Hypnotic Suggestions to Deter Suicide: Exploring James R. Hodge, M.D.'s Approach

Ever heard of Hypnotic Suggestions to Deter Suicide? It's not the first line of defense, but with rising suicide rates, it's worth a deeper look.

In Australia, 8.6 Australians die by suicide daily, more than double the road toll, with 75% being men (ABS, 2022). Suicide is the leading cause of death for Australians aged 15 to 44 (AIHW, 2022a).

In the US, the 2022 suicide rate was 14.21 per 100,000, the highest on record, with males 3.85 times more at risk than females. In the UK, the rate is 10.5 per 100,000, with males at 16.1 per 100,000 compared to females at 5.3 per 100,000. Scotland reported 13.9 per 100,000, and in Ireland, socioeconomic factors have significantly raised suicide rates (ONS, BMJ, Wikipedia).

Dr. James R. Hodge, Patient reactions like;

"I was getting all my pills ready to take them, but somehow I felt that I just had to call you," or "I was all ready to get in the car and go away to kill myself, but I felt I had to call you first". Show the potential power of this approach.

For those experiencing crisis or suicidal thoughts, it is crucial to seek immediate help. In Australia, you can contact Lifeline on 13 11 14, and in other countries, please reach out to your local emergency services.

These statistics underscore the need for continued research and interventions. Exploring the work of Dr. James R. Hodge and his approach using hypnotic suggestions to deter suicide could offer valuable insights and potentially lifesaving strategies.

Hypnotic Techniques for Suicide Prevention

Hypnosis has been debated in its application for depressed patients. Some hypnotherapists argue that it should be used cautiously, if at all, particularly in cases of severe depression or manic-depressive illness (Terman, 1980; Waxman, 1978; Brown & Fromm, 1986). The concern lies in the potential exacerbation of depression through the uncovering of emotion-laden material. However, when employed by experienced therapists and with patients who are depressed but not severely so, hypnosis can facilitate the rapid uncovering of significant etiologic factors.

Dr. James R. Hodge (1972) found that suggestions to deter suicide have proven effective. He noted,

"Patients accept these suggestions quite easily, almost as if they do not believe them. They may or may not recall the suggestions before, during, or after a suicidal impulse; and they are frequently perplexed or even angry that something will happen to prevent their carrying out their suicidal attempts or that they will feel a need to contact me before carrying out such an attempt."

Examples of patient reactions include statements like, "I was getting all my pills ready to take them, but somehow I felt that I just had to call you," or "I was all ready to get in the car and go away to kill myself, but I felt I had to call you first."

Suggestive hypnosis carries a significantly lower risk of adverse effects compared to intense uncovering techniques or methods such as age progression, which might lead to greater feelings of hopelessness if the patient envisions a negative future. Hodge's approach, particularly when part of a comprehensive treatment plan involving medication and cognitive behavior therapy, has shown positive benefits with minimal risk. His guidelines for these suggestions are direct, which is necessary in these critical situations.

Rationale

Most suicidal impulses are temporary and often brief, especially when the underlying problem is identified, and the patient can discuss their issues or interrupt their suicidal thoughts. Hypnosis can offer a temporary deterrent effect on suicidal impulses, providing the patient with an alternative to immediate action. The main premises for these hypnotic suggestions are:

  1. Temporary Deterrence: Hypnosis should only provide a temporary deterrent effect on suicidal impulses. Long-term resolution should be achieved through psychotherapy, addressing the psychodynamics of the patient's suicidal tendencies.

  2. Avoid Permanent Confrontation: Direct and permanent challenges to prevent suicide are likely to fail. The implication of a challenge and control ("cannot ever") may lead the patient to test the effectiveness of the hypnotic suggestions, potentially overcoming them.

  3. Opportunity for Intervention: A temporary deterrent can be enough to prevent a suicide attempt, giving the psychiatrist a chance to work with the patient and consider hospitalization if necessary. Discussion and analysis within the trance can be effective, and if not, it facilitates easier patient protection and hospitalization arrangements.

  4. Realistic Alternatives: Providing the patient with a realistic, logical, and semi-compulsory alternative to suicide, such as contacting the psychiatrist, can be effective.

Suggestions

In addressing suicidal thoughts and impulses, the following suggestions had been implemented:

Initial Suggestion: "In the future, though you may have some suicidal thoughts and feelings and impulses, you will not be able to carry out an actual suicide attempt until you have discussed it with me, in advance, and in my office. I do not know how you will prevent yourself from carrying out the suicidal impulse, but you will find a way. Do you understand?"

Additional Commitment: "Now, one other thing. I want you to agree with me that you will enter a trance at any time I insist on it even if you do not want to at that time. Will you agree to that?"

Patients typically agree, but if they do not, further explanation and reassurance are provided until they consent.

Alternative Wording: "In the future, while you may have some suicidal thoughts and feelings and impulses, you will be unable to carry out a suicide attempt unless you are in a hypnotic trance. The suicidal thoughts and/or feelings will serve as an alert to the possibility that you may be about to enter the trance, but you will not actually enter it unless

(a) the feelings become very strong and you feel unable to handle them, or

(b) you actually begin to make preparations for a suicide attempt.

In either situation, you will enter the trance, begin to feel better and more relaxed, and be unable to commit suicide until you have contacted me and informed me that you are in a trance and planning suicide. If I am not available, you will continue to relax in the trance and may remain in it as long as necessary to protect yourself until I am available. However, when you are no longer suicidal, your trance will terminate ten minutes later."

To summarize: The more suicidal you are, the more compelled you will be to enter a trance and contact me. In the trance, you will be unable to commit suicide without my permission. The trance itself may break up your suicidal thoughts and help you relax and find better ways to handle your problems.

Conclusion

As a community, we have a profound responsibility to enhance our support for individuals facing challenges like rising suicide rates. Exploring interventions like hypnosis, inspired by Dr. James R. Hodge's innovative suggestions, opens new avenues of hope and healing. Given the recent increase in suicide rates, it is crucial to explore all potential interventions, including hypnosis, to offer additional support to those in crisis. Dr. James R. Hodge’s, Akron, Ohio  hypnotic suggestions to deter suicide provide a framework worth considering and researching further. While hypnosis should not be the primary intervention for suicide prevention, its role as a supplementary tool could be vital in providing temporary relief and creating opportunities for more comprehensive therapeutic interventions. By integrating these structured suggestions into comprehensive treatment plans, hypnosis can become a powerful tool in deterring suicidal behavior and providing patients with a vital lifeline during their most vulnerable moments. Let's innovate and collaborate further, aiming to extend these critical lifelines and foster resilience within our communities together.

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