Risks in Meditation, Guided Imagery, Relaxation and Hypnosis

📖 What’s This Paper About?

This paper explores the often-overlooked risks associated with meditation, guided imagery, relaxation techniques, and hypnosis. While these practices offer potential for transformation and growth, they also involve deliberately guiding participants into altered states of consciousness that can sometimes lead to complications and adverse effects.

Why This Matters

Many meditation and mindfulness instructors lack adequate training about potential complications. The author draws from personal experiences where practitioners encountered serious psychological difficulties during retreats and guided sessions, revealing how even well-intentioned guidance can trigger traumatic memories, dissociative states, and temporary psychosis in vulnerable individuals.

• Many practitioners undergo minimal training about potential risks
• Altered states of consciousness can destabilize reality testing
• Suggestions during guided practices may have unintended psychological effects
• Traumatic memories can spontaneously emerge during meditation

Top 5 Takeaways

2. Trauma Reactivation

Meditation and related practices can unexpectedly trigger vivid traumatic memories. The author describes how participants in a death meditation retreat experienced spontaneous trauma flashbacks that required immediate intervention, as instructors were unprepared to handle these emergent psychological crises.

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The Bigger Picture

This paper challenges the widespread notion that meditation and similar practices are universally beneficial and risk-free. By highlighting the hypnotic elements inherent in all guided consciousness-altering practices, the author argues for better preparation, screening, and training of facilitators. The field requires a more nuanced approach that acknowledges both the transformative potential and the legitimate risks of these increasingly popular practices.

Final Thought

Every tool that can heal also carries potential to harm. Professional ethics demand we understand both the mechanisms and limitations of the consciousness-altering techniques we employ with others.

RISKS IN MEDITATION, GUIDED IMAGERY, RELAXATION AND HYPNOSIS

Nachi Alon

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Psycho-Dharma School of Buddhist Psychology

Keywords: meditation, altered states, trauma, therapist-patient relationships, mindfulness, guided imagery, hypnosis

Introduction

Thirty-two years ago, at the beginning of my Buddhist journey, I participated in a course at a Tibetan monastery in Kathmandu where we practiced death meditation, which was a standard part of the course. During this meditation, intense memories from my military service unexpectedly surfaced with extreme vividness and without any prior warning. Fortunately, I had encountered these memories before and knew how to handle them. Had these memories emerged for the first time there, they likely would have triggered a crisis. My teachers, both Tibetan and Western, did not know how to handle such situations. In that guided meditation, other students also experienced traumatic crises. I appointed myself as a temporary therapist and assisted them in ways I’ll describe later. All felt they were in severe crises, and without the help they received from me, it’s doubtful they would have easily recovered.

At the end of the course, I offered to conduct a one-day workshop on the topics appearing in this article. While Buddhism was indeed their expertise, I said, I feared this expertise was not sufficiently aware of potential complications. During the workshop, all the teachers identified problems and complications they had encountered, and gained new understanding of phenomena they previously hadn’t understood in their students, which had sometimes led to students leaving.

Twenty years later, I participated in intensive days focused on compassion in Tibetan Buddhism as a student, led by a Western teacher. The group was diverse and most participants had no previous meditation experience. At the beginning of the first training day, the teacher chose to guide a meditation called tong-len (giving and taking): The student imagines helping a loved one who is suffering physically: “… to do this, breathe in the suffering and torment of your loved one… these appear as black soot entering your body and gradually creating a darkening deposit inside the lungs or near the heart… into the space that opens up in the sufferer, transfer-send energy, light, and compassion that fills you… gradually the suffering transfers to you and solidifies internally, and the light passes from you to the sufferer…” Several students visibly responded with distress to this too-concrete exercise. Others became anxious about the idea of the soot forming into a dangerous solid mass, and that they would lose their energy when transferring it to the sufferer. Some decided to leave the training. No one spoke with them or tried to help with the training crisis.

This premature training, which with appropriate guidance inspires great inspiration and cultivates compassion, caused unnecessary distress, and some may have been harmed by it.

