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.
Your search for all content returned 76 results
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.
The most popular nonpharmacological techniques for managing hypertension are introducing a healthy diet, weight loss, exercise, decreased alcohol intake, and psychological interventions for stress and anxiety reduction. Hypnotherapy is a good candidate for directly delivering or supporting such nonpharmacological interventions. Hypnosis can also be used to target the risk factors of hypertension, such as obesity, anxiety, and stress. Several studies show that hypnosis can be effective to assist weight loss. Hypnotherapy has also been confirmed to reduce anxiety and stress, in some cases even more effectively than cognitive behavioral therapy (CBT). Hypertension is not painful and is usually unnoticed by the person suffering from it; while lifestyle and dietary changes for the management of hypertension require considerable effort, patients are often noncompliant. Thus, the importance of improving compliance and cooperation cannot be overstated. The hypnotherapist also has to work closely with the physician during the therapy.
Prostate cancer is the second most common malignancy among men: Approximately one in six men are expected to be diagnosed with prostate cancer in their lifetime. Depending upon treatment needs, hormone therapy is often utilized to reduce overall androgen levels or the chances of androgens reaching cancer cells. The goal of antiandrogen hormone therapy, which can be chemical or surgical in nature, is to shrink or slow the growth of Prostate Cancer Cells. Cancer of any type is often accompanied by uncomfortable physical symptoms and symptoms of psychological distress, such as feelings of anxiety, sadness, irritability, and nervousness. In addition to the distress associated with any cancer diagnosis, a diagnosis of prostate cancer often produces a unique and significant set of distressing physical and emotional challenges related to urinary, erectile, and bowel dysfunctions.
This chapter describes specific issues involved in the effective assessment of the patient with an eating disorder before the decision to utilize hypnosis is implemented. The comprehensive and in-depth assessment of patients with an eating disorder is of great value for understanding the underlying dynamics of the condition, the patient’s character, and the crafting of an effective treatment plan. Ego-strengthening suggestions are an important part of most hypnotherapy interventions. This technique has been useful with patients in whom the underlying dynamic for the eating disorder is related to past trauma. Many patients have a chance to fully abreact emotions attached to the original trauma, and the emotional catharsis in the abreaction itself already produces some relief. Ego-state therapy has become a frequent focus in the hypnosis literature. This therapy concerns a notion of how much the individual’s behavior is the result of dissociated ego states in a state of conflict.
This chapter focuses on hypnotic and cognitive behavioral strategies for the treatment of stress. Stress has been associated with biochemical, physiological, emotional, and behavioral changes. Clinical practitioners from diverse theoretical and psychotherapeutic approaches use hypnosis in the treatment of stress-related problems. Hypnosis, when utilized with medical procedures and presurgical anxiety, meets the criteria for being a well-established treatment that is both effective and specific. The chapter presents summaries of stress management techniques and an integrated hypnosis and cognitive behavioral model for treatment of stress. Evidence-based treatments for stress include progressive muscle relaxation, autogenic training, relaxation response, biofeedback, guided imagery, mindfulness-based therapy, and cognitive behavioral therapy. An integrated approach using cognitive behavioral treatment and hypnosis provides an effective, structured, and time-limited approach for clients with complex stress-related problems. This integrated approach can be modified for a variety of potential stress-related problems given its reliance on individual case conceptualization and treatment planning.
Hot flashes are the most prevalent symptom associated with menopause and are characterized by sudden warmth, primarily in the face and chest, sweating, chills, anxiety, and irritability. Hot flashes can disrupt sleep and result in discomfort and distress, which can negatively affect quality of life. The onset of hot flashes coincides with a decrease in estrogen levels that occurs during the menopausal transition; therefore, hormone replacement therapy has been the most commonly used treatment for hot flashes. Menopause, the cessation of the menstrual cycle, typically occurs between the ages of 45 and 55 when the release of estrogen and progesterone declines dramatically. The transition from premenopausal to postmenopausal is around four years and begins with changes in the normal menstrual cycle, culminating in amenorrhea. Hypnotic relaxation therapy can be adapted to effectively treat hot flashes both the frequency and severity of the hot flashes.
