When the living and breathing body of a 71-year-old Parkinson’s disease patient was recently lying in a sterile operating theater at the Galilee Medical Center in Nahariya, his head was in Thailand.
In a pioneering procedure performed a few months ago by neurosurgeons and a psychologist with expertise in hypnotism, Ali Abu-Ria from the city of Sakhnin in the Lower Galilee underwent deep brain stimulation (DBS) surgery fully conscious, as psychologist Dr. Udi Bonshtein used hypnosis on him instead of anesthesia. DBS involves the implanting of electrodes in the brain.
In his mind, the patient was on an exotic beach in Thailand, resting under coconut palms as the sound of waves rippled in the background, imagining places he still hoped to visit one day. This patient chose Thailand because he had been a tour guide and always wanted to go there. Before the neurosurgeon turned on the drill to make holes in his skull, he was hypnotized so he wouldn’t hear the noise.
Abu-Ria, whose limbs shake constantly due to Parkinson’s disease, was wide awake. He suffered from constant tremors, and his muscles were stiff and tense. He was not allowed to get medication close to the surgery, so hypnosis helped him cope with the psychological stress and fear of the procedure.
A few weeks ago, Bonshtein successfully hypnotized a woman for a DBS procedure at his hospital. The woman was afraid of flying and preferred to be “sent” on a cruise instead.
Hypnotic healing
Hypnosis is defined by the experts as a state of consciousness involving focused attention and reduced peripheral awareness, characterized by an enhanced capacity for response to suggestion.
“I created a state where his attention was focused solely on my voice and touch,” explained Bonshtein, who heads the hospital’s psychology service. “During the operation, while the surgeon was drilling into his skull and inserting electrodes into his brain, I spoke with him about positive, uplifting things. He never once complained about pain and remained completely relaxed for five straight hours despite the complexity of the surgery.”
This rare and extraordinary case involved a fully awake patient undergoing brain surgery while hypnotized. Bonshtein said, “Hypnosis is a powerful tool that helps shorten and improve medical treatment. I believe this is the first such case in Israel.”
One of the first DBS hypnosis procedures was carried out in recent years on a 73-year-old patient from Thuringia, Germany, whose tremors did not adequately improve with medication. The patient was reportedly very satisfied with the result of the six-hour operation by the team from the Jena University Hospital.
After his recovery in the Nahariya hospital, Abu-Ria recalled: “I remember every minute of the operation. It was actually a good experience. I was completely calm. I imagined he was taking me on a trip to Thailand. I feel like a new person now, and the tremors I suffered from have stopped.”
“This type of surgery can be frightening and unpleasant for patients,” the psychologist noted. “Hypnosis helped him release tension, manage discomfort and pain, and ultimately, it made the surgeon’s work easier.”
Hypnosis in Israel
Bonshtein studied hypnotism at Tel Aviv University’s Faculty of Medical and Health Sciences almost three decades ago and received a license to do it.
“About 1,000 psychologists, physicians, and dentists have such a license from the Health Ministry, but most don’t use it. I think that only a few dozen use hypnosis on a daily basis,” he told The Jerusalem Post in an interview. Very few use it for reducing the pain of surgery.
“In general, surgeons don’t put much faith in such psychological techniques. They’re used to anesthesia. But we have awareness of hypnosis as a tool in my hospital. In other Israeli medical centers, it’s used sporadically, mostly for research. This is unfortunate.”
Bonshtein wrote in a 2018 article published in the Journal of Anesthesia and Intensive Care Medicine that “the Israeli Uses of Hypnosis Law defines it as an activity or process designed to change another person’s awareness and consciousness, affecting changes in his or her body, feelings, emotions, thinking, memory, or behavior by using suggestions.
“Hypnosis often entails a process of deep concentration, which enables a differential effect on brain modules that typically work in coordination. It can enable practitioners to manipulate various areas of function, and it can be used to uncouple sensory experience from overall experience, as well as serve analgesic purposes.”
Not only is hypnosis one of the oldest and most effective methods for pain relief, but there is also plenty of scientific grounding and discussion regarding its successful clinical uses, he continued.
Not like the movies
Even though hypnotism in the movies is almost always carried out by swinging a disk or watch on a chain in front of the patient and used for a negative purpose, Bonshtein said he uses his voice to focus the patient’s attention.
“I don’t force them. They have to trust me and surrender themselves to the procedure. Nearly anybody can be hypnotized, except for people who fear that things will emerge without them being in control. Patients who know me go very quickly. It’s Pavlovian. They see me, hear my voice, even the color of the curtains in my office, and they are under.”
He even used hypnotism on his wife before she delivered their baby and on his children before they took difficult tests. But the effects are limited – except in a patient who asked him to hypnotize him to stop smoking. “Every time he smelled tobacco smoke, he wanted to vomit. Then he decided to quit permanently on his own.”
“I’m not always available to do it, but recently, I was called to hypnotize a patient with a shoulder displacement who was suffering greatly from pain. In two and a half minutes, he went under, and the shoulder was pulled into place in seconds,” the psychologist recalled.
“Acupuncture can also be used for some procedures, as it also works on suggestion.”
Bonshtein doesn’t recommend hypnosis for everybody. “The depth of consciousness is different, and it depends on how much time I can take. Cognitive behavioral therapy can be very helpful for some cases. The patient must be motivated to stop negative behavior. Alcoholics may not be willing to stop drinking. I certainly can’t make a terrorist give up his crimes.”
PTSD help
Many of his patients are soldiers or civilians who suffer from post-traumatic stress disorder (PTSD), and it is very effective. Bonshtein has tried to get the Defense Ministry to open up such a service at his medical center, but “there is bureaucracy, and so many need help.”
Galilee Neurology Department director and Parkinson’s disease and movement disorders expert Prof. Samih Badarny said that the surgery is carried out while the patient is awake to allow real-time testing of whether electrode stimulation improves symptoms and to ensure that no side effects arise, which can then be corrected immediately.
At the end of the operation, the neurosurgeon – Dr. Yuval Grober – who performed DBS on the patient, declared that he had never before encountered a patient so calm and at ease during an awake brain surgery. “He didn’t complain of any pain despite the challenging and highly complex procedure.”
Bonshtein noted that many patients currently seeking psychological support due to the war could also benefit significantly from hypnosis.
“Integrating hypnosis helps shorten medical treatment, makes it more efficient, and has a direct effect on both body and mind. Through hypnosis, we can address psychological aspects like anxiety or hope, physical and functional aspects like digestion or immune system function, and sensory-perceptual elements such as pain relief, just as I did with the Parkinson’s patient during surgery.”
He stressed that hypnosis can be used as a supplementary tool in virtually any therapeutic approach, including cognitive-behavioral therapy, enhancing both its depth and effectiveness.
“The general public and even many medical professionals are unaware of the therapeutic potential of hypnosis. It’s important for doctors to know when hypnosis is appropriate and when to refer patients to a hypnosis clinic,” he said.
Recently, the Nahariya hospital established a dedicated hypnosis clinic, staffed by 20 doctors and psychologists whom Bonshtein trained in applying the technique. The hospital’s medical teams are currently looking into more ways to integrate hypnosis into clinical procedures.