In addition to watching for gross muscle relaxation, the savvy hypnotherapist will watch for other indicators of hypnosis. When a client responds to your suggestions by relaxing her arms and legs, it is not strong evidence that hypnosis is occurring, only that she is following directions for relaxation, and of course you know that hypnosis is not relaxation. But when you see signs such as Rapid Eye Movement (REM) and flushing of the skin, you are observing physiological evidence that hypnosis is occurring. When your client is in hypnosis, your suggestions can have an effect on her unconscious mind and have an effect on the Autonomic Nervous System. When this is occurring, your suggestions for relaxation are accepted at this deeper level of the mind, which among other things, controls the smooth muscles of your client's body, including her internal organs and vascular system.
When your suggestions are accepted by the unconscious mind, your suggestions can cause a relaxation response in the tiniest muscles that surround the smallest blood vessels and the effect can be seen on the surface of the skin. When this kind of relaxation is accomplished, more blood flows through the smallest blood vessels in the skin and the surface of the skin will "flush" and may even become warm to the touch. Your clients may even experience feeling chilled (air feels cooler as the skin warms). As her vascularity near her skin relaxes and expands she might also experience a tingling or itching.
REM is commonly observed in clients experiencing the deeper levels of hypnosis and is commonly observed in clients when they are in deep levels of natural sleep. If the client becomes unresponsive, you will need to check to make sure that the client is not asleep or in a deeper level of hypnosis than is useful, for example the Esdaile State (commonly know as Hypnotic Coma State). These deeper levels of hypnosis are perfectly safe, but are not ideal for hypnotherapy (unless the hypnotherapist intends to guide the client into a state of hypnotically-induced anesthesia for a medical procedure or for working on chronic pain).
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