Sexual self-image plays a crucial role in healthy sexual functioning. More clinical studies are needed to evaluate hypnosis as a treatment for the improvement of sexual self-image. The use of hypnosis to improve sexual self-image should only be conducted by trained clinicians who understand the complexities and vulnerabilities of patients presenting negative sexual self-schemas and sexual dysfunction. It is important for the trained clinician to be aware of both the physical and psychological manifestations of sexual dysfunction and for proper diagnosis to be made prior to treatment, particularly the need to assess for sexual trauma and abuse. Once a diagnosis is made, it is then crucial for a treatment plan to be established that develops trust and rapport between the clinician and the patient. Treatment plans should include suggestions that are appropriate for the patient as well as suggestions for relaxation, anxiety reduction, and self-acceptance.
Major advances have been made in preventing chemotherapy-induced nausea and vomiting (CINV) in patients receiving chemotherapy. A variety of highly effective antinausea medications are currently available and customarily employed. Certain chemotherapy drugs, such as cisplatin and dacarbazine, given without antinausea medications, have a 90” chance of causing acute nausea and vomiting (N&V). Other chemotherapy drugs, such as vinblastine, have less than a 10” incidence of N&V even without the concomitant use of antinausea medications. Highly effective antinausea medications, such as ondansetron, olanzapine, and granisetron, called 5HT3 antagonists, and aprepitant, called substance P antagonists, often completely prevent CINV. Hypnosis is a well-established and highly valuable resource for patients undergoing chemotherapy. Hypnosis prevents anticipatory nausea and reduces the need for antinausea medications and their side effects. Even when nausea and vomiting do occur, it reduces the physical and emotional effect of the experience.
- Go to chapter: Cataract Eye Surgery: Preparation for Eye Surgery Assisted by Positive Therapeutic Suggestions
Cataract removal is one of the most commonly performed surgical procedures worldwide. Most people experience some extent of anxiety in the perioperative period of their cataract surgery; elderly patients and patients with high trait anxiety are the most affected. In most surgical procedures, patients tend to seek out information about the operation. A good way of doing this is using positive therapeutic suggestions. The setting and scene of eye surgery can be utilized well to support relaxation and hypnosis. Prior studies have shown that using positive suggestions before and during ophthalmic surgery can increase the subjective well-being of the patient and can also result in higher satisfaction with the surgery for the patient. Detailed description of the steps of surgery can evoke prior surgical experiences. Used in a controlled environment, this technique might help patients who have unprocessed traumatic experience from a prior surgery to resolve these traumas.
Hypnotic phenomena can include subjective changes as well as behavioral responses to each suggestion. This chapter presents descriptions of two of the more profound types of phenomena, delusion phenomenon and dissociation phenomenon, that can be elicited with hypnosis, keys to successful hypnotic inductions, a technique to help resistant patients respond to hypnosis, and effective deepening protocols. It provides techniques that have been found to elicit hypnotic responses beyond what might be predicted by hypnotizability scale scores. Voluntary behaviors can be carried out without hypnosis, using methods ranging from mere suggestion to simple directions to role-playing by the subject to please the hypnotist. The chapter discusses the experience of an involuntary automatic action, which can be demonstrated by the Kohnstamm phenomenon. The “Verbal-Non-Verbal Dissociation technique” builds upon the Kohnstamm phenomenon. It is worth attempting even with those who have scored in the lowest ranges of the hypnotizability tests.
Loin pain hematuria is a medical condition that can cause the following symptoms: recurrent or persistent unilateral or bilateral flank pain, loin tenderness, microscopic or macroscopic amounts of blood in the urine, low-grade fever, painful urination, and abnormal amounts of protein in the urine. These symptoms can be severe and often result in excessive use of pain medications and significant interference with activities of daily living. Additionally, psychological symptoms, such as depression and anxiety, have been associated with the condition. To the author’s knowledge, only one case study has been published examining hypnotherapy for the treatment of the physical and psychological symptoms associated with loin pain hematuria. The results reported in this case study indicate that hypnotherapy may be useful in addressing the physiological discomfort, emotional distress, and lifestyle interference associated with loin pain hematuria. Additionally hypnosis provides a medically benign and conservative alternative to surgical interventions and narcotic med.
Nail biting is a common oral habit in children, adolescents, and young adults, and less so in older adults. Like many habit behaviors, the vast majority of people who bite their nails do not seek assistance/ treatment for this problem; even with children in whom it is more common, only a small percentage are brought for “help” by their care-giver. A variety of approaches behavioral, pharmacological, and combinations thereof have been utilized to treat nail biting with varying degrees of success. Most recently, the nutraceutical N-acetyl cysteine (NAC) has been touted to be effective for habit problems like nail biting, in theory at least in part because of antioxidant properties that may impact on mood and mediate the impulsivity associated with the target habit behavior. Cinical experience teaches that hypnosis when used appropriately by experienced clinicians, is a safe, easy, and very effective treatment to eliminate the habit of nail biting.
