This document discusses hypnosis from an evolutionary psychology perspective. It argues that hypnosis is an adaptive trait that provided benefits to individuals and groups throughout human evolution. Trance states facilitated group bonding, modulated pain and immune response, and increased healing. Rapport also had adaptive value by enhancing empathy and social learning. The document proposes hypnosis activates inner healing resources through the synergistic effects of rapport and trance. It views Milton Erickson's approach as implicitly evolutionary and recommends future work further integrate clinical hypnosis research with evolutionary theory and neuroscience.

1. AND HYPNOSIS AS
PSICOTHERAPY:
THE ERICKSONIAN APPROACH
FROM AN EVOLUTIONARY POINT
OF VIEW
Ambrogio Pennati *, MD, psychiatrist, private practice, Milano, Italy
pennati.ambrogio.md@fastwebnet.it
Giampiero Mosconi §, MD, psychologist, private practice, Milano, Italy
giampieromosconi@virgilio.it
Italian Medical Association for the Study of Hypnosis (AMISI, www.amisi.it),
§President and * Member of Board of Directors

2. Evolutionary Psychology and
Psychotherapy
 Evolutionary psychology seems to be a
euristically fertile approach to life sciences,
such as medicine, psychology, economics,
sociology. Although there is not (and we hope
that will never be) an evolutionary
psychotherapy, such point of view could offer
new perspectives in psychotherapy, as some
experiences in jungian and freudian
psychoanalisys, cognitive-behavior therapy,
systemic therapy suggest.

3. Evolutionary Psychology and
Hypnosis
 As a matter of fact, only pioneristic, short and
merely speculative papers about the
relationship between evolutionary psychology
and hypnosis are available. We think that
adopting the evolutionary perspective in the
study of hypnotic phenomena could generate
new research and new conceptualizations in
our field. We think that at the core of
Ericksonian work there is an implicit
evolutionary way of thinking, not fully
blossomed because of the zeitgeist in which
he operated.

4. A paradigmatic shift
Evolutionary psycvhology suggests that a shift from
the Standard Social Science Model (and its
corollary of human mind as blank slate) to the
Naturalistic Model could be useful in bypassing
most of the conceptual conundrums of
psychotherapy.
In our case this shift could bypass the “state or
process” issue of hypnosis.
The evolutionary approach identify the ability to
develop trance experience as one of the most
important adaptative module in the in the brain for
the individual, the group and the specie.

5. Definition of Trance
 We operatively define the trance as an Altered State
of Consciousness (ASoC) in which the following
phenomena can consensually occur in a statistically
significant percentages:
 Dissociation between executive and monitoring
function of the Self
 High frequency of ideodinamic behaviors
 Verbal and/or motor inhibition
 Extreme focusing of attention, internal or external
 Facilitation of autoreferential thinking
 Mnesic alterations
 Changes in quality and quantity of the time experience
 Changes in quality and quantity of perceptual
experience

6. The Adaptative Value of Trance
 Social value: increased group identity, discharge
among the group of peers of otherwise unacceptable
feelings, self-trascendence, facilitation of meme-
related complexes, facilitation of mimetic learning
 Individual value: self trascendence, modulation of
pain, modulation of immune system, modulation of
autonomic response, increased efficiency of fight or
flight response, increased efficiency of mating
strategies, increased chance of activation of internal
healing modules (see below)
 Biological value: increased probability of selection of
the fittest gene or meme by reshuffling of genetic and
memetic pool (ritual and/or orgiastic trance)

7. The Evolutionary Value of
Rapport
 The mirror neurons systems seems to play a
determinant role in the ability to develop empathic
relationships among humans. Such relationships
are essential for the survival struggle and
reproductive success of the individual and the
group, gene (kin) or meme related. Empathic
learning may be activated without awareness
(procedural), and therefore it could be more
efficient and resilient than the declarative learning,
which relies upon linguistic and eidetic structures
of information.
 We could define Altered States of Consciousness
(AsoC) inductors the multifaceted procedures that
homo sapiens utilized to achieve trance states.
Such inductors rely upon the empathic rapport.

