FROM what we already know concerning the nature of hypnosis, it is obvious that no one method of producing the trance state will be universally successful. Although the general principles underlying each technique are the same, there are many variable factors which decide the method of choice for any particular case or circumstance.

For instance, one can hardly expect the technique of the stage with its glaring lights and highly emotional atmosphere to be suitable for the quiet of the consulting room. A highly nervous and often elderly patient is unlikely to respond to the domineering methods so often adopted on the stage in the way that a young, healthy adolescent in pursuit of an evening’s entertainment will do.

Although all patients seeking serious hypnosis ardently profess their desire to be cured, it is obvious to a skilled operator from their attitude, that many powerful and conflicting emotions are involved.
Some approach with great faith and hope, others are slightly sceptical, while a few are definitely antagonistic. Many have great belief in the power of hypnotism to cure them of their ills, especially if they know of actual cases, say, among friends or relatives -  who have benefited from the treatment. Others seek relief through hypnotism as a last desperate resort, all other treatments having failed. As a result they more than half expect failure again, and this frame of mind is not conducive to the best possible results. 

A few have no desire whatever to lose their symptoms and have merely agreed to try hypnotism to please their friends or relations. Secretly they resolve to resist the hypnotist, while proclaiming loudly their desire for cure, so that, if failure occurs, as it most likely will under these circumstances, they can proudly say, ‘Well, I did my best to get cured - I even tried hypnotism.’

It will he seen at once that the task of the medical man who specializes in hypnosis is infinitely harder than that of the so-called ‘Hypnotic geniuses’ of the stage. First of all the medical hypnotist cannot select his subjects, and must aim at inducing hypnosis in 100% of all patients who seek his aid. The stage hypnotist dismisses all those who fail to pass his tests, and so selects only the easiest and most susceptible subjects for his demonstration. 

Further, the volunteers are usually limited to healthy young people between the ages of eighteen and twenty-six. The first task of the medical man is to sum up the patient in order to decide on the best line of approach for his particular case. This is no easy matter, as patients and circumstances vary so greatly. No rule-of-thumb method will suffice, and only long experience can provide that nicety of judgment which is so necessary.

The process of hypnotism may, in a sense, truly be said to have begun the moment the patient first decides to seek treatment. Somehow he has been convinced that he has something to gain from hypnotism, and it is the hypnotist’s task to develop this attitude and so gain increased influence before even attempting to induce hypnosis.

To this purpose every effort is made to put the patient at ease: for no matter what the outward appearances may be, few patients approach their first session of hypnosis without some qualms. A natural, friendly, but not familiar manner enables the hypnotist while noting preliminary details, not only to establish confidence, but to observe characteristics of the patient. Those who are obviously nervous and apprehensive and sit fidgeting and twisting their fingers are going to need reassuring. ‘Know-it-all’ types of individuals who answer questions condescendingly with a superior 
self-satisfied smile are going to need deflating in one way or another.

Some of these patients can be highly irritating, but the hypnotist must keep control of the situation by maintaining an unruffled calm even in the face of deliberate rudeness. Prestige is very important to the hypnotist and on no account must he ‘lose face’ by giving way to temper.
The following case will illustrate the sort of attitude one is likely to meet in difficult patients. This particular young man was sent along by his doctor because he could not stop being rude to everybody. Needless to say, this involved him in considerable trouble.

He arrived half an hour late for the first appointment, but instead of apologizing simply announced belligerently, ‘I’m late.’ From his manner it was obvious that he wanted to pick a quarrel. All he received, however, was the calm reply: ‘Oh, it doesn’t matter. An hour was set aside for you, so you’ll still be able to have half an hour.’ He then announced in a truculent manner that if he were a ‘great Harley Street specialist’ he would have a much bigger suite of rooms to impress patients. He was informed quite calmly that patients came to see the hypnotist, not the rooms, and that they were more likely to be impressed by the result of treatment than by any large suite of rooms.
After a few more similar attempts he realized it was impossible to start an argument; and abandoning all efforts in this direction, soon proved to be an excellent subject.

The preliminaries over, it is as well to find out what the patients know about hypnotism and to reassure them on any points about which they may be doubtful. Usually their knowledge is very scanty, being derived either from sensational newspaper stories or the witnessing of a performance on the stage. When asked to describe their experiences, they will usually reply somewhat after this manner: ‘Oh, I saw a man put to sleep on the stage, and he was so deeply asleep he didn’t know what had happened even when the hypnotist stood on him and stuck pins into him.’
In such a case it is necessary to explain the difference between stage and medical hypnotism. Few people seem to notice that the stage hypnotist deliberately selects a few easy subjects from among the volunteers and dismisses the rest whom he knows would be difficult.

