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A battle is brewing over who can perform hypnotherapy, and who can’t. At stake: the careers of hypnotherapists — and the mental health of their clients  

By the time Rachel Blanchette turned to hypnotherapy for help, she’d been cutting herself for nearly a decade. The self-destructive compulsion started when Blanchette was 16. By her mid-20s, she wasn’t just embarrassed by it; she was sick of it — sick of avoiding relationships and situations that could expose her secret.

“I was at a point where I was stuck,” Blanchette says today. “As an adult, I felt I was dealing with a teenage problem. I wanted to grow up and move on with my life.”

She’d done talk therapy before, and it didn’t work. But in her desperation, Blanchette decided to give counseling another shot. An Internet search and a few phone calls led her to a Las Vegas marriage and family therapist she clicked with. The therapist listened to Blanchette’s story, and then told her she might benefit from hypnosis. Cutting, the therapist explained, is like an addiction. A long-term solution would require addressing more than just the behavior; she’d need to get to the root cause of the behavior — something hypnosis could help with — and work on that. Blanchette knew a little about hypnosis from an aunt who’d used it to quit smoking. “In my family, we used to tease her about it,” she says. “But she never picked up another cigarette.”

Support comes from

Blanchette decided to go for it. She had several months of sessions, in which the therapist used hypnosis in addition to other techniques (“It was just one tool in her toolbox,” Blanchette says). But she knew early on it was working. She recalls one early session, in particular: “While I was in the hypnotic state, I went back to childhood and forgave people I had problems with and even myself. … It was really powerful. I was finally able to move on. It felt like a miracle.”

That was five years ago, and Blanchette hasn’t cut herself since. This year, she got married and moved out of state.

Someone with similar issues might have trouble finding a hypnotherapist in Nevada now. That’s because the hypnotherapy done on Blanchette — performed by a marriage and family therapist — is illegal, at least according to the state’s Board of Psychology Examiners. Based on an obscure 2009 Nevada Supreme Court opinion, early this year the psychology board started sending cease and desist letters to a variety of professionals telling them, essentially, that unless they’re licensed psychologists, they’re not allowed to practice hypnotherapy.

“Basically, I’m unemployed, as are all of our graduates,” says Robert Bud James, who runs hypnotherapy training school New Vistas International in Reno. “That’s the severity of the impact. … My business partner, who’s a marriage and family therapist, used hypnotherapy at a pain clinic for four years. These are legitimate professionals who are helping people.”

As of this writing, the situation is in limbo. Attorneys representing unions for people who practice hypnotherapy have asked the psychology board to lift its cease and desist order. (The practice of biofeedback is also included in the ban, but has been the subject of less pushback by professionals.) The psych board, in turn, has asked the state’s attorney general to render her own interpretation of the law. As they await the AG’s opinion, expected to be delivered in November, a panoply of licensed and unlicensed professionals are holding their breath; from drug and alcohol counselors to sociologists, guidance counselors to life coaches, they believe their livelihoods — and the well-being of Nevadans like Blanchette — depend on what happens next.

 

You are (not) getting very sleepy

By the time you arrive for your first face-to-face appointment with hypnotherapist Kevin Cole, he’s already started working on you. Over the phone, he’s spent time getting to know you, helping you articulate your goals and making sure you’re ready for his service. So, when you finally do step into his small, warm office tucked in an out-of-the-way professional park on South Pecos, you have a pretty clear idea why you’re there.

Still, Cole doesn’t rush into things. He has you fill out an intake form that makes it clear that he doesn’t diagnose or treat illness and doesn’t prescribe medication. He carefully explains what hypnosis isn’t (sleeping, for instance, or doing things you won’t remember later) and what it is: a state so relaxed that your chatty, critical mind pipes down and lets your more suggestible mind open up. In this state, you’re receptive to changing well-established patterns, replacing negative habits with positives ones.

Cole explains how the process works and answers your questions. If you bring up the entertainers who make “volunteers” quack like a duck for audiences’ amusement, he assures you that unconscious triggers would jar you out of the hypnotic state should deeply held morals or ethics be violated. He takes pains to create a safe environment: You need to be able to relax, after all.

[Hear More: How can we fix the state’s mental health system? Hear a discussion on “KNPR’s State of Nevada.”]