I have encountered many cases where well-meaning therapists and doctors said things that led to distress, fears, and even depression, without being able to understand what in their manner of speaking caused these reactions. I have seen many cases where people were treated by “therapists” or “spiritual teachers” in ways that caused psychological damage. The Goel Ratzon affair, for example, exposed the ability of people to influence others through sophisticated, binding, and harmful communication techniques. The advertising and sales world is a field where interested parties using sophisticated communication means lead us to behaviors that sometimes harm us while benefiting them.

My aim in this article is to familiarize therapists and facilitators with the main consciousness processes in meditation and its close relatives—guided imagery, relaxation, and hypnosis; to present the possible complications in guidance that isn’t sufficiently aware; and to suggest ways of addressing them. In the field of hypnosis, things are relatively simple because the law establishes a detailed training program. But in meditation, especially in the era of mindfulness, few are familiar with the potential for harm. Unfortunately, this potential for harm is not sufficiently learned during instructor training. The same applies to guided imagery, relaxation, and similar tools.

1. Factors Determining Whether Processes Will Be Beneficial or Harmful

Meditation, mistakenly perceived as training suitable for everyone and every subject, receives universal praise in our time. The same applies to its distant relatives: “guided imagery,” “relaxation” in its various forms, and focused methods such as NLP and “focusing,” all of which have significant hypnotic elements. Each of these fields has great potential for development and liberation, but also potential for complications and even harm.

Hypnotic literature describes these topics well in hypnosis, but unfortunately, this literature is not sufficiently familiar to those who don’t practice hypnosis and don’t understand the hypnotic foundations in other practices.

1. The therapist’s/facilitator’s motivation: First and foremost, the therapist’s or facilitator’s motivation is examined: Does the therapist act for the benefit of the client, or to fulfill his own interests and desires? These interests can be psychological, such as feeling grandiose following the admiration and respect of students and patients, or tangible, such as benefits like money and sexuality, resulting from the dependence the patient creates with the therapist. An example is stage hypnotists who use hypnotized subjects to impress the audience and convince them they possess supernatural powers; or “spiritual teachers” of the exploitative kind who turn their students into servants, financiers, or partners in forced sex.

2. The therapist’s/facilitator’s professionalism: Is the therapist trained to understand the specific patient with his capabilities and complexities, and to adapt the therapy process to help his personality and needs? Is he trained in identifying problems and dealing with them? Does he master the means of communication, especially suggestions, and is he attentive enough to ensure the suggestions are appropriate for the patient and the plan, and their nature is positive? (Negative suggestions are very common even among therapists, just as they are common among doctors, and there is a lack of expertise in this vital area.)

3. The therapist’s and patient’s personalities and psychological risks present in their personalities: Is each of their reality testing intact? Is the patient free from a tendency toward over-dependency? Are there hidden depression, psychotic potential, or history of unidentified traumas in the patient’s life? As for the therapist, does he suffer from excessive self-evaluation, does he need admiration, control, or power, is truth an important value in his life, does he have honest self-reflection, and so forth.

2. The Field Common to Hypnosis, Meditation, Guided Imagery and Their Relatives: Deliberate Guidance to Other States of Consciousness

Meditation, guided imagery, relaxation, and hypnosis are not separate fields. These are different aspects of the same field, where one person (“the facilitator,” “therapist,” “hypnotist,” etc.), assists another person, through verbal and non-verbal language including suggestions, to transition to states of consciousness (Altered states of consciousness) that differ from the everyday state of consciousness.

What distinguishes this field, as opposed to states of consciousness appearing spontaneously or following the use of consciousness-altering substances, is that the transition from the normal state of consciousness to another mental state is done through directed communication. In later stages of training, learners can put themselves into such states through self-instructions. There are people who discovered these abilities in themselves from a very young age. For example, there are children (usually defined as “dreamers” or “floaters”) who put themselves in class into a state disconnected from reality by focusing on one point on the desk and sinking into daydreams for a long time. At the end of the class, they don’t know what happened in it and can’t define where they were.