Patients often think that they should behave like the people they saw on the stage. This is all the more remarkable when questioning often reveals the fact that they themselves had volunteered but had failed in the selection tests. Nevertheless, they expect to perform as well as the selected subjects and look forward to being ‘completely unconscious’ while the hypnotist talks to their subconscious minds.

To such people it should be explained that a deep trance occurs only in a small proportion of people, especially at the first attempt. Further, that although they may go very deeply ‘asleep’ in the hypnotic sense, it is more likely that they will simply go into a light or medium stage which is quite sufficient for medical purposes. Further, they should be told that they will not be unconscious, but will hear the hypnotist speaking all the time.
It can be explained that they will simply go into a pleasant drowsy state like being half asleep and half awake. In this condition they will obey all suggestions of the hypnotist unless they object, and pay little or no attention to anything else.

It should be stressed that hypnosis is not ordinary sleep, but a state of mind in which suggestion can act more powerfully than in the waking state.
It helps if the hypnotist can demonstrate auto-hypnosis on himself, say by rendering his hand numb and driving a hat-pin through it. Patients are obviously impressed on the principle of ‘Physician, heal thyself’; besides which, this simple performance demonstrates that hypnosis is not sleep, nor is it unconsciousness.

As squeamish patients may be upset, it is as well to ask if they wish to see it before giving such a demonstration. If nervous, they should be reassured that they will not be subjected to such treatment.
This simple test helps to demonstrate to the patient the difference between ‘will-power’ and imagination. It is pointed out that no doubt they could force themselves to do this by will-power if the incentive were great enough but that, under these conditions, they would feel it. On the other hand, by using imagination and thinking strongly that the part was numb they would be able to perform the feat without pain. 

Patients always have the wrong idea that hypnosis is a matter of ‘will-power’ and, when they observe the powerful effects of auto-hypnosis, they are encouraged in the belief that imagination will be able to help them overcome their troubles.
On the principle of ‘practise What you preach’ all hypnotists should develop the power of self-hypnosis as much as possible: not merely because it is useful to demonstrate to patients, but for the greatly increased confidence and self-control which it gives. Patients who wish to be cured of alcoholism or excessive smoking are not likely to be impressed by a doctor whose breath betrays the fact that he indulges in drink and tobacco to excess himself.

The hypnotist must have the utmost confidence in himself and his ability to help the patient by inducing hypnosis. Any hesitancy or nervousness will betray itself in his manner or voice and patients, sensing this doubt in himself, rapidly lose confidence. This does not mean that the hypnotist must develop a bombastic domineering manner; but in a quietly confident way, he should make it quite plain that he is sure of himself and his ability to help the patient.

No extravagant claims should be made, but at the same time, no doubt or hesitation should be shown. If asked, ‘Do you think you will be able to hypnotize me, and will it do any good?’ he should reply something like this:
‘Certainly; all intelligent people can be hypnotized, and I am sure that hypnotism can help your condition.’ It would be fatal to a successful outcome to hesitate and say: ‘Well, I don’t know - perhaps I can and perhaps I can’t. I hope it will help, but I’m not sure'.

Many people have the fear that once ‘hypnotized’ it may be impossible to wake them up. They should be assured that there is never any difficulty about this, and that even if the hypnotist were suddenly incapacitated, their trance would simply turn into ordinary sleep from which they would awaken quite safely in a matter of minutes or hours.
Often it is necessary to assure patients that there is nothing ‘occult’ about hypnotism. It should be pointed out that, although hypnotism can explain many of the weird phenomena claimed as supernatural, such as automatic writing or crystal gazing, there is really nothing occult about it at all. 
Occasionally, intensely religious patients may fear that they ‘will lose their faith’ if they are hypnotized. One such patient was able to ‘go off’ quite happily when given a small crucifix to hold.

Patients often express the fear that they cannot be hypnotized because their ‘will-power’ is too strong, or their ‘brain is too active’. Such people do not realize that there are degrees of hypnotism, as we have seen. They think that they must be either deeply hypnotized or not at all. When told that practically everybody, except those frankly insane, can be hypnotized to one degree or another, and that the depth of hypnosis can be increased by repeated sessions, they gain the necessary confidence in their own ability.

It should be stressed that hypnotism has nothing to do with will-power, but depends upon a manipulation of the imagination. Secretly many people resist hypnosis because they think that to give in would show they were ‘weak willed’.
When this wrong impression is corrected there is usually no difficulty. With intensely nervous and apprehensive patients it may be better to devote the first session to teaching them simply to relax.

To the ‘know-it-all’ types it should be pointed out that hypnosis is a matter of co-operation and not a contest of wills or wits between the hypnotist and the patient. Therefore, there will be no hypnosis if they do not do their part.
Further, it should be emphasized that, if there is no hypnosis due to their lack of co-operation, then there will be no cure. When the onus is put upon them in this fashion there is usually no difficulty.