Successful Repeated Hypnotic Treatment of Warts in the Same Individual: A Case Report

American Journal of Clinical Hypnosis, Apr 2005 by Goldstein, Robert H

We report on a case of a female patient who was successfully treated with hypnosis for warts on 2 occasions separated by an interval of 7 years. Of note is the fact that she had low expectations regarding the benefit to be derived from hypnosis and did not at first appear to be highly hypnotizable.

Keywords: Hypnosis, treatment, warts.

The use of hypnotic methods in the treatment of warts has been reported and utilized for at least 70 years (Scott, 1960). Numerous case studies have appeared in the literature, usually with small numbers of patients (Obermayer & Greenson, 1949; McDowell, 1949;Yalom, 1964; French, 1977; Clawson & Swade, 1975; Tasini & Hackett, 1977; Dreaper, 1978; Morris, 1985; Noll, 1988; Reid, 1989; O'Laughlan, 1995), although larger case series have also been reported (Bloch, 1927; Vollmer, 1946; Ewin, 1995). Research into the hypnotic treatment of warts has dealt, in large measure, with the efficacy of the process, the extent to which hypnotic treatment yields results that exceed those expected as a result of spontaneous remission, and comparisons of hypnotic treatments with other modalities (DuBreuil & Spanos, 1993).

Some investigations have also focused on the role of placebo effects (Clarke, 1965; Stankler, 1967;Spanos, 1988) as well as on the impact of differing levels of hypnotizability (Asher, 1956; Ulman & Dudek, 1960; Chandrasena, 1982), and on variations in subjects' cognitive processes and expectations as these relate to the procedure employed (Kirsch, 1985; Spanos, 1988; Spanos, 1990).

Individual case reports have generally been considered to be a potential source of clinical hypotheses but have not been viewed as proof of the role of hypnosis because of the large number of coexistent factors that cannot be adequately controlled in the individual case (Mott, 1986). Therefore, the case that will be reported here is not presented as definitive evidence of hypnotic efficacy. However, there do not appear to be any case reports that are currently available in which a single individual was successfully treated with hypnosis on two separate occasions separated by a considerable time period and, therefore, it was thought that this case may be of interest to readers of this Journal.

History

When seen on the first occasion, the patient presented as a pleasant articulate 16-year-old Caucasian female who was referred to the author at the suggestion of the dermatologist who had been treating her for bilateral plantar warts for somewhat over a year. The warts had, in fact, been present since the patient was 9 years old. Medical therapy had included the application of liquid nitrogen and other topical agents. The patient reported that these had been somewhat helpful since the warts had "come and gone" (i.e., increased and diminished) several times. She reported that at one point they had "almost gone," but rapidly reappeared when treatment was discontinued. On the most recent dermatological consultation, the patient was offered the options of laser therapy, extensive surgery, and hypnosis. When she learned that neither of the first two would assure that the warts might not recur, she agreed to referral for hypnosis.

The patient described her belief that the warts had been contracted "in the pool" where, as an active competitive swimmer, she spent considerable time. She added that they had seemed to becorre more troublesome during the swim season. The warts were not described as being particularly painful, but their location, on both heels, was noted to be "annoying." She described herself as being "sick of them" and as wanting them "to go away." She stated that she had been led to believe that with the medical treatment that had been carried out thus far, "the average person would have gotten rid of them by now."

The patient reported no prior history of mental health contacts and had no prior experience with hypnosis, but did mention that her mother had known people who had hypnosis for childbirth and that "it had worked."

Treatment

Hypnosis was explained to her as being a process in which she could learn to focus her attention and that she would be in full control of the experience. An initial eye roll test (Spiegel & Spiegel, 1978) resulted in a response rated as a 2 out of 4 and hence could be interpreted as indicating a modest capacity for hypnotic responding. Initial induction was accomplished by eye fixation with upward gaze, eye closure, and deepening by backward counting from ten to one together with imagery of descending a staircase. Imagery of a relaxing pleasurable scene was suggested based on her description of her favorite situations; that is, stretched out on a blanket on the grass with her cat or relaxing in a tub of warm water. After approximately 15 minutes devoted to a gradual induction and deepening, communication via finger signals was established and an inquiry was conducted during which the patient indicated that she was comfortable with the idea of ridding herself of the warts and that she had no need to retain them.