Chronic pain is common and contributes to significant emotional suffering and physical disability worldwide. For example, individuals with chronic pain endorse substantially more symptoms of depression and anxiety than those without chronic pain. By far, the most common treatments of chronic pain are analgesic medications, including opioid drugs. Chronic pain is not primarily a biomedical problem, and is therefore not easily resolved with a single simple biomedical treatment. This chapter provides an introduction to the use of hypnosis for the treatment of chronic pain for the clinician who is interested in incorporating hypnotic approaches into his or her clinical practice. It presents a basic overview of a contemporary biopsychosocial model of pain-a model that should be clearly understood by health care professionals who work with individuals with chronic pain. The chapter finally describes a detailed and specific protocol for training patients in the use of self-hypnosis for chronic pain management.
Hypnosis as an analgesic and anesthetic has had a long history of application in dentistry. In the use of hypnosis to manage dental pain or anxiety, this may include assessment of mental status and determination of hypnotizability. Also, occasionally, patients do present with medical concerns in which they would prefer to avoid chemical anesthesia of any sort. Another application of hypnosis in dentistry is in the control of gagging. Hypnosis and its core paradigm, principles, and techniques offer the dental clinician a method by which patients may experience comfort and tolerate dental procedures better. Bruxism is a complex dental problem that falls within the domains of psychological issues, purely dentition-related ones, and sleep disorders. From the dental perspective, it is usually addressed from the constellation of temporomandibular disorders. Research is generally supportive of the use of hypnosis for managing pain, reducing anxiety, and performing other applications in dentist.
Posttraumatic stress disorder (PTSD) can severely diminish the quality of life of the patient. Clinicians who wish to utilize hypnosis to help treat patients presenting with PTSD should familiarize themselves with the symptomatology and utilize appropriate screening measures. A thorough history screening will provide clinicians with important information regarding the onset of the trauma. Utilizing this information, clinicians are better able to adapt their treatment as well as the use of hypnotic suggestions to best suit the needs of their patients. Research on hypnosis for PTSD adjunctively with other treatments has been promising. While additional investigation is needed to determine which hypnotic techniques offer greater potential for the resolution of PTSD symptomatology, more recent studies have demonstrated support in favor of using manualized abreactive ego state therapy (EST) as a rapid psychological intervention for the treatment of PTSD providing durable symptom relief.
This chapter reviews clinical presentations of ego-state problems and the diagnosis of ego-state pathology, methods for clinical activation of ego states, how ego-state therapy is conducted, and the goals and principles of ego-state therapy. Ego-state therapy has a very sparse evidence base and has research problems similar to psychodynamically oriented psychotherapies and hypnotically facilitated therapies in general. The chapter describes the nature of ego states and of their configurations in health and distress. It shows how ego-state pathology manifests itself, how it is diagnosed, and how it is treated safely within a phase-oriented strategy by using a series of clinical vignettes. The chapter also reviews ego-state therapy from its beginnings as a hypnoanalytic therapy to its expansion into a widely practiced therapeutic modality, with standards for training and competence. Ego-state issues affect many behaviors and phenomena in health care patients that might be otherwise inexplicable.
This book is an interdisciplinary resource on clinical hypnosis research and applications in psychology and medicine. It encompasses state-of-the-art scholarship and techniques for hypnotic treatments along with hypnosis transcripts and case examples for all major psychological disorders and medical conditions. This book addresses hypnotic theories such as socio-cognitive and neo-dissociation theories, neurophysiology of hypnosis, hypnotherapy screening, measurement of hypnotizability, professional issues, and ethics. Chapters present hypnotic inductions to treat 70 disorders including asthma, anxiety, depression, pain, sleep problems, phobias, fibromyalgia, irritable bowel syndrome (IBS), menopausal hot flashes, Parkinson’s disease, palliative care, tinnitus, addictions, and a multitude other common complaints. The book examines the history and foundations of hypnosis, myths and misconceptions, patient screening, dealing with resistance, and precautions to the use of hypnosis. It also examines a variety of hypnotherapy systems ranging from hypnotic relaxation therapy to hypnoanalysis. For each application, the text includes relevant research, specific induction techniques, and an illustrative case example. Additionally, this book covers professional issues, certification, hypnosis in the hospital, and placebo effects.
