Integrative Therapies

Insurance policies are private contracts between insurance companies and those receiving benefits under that policy, so different health insurance policies are ultimately going to contract in and out of different forms of treatment. As a general rule, you can always look for policies that cover more kinds of integrative therapies if those are important to you and your specific course of treatment.

Outside of shopping around for policies that may have more of the types of services you’re looking for, one way to push for movement in this and any other issue area is to pursue some form of legislative advocacy. For integrative therapies, you can speak to your representatives and tell them that these types of treatments should be covered as “essential health benefits” in all plans.

For information on your elected officials go to: http://www.house.gov (to find your U.S. Representative), http://www.senate.gov (to find your U.S. Senators), and http://www.votesmart.org (to find your local elected officials).
Insurance policies are private contracts between insurance companies and those receiving benefits under that policy, so different health insurance policies are ultimately going to contract in and out of different forms of treatment. As a general rule, you can always look for policies that cover more kinds of integrative therapies if those are important to you and your specific course of treatment.

Outside of shopping around for policies that may have more of the types of services you’re looking for, one way to push for movement in this and any other issue area is to pursue some form of legislative advocacy. For integrative therapies, you can speak to your representatives and tell them that these types of treatments should be covered as “essential health benefits” in all plans.

For information on your elected officials go to: http://www.house.gov (to find your U.S. Representative), http://www.senate.gov (to find your U.S. Senators), and http://www.votesmart.org (to find your local elected officials).

There are many sources of information about these complementary therapies on the internet, but most are self-serving (the source of the information stands to profit from the alternative therapy). I am convinced that modern cancer therapies can be effective and that they should not be delayed to try complementary therapies. If there are no standard therapies available, complementary therapies are reasonable. This does not mean that a lung cancer patient should not try to eat a healthy diet during therapy, but I recommend that patients do not take megadoses of any natural or alternative supplement. There are many sources of information about these complementary therapies on the internet, but most are self-serving (the source of the information stands to profit from the alternative therapy). I am convinced that modern cancer therapies can be effective and that they should not be delayed to try complementary therapies. If there are no standard therapies available, complementary therapies are reasonable. This does not mean that a lung cancer patient should not try to eat a healthy diet during therapy, but I recommend that patients do not take megadoses of any natural or alternative supplement.

Turmeric is a spice commonly used in traditional Indian cooking and medicine. It accounts for the deep yellow color of some curries. Curcumin is a chemical found in turmeric that has some activity against cancer cells in a laboratory. Turmeric is mainly used for its anti-inflammatory properties. A search of the National Cancer Institute database on clinical trials did not reveal any human trials on cancer prevention with turmeric. This is still being investigated in the lab, and if successful there, will move on to human trials. Turmeric is a spice commonly used in traditional Indian cooking and medicine. It accounts for the deep yellow color of some curries. Curcumin is a chemical found in turmeric that has some activity against cancer cells in a laboratory. Turmeric is mainly used for its anti-inflammatory properties. A search of the National Cancer Institute database on clinical trials did not reveal any human trials on cancer prevention with turmeric. This is still being investigated in the lab, and if successful there, will move on to human trials.

There are some situations in which a cancer patient may want to be sure to drink more water than usual. Some of these situations would include having nausea or diarrhea during treatment (these can lead to dehydration), receiving treatment that makes it difficult to swallow, or getting a chemotherapy that is potentially toxic to the kidneys. The question remains, how much water is enough? That can depend on a lot of factors (physical activity, humidity in the environment, amount of perspiration) and can vary from one individual to another. The Institute of Medicine recommends about 13 cups for men and 9 cups for women as a general guideline. Logic would dictate that you certainly need enough to prevent dehydration. Some of the symptoms of dehydration include fatigue, headache, lightheadedness, dry mouth and skin, decreased urination, constipation, and of course thirst. There are some situations in which a cancer patient may want to be sure to drink more water than usual. Some of these situations would include having nausea or diarrhea during treatment (these can lead to dehydration), receiving treatment that makes it difficult to swallow, or getting a chemotherapy that is potentially toxic to the kidneys. The question remains, how much water is enough? That can depend on a lot of factors (physical activity, humidity in the environment, amount of perspiration) and can vary from one individual to another. The Institute of Medicine recommends about 13 cups for men and 9 cups for women as a general guideline. Logic would dictate that you certainly need enough to prevent dehydration. Some of the symptoms of dehydration include fatigue, headache, lightheadedness, dry mouth and skin, decreased urination, constipation, and of course thirst.