Characteristics of the transition to other states of consciousness:

a. Consciousness gradually distances itself from its habitual data processing, aimed at understanding reality (“reality testing”) and problem-solving, toward a different mode of data processing, based on experience, emotions, and bodily sensations. Regular data processing is based on quasi-scientific logical processes: assumptions, facts and conclusions, inferences, analytical, sequential (step by step) processing, and acceptance of the reality of normal time and space, based on everyday language, using among other things relatively abstract concepts. Experiential data processing, on the other hand, is based on processes outside of logic, such as imagery and metaphors. It is holistic rather than analytical, concrete rather than abstract, does not develop sequentially but combines different experiences simultaneously, can create connections outside the norm such as “seeing sounds” or “hearing colors,” and its time and space boundaries can change: not “clock time” but “mental time,” not the familiar geographical space but psychological space. The language is not scientific language but the language of dreams. In this concrete reality, mental events requiring abstraction, such as humor, dissipate and are not active. In such a state, a patient can take a joke quite literally: for instance, taking an expression like “he did it in his pants” as a concrete description rather than a figure of speech. In the transition to experiential data processing, there is potential for transformation, as claimed by various therapeutic approaches, because in these realms the transformations are deeper than those occurring in the realms of logic.

b. This combination of suggestions, relaxation, and imagination gradually leads from normal reality perception to a perception of reality based on the senses, emotion, imagination, and experience. In this state of consciousness, intellectual logic and with it intellectual control are suspended, and the willingness to accept other perceptions increases, perceptions whose power lies in imagery, not analysis. In hypnotic terms, the subject’s suggestibility, meaning their ability and willingness to respond uncritically to suggestions, increases significantly – whether they are deliberate and positive suggestions or unintentional and negative statements.

c. For the learner to be willing to give up their normal reality testing, entrust to the therapist/facilitator the role of representing and expressing reality, and willingly enter the internal reality the facilitator led them to, they need a great deal of trust in the therapist, their professionalism, their motivation, and their values. If the therapist/facilitator does not live up to the trust placed in them, this is almost a recipe for failures and even failures with potential for harm.

d. The language of guidance, or: how do we transition from normal reality testing to the different state of consciousness: The guidance from the everyday pole to the experiential pole is done through verbal and non-verbal language. The deliberate use of language to guide to another state of consciousness includes, among other things, expanding the use of metaphors, and the languages of emotion, senses, and experience, emphasis on the present (as opposed to the past and future languages more common in the logical pole), and in suggestions.

“But,” meditation instructors will say, “what do suggestions have to do with meditation? In meditation, there are no suggestions at all! All we do is guide the learners in their inner work. Suggestions belong to the work of hypnotists, not our work.”

They are mistaken: we cannot help but give suggestions, even in the most everyday conversation. “Suggestion” literally means “proposal”: the speaker suggests his way of looking at a topic. Every statement of ours is a suggestion for contemplation, and its purpose is to bring our conversational partners to adopt this suggestion. Behind every sentence of ours stand explicit and implicit assumptions, and the sentence conveys them, explicitly or implicitly. Thus, for example, behind the simple question “Excuse me, do you know what time it is?” hides a sort of instruction: “Look at your watch and tell me the time.” The apparent question is not a request for information but an indirect instruction for action.

e. The cornerstone of all guidance: Suggestion

The concept of suggestion is critical for understanding guidance processes. In the Oxford dictionary, it is defined as: “A proposal; hint; planting a belief or impulse to action by means of hint.” In this way, they differ from direct instruction. This is the difference between “Help me lift the chair!” (direct instruction) and “Would you be willing to help me lift the chair?” (indirect hint).

Suggestions are frequently forms of quasi-logical speech, formulated as a recommendation, proposal, request, etc., designed to bring about a change in thinking, feeling, or action, without explicitly stating that this is their purpose.

Let’s analyze a typical section of guidance in meditation training. The guidance is taken from Jon Kabat-Zinn’s book, who brought mindfulness training to the world, and it is used in countless frameworks for mindfulness training. I will present the main text in bold letters, and point out in italicized letters the meanings and suggestions hidden in it, as poetry researchers do when analyzing the implicit statements within it.