Hypnosis today continues to be contaminated by unfortunate misappropriations or misattributions of its core healing qualities based on how it has been practiced and/or understood throughout its history. A solid appreciation of professionally accredited training opportunities is an important step for any clinician seeking to incorporate clinical hypnosis into her or his therapeutic armamentarium. There exist well-defined pathways to acquire training in clinical hypnosis through professionally accredited organizations, though what “professional accreditation means” in today’s world can be another instance of what people might call “professional truthiness”. The accredited organizations that this author views as legitimate maintain well-delineated criteria defining clinical academic and experiential foundations in clinical practice that must exist prior to seeking training in hypnosis. Prior to engaging in practice using clinical hypnosis, accredited professional organizations require clinician to be licensed to practice in his or her relevant health professional discipline independent of subsequent training in clinical hypnosis.
Hypnotic relaxation therapy (HRT) is a particular system or approach to hypnotherapy. It involves a careful case formulation and treatment planning that capitalizes on the evolving body of empirical evidence for hypnotic relaxation interventions and psychotherapy. It is both structured and individualized and considers that all information is processed at both the conscious and unconscious levels of awareness. It is a highly integrative therapy that may be directed toward the development of coping skills, symptom relief/ alteration, facilitating insight, or relapse prevention. The Elkins Hypnotizability Scale (EHS) was developed for ease of administration by the clinician, time efficiency, and relevance to clinical practice. From the perspective of HRT, the conscious and unconscious minds are conceptualized from a social-psychological perspective, specifically Cognitive-Experiential Theory. Rapport and a positive therapeutic relationship are essential to achieve an optimal response to HRT in the context of psychotherapy or medical procedures.
The topic of hypnosis and its use in medical and clinical settings is one that, seemingly more often than not, quickly elicits a demonstratively expressed opinion among medical and mental health practitioners, scientists, and observers. These opinions are delivered with widely varied degrees of actual knowledge and understanding about hypnosis, its uses, and its history. This chapter provides a comprehensive resource to those seeking a more substantive understanding of hypnosis and its uses both established and emerging. The use of hypnosis was evident in psychiatric treatment during and following World War I and World War II. The history of hypnosis in medical and clinical settings provides an excellent example of the importance of understanding the historical context in which a particular clinical approach was developed. The history of hypnosis is long, complex, and essential to understanding the current state of knowledge, application, and research of hypnosis in medical and clinical settings.
According to a survey of adult primary-care patients, the prevalence of dysphagia in the general population is surprisingly high, running approximately 23”. The distribution of those affected by dysphagia is bimodal. Infants and children born with cleft palate, cerebral palsy, or other neurodevelopmental conditions represent one of the modes, while generally older adults who have suffered stroke, head/neck cancers, Parkinson’s disease, amyotrophic lateral sclerosis (ALS), and, increasingly, those with Alzheimer’s disease combine to constitute the second general population spike. The established benefit of hypnosis with anxiety-spectrum concerns, as well as the psychophysiological aspects of different neuromuscular conditions, would seemingly make the use of hypnosis in treating individuals with dysphagia an obvious resource. For many, anticipation of the swallowing difficulty will tighten relevant muscles and can constrict breathing, increasing the odds of experiencing the dysphagia. Many approaches for evoking relaxation of mind and body are available.
This chapter reviews the burgeoning body of information on prolonged grief disorder (PGD), a construct that has been heretofore titled complicated grief, traumatic grief, and pathological grief with subcategories including interrupted, delayed, and absence of grief. It also reviews the literature on the treatment of PGD with hypnosis and presents a case example of hypnosis-aided behavioral treatment in a case of spousal bereavement. Healthy adjustment to bereavement has been described by several theoretical models. These models share several features including focus on resilience and adaptation, premise that adaptation requires strategies in a multitude of situations, the importance of developing and operationalizing coping strategies, and the role that the sociocultural context plays in the adaptation process. Hypnotherapy is a valuable approach to treat bereavement. The chapter presents a hypnotic-mediated approach that emphasizes reconnecting and restoration aspects of PGD treatment.
