Coma/Esdaile State: New research reveals possibilities for our Profession

By Kevin Hogan

James Esdaile was a surgeon and a "hypnotist" who worked in India in the mid-1800's. Up until anesthesia was discovered, he induced trance in his patients with mesmeric type hand and arm motions to perform surgeries when possible. The experience his clients had while in trance is what we as hypnotherapists have tried to duplicate and now call the Esdaile State.

The hypnotic state is induced very differently than Esdaile's method of course, but the results may be similar. In the 1800's about half of all people died during surgery. Esdaile's success rate for mortality was almost 8 out of 10. Esdaile was doing something right. When Esdaile arrived back in England, Esdaile's colleagues were unable to replicate Esdaile's work. Esdaile was branded a charlatan and his career was destroyed.

One hundred years later Dave Elman was a stage hypnotist who Eventually came across "the hypnotic coma state", which he later found seemed to be very close if not identical to the Esdaile state. As Elman taught doctors how to use this state there was great excitement about the possible uses of such deep trance among his hypnosis seminar participants." As more doctors learned how to induce this trance state (and similar other "states") , the number of childbirth's with reduced pain and dental surgeries with no anesthesia rose greatly in those practices. There was definitely reason to be excited about this Esdaile/Coma state.

Here in Minnesota at the Minnesota Institute of Hypnosis and Hypnotherapy we wanted to safely replicate the so called Esdaile state and also explore another proposed state of trance that we will call "Deep Trance." This state has been purported to have special phenomenon related to it. It's believed for example that Edgar Cayce may have experienced his so called readings of the Akashic Records in this or a similar state. Others claim that healing energy can be conduited from the person in the deep trance state to another person who is in physical contact with the person in deep trance. Our goal in exploring these states was to gain insights into these claims and see if any or all held promise for further study.

We used nine volunteers in our research - eight men and one woman. All were over 18 years old and all were students in an advanced hypnosis training.

The first state after somnambulism we would attempt to test for would be the Esdaile State which is all but synonymous with the Coma State. There are four tests that we used and that Elman used to determine if someone was in the Esdaile/Coma state:

• The client passes a test for anesthesia without being informed that he is about to be tested. (He feels no pain.)
• Client is commanded to move a group of muscles. (Raise a leg or arm.) If this command is neglected the client passes.
• The client is asked to open his eyes. If he does so he fails the test.
• Catatonia. An arm or leg is raised or shifted. It should stay where it is without suggestion or further prompting.

Now, 50 and 150 years later again, we bring back the work of Elman and Esdaile for your consideration.

The decision to research this area was made in early 1999. Chris McAtee, CMH, and myself decided to research the "coma states" of hypnosis as mentioned in the title. Several people train the various coma states across the country and I wanted to know how often they can be achieved and to what benefit, especially for the possibility of surgery with hypnosis.

This research was done at our April Master Certification training in Minneapolis. Only 50% of the people in our training were allowed to participate. We screened people out of the research based upon the likelihood that they would negatively influence accurate and reliable results. Therefore our trainers were not allowed to participate (myself, Elizabeth Nahum and Wendi Friesen). Women, with one exception, were not allowed to be in the room, with one exception, because there is a lot of touching and body manipulation that could have been inappropriate and misinterpreted in some other manner than research.

You can imagine that we all wanted to be in the room when the research was being done but it was obvious that my presence and that of other trainers would influence the results through the "Expectation Effect." ("Kevin is here therefore, I will make this work", or "Kevin is skeptical and I don't think this will work either".) Chris and I decided to test the coma states in a scientific manner to see what results could be obtained and what we could learn about hypnosis that we didn't already know. My contribution was to make sure the work was done scientifically and then disappear to see what an excellent but little known hypnotherapist could do with the coma states. That was Chris's job.

Chris's work was objective and thorough as you will soon see.

The following individuals were all participants in the experiment. Those with an * sign by their name were familiar through their certification studies with what might be possible or not with the various states, before we began:
Bijan Hararian
Monica Piechowski *
Albrik Avanessian
Ray Grizzell
Uri Blumenthal *
Kim Johnson *
Craig Lang
David Behr
John Hilder *

Chris asks the group of nine participants, "How many people here are familiar with Sichort, Coma or Esdaile states of hypnosis?" The four people noted above raised their hands.

"You will keep silent about what you know, as this is a scientific study and the study needs to be as unbiased as possible. We will be doing tests throughout the night. At some point you will emerge from trance and when you do, simply read the instructions on the board: (They would later find this message: 'Take 5 minutes for a break. Relax, come back, observe and enjoy'.)"