Warning signs that you are dealing someone of questionable ethics when it comes to cancer care are:
• They promise you a cure that conventional treatment won’t give you
• They are asking you to spend a significant amount of money on treatment. Most complementary therapies are not covered by insurance, but watch out for those who are asking for a significant amount of money from you for their treatment.
• They recommend that you discontinue treatment with your oncologist. There may come a time when you choose to discontinue treatment with your oncologist but that’s a conversation that you should have with him or her and usually after potentially curative therapies have been exhausted or the side effects of therapy outweigh any potential benefits.
• They have a miracle cure that the FDA won’t approve.
• Ask about whether or not there are published studies on the effectiveness of the treatment they are recommending for you.
• Be careful if they tell you there are no risks or side effects
• Use your common sense…if it sounds too good to be true, it probably is. Warning signs that you are dealing someone of questionable ethics when it comes to cancer care are:
• They promise you a cure that conventional treatment won’t give you
• They are asking you to spend a significant amount of money on treatment. Most complementary therapies are not covered by insurance, but watch out for those who are asking for a significant amount of money from you for their treatment.
• They recommend that you discontinue treatment with your oncologist. There may come a time when you choose to discontinue treatment with your oncologist but that’s a conversation that you should have with him or her and usually after potentially curative therapies have been exhausted or the side effects of therapy outweigh any potential benefits.
• They have a miracle cure that the FDA won’t approve.
• Ask about whether or not there are published studies on the effectiveness of the treatment they are recommending for you.
• Be careful if they tell you there are no risks or side effects
• Use your common sense…if it sounds too good to be true, it probably is.

Cancer programs may vary depending on the size of your medical center and the services that are available to you. Academic medical centers that are involved in cancer research often have the NCI designation “Comprehensive Cancer Center”. Just because a cancer center calls itself “comprehensive” does not necessarily mean it has this NCI designation. Smaller community cancer programs have often been accredited by the American College of Surgeons and this would be something you should ask about. A radiation oncology program should be accredited by the American College of Radiology.

There are no defined criteria for an “integrative” cancer care program. There are several things you should look for, however. One would be a physician, preferably an oncologist, who has done additional training in integrative medicine. There is an associate fellowship program in integrative medicine at the University of Arizona which was developed by Dr. Andrew Weil and is the one I have completed. A few other universities offer fellowship programs in integrative medicine so you should ask the integrative medicine physician what his or her additional training has been. In two to three years there will hopefully be a national board certification for integrative medicine physicians which will make the task of finding one infinitely easier. An integrative cancer program should emphasize evidence-based therapies that are combined with conventional therapies.
Cancer programs may vary depending on the size of your medical center and the services that are available to you. Academic medical centers that are involved in cancer research often have the NCI designation “Comprehensive Cancer Center”. Just because a cancer center calls itself “comprehensive” does not necessarily mean it has this NCI designation. Smaller community cancer programs have often been accredited by the American College of Surgeons and this would be something you should ask about. A radiation oncology program should be accredited by the American College of Radiology.

There are no defined criteria for an “integrative” cancer care program. There are several things you should look for, however. One would be a physician, preferably an oncologist, who has done additional training in integrative medicine. There is an associate fellowship program in integrative medicine at the University of Arizona which was developed by Dr. Andrew Weil and is the one I have completed. A few other universities offer fellowship programs in integrative medicine so you should ask the integrative medicine physician what his or her additional training has been. In two to three years there will hopefully be a national board certification for integrative medicine physicians which will make the task of finding one infinitely easier. An integrative cancer program should emphasize evidence-based therapies that are combined with conventional therapies.

EmbodiWorks provides an educational website with integrative cancer care resources about whole person health and healing in five areas–body, mind, spirit, social, and environmental. We also have a Resources section to help cancer patients and caregivers navigate their cancer journey. Our goals are to reduce cancer risk and improve cancer-related survival, quality of life, and whole person health care.

Please visit our site at www.embodiworks.org. There are several great ones (unfortunately there are many more to be avoided!)
MSK Cancer Center Integrative Medicine: http://www.mskcc.org/cancer-care/integrative-medicine
MD Anderson Cancer Center (CIMER):http://www.mdanderson.org/education-and-research/resources-for-professionals/clinical-tools-and-resources/cimer/index.html
Pub Med (National Library of Medicine): http://www.ncbi.nlm.nih.gov/pubmed/
National Cancer Institute: http://www.cancer.gov/cancertopics/pdq/cam/cam-cancer-treatment/patient/page2

