This chapter describes key steps, with scripts, for the phases of therapy with a dissociative identity disorder (DID) client, and for an eye movement desensitization and reprocessing (EMDR) session with a DID client. In brief, the method employs the artful use of EMDR and ego state therapy for association and acceleration, and of hypnosis, imagery, and ego state therapy for distancing and deceleration within the context of a trusting therapeutic relationship. It is also endeavoring to stay close to the treatment guidelines as promulgated by the International Society for the Study of Trauma and Dissociation. The acronym ACT-AS-IF describes the phases of therapy; the acronym ARCHITECTS describes the steps in an EMDR intervention. Dual attention awareness is key in part because it keeps the ventral vagal nervous system engaged sufficiently to empower the client to sustain the painful processing of dorsal vagal states and sympathetic arousal states.

This chapter serves as a one-stop resource where therapists can access a wide range of word-for-word scripted protocols for Eye Movement Desensitization and Reprocessing (EMDR) practice, including the past, present, and future templates. These scripts are conveniently outlined in an easy-to-use, manual style template for therapists, allowing them to have a reliable, consistent form and procedure when using EMDR with clients. The idea of the safe place has been a staple in practices of Clinical Hypnosis practitioners. The first known use of the Safe Place with EMDR was when Dr. Neal Daniels, an EMDR practitioner working at the Veterans Administration Hospital in Philadelphia, adopted this resource to assist the veterans with whom he worked to ground themselves and contain their affect before doing trauma work. Dr. Francine Shapiro saw the merit of this intervention and by 1995 included a formalized version into the first EMDR text.

Rational emotive behavior therapy (REBT) is often used in conjunction with hypnosis and has been shown to work effectively in several controlled outcome studies. Many authorities have held that therapeutic hypnosis itself largely works through suggestion and mainly consists of giving clients strong positive statements and inducing them to internalize and act on these self-statements. Autohypnosis and regular hypnosis assume that humans upset themselves with ideas, images, and other cognitions and those they can be taught and trained to change these cognitions and thereby significantly change their feelings and actions. Hypnosis and REBT are both highly active-directive methods and differ significantly from many other passive and nondirective therapies, such as psychoanalytic and person-centered therapies. REBT and hypnosis both emphasize homework assignments and vivo desensitization and frequently urge clients to do the things they are afraid of and to work against their feelings of low frustration tolerance and their self-defeating addictions.

This chapter focuses on enhancing clients’ understanding of self-hypnosis. Mindful self-hypnosis may be accomplished with or without audio recordings. Up to this point (session 4), mindful hypnotherapy (MH) has involved providing audio recordings of hypnotic inductions, asking the client to “practice self-hypnosis using audio recordings“, and tracking progress on the Mindful Self-Hypnosis Daily Practice Log. Practice using the audio recordings is very beneficial. Learning and practicing self-hypnosis with and without audio recordings has a number of benefits as it can enhance the progress of MH. Self-hypnosis without audio recordings can be used in a very flexible manner and clients can use it to achieve a hypnotic state and reinforce mindful suggestions and goals. Self-hypnosis can be very empowering as it gives greater control to the client and hypnotic suggestions can be self-directed.

This chapter addresses training considerations regarding clinical hypnosis and mindfulness, standards of training in clinical hypnosis, development as a mindful hypnotherapist, competency, and future research. Training for MH should include a firm understanding of both hypnosis and mindfulness. Workshops in clinical hypnosis and application in practice are essential to deepen understanding. Likewise, workshops, retreats, and personal experiences of mindfulness can be extraordinarily helpful in understanding the phenomenology of mindfulness and can allow a clinician to integrate mindfulness in clinical work more adroitly. This book provides the basics of MH, guidance, and transcripts for use in clinical practice. It encourages therapists to begin to utilize MH as may be appropriate in their clinical practice and mindful self-hypnosis in their personal self-care. Workshops on MH as well as training in the rich foundational knowledge in hypnosis and in mindfulness practices can be an important source of developing competency in these methods.

Mindfulness interventions are predicated on the idea that suffering is amplified when there is a strong resistance or attachment to particular experiences. Therefore, one of the core components of mindfulness interventions such as mindful hypnotherapy (MH) is helping clients to develop a nonjudgmental attitude toward their experiences. Session 2 is intended to open the client’s eyes to the possibilities of nonjudgmental awareness by fostering curiosity and openness to physical experiences. The session invites the client to attend to physical experiences that are relatively innocuous (such as breathing, mild pleasantness, or mild irritation), but encourages them to pay attention to these experiences as though it were the first time they have ever experienced the sensation. With practice and experience, this mindful attitude can also be used with more intense and unpleasant experiences, and it can even be used to mindfully notice thoughts and emotions.

Mindful hypnotherapy uses individualized hypnotic suggestions as well as standardized transcripts to facilitate a client’s integration of mindfulness into their lives. Hypnotic suggestions can serve a wide variety of purposes depending on a client’s needs and goals. Hypnotic suggestions can be expressed in a variety of ways in the context of mindful hypnotherapy, but there are certain principles that help distinguish effective hypnotic communication from ineffective hypnotic communication. This chapter presents the basics of formulating hypnotic suggestions, including principles such as pacing and leading and the use of reinforcement during hypnotic suggestions. It discusses the different styles of hypnotherapy as they relate to the delivery of hypnotic suggestions as well as the importance of therapeutic metaphors (or storytelling) in mindful hypnotherapy. Examples of hypnotic suggestions are also included to illustrate each principle.

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.

Compassion is an attitude with tremendous potential for healing and for transforming one’s actions. Compassion’s potential to transform the world for the better means that many people have come to think of compassion as a moral imperative. Compassion for oneself is often regarded as unimportant at best and narcissistic at worst. This session is an opportunity to examine and perhaps challenge some of these unspoken assumptions about the role of compassion. The result of this process is that a client unlocks the profound healing potential of compassion for themselves and for the people around them. Throughout the session, the therapist can help expand a client’s view of compassion from an exclusively moralistic, one-way street to a broader view that encompasses both themselves and others. Session 5 falls just past the middle point of mindful hypnotherapy (MH) and occupies an important place in the overall intervention.