One of the simplest and best-known methods is that of fixed gazing coupled with verbal suggestion. The patient is asked to gaze steadily at some bright object which is held slightly above eye level so that the eyes are looking upwards. He is instructed to imagine he can feel his eyelids getting tired and heavy. As the eyes begin to blink and the lids get heavier and more tired, suggestions of approaching closure are made.

In the majority of people the lids soon get tired and close down easily, remaining firmly closed although they may quiver for a time. The hypnotist may assist this by pressing lightly on the lids.
As the eyes close the patient may give a slight sigh, as though abandoning all effort, and the breathing may change, becoming a little slower.
As a general rule all voluntary movement ceases and the patient is content to sit quiet and motionless for perhaps half an hour or more.

This ability to sit perfectly still without fidgeting over a long period of time, is a definite sign of hypnosis, for nobody can do this in the ordinary waking state. Patients will often state that they felt that their face was itching but that they could not be bothered moving. This unnatural lassitude and lack of desire to change their position is characteristic of hypnosis.

An experienced operator soon learns to judge whether the patient is hypnotized or not without resorting to the well-known tests. These tests are definite challenges and may often fail even with very good subjects. One of these tests best known to the lay public is the supposed inability of the hypnotized person to open the eyes. This is often the case and, as we have seen, it may occur even in the waking state when eye closure is used as a test of susceptibility. Nevertheless, there are some people who can resist this challenge and open their eyes, although they may be quite deeply hypnotized.

One such patient, for instance, was able to go into quite a deep trance during which she developed anaesthesia, so that she felt no pain when a pin was passed through the skin of her hand. Further, she was able to develop rigid catalepsy of the whole body, and could support the weight of the hypnotist sitting on her while she was stretched between two chairs. In spite of this she was always able to open the eyes when challenged to do so. On the other hand, many people are unable to open their eyes, but cannot develop any other phenomena.

Another test is to suggest that the arm is going rigid and inform the patient that it is so stiff that he will be unable to bend it. This, too, will often succeed, but may fail in some cases.
While a successful outcome of such tests helps to increase the patient’s susceptibility and so paves the way for even deeper hypnosis and more striking phenomena, a failure, which is always possible, will shake the patient’s confidence. If a test fails the patient is only too apt to think that hypnosis will fail also. In this way many patients have been deprived of benefits from hypnosis - which they could have otherwise obtained.

In such cases the hypnotist, either because of inexperience or a desire to show his ‘power’, has insisted on challenges which they have been able to overcome. For instance, a patient who has stuttered badly for many years came along with the story that a certain lay hypnotist had been unable to hypnotize him even after several sessions. Enquiry revealed that the patient had, in fact, been hypnotized to a light degree, but that he had been able to resist successfully all the challenges of the hypnotist.
As a result, he considered that he had not been hypnotized and therefore could derive no benefit.
It was pointed out that hypnosis depended upon co-operation, and that if he determined to resist, then ‘nobody could hypnotize him. Further, he would have the doubtful satisfaction of keeping his stutter as a reward for his efforts in resisting hypnosis. A parallel was drawn between his case and that of the man who successfully resisted the dentist by refusing to open his mouth, and so kept his toothache.

When it was explained that hypnotized subjects could sometimes resist challenges and that great benefit could result from even light hypnosis, he readily agreed to co-operate. As a result he became quite a good subject, and soon lost his stutter. Although able to resist most challenges he could nevertheless develop anaesthesia.

The experienced operator soon learns to judge the depth of trance from appearances without rashly challenging the patient. When reasonably certain that a challenge will succeed, and if it is felt to be necessary for any particular purpose, then it can be introduced in a casual fashion. For instance, it may be stated in the course of other suggestions for deepening the trance that the arm is feeling so tired that the patient cannot be bothered moving it. 
If the patient does not even try, it can be confidently assumed that the suggestions are working, for this reaction is not what one would expect in the waking state. On the other hand, if the patient does move the hand or arm, no great harm is done as there was no direct challenge.
Suggestions can be continued and the patient assured that the arm will gradually become more and more tired. 
This technique can be applied to most of the tests and is better than the crude direct challenge.

In this way the depth of trance can be gradually increased and the appearance of the various phenomena suggested. The hypnotist should always strive to obtain the patient’s co-operation and to let him think that he is participating in an interesting experiment, which indeed he is.
A few patients are so good that they can reach the stage of somnambulism during the first session; but the medical hypnotist, in contrast to the stage performer, is unlikely to meet many of these.
In general, it is best to be satisfied with a light to medium hypnosis at the first session. If necessary, then the depth of hypnosis can be increased at each succeeding attempt, until the patient reaches the maximum of which he is capable, but in general light hypnosis is sufficient.

Care should be taken after each test to restore the parts to normal. For instance, if rigidity of the arm is suggested and obtained, then it should be remembered to remove this before waking the patient.
Failure to attend to these details may easily set up a severe neurosis. Amateur hypnotists and stage performers, who may forget to countermand suggestions in the excitement of the performance, may cause serious mental trouble. This is all the more likely because stage hypnotists deal with extremely susceptible subjects in whom they often induce various hallucinations. They are unable to give individual attention to each subject and may easily forget to remove suggestions. As a result, such subjects may suffer con-siderable mental harm.

The medical hypnotist should remember that the trance demands the closest possible attention to detail. Every care must be taken to see that the patient does not awaken with suggestions present which it is not desired that he should obey.

