The Americanization of Mental Illness

By ETHAN WATTERS

Published: January 8, 2010

AMERICANS, particularly if they are of a certain leftward-leaning, college-educated type, worry about our country’s blunders into other cultures. In some circles, it is easy to make friends with a rousing rant about the McDonald’s near Tiananmen Square, the Nike factory in Malaysia or the latest blowback from our political or military interventions abroad. For all our self-recrimination, however, we may have yet to face one of the most remarkable effects of American-led globalization. We have for many years been busily engaged in a grand project of Americanizing the world’s understanding of mental health and illness. We may indeed be far along in homogenizing the way the world goes mad.

This unnerving possibility springs from recent research by a loose group of anthropologists and cross-cultural psychiatrists. Swimming against the biomedical currents of the time, they have argued that mental illnesses are not discrete entities like the polio virus with their own natural histories. These researchers have amassed an impressive body of evidence suggesting that mental illnesses have never been the same the world over (either in prevalence or in form) but are inevitably sparked and shaped by the ethos of particular times and places. In some Southeast Asian cultures, men have been known to experience what is called amok, an episode of murderous rage followed by amnesia; men in the region also suffer from koro , which is characterized by the debilitating certainty that their genitals are retracting into their bodies. Across the fertile crescent of the Middle East there is zar, a condition related to spirit-possession beliefs that bring forth dissociative episodes of laughing, shouting and singing.

The diversity that can be found across cultures can be seen across time as well. In his book “Mad Travelers,” the philosopher Ian Hacking documents the fleeting appearance in the 1890s of a fugue state in which European men would walk in a trance for hundreds of miles with no knowledge of their identities. The hysterical-leg paralysis that afflicted thousands of middle-class women in the late 19th century not only gives us a visceral understanding of the restrictions set on women’s social roles at the time but can also be seen from this distance as a social role itself — the troubled unconscious minds of a certain class of women speaking the idiom of distress of their time.

“We might think of the culture as possessing a ’symptom repertoire’ — a range of physical symptoms available to the unconscious mind for the physical expression of psychological conflict,” Edward Shorter, a medical historian at the University of Toronto, wrote in his book “Paralysis: The Rise and Fall of a ‘Hysterical’ Symptom.” “In some epochs, convulsions, the sudden inability to speak or terrible leg pain may loom prominently in the repertoire. In other epochs patients may draw chiefly upon such symptoms as abdominal pain, false estimates of body weight and enervating weakness as metaphors for conveying psychic stress.”

In any given era, those who minister to the mentally ill — doctors or shamans or priests — inadvertently help to select which symptoms will be recognized as legitimate. Because the troubled mind has been influenced by healers of diverse religious and scientific persuasions, the forms of madness from one place and time often look remarkably different from the forms of madness in another.

That is until recently.

For more than a generation now, we in the West have aggressively spread our modern knowledge of mental illness around the world. We have done this in the name of science, believing that our approaches reveal the biological basis of psychic suffering and dispel prescientific myths and harmful stigma. There is now good evidence to suggest that in the process of teaching the rest of the world to think like us, we’ve been exporting our Western “symptom repertoire” as well. That is, we’ve been changing not only the treatments but also the expression of mental illness in other cultures. Indeed, a handful of mental-health disorders — depression, post-traumatic stress disorder and anorexia among them — now appear to be spreading across cultures with the speed of contagious diseases. These symptom clusters are becoming the lingua franca of human suffering, replacing indigenous forms of mental illness.

DR. SING LEE, a psychiatrist and researcher at the Chinese University of Hong Kong, watched the Westernization of a mental illness firsthand. In the late 1980s and early 1990s, he was busy documenting a rare and culturally specific form of anorexia nervosa in Hong Kong. Unlike American anorexics, most of his patients did not intentionally diet nor did they express a fear of becoming fat. The complaints of Lee’s patients were typically somatic — they complained most frequently of having bloated stomachs. Lee was trying to understand this indigenous form of anorexia and, at the same time, figure out why the disease remained so rare.

As he was in the midst of publishing his finding that food refusal had a particular expression and meaning in Hong Kong, the public’s understanding of anorexia suddenly shifted. On Nov. 24, 1994, a teenage anorexic girl named Charlene Hsu Chi-Ying collapsed and died on a busy downtown street in Hong Kong. The death caught the attention of the media and was featured prominently in local papers. “Anorexia Made Her All Skin and Bones: Schoolgirl Falls on Ground Dead,” read one headline in a Chinese-language newspaper. “Thinner Than a Yellow Flower, Weight-Loss Book Found in School Bag, Schoolgirl Falls Dead on Street,” reported another Chinese-language paper.

In trying to explain what happened to Charlene, local reporters often simply copied out of American diagnostic manuals. The mental-health experts quoted in the Hong Kong papers and magazines confidently reported that anorexia in Hong Kong was the same disorder that appeared in the United States and Europe. In the wake of Charlene’s death, the transfer of knowledge about the nature of anorexia (including how and why it was manifested and who was at risk) went only one way: from West to East.

Western ideas did not simply obscure the understanding of anorexia in Hong Kong; they also may have changed the expression of the illness itself. As the general public and the region’s mental-health professionals came to understand the American diagnosis of anorexia, the presentation of the illness in Lee’s patient population appeared to transform into the more virulent American standard. Lee once saw two or three anorexic patients a year; by the end of the 1990s he was seeing that many new cases each month. That increase sparked another series of media reports. “Children as Young as 10 Starving Themselves as Eating Ailments Rise,” announced a headline in one daily newspaper. By the late 1990s, Lee’s studies reported that between 3 and 10 percent of young women in Hong Kong showed disordered eating behavior. In contrast to Lee’s earlier patients, these women most often cited fat phobia as the single most important reason for their self-starvation. By 2007 about 90 percent of the anorexics Lee treated reported fat phobia. New patients appeared to be increasingly conforming their experience of anorexia to the Western version of the disease.

What is being missed, Lee and others have suggested, is a deep understanding of how the expectations and beliefs of the sufferer shape their suffering. “Culture shapes the way general psychopathology is going to be translated partially or completely into specific psychopathology,” Lee says. “When there is a cultural atmosphere in which professionals, the media, schools, doctors, psychologists all recognize and endorse and talk about and publicize eating disorders, then people can be triggered to consciously or unconsciously pick eating-disorder pathology as a way to express that conflict.”

