This chapter highlights that the realm of hypnosis is full of startling, counterintuitive, and even “magical” experiences and phenomena and devotes some attention to the potential advantages of trying to cage such phenomena within the framework of rigorous research design. It outlines major features of effective research design, which apply as fully to hypnosis as to any other domain, by referring to some classic experiments in the history of science. The chapter distinguishes among three major types of hypnosis research, intrinsic, neurophysiological and instrumental hypnosis researches, which require somewhat different handling of these basic design issues. Qualitative reviews and meta-analytic studies consistently document the potential of hypnosis to play a role in the treatment of a wide variety of psychological and medical conditions, ranging from acute and chronic pain to obesity. Neurophysiological research is one of the most intriguing and active areas of hypnosis-related inquiry.
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Unwanted sequelae of therapeutic trance states were observed in the healing temples of ancient Greece. Hypnosis, like other beneficial therapeutic modalities, is inevitably associated with instances of unintended, unwanted, and undesirable consequences. These range from transient and trivial discomforts to more lasting mild through severe uncomfortable forms of physical, psychophysiological, and psychological distress. While unwanted responses to hypnosis are more common and covert than has been generally understood, the risk of their occurrence can be markedly reduced by the more thorough evaluation of the patient, the regular use of rather basic and straightforward clinical interventions, and the individualization of the techniques and imagery brought to bear in the treatment setting. Further, initially unrecognized incipient problems often can be identified and nipped in the bud by monitoring alertness with the clinician- and patient-friendly Howard Alertness Scale (HAS) and the more assertive use of directive approaches to dehypnosis.
This chapter deals with the subject of hypnosis in rehabilitation, as it pertains to the amelioration of suffering from untoward medical events that alter a person’s physical, intellectual, or emotional capacities. The genesis of suffering from a lasting medical event includes the wounding of self and the narcissistic injury or threat that incurred. The chapter focuses on one particular approach to restoring a sense of self that is not identified necessarily with the self as a physical being alone or as an agent or narrator of one’s life. Suffering from injury or disability is increased when the cognitive self cannot create a meaningful narrative that integrates the loss of function and ability. Ego-state therapy can be used to target “the narrative self” or any aspect of the psyche that is suffering from the medical condition and disability arising from such.
This chapter focuses on multifaceted hypnosis intervention, which combines elements of behavior therapy, cognitive behavioral therapy, and mindfulness and acceptance-based approaches based on empirically supported principles and methodologies. It describes the nature and pros and cons of nicotine replacement therapy (NRT) and indicates that NRT can contribute to the success of cognitive behavioral interventions for smoking. The harmful effects of smoking on health are well known. From increased risk of many types of cancers, cardiovascular and pulmonary disease, stroke, and ulcerative disease, smoking is the leading cause of premature mortality and morbidity in the United States and worldwide. As a cost-effective and brief intervention, hypnosis represents a viable and promising approach for achieving smoking cessation and thereby could significantly reduce smoking-related health risks. Motivation and positive expectancies are likewise key to maximizing hypnotic responses. The self-hypnosis script invites participants to take slow deep breaths and become absorbed in their experience.
Children and teens with anxiety disorders share some common patterns in their thinking and response. They share core difficulties in accurately appraising specific situations, experiences, and other stimuli. Enhancing self-regulation, that is, shifting one’s attention in order to control and modulate one’s psychophysiological reactivity, emotions, thoughts, and behavior leads to various, individualized goals for treating anxious youth with hypnosis, cognitive behavioral therapy (CBT), and other mind-body approaches. Chronic childhood anxiety, the earliest and most frequent mental disorder among youth, has a potentially lifelong negative impact on self-regulation, learning, memory, and social behavior. Despite the dearth and variable quality of research, hypnosis offers a valuable adjunct to psychological interventions in the treatment of childhood anxiety, presenting as anxiety disorders, anticipatory and medical procedural anxiety, primary care presentations, or “normal nervous” responses to developmentally based situational stressors.
