The Inherent Relationship between Traditional Chinese Medicine (TCM) and Hypnotic Rituals

Hypnosis has gained in recognition as an effective treatment for many psychological and physical ailments, and has a wide application area [1-6]. Correspondingly, acupuncture has been acknowledged as valuable for treating various health conditions [7-9]. On the other hand, these two complementary and integrative medicine therapies are commonly administered separately in general practice, while there are views elaborating the simultaneous administration of both hypnosis and acupuncture (i.e. hypno-acupuncture), and supporting the synergism hypothesis between hypnosis and acupuncture when applied together [7,10,11]. Hence, with this study, we aim to elaborate the inherent relationship between Traditional Chinese Medicine (TCM) [8,9,12,13] and the hypnotic rituals of a conscious hypnosis method named “Awareness Under Conscious Hypnosis (AUCH©)” [14-16], and thus to examine further the feasibility of the integrative use of hypnosis and acupuncture.


Introduction
Hypnosis has gained in recognition as an effective treatment for many psychological and physical ailments, and has a wide application area [1][2][3][4][5][6]. Correspondingly, acupuncture has been acknowledged as valuable for treating various health conditions [7][8][9]. On the other hand, these two complementary and integrative medicine therapies are commonly administered separately in general practice, while there are views elaborating the simultaneous administration of both hypnosis and acupuncture (i.e. hypno-acupuncture), and supporting the synergism hypothesis between hypnosis and acupuncture when applied together [7,10,11]. Hence, with this study, we aim to elaborate the inherent relationship between Traditional Chinese Medicine (TCM) [8,9,12,13] and the hypnotic rituals of a conscious hypnosis method named "Awareness Under Conscious Hypnosis (AUCH©)" [14][15][16], and thus to examine further the feasibility of the integrative use of hypnosis and acupuncture.
in induction step and also with the autohypnotic key used in autohypnosis step of AUCH© Method. Also, the mapping is illustrated via describing some of the basic hypnotic rituals of AUCH© Method. While showing TCM meridians and points on the map, "Teaching Atlas of Acupuncture: Channels and Points" [12] and also "The Pictorial Atlas of Acupuncture: An Illustrated Manual of Acupuncture Points" [13] are used as the reference sources.

Awareness Under Conscious Hypnosis (AUCH©) Method
AUCH© is a Conscious Hypnosis method established by Dr. Hüsnü İsmet Öztürk in 1951 and in which the person under hypnosis is fully conscious and awake during the whole hypnotic process. AUCH© Method can be applied in many different fields of medicine for complementary and integrative healing purposes. It has a holistic view of human that has many different value and belief systems and sociocultural norms, thus provides an inherently and systematically integrative therapeutic approach. This leads to the possibility of using other medical and psychological disciplines as a part of the transcultural and interdisciplinary methodology of AUCH©. In this respect, TCM has an inherent relationship with AUCH© Method since the body parts induced spontaneously during AUCH© hypnotic treatment protocol coincide considerably with the acupuncture points and meridians of TCM [15].

Hypnotic treatment protocol of AUCH©
AUCH© is a state of consciousness aiming to make changes in attention, perception, memory, emotions and senses of the patient in order to regulate, maintain and improve patient's psychological, physiological and social wellbeing. For this purpose, AUCH© uses a treatment protocol consisting of three steps: "1) MAYA© (Making Acceptance with Your Awareness), 2) Induction and 3) Autohypnosis" [14] (Table1). To listen to the patient; observation and consultation; To accept the patient to the therapy; To establish rapport (attachment); To shape the therapy plan according to the needs and expectations of the patient; To use stories or metaphors for giving the patient positive aspects of conflicts and a wider perspective; To give general info regarding hypnosis, AUCH© and treatment tools/methodology (Warming up period); To understand basic & actual capacities and conflicts of the patient; To improve rapport; to answer patient's all questions regarding treatment method (Cooling down period) To illustrate AUCH© application videos to encourage the patient for the treatment and the utilization of selfhelp capabilities; To take the consent of the patient.

2) Induction
To use hypnotic suggestions, induction techniques ("Eye-to-Eye Fixation and Giving Suggestions Technique" as the main induction technique) and hypnotic rituals according to the needs and expectations of the patient in order to solve conflicts and problems of the patient; To develop or differentiate patient's capacities while increasing communication capabilities (differentiation); To use collective and personal myths to increase the effectiveness of the therapy; To apply "hand passes, touchings and tapings" as a part of hypnotic rituals intrinsic to AUCH© Method on and over head and body parts coinciding considerably with acupuncture points, meridians and zones.

3) Autohypnosis
To give the patient the ability to use autohypnosis whenever/ wherever needed but under certain conditions designated by the practitioner in order to achieve, reinforce and maintain the therapeutic aims; To lead the patient to determine and achieve future goals and roles by using self-help capacities (detachment).
If the aimed therapeutic results are reached, to teach the patient the use of "autohypnotic key" specific to AUCH© method, "covering the thumb with other four fingers in a fist", which spontaneously induces hand areas coinciding substantially with acupuncture points, meridians and zones. The