Cystic fibrosis (CF) causes the body to produce thick secretions that lead to damage of the respiratory, gastrointestinal, and reproductive systems. Symptoms of CF can include cough, shortness of breath, pneumonia, chronic sinusitis, abdominal pain, malnutrition, and infertility. The damage caused by CF in the lungs is so severe that the disease is life-shortening. People with CF face many challenges directly and indirectly related to their chronic illness. Teaching them self-coping skills such as hypnosis is associated with a significant improvement of their quality of life and is empowering to the patients. The effectiveness of clinical hypnosis is enhanced through the use of a patient-centered approach. Such an approach should be integrated into health care broadly as part of standard medical care. Notably, providing concurrent medical and psychological therapy allows amelioration of symptoms that are influenced by psychological effects and may be associated with a reduction in necessary medical therapy.
This chapter focuses on mindfulness as a psychological trait and presents a brief review of the evidence supporting the mindfulness-based and mindfulness-influenced therapies, which have emerged over the past 35 years. Mindfulness is a central element of third-wave cognitive therapies such as mindfulness-based stress reduction (MBSR), acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), and mindfulness-based cognitive therapy (MBCT). There is a substantial evidence base for the use of mindfulness in therapy for mood disorders, borderline personality, and even some evidence for chronic pain. Despite the fact that there is a sound theoretical basis for delivering a mindfulness-based intervention in a hypnotherapeutic context, there are no current empirical trials to demonstrate the outcome of such an approach. The chapter presents sample case study and hypnosis script to serve qualified clinicians as a template for implementing a combined mindfulness and hypnosis approach.
In the early 20th century, asthma was considered as one of the “Holy Seven” psychosomatic disorders and thus was thought to be amenable to psychological therapy. In multiple case reports, hypnosis has been reported to have beneficial effects on the subjective aspects of asthma, which include symptom frequency and severity, coping with asthma-specific fears, managing acute attacks, and frequency of medication use and health visits. Asthma is treated with a combination of anti-inflammatory and bronchodilator medications that typically are inhaled. Hypnosis may also be efficacious for decreasing airway obstruction and stabilizing airway hyper-responsiveness in some individuals. There are several additional hypnotic techniques, such as breathing techniques, subconscious exploration, and age regression, which can be useful in the treatment of patients with asthma. Patients can be taught to use some of these techniques through self-hypnosis on an as-needed basis.
This chapter describes a unified treatment protocol for emotional disorders. Cognitive hypnotherapy (CH) provides a variety of treatment interventions for emotional disorders distilled from decades of research on effective cognitive, behavioral, and hypnotherapeutic treatments for anxiety, mood, and trauma-based disorders. CH combines hypnotherapy with cognitive behavioral therapy (CBT) in the management of emotional disorders. This blended version of clinical practice meets the criteria for an assimilative model of integrated psychotherapy, which is considered the best integrative psychotherapy model for synthesizing both theory and empirical findings. Ego-strengthening suggestions are utilized in hypnotherapy to increase self-esteem and self-efficacy. The goals of ego-strengthening suggestions are to reduce anxiety and depression, and to gradually restore the patient’s self-confidence in his or her ability to cope effectively with problems and distress. Posthypnotic suggestions (PHS) are routinely delivered during hypnotherapy to counter problem behaviors, negative emotions, dysfunctional cognitions, negative self-hypnosis (NSH), and negative self-affirmations.
Anger is a curious phenomenon and an ambiguous psychological state. While it is generally viewed as a negative emotion to be addressed in psychological therapy, it is likewise often seen as a positive emotion. Anger tends to be seen as, and often is, empowering, at least in the short run. It can often coerce and direct other people’s behavior, establish social dominance, and aid in acquiring additional resources. But in the long run, an excessive level of anger can lead to health problems, poorer relationships, and diminished occupational functioning. Psychological therapy has been shown to be effective in treating anger problems. There are few research studies specifically on the use of hypnosis in treating anger. However, anger reduction may occur when hypnosis is targeted toward reduction of anxiety and stress.
Type 1 diabetes mellitus (T1DM) is an autoimmune disorder that destroys the beta cells in the pancreas. This destruction leads to the body’s inability to produce insulin, a hormone that is needed to regulate blood glucose. Symptoms that often appear upon onset of diabetes include frequent urination, polyuria, excessive thirst, weight loss, and elevated glucose levels. Type 2 diabetes mellitus (T2DM) is attributable to incremental deficits in insulin production leading to insulin resistance. Several aspects of diabetes management, including weight control, stress management, exercise, and sleep hygiene, have their own body of research or anecdotal clinical evidence to support hypnosis as a component of targeting these areas of health and wellness. Hypnosis can be a very beneficial adjunctive treatment for patients with diabetes. Targets for hypnotic intervention include dietary changes, improved sleep, weight control and motivation, compliance with medical treatments, and stress management.