Insomnia is a really common problem for cancer patients. Although there are very effective prescription medications out there, most have some unwanted side effects. Effective nonprescription treatments for insomnia include regular exercise (preferably not just before bedtime), a balanced diet, meditation, acupuncture, and yoga just to name a few. For those of you who are still intent on taking a little something at bedtime to help you sleep, I usually recommend some combination of hops, valerian, lemon balm, and/or passion flower. Chamomile tea is helpful as well. Insomnia is a really common problem for cancer patients. Although there are very effective prescription medications out there, most have some unwanted side effects. Effective nonprescription treatments for insomnia include regular exercise (preferably not just before bedtime), a balanced diet, meditation, acupuncture, and yoga just to name a few. For those of you who are still intent on taking a little something at bedtime to help you sleep, I usually recommend some combination of hops, valerian, lemon balm, and/or passion flower. Chamomile tea is helpful as well.

This is really a common side effect with Tamoxifen treatment and all too frequently leads to discontinuation of a really helpful drug. Recommendations that are at the top of the list include regular exercise and a Mediterranean diet. Do those first. Next I would consider acupuncture. There was a study in the Journal of Clinical Oncology a couple of years ago that compared acupuncture to an antidepressant drug commonly used for hot flashes called Effexor. Acupuncture was just as effective in decreasing hot flashes and patients reported increased libido, and improvements in energy, clarity of thought, and sense of well-being with acupuncture. Side effects for the Effexor group included dry mouth, nausea, constipation,and decreased appetite. Black cohosh is another option. I won’t go into all the weaknesses of the big studies that have been done on black cohosh and hot flashes but I’ll summarize by saying the preponderance of the evidence shows that black cohosh is effective in treating hot flashes. It is not a phytoestrogen as some have believed in the past. Many of the common herbal preparations used for hot flashes do contain phytoestrogens so I would avoid those and stick with plain black cohosh. This is really a common side effect with Tamoxifen treatment and all too frequently leads to discontinuation of a really helpful drug. Recommendations that are at the top of the list include regular exercise and a Mediterranean diet. Do those first. Next I would consider acupuncture. There was a study in the Journal of Clinical Oncology a couple of years ago that compared acupuncture to an antidepressant drug commonly used for hot flashes called Effexor. Acupuncture was just as effective in decreasing hot flashes and patients reported increased libido, and improvements in energy, clarity of thought, and sense of well-being with acupuncture. Side effects for the Effexor group included dry mouth, nausea, constipation,and decreased appetite. Black cohosh is another option. I won’t go into all the weaknesses of the big studies that have been done on black cohosh and hot flashes but I’ll summarize by saying the preponderance of the evidence shows that black cohosh is effective in treating hot flashes. It is not a phytoestrogen as some have believed in the past. Many of the common herbal preparations used for hot flashes do contain phytoestrogens so I would avoid those and stick with plain black cohosh.

Inflammation is heat or fire in the body. This includes a distinction between acute and chronic inflammation. Think about when you've had a cut or wound. Your skin is red, flamed, and perhaps uncomfortable. That's acute inflammation. But in chronic inflammation, the "flare" does not stop. It continues on and on for months and years where the body acts with immune and other processes to heal a "wound" and yet there isn't one. The chronic inflammation then begins to support health conditions such as cancer.

To reduce inflammation, eat organic vegetables, some fruits, spices such as turmeric, and consider specific supplements. Inflammation levels can also be tested. The most common blood test is called c-reactive protein (CRP) high sensitivity available through mainstream blood laboratories. A healthy level is below 1.0 mg/L.

You can learn more about inflammation and cancer, including a more in depth explanation about inflammation and how to reduce it, in an article on the EmbodiWorks integrative cancer care resources website at http://www.embodiworks.org/cancertreatments/bodymindspirit/inflammation/.

Wishing you optimal health and healing. While low levels of inflammation are normal and necessary, chronic high-levels of inflammation in the body have been shown to allow the progression of development from pre-cancerous forms to full blown malignant disease. Food such as refined and artificial sugar, processed foods, bad fats and animal-based foods lead to the conversion of a type of fat – arachidonic acid – into compounds which promote inflammation which in turn can lead to cellular damage and disease. One can reduce inflammation in a number of ways but a basic guideline is to focus on a plant-based whole food diet.

