The benefits of hypnosis for people undergoing IVF
Introduction
We all know, whether it is through professional or personal experience, that having fertility problems can be really challenging. In many ways, going through fertility treatments like IVF has compounded the struggle and stress of infertility. IVF is a very time consuming, intense and demanding procedure and people put a lot of financial and emotional investment into it, and some believe that their happiness depends upon the successful outcome. Irrespective of the outcome, going through a cycle of IVF is likely to have a negative effect physically, emotionally and psychologically. The impact of which is likely to be magnified by treatment failure.
Medical interventions can certainly help to address and take care of the biological aspects of fertility, but without the necessary psychological and emotional support these treatments are somewhat incomplete. Following Rene Descartes proposition that the mind and body operate separately with no interconnectedness, the body became seen as a machine which could be mechanically fixed. Treatments such as IVF continue, in some ways, to propagate the myth that conception is purely a mechanical process. And yet we all know that the creation of life remains a mysterious and intriguing thing, and the answers probably can’t be found under a microscope.
An integrated approach to IVF, combining physical, mental and emotional interventions, seems more likely to produce positive results and help make the procedure much easier for people to deal with. Hypnosis is one of the most effective tools that I know of for helping the mind to support the body throughout IVF treatment, as well as to help people to cope better with the whole experience. In this article I would like to share some of what I know about hypnosis and how it can be used with people undergoing IVF. For those who are not familiar with hypnosis, I have included some information about what it is and its general applications in therapy. Finally, we will look at a case example which will demonstrate how hypnosis and mind-body approaches[1] were used with a woman who was undergoing her fourth and final round of IVF.
Hypnosis and hypnotherapy
‘Hypnosis is a peaceful, creative and productive state of inner absorption. It is a natural learning state that occurs from within. Hypnosis is a natural human ability, and a powerful tool for change.’
– Stephen Gilligan (Gilligan, 1997)
Unfortunately, hypnosis is largely misunderstood and still continues to carry a stigma from stage hypnosis. There is a lot of mystery surrounding this very natural state of consciousness and many people are still unsure as to what hypnosis really is.
Essentially, hypnosis is a trance state induced through focusing attention on any current internal or external sensory experience. Hypnotherapy is the art of utilising this state of absorption to facilitate inner change. Trance states can be accessed in a wide variety of ways, many of which occur spontaneously. A trance state can also occur when we voluntarily choose to focus our attention on something. Any activity which absorbs our attention will induce a trance state, whether it is reading, watching TV, making love or dancing.
As well as this state arising spontaneously and voluntarily, it can be induced when somebody else focuses our attention. This capacity stems from a primary survival need for us to be able to learn from others, be part of groups and absorb cultural norms. When our attention is guided by another in a compelling way we are likely to accept their suggestions (Griffin & Tyrrell, 2004, p. 62). This gives us the capacity to learn things from others as well as from our own experience.
During hypnotherapy people are often guided into a state of hypnosis as they listen to words that help them to focus their attention on the feelings of deepening relaxation. This helps to induce a pleasurable and comfortable therapeutic trance state which has the added benefit of relaxation. Hypnosis can be experienced to varying depths and is experienced differently from person to person. Whilst in a state of hypnosis we can be aware of what is going on around us, although we are likely to become so absorbed in our own inner experience that we choose to pay little attention to unnecessary distractions.
The hypnotic state is often characterised by a distorted experience of time. We experience perceived time as substantially longer or shorter than actual time. Most commonly we experience a long time in trance as seemingly quick. Similarly when we are enjoying an experience, time just seems to fly by. Other common phenomena and experiences of hypnosis include analgesia (partial loss of sensation), anaesthesia (total loss of sensation), catalepsy (automatic contraction and apparent paralysis of muscles) and dissociation (feeling separated from ones immediate ordinary sensory experience and environment). Whilst in this state we may be able to recall things more vividly and easily and are more likely to remember events with all our senses. This sometimes gives us the feeling that we are experiencing the event as if we were there right now. For this reason, imagined events can feel quite ‘real’.
Being in a state of hypnosis in many respects, is both a very ordinary and extraordinary experience, which is likely to feel familiar or similar to things we have experienced before. People who have experienced guided visualisation or other meditative states, describe it is being very similar in many ways.
The applications of hypnosis in therapy
Whilst just being in a hypnotic state can be healing, it is how we utilise it that can give rise to positive changes. The following summary outlines why this state is beneficial and the ways in which hypnosis can be used therapeutically.