Then, you begin. He may simply show you how to sit comfortably and breathe. If you’re there for help with something like weight-loss or smoking cessation, he may teach you techniques for neutralizing cravings. In a soothing, rhythmic voice, he lulls you into a trance. Once you’re there, he makes suggestions tailored to your intention. When he’s done, he gently talks you back into alertness — no abrupt clapping or gong-ringing. He gives you a few moments to take in what’s happened, then answers any questions, plans any necessary follow-up.

“Very seldom do I work with someone just once, but very seldom do I do as many as five,” Cole says. “I want to empower them, not get them to just talk about it all the time. I want to teach them practical life skills.”

A large body of research suggests hypnosis isn’t just the stuff of hippie communes and risqué Strip shows anymore. Studies indicate it’s effective in helping people with eating disorders, irritable bowel syndrome, pain management, test anxiety and other problems. Although there’s still a lot of research to be done about its long-term effectiveness, the greater health care community is gradually embracing it.

Along with mainstream acceptance has come a diverse and thriving industry. There are people like Cole who see themselves as offering a specific mental health support service — one meant to complement the work of licensed professionals, such as psychologists. In fact, psychologists often refer clients to hypnotists. Cole says such referrals have helped grow his business and are partly why he was so shocked to receive the psychology board’s cease and desist letter in July.

Here’s an excerpt:


“Please be advised that the practice of biofeedback/hypnosis is part of the practice of psychology as defined in NRS 641.025. Therefore it’s unlawful to engage in either activity unless and until you are licensed as a psychologist. … Please immediately cease practice and or advertising the above activities.”

 

The letter goes on to say that the board may get court orders against practitioners who don’t comply. Hypnotherapy represents 100 percent of Cole’s business. If he’s forced to stop practicing it, he says, he’ll have to return to San Diego, where he moved from in 2011, in order to pursue his livelihood unfettered. 

 

A niche service

Hypnotists like Cole aren’t the only ones who stand to be affected. There are others who use hypnotism, like Blanchette said about her own therapist, as one technique among many. Some, such as drug and alcohol counselors, marriage and family therapists (MFTs), and sociologists, are licensed professionals. Others, such as guidance counselors, life coaches and spiritual advisers, are unlicensed professionals. But hypnotherapy is a vital part of their overall practices. American Council of Hypnotist Examiners President John Butler says he has 25 practicing members in Nevada, but this may be only a fraction of the total number of people actually doing hypnotherapy in the state. Reno attorney Hal Taylor, who represents the Hypnotherapists Union Local 472 of the Office and Professional Employees International Union, estimates the number of people practicing hypnotherapy in Nevada to be in the “hundreds.”

But Butler and Taylor argue that the community’s commitment to ethics is more important than its size. Trainers drill into student hypnotherapists’ heads that they are not to pass themselves off as physicians (hence, Cole’s intake disclaimer). A hypnotist can offer his services to a mental health patient who’s under the care of a licensed professional or refer a client who exhibits signs of mental illness to a licensed professional, but he’s not — and is warned never to pretend to be — a psychologist. He’s a hypnotist, with his own specific skill set and expectations.

“One thing we see, for instance, is test anxiety,” says New Vista’s Bud James. “That’s something we can work with, very simply by helping the client walk through the mental exercise — like a basketball player, who can close his eyes and mentally shoot hoops. We can have the individual mentally take the test. You repeat it enough times and it becomes a new learned behavior. … Now, let’s say we saw them a few times and it didn’t help. They have a deeper-seated issue. They should see a professional, who can do whatever they do to find the roots of that anxiety and deal with it.”

The ethics message being taught at schools like James’ seems to have gotten through to practitioners. Both Butler and Taylor said they’re aware of no complaints or legal actions against their members in Nevada.

So, if licensed professionals rely on hypnotists to provide a niche service, and if hypnotists aren’t hurting anybody, then why is the psychology board going after them?

 

Mind the money

Nobody involved seems to think the psychology board is making a financially motivated move, apart from a few angry individuals venting on NV Hypno and Biofeedback Pros, a Yahoo group created to discuss the situation. The community’s leaders say they think that practicing psychologists don’t really want to “own” hypnotherapy, because it’s below their pay grade.

Then why the threatening cease and desist letters? The psychology board declined requests for an interview and answered all factual questions with a blanket “No comment.” The attorney general’s office also declined to comment, citing ongoing legal action.

This litigation, the hypnotherapy community believes, is where the trouble started. One morning in March 2005, at Jack and Terry Mannion Middle School in Clark County, a teacher named Roger Phillips got into an altercation with some students. As he was going out one of the school’s doors, a group of kids tried to go in. Phillips told them they weren’t allowed in yet, but they blocked the door and shoved each other to get past him. A boy named Eric Webb pushed a friend into Phillips.

