Can A Professional Hypnotist Help A Diabetic Client?

David C. Grinstead, MA, CH 

Northcentral University

August 19, 2005

 Abstract

         The professional hypnotist is a motivator, a coach, a guide and a stress management consultant who can assist a client with diabetes by teaching techniques that allow the client to use his or her natural ability to positively change the way she or he thinks, feels, or behaves in relation to the diabetic condition. Working under the direction of a referring licensed practitioner, the hypnotist teaches the client to create these positive changes through the use of motivational coaching and self-hypnosis combined with imagery and creative imagination related to a positive and healthy lifestyle. Published literature and personal experience will be used to support this hypothesis. 

Can A Professional Hypnotist Help A Diabetic Client?

Diabetes is not a standalone disease. There are many contributing factors that often worsen the symptoms and speed up the progression of diabetes. It is so serious that diabetes is considered to be a worldwide epidemic. Out of control diabetes can result in other illnesses such as blindness, kidney disease, impotence (Hastings, 2005), heart disease, stroke, amputations, nerve damage and death (NC Health Smart, June 2004).

          Sometimes I have clients that have been told by their medical doctor that they have Impaired Glucose Tolerance (IGT). This means that though not yet having full-blown diabetes, there are some problems with the processing of their sugar. Other than the medical team providing guidelines so as to avoid becoming diabetic, they generally must wait until the patient returns for treatment for diabetes. This is because, in spite of the suggested life style changes and guidelines, nothing changes for most of the patients. Major contributing factors to this situation are that people with IGT generally have these standard characteristics: overweight, stressed out, poor eating habits, low exercise levels, and lack of motivation for change (Hastings, More ways).

 Matters of the psychic are of primary concern when dealing with the diabetic condition. Factors such as fear, anxiety, and stress have great influence on the symptoms and progression of the illness. As earlier as the 17^th century emotional factors were recognized in diabetes “when Thomas Willis, describing the sweet taste of diabetic urine, said that the disease was due to ‘progressive sorrow’ (Kroger, 1963, p. 172).” This relationship of psychic factors and how they can affect or interfere with therapy or directly influence the disease is a long recognized reality by multiple investigators.

Hypnosis is particularly useful for diabetics because of the relaxation response that it induces. The control and management of stress is crucial in the effective treatment of diabetes. Stress negatively affects a person with diabetes in many ways:

As a diabetic’s stress levels increase, so does their blood sugar. This is due to the ‘fight-or-flight’ response that people experience as a result of negative stress. When a person enters this state of mind, their body releases chemicals known as ‘insulin-antagonists’. These chemicals temporarily block the action of insulin while simultaneously causing the release of stored sugar in the liver and muscles (Devin, 2005).

By definition a hypnotist is a stress management consultant and this is an important area of disease management where the professional hypnotist can benefit a client with diabetes.

When we get stressed, our body’s cortisol levels are elevated. High levels of cortisol, a hormone released by the adrenal cortex, cause high blood  sugar levels. With hypnotherapy and self-hypnosis, though, cortisol levels and blood glucose levels may decrease (Leighton, 2005, p. 2).

Much more can be done for the diabetic than just keeping his urine sugar-free by means of diet and insulin. An appreciation . . . as well as recognition of how to cope with current stresses, allows a wider scope for the physician in the treatment of this condition. In selected cases, the use of hypnotherapy can reduce the quantity of insulin needed to keep the urine sugar-free… (Kroger, 1963, pg. 172).

           Stress relief techniques work for the diabetic because of the use of imagery that is the foundation of mind-body-spirit medicine. In clinical and medical hypnosis imagery is the essential and activating element. The same holds true for guided imagery, relaxation therapy, meditation, creative imaging, progressive relaxation, and biofeedback.

Imagery is the thought process that invokes and uses the senses. These include vision, sound, smell, and taste, and the senses of movement, position, and touch. Virtually nothing exists in our experience that we do not image in some way, and those images can produce physiologic, biochemical, and immunologic changes in the body that affect health outcomes.

Imagery has been found beneficial in the treatment of eczema, acne, diabetes, breast cancer, arthritis, migraine and tension headaches, and severe burns.

