions so that «the children can find helpful solutions while daydreaming».
The children anchor the feeling they experience in their safe place while in a trance in their bodies using words, a hand gesture, a colour or music. If the children encounter a challenging situation in everyday life, they can remember to say the words or make the hand gesture.
Hypnosis is not only a form of therapy, but also a form of communication, even an attitude.
Anchoring the pleasant sensation in the body
Lea, for example, remembered in a trance the feeling she experienced when playing with her deceased grandmother. With a hand movement, she anchored this feeling in her body. When she felt lonely at home, she could use the hand movement to evoke the beautiful feeling she had with her grandmother. In this way, she gradually got her binge eating under control.
Eva-Maria Albermann records the trances for young people so that they can listen to them on their mobile phones. «It's like a handrail. At some point, they won't need it anymore because they can say the words to themselves. Then they practise self-hypnosis.»
«The solution is within you»
All three experts interviewed emphasise that hypnosis can be used not only in therapy, but is also a form of communication, even an attitude. The attitude: «The solution is within you.» Anna Bewer Silvestri describes hypnotic language as mindful and positive.
That's why she doesn't say, «You're not dry,» but rather, «You don't yet know how your head and your bladder can communicate with each other.» Not, «You're afraid to go to school on your own,» but rather, «You don't yet know how to get to school safely on your own.» She uses conversational hypnosis every day in her consultations with parents and children.
As an example, she mentions a child who is afraid of vaccinations. She says to the child: «You're in charge of the pace here. What do you need so that we can do the vaccination? Music? An animal you can hold?» She explains every step she takes to the child and lets them help decide: left or right arm? Colourful or white plaster? This promotes the child's self-efficacy because they feel that they are in control of the situation. In this way, they can gradually overcome their fear of the injection.
Investing in the child's trust
Can't all these decisions be overwhelming? «Sometimes, yes. When I notice that a child is overwhelmed, I simplify the decision tree until they can answer one question. Usually, that question is about the colour of the plaster.» She has even postponed vaccinations because a child wasn't ready – sometimes to the displeasure of the parents.
Then she says to them: «I understand that this is difficult for you. But it's like an investment in self-efficacy. If I invest in your child's trust now, they will willingly hold out their arm to me in the future. If we force them, we take away their ability to regulate their emotions and overcome their fear.»
I always encourage parents to focus their attention on what is going well.
Anna Bewer Silvestri, paediatrician
With the help of parents
Focusing on strengths rather than weaknesses – parents can do that too. So can they use hypnotic language themselves? Yes, all three experts agree. «I always encourage parents to focus their attention on what is going well,» says Anna Bewer Silvestri. For example, if a child wets themselves six out of seven days, parents should praise the one dry day instead of constantly focusing on the six wet ones. Caroline Maroni is aware that many parents were not raised in a resource-oriented manner themselves, which is why they may find this difficult at first.
According to the three experts, stories and rituals in everyday life are also part of hypnosis, alongside language. Stories in which a child cannot do something at the beginning but eventually surpasses themselves. A heart painted on the hand to make saying goodbye easier for the child. Or a worry box in which the child can place their difficult feelings in the evening. Eva-Maria Albermann says: «Hypnosis is not about always seeing everything in a positive light, but about constantly looking at what is going well and putting energy into that.»
What parents should consider when choosing a therapist
The Swiss Society for Clinical Hypnosis and Hypnotherapy (GHYPS) and the Swiss Medical Society for Hypnosis (SMSH) offer in-depth training in medical or clinical hypnosis. Hypnotherapy with a doctor, psychiatrist or psychotherapist is covered by health insurance. Otherwise, parents have to pay for it themselves.
For GHYPS President Caroline Maroni, the choice also depends on whether parents are looking for someone for therapy or coaching. This is because hypnosis can also be offered by coaches, for example for learning difficulties. She cites the courses at the IEF Zurich and the University of Basel as sound further training options for coaches.
Caroline Maroni emphasises that it is important for therapists to use hypnosis responsibly. In a trance, the analytical and rational mind recedes into the background and clients are open to suggestions – she also calls these linguistic invitations. «That is the strength of hypnosis,» says Caroline Maroni. «However, this state can also be abused.» People who are in distress are particularly susceptible to suggestion. For this reason, parents should choose therapists carefully.
Find out more about what happens in the brain during hypnosis here.