One Hour Induction begins at 4:40 PM
The induction begins at 4:40 and continues until 5:47 and that induction was a modified group Elman induction and a progressive relaxation followed by a gradual deepening with a few 10-1 counts. Once everyone was past somnambulism Chris didn't know if some may be in coma or a deep trance at this point.

Chris now installs ideomotor signals, yes and no, on the left hand. Coma deepening begins to the A, B, C levels, to the basement of trance. Chris now hopes to observe the following in participants:

• No response to suggestion
• Expects limbs that are moved from a position of rest to an awkward position to stay in place.
• Anesthesia without suggestion.

Test Two:
Suggestion given "Now open your eyes".
Five followed the suggestion in one minute, some immediately, some slowly.
Then they read the board and realize that they had just gotten door number three, so to speak. They were now allowed to observe the balance of the evening.

Four people now remain in trance.
Test Three:
Of the four, remaining in trance, Chris proceeds to test for unsuggested catalepsy of both arms and both legs. Kim and David are seated in chairs, John and Ray on the floor. Kim fails this test as his limbs drop to their original positions. Kim remains in trance but is not likely to be in coma state.

Test Four:
Test for anesthesia unsuggested, one pinch on back of hand behind the thumb. Chris decided to test his own hand in this location and it hurt more to him than other places on the hand. Then he would do one test on a forearm for each person. Deliberate use of fingernails and extra effort to elicit response. All four pass. No one apparently feels pain of the four. Shortly after this, Kim opens eyes when testing for unsuggested catalepsy. (Anesthesia can proceed catalepsy.) Three of Nine "Succeed". David, John, and Ray achieve Esdaile state: defining Esdaile as unsuggested catalepsy and unsuggested anesthesia in trance. Everyone in the room is amazed. Arms are staying there, tests for anesthesia are passed without and challenge. At this point, everyone not in trance has the opportunity to examine the muscles in John's arms. Biceps are loose and flaccid. No tightness or tension is noted. Bijan and Uri both checked temp and pulses, noting the pulses as steady, relaxed and even. Temperatures are warm but not hot. Those watching test for anesthesia again Again there is no reaction. Same as before.

Each of the three are given instruction to enter Sichort state. We decided to explore this state as well. Essentially, it is an even deeper level than what you the three in trance are now experiencing. We suggested that the participants be safe in state, totally aware of surroundings, then Chris said, "I must ask you for the assistance of the unconscious mind". Chris said, "Now I speak as if I am speaking to the subconscious as an individual entity". He says, "Subconscious mind, please help David,...to benefit David..." . Each individual is given these custom designed suggestions then are given one group 1-10 count at the end of the individual suggestions. At this point Chris checks for REM. All had REM. David's eyes were up and down, still seated in a chair. Slumped to his left, the body supported in chair. Chris speculates that some self preservation is involved. Ray and John both have REM to the left and right.

Installing a Post Hypnotic Re-induction Word
Installed word for re-induction: Fringshunk
End of induction 5:47.

This is the end of the first hour of the experimental research at the Minnesota Institute of Hypnosis and Hypnotherapy's Master Certification Training.

We wanted to know what experiences could occur within the Sichort State. We wanted to experiment with Person to Person Healing. The most important key was that we did not want any of the participants to know what to expect in the deeper states. We set up the experiment so that it would be as representative as possible of what a full time professional hypnotherapist would experience but not a "Kevin Hogan or a Jerry Kein." Results obtained by someone perceived to be an authority figure in a field are largely irrelevant as we all know. Those results obtained by a skilled and relatively unknown clinician are what the population of hypnotherapists need to know.

Many therapists claim virtually universal successes in accessing phenomenon with deep trance states and part of our goal was to find out what you, the hypnotherapist can really expect from deep trance states and what their practical application might be in your practice.

The states we specifically are interested in are those of the Esdaile state, the coma state, the Sichort state and the Deep Trance State. What are they? What is experienced and are they clearly distinct from each other in a research setting. What phenomenon can we as hypnotherapists expect to have our clients experience in these states? What are the possible client benefits from these states? Finally, is it possible that Deep Trance can be utilized for "Person to Person Healing"?

I left off in the previous section with the end of the one hour formal induction and installation of a re-induction word with the three subjects that made it to the stage we will pick up with.