The problem becomes especially worrisome in a time of globalization, when symptom repertoires can cross borders with ease. Having been trained in England and the United States, Lee knows better than most the locomotive force behind Western ideas about mental health and illness. Mental-health professionals in the West and in the United States in particular, create official categories of mental diseases and promote them in a diagnostic manual that has become the worldwide standard. American researchers and institutions run most of the premier scholarly journals and host top conferences in the fields of psychology and psychiatry. Western drug companies dole out large sums for research and spend billions marketing medications for mental illnesses. In addition, Western-trained traumatologists often rush in where war or natural disasters strike to deliver “psychological first aid,” bringing with them their assumptions about how the mind becomes broken by horrible events and how it is best healed. Taken together this is a juggernaut that Lee sees little chance of stopping.

“As Western categories for diseases have gained dominance, micro-cultures that shape the illness experiences of individual patients are being discarded,” Lee says. “The current has become too strong.”

Would anorexia have so quickly become part of Hong Kong’s symptom repertoire without the importation of the Western template for the disease? It seems unlikely. Beginning with scattered European cases in the early 19th century, it took more than 50 years for Western mental-health professionals to name, codify and popularize anorexia as a manifestation of hysteria. By contrast, after Charlene fell onto the sidewalk on Wan Chai Road on that late November day in 1994, it was just a matter of hours before the Hong Kong population learned the name of the disease, who was at risk and what it meant.

THE IDEA THAT our Western conception of mental health and illness might be shaping the expression of illnesses in other cultures is rarely discussed in the professional literature. Many modern mental-health practitioners and researchers believe that the scientific standing of our drugs, our illness categories and our theories of the mind have put the field beyond the influence of endlessly shifting cultural trends and beliefs. After all, we now have machines that can literally watch the mind at work. We can change the chemistry of the brain in a variety of interesting ways and we can examine DNA sequences for abnormalities. The assumption is that these remarkable scientific advances have allowed modern-day practitioners to avoid the blind spots and cultural biases of their predecessors.

Modern-day mental-health practitioners often look back at previous generations of psychiatrists and psychologists with a thinly veiled pity, wondering how they could have been so swept away by the cultural currents of their time. The confident pronouncements of Victorian-era doctors regarding the epidemic of hysterical women are now dismissed as cultural artifacts. Similarly, illnesses found only in other cultures are often treated like carnival sideshows. Koro, amok and the like can be found far back in the American diagnostic manual (DSM-IV, Pages 845-849) under the heading “culture-bound syndromes.” Given the attention they get, they might as well be labeled “Psychiatric Exotica: Two Bits a Gander.”

Western mental-health practitioners often prefer to believe that the 844 pages of the DSM-IV prior to the inclusion of culture-bound syndromes describe real disorders of the mind, illnesses with symptomatology and outcomes relatively unaffected by shifting cultural beliefs. And, it logically follows, if these disorders are unaffected by culture, then they are surely universal to humans everywhere. In this view, the DSM is a field guide to the world’s psyche, and applying it around the world represents simply the brave march of scientific knowledge.

Of course, we can become psychologically unhinged for many reasons that are common to all, like personal traumas, social upheavals or biochemical imbalances in our brains. Modern science has begun to reveal these causes. Whatever the trigger, however, the ill individual and those around him invariably rely on cultural beliefs and stories to understand what is happening. Those stories, whether they tell of spirit possession, semen loss or serotonin depletion, predict and shape the course of the illness in dramatic and often counterintuitive ways. In the end, what cross-cultural psychiatrists and anthropologists have to tell us is that all mental illnesses, including depression, P.T.S.D. and even schizophrenia, can be every bit as influenced by cultural beliefs and expectations today as hysterical-leg paralysis or the vapors or zar or any other mental illness ever experienced in the history of human madness. This does not mean that these illnesses and the pain associated with them are not real, or that sufferers deliberately shape their symptoms to fit a certain cultural niche. It means that a mental illness is an illness of the mind and cannot be understood without understanding the ideas, habits and predispositions — the idiosyncratic cultural trappings — of the mind that is its host.

EVEN WHEN THE underlying science is sound and the intentions altruistic, the export of Western biomedical ideas can have frustrating and unexpected consequences. For the last 50-odd years, Western mental-health professionals have been pushing what they call “mental-health literacy” on the rest of the world. Cultures became more “literate” as they adopted Western biomedical conceptions of diseases like depression and schizophrenia. One study published in The International Journal of Mental Health, for instance, portrayed those who endorsed the statement that “mental illness is an illness like any other” as having a “knowledgeable, benevolent, supportive orientation toward the mentally ill.”

Mental illnesses, it was suggested, should be treated like “brain diseases” over which the patient has little choice or responsibility. This was promoted both as a scientific fact and as a social narrative that would reap great benefits. The logic seemed unassailable: Once people believed that the onset of mental illnesses did not spring from supernatural forces, character flaws, semen loss or some other prescientific notion, the sufferer would be protected from blame and stigma. This idea has been promoted by mental-health providers, drug companies and patient-advocacy groups like the National Alliance on Mental Illness in the United States and SANE in Britain. In a sometimes fractious field, everyone seemed to agree that this modern way of thinking about mental illness would reduce the social isolation and stigma often experienced by those with mental illness. Trampling on indigenous prescientific superstitions about the cause of mental illness seemed a small price to pay to relieve some of the social suffering of the mentally ill.

But does the “brain disease” belief actually reduce stigma?

In 1997, Prof. Sheila Mehta from Auburn University Montgomery in Alabama decided to find out if the “brain disease” narrative had the intended effect. She suspected that the biomedical explanation for mental illness might be influencing our attitudes toward the mentally ill in ways we weren’t conscious of, so she thought up a clever experiment.

In her study, test subjects were led to believe that they were participating in a simple learning task with a partner who was, unbeknownst to them, a confederate in the study. Before the experiment started, the partners exchanged some biographical data, and the confederate informed the test subject that he suffered from a mental illness.

The confederate then stated either that the illness occurred because of “the kind of things that happened to me when I was a kid” or that he had “a disease just like any other, which affected my biochemistry.” (These were termed the “psychosocial” explanation and the “disease” explanation respectively.) The experiment then called for the test subject to teach the confederate a pattern of button presses. When the confederate pushed the wrong button, the only feedback the test subject could give was a “barely discernible” to “somewhat painful” electrical shock.

