As the surgical team scrubbed up in the operating room, Harold Wain, a psychologist at Walter Reed Army Medical Center in Washington, stroked Kathy Platoni's hand. His voice was soft, soothing. "Roll your eyes up to the ceiling," he said. "Close your eyes. Take a deep breath. Hold. Exhale. Let your body relax and float."

Platoni fell into a deep trance. With a scalpel, the surgeon made a horseshoe-shaped incision in the roof of her mouth. Platoni lay still, numb to the touch of the knife, though no anesthesia had been administered. While the surgeon sliced through skin and bone to restructure her upper jaw and correct mouth malformations, Platoni remained in an hypnotic trance. She remembers feeling no pain, not even an aching or throbbing during the 2 1/2-hour procedure. The only sensation she recalls is the tickling of the suture thread against her lips as the doctor sewed her up.

While few patients would brave an operation without drugs, about 15 percent of the population could actually use hypnosis as the sole anesthesia during surgery, according to Wain. The best subjects, he adds, are mentally healthy people, because schizophrenics, addicts, Alzheimer's sufferers and distrustful or depressed people don't have sufficient concentration capacity.

Nevertheless, a growing number of doctors are exploring hypnosis as an alternative or adjunct to anesthesia. Nearly 20,000 physicians and psychologists use it in their practices, according to the American Society of Clinical Hypnosis in Des Plaines, Ill. And some medical schools, following the lead of Columbia and Stanford, offer courses in a subject that was once regarded as the province of charlatans.

Platoni, a clinical psychologist herself, credits Wain with enabling her to remain in a deep trance during surgery. At the time of the operation in 1986, she was living in Fort Belvoir and chose hypnosis because of her aversion to sodium pentothal and even Novocain.

"I'm very tiny," she explained, "and I always feel confused and disoriented for a couple of days after anesthesia. That much loss of control makes me uncomfortable."

Platoni met with Wain for four 10-minute sessions prior to the operation. He determined that she was hypnotizable and taught her how to go into a trance. Once she was in a receptive state, he gave her suggestions to relax her body and make her mouth feel numb.

Throughout the operation, Wain talked to Platoni, focusing her on an image of herself sunbathing in the Bahamas, watching sailboats racing in the wind. To reinforce the numbness, he would say, "Look out at the water. Cool winds have just come up. Feel them on your mouth and lips. At the same time, continue to go deeper and deeper into a more comfortable state." At the close of the operation, Wain counted from one to five, slowly bringing Platoni out of her trance. Her first words were, "How did I do?" The surgeon was amazed that she felt no discomfort or fatigue. "I had this big smile on my face," Platoni recalled. "It was a real accomplishment for me to go through the operation without anesthesia."

"Psychologically, Kathy did not endure the discomfort of surgery," said Wain. "In many ways, her body never experienced the trauma one normally goes through. She didn't have any soreness after the operation because she was able to induce her own analgesia.

Surgeons began experimenting with hypnosis in the late 18th century, but the practice fell into disfavor with the discovery of ether and chloroform. When Freud repudiated hypnosis in the 1890s, it dropped to the level of vaudeville entertainment. Hypnotists were stereotyped as hucksters who coerced gullible victims to do their bidding. That image, according to Wain, is pure Hollywood.. Today's therapists say they help patients enter an altered state in which they can assert greater control over both mind and body.

Although the American Medical Association decreed in 1958 that hypnosis "is a useful technique in the treatment of certain ailments when employed by qualified medical and dental personnel," most doctors prefer chemical anesthesia, in part because no one knows how hypnosis actually works.

"It is too unreliable for daily practice because it is time-consuming and may be of help to only a few patients," said Michel Dubois, an anesthesiologist at Georgetown University Hospital.

Henry L. Bennett, an anesthesiologist at the University of California at Davis School of Medicine, said he thinks that hypnosis can help patients before surgery. But, he said, relying on hypnosis as the only means of anesthetic is "a very bad idea. Anesthesia is so safe now that it is a grandstanding ploy to not include pharmacological agents when you're having major surgery."

Ronald L. Katz, an anesthesiologist at the University of California at Los Angeles, said he uses positive hypnotic suggestions prior to and during surgery "as one of many tools to take care of my patients. But if you want to use hypnosis as the sole anesthesia . . . there are negatives." Among them is the fear that a patient will awaken prematurely, before the conclusion of surgery. As added protection, some physicians have medication available just in case.

Wain uses hypnosis routinely in his psychotherapy practice. "I recognized that a lot of the insight was based on a receptive state that the patient was in. I was looking for ways to expedite the process, and it occurred to me that hypnosis was an altered state of readiness or perceptive attention. I found that through the process of perceptive attention, one could expedite {therapy}," he said.

Wain emphasized that patients under hypnosis are not asleep but are in a state of resting alertness, capable of diverting attention away from painful stimuli. Because hypnosis can help patients diminish discomfort, it is now being used in every ward at Walter Reed Army Medical Center, according to Wain, for pain control.

Some breast cancer patients use it for relaxation, to help conquer the nausea of chemotherapy. Often, hypnosis is used in the emergency room to let patients manage pain. Classes that help people stop smoking and control weight also have found hypnosis useful.

Doctors and therapists use many techniques to help patients disassociate from pain. In addition to imagery, they sometimes suggest transferring the pain into another sensation or telling people to feel coolness or warmth. Or, they advise, picture pain flying away, as though it were a baseball sailing up and out of a stadium.

David Gage, a Washington psychologist, underwent surgery a few years ago for the removal of a tumor in his leg. He used no drugs, because, he said "I was interested in using hypnosis with my patients." Gage relied solely on the help of a fellow psychologist to talk him through the surgery. "I didn't feel any pain . . . {only} some warmth or heat or pressure, and when I would begin to feel anything disconcerting, I would do other things with my mind. I would see myself looking down at the whole thing from above as a way of altering my experience."

And though Gage said he didn't feel much discomfort, at some level his body registered the pain, according to psychiatrist Martin Orne, a leading hypnosis expert at the University of Pennsylvania and the Institute of Pennsylvania Hospital. "Hypnosis allows the individual to block out the pain at the level of the brain by not attending to it, by being able to disregard it as though it didn't exist." Athletes, Orne noted, commonly block out pain, such as a boxer who continues to fight with a broken hand but does not register the pain until the match is over.

Kathy Platoni is planning to undergo additional jaw surgery soon and again plans to use hypnosis as the only anesthetic. Though the surgical team will be standing by with anesthesia to put her to sleep, if necessary, Wain, who expects to hypnotize her, said he doubts she will need it. "We've never had anyone come out of a trance during surgery," he said, "because it is a very comfortable place to be."

Judy Licht is a freelance writer in Washington.