To begin this section, I'd like to bring in the experiences of two participants who experienced deep trance and then later opened their eyes when commanded to do so even though the trance depth they were to experience should have precluded.

First, Kim Johnson reports on his experience then bridges into his work with others after he emerges from deep trance.
KJ: The initial trance induction was done by Chris McAtee and was effective. During the induction his voice inflected a slow motion pattern at times that was remarkably calming. This speech pattern seemed to go lower and much slower than I recall. (Kim experienced 3:1 time distortion)
During the first phase of the induction I must have gone to a very deep state of trance, due to conscious recall only when Chris McAtee (the facilitator) had started the procedure for Esdaile state induction, explain levels A, B and C. Then I seemed to snap back to more conscious awareness to be able to experience level A, then to level B and that was the last I recall of level progression. my next recall was in being asked to lift my arm and leg which I had been able to react to. The next conscious recall was when Chris pinched my arm, I was aware of the pinch but had no sensitivity to it. I had awareness after that of other voices in the room other than Chris's and shortly thereafter opened my eyes. Whether I had instructions to do so or not, I was not aware.
(Kim was instructed to open his eyes by Chris but we speculated that all of the participants would have ignored the commands for opening eyes based upon our reading about these states. As stated in the previous section, three of the nine participants did NOT respond to the command to open their eyes.)

KJ: I was then interested in participating in the active pursuit of testing those subjects that appeared to have reached the Esdaile State. I proceeded to test for catalepsy without suggestion on all of the remaining three subjects including David Behr, John Hilder, and Ray Grizzell. I found John to have profound catalepsy. Any position I moved his arm to, it would stay without any additional tapping or reinforcing of the stiffness directive. In lifting his leg to see if larger muscle groups would respond without tapping the leg or reinforcing for stiffness (non-verbally) the right leg did not stay in position and dropped to the floor without any apparent agitation to John. (Previous reports on deep trance states would suggest that John's leg should have stayed cataleptic, but in fact, it did not.) Ray and David did not exhibit catalepsy without tapping arm indicating reinforcement which is how I perceived Chris's methodology to be, though non-verbal.

KJ continues: Chris then attempted the induction of Deep Trance with Dave, John and Ray. After induction I looked from REM activity. John had strong REM, Ray had minor eye movement and Dave's head was tilted down and it was difficult initially to determine the degree of REM. After this, Chris gave specific healing instructions to Dave and induced somnambulism with Craig Lang for work in the healing stage, coming up.
Next, Chris induced somnambulism with Uri Blumenthal who laid side by side next to John Hilder with the intention of beginning of healing work. I (KJ) turned on a light to be able to see reactions better and notice again REM in all three subjects clearly. Next was the joining of Chris and I (KJ) to actively "add energy" to facilitate the adding of additional energy to the "mix." Chris joined with Dave and Craig. I (KJ) joined with John and Uri. My experience was immediate depth of trance and movement of eyes under closed eyelids. Perceptible tingling of hand where joined with John as though some energy flow was occurring. What seemed like five minutes I was tapped on the shoulder indicating completion of this phase of testing had actually been 15 minutes. After we emerged from trance we proceeded to emerge the others from their states. Dave emerged looking somewhat disoriented and took a minute before getting out of the chair. he explained some interesting experience that he was not able to elaborate on during that initial minute. When John emerged, Chris immediately assisted him to his feet from the floor. He was obviously disoriented but was able to maintain his equilibrium. Both John and Dave seemed to take some time to reorient for introspection of the experience. We were then told that Ray had emerged and re-entered the trance state through the key word given to him by Monica Piechowski, the only woman in the room. John had been in trance for two hours. Dave and Ray for 1:45. Three days later I (KJ) inquired of Uri Blumenthal his experience of the healing trance called "Pesron to Person Healing." Kim asked Uri, "So how are your sinuses? Did any healing occur?" Uri replied, "The sinuses are a bit better but still give me noticeable grief." Not sure how effective the physical plane healing was. On the other hand, I (UB) did notice spiritual manifestations in both myself and those guys who 'who went all the way'. For example I now can see auras. (It might be well noted here that Uri Blumenthal is a computer scientist with IBM with an understanding of scientific procedure and protocol.)
KJ continues: There were other interesting stories of the experience in this trance state but I will let those who experienced them share them with the readers of this fascinating research piece.

Uri Blumenthal is a computer scientist with IBM and he offers the following results based on our research experiment.