I am in favor any therapy that has demonstrated a track record of success. And what might be best for one individual might not be the best for another person. That being said, when my colleague and friend, Dr. Andrew Weil, and I are asked, “For what conditions does hypnosis work best?” we usually respond, “Gut and skin conditions”. Dr. Weil feels that both the digestive system and skin have a greater abundance of nerve and blood supply that can be activated by hypnosis. I do not know all of the exact mechanisms that are activated anatomically, but in almost 40 years of practice experience, I have seen the best and most rapid results when hypnosis is used or added to the treatment of digestive disorders like irritable bowel, hyperacidity, inflammatory bowel, nausea… and for skin conditions like urticaria (hives), itching, burn recovery, acne, and even cases of psoriasis. I am in favor any therapy that has demonstrated a track record of success. And what might be best for one individual might not be the best for another person. That being said, when my colleague and friend, Dr. Andrew Weil, and I are asked, “For what conditions does hypnosis work best?” we usually respond, “Gut and skin conditions”. Dr. Weil feels that both the digestive system and skin have a greater abundance of nerve and blood supply that can be activated by hypnosis. I do not know all of the exact mechanisms that are activated anatomically, but in almost 40 years of practice experience, I have seen the best and most rapid results when hypnosis is used or added to the treatment of digestive disorders like irritable bowel, hyperacidity, inflammatory bowel, nausea… and for skin conditions like urticaria (hives), itching, burn recovery, acne, and even cases of psoriasis.

I think I pretty much described “What is hypnosis…” in the first five question answered and would refer you to read those responses. You’ll see that I favor the definition of hypnosis described by the professional association, The American Society of Clinical Hypnosis, which is:

“Hypnosis is a state of inner absorption, concentration, and focused attention. It’s like using a magnifying glass to focus the rays of the sun and make them more powerful. Similarly, when our minds are concentrated and focused, we are able to use our minds more powerfully. Because hypnosis allows people to uses more of their potential learning self-hypnosis is the ultimate act of self-control.”

Hypnosis offers several benefits in application for individuals dealing with cancer. On of my audio programs “Cancer Support: Chemotherapy and Radiation” (available at www.healingwithhypnosis.com) addresses many of these benefits. And there are many other excellent audio programs offered by my colleagues in clinical hypnosis as well. Although there is a wide range of cancers and cancer treatments, I would list the following as ways in which hypnosis can help:

• Lessening anxiety – Although “cancer” is only a word and not a sentence, many experience anxiety about the diagnosis, the treatment they will undergo, and the worry or anxiety about what the outcomes may be and how they affect one’s life and the lives of their loved ones.
• Preparation for surgery and recovery after surgery – The research is consistent in showing that hypnosis helps patients achieve better outcomes from the following aspects of surgery: less pre-surgical anxiety, greater pain management ability (less pain), less pain medication required, shorter operating time, more rapid recovery with less discomfort and rates of infection, faster wound healing, and shorter hospital stays.
• Reducing and managing pain – Some cancers cause more pain than others, and hypnoanalgesia is term used to describe greater comfort (less pain) due to hypnosis. With greater pain control the need for narcotic medications are reduced and the individual is more alert and attentive to interacting with activities of life and family.
• Less side effects of chemotherapy and radiation therapy – Hypnosis has a very good track record for helping individuals undergoing chemotherapy and radiation therapy to experience less nausea and emesis, less pain, reducing hot flashes (e.g., associated to Luprin treatment for prostate cancer patients).
• Improving sleep – Hypnosis in and of itself is not the same as sleep, for individuals using hypnosis are awake, but so well relaxed that it helps improve going to sleep, staying asleep, being able to return to sleep when awakened during the night, and experiencing a greater restorative quality of one’s sleep.
• Reducing stress – When hypnosis is learned (remember, ALL hypnosis is self-hypnosis) it naturally helps lessen our emotional and physical stress responses, and helps to better insulate us to the stresses we are exposed to in life.
• Improving positive outlook and mood – Hypnosis is a valuable tool for many aspects of medical conditions, and with a sense of greater control, we also acquire an improved or more positive outlook. That means a cancer patient has more resistance to depression that might accompany the stresses that tax one’s emotional and physical endurance during the cancer experience. I think I pretty much described “What is hypnosis…” in the first five question answered and would refer you to read those responses. You’ll see that I favor the definition of hypnosis described by the professional association, The American Society of Clinical Hypnosis, which is:

“Hypnosis is a state of inner absorption, concentration, and focused attention. It’s like using a magnifying glass to focus the rays of the sun and make them more powerful. Similarly, when our minds are concentrated and focused, we are able to use our minds more powerfully. Because hypnosis allows people to uses more of their potential learning self-hypnosis is the ultimate act of self-control.”

