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by Dabney Ewin
Crown House, 2009
Review by Chris Vaughan on May 4th 2010
Dabney Ewin must be a useful man to have around your hospital. He's a surgeon, a physician and a psychiatrist. And alongside these skills he offers hypnosis, not just as an adjunct, but as a therapy in its own right.
That he is a surgeon is interesting because surgeons played a pioneering role in the history of hypnosis. It was the nineteenth century Scottish surgeon, Braid, who coined the term 'hypnosis'. However, Braid put people into a trance to make the surgery more bearable. Ewin,too, sometimes uses hypnosis for certain surgical procedures. He says, "Involuntary muscle spasm fights against fracture reduction and the relaxation obtained with hypnosis makes it easy". But then he adds, "I usually inject some local anesthetic since it makes me feel more comfortable" (p50).
This is because Ewin knows that people have varying capacities for going into trance. In order to do hypnoanalysis, for instance, he has found that he can use the closed eye roll method of induction and ideomotor questioning to achieve what he wants, most of the time. This way he is able to shut down the left brain functions and engage the global, metaphoric and intuitive processing of the right brain.
He does teach his students direct suggestion in hypnosis, with a large book of scripts on hand. But although he says direct suggestion is better than placebo, with a 50% success rate, hypnoanalysis with ideomotor signals gets closer to 80%. Ewins seems to suggest that the beginner can get too hung up on inducing trance, mesmerized, if you like, when the real skill is knowing the right suggestion, the suggestion that cures, just as for the surgeon, it's knowing where to cut. "Inductions are easy", he says. "Our workshops are to learn how to sort out the right suggestion and make it acceptable to the patient" (p112).
Indeed with regard to trance, Ewin makes this personal observation, " A patient tends to go as deep as he/she needs to go to solve a problem. A patient tends to stay as light as necessary to protect him/her self" (p78).
All this information readers will have to assemble for themselves because the book is arranged into numbered, self-contained items or Things, usually a short page in length, never more than two. It is, therefore, a short book and because he has set himself the task of compiling a list adding up to a magic 101, there are also some place-fillers. Furthermore Ewin's popular style makes it a deceptively easy book to read. But here summarised is a lifetime's breadth and depth of experience and readers will find themselves revisiting the text, time and again to familiarise themselves with his thoughts.
Ewin is used to teaching medical students and what he says is derived from his work as a medic. Often the points he wishes to make are purely medical but it is not just tyro doctors that will find this book of use. Anyone starting out in hypnotherapy will find it rewarding. I would think also those who are well-practiced in helping people using hypnosis will find it instructive to compare notes with someone as well-regarded as Ewin who writes with an easy grace, with humour and with practical wisdom. But because this is not a text book and is discursive in style, it is helpful if the reader has a preliminary grounding in the theory and practice of hypnosis, to get full value from this book.
Ewin is a very encouraging mentor because his book is based both on a lifetime of practice and a solid belief in the beneficial aspects of hypnosis. Indeed, a great deal of a hypnotist's success is due to a belief in the efficacy of what they are doing and, of course, for any beginner, struggling to master the techniques of a new trade, uncertainty can show through.
Ewin says that one of the best things that happened to him was to be successfully treated with hypnosis early in his study of the subject. It convinced him of its validity and gave him a strong sense of conviction that his patients could solve their problems too, if he gave them choices (p93).
Elsewhere, he quotes Sarbin: "Hypnosis is believed-in imagination", a belief that has to be transmitted from the hypnotist to the subject. Reflecting on William Kroger's humorous reversal: "Don't let your failures go to your head", Ewin says that too often a novice is unsure of the technique, communicates this to the patient, gets a poor result, and then abandons hypnosis (p109).
It is true to say that in the eyes of some in the medical community hypnosis has never been able to shake off its voodoo aura, even though it received the blessing of the American Medical Association more than fifty years ago. And Ewin admits that with hypnosis we are not entirely sure what is going on, that respected scientists disagree vigorously on details of its true nature. "Nonetheless, it is a simple concept for me as a clinician working with a patient. I can drive a car without understanding all the machinery and electronics, and I can treat nearly all of the patients who come to my office." (p67)
But implicit in the text is that ignorance of hypnosis and the nature of suggestion, by doctors and nurses, can wreak a lot of damage. Loose talk costs lives is not just a wartime slogan but, from the evidence here, should be a maxim that is ingrained in the make-up of everyone associated with the medical profession. Perhaps as patients the majority of us are in a culturally induced trance anyway when we consult the doctor, primed to respect the doctor's credentials and give credence to his every word. In this state of heightened awareness and narrow focus, we are highly suggestible.
In the book's opening sentence, Ewin declares "We are treating people with words, so the dictionary and thesaurus are our pharmacopoeias". And throughout the book, he gives several examples of iatrogenic verbal harm.
Words come freighted with associations and the practitioner needs to be alive to this and know also that fear can put the patient in a hypnoidal state making them hypersensitive to suggestion and be aware, too, of what Ewin calls the Law of Pessimistic Interpretation, or as David Cheek puts it: "If a statement can be interpreted optimistically or pessimistically, a frightened person will interpret it pessimistically" (p75). In spite of knowing of the existence of the placebo effect, many doctors still seem ignorant of its opposite.
Ewin, as well as listing words that have worked well for him, also gives examples of words that have a surface innocence but have acquired negative connotations through common parlance. Words such as "fix" "quit" and "try" rather than acting as a smooth verbal balm can result in frustrating the healing process.
In his medical practice, Ewin will be well-versed in the techniques and approach of modern, positivist scientific medicine which have been so successful. In using hypnosis he is also advocating a collaborative, interactional approach with his patients. He is bent on treating not just the disease but the person. He says, "Precious is the best single word I know for ego strengthening, along with "You're just as good as anybody else, and you don't have to prove that to anybody. It's all right just to be yourself." We so easily forget that we are created precious (not perfect) and we can find meaning in our lives" (p 15).
As I read this entrancing book, I found myself falling deeper and deeper under Ewin's spell… As he says to his patients in the Emergency Room, "I'm Ewin, I can help you. Will you do what I say?... Fine, you're safe now. Close your eyes, take a deep breath, and turn this over to me. You can let your thoughts and feelings go off to your laughing place while I do what is necessary to get you well" (p102).
Who can resist?
© 2010 Chris Vaughan
Chris Vaughan writes about himself: I live in Birmingham, England. I am now retired after a career in the pharma industry and am very much involved in community activities. I am a board member of the Birmingham Environmental Partnership and chair a local patient network. I have written a book on the British Health Service and I currently write for a health website. I am very interested in the mind-body conundrum.