There is no conclusive evidence at this point that Deep Trance is significantly different from Esdaile State, except that some suggestions "worked". (See below) At least one motor suggestion worked (Chris brought the catatonic arm down using "relax the arm" suggestion, therefore, some motor suggestions are obeyed in U.D. Upon my (UB) request, John being the UD state, increased the skin temperature of his right hand by approximately one degree C. After a few minutes the skin temperature returned to normal. This demonstrates that non-motor suggestion are followed in Deep Trance!

Instant re-hypnosis key was installed on all three subjects who made it "past" Esdaile suggestions and performed successfully, bringing them all back to Deep Trance state after they were brought all the way up to the waking state. This conclusively proves that posthypnotic suggestions work in the Deep Trance State. It appears that the subjects are fully aware of their environment, there is no amnesia, therefore it is assumed that the Executive Ego, is in charge. However, spontaneous anesthesia holds- the subject is aware of the action but remains undisturbed. I (UB) observed 10% heart rate increase on John (76-84) All subjects exhibited REM. Breathing was rhythmic, normal and somewhat more shallow in Deep Trance. An attempt to perform Person to Person Healing was made. I (UB) was the patient to be "healed by John". I didn't notice or feel anything outside of the ordinary while in light trance in physical contact with John. The results are inconclusive: my sinuses became a touch better, but by no means "healed". Spiritual and psychological effects were noticed in all subjects by me (UB), starting immediately after emerging. They appear calmer, gentler, "wiser" if you wish. Not dissimilar to the astronauts returning from the moon. After being in the healing trance and in physical contact with one of the Deep Trance subjects, I noticed similar changes in myself, but to a smaller degree. My ability to see auras is small but there.

My (KH) interest in this area began as that of a complete skeptic. Now I am certain that there is real reason for additional research in this area and we will continue to do so here in Minnesota at the Minnesota Institute of Hypnosis and Hypnotherapy.

The most significant conclusion from our research was that the three people who succeeded at achieving Deep Trance were clearly different from the other six students in a few critical ways. First, these three students all saw McAtee do some specific powerful piece of work during their training. For example, McAtee helped Grizzell experience glove anesthesia which he was unable to initially experience. McAtee induced deep trance on Hilder on the first day of our certification class. There was clearly a priming effect. Watching Chris do something incredible earlier in the training seemed to enhance Chris's authority, which is why none of the actual course trainers were allowed to participate for fear of authority bias. It is interesting to note that none of the three individuals achieving deep trance states knew McAtee before the training. Johnson, Piechowski, and Blumenthal all did know Chris.

We believe that "knowing" the therapist as a friend or colleague may work against the success of the experience as it takes away from the "authority" of the person doing the work. "Wanting to achieve the states" was not enough as the three listed under point two were all aware of the phenomenon and wanted to experience all of the depths but all failed to do so. Prior knowledge of these states did not bias the results as much as we thought. Grizzell and David Behr didn't know what to expect so they should have been tripped up in our tests if these deep states were "bogus". Hilder did have previous knowledge of Esdaile state work. Not everyone responds to the trance inductions, suggestions and commands that were given. Chris McAtee and I predicted that a few would respond as we historically read about and in fact that was the experience. The nine people who experienced the deep trance states were all profoundly moved by the experience.

Tests we intend to run in the future will be a longitudinal study of those who experience mind-mind healing. We want to know if this experience can predictably produce long term health improvement. We believe that in at least some people these deep trance states may be useful as a form of hypnoanesthesia though we do not know specifically how effective it would be, nor can we predict the duration of such anesthesia. We believe that blood cell counts may be able to be altered by this experience and would like to test for this in the future.

We know that skin temperature and heart rate are changed through this experience and will continue to find what benefits, if any, this will bring clients. (Could increasing or decreasing blood flow change the intensity of headaches, etc.)

We believe that an "in trance" MRI would offer great insights into the deep trance phenomenon.

We believe that is necessary to see if the Hidden Observer (Hilgard) feels pain in the deeper states of trance. There is reason to believe that the Hidden Observer will continue to experience pain but this must be tested in real time to be certain.

Finally, it is important to understand that this research was done with a group of 8 men and one woman. We believe that mixing genders in group work like this may reduce the positive experiences for many reasons.

We believe that the results that we obtained with an excellent though largely unknown hypnotherapist (Chris McAtee) offer optimism for results with the coma state and the other deep states of trance however little they may differ from each other.

There is much to learn about how deep trance may, or may not, help our clients heal. Ongoing research will help us answer this question with more clout in the future.