Hypnosis offers several benefits in application for individuals dealing with cancer. On of my audio programs “Cancer Support: Chemotherapy and Radiation” (available at www.healingwithhypnosis.com) addresses many of these benefits. And there are many other excellent audio programs offered by my colleagues in clinical hypnosis as well. Although there is a wide range of cancers and cancer treatments, I would list the following as ways in which hypnosis can help:

• Lessening anxiety – Although “cancer” is only a word and not a sentence, many experience anxiety about the diagnosis, the treatment they will undergo, and the worry or anxiety about what the outcomes may be and how they affect one’s life and the lives of their loved ones.
• Preparation for surgery and recovery after surgery – The research is consistent in showing that hypnosis helps patients achieve better outcomes from the following aspects of surgery: less pre-surgical anxiety, greater pain management ability (less pain), less pain medication required, shorter operating time, more rapid recovery with less discomfort and rates of infection, faster wound healing, and shorter hospital stays.
• Reducing and managing pain – Some cancers cause more pain than others, and hypnoanalgesia is term used to describe greater comfort (less pain) due to hypnosis. With greater pain control the need for narcotic medications are reduced and the individual is more alert and attentive to interacting with activities of life and family.
• Less side effects of chemotherapy and radiation therapy – Hypnosis has a very good track record for helping individuals undergoing chemotherapy and radiation therapy to experience less nausea and emesis, less pain, reducing hot flashes (e.g., associated to Luprin treatment for prostate cancer patients).
• Improving sleep – Hypnosis in and of itself is not the same as sleep, for individuals using hypnosis are awake, but so well relaxed that it helps improve going to sleep, staying asleep, being able to return to sleep when awakened during the night, and experiencing a greater restorative quality of one’s sleep.
• Reducing stress – When hypnosis is learned (remember, ALL hypnosis is self-hypnosis) it naturally helps lessen our emotional and physical stress responses, and helps to better insulate us to the stresses we are exposed to in life.
• Improving positive outlook and mood – Hypnosis is a valuable tool for many aspects of medical conditions, and with a sense of greater control, we also acquire an improved or more positive outlook. That means a cancer patient has more resistance to depression that might accompany the stresses that tax one’s emotional and physical endurance during the cancer experience.

I would recommend learning: to effectively relax, better comfort management, imagery and visualization for rapid and effective healing, improved confidence, and knowing what behavioral and mind-body steps they can implement for greater healing and recovery. I published a paper on the subject of hypnosis and surgery which is available for download at this link - http://www.healingwithhypnosis.com/AZCIM/Gurgevich_SurgeryHypnosis.pdf. I also have an audio program available from my website called “Surgery and Recovery” - http://www.healingwithhypnosis.com/mm5/merchant.mvc?Screen=PROD&Product_code=000033. I would recommend learning: to effectively relax, better comfort management, imagery and visualization for rapid and effective healing, improved confidence, and knowing what behavioral and mind-body steps they can implement for greater healing and recovery. I published a paper on the subject of hypnosis and surgery which is available for download at this link - http://www.healingwithhypnosis.com/AZCIM/Gurgevich_SurgeryHypnosis.pdf. I also have an audio program available from my website called “Surgery and Recovery” - http://www.healingwithhypnosis.com/mm5/merchant.mvc?Screen=PROD&Product_code=000033.

To me, mind-body healing is the use of one’s mind to affect a therapeutic response. Sometimes ‘healing’ means ‘curing’, but not always, for healing may also mean easing suffering, limiting pain, or bringing emotional and/or physical comfort even though the disease or condition persists.

In my practice of health psychology, mind-body healing is implemented by first assessing the person’s needs, personality, learning style, and then offering a combination of clinical hypnosis, psychotherapy, and counseling with an emphasis on instructing the individual on the many ways they can help themselves and benefit from learning more about the exquisite interaction of mind, body, and spirit.
To me, mind-body healing is the use of one’s mind to affect a therapeutic response. Sometimes ‘healing’ means ‘curing’, but not always, for healing may also mean easing suffering, limiting pain, or bringing emotional and/or physical comfort even though the disease or condition persists.

In my practice of health psychology, mind-body healing is implemented by first assessing the person’s needs, personality, learning style, and then offering a combination of clinical hypnosis, psychotherapy, and counseling with an emphasis on instructing the individual on the many ways they can help themselves and benefit from learning more about the exquisite interaction of mind, body, and spirit.

Fortunately, there are few risks with hypnosis as the patient is only exposed to learning methods that will help them access their mind-body connection and discovering that all hypnosis is really self-hypnosis. However, I believe the two greatest risks of hypnosis and hypnotherapy are:

1. using hypnosis to remove pain that is still serving a vital purpose, and
2. hypnosis or hypnotherapy being offered by a person that is not trained or qualified to be treating a patient with it.