- One of the major reasons that the state of hypnosis can itself be therapeutic is that when we enter trance by directing our attention on increasing comfort, the parasympathetic nervous system is activated, giving rise to the relaxation response. This response works in opposition to the ‘fight or flight’ response and counteracts the body’s physical and emotional response to stress allowing it to return to a calm balanced state. Simply being in the state of hypnosis will create physiological changes which reduce stress and its negative effects on health and wellbeing.
- Another added benefit of hypnotic relaxation, is that it reduces emotional arousal like anger or fear. During a state of high emotional arousal the brains cortical functions become limited. Relaxation reduces the arousal giving us access to our higher rational abilities. It is for this reason that we are more likely to gain perspective and reach new insight and understandings whilst in a hypnotic state.
- The hypnotic state allows us to communicate with or access our unconscious mind which enhances our ability to recall past experiences, access our inner wisdom and tap into our personal resources. This means that we can draw on each client’s unique history to help them receive more of what it is they need in current and future situations. For example, to help them build confidence or increase motivation.
- Since our higher cortical functions are activated and our unconscious resources are more readily available to us in a state of hypnosis, we are more easily able to find solutions and resolve problems.
- All of our habitual and automatic behaviours are stored in the unconscious. Hypnotherapy can be used to decondition habits and to create new automatic behaviours and responses. For example, this could be particularly useful to reduce an anxiety response in the case of a needle phobia.
- By integrating successful Cognitive Behavioural approaches with hypnosis, we can challenge beliefs and find new beliefs which will create healthier automatic responses to situations and events.
- During hypnosis our imagination and creative abilities are enhanced. We can use this vivid imagination to see ourselves thinking, feeling and behaving in the way we would like to in future situations. Using hypnosis for positive mental rehearsal can create a healthy mental and physiological response when that situation is encountered again in real life. This is particularly useful for future situations which previously provoked anxiety, fear, dread or concern. Positive mental rehearsal will improve our future responses as well as reduce the anxiety caused when we think about the event.
- Past disturbing or traumatic events that continue to carry an emotional charge for us can be resolved using hypnotherapy. These experiences can be integrated so that the necessary learning remains, but the emotional and physical arousal is reduced. Resolving and integrating these past experiences allows us to live without the negative impact of that event affecting our present lives.
- In a state of hypnosis, our inner senses become heightened and allow us to become more sensitive to our own subtle experiences. We can use this sensitivity to become more aware of our physical body and its messages to us. We know that there are many ways in which we can use the mind to create changes in the body. Guided visualisation is a well known approach to using the mind, and specifically the imagination, as a means to create physical change. And so, in the above mentioned ways we can use hypnosis to alleviate any physical conditions, illness or pain.
- One of the great strengths of hypnotherapy is that hypnosis is a tool that can be learnt. Once we have learnt to induce a state of hypnosis on our own, we can use this tool to benefit us on an ongoing basis. We can learn a variety of ways in which we can use hypnosis to re-enforce changes and continue to facilitate new positive learning. (Hugo, 2009)
Hypnosis and IVF
Whilst the applications of hypnosis are extensive and varied, there are four main ways in which we can use hypnosis to help people going through IVF. Firstly, clients can be taught how to achieve a deep state of relaxation using hypnosis which will help to significantly reduce levels of stress. Secondly, hypnosis can be used to ensure that they have access to the skills and inner resources needed to cope better and handle an unsuccessful outcome more easily. Thirdly, hypnosis can be used to help people prepare mentally, emotionally and physically for IVF. This preparation can range from positive lifestyle changes, changing limiting beliefs to eliminating a needle phobia. And lastly, hypnosis can help to increase the chances of a successful outcome.
According to a study presented to the European Society of Human Reproduction and Embryology conference in Berlin in July of 2004: hypnosis can effectively double the success of IVF treatments. The study was conducted by Professor Eliahu Levitas and his team at Soroka Hospital in Israel to determine if hypnosis could improve the success of the embryo transfers stage of IVF. The study of 185 woman found that 28% of the women who were hypnotized for the IVF treatment became pregnant, compared to 14% of the women in the control group. (Levitas, 2006) Professor Levitas studied the effects of hypnosis for the IVF treatment and embryo transfer only, because prior studies that demonstrated the stress of the procedure created small contractions of the uterus that prevented the successful implantation of the fertilized egg. The professor indicated that tranquilizers had been used in prior studies, but nothing worked as well as hypnosis. “Performing embryo transfer under hypnosis may significantly contribute to an increased clinical pregnancy rate,” Professor Levitas told the conference in Berlin.