8. Trance, Rapport, Hypnosis
From an historic point of view hypnosis could be
defined as the process of the complex,
bidirectional, fluctuacting interactions between
 ASoC inductors recognized by the western
scientific comunity as empirically validated and
useful in medicine and psychology , according
to the scientific paradigm of the zeitgeist, and
 The trance states obtained following such
induction procedures

9. Trance, Rapport, Hypnosis
Hypnosis
TranceRapport

10. Hypnosis and Psychotherapy
 Psychotherapy could be operationally defined as
every modality of helping people in coping with
stress, emotional problems, relational problems,
or problematic habits; such modalities share the
fact of being all treatment based on talking ot
another people and doing something together”
(RCPychiatrists).
 Hypnosis could be therapeutic because both the
induction procedure in sé (modeling, emotional
tuning, procedural learning, based on rapport, of
new behavioral or cognitive adaptative strategies)
and hypnotic trance (emotional release of
otherwise unacceptable feelings, activation on
internal healing modules, self-trascendence).

11. Hypnosis as synergicistic
empowerment of inner healing
resources
Hypnosis could be interpreted as the potentially
most powerful device to activate inner healing
resources thanks to
 Interpersonal power of rapport
 Intrapersonal power of trance
that synergically activated internal healer
modules.

12. Hypnosis and Ethiopatogenetical
Models of Illnesses
The majority of psychotherapeutic approaches tried to
develop etiopathogenetical models of disorders
coherent with their postulates, but all these models
lack of statistical and scientific validation. Hypnosis
too searched for a coherent model (neodissociative
theory), but also in this case empirical validation is
insufficient or absent.
Metaanalysises show that there is no evidence (ie,
directly linked to the model) of the superiority of a
theoretical model among the others, and that aspecific
variables are the key factors in the efficacy of
psychotherapies.
Therefore, every theoretical approach to psychotherapy
seems to be merely speculative.

13. Recent empirical data
 Data from clinical field suggest that
empatethical sharing of memes (beliefs,
values, social rituals, ideas about the cause of
the illness) with the clients can enhance the
response to different treatments.
 Since there are no evidences of superiority of
a model of psychotherapy among the others
we can suppose that building a memetic
rapport empathetically based is the best
operative option in psychotherapy.

14. The Ericksonian way
Nowadays we can think at Milton Erickson’s
work as a pionieristic, revolutionary way of
thinking and working based on implicit,
intuitive evolutionary approach to clinical
activity. Such approach is rooted in shamanic
traditions and overtly proposed by ME in his
look and style. ME optimized his skills with
anthropological and psychiatric studies,
looking for social and biological basis of trance
induction and trance states.

15. Which paradigm?
 The linear, cause-effect, newtonian, thre-
dimensions paradigm seems obsolete to help
us to understand hypnotic clinical phenomena
 The holistic way of thinking, based on the
complexity theory, seems more useful in
explaining the fuzzy nature of life sciences

16. Hypnosis in Psychotherapy and
Hypnosis as Psychotherapy
• Hypnosis in
psychotherapy (mainly
linguistic,
linear/newtonian
paradigm)
rapport
• Hypnosis as
psychotherapy (mainly
somatic,
complexity/holistic
paradigm)
trance

17. Hypnosis in Psychotherapy and
Hypnosis as Psychotherapy
 Hypnosis in psychotherapy could enhance the
effectiveness of different approaches through
elicitation of rapport modules; it is based on
empathic communication skills
 Hypnosis as psychotherapy could enhance
self-trascendence and inner healer modules
through activation of trance states

18. Hypnosis and Theory of Mind
Recent neurophysiological data suggest that the
ability to make inference on the mental state of
the others and to empathize with them is
linked to a decrease in activity of the cortex of
anterior cingulus; hypnotic induction seems to
generate the same effect. We can therefore
affirm that Hypnosis doesn’t need a theory of
mind, since it is Theory of Mind in Action.

19. Placebo, Hypnosis, Internal
Healer
As “internal healer” we can identify the
biochemical and neurophysiological modules
of placebo:
 increased opioid and dopaminergic activity
 reduction in anterior cingulate cortex activity
 modulation of immune system
 modulation of social neuroendocrine pathways

20. Hypnotic Psychotherapy
 Hypnotic psychotherapy can be defined as the
structural blend between hypnosis in
psychotherapy and hypnosis as
psychotherapy. It is based on
 Rapport
 Trance
 Theory of Mind conscious activation
In the context of the aspecific factors that
constitute the good clinical setting.

21. Suggestions for future work
 Integration of clinical and theoretical research
with the recent biochemical and
neuropshysiological (EEG, PET, f-NMR) data
 Integration of behavioral and emotive hypnotic
patterns in an evolutionary interpretative frame
 Integration of clinical practice language with
the traditional western and eastern healing
approaches to reconciliate different therapeutic
experiences
 Assumption of a new holistic paradigm of
health