My rule of thumb is that one should not use hypnosis to treat a condition unless they are qualified and competent to treat the condition without hypnosis as well. This does not mean that only a surgeon can use hypnosis in helping a person prepare for surgery and recovery with hypnosis, but that the clinician should have the training and qualifications for the application being offered to the patient.

There is little legislation, laws or rules governing who can do hypnosis. And there are many programs offering ‘certification’ or a certificate to become a ‘certified hypnotherapist’. Sometimes only a fee is required, or it could be a weekend workshop open to anyone, or it may be a well-designed and supervised training. You just do not know unless the clinician is certified by the American Society of Clinical Hypnosis (http://www.ASCH.net), a member of a professional association representing their field of expertise, licensed by their state board for professional practice, and has had appropriate supervision and training. The only bona-fide professional association I am aware of that has developed standards of training, supervision, and certification is the American Society of Clinical Hypnosis and their affiliate organizations.

I like to use the example or comparison to becoming a ‘certified injectionist’. One can take a weekend workshop and become quite adapt at giving intramuscular, subcutaneous, and even intravenous injections. However, when one needs professional help, they should seek someone qualified to treat their condition, and not just know how to give an injection. And unfortunately, there is little to protect the consumer from anyone saying they are a hypnotherapist. A professional psychologist, Steve Eichel PhD, sent applications to many organizations that offered a certificate as a certified hypnotherapist. He put the applicant’s name as Zoe D. Katz (German for Zoe the cat, his cat). He even listed Zoe’s occupation as ‘feline’… and by submitting a fee; he collected many certificates showing Zoe D. Katz as a certified hypnotherapist. To me, the use of hypnosis for clinical applications by untrained individuals is a risk of hypnosis.
Fortunately, there are few risks with hypnosis as the patient is only exposed to learning methods that will help them access their mind-body connection and discovering that all hypnosis is really self-hypnosis. However, I believe the two greatest risks of hypnosis and hypnotherapy are:

1. using hypnosis to remove pain that is still serving a vital purpose, and
2. hypnosis or hypnotherapy being offered by a person that is not trained or qualified to be treating a patient with it.

My rule of thumb is that one should not use hypnosis to treat a condition unless they are qualified and competent to treat the condition without hypnosis as well. This does not mean that only a surgeon can use hypnosis in helping a person prepare for surgery and recovery with hypnosis, but that the clinician should have the training and qualifications for the application being offered to the patient.

There is little legislation, laws or rules governing who can do hypnosis. And there are many programs offering ‘certification’ or a certificate to become a ‘certified hypnotherapist’. Sometimes only a fee is required, or it could be a weekend workshop open to anyone, or it may be a well-designed and supervised training. You just do not know unless the clinician is certified by the American Society of Clinical Hypnosis (http://www.ASCH.net), a member of a professional association representing their field of expertise, licensed by their state board for professional practice, and has had appropriate supervision and training. The only bona-fide professional association I am aware of that has developed standards of training, supervision, and certification is the American Society of Clinical Hypnosis and their affiliate organizations.

I like to use the example or comparison to becoming a ‘certified injectionist’. One can take a weekend workshop and become quite adapt at giving intramuscular, subcutaneous, and even intravenous injections. However, when one needs professional help, they should seek someone qualified to treat their condition, and not just know how to give an injection. And unfortunately, there is little to protect the consumer from anyone saying they are a hypnotherapist. A professional psychologist, Steve Eichel PhD, sent applications to many organizations that offered a certificate as a certified hypnotherapist. He put the applicant’s name as Zoe D. Katz (German for Zoe the cat, his cat). He even listed Zoe’s occupation as ‘feline’… and by submitting a fee; he collected many certificates showing Zoe D. Katz as a certified hypnotherapist. To me, the use of hypnosis for clinical applications by untrained individuals is a risk of hypnosis.

If you have seen it in the movies, TV, or a night club, you are probably watching “stage hypnosis” which is the non-professional use that employs many of the techniques of persuasion, influence and hypnotic methods for the purpose of entertainment. Many stage hypnotists, although quite skilled in the techniques of hypnosis, are performers or entertainers first and foremost. These individuals are not trained in medicine, psychology, nursing, social work or counseling. They are entertainers. Which means that “the act” or performance may include illusion, deception, trickery, social pressure, and at times even a hired confederate to be part of the act. Stage hypnotist prey upon the myths and misconceptions commonly held about hypnosis (and portrayed in their performance), such as: hypnosis is something done to someone (this is the greatest myth and misconception), or one goes under another’s control or loses consciousness, or might do something out of their character or values. These are all false. Hypnosis is not done to someone. No one ‘gets hypnotized’ or loses consciousness. I have treated well over 15,000 patients with clinical hypnosis, in sessions that number over 40,000; and I have never ‘hypnotized’ anyone anymore than I could have ‘meditated’ them. But I have taught a great number how to use hypnosis and that all hypnosis is really self-hypnosis.