The mapping based on the inherent relationship between TCM and the hypnotic rituals applied during hypnotic induction step
Various hypnotic induction techniques can be used to induce hypnosis in Induction Step. On the other hand, in AUCH© method, "Eye-to-Eye Fixation and Giving Suggestions Technique" is the main induction technique during whole induction period. This induction technique is unique to AUCH© method due to the active use of hypnotic rituals including "hand passes, touchings and tapings" on and over head and body parts, and also based mainly on the hypnotic suggestions given to the patient. AUCH© Method has 41 main hypnotic rituals that can be applied during Induction Step, but in this study only three of them will be mentioned. To prevent confusion, they will be numbered respectively, but this numbering does not necessarily mean they need to be applied subsequently in practice.
The starting position of the "Eye-to-Eye Fixation and Giving Suggestions Technique" and the first hypnotic ritual is settled by the practitioner as below (Figure 1  After settling the starting position of this technique, the practitioner looks through the eyes of the patient from a distance of approximately 20-25 cm while pressing downwards the left thumb on the sagittal plane slowly from GV24 area towards glabella following GV meridian. The left thumb stops on the area covering Ex-Yin Tang when the patient's eyes get closed simultaneously. At the same time, the practitioner moves the right thumb upwards with a gentle pressure on the sagittal plane towards mentolabial groove and stops on the area including The second hypnotic ritual that can be used during the application of the "Eye-to-Eye Fixation and Giving Suggestions Technique" is applied on either side of the face like this ( Figure  3): ii. Each index finger is placed superior to the apex of the ear and over the triangle area having GB7, GB8 (the intersection point of the GB and BL Meridians) and TW20 (the intersection point of the GB and TW Meridians) as its corners.
iii. Each middle finger and ring finger is placed behind the auricle while middle finger is located around GB10 (the intersection point of the GB and BL Meridians) and TW19, and ring finger is positioned covering GB11 (the intersection point of the GB and BL Meridians).
iv. Each little finger is located on the mastoid process around GB12 (the intersection point of the GB and BL Meridians).
Then, the practitioner makes circular hand passes on each temporal region with the tips of other fingers while each thumb is fixed on its initial position, i.e. in front of tragus. These hand

Journal of Complementary Medicine & Alternative Healthcare
passes on each side of the patient's head starts from the upper ear muscle and goes towards mastoid process following the path behind the auricle. Along this path, GB and TW meridians were passed by fingertips with a gentle pressure. When each index finger reaches to the lobule of the ear and passes over the area including GB12 and TW17, each thump makes a lateral rotation and turns upwards without touching the patient's body. Then, with a light touch, the dorsa-distal surfaces of the other four fingers on each side slide further down to the neck, pass over sternocleidomastoid muscle then clavicle, and reach to the neck triangle which is located above the clavicle between the front edge of the trapezius muscle and the lateral part of the sternocleidomastoid muscle. These hand passes finally end on the hand fingertips of the patient on either side, after passing over the anterior, lateral, posterior and/or medial surface of each arm depending on the position of the patient.
As mentioned before, these hypnotic rituals are among the 41 basic hypnotic rituals used during the treatment process of AUCH© method. On the other hand, additional micro hand passes, touchings and tapings, also hypnotic rituals can be applied on and over the upper and lower body during or apart from these hypnotic rituals depending on the treatment plan.
It is also important to note that all the hypnotic rituals including hand passes, touchings and tapings are accompanied by hypnotic suggestions given simultaneously during whole induction period according to the needs and expectations of the patient; and that these hypnotic suggestions are the main and key therapeutic tool in AUCH© method. The suggestions are designed in accordance with the diagnosis made according to the observations and information gathered during MAYA© step. Also, if needed, the suggestions can be reshaped or new suggestions can be added to the existing ones during treatment period.

The mapping based on the inherent relationship between TCM and the hypnotic ritual applied during autohypnosis step
If the treatment applied becomes successful providing the desired outcomes, autohypnosis is taught to the patient as the third step of AUCH© hypnotic treatment protocol. So, the patient can achieve, maintain and reinforce the awareness, well-being and self-help ability gained during the treatment whenever and wherever needed as soon as it is within the borders specified by the practitioner. Although it is possible to use different autohypnosis techniques, AUCH© method uses a unique

Journal of Complementary Medicine & Alternative Healthcare
autohypnotic key, a hand gesture made with the dominant hand, to initiate autohypnosis process. This autohypnotic key, which is covering the thumb with other four fingers in a fist, is intrinsic to AUCH© method since the hand area induced spontaneously with the hypnotic ritual applied during autohypnosis step coincide considerably with TCM acupuncture points and meridians as illustrated in Figure 5 and 6. On the other hand, it should be noted that the main therapeutic tool used during autohypnosis is the set of hypnotic suggestions given by the practitioner to the patient according to the treatment plan in consideration of the patient's needs and expectations.

Conclusion
It is worth to consider the inherent relationship between TCM and hypnotic rituals of AUCH© Method since AUCH© Method could open a new window to the feasibility and acceptability of the integrative use of hypnosis and acupuncture. The hypnotic treatment protocol and the basic hypnotic rituals used in AUCH© Method have been developed spontaneously after many years of clinical experiences and observations of the first author in the search of enhancing the hypnotic experience and increasing the efficiency of the treatment. On the other hand, it is possible to examine the efficiency of AUCH© Method by considering its applications in minor and major surgical operations or other painful or anxiety provoking medical or surgical interventions besides its various effective applications in different fields of medicine. AUCH© can be applied as a valuable tool to prepare the patient for surgery both mentally and physiologically, to maintain the stability of vital signs and retain proper homeostasis during intraoperative period, and to facilitate postoperative healing. Furthermore, AUCH© can be used as the sole anesthetic for surgery by controlling the physical stimulus of pain and also the emotional response to pain such as anxiety, muscle tension, and apprehension [16][17][18][19][20]. On the other side, further research is necessary to elaborate the mechanism and rationale behind the inherent relationship between TCM and hypnotic rituals of AUCH© Method, and as a result to offer further understanding regarding the integrative use of hypnosis and acupuncture.

Authors
All research done by the authors.

Financial Support
This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.