Whilst this is just one study showing relatively small numbers, I think it certainly warrants consideration and further research. Many of the women, with whom I have worked, have used self hypnosis during embryo transfer and reported that overall they have felt much calmer, more relaxed and at ease with the experience. If only for this reason alone, every woman going through embryo transfer should be equipped with the aid of self hypnosis.
Case example
A few months ago, a young woman called Mary[2] came to see me for hypnotherapy because she was due to go for her fourth and final round of IVF treatment. She, like many others, had been diagnosed with unexplained infertility. Instead of giving up after trying naturally for 18 months, her and her husband decided to give IVF a go. After a year of unsuccessful fertility treatment she felt at an all time low. She spent some time telling me about what the last two and half years had been like for her and how it had left her feeling. She explained how trying to have a baby had become all consuming, and that without her attention the other areas of her life had begun to deteriorate. She had turned down work opportunities, social engagements, holidays and family gatherings all in an attempt to get pregnant or avoid the heartache of not being pregnant yet. She had changed her diet and entire lifestyle to include only things which she believed would help her to conceive. She spent hours every day on infertility chat rooms and seemed to know as much about infertility and medical treatments as a reproductive endocrinologist. Although her relationship with her husband was strong, he had finally drawn the line and said that he was only prepared to do one more cycle of IVF. He could see how much their attempts to get pregnant were affecting her, and he did not want the next 5 years of their life to be on hold while they continued trying.
Although terrified at the prospect of stopping, she knew that she could not go on like this for much longer. Her health and psychological wellbeing were suffering, and she felt she no longer had the energy to keep on struggling. Knowing that this was her last attempt at IVF, she decided to try hypnotherapy. She was hoping that hypnotherapy would help increase the chances of success, but also knew that she needed some help to cope with each stage of IVF, as well as the pregnancy test.
As a result of my work with people who have fertility problems I have developed a safe and effective therapeutic framework which has come to be known as the Fertile Body Method. For an overview of this approach please refer to Figure 1: The six stages of the Fertile Body Method.
Stage 1: Outcome
After hearing about Mary’s situation we began detailing what outcome she wanted from the hypnotherapy treatment. I used solution focused[3] questions get a detailed and specific goal for therapy. Through this process we identified significant markers along the path to this goal, as well as some of the resources she may need to get there.
Mary’s goal focused on wanting to feel ready mentally, emotionally and physically for the IVF treatment. We discussed in detail, what this would be like and how she would know she was prepared in the way she wanted to be. We identified some unhealthy beliefs that would need to change, as well as what she would need to be doing differently before and during this cycle. She then went on to describe how she would feel when all of this is happening. Mary knew she would need inner strength to be able to come to terms with the possibility that it may not work, and greater perspective so that she could see how her life could be happy without her own children.
Stage 2: Balance
Once the outcome for therapy was clear, we began by looking at how we could restore balance to Mary’s life. This stage in the process is vital, and really needs to precede all other therapeutic intervention. This stage ensures that general wellbeing is restored and that the client is in a stable and resourceful state before continuing to address more complicated issues.
During this second stage we did some work together to give the different areas of her life the attention they needed. We created mini-goals to identify what changes she would like to make to her relationship, social life, work, hobbies and lifestyle and used hypnosis to help her implement these changes in her life. This immediately broadened her narrow baby focus to include the rest of her life and allowed her to begin putting more energy and time into the things in her life which gave her a sense of satisfaction and pleasure. I also taught her self-hypnosis so that she could enjoy some time each day in deep relaxation.
After a couple of weeks Mary felt that she was well underway to having a more well rounded life, and was already noticing the benefits of having made these changes. Now in a more stable and resourceful state it became much easier for her to access her inner resources which we worked together to develop and build.
Stage 3: Resolve
Mary now felt ready to begin to address her fear of being childless and resolve some of the unhealthy beliefs she had about herself as an infertile woman. She believed she was a failure if she didn’t have a baby of her own, and that she had let everyone in her family down. She also believed that her life could not be worthwhile without children. All of these beliefs were contributing to her high levels of anxiety and preventing her from coming to terms with being childless.
With a combination of cognitive behavioural techniques and hypnosis, Mary was able to overcome her fear and begin to see how she was worthwhile irrespective of whether she had children or not. I also asked her to create a picture collage of how she would like her life to be like if she did not have children. During this process she began to think about what some of the benefits of not having children might be and was able to see how she could be happy without children. This brought her such a sense of relief and she explained that she felt as if a weight had been lifted.
Stage 4 & 5: Enhance and Prepare
I created a tailor made self hypnosis CD with specific guided visualisations designed to help enhance fertility. The CD contained visualisations for the different stages of IVF: stimulation, embryo transfer and implantation.