Analyzing the data, Mehta found a difference between the group of subjects given the psychosocial explanation for their partner’s mental-illness history and those given the brain-disease explanation. Those who believed that their partner suffered a biochemical “disease like any other” increased the severity of the shocks at a faster rate than those who believed they were paired with someone who had a mental disorder caused by an event in the past.

“The results of the current study suggest that we may actually treat people more harshly when their problem is described in disease terms,” Mehta wrote. “We say we are being kind, but our actions suggest otherwise.” The problem, it appears, is that the biomedical narrative about an illness like schizophrenia carries with it the subtle assumption that a brain made ill through biomedical or genetic abnormalities is more thoroughly broken and permanently abnormal than one made ill though life events. “Viewing those with mental disorders as diseased sets them apart and may lead to our perceiving them as physically distinct. Biochemical aberrations make them almost a different species.”

In other words, the belief that was assumed to decrease stigma actually increased it. Was the same true outside the lab in the real world?

The question is important because the Western push for “mental-health literacy” has gained ground. Studies show that much of the world has steadily adopted this medical model of mental illness. Although these changes are most extensive in the United States and Europe, similar shifts have been documented elsewhere. When asked to name the sources of mental illness, people from a variety of cultures are increasingly likely to mention “chemical imbalance” or “brain disease” or “genetic/inherited” factors.

Unfortunately, at the same time that Western mental-health professionals have been convincing the world to think and talk about mental illnesses in biomedical terms, we have been simultaneously losing the war against stigma at home and abroad. Studies of attitudes in the United States from 1950 to 1996 have shown that the perception of dangerousness surrounding people with schizophrenia has steadily increased over this time. Similarly, a study in Germany found that the public’s desire to maintain distance from those with a diagnosis of schizophrenia increased from 1990 to 2001.

Researchers hoping to learn what was causing this rise in stigma found the same surprising connection that Mehta discovered in her lab. It turns out that those who adopted biomedical/genetic beliefs about mental disorders were the same people who wanted less contact with the mentally ill and thought of them as more dangerous and unpredictable. This unfortunate relationship has popped up in numerous studies around the world. In a study conducted in Turkey, for example, those who labeled schizophrenic behavior as akil hastaligi(illness of the brain or reasoning abilities) were more inclined to assert that schizophrenics were aggressive and should not live freely in the community than those who saw the disorder asruhsal hastagi (a disorder of the spiritual or inner self). Another study, which looked at populations in Germany, Russia and Mongolia, found that “irrespective of place . . . endorsing biological factors as the cause of schizophrenia was associated with a greater desire for social distance.”

Even as we have congratulated ourselves for becoming more “benevolent and supportive” of the mentally ill, we have steadily backed away from the sufferers themselves. It appears, in short, that the impact of our worldwide antistigma campaign may have been the exact opposite of what we intended.

NOWHERE ARE THE limitations of Western ideas and treatments more evident than in the case of schizophrenia. Researchers have long sought to understand what may be the most perplexing finding in the cross-cultural study of mental illness: people with schizophrenia in developing countries appear to fare better over time than those living in industrialized nations.

This was the startling result of three large international studies carried out by the World Health Organization over the course of 30 years, starting in the early 1970s. The research showed that patients outside the United States and Europe had significantly lower relapse rates — as much as two-thirds lower in one follow-up study. These findings have been widely discussed and debated in part because of their obvious incongruity: the regions of the world with the most resources to devote to the illness — the best technology, the cutting-edge medicines and the best-financed academic and private-research institutions — had the most troubled and socially marginalized patients.

Trying to unravel this mystery, the anthropologist Juli McGruder from the University of Puget Sound spent years in Zanzibar studying families of schizophrenics. Though the population is predominantly Muslim, Swahili spirit-possession beliefs are still prevalent in the archipelago and commonly evoked to explain the actions of anyone violating social norms — from a sister lashing out at her brother to someone beset by psychotic delusions.

McGruder found that far from being stigmatizing, these beliefs served certain useful functions. The beliefs prescribed a variety of socially accepted interventions and ministrations that kept the ill person bound to the family and kinship group. “Muslim and Swahili spirits are not exorcised in the Christian sense of casting out demons,” McGruder determined. “Rather they are coaxed with food and goods, feted with song and dance. They are placated, settled, reduced in malfeasance.” McGruder saw this approach in many small acts of kindness. She watched family members use saffron paste to write phrases from the Koran on the rims of drinking bowls so the ill person could literally imbibe the holy words. The spirit-possession beliefs had other unexpected benefits. Critically, the story allowed the person with schizophrenia a cleaner bill of health when the illness went into remission. An ill individual enjoying a time of relative mental health could, at least temporarily, retake his or her responsibilities in the kinship group. Since the illness was seen as the work of outside forces, it was understood as an affliction for the sufferer but not as an identity.

For McGruder, the point was not that these practices or beliefs were effective in curing schizophrenia. Rather, she said she believed that they indirectly helped control the course of the illness. Besides keeping the sick individual in the social group, the religious beliefs in Zanzibar also allowed for a type of calmness and acquiescence in the face of the illness that she had rarely witnessed in the West.

The course of a metastasizing cancer is unlikely to be changed by how we talk about it. With schizophrenia, however, symptoms are inevitably entangled in a person’s complex interactions with those around him or her. In fact, researchers have long documented how certain emotional reactions from family members correlate with higher relapse rates for people who have a diagnosis of schizophrenia. Collectively referred to as “high expressed emotion,” these reactions include criticism, hostility and emotional overinvolvement (like overprotectiveness or constant intrusiveness in the patient’s life). In one study, 67 percent of white American families with a schizophrenic family member were rated as “high EE.” (Among British families, 48 percent were high EE; among Mexican families the figure was 41 percent and for Indian families 23 percent.)

Does this high level of “expressed emotion” in the United States mean that we lack sympathy or the desire to care for our mentally ill? Quite the opposite. Relatives who were “high EE” were simply expressing a particularly American view of the self. They tended to believe that individuals are the captains of their own destiny and should be able to overcome their problems by force of personal will. Their critical comments to the mentally ill person didn’t mean that these family members were cruel or uncaring; they were simply applying the same assumptions about human nature that they applied to themselves. They were reflecting an “approach to the world that is active, resourceful and that emphasizes personal accountability,” Prof. Jill M. Hooley of Harvard University concluded. “Far from high criticism reflecting something negative about the family members of patients with schizophrenia, high criticism (and hence high EE) was associated with a characteristic that is widely regarded as positive.”