Clinical or medical hypnosis is quite different from stage hypnosis. The purpose is to achieve a therapeutic outcome, the therapist is a licensed professional trained and qualified in a clinical specialty, and the therapist is using hypnosis as a tool to help the patient. It is used as one of the modalities of mind-body medicine to access the mind-body connection in order to elicit healthy and beneficial (therapeutic) responses in the patient. This can cover the range from medical conditions, psychological conditions, behaviors and habits, and sometimes to improve performance (like with a professional athlete, musician, dancer, etc).
If you have seen it in the movies, TV, or a night club, you are probably watching “stage hypnosis” which is the non-professional use that employs many of the techniques of persuasion, influence and hypnotic methods for the purpose of entertainment. Many stage hypnotists, although quite skilled in the techniques of hypnosis, are performers or entertainers first and foremost. These individuals are not trained in medicine, psychology, nursing, social work or counseling. They are entertainers. Which means that “the act” or performance may include illusion, deception, trickery, social pressure, and at times even a hired confederate to be part of the act. Stage hypnotist prey upon the myths and misconceptions commonly held about hypnosis (and portrayed in their performance), such as: hypnosis is something done to someone (this is the greatest myth and misconception), or one goes under another’s control or loses consciousness, or might do something out of their character or values. These are all false. Hypnosis is not done to someone. No one ‘gets hypnotized’ or loses consciousness. I have treated well over 15,000 patients with clinical hypnosis, in sessions that number over 40,000; and I have never ‘hypnotized’ anyone anymore than I could have ‘meditated’ them. But I have taught a great number how to use hypnosis and that all hypnosis is really self-hypnosis.

Clinical or medical hypnosis is quite different from stage hypnosis. The purpose is to achieve a therapeutic outcome, the therapist is a licensed professional trained and qualified in a clinical specialty, and the therapist is using hypnosis as a tool to help the patient. It is used as one of the modalities of mind-body medicine to access the mind-body connection in order to elicit healthy and beneficial (therapeutic) responses in the patient. This can cover the range from medical conditions, psychological conditions, behaviors and habits, and sometimes to improve performance (like with a professional athlete, musician, dancer, etc).

First, let me say that I believe all hypnosis is self-hypnosis. And I do not believe anyone has a precise definition of hypnosis, but I favor the definition provided by the American Society of Clinical Hypnosis: (source, http://www.asch.net)

“Hypnosis is a state of inner absorption, concentration, and focused attention. It’s like using a magnifying glass to focus the rays of the sun and make them more powerful. Similarly, when our minds are concentrated and focused, we are able to use our minds more powerfully. Because hypnosis allows people to uses more of their potential learning self-hypnosis is the ultimate act of self-control.”

While the American Society of Clinical Hypnosis definition refers to it as a “state” of inner absorption, some other definitions refer to it as “a process” or as “a procedure” that involves a therapist and a subject. I do not think anyone has an absolute definition of hypnosis and prefer to think of it as a combination of a procedure, a process, and a state of inner absorption, with the emphasis on ‘a state of inner absorption’. That is, hypnosis is a type of relaxed or passive concentration where we are so absorbed and focused on our own ideas, we are able to exclude or minimize the energy we give to the other things going on around us. I particularly like the example of using our mind as a magnifying glass to focus and concentrate our ideas and thoughts so that our subconscious mind receives them clearly and accepts them.

You probably do not realize it, but you often put yourself into hypnotic trances every day. You often become so inwardly absorbed and focused on your thoughts that you can ignore many of the things going on around you, even as you know they are happening. One common example is becoming so caught up in a good book or a powerful movie that you react as if it were real. But I think the best example of this kind of everyday trance is a day dream.

Think about the times when you were in a classroom as the teacher was lecturing at one end of the room and you were staring out a window. Your eyes were open and you were seeing, yet you weren’t looking at what you were seeing. Your ears were also open and recording the changes in air pressure we call sound waves, so you were hearing but you weren’t listening to what you were hearing. This daydream-like state is what a hypnotic trance feels like. And in this state of relaxed or passive concentration we are more accepting of suggestions that may be offered to us by a therapist, an audio program, or simply by our own self-talk, imagination or visualization of what we desire.

