Sunday, August 7, 2016



Neuro-hypnotherapy is practiced by licensed clinical hypnotherapist who has been trained in the area of EEG biofeedback technique. Neuro-hypnotherapy is first of its kind in Malaysia developed by Hiro Koo. It is based on the concept of clinical hypnotherapy which can be classified as psychotherapy as well. It is well known to deal with the subconscious mind directly and is commonly used to deal with symptoms of various problems such as habit breaking, smoking cessation, weight management, and mood-related issues. There are many approaches and techniques in the field of clinical hypnotherapy. The most commonly used clinical hypnotherapy techniques for patient with tic disorder are hypno-behavioural methods such as hypno-desensitization and habit reversal therapy. Cognitive behavioural hypnotherapy (CBH) can also be used to deal with tic disorder or the comorbid feature of TS such as OCD or anxiety related symptoms.

Neuro-hypnotherapy for tic disorder includes a combination of different types of therapies.  The first step of the neuro-hypnotherapy is psychoeducation. During this initial step, the possible causes of tic disorder will be elaborated by the clinical hypnotherapist. Patients will be guided on ways to communicate with the school or co-workers effectively to prevent conflict and misunderstanding, while their caregivers will be educated on ways to provide appropriate amount of support. Furthermore, although habit reversal is an effective intervention for tic disorder, individuals should be informed that tic disorder is not just a bad habit but neurological disorder. Thus, it cannot be solved based on positive or negative reinforcement alone, let alone the possibility that reinforcement in either positive or negative manner may worsen the symptoms. It is very important to neutralize the self-defeating belief, while empowering the patient and setting realistic expectations.

The following sessions will focus on functional intervention, cognitive behavioural hypnotherapy, HRT, as well as relaxation therapy. During the functional intervention session, patient will be hypnotized in order to identify how environmental factors may worsen, maintain or improve the symptoms. Patient is able to observe his or her behaviour before and after the tics occurrence during the neuro-hypnotherapy session. CBH technique can then be applied to deal with the irrational feelings, cognitive distortion, and unhealthy coping ways.

According to the systematic review done by Dutta and colleague (2013), HRT can significantly reduce tic severity for patient with tic disorder. During the neuro-hypnotherapy session, the hypnotized patient will observe all of their tics in detail such as how it feels in the particular muscle group and where it feels most intensively in the body. During this stage, HRT will be incorporated into neuro-hypnotherapy session to find out the premonitory urge. Thus, patient will notice how it feels before the tics occur more clearly. Hypno-desensitization focuses on helping patient getting used to the premonitory urge, so that the patient doesn’t need to react to it by doing the tic. In this way, premonitory urge can be controlled before the tic happens. Soon after the patient becomes more aware of the premonitory urge, competing response will be discussed and implemented. During the neuro-hypnotherapy session, an intentional movement that can prevent tic from happening will be suggested. After that, the clinical hypnotherapist will use the hypno-exposure therapy to reinforce the competing response.  

Progressive hypnotherapy relaxation is taught to relax the patient as it can directly reduce the stress response. Tics are commonly known to become worse when triggered by stress. Progressive hypnotherapy relaxation technique which requires patient to progressively tensing and then relaxing the different muscle groups is taught in a self hypnosis format. This is a very helpful method to reduce the arousal level in the brain and empower the patient with positive coping strategy. Patient was taught to utilize this progressive hypnotherapy relaxation technique whenever he or she has the need to stay calm and relax.

During the neuro-hypnotherapy session, electrodes are applied to the individual’s scalp, which allows the patient and therapist to observe the brainwave activity. The electrodes do not hurt and conduct no amount of electricity that one can feel. The person’s hair is not removed or shaven during the electrode placement. This is done in real-time setting, so the individuals see exactly what is going on in their brain as they think of certain thoughts, feel stressed, or relaxed. After the self hypnosis session, patient commonly will learn how to self regulate their brain activity naturally, without pharmaceutical medications.

Retrieved from the Integrative treatment for tics and tourette syndrome in Malaysia (Author: Hiro Koo).

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