Widely regarded as positive, that is, in the United States. Many traditional cultures regard the self in different terms — as inseparable from your role in your kinship group, intertwined with the story of your ancestry and permeable to the spirit world. What McGruder found in Zanzibar was that families often drew strength from this more connected and less isolating idea of human nature. Their ability to maintain a low level of expressed emotion relied on these beliefs. And that level of expressed emotion in turn may be key to improving the fortunes of the schizophrenia sufferer.

Of course, to the extent that our modern psychopharmacological drugs can relieve suffering, they should not be denied to the rest of the world. The problem is that our biomedical advances are hard to separate from our particular cultural beliefs. It is difficult to distinguish, for example, the biomedical conception of schizophrenia — the idea that the disease exists within the biochemistry of the brain — from the more inchoate Western assumption that the self resides there as well. “Mental illness is feared and has such a stigma because it represents a reversal of what Western humans . . . have come to value as the essence of human nature,” McGruder concludes. “Because our culture so highly values . . . an illusion of self-control and control of circumstance, we become abject when contemplating mentation that seems more changeable, less restrained and less controllable, more open to outside influence, than we imagine our own to be.”

CROSS-CULTURAL psychiatrists have pointed out that the mental-health ideas we export to the world are rarely unadulterated scientific facts and never culturally neutral. “Western mental-health discourse introduces core components of Western culture, including a theory of human nature, a definition of personhood, a sense of time and memory and a source of moral authority. None of this is universal,” Derek Summerfield of the Institute of Psychiatry in London observes. He has also written: “The problem is the overall thrust that comes from being at the heart of the one globalizing culture. It is as if one version of human nature is being presented as definitive, and one set of ideas about pain and suffering. . . . There is no one definitive psychology.”

Behind the promotion of Western ideas of mental health and healing lie a variety of cultural assumptions about human nature. Westerners share, for instance, evolving beliefs about what type of life event is likely to make one psychologically traumatized, and we agree that venting emotions by talking is healthier than stoic silence. We’ve come to agree that the human mind is rather fragile and that it is best to consider many emotional experiences and mental states as illnesses that require professional intervention. (The National Institute of Mental Health reports that a quarter of Americans have diagnosable mental illnesses each year.) The ideas we export often have at their heart a particularly American brand of hyperintrospection — a penchant for “psychologizing” daily existence. These ideas remain deeply influenced by the Cartesian split between the mind and the body, the Freudian duality between the conscious and unconscious, as well as the many self-help philosophies and schools of therapy that have encouraged Americans to separate the health of the individual from the health of the group. These Western ideas of the mind are proving as seductive to the rest of the world as fast food and rap music, and we are spreading them with speed and vigor.

No one would suggest that we withhold our medical advances from other countries, but it’s perhaps past time to admit that even our most remarkable scientific leaps in understanding the brain haven’t yet created the sorts of cultural stories from which humans take comfort and meaning. When these scientific advances are translated into popular belief and cultural stories, they are often stripped of the complexity of the science and become comically insubstantial narratives. Take for instance this Web site text advertising the antidepressant Paxil : “Just as a cake recipe requires you to use flour, sugar and baking powder in the right amounts, your brain needs a fine chemical balance in order to perform at its best.” The Western mind, endlessly analyzed by generations of theorists and researchers, has now been reduced to a batter of chemicals we carry around in the mixing bowl of our skulls.

All cultures struggle with intractable mental illnesses with varying degrees of compassion and cruelty, equanimity and fear. Looking at ourselves through the eyes of those living in places where madness and psychological trauma are still embedded in complex religious and cultural narratives, however, we get a glimpse of ourselves as an increasingly insecure and fearful people. Some philosophers and psychiatrists have suggested that we are investing our great wealth in researching and treating mental illness — medicalizing ever larger swaths of human experience — because we have rather suddenly lost older belief systems that once gave meaning and context to mental suffering.

If our rising need for mental-health services does indeed spring from a breakdown of meaning, our insistence that the rest of the world think like us may be all the more problematic. Offering the latest Western mental-health theories, treatments and categories in an attempt to ameliorate the psychological stress sparked by modernization and globalization is not a solution; it may be part of the problem. When we undermine local conceptions of the self and modes of healing, we may be speeding along the disorienting changes that are at the very heart of much of the world’s mental distress.

Ethan Watters lives in San Francisco. This essay is adapted from his book “Crazy Like Us: The Globalization of the American Psyche,” which will be published later this month by Free Press.

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Maximum Power,

Dr. Dave Hill, DCH
http://www.drdavehill.com

“All our dreams can come true, if we have the courage to pursue them.” -Walt Disney

Filed under: Hypnosis, <a href=”http://hypnotistdavehill.wordpress.com/category/hypnotherapy/”>Hypnotherapy, Hypnotism, Hypnotist

The Americanization of Mental Illness

How Hypnotherapy Works

To understand how hypnotherapy works, we first need a general understanding of the conscious and subconscious mind.

The Conscious Mind

The conscious mind is the logical, rational mind that asks critical questions and analyzes situations. It also stores our temporary memory, which enables us to remember, for example, what we had for breakfast, or a conversation we had last week.

Many of us rely on our conscious mind when we first attempt to deal with a problem. Sometimes we try to analyze the problem, sometimes we rationalize our behavior in light of the problem, and, in the case of a bad habit, we might try to exert willpower to change it. Unfortunately, our conscious mind can’t always get in touch with what is really motivating us, and we are therefore unable to resolve our problems. Willpower ultimately always proves to be futile as well because by nature it is temporary and doesn’t last.

Hypnosis is an effective tool because it bypasses these limitations of the conscious mind in order to utilize the gifts of the subconscious mind, which help us make authentic realizations and permanent change.

The Subconscious Mind

While the conscious mind is analytical, rational, and logical, the subconscious mind rules over our emotions and intuition. While we might think of the conscious mind as a flash drive with just enough room to store the memory of our more recent experiences, we might think of the subconscious mind as an enormous computer that stores the memory of all of our experiences from the time we first became conscious beings.

In addition to storing the memory of our experiences, the subconscious mind also stores all of our core beliefs and our habits, which grow out of those experiences.