Dystonia is a neurological movement disorder, in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures. The most frequent form of focal dystonia is referred to as spasmodic torticollis. Spasmodic torticollis is a painful, chronic neurological movement disorder causing the neck to involuntarily turn to the left, right, upward, and/or downward. Both agonist and antagonist muscles contract simultaneously during dystonic movement. Over time, the involuntary spasm of the neck muscles will increase in frequency and strength until it reaches a plateau. Symptoms can also worsen while the patient is walking or during periods of increased stress. Other symptoms include muscle hypertrophy, neck pain, dysarthria, and tremor. The muscles most frequently involved are the sternocleidomastoid (SCM) and the trapezius, but the excessive activity is not confined to these muscles and may “overflow” into adjacent muscles.
In a clinical treatment context, the importance of hypnotizability is closely akin to the importance of individual differences in response to other treatments, for example, medications, the appreciation of which is crucial for high-quality health care. Hypnosis produces a number of potentially important subjective effects that can be measured, including feelings of hypnotic depth, transferential phenomena like archaic involvement, and other phenomenological states. However, there is fairly wide agreement that a key subjective effect of hypnosis is an alteration of the sense of agency, such that when the hypnotic subject carries out a suggestion, it feels as if it is happening on its own, extra-volitionally. Hypnosis scales are the foundation for laboratory research on hypnosis, and published laboratory research on hypnosis virtually always uses them. The measurement of hypnotizability through standardized hypnosis scales has provided the foundation of modern hypnosis research but has had relatively little impact on clinical practice.
Flow is an experience that occurs when a person is performing at his or her most effective in regards to mental energy. People who have entered a flow state are intrinsically motivated and enjoy the experience. This peak experience involves a state of absorption where one experiences a balance between his expected challenge in the task and his ability level. There are currently nine identified components of flow: challenge-skill balance, clear goals, unambiguous feedback, action-awareness merging, concentration on the task at hand, sense of control, loss of self-consciousness, transformation of time, and the autotelic experience. Entering a flow state can be of benefit to people in many fields and many stages of life. Currently, hypnosis has been used to help create triggers for flow in athletes so that they may be able to pair previous flow states and recall them using the trigger.
Parkinson’s disease is a severe neurological disorder that results in the progressive diminishment of the physical and mental health of those affected. The disease attacks neurons located in the basal ganglia and substantia nigra of the brain. Damage to these brain structures, along with the subsequent decrease in dopamine availability, leads to the hallmark symptoms of the disease, which include rest tremor, rigidity, and slowed or difficult movement, also known as bradykinesia. Another common symptom, involuntary muscle movement, or dyskinesia, is brought about by the long-term usage of levodopa, which is the most commonly prescribed treatment for the disorder. Apart from these motor complications, Parkinson’s disease is associated with a number of severe psychological concerns as well. In fact, over 60” of patients with Parkinson’s disease either report or display neuropsychiatric symptoms. Common symptoms include anxiety, depression, sleep disturbance, and impulsiveness.
Conversion disorders (CD) are neuropsychiatric conditions characterized by neurological signs and symptoms not due to a medical condition and are part of the somatic symptom disorder category. They include weakness or paralysis, abnormal movements, swallowing symptoms, speech symptoms, seizures, anesthesia and sensory loss, sensory disorders, and mixed symptoms. Psychotherapy is considered the primary treatment for CD, even though there is no agreement on the most effective strategy, mainly because there is little structured evidence available. Although hypnosis appears to be a valid treatment for CD, few controlled studies have been performed in this field. Recently, there has been a growing interest in applying hypnosis to CD both for clinical reasons and for exploring brain functioning with neuroimaging methods. The ultrabrief treatment of three hypnotic sessions, and several nonhypnotic control sessions, is centered on the basic conflict resolution and on the use of minimal cues to change the symptom’s body experience.