After curative suggestions have been given, the patient may be prepared for waking from the trance. A post-hypnotic suggestion should always be given that at the next session the patient will go into hypnosis quickly and easily. For some reason, patients nearly always fear that they may not wake up, but actually there is no danger of this whatsoever. Usually, it is sufficient to give some simple instructions or a signal for waking. For instance, the hypnotist may say: ‘When I count up to seven you will wake up,’ or ‘When I count three and snap my fingers you will be wide awake.’
Occasionally a patient is met who dislikes waking because the trance state is so pleasant. In the rare case of the patient who refuses to wake up the hypnotist can tell him to rest as long as he likes and then wake when he desires. If left to himself, the patient will always wake quite safely, as the trance state turns into ordinary sleep.

It is interesting to note the reactions of the patient on awakening from hypnosis. Usually there is a slight start, and if the trance has been sufficiently deep there may be partial if not complete loss of memory for events in the trance. In this case the patient will be tremendously impressed. On the other hand, if only a light to medium trance has been achieved the patient is likely to express his disappointment, saying, ‘But, Doctor, I wasn’t asleep, I heard everything you said.’ Patients rarely fail to say this, in spite of the fact that they have been told beforehand that hypnosis is not sleep, and that they must hear everything the hypnotist says.

Nevertheless, they are often surprised at the results. One professional man who had developed ‘writer’s cramp’ expressed his desire to try hypnosis. Only a very light hypnosis was achieved at the first session and, on waking, the patient expressed his disappointment at his failure to achieve hypnosis. When assured that he had been lightly hypnotized, he said, ‘Oh no, I couldn’t have been - I could hear you all the time!’ He stated that he was certain he felt no different. When invited to write he expressed his disbelief in his ability to do so; but this turned into amazed incredulity as he found his pen flowing smoothly over the paper and his ‘writer’s cramp’ a thing of the past.

Experienced workers in medical hypnosis realize that therapeutic results do not depend upon depth of trance; and it is important that patients also should realize that a deep trance is not necessary for cure.
It will be observed that the method of inducing the trance which has just been described requires the patient to gaze steadily at a bright object.
In some cases the patient is unable to do this; and in these circumstances it is better to employ another very simple method. 

The patient simply closes the eyes and breathes calmly and peacefully while the hypnotist gives suggestions of relaxation. This may take a little longer but as the suggestions take hold, the patient, who may have been restless, becomes calm and relaxed and soon sinks into a hypnotic state. The onset of this is marked by complete relaxation and inhibition of all voluntary movement.

Still another method is that of direct gazing. Here the patient is asked to look steadily into the eyes of the hypnotist. As he does so, suggestions are made that his eyes are getting tired; and often, in a very short time, the patient closes the eyes and hypnosis has been induced.

Another method employs a counting technique, and the patient opens and shuts the eyes as the hypnotist counts. Instead of counting a metronome may be used and the patient instructed to blink the eyes in time to the instrument.

One simple method is to place the hand gently but firmly on the patient’s head and instruct him to close the eyes, but to think strongly of the hypnotist’s hand while keeping the eyes turned up and imagining he can see it. In many cases this method will succeed where others have failed.

All these methods and dozens of others depend on the same general principles. In all the co-operation of the patient is required, and is obtained either voluntarily or in some cases by a trick.

This leads to the question, ‘Can a person be hypnotized against his will?’ As we have seen, hypnosis depends upon the imagination rather than the will-power; so that, given a sufficiently skilled operator and the right circumstances, it is possible that a person may be tricked into hypnosis.
For instance: it is sometimes possible to change ordinary sleep into hypnosis by simply resting the hands on the head and making suggestions. Again, hypnosis may be induced under the pretence of teaching the subject to relax. The subject is simply told that relaxation will do him good and, as the appropriate suggestions are given, he may easily go into hypnosis.

In my opinion it is rarely desirable to employ these methods, as the patient is bound to realize what has happened and is entitled, very naturally, to be annoyed.

The method of giving suggestions after changing ordinary sleep into hypnosis may be useful in the case of children. Responsible parents may be instructed in the method and given simple but detailed directions and suggestions to use. In this way they can give their children treatment at home and so reinforce the suggestions of the hypnotist.

There remains the method of inducing hypnosis following the injection of a drug. An intravenous injection is given, the object being to render the subject drowsy and suggestible without going to sleep. As patients vary in their reaction to drugs it is very difficult to control the depth of hypnosis and many subjects pass into sleep.
Further, there may be some unpleasant reactions and patients need some time to sleep off the effects. Obviously, this drug-induced artificial state cannot be as good as the naturally induced hypnosis where the brain remains clear and is capable of thinking and absorbing curative suggestions.

Occasionally an extremely nervous or anxious patient may benefit from a small dose of some mild sedative which will enable him to concentrate his mind and co-operate with the hypnotist.
Once hypnosis has been achieved, however, further doses of sedative can be avoided and the patient trained to achieve a deeper trance naturally.

Psychiatrists with little practical knowledge of real hypnosis naturally favour the injection method because it is quick and easy. Results, however, show that the naturally induced hypnosis is far superior in every way. 

The following report from the Evening Standard, concerning a man who had lost his memory, illustrates the general unreliability of these drug-induced states. The so-called ‘truth drug’ is identical with that used by psychiatrists in their efforts to induce what may be called artificial hypnosis.

‘...Patient 11278 was given an injection of the “truth drug”, pentothal, and cross-examined by a psychiatrist. But little information of any value was obtained...’

The hypnotist must be able to give his whole attention to the patient, and so-called ‘group treatment’ is highly undesirable. The real cause of what might be identical symptoms is unlikely to be the same in any two patients. Insomnia, for instance, may be due to domestic or financial worry in one patient or fear of illness in another. Unless the real cause is found and treated, the condition will relapse, or other symptoms develop. Mass produced methods such as hypnotic gramophone records for treating symptoms are not advised.