The subconscious mind also has an important protective feature. When it perceives a threat to our emotional or physical security, it will create a belief or a habit to keep us safe. Here’s an example: A five-year old girl experiences some sort of trauma that leaves her feeling insecure. (Keep in mind that what is traumatic from a child’s perspective may not always be traumatic from an adult perspective.) The subconscious mind goes through its files in search for something that made her feel secure in the past. One of the earliest sources of comfort for all of us is food and the subconscious mind activates the habit to eat to find security. This may be just what the girl needs to see her through the trauma and give her a sense of security, but because the subconscious mind doesn’t realize when a threat is no longer present, and she gets stuck with the habit of overeating when she feels stress.

The good news is that through hypnosis, the subconscious mind can identify and let go of those habits or beliefs that we have outgrown.

The Critical Factor of the Conscious Mind—The Gatekeeper to the Subconscious

From the time we first become conscious beings until about the age of six, our subconscious mind is wide open to receive those suggestions and influences that establish our self-esteem and habits. At about the age of six we develop what hypnotherapists refer to as the critical factor of the conscious mind. You might think of this as a gatekeeper who stands between the conscious mind and the subconscious mind and who decides what suggestions and influences get let in.

Unfortunately, when we experience trauma, the gatekeeper doesn’t do a very good job at keeping the negative influences out. I imagine him being knocked over by an experience, and in a daze, unable to do his job. While he’s collecting himself, in goes the negative suggestions that have a hand in shaping us.

Positive suggestions—suggestions for healthy change are another story. The gatekeeper has his wits about him and scratches his chin. He evaluates the suggestion, analyzes it, and takes his time as he decides if, indeed, the suggestion is a good one. If the suggestion is allowed into the subconscious mind, the good news is that the subconscious will accept it and feel it, and it goes into the computer forever.

Bypassing the Critical Factor of the Conscious Mind—Getting Past the Gatekeeper

The key to hypnotherapy is getting past the gatekeeper and into the subconscious mind. You can do this by going into hypnosis, also known as a trance state. All that really means is getting relaxed both physically and, more important, mentally. You won’t be asleep, and you won’t feel like you are in some strange, altered state. It’ll just be you, with your eyes closed, sitting comfortably in a recliner, letting go of that analytical part of you that’s running through tomorrow’s schedule and questioning everything around you. With the volume of your conscious mind turned down real low, you can focus all your concentration on the words and directions of the hypnotherapist.

For a suggestion to get past the gatekeeper, and for hypnosis to work, you also must have the right mental attitude. You need to be able to say, I like that idea, and I know this will work. That gatekeeper is going to detect any hesitancy or reservations that come from your conscious mind and will prevent any suggestions from getting through that you don’t like or are uncomfortable with. You must be ready to make a change and believe that hypnosis will make that change possible.

Speaking with Your Subconscious Mind

Once you are in a trance state and have accessed your subconscious mind, there are a couple of options. The first option is for the hypnotherapist to help you simply cancel out old suggestions and influences and replace them with the new, healthier ones that you desire. The second option is for the hypnotherapist to help you to find the file with the experience that has caused a problem. Once the file is found, the hypnotherapist has techniques to help you explore the experience, heal, and gain a new perspective, strengthened by positive suggestions.

Your imagination plays a very significant role here. To effect change, you need to be able to see yourself or, if you are not a visual person, to imagine yourself having successfully overcome your obstacles. Bringing your goals to life in your subconscious mind turns them into reality.

The amazing thing about hypnotherapy, and why it is so effective, is that once a suggestion gets past the gatekeeper and is visualized or imagined in the subconscious mind, it will be accepted as if it were true. This means that the changes you make with hypnosis involve no willpower. For example, a person who has been smoking for years can become and non-smoker and never again feel the urge for a cigarette.

Feeling the Truth from Your Subconscious Mind

Because the subconscious mind is the emotional mind and without a critical factor, you can depend on it to tell you what you really feel about a situation or a decision you must make. You will feel the truth to the core of your being. This makes hypnosis an effective tool for someone who doesn’t necessarily want to change a habit but is interested in self-exploration and general growth.

Maximum Power,

Dr. Dave Hill, DCH
http://www.drdavehill.com

“All our dreams can come true, if we have the courage to pursue them.” -Walt Disney

Posted in Hypnosis, Hypnotherapy, Hypnotism, Hypnotist

<a href=http://hypnotistdavehill.wordpress.com/2010/01/10/how-hypnotherapy-works/>How Hypnotherapy Works

The Twelve Days of Christmas

Here is the historical origin of “The Twelve Days of Christmas.”

-The partridge in a pear tree was Jesus Christ.

-Two turtle doves were the Old and New Testaments.

-Three French hens stood for faith, hope and love.

-The four calling birds were the four gospels of Matthew, Mark, Luke & John.

-The five golden rings recalled the Torah or Law, the first five books of the Old Testament.

-The six geese a-laying stood for the six days of creation.

-Seven swans a-swimming represented the sevenfold gifts of the Holy Spirit: Prophesy Serving, Teaching, Exhortation, Contribution, Leadership, and Mercy.

-The eight maids a-milking were the eight beatitudes.

-Nine ladies dancing were the nine fruits of the Holy Spirit–Love, Joy, Peace, Patience, Kindness, Goodness, Faithfulness, Gentleness, and Self Control.

-The ten lords a-leaping were the Ten Commandments.

-The eleven pipers piping stood for the eleven faithful disciples.

-The twelve drummers drumming symbolized the twelve points of belief in the Apostles’ Creed.

Maximum Power,

Dr. Dave Hill, DCH
http://www.drdavehill.com

“All our dreams can come true, if we have the courage to pursue them.”
-Walt Disney

Filed under: Hypnosis, <a href="http://hypnotistdavehill.wordpress.com/category/hypnotherapy/”>hypnotherapy, Hypnotism, Hypnotist

The Twelve Days of Christmas

Study: Alcohol Deadlier Than Heroin, Crack

By AOL Health Editors Nov 1st 2010 10:39AM

Alcohol is more dangerous than illegal drugs like heroin and crack cocaine, according to a new study.

British experts evaluated substances including alcohol, cocaine, heroin, ecstasy and marijuana, and ranked them on how destructive they are to the individual who takes them and to society as a whole.

The analysis took into consideration how addictive a drug is and how it harms the human body. It also looked at environmental damage caused by the drug, its role in breaking up families and its economic costs, such as health care, social services and prison.