First the full text:

“…Imagine the most beautiful mountain you know… Notice how solid it is, how grounded, how beautiful… Sit and breathe with the image of this specific mountain… Try to internalize the mountain into your body, so that your body sitting here, and the mountain in your mind’s eye, become one… Feel in your body the sense of uplifting spirit… the quality of the mountain rising as an axis. …Allow yourself to be a breathing mountain, quiet, motionless, being completely what you are – beyond words and thoughts, a centered presence, rooted, steady…”

Now let’s break down the text into its components:

“…Imagine the most beautiful mountain you know…”

The implicit text:

• You as a group and I as a facilitator are in different positions: I have the knowledge and authority to guide, your role is to respond to my guidance.

• The guidance is ostensibly for all of you, but each of you will translate it to your personal experience according to your experience. You move from “together” to “separate.”

• Move from normal reality testing (for which the appropriate instruction would be “think”) to the experiential-emotional world (“imagine”).

“…Notice how solid it is, how grounded, how beautiful…”

• The mountain (imagined) is now described as if it is completely real and standing before the learners’ eyes, existing here and now (“how solid it is”). The transition from past tense to present tense, and the transition from abstract to physical characteristics, enables the solidification of the mountain and encourages tangible “seeing.”

• Alongside the “objective” characteristics (“solid”, “grounded”) there is a subjective dimension (“beautiful”). Attention is directed both at the mountain as an object and at the internal response to it.

• You and I are encountering this mountain together (we see together how solid it is).

“…Sit and breathe with the image of this specific mountain…”

• Connection between elements that are not logically connected (breathe with the image of the mountain).

• Suggestive connection: there is an internal connection between the task of imagining the mountain and breathing.

• Use of the double meaning of the word “image”: “picture” and also “the act of imagining”. Deliberate ambiguity.

• Implicit prediction: as long as you breathe, the image will be present.

• Implicit instruction to focus on one image: “the image of this specific mountain.”

• Creating the impression of specific guidance while in practice the speech is general: each of the participants has “this specific mountain” of their own.

• Instruction for split attention: focus on the image and at the same time on breathing. The persistence of the split between the image and breathing will lead to a “split” experience, which promotes transition to other states of consciousness (“dissociation”).

“…Try to internalize the mountain into your body, so that your body sitting here, and the mountain in your mind’s eye, become one…”

• “Internalizing the mountain into the body” is a statement outside of normal logic, blurring the normal picture of the world (where the mountain is large and the body is small) and encouraging the continuation of abandoning everyday logic (what is the meaning of “the body and the mountain will be one”?).

• The expression “your body sitting here” separates “you” from “your body”. These separations (dissociation) deepen the distancing from the everyday experience, where the body and the self are one unit.

• New separation: between “you” and “the mountain in your mind’s eye”.

• “The body sitting here and the mountain in your mind’s eye will become one”: a renewed connection, which doesn’t belong to the everyday experience: after the self and the body were separated, a renewed connection is made between “the body” and “the mountain in your mind’s eye.”

“…Feel in your body the sense of uplifting spirit… the quality of the mountain rising as an axis.”

• Hint that the process leads to spiritual upliftment, presented as a fact and not as a possibility.

• Completion of the unification of the mountain and the body: “Feel this in your body.”

• The quality attributed to the mountain is “rising as an axis.” This is a selective presentation of the mountain, presented as a fact.

“…Allow yourself to be a breathing mountain, quiet, motionless, being completely what you are…”

• Blurring the boundary between imagination and reality: the text leaves the mountain as an image and moves to describing it as a fact.

• “Breathing mountain” is a connection outside of normal logic.

• Illusion of control: it is in your power to be a breathing mountain if only you allow yourself.

• Transition from the connection between the body and the mountain to a connection “between you” and the mountain. This creates a new temporary identity.

• Connection beyond normal logic between “being a mountain” and “being completely what you are”. The metaphor “being a mountain” has turned into a real identity: “being completely what you are”.

