Repetition in Hypnotherapy Revisited

by Tim Brunson PhD

The repetition of ideas and concepts is most definitely a significant aspect of how humans communicate and greatly affects how we acquire knowledge and skills. Advertising agencies use it – although in ways that too often annoy their intended audiences. When studying Tai Chi in Nuremberg many decades ago, I remember my Chinese-Malaysian master using the German phrase Übung macht den Meister, which roughly translates as "Practice makes perfect." This was ever so true when as a student helicopter pilot I practiced shutting down my engine and successfully auto-rotating to the ground at least a hundred times before my instructor considered me ready to take my flight exam. So, repetition obviously plays a very big role in the acceptance of a message and how mastery is achieved. As all communication and skill mastery needs to be considered in the context of how the brain is affected, it is no wonder that repetition plays a role in the practice of hypnotherapy.

The use of repetition in hypnosis is not new. In David Elman's classes, he instructed his medical and dental students to repeatedly practice every hypnotist skill and especially self-hypnosis ones such as glove anesthesia. When, demonstrating a technique, which he called refraction, he also pointed out the value of repeatedly bringing his subject out of a trance state and then once again deepening their trance repeatedly so as to achieve increased depth. Then later he explained how a hypnotic subject will more likely conform to an operator's suggestions after receiving repeated suggestions. While this illustrates the value of repetition in hypnosis, it does little to explain why this happens – or if it can be improved.

To go further, I look at the "use it or lose it" concept proposed by the late Canadian psychologist, Donald Hebb, PhD. He noted that when a rat repeated a certain behavior pattern, the associated neural networks become thicker, which may provide a neurological explanation as to why repetition affects mastery. What logically flows from this is that once the neural pathway associated with a certain suggestion is established and strengthened, like any habituated thought, it results in increased efficiency for that idea. Additionally, Nobel Prize winner Eric Kandel, MD, PhD, when trying to explain how the brain encodes long-term memories, likewise pointed out that when sufficiently stimulated with a novel or emotionally potent idea, a certain gene in our neurons is expressed thereby causing them to grow more dendrites. Apparently this explains why Hebb's theories seem to be true. Thus, when an idea or concept is repeated, it becomes increasingly efficient and therefore is more likely to be accepted in both the short and long-run – a condition that is facilitated by the increased thickness of the associated neural networks.

It would seem then that this is the final conclusion: if repeating suggestions make them more likely to be acceptable, all that a hypnotist needs to do is say the same thing over and over again and justifiably expect to get better results. While this may be true in the short run, most experienced hypnotherapists are fully aware that should the same script be used repeatedly over a long period of time, after the point when an optimal effect is achieved, the subject will begin encountering diminishing results. This is because once a particular level of habituation occurs, the transformative consequence of the script fails to achieve the same level of brain plasticity. Therefore, it seems that repetition has more of a short-term effect than a long-term one. What then is the ideal balance when it comes to how repetition is used in hypnosis? And, when used in the short-term, can it be made even more effective?

In order to answer these questions, I feel that it is necessary to look at the role of repetition in hypnosis in a way that goes beyond the concept of strengthening neural pathways. I radically changed my views after being exposed to the work of V.S. Ramachandran, PhD, a San Diego-based neuroscientist, who has explored how a particular thought or perception affects not just one, but many different parts of a person's brain. For instance, he noticed that people with a developed aesthetic talent tend to excel as artists since a perceived or imagined input produces a reaction that affects more than one part of the brain simultaneously. Furthermore, when such a synesthesia occurs, it affects the growth of neural networks in numerous parts of the brain while simultaneously improving intra-brain communication. This is not limited to accomplished artists. Rather, it happens to some extent to all of us as a natural function of our brains. Ramachandran realized that any change in our neural pathways is happening in not just one part of the brain, but many. So, if repetition is used, it should be done so with the realization that many parts of the brain will be affected. Indeed, this way of looking at the value of repetition goes far beyond that intended by Elman and Hebb. An example, which immediately comes to mind, would be suggestions and/or imagery that involve a particular repetitive motion or action while also incorporating the subject's verbal or linguistic activity – such as while giving a public presentation. As a minimum, this input would simultaneously affect both the basil ganglia and the speech centers of the left temporal lobe – thus having a synesthetic quality.

The purpose of efficient selective thought – which is the foundation of the process known as hypnosis – is the transformation of the mind as a result of physically altering the subject's brain. This requires new neural networks as well as changing the combination of neural substrates, which are activated, idled, or inactivated at any given moment. When considering only the value of repetition, the goal would be to strengthen the efficiency of networks by repeating a thought or perception. However, when you consider that you also have the opportunity of creating a more "competent" brain synesthetically, the possibilities are endless. For instance, a predominately left-brained engineer could benefit by increasing his or her imagination and/or intuition. Immediately, this brings to mind notables such as Leonardo da Vinci and the late Steven Jobs, the visionary who founded the Apple Corporation.

So what I want hypnotherapists to do is not only become more adept in using basic repetitions, but to also do so in a way that synesthetically stimulates the brain so that increased competence can be achieved while also developing more efficient neural networks and overcoming the staleness of excessive habituation.

To do this I have proposed is a concept, which I call "recursive optimization." Recursion implies that something is repeated not in the exact same way, but in a similar way. This gives the subject the ability to experience the repeated core suggestion while doing so in a way that varies context and even allows for the novelty and implies that multiple parts of the brain communicate. Thus, a suggestion presented similarly but significantly differently can help optimize the effect of repetition – while doing much more. Even though the original suggestion may have a synesthetic quality, each modified version creates an opportunity to bring in additional subordinate suggestions that affect additional neural substrates.

I stumbled upon the concept of recursive optimization while simultaneously developing Neurology of Suggestion-related courses and producing a series of over 150 self-help and clinical hypnosis recordings. What I realized was that superior results were attained when a suggestion was repeated in similar ways during a script that averaged around 650 words. By altering the words somewhat each time that the suggestion was repeated, it appeared that the subject encountered a much more intensive reaction than if I had relentlessly regurgitated my words the exact same way – as originally implied by Elman. This technique – especially when used with the looping effect that is part of all of my scripts – tends to impact multiple neural substrates simultaneously, thus affecting the transformation of many areas of the brain. (Please note that this is somewhat akin to the "whole brain" and holistic concepts first addressed in the 1970's – although I don't believe that their proponents had a clue as to how or why this occurred as neuroscience had yet to be sufficiently advanced.)

Therefore, it seems that a combination of effective looping in a script coupled with a recursive method of repeating suggestions and imagery produces a much more intense impact on the transformation of a subject's brain. Thus, when employed within the context of the wider Neurology of Suggestion concepts, optimal results are achieved. I have seen these techniques employed by a number of coaches as well as by many mental health and medical clinicians, who claim to have achieved significantly better results as opposed to using more traditional hypnotherapy script writing and delivery techniques. Thus, these technologies continue to predominate in the form of script writing, which I share with my students.