Heroin, crack cocaine and methamphetamine, or crystal meth, were the most lethal to individuals. When considering their wider social effects, alcohol, heroin and crack cocaine were the deadliest. But overall, alcohol outranked all other substances, followed by heroin and crack cocaine. Marijuana, ecstasy and LSD scored far lower.

The study was paid for by Britain’s Centre for Crime and Justice Studies and was published online Monday in the medical journal, Lancet.

The study comes at a time when drinking in the U.S. has reached a 25-year high, according to a Gallup poll released in August.

The poll found that number of adults in the United States who drink alcohol has spiked to 67 percent, a modest increase over last year and the highest rate on record since 1985.

Though wine has gained popularity points and beer has lost some, a tall, frosty glass of barley and hops is still the favorite alcoholic beverage, with wine coming in second and liquor third.

Professor David Nutt, author of the Lancet study, told the BBC alcohol is the most dangerous drug because it’s also the most widely used.

“Crack cocaine is more addictive than alcohol but because alcohol is so widely used there are hundreds of thousands of people who crave alcohol every day, and those people will go to extraordinary lengths to get it,” he said.

Others agreed.

“Just think about what happens (with alcohol) at every football game,” Wim van den Brink, a professor of psychiatry and addiction at the University of Amsterdam, told the AP.

“What governments decide is illegal is not always based on science,” he said, adding that revenue and taxation, like those garnered from the alcohol and tobacco industries, may influence decisions about which substances to regulate or outlaw.

“Drugs that are legal cause at least as much damage, if not more, than drugs that are illicit,” said van den Brink, who was not linked to the study, but co-authored a commentary in the Lancet.

When used in excess, alcohol damages nearly all organ systems. It is also connected to higher death rates and is involved in a greater percentage of crime than most other drugs, including heroin.

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Source: Study: Alcohol Deadlier Than Heroin, Crack – AOL Health
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Maximum Power,

Dr. Dave Hill, DCH
http://www.drdavehill.com

“All our dreams can come true, if we have the courage to pursue them.”
-Walt Disney

Filed under: Hypnosis, <a href="http://hypnotistdavehill.wordpress.com/category/hypnotherapy/”>Hypnotherapy, Hypnotism, Hypnotist

Study: Alcohol Deadlier Than Heroin, Crack

Happy Thanksgiving!

Keep an eye out around the 2 min 30 second mark for the Marine in his dress blues as he stoops down and extends his hand to greet the little girl! Click on the following:

http://media.causes.com/576542?p_id=92681239

Happy Thanksgiving to all…

Maximum Power,

Dr. Dave Hill, DCH
http://www.drdavehill.com

“All our dreams can come true, if we have the courage to pursue them.”
-Walt Disney

Filed under: Hypnosis, <a href="http://hypnotistdavehill.wordpress.com/category/hypnotherapy/”>Hypnotherapy, Hypnotism, Hypnotist

Happy Thanksgiving!

Stressed Out? Relaaaax…With Hypnosis

John used to down two scotch and waters before dinner every night just to relax enough to make the transition from work to home life. But after dinner he would be so relaxed he’d nod off while reading the paper and find himself unable to go to sleep upon retiring. He desperately needed to unwind after a stressful workday as a management executive and was looking for an alternative to “social drinking” when he stumbled upon hypnosis.

No after work John takes a fifteen minute “transition break” by closing himself off in his bedroom, turning off the lights and the phone and putting on some soft music. He slips into comfortable clothes and stretches out on his bed or recliner. As the music begins to soothe his nerves his thoughts turn to his “safe place,” a mental haven where he has gone many times to escape from the stresses of the outer worlds. Here in his own imagination John is in complete control. He can visit his favorite location – a stretch of deserted beach – or another safe place in a cool pine forest where he listens to the nearby waterfall. Wherever he is, John knows he is safe, comfortable, and in complete control, with no one asking anything of him or wanting anything from him. Here he can – and does – imagine himself as he desires to be – healthy, happy, relaxed, and at peace with himself and everyone around him. If he experienced any difficulties at work, he puts these problems into the basket of a hot air ballon and watches them genlty blow away, knowing that they will be taken care of in the best possible way. John may take a dip in the ocean or playfully dance under a gentle waterfall, cleansing both his mind and his body of all stress, all tension, all negative emotions, and feeling a restorative healing energy take place as he continues to enjoy this peaceful, relaxing state.

After about fifteen minutes, John instinctively ends his imaginative journey and slowly returns his thoughts to the present, reminding himself that he is back in his room feeling refreshed and revitalized, yet completely and fully relaxed and ready to enjoy his evening with the family.

The relaxed, good-natured John who emerges from the bedroom is a completely different person from the harried, stressed and sometimes short-tempered man who went in. John’s family members, as well as John, are grateeful that he has discovered hypnosis.

John is just one of a growing number of people who find that hypnosis works for them as an effective, non-drug alternative for stress reduction. With stress an ever present part of today’s lifestyle and the growing evidence of the link between stress and illness – including such conditions as hypertension, heart disease, ulcers, immune deficiency diseases, and even cancer – hypnosis provides welcome relief with no side effects.

Hypnosis, simply put, is a relaxed and focused state of mind. Most people can be trained to enter this state of deep relaxation and purposefully narrowed attention easily and safely in just a few sessions with the help of a trained hypnotherapist. Once the training has taken place, most clients can induce a self-hypnotic state, following the instructions of the hypnotherapist. Unlike alcohol or drugs, hypnosis can be used anytime and anywhere. All that it requires is an opportunity to relax for a few minutes. Once can practice hypnosis while gazing out an office window or sitting in a quiet corner of the office break room.

By quieting down the body and the mind hypnosis sets into motion a chain reaction of physiological responses, such as hormonal changes and changes in the immune system function. Hypnosis reduces the effects of stress on the body by thwarting the “flight or fight” response, lowering heart rate and blood pressure and relaxing muscle tension. These changes, in turn, stimulate other positive changes such as lowered production of stress hormones and increase of protective T-cell production by the immune system.

Since the 1970′s a growing number of scientific studies indicate that hypnosis, among other mind body therapies such as biofeedback and meditation are effective options in the treatment of illness where stress is a major factor. While not meant to take the place of traditional medical care, hypnosis can act as a useful adjunct therapy – one that is not only effective but enjoyable as well. One such study at Duke University showed that practicing relaxation resulted in reduced hypertension and reduced blood sugar levels in test patients. Another study indicated that the practice of hypnosis could increase the chance that in-vitro fertilization procedures would be successful for patients.