We spent our second last session together focusing on helping her to feel ready and prepared for the IVF treatment which was due to start within the next couple of weeks. I also used hypnosis to ‘install’ a self help tool called an anchor[4] which helped her to feel more in control throughout the treatment.
Stage 6: Support
Mary used the anchor and self hypnosis CD throughout her IVF treatment and booked her last appointment with me after she had heard the results of treatment. To her absolute disappoint, the IVF treatment failed. When I saw her for our session together I was so inspired by the courage and strength that she showed. Despite being very disappointed that the treatment had not worked, she felt she was able to handle it because she knew that it no longer meant the end of her world. She also told me that the treatment had gone really well and she had felt the best she had ever felt. She knew that she had done everything she could and it was now time for her and her husband to focus on building their life together. Because the outcome of the IVF had been unsuccessful the focus of the session was to support Mary through this time of grief and moving on. She came to see me after that for one more session to help support her to maintain some of the positive changes that she had made in her life and to continue to build a happy and fulfilling life for her and her husband.
When I received a phone call from Mary three months later to say that she had conceived naturally and was pregnant, I was shocked but not surprised. The work we had done together had helped Mary to make many changes to her life, and above all else had helped her to let go of the anxiety and fear that she had about being childless. How and why she conceived will forever remain a mystery. However the transformative journey that Mary undertook in an attempt to become a mother, will have a long lasting effect on her and her family’s future. It may even be that it was a very necessary part of her unique preparation for parenthood.
Conclusion
Hypnosis is a powerful state for facilitating emotional and physiological change, and if used in conjunction with effective counselling skills, could significantly benefit men and woman undergoing fertility treatment. The current success rates for IVF are relatively low (HFEA, 2008) and could potentially be improved through an integrated approach. I feel very passionate about the benefits of hypnotherapy becoming available to more people with fertility problems and would love to see it offered as a standard part of IVF treatment.
Bibliography
Dilts, R., & Judith, D. L. (2000). Encyclopedia of systemic NLP and NLP new coding. Scotts Valley: NLP University Press.
Domar, D. A. (2002). Conquering Infertility: Dr Alice Domar’s guide to enhancing fertility and coping with infertility. Viking Penguin.
Erickson, M., & Rossi, E. (1976). Two-Level Communication and the Microdynamics of Trance and Suggestion. The American Journal of Clinical Hypnosis , 1.
Gilligan, S. (1997). The Courage to Love: Principles and Practices of Self-relations Psychotherapy . W. W. Norton & Co.
Griffin, J., & Tyrrell, I. (2004). Human Gives: A new approach to emotional health and clear thinking. Great Britain: HG Publishing.
HFEA. (2008). The HFEA guide to Infertility. London.
Hugo, S. (2009). The Fertile Body Method: a practitioner’s manual. Crownhouse Publising.
Levitas, E. e. (2006). Impact of hypnosis during embryo transfer on the outcome of in vitro fertilization-embryo transfer: a case-control study. Fertility and Sterility , 85 (5), 1404-1408.
Rossi, E. L. (2002). The osychobiology of gene expression: Neuroscience and neurogenesis in hypnosis and the healing arts. New York: W.W Norton & Company Ltd.
Rossi, E. L., & Cheek, D. B. (1994). Mind-Body Therapy; ideodynamic healing in hypnosis. New York: Norton.
Schwartz, J. (2008). The mind-body fertility connection: The true pathway to conception. Woodbury: Llewellyn Publications.
Note: this article includes excerpts from ‘Hypnosis and fertility: how can hypnotherapy improve the IVF experience and increase the chances of success’ by Sjanie Hugo published in the Hypnotherapy Journal Nov 2008.
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Figure 1: The six stages of the Fertile Body Method |
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[1] ‘Mind-body approaches’ is a term I use to describe any psychological intervention which is intended to create physiological change. Hypnosis is just one of the many tools that can be used in this way. (Domar A. D, 2002)
[2] The name of this client has been changed to protect her identity
[3] Solution focused therapy (SFT) focuses on what clients want to achieve through therapy rather than on the problem that made them seek help. The specific steps involved in its practice, are attributed to husband and wife Steve de Shazer and Insoo Kim Berg and their team at the Brief Family Therapy Family Centre in Milwaukee, USA
[4] An anchor is a stimulus which initiates a conditioned response. Therapeutic anchors give people access to useful resources by anchoring a positive past experience. The resource state can be anchored to any cue which the client can conveniently and efficiently activate at the needed time such as squeezing the thumb and forefinger together. (Dilts & Judith, 2000)