Research strongly suggests that imagery is capable of altering specific immune parameters, hormonal responses, and immune cell migration. Further, imagery assessment tools have been used to assess treatment for cancer, spinal pain, and diabetes and have been proven highly accurate as predictors of treatment outcomes.

Published outcomes from research on mental imagery are almost uniformly positive and include significant reductions in pain and anxiety, length of hospital stays, pain medication use, and reported side effects (Freeman & Lewis, 2001, p. 265).

 The hypnotist makes use of the full range of imagery by including words, thoughts, and feelings that represent all five senses. This is much more than just seeing with the mind’s eye. It utilizes the full human capacity for internal control in a direct and powerful way and in this way differs from simple visualization techniques. Sometimes all a patient needs is some one-on-one hypnotic motivational coaching in order to make healthy life style changes such as: improving eating habits, losing weight, starting an exercise program, improving blood glucose self-monitoring habits, or reducing stress. However, in order for hypnotherapy to be effective a desire for change must be present. “People who go into hypnotherapy expecting miracles and who are not committed to change may be disappointed (Leighton, 2005, pg 2).”

         Proper exercise is most important in the management of diabetes because 95% of all persons with diabetes have Type 2 and since 90% of those persons are obese, the need for motivation is clear. Exercise contributes greatly to an individual’s sense of well being and lowers stress levels. And there is much documentation showing how many Type 2 diabetics, because of exercise and proper eating habits, have had significant weight reduction followed by complete symptom remission (Hastings, 2005).

          Motivation and the ability to make better food choices is an absolute necessity in the proper management of the diabetic condition. The harmful state of emotional affairs accompanying diabetes makes it difficult for a diabetic to do as instructed by the doctor. Because of the stress and emotional pain often associated with the disease, people often reach for whatever makes them feel better immediately. Often it is too much and the kind of food that is not good for a diabetic.

The rationalizations proffered for overeating are many. Some of these are: It runs in my family; it’s my glands; others eat twice as much as I do. However, the actual causal factors are hostility, anxiety, guilt, self-pity, self-punishment and depression. These are usually found in combination and are often repressed from awareness (Kroger, 1963, 174).

           The long-term consequences of uncontrollable eating can be devastating. Amputations are an all too common outcome as many are the result of indiscriminate and out of control eating habits. These are devastating events and just another one of the horrific many complications resulting from an improper diet. Yet, those with diabetes, who want too, can put away the denial and consciously manage their eating habits and their illness. “Though the use of hypnosis, people can actually change their inner motivations, to decrease their desire for unhealthy food, and change bad eating habits. At the same, time they will actually increase their desire for healthier foods, and develop better eating habits (Hastings, 1999).”

          Pain is another important, common element that must be dwelt with when working with pre-diabetics and diabetes. It is almost always overlooked because of the question of which came first—diabetes, pain, or depression.

Pain raises blood sugar levels. Also, pain can definitely engender inappropriate pain management (self-medicating) conduct.  This behavior may include over-eating and other activities that precipitate or aggravate diabetes.

n a recent study involving 993 patients at the Veterans Affairs Healthcare system in Michigan, Sarah Krein, PhD, RN, noticed one strong conclusion: chronic pain was a major limiting factor in the performance of self-care behaviors that are important for minimizing diabetes-related complications (Hastings, More Ways).

          Just as many people learn to live with depression, diabetic clients may also have learned to cope with their pain. And there maybe many who just get by while living with both. Therefore, it is important that pain management be considered when working with diabetes. Pain and depression go hand in hand while feeding off of each other. Pain can be managed effectively with hypnosis, thereby making a major difference in the daily life and long-term prognosis of client’s with diabetes (Hastings, More Ways)

          An area of potential personal embarrassment and feelings of personal inadequacy that can be aided with hypnosis is sexual dysfunction. Almost 60% of male diabetics must deal with impotence. Growing out this experience are two areas of concern: (1) Harmful and unneeded stress that may result between the diabetic and their partner. (2) The chance of a male diabetic taking a sexual enhancement medication that is potentially harmful (Hastings, 2005).