With more studies every day illustrating the effectiveness of hypnosis for stress reduction and its accompanying health benefits, shouldn’t you try hypnosis? It’s simply, easy, and pleasant. Contrary to popular myth, a hypnotherapist does not “take over” your mind or influence your thoughts, except at your request. You are aware at all times of the suggestions that are offered and your mind will automatically reject any suggestions that conflict with your values, morals, and beliefs. Also, the suggestions will lead you to more relaxation, a healthier and more balanced life.

Maximum Power,

Dr. Dave Hill, DCH
http://www.drdavehill.com

“All our dreams can come true, if we have the courage to pursue them.”
-Walt Disney

Filed under: Hypnosis, <a href="http://hypnotistdavehill.wordpress.com/category/hypnotherapy/”>Hypnotherapy, Hypnotism, Hypnotist

Stressed Out? Relaaaax…With Hypnosis

Gerry Spence – Winning Courtroom Strategies

Enjoy!

The finest trial attorney is a master of hypnotic influence.

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In accordance with Title 17 U.S.C. Section 107, any copyrighted work in this message is distributed under fair use without profit or payment for non-profit research and educational purposes only.
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Maximum Power,

Dr. Dave Hill, DCH
http://www.drdavehill.com

“All our dreams can come true, if we have the courage to pursue them.”
-Walt Disney

Filed under: Hypnosis, <a href="http://hypnotistdavehill.wordpress.com/category/hypnotherapy/”>Hypnotherapy, Hypnotism, Hypnotist

Gerry Spence – Winning Courtroom Strategies

COLOR HAS A POWERFUL EFFECT ON BEHAVIOR, RESEARCHERS ASSERT

By LINDSEY GRUSON
Published: October 19, 1982

WHEN children under detention at the San Bernardino County Probation Department in California become violent, they are put in an 8-foot by 4-foot cell with one distinctive feature – it is bubble gum pink. The children tend to relax, stop yelling and banging and often fall asleep within 10 minutes, said Paul E. Boccumini, director of clinical services for the department.

This approach to calming manic and psychotic juveniles contrasts sharply with the use of brute force favored as little as three years ago. ”We used to have to literally sit on them,” said Mr. Boccumini, a clinical psychologist. ”Now we put them in the pink room. It works.”

Not all psychologists are quite so sure; many, to put it mildly, remain skeptical. Nonetheless, officials at an estimated 1,500 hospitals and correctional institutions across America have become sufficiently convinced of the pacifying effect of bubble gum pink to color at least one room that shade.

Passive pink, as it is also called, is perhaps the most dramatic example, and certainly the most controversial, of many attempts to use light and color to affect health and behavior. Already, there are enough color schemes to spark nightmares about mind control: red to increase appetite and table turnover in restaurants, ultraviolet to reduce cavities and spur children’s I.Q.’s, and blue to swell the ratio of female chinchilla babies to males.

In industrial societies whose members spend more and more time in enclosed areas under artificial lights, any effect of color and light becomes important. And now that man is primed to build artificial habitats under the seas or in outer space, totally isolated from sunlight or totally exposed to it, the urgency of understanding the effect of artificial light can only become critical. As a result the ancient and once discredited field of chromotherapy has been rejuvenated. Many scientists have become convinced that light has a far greater impact on health and behavior than previously thought. (Chromotherapy is now called photobiology or color therapy to distinguish it from the once-popular work of Victorian quacks.)

”It seems clear that light is the most important environmental input, after food, in controlling bodily function,” reported Richard J. Wurtman, a nutritionist at the Massachusetts Institute of Technology. Several experiments have shown that different colors affect blood pressure, pulse and respiration rates as well as brain activity and biorhythms. As a result, colors are now used in the treatment of a variety of diseases.

Within the past decade, for instance, baths of blue light have replaced blood transfusions as the standard treatment for about 30,000 premature babies born each year with potentially fatal neonatal jaundice. Further, because the blue light irritates nurses working in these wards, many hospitals have added gold lamps to soothe their staffs.

Meanwhile, in England, London’s Blackfriars bridge was repainted blue in an attempt to reduce the number of people who commit suicide by jumping from it. The Soviet Union, one of the leaders in photobiology, showers coal miners with ultraviolet, which they believe prevents black lung disease, and supplements the fluorescent lights of schoolrooms with ultraviolet lamps.

The result, said Faber Birren, a color consultant for industry, is that ”children grow faster than usual, work ability and grades are improved and catarrhal infections are fewer.” Mr. Birren has published hundreds of articles and books on color and is widely considered the most authoritative source on the subject.

In the United States, ultraviolet has become a standard treatment for psoriasis. And white fluorescent light, in conjunction with photosensitizing drugs, is widely used to help heal herpes sores. More controversially, several municipalities are experimenting with passive pink to stop graffiti, while football coaches try the color in visitors’ dressing rooms, hoping to debilitate their opponents.

Though doctors and researchers may differ over how much is too much, they agree that some portions of the electromagnetic spectrum -such as X-rays, microwaves and ultraviolet rays – have significant effects on health. But by and large they reject such suggestions for visible light.

For example, Richard Wener, an environmental psychologist at the Polytechnic Institute of New York, said the claims made for passive pink were inflated. ”People love to see a magic bullet,” he said. ”It strikes me as very unlikely that we’ll find such a simple solution to very complex problems. In the real world, we usually find that the magical is fantastical.”

Some skepticism may be owing to the scars left by 19th-century color healers, who claimed to cure everything from constipation to meningitis with glass filters. Nor has photobiology’s roots in mysticism, which empowered color with symbolism and magic, added to its credibility.

In addition, most color studies have been psychological, focusing on how light and color may affect behavior. Assertions about physiological effects have not, at least until recently, been based on strict and scientifically designed research. Mr. Birren also asserts that the training of 20th-century doctors makes them favor ”pills and surgery” and ”shots and prescriptions” over such cures as color therapy.

Many color therapists complain that their work is dismissed out of hand. John Ott, a retired banker and a leading photobiologist who directs the Environmental Health and Light Research Institute in Sarasota, Fla., said he has been called ”a crackpot” for suggesting experiments on the relationship between color and behavior.

Color therapists themselves disagree about why and how color acts as they believe it does. Mr. Birren, who has concentrated on the psychological effects of color, said he does not believe those effects are directly physiological. As designers and interior decorators have discovered, color sets a mood; this in turn, Mr. Birren said, affects health because as many as half of modern man’s diseases may have a psychosomatic component.