Childbirth is one of the most intense and demanding events that a woman is likely to experience, and both physical and psychological resources must be mobilized to cope with the labor process. Meaningful and adequate support must be given to the woman undergoing labor and delivery because the costs for society and the individual of a negative childbirth experience may be substantial. Negative and traumatic birth experiences have been associated with an increased risk of both short-term and long-term consequences. Hypnosis can have a positive impact on the childbirth experience. Hypnosis can be provided as antenatal training and during labor and delivery as self-hypnosis or as guided hypnosis. Attention should be paid to ego-strengthening, reframing the labor and childbirth process, and helping the pregnant and laboring woman to keep a positive focus. Basic hypnotic strategies such as progressive relaxation and securing a safe place can be very useful.
This chapter discusses the types of depression in which hypnosis can be useful and explains the technique of using hypnosis as an explorative and therapeutic tool in the treatment of depression. The symptoms of depression may manifest in the form of depressed mood, excessive sadness, crying spells, or aches and pains in various parts of the body. The patient’s depression represents an underlying, unresolved grief or a form of pathological, prolonged, incomplete mourning reaction. The new trend has gradually shifted away from the exploration of a history of a past trauma or unresolved memories of childhood abuse and instead has focused on the patterns of maladaptive cognitions and behaviors that are associated with depression. The use of hypnosis in patients with depression is best done by therapists who are well-trained in psychodynamics and in the care of suicidal patients.
In 1965, John Hartland proposed that before practitioners undertake direct symptom removal through hypnosis, it was advantageous to engage in a preliminary process of ego-strengthening. Ego-strengthening represents both an autonomous treatment approach and a strategy that can supplement other treatments. Since Hartland first introduced the ego-strengthening model in 1965, many patients with mental health and medical disorders have shown significant improvement in their overall well-being, and in some cases reduction in their presenting symptoms as well. People still have access to a wide range of verbatim scripts for ego-strengthening suggestions, but they also have the newer approaches using guided imagery, the inner strengths model, the process of age progression, and the mobilization of helpful ego states. At this time, in a world of damaged egos/selves, entire communities with traumatic psychological injury, and individuals battling addictive behavior, ego-strengthening psychotherapy and ego-strengthening hypnosis provide an approach applicable in most clinical practices.
This chapter offers a scientific perspective on the variety of problems that might emerge between a patient and practitioner during hypnotic induction. Clinical hypnosis is a cooperative endeavor, in which the priming of unconscious associations combines with the creation of a deep expectation that therapeutic change will occur. Experts agree that fear is the most common reasons for resistance to induction and the most common fear is of the hypnotic state itself. Perhaps one of the hapless problems that can occur during hypnotic induction is that of mis-communication. The patient may be highly ambivalent about a large number of things, including trusting others, making changes to behavior, or whether or not to remain in therapy. Before induction, it is important to assess the patient’s history of hypnotic experiences and subsequent attitudes. This knowledge enables the practitioner to select inductions and hypnotic techniques that are compatible with the patient’s expectancies.
This chapter aims to bring together the postmodern psychoanalytic perspective for both contemporary models of psychodynamic thought and hypnosis and the relational variables as they relate to hypnosis from this perspective. The relationship between hypnosis and psychoanalytic/psychodynamic thought dates back to Freud and Breuer’s book, Studies on Hysteria. Their collaboration involved the use of hypnosis in treating hysterical symptomology. The chapter reviews the relational variables that the psychodynamically and hypnotically trained practitioners use for assessment and treatment as they arise in the interaction field for both. The relational variables are the therapeutic alliance, transference, counter-transference, projective identification, and the use of transitional experience. Projective identification is an important relational variable for the psychodynamically trained therapist who is also trained in the uses of hypnosis. The chapter presents a brief case example of how the relational variables contributed to initially working with the patient and ultimately deciding the appropriate hypnotic suggestions.