“…being completely what you are – beyond words and thoughts, a centered presence, rooted, steady…”

• “What you are” is not exhausted in the realm of words and thoughts. These are only partial expressions of what you are.”

• Diminishing the importance of words and thoughts compared to “presence beyond them.”

• “What you are” is “presence”: an ambiguous expression that is not definable, belonging more to the experiential pole than to the logical pole.

• “Centered presence, rooted, steady…”: a series of ambiguous and subjective metaphors.

Every word in this text is calculated to enhance the chance that the listener will move from normal reality testing to the metaphorical, semi-dreamlike world, where the normal conceptual boundaries blurred and other connections were formed. There is a gradual but rapid process that begins with “see in your mind’s eye a mountain” and ends with “you are a mountain and that is completely who you are in truth.”

Such suggestions are embedded in every guidance for meditation, just as they are embedded in standard yoga guidance “breathe into the painful place,” and just as they appear in the advertising world such as “Pandor doors – we can see you didn’t compromise” (compromise is weakness; purchasing the doors is evidence of your strength as a person).

To summarize: suggestion is a foundational fact in every form of communication, and we cannot help but use it. Usually we are not aware of the suggestions passing between us and others, but we are influenced by them and influence through them. Understanding these mechanisms allows for making deliberate use that can help, and to the same extent can harm (see the series of suggestions Iago passes to Othello, transferring Othello beyond his senses and bringing him to destroy his life and Desdemona’s life).

What phenomena can occur in spontaneous meditation or under the facilitator’s guidance

In addition to increased suggestibility, various psycho-physical phenomena often appear, either spontaneously or inspired by the therapist’s suggestions (“the classic hypnotic phenomena”). These phenomena include, among others:

1. Changes in body sensations and body image, such as feelings of great heaviness or great lightness, disappearance of body sensation or detachment from it, changes in the sensation of body size.

2. Changes in sensations, such as disappearance of pain sensations (anesthesia, analgesia).

3. Changes in muscle operation, such as extreme rigidity (“catalepsy”) or extreme relaxation.

4. Changes in sensory function, in the range between visualization (vivid imagery) and hallucination (hallucination). Similar phenomena can occur in all senses, such as the ability to feel the presence of a scent that isn’t in “reality”.

5. Changes in memory, such as super-recall (“hyper-mnesia”) of events that were seemingly forgotten, or forgetting (“amnesia”) of events that were previously available. Sometimes, traumatic history can appear intentionally or unexpectedly with experiential intensity and even as hallucination.

6. Changes in thinking, such as adopting non-logical logic (“trance logic”).

7. Changes in the sense of identity, such as age regression to past periods to the point of returning to childlike behavior and thinking (regression in time) or “return to the future” to such an extent that it feels as if it is actually happening now. Sometimes the sense of identity disappears completely and is replaced by an oceanic feeling of merging with the entire universe.

8. Emotional changes, ranging from emotional detachment, through intensification of painful emotions, anxiety or crying attacks, to significant intensification of emotions such as love.

These phenomena can appear on their own, separately or in interaction with other phenomena, or in response to the facilitator’s instructions (“See yourself on a riverbank… This is the river of consciousness… See the movement of the water…”). They can be very surprising and sometimes threatening, for both sides. Their very occurrence can advance a beneficial therapeutic process that inspires trust, but they can also cause complications and loss of essential trust. They can add validity to the patient’s belief that the depth of the experience proves the great power of the therapy, or their belief in the therapist’s magical power, or encourage a demonic image. They can deepen the therapeutic relationship significantly, to the point of reaching the hypnotic “rapport” where the patient is attentive to the therapist, and to them alone. They can arouse curiosity and willingness to continue, or lead to vigorous avoidance of the entire process.

It is clear that when the facilitator is not familiar with these possible developments and is not prepared for them, they may react in ways that are not appropriate and thereby influence in a way that will inhibit the helpful process and even worsen the learner’s condition.