What happened next, according to court documents, depends on who you ask. In Phillips’ version, he sternly takes Webb to task (and to the principal’s office); in Webb’s version, the teacher inappropriately lays hands on the child, traumatizing him.

In any case, Webb ended up being examined by a doctor and getting treatment from a physical therapist and a licensed drug and alcohol counselor named David Hopper. Hopper saw Webb for five months in 2005 and, among other things, performed biofeedback on him (in this treatment, the practitioner attaches sensors to the patient as a means of gauging and helping him control nervous-system reactions to stimuli). His total bill was $5,700.

In September, Webb’s parent and guardian sued the school district and Phillips. An arbitrator in the case awarded the plaintiffs fees to cover their medical and physical therapy expenses — but not the biofeedback. The arbitrator deemed Hopper’s services unnecessary and unreasonable, because he was not qualified to perform them and his credentials were not adequate to qualify him as a psychologist. In other words, the school district didn’t owe the family money, the arbitrator said, because the family had sought psychological services (specifically, biofeedback) from someone who’s not a licensed psychologist. The Webbs appealed, but in October 2009, the Nevada Supreme Court agreed with the arbitrator’s original conclusion: no reimbursement for Hopper’s biofeedback sessions.

The complex case turns on Nevada Revised Statute 641.025, which defines the practice of psychology as a practice that “includes, without limitation, such specialized areas as” psychological testing, counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback and several others. But does that “includes” mean that only psychologists can do these things?

Not according to leaders of the movement that has coalesced to fight the psychology board’s cease and desist action. Taylor and James attended the board’s Aug. 5 meeting, along with other members of the hypnotherapy community, who made their case during public comments. Following the meeting, Taylor wrote a lengthy brief outlining the Local 472’s concerns and demands. “That these ‘specialized areas of competence’ are available to psychologists does not mean that they may only be used by psychologists,” he wrote. Butler joined Taylor in asking the board to open a discussion that would resolve the conflict and, in the meantime, to immediately withdraw its cease and desist orders, “which have caused such distress to Nevadan hypnotherapists and their clients.”

The board replied that it would make a decision after receiving the attorney general’s opinion on NRS 641.025. Deputy Attorney General Sarah Bradley is working on the case and is expected to report at the psychology board’s Nov. 7 meeting. But the elephant is still in the room: Why did the psychology board act now on a case that the Nevada Supreme Court decided four years ago?

Those from the hypnotherapy community can only speculate. But the minutes from the board’s August meeting contain a clue. Item 15 reads in part: “The board is currently in the middle of an ongoing court case involving an individual who practices biofeedback without being a licensed psychologist. The case against this individual brought up raising concerns of other’s [sic] possible harmful practice of hypnosis and biofeedback in Nevada without regulation. Many individuals expressed concerns with NRS 641.025 … stating that they could no longer practice hypnosis and biofeedback unless licensed as psychologists.”

The case in question is the psychology board’s district court complaint against Hopper for “injunctive relief.” It is the board’s attempt to stop Hopper from practicing what it calls psychology without a license.

 

Of one mind

One irony of the situation is that the Webb’s lawsuit turns on the practice of biofeedback, and hypnotherapists got caught up in it by association. But James says it hasn’t pitted one faction against the other; on the contrary, it’s banded practitioners of alternative therapies together.

In September, Butler, James and a Minden, Nev., hypnotherapist named Nancy Epstein met up at an American Council of Hypnotist Examiners conference in Pasadena, Calif. They planned a unified strategy for getting through the impasse. They began calling legislators and government officials to see what they could do. Along the way, they learned that the deputy attorney general was on track to finish her opinion in time for the November meeting, and that her office wouldn’t enforce the cease and desist letters in the meantime. This meant members who’d put their practices on hold were now free to go about their business — at least for a couple months. A collective cheer went up in the Yahoo group, with hypnotherapists from around the state thanking the individuals who had agitated on their behalf.

Unlike the psychology board’s decision, the newfound unity of biofeedback and hypnotherapy practitioners can’t be undone. And it’s a weapon they intend to wield going forward.

“We want the attorney general to determine that the psychology board has overstepped its bounds and prevent them from doing it again,” James says. “From that point, the next thing I’d like to see, honestly, is this fence mended. We’re an excellent adjunct to the psychology community, and they need to realize that.” 

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