But Alexander Schauss, director of the American Institute for Biosocial Research, said color had a direct physiological impact. The electromagnetic energy of color, he said, interacts in some still unknown way with the pituitary and pineal glands and the hypothalamus, deep in the brain, These organs regulate the endocrine system, which controls many basic body functions and emotional responses, such as aggression.

”Color very definitely has a physiological effect,” said Harold Wohlfarth, who is president of the German Academy of Color Science and a photobiologist at the University of Alberta. In an experiment at the Elves Memorial Child Development Centre, a private school for handicapped children in Edmonton, Alberta, he found that light had the ”identical” impact on the blood pressure, pulse and respiration rates of two blind children as on seven students with normal sight.

In the study, reported in the International Journal of Biosocial Research (Volume 3, No. 1), the walls of the schoolroom were changed from orange and white to royal and light blue. A gray carpet was installed in place of an orange rug. Finally, the fluorescent lights and diffuser panels were replaced with full-spectrum lighting.

As a result, Professor Wohlfarth reported, the children’s mean systolic blood pressure dropped from 120 to 100, or nearly 17 percent, The children were also better behaved and more attentive and less fidgety and aggressive, according to the teachers and independent observers. When the room was returned to its original design, however, the readings gradually increased and the children once again became rowdy, he said.

Professor Wohlfarth said the minute amounts of electromagnetic energy that compose light affect one or more of the brain’s neurotransmitters, chemicals that carry messages from nerve to nerve and from nerve to muscle. Several experiments on rats and other small mammals already have provided evidence, he said, that light striking the retina influences the pineal gland’s synthesis of melatonin, a hormone that has been found to help determine the body’s output of serotonin, a neurotransmitter. The precise role of the hormone, however, remains to be established.

As part of a $500,000 study of the effect of light on pupils in four schools in Edmonton, Professor Wohlfarth is trying to identify which of the brain’s thousands of neurotransmitters, besides serotonin, is affected by electromagnetic energy.

”Perhaps these are new beginnings,” concluded Mr. Birren. ”The magical properties of light and color, granted by men since the earliest of times, accepted, renounced and accepted again through the ages, have forever held fascination. It would be delightful, of course, if a thing of such psychological beauty – color – also held a mundane role in human physiological well-being.”

New York Times, Published: October 19, 1982

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In accordance with Title 17 U.S.C. Section 107, any copyrighted work in this message is distributed under fair use without profit or payment for non-profit research and educational purposes only.
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Maximum Power,

Dr. Dave Hill, DCH
http://www.drdavehill.com

“All our dreams can come true, if we have the courage to pursue them.”
-Walt Disney

Filed under: Hypnosis, <a href="http://hypnotistdavehill.wordpress.com/category/hypnotherapy/”>Hypnotherapy, Hypnotism, Hypnotist

COLOR HAS A POWERFUL EFFECT ON BEHAVIOR, RESEARCHERS ASSERT

A Simply Philosophy of Life

WORK: it keeps the mind occupied and nimble and delivers purpose.

PLAY: it balances the time, effort, and anguish of work.

FIGHT: only for what is worth fighting for.

LOVE: only what is worth loving, and do so with all your heart.

BELIEVE: in something, but believe every day.

-Mark Bouris, Businessman, Entreprenuer

These men did all of this and more

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In accordance with Title 17 U.S.C. Section 107, any copyrighted work in this message is distributed under fair use without profit or payment for non-profit research and educational purposes only.
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Maximum Power,

Dr. Dave Hill, DCH
http://www.drdavehill.com

“All our dreams can come true, if we have the courage to pursue them.” -Walt Disney

Filed under: Hypnosis, <a href="http://hypnotistdavehill.wordpress.com/category/hypnotherapy/”>Hypnotherapy, Hypnotism, Hypnotist

A Simply Philosophy of Life

Perception? A Question To Ponder…

THE SITUATION

In Washington, DC, at a Metro Station, on a cold January morning in 2007, this man with a violin played six Bach pieces for about 45 minutes. During that time, approximately 2,000 people went through the station, most of them on their way to work.

After about 3 minutes, a middle-aged man noticed that there was a musician playing. He slowed his pace and stopped for a few seconds, and then he hurried on to meet his schedule.

About 4 minutes later: The violinist received his first dollar. A woman threw money in the hat and, without stopping, continued to walk.

At 6 minutes: A young man leaned against the wall to listen to him, then looked at his watch and started to walk again.

At 10 minutes: A 3-year old boy stopped, but his mother tugged him along hurriedly. The kid stopped to look at the violinist again, but the mother pushed hard and the child continued to walk, turning his head the whole time. This action was repeated by several other children, but every parent – without exception – forced their children to move on quickly.

At 45 minutes: The musician played continuously. Only 6 people stopped and listened for a short while. About 20 gave money but continued to walk at their normal pace. The man collected a total of $32.

After 1 hour: He finished playing and silence took over. No one noticed and no one applauded. There was no recognition at all.

No one knew this, but the violinist was Joshua Bell, one of the greatest musicians in the world. He played one of the most intricate pieces ever written, with a violin worth $3.5 million dollars. Two days before, Joshua Bell sold-out a theater in Boston where the seats averaged $100 each to sit and listen to him play the same music.

This is a true story. Joshua Bell, playing incognito in the D.C. Metro Station, was organized by the Washington Post as part of a social experiment about perception, taste and people’s priorities.

This experiment raised several questions:

· In a common-place environment, at an inappropriate hour, do we perceive beauty?

· If so, do we stop to appreciate it?

· Do we recognize talent in an unexpected context?

One possible conclusion reached from this experiment could be this:

If we do not have a moment to stop and listen to one of the best musicians in the world, playing some of the finest music ever written, with one of the most beautiful instruments ever made. . .

How many other things are we missing as we rush through life? I wonder…

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In accordance with Title 17 U.S.C. Section 107, any copyrighted work in this message is distributed under fair use without profit or payment for non-profit research and educational purposes only.
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Maximum Power,

Dr. Dave Hill, DCH
http://www.drdavehill.com

“All our dreams can come true, if we have the courage to pursue them.” -Walt Disney

Filed under: Hypnosis, <a href="http://hypnotistdavehill.wordpress.com/category/hypnotherapy/”>Hypnotherapy, Hypnotism, Hypnotist

Perception? A Question To Ponder…