It is very important to know that these phenomena can occur in a deep and extensive manner regardless of the quality and sophistication of the instructions: the ability to transition to another state of consciousness is primarily the learner’s ability, not the facilitator’s. Studies measuring the ability to enter hypnosis (“hypnotizability” or “suggestibility”) show that this ability is normally distributed: about 10% of the population will enter deep states, including these phenomena, even when the guidance is standard and unsophisticated.

3. Complications and risks in meditation, guided imagery, relaxation and hypnosis

a. “Simple” complications: There are learners for whom the exit from the state and return to the everyday state of consciousness is difficult for them, and they appear as if they haven’t fully exited: they need more relaxed exit time. When the facilitator doesn’t notice the difficulty, they may continue with the guidance in a way that complicates the exit. Similar complications occur when a group begins to engage in charged topics immediately after meditation, and its members criticize, mock or joke, without noticing that there are participants who are still immersed in various phenomena of meditation.

b. Complications from changes in reality testing: We’ve seen that in hypnotic/meditative processes, logical reality testing makes way for experiential-emotional-sensory reality. The patient/learner temporarily suspends reality reading and entrusts it to the facilitator: the suggestions become the description of the patient’s reality, whose eyes are closed and whose consciousness has been directed to realms that are not in immediate reality. For those whose reality testing is relatively intact, the suspension does not create a problem: we all suspend our normal reality testing for a while, for example when watching an engrossing movie. But, for those whose reality testing is already fragile, the very hypnotic/meditative state can destabilize further, and even push for a temporary collapse of normal reality testing. Thus, for example, a person who tends to a suspicious worldview, attributing hidden intentions to people or a constant feeling of looming disaster, can in the meditative state reach an extremity of these tendencies to the point of reaching a genuinely paranoid state. Similarly, a person who is in covert depression, with feelings of worthlessness, hopelessness and distrust, can reach, just from staying in the different state of consciousness, overt depression.

Things are even more problematic for those who are on the border of dysfunctional reality testing, such as those who are in transition from a depressive state to a manic state, or those whose excessive use of consciousness-altering substances has undermined their normal reality testing: further, “meditative” undermining of reality testing may lead to a psychotic state. Also, people who have undergone traumatic states that are seemingly inactive can experience in these processes a renewed return, of a very realistic nature, of the traumatic events, to the point of eruption of an overt post-traumatic state.

Another vulnerable group is of people who are not accustomed to looking inward at their psyche, and action, not contemplation, is their main channel. For these people, the very prolonged stay in a state without action is difficult and attention turning inward, can arouse anxiety, with a tendency to escape – sometimes at any cost – from the state.

In addition to these main risks, in therapeutic or meditative group work, participants who have not been properly instructed can add difficulties: if they do not properly understand the characteristics of the meditative state, they can deepen the difficulties of someone who is already struggling to exit. For example, if they joke about the state of a guide who is in post-meditation difficulty, or if they immediately move after meditation to talk about difficulties and problems of daily life, they can trigger severe anxiety in someone who is still in meditation, without understanding the situation.

My experience as a hypnotist and meditation teacher shows that such malfunctions, especially of the severe kind such as collapse of reality testing, are very rare. The more common malfunctions are difficulty exiting the state, and the appearance of traumatic memories. The rarer malfunctions are deepening of overt or covert depression, deepening of suspicious thoughts and persecutory thoughts.

c. Complications due to ambiguous suggestions: A friend of mine was hospitalized in a cardiac intensive care unit after what appeared to be a severe heart attack. He was released after a short time, and within a short time sank into depression that lasted for weeks. He and those around him did not understand the reason for the depression, especially after successful treatment. In an attempt to understand this, I suggested that we revisit the main events in a hypnotic process. When he returned to the intensive care unit room, my friend responded with immense anxiety: “I’m going to die within a short time,” he said. He could “hear” unclear voices, with parts of sentences standing out: “He’s gone”, “He’s about to die”; “We’ve finished our job”. “Notify the office to contact the family”, “We can stop trying”. His wife, who arrived at the intensive care unit some time after the attack, filled in the missing details: when he was in intensive care, there was indeed an emergency procedure with another patient in an adjacent room. The things my friend reconstructed were indeed close in spirit to what she heard in the commotion of treating the adjacent room. My friend, who was disoriented following the attack and treatment (and therefore his reality testing was weak), picked up these things and was convinced, in the confused state in which he was, that the things were being said about him! This inattentive conversation about another patient was perceived in his suggestible and foggy state as a statement about him. Now the depression was completely understandable: these sentences became a negative suggestion, saying: “You are about to die, we cannot help.” These random suggestions were absorbed as “truth,” while the encouraging statements were not recorded in consciousness at all.