I think there that the major difference between hypnosis and meditation involves intention. That is, when we are in the meditative state of inner absorption and using it with a very deliberate purpose or intention of offering suggestions to our mind-body (aka subconscious) to elicit a therapeutic response, then I call that hypnosis. If we are enjoying the meditative state purely for the many benefits inherent in mediating alone, then I call that meditation. Bottom line is that I see the ‘trance state’ as a meditative state of inner absorption, and when that state of inner absorption is being intentionally used to effect a therapeutic outcome, then I call it hypnosis as opposed to just meditation.

PS: And I like Miraval too… in fact, our Arizona Center for Integrative Medicine plays a role at Miraval, and the current medical director, James Nikolai MD, is one of our Fellowship graduates.
First, let me say that I believe all hypnosis is self-hypnosis. And I do not believe anyone has a precise definition of hypnosis, but I favor the definition provided by the American Society of Clinical Hypnosis: (source, http://www.asch.net)

“Hypnosis is a state of inner absorption, concentration, and focused attention. It’s like using a magnifying glass to focus the rays of the sun and make them more powerful. Similarly, when our minds are concentrated and focused, we are able to use our minds more powerfully. Because hypnosis allows people to uses more of their potential learning self-hypnosis is the ultimate act of self-control.”

While the American Society of Clinical Hypnosis definition refers to it as a “state” of inner absorption, some other definitions refer to it as “a process” or as “a procedure” that involves a therapist and a subject. I do not think anyone has an absolute definition of hypnosis and prefer to think of it as a combination of a procedure, a process, and a state of inner absorption, with the emphasis on ‘a state of inner absorption’. That is, hypnosis is a type of relaxed or passive concentration where we are so absorbed and focused on our own ideas, we are able to exclude or minimize the energy we give to the other things going on around us. I particularly like the example of using our mind as a magnifying glass to focus and concentrate our ideas and thoughts so that our subconscious mind receives them clearly and accepts them.

You probably do not realize it, but you often put yourself into hypnotic trances every day. You often become so inwardly absorbed and focused on your thoughts that you can ignore many of the things going on around you, even as you know they are happening. One common example is becoming so caught up in a good book or a powerful movie that you react as if it were real. But I think the best example of this kind of everyday trance is a day dream.

Think about the times when you were in a classroom as the teacher was lecturing at one end of the room and you were staring out a window. Your eyes were open and you were seeing, yet you weren’t looking at what you were seeing. Your ears were also open and recording the changes in air pressure we call sound waves, so you were hearing but you weren’t listening to what you were hearing. This daydream-like state is what a hypnotic trance feels like. And in this state of relaxed or passive concentration we are more accepting of suggestions that may be offered to us by a therapist, an audio program, or simply by our own self-talk, imagination or visualization of what we desire.

I think there that the major difference between hypnosis and meditation involves intention. That is, when we are in the meditative state of inner absorption and using it with a very deliberate purpose or intention of offering suggestions to our mind-body (aka subconscious) to elicit a therapeutic response, then I call that hypnosis. If we are enjoying the meditative state purely for the many benefits inherent in mediating alone, then I call that meditation. Bottom line is that I see the ‘trance state’ as a meditative state of inner absorption, and when that state of inner absorption is being intentionally used to effect a therapeutic outcome, then I call it hypnosis as opposed to just meditation.

PS: And I like Miraval too… in fact, our Arizona Center for Integrative Medicine plays a role at Miraval, and the current medical director, James Nikolai MD, is one of our Fellowship graduates.

Thank you for your response. I actually met you last year at the Society of Integrative Oncology (SIO) conference. I am very well of the integrative therapies out there and teach it to my clients. In addition, I used to work at youcanthrive as a integrative patient navigator/health coach but the program is limited to 3 months. I was hoping that maybe there was something more long-term. As you know these services can become quite costly. The women I work with are all in an underserved community and would never be able to afford anything other than meditation or fitness in the form of walking where there is not cost at all.

I really enjoyed this session! Thanks Annie!!

Much continued success to you and all the work you are doing.
There are many success stories - and many different things people have incorporated on their own path to wellness. I cannot point to any one thing, that is the pharmaceutical approach. Several things stopped tumor growth for me personally, and I have heard stories of many substanced that people attributed their continuing life, survivorship, or remission to.

Our website has a section on alternative medicine for cancer - that's the place to refer to for specific ideas.
As to cost, that is much more difficult. If insurance covered this area, it would not be anywhere near as costly as conventional medicine,, but it does not. We are trying to organize around that issue! Right now there are a few local groups that help out. New York City has one - youcanthrive.org, Denver has Emerald Heart, and there are a few other, Charlotte Maxwell in San Francisco/Oakland area.

Good luck.