          As a tool for effectively managing sexual problems, hypnosis has been used for a long time. Almost 50 years ago, Erickson and Kubie (1941) provided us with the earliest known case of successful treatment of ISD with hypnosis. Hypnotic interventions with sexual dysfunctions (Araoz, 1980, 1982; Crasilneck, 1979, 1982; Hammond, 1984b, 1985c; Zilbergeld & Hammond, 1988) seem to hold considerable promise in sex therapy . . . (Hammond, 1990, pg. 350).

By learning self-hypnosis clients gain a sense of self-confidence, self-control and reduce stress.  Both mental and physical tension plus physical fatigue lower sexual performance and interest levels. The learned ability to change mental gears and focus on sensual involvement provides an opportunity for greater sexual activity. The use of imagery to increase sexual arousal and passion prior to sexual involvement is another advantage of self-hypnosis for diabetes.

One example of hypnosis helping people with diabetes to change their insulin requirements and sometimes eliminate them, is illustrated in a case study found in the book, "Mind-Body Therapy," by Ernest L. Rossi, PhD and David B. Cheek, M.D. "A 33 year-old diabetic woman was seen in the fourth month of her third pregnancy in consultation with two other physicians who felt that her pregnancy should be terminated because of severe toxemia and two serious episodes of diabetic come which had occurred in her second pregnancy."

Dr. Cheek then noted that: "With the hope of understanding her psychological reactions better, I talked with the patient and her husband about using hypnosis to help control pain and thus help control her insulin needs. Their interest and response was favorable. During a two-hour session, the patient was trained in achieving complete anesthesia of her abdomen. She was taught to awaken from hypnosis if a nurse or physician should enter her room in order that she might not give a dangerous impression of being in a diabetic coma. She was much impressed by her ability to produce anesthesia. On admission to the hospital she was taking 180 units of insulin a day, using 60 units of protamine zinc, and filling out her requirements with Regular insulin. The response to the surgery was remarkable. She maintained a normal temperature, pulse, and respiration after a total hysterectomy under spinal anesthesia. Her blood sugar never went over 117 mg. / 100 cc. although she was eating a regular hospital diet from the day of surgery. A 3-plus glycosuria on the day of operation dropped to zero on the second day. No insulin was used during the hospital stay. During the next 11 months, she used only an occasional dose of insulin during periods of emotional stress.” (Hasting, 1999).

         In conclusion, a properly trained professional hypnotist, working under the direction of a licensed practitioner, should be included as part of a diabetic’s health care team. As a motivator, a coach, a guide and a stress management consultant the hypnotist can be of great benefit to a person dealing with diabetes.

 References

Freeman, L.W., & Lawlis, G.F. (2001). Mosby's Complementary Alternative Medicine: A

Research-Based Approach. Mosby: St. Louis, MO.

Hammond, D.C. (PhD) (1990). Handbook of hypnotic suggestions and metaphors.

Norton & Company: New York

Hastings, C.D. (C.I., C.Ht.) (2005). Hypnosis: A new paradigm of healing for Diabetics

Retrieved August 8, 2005:

http://www.newconnexion.net/article/05-05/diabetes.html

Hastings, C.D. (hypnotist). More ways a hypnotist can responsibly help a person with

          diabetes. Retrieved August 8, 2005:

          http://www.mindbodyhypnosis.com/diabetes.html

Hasting, C.D. (1999). Hypnosis—more than watch waving—therapist uses hypnosis to

          achieve success. Retrieved August 8, 2005:

          http://www.diabeteshealth.com/read,1009,1676.html.

Kroger, W.S. (M.D.) (1963). Clinical and experimental hypnosis in medicine, dentistry

and  psychology. Philadelphia and Toronto: J. B. Lippincott Company.

Leighton, Mary (RN, BSN, CDE) (Winter 2005). Hypnotherapy—could it make the

difference for you. Diabetes News: Diabetes Education Center of the Midlands,

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North Carolina Health Smart (June 2004). The State of Member Health 2004: health trends and implications for plan members and North Carolina