Another patient of mine, an intelligent and efficient man, sought help for pain treatment from a healer who was employed by the company where he worked. The healer would massage him and while doing so would chat “half to himself.” During the treatment that continued, the patient sank into depression, and was convinced that he would never get out of his situation, that he would never find a satisfactory relationship and that his health was in danger. After reading a book about hypnosis, he began to think that perhaps the healer had applied hypnosis during the work with him. The reconstruction of the healer’s actions was surprising: in the conversation before the treatment, the healer asked “Where did you eat today? At home?” and remarked “He who eats alone dies alone.” In another conversation, the healer remarked, when they were talking about social connections: “He who ignores society, society ignores him. He who betrays society, society will betray him.” Note the double meaning of the word “society”: Is the healer talking about human society or about the employing company? Is he talking about social relationships or about employment relationships? In the second meaning, his words are a clear threat “on behalf of the company.” Ambiguity, double meanings and different levels of communication are among the characteristics of suggestion.

4. Ways therapists/facilitators cope with the appearance of complications

The responsibility resting on the therapist/facilitator: When phenomena such as those described above occur during meditation/hypnosis, or if complications appear in varying levels of severity, from difficulty waking up to a psychotic event, the therapist/facilitator has an absolute responsibility to do everything possible to return the situation to its previous state without delay. These events occurred in connection to the guidance, and there is no reason to view them as “mental phenomena of the patient.” The very definition of work as “meditation” or “hypnosis” is enough to place this responsibility on the facilitator: these very words contain suggestions that increase the likelihood that unexpected phenomena will appear. The therapist must not continue to act as if nothing happened, must not say to himself and to others that “things will work out” or that they occurred “without connection to meditation” or that “it’s yours!”.

The therapist/facilitator’s responsibility includes:

1) Before developing the facilitator role:

It is essential that as a condition for starting guidance, the facilitator receives appropriate training: there are many facilitators whose training did not include the knowledge shared here, and therefore is insufficient. It is the responsibility of the facilitator and whoever trained them to ensure the assimilation of the knowledge shared here, just as it is the responsibility of sports instructors to master the tools of first aid and emergency situations. Without the knowledge above, the fact that they have many years of experience in meditation – twenty years with the best teachers – does not constitute sufficient training for guiding meditation, and does not provide any guarantee of appropriate guidance!

2) Familiarity with the students and trainees before starting hypnotic/meditative work:

The therapist should study their students-patients well, to get an impression of their strengths and vulnerable points. It is important to receive a history of past crises. Formal completion of a form on the absence of psychiatric background is not enough and cannot replace more thorough familiarity. If the facilitator identifies vulnerable students, it is possible to work with them using bodily tools such as Tai Chi, which do not require directing all attention inward. The facilitator’s responsibility is both for each and every one of the learners and for the group as a group, and it is incumbent upon them to address all these dimensions throughout the training.

3) During the guidance:

The facilitator should monitor each one of the practitioners, to recognize their typical responses, and identify in advance a tendency for complications. This familiarity will help to choose the nature of training appropriate for the specific learner and for the whole group. From here stems gradual work, from the easy to the difficult, and avoidance of premature entry into practices with threatening potential. Especially one should be cautious with advanced tools, such as the Tibetan tong-len or meditation on death: these require gradual training and extended preparation, and premature activation of them can endanger students. Also, there is importance to proper conclusion of the process, ensuring that everyone has “returned” from the internal world to the present. If there is a gap between the facilitator’s impression and the assurance of the learner that “everything is fine,” the facilitator will not give up on additional steps to conclude the process, even if the learner objects to this or underestimates the issue.

