ISG in the UK co-sponsored an “online clinic on skin conditions” that’s taking place this week. It’s still going on, and there are some worthwhile and interesting responses now, but Jennifer and I think that the forum was marred by the inclusion of a hypnotherapist on the panel of medical experts.
In one of the first questions on the forum, a parent with a 16-month old daugher with a form of epidermolytic ichthyosis (formerly known as EHK or epidermolytic hyperkeratosis) posted that she was concerned with “thick yellow skin on palms and soles and really thin skin on hands and feet” with “a lot of flakes, build up and blistering” and overheating. The first reply, by the hypnotherapist, naturally suggested hypnotherapy. For a 16-month-old.
Our first reaction, which you might have seen on Facebook, was unprintable given our editorial standards for our blog.
Jennifer responded on the forum, expressing incredulity. After she posted a link to the post on Facebook, several others also contributed to the discussion. Those posts have subsequently been deleted from the forum.
The hypnotherapist has now replied that he mistakenly thought that the patient was 16 years old, and not 16 months old. And while he acknowledges that hypnotherapy isn’t a suitable treatment for a 16-month-old infant, he continues to assert that hypnosis may be used “in conjunction with ongoing treatments”.
The hypnotherapist’s original response is no longer available, but neither Jennifer or I recall any such qualifications in his original response. And his updated response further cites to a “remarkable reference” to a case study in which hypnotherapy was reportedly used to treat someone with “congenital ichthyosisform erythrodermia (sic) of Brocq”.
Let’s look at the facts.
In his blog post about that citation, the hypnotherapist cites several scientific journals:
2. In 1961, Dr. C.A.S. Wink wrote to the British Medical Journal in “Congenital Ichthyosiform Erythrodermia Treated by Hypnosis“. Br Med J. 1961 September 16; 2(5254): 726-2, 741-743. Dr. Wink surveyed prior literature (from Dr. Mason and from Dr. JM Schneck in 1954, “Ichthyosis treated with hypnosis“, Dis Nerv Syst. 1954 Jul;15(7):211-4), and further reported on two other cases treated by hypnosis.
3. In 1962, The Lancet published an article by H.C. Bethune, “Psychophysiological Mechanisms in Skin Diseases”. We are unable to find the full-text of this article online.
4. In 1965, Dr. Schneck, the author of the 1954 study, wrote an article, “Hypnotherapy for ichthyosis“. [2] Psychosomatics, 7:233-235. We can’t access the full version, but Dr. Schneck starts by noting, “Hypnotherapy has not furnished a dramatic cure for ichthyosis, but a few examples are available of favorable skin changes induced during treatment.”
5. In 1966, Dr. Cecil Kidd published a study in the British Journal of Dermatology called, “Congenital Ichthyosiform Erythroderma Treated by Hypnosis“. Br. J. Dermatol. 781966; 78:101-105/
So to summarize, the cited peer-reviewed support that hypnotherapy can be used to treat severe ichthyosis consists of articles published between 1952 and 1966. But after 1966, apparently, the reports of miraculous improvement of ichthyosis through hypnotherapy stop. There are exactly six citations back to these articles in the 24-year span from 1978-2003, but every one of them is a review of old material, not a new study. These more recent articles pretty much say, ”Hey, that’s interesting, look what they found,” but they do not report any further instances.
But in discussing these “remarkable reference[s]“, the hypnotherapist calls the Mason article as “[o]ne of the most impressive studies of the use of hypnosis in treating skin disorders”.
I remain skeptical.
Why exactly would there be reports of success with hypnotherapy 50 years ago (on less than 5 cases over 14 years), with no subsequent reports in the scientific literature since then? Is it the result of a tinfoil hat conspiracy by the pharmaceutical companies? Or does it merely reflect scientists’ attitudes towards hypnotherapy in general — that it was very much “in vogue” 50 years ago, but those results are now regarded as impossible to reproduce?
Let me be clear: After researching the issue this afternoon, I believe that hypnotherapy may be used to alleviate many symptoms associated with severe ichthyosis, including itching, pain and anxiety. There have been recent meta-studies — including independent studies sponsored by the NIH — which present evidence that hypnotherapy is effective for pain management. (I’d like to dig in and see how that compares against placebo, but that’s neither here nor there.)
But I also believe that there is very little empirical evidence supporting that hypnotherapy can be used to “cure” ichthyosis.
I registered for the forum and asked some direct questions of the hypnotherapist. To summarize his response:
1. He is not aware of anyone attempting to replicate the results he cited within the past 50 years, and acknowledges that an explanation for this is that no one’s been able to replicate those results.
2. He’s been practicing hypnotherapy for 15 years, and in the course of his career, has only seen two patients with ichthyosis vulgaris. In both of his vulgaris patients, he says that the scaling on their skin decreased, and that his focus was on decreasing habitual scratching behaviors.
I don’t find this evidence persuasive, and think there’s a lot of danger with extrapolating results from the treatment of two vulgaris patients to patients with more severe forms of ichthyosis.
In his responses to me (and his response following his retraction of his initial advice), the hypnotherapist is very careful to point out that he believes that hypnotherapy is a “useful adjunct” to medical care and treatment, and that he is not recommending hypnotherapy as a “curative treatment”. And his initial blog post clarifies, “there is still not a strong enough body [of evidence] to start suggesting hypnosis can be a full-on alternative, stand-alone treatment.”
I feel that someone being held out by a support group as a medical expert, who cites these old studies whose results have not been replicated and extrapolates success with patients with ichthyosis vulgaris to the more severe forms of ichthyosis does a huge disservice to people who have ichthyosis and who are desperately looking for a cure.
Because I wholeheartedly support the scientific method and evidence-based treatment, I am willing to change my mind about this if presented with evidence. So, for anyone supporting hypnotherapy as a “cure” for ichthyosis: Show me your evidence. Has anyone been able to replicate the results described in the 1950′s and 1960′s by Mason, Schneck, Wink et al.? I haven’t seen any credible evidence that those results can be replicated, and until I do, I’ll have strong opinions about how those assertions should be regarded. In other words, until I see evidence, I’ll regard hypnotherapy-as-a-cure-for-ichthyosis as being in the same pile as crystal therapy and homeopathic medicine.
Don’t get me wrong. I’m glad ISG sponsored an online forum. As I’ve mentioned in the past, I think that dialog within the ichthyosis community is an important tool in spreading knowledge and improving the quality of life of affected families. But I also think it’s dangerous to cite “remarkable results” from hypnotherapy published 50 years ago and never replicated, and likewise dangerous to extrapolate those types of results from vulgaris patients to patients with severe forms of ichthyosis.
Further disclaimers: If I’ve gotten something wrong, I welcome dialog, either via the comments here, on Facebook, or via private messages. And, to reiterate what’s stated on our “About” page, this post reflects my opinions alone, and is not approved by anyone other than Jennifer.