This chapter examines and summarizes neuroimaging and electrophysiological assays of hypnotizability, hypnotic induction, and post hypnotic suggestions. It delves into the neuroscience of hypnosis by focusing on three central components: interindividual differences in hypnotizability or susceptibility to suggestion, the induction procedure, and the type and content of the hypnotic suggestions. First, hypnotic phenomena seem to engage frontal areas of the human brain. In particular, hypnosis involves regions implicated in mental alertness, executive control, top-down regulation, and monitoring processes. Second, hypnosis induces global changes in neural connectivity patterns-in other words, hypnosis emerges from complex brain dynamics. Third, research highlights the ability of post hypnotic suggestions to selectively engage relevant brain regions. This aspect underscores the precision of suggestion to target and influence specific perceptual, cognitive, or motor processes. Electrophysiological studies of hypnotic induction reveal general fluctuations in neural activity.
Ericksonian hypnotherapy, like its originator Milton H. Erickson, MD, is profoundly simple, yet simply profound. Erickson spent most of his professional life reestablishing the validity of hypnosis for medical, dental, and psychotherapy professionals. A great deal of Erickson’s early professional life was spent on scientific research. He always regarded himself as a scientist interested mainly in hypnotic phenomena. Erickson believed posthypnotic suggestions, as well as all other suggestions or interactions in trance, had to be agreeable to the conscious. Even though the conscious mind is bypassed in hypnosis, it continues to have this amount of monitoring. Hypnosis speaks from and to the unconscious, which Erickson believed to be benign and similar to a small child happy, enthusiastic, curious, loving and sharing, and excited and joyful, in a childlike way. Catalepsy is another sign of a trance. Catalepsy allows people to balance their muscles perfectly in ways that cannot be done consciously.
Aviophobia is a specific situational phobia for which people frequently seek therapy. Fearful flyers are a diagnostically diverse group, including those who are fearful but whose symptoms do not fully meet the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria for aviophobia, meet criteria for aviophobia, have a primary diagnosis of agoraphobia, and have multiple phobias. Although experts agree that exposure therapy is the “gold standard” for specific phobia, many individuals fail to make rapid progress or achieve partial success with standard treatments. Clinicians need to personalize therapy to increase retention and improve outcomes. Hypnosis can be used in a different ways to amplify techniques and target the specific elements that keep the phobia active. Fearful flyers have the promise of not only affective and behavioral changes that result from therapy but also the functional and structural brain changes that accompany the creation of new neural networks.
For skin disorders, hypnosis may help decrease pain and pruritus in the skin, allow exploration of and intervention in psychosomatic aspects of skin diseases, and lead to the resolution of some skin diseases, including verruca vulgaris. Psychosomatic hypnoanalysis with ideomotor signaling may benefit patients with chronic psychosomatic skin disorders who are nonresponsive to other simpler approaches. The author has discussed the successful use of psychosomatic hypnoanalysis in dermatology. This technique can be used for screening for psychosomatic factors related to skin disorder triggering or exacerbation. Hypnosis may be used to increase healthy behaviors, to decrease situational stress, to reduce needle phobias, to control harmful habits such as scratching, to provide immediate and long-term analgesia. It is also used to ameliorate symptoms related to diseases such as itching or pain, to accelerate recovery from surgery, and to enhance the mind-body connection to promote healing.
This chapter discusses the clinical applications and the evidence for efficacy of hypnosis in palliative care, and proposes the incorporation of hypnotic suggestion as an adjunctive strategy to manage pain, nausea, and anxiety in patients with advanced illness. As hypnosis has received growing acceptance by physicians, nurses, and other health care practitioners, it has received past recognition by the American Medical Association (AMA) and British Medical Association. Pain and palliative care patients are good candidates for hypnotic training for several reasons. Patients with progressive illness face many challenges including physical symptoms; existential challenges brought through isolation, infirmity, reduced activity, and challenged self-identity; and spiritual questions brought through death’s inevitability and proximity. There is growing evidence that hypnotic training should be introduced early and reinforced throughout the care of patients with life-threatening illness.
This chapter presents some of the many laws and principles that are known in the literature as tools of the hypnotic therapist’s everyday practice. The intrapersonal trance follows the laws of perceived reality, subjective interpretation, and expectancy. The expert hypnotist follows the natural flow of the continuum phenomenon from intrapersonal trance where the law of perceived reality, subjective interpretation, and expectancy are dominant to interpersonal trance, where it is necessary to follow the principles of collaboration, individualization, and utilization of what the subject brings. The practical application of these laws and principles are substantiated and reinforced by the three most important Coué laws. Following the laws of concentrated attention, dominant effect, and reversed effect gives us the flexible solidity of a master who knows that all he or she has learned about the theory is now in his or her mind and heart, in his or her conscious and unconscious mind.