4) If a complication has appeared:

The therapist should devote themselves totally to support and work with the complication, even if this involves allocating additional time, follow-up calls as required, staying in contact with the patient’s family, availability and even special trips.

Among other things, the facilitator will provide information about the phenomena and their meanings, and adopt a normalizing stance, which will counter a pathological view. They will also provide a positive interpretation, such as: “The appearance of traumatic memories will enable appropriate work to free yourself from them, whether with my help or through professionals.” Or: “I didn’t intend for this to happen, and indeed I was surprised; but there is great value in the fact that the things appeared, because this will allow us to understand them and free ourselves from them.”

Other relevant information can be in statements such as: “I understand that in states of distress your consciousness tends to disconnect and go to other places, or to leave the body to an observation point from outside and so on. This is natural and understandable, but perhaps now it will be possible to find other ways of responding whose prices will not be so high.”

The appearance of traumatic memories is one of the only events in therapy where the therapist should insist that the patient not flee from them, a common behavior among victims. They will say: “These memories have always created distress and were therefore repressed outside of consciousness, if we let them go – as you request – we will perpetuate them. This time we will look at them directly to free ourselves from them, even if it hurts. Today you are capable of this and will benefit. I will be with you all the necessary time.”

Request and acceptance of professional support and guidance from people experienced in such work, and from people close to the learner. Mobilization of support for the interim period of recovery and self-return of the learner.

If the therapist needs to devote themselves to more intensive work with one learner, they should entrust the attention to the whole group to an additional experienced facilitator.

In extreme cases – calling for immediate intervention agents, from emergency medical services to psychiatric hospitalization.

Explanation, accompaniment and support for the entire group of trainees/patients, monitoring their responses and identifying difficulties that have appeared in them.

The key actions the wise facilitator will take include, among others: Providing information and explanation to the learner and the group about the hypnotic phenomena and their normality and non-pathology.

5) After the end of the complication:

A debriefing that will help understand what happened, both with the learner and with the group. It is essential that the therapist be honest and brave enough to admit a mistake or an omission, if there was one. It is especially important that the facilitator avoid psychological evasions harmful such as “let’s talk about you and not about me: it doesn’t matter what I did, what matters is what happened to you.”

It is also important that the facilitator discuss the matters with their peer group and/or with their supervisors, in order to learn for the future and to direct the attention of colleagues to a difficulty that was not sufficiently recognized.

Summary

In conclusion, in order for us to engage professionally and responsibly with the tools entrusted to us as therapists, facilitators, trainers and consultants, we must understand these tools and their effects. In guiding meditation, guided imagery, relaxation and similar tools, we use language in a sophisticated way to lead to far-reaching cognitive, physical and behavioral changes. Every tool has potential for harm, growing as the tool becomes more sophisticated. If we do not understand the nature and principles of these tools, we can cause complications, and sometimes even real damage. Professional and human responsibility requires understanding the tools and their effects, and using them wisely.

References

This is informational, not medical advice.

Sources

Sources

1. Nachi Alon, clinical psychologist since 1973. Works in hypnosis as a therapist and instructor since 1976. Works in meditation in the Buddhist world. Among the founders and teachers of the School of Buddhist Psychology Psycho-Dharma.

2. Abramovitz, Dr. Eitan, (2013). Hypnosis and Hypnotherapy – A Guide for Therapists. Makor-Iyun Books.

3. Bonshtein, Dr. Udi (2014). Hypnosis: The Mind's Way to Create the Body. Tel Aviv: University of Haifa Press and "Yedioth Books".

4. The concept of suggestion is critical to understanding the processes of guidance. In the Oxford dictionary it is defined as: "Proposal; hint; planting a belief or impulse to action by means of hint" (i.e., by indirect means – N.A.). We will deal with this in detail in section 3.