Handbook Of Hypnotic Phenomena In Psychotherapy

John H. Edgette, Janet Sasson Edgette

• Publisher: Routledge
• Year: 2013
• Topic: Psychology
• eBook ISBN:
  9781134861491
• Subtopic: History & Theory in Psychology
• Index: Psychology

Despite their clinical utility, hypnotic phenomena are vastly underutilized by therapists in their work with patients. Whether this is due to uncertainty about how to use specific techniques constructively or how to elicit particular phenomena, or anxiety about not being able to obtain a desired result, this volume will guide hypnotherapists toward higher levels of clinical expertise. By describing varied hypnotic phenomena and how they can be used as vehicles of intervention, The Phenomenon of Ericksonian Hypnosis takes the therapist beyond these fundamental applications toward a broader, more sophisticated scope of practice. This immensely readable book addresses the selection, eliciting, and therapeutic use of hypnotic phenomena that are natural outgrowths of trance. It offers step?by?step instruction on eliciting age progression, hypnotic dreaming, hypnotic deafness, anethesia, negative and positive hallucination, hypermnesia, catalepsy, and other hypnotic phenomena. The book includes specific instruction on how to use the phenomena manifested in trance to provide more effective treatment. Numerous case examples vividly illustrate intervention with anxiety disorders, trauma and abuse, dissociative disorders, depression, marital and family problems, sports and creative performance, pain, hypersensitivity to sound, psychotic symptomatology, and other conditions. The Phenomenon of Ericksonian Hypnosis will be used by therapists as a valuable clinical tool to expand their conceptualizations of hypnosis, and thus enable them to offer a wider repertoire of skills with which they can confidently treat clients.

PART I

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Preludes

Chapter 1

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AN OVERVIEW OF ERICKSONIAN HYPNOSIS

Over the last decade, the popularity of Ericksonian clinical hypnosis has grown tremendously among clinicians. This approach to hypnosis and treatment is based upon the therapeutic insights and interventions of Milton H. Erickson, M.D. (1901–1980). Since the time of his death there have been six International Congresses on Ericksonian Approaches to Hypnosis and Psychotherapy, each drawing about 2,000 attendees. Any one of these meetings would constitute the largest collection of individuals in history learning about hypnosis (Zeig, 1988a). Furthermore, each year hundreds of workshops are given around the world, training thousands of professionals.

This chapter is designed to give an overview of Ericksonian hypnosis—what it is, how it works, how it is different from more classical hypnosis styles, and what its clinical uses are. It provides the foundation for the rest of the book, which deals more specifically with hypnotic phenomena, one of several vehicles of intervention in psychotherapies in which hypnosis plays a part.

HYPNOSIS

In basic terms, hypnosis refers to an altered psychological state generally characterized by certain physiological attributes (e.g., relaxed muscle tone, reduced blood pressure, slowed breath rate), by an enhanced receptivity to suggestion, and by an increased access to unconscious feelings, ideas, and memories (Erickson, 1989). It is not a stereotypical ritual involving pendulums, watches, or crystal balls, nor is it a static, fixed internal state. Rather, it is an interchange or form of communication between two (or more) people that results in the accessing and subsequent utilization of latent or underdeveloped resources. These resources may consist of past experiences, affects, or forgotten skills, and their renewed experience or application can result in changes in one's memory, perception, sensation, and/or emotion so that new behaviors and attitudes manifest (Zeig, 1987).

Trance is understood as an experience that allows for the creation of a new phenomenal world for the client. New behaviors and attitudes are able to evolve and manifest because old, limiting, rigid, or maladaptive ones are modified, dissipated, or shifted to more innocuous areas of emotional or social functioning. An example of the latter is where one's compulsive need to worry about meeting work deadlines can be channeled into worrying about when changes in one's worry pattern will first be noticed, or into worrying about how one will best use newly found recreation time.

DIRECT AND INDIRECT SUGGESTION

Suggestions made by the therapist during trancework can be either direct or indirect. Direct suggestion refers to a proposal made in a straightforward, recognizable way. Thus, a client may be told to remember vividly (hypermnesia) an earlier experience (age regression) that had filled him or her with feelings of mastery and confidence. Alternately, a client may be encouraged to have a dream (hypnotic dreaming) that will offer an insight, a partial solution, or an idea for a new direction of exploration.

On the other hand, one would use indirect suggestion to allude to a proposed action instead of suggesting it outright. For instance, a burn victim may be told stories of how firefighters put out fires and how they protect themselves from, and cope with, the experience of heat. Similarly, it can be recounted to an insomniac how she once learned to float effortlessly in water, hinting at the processes of relaxing and letting go that are requisite for sleep. In describing the process of floating, the therapist importantly avoids saying “you can go to sleep right away by relaxing and letting go, Leslie, but don't try hard to make those things happen because then they won't; instead let them happen naturally.” Indirect suggestion is always useful when conscious effort on a person's part to remedy the situation serves only to exacerbate the problem. Among those in the Ericksonian community these ideas regarding the merits of indirect suggestion are widely and strongly endorsed. The ideas seem to pan out consistently in clinical work and seem sensible. A cautionary note, however, is that experimentalists have been unable to demonstrate consistently any advantage to employing indirect suggestion (Lynn, Neufeld & Mare, 1993). Here what seems obvious in clinical work needs to be reconciled with what is being found in the research.

Among the general population exists the misconception that the effectiveness of hypnosis is largely derived from a direct suggestion on the therapist's part for the client to give up the symptom (e.g., “You will no longer feel depressed” or “You will not desire cigarettes”). Hypnosis, and particularly Ericksonian hypnosis, is better suited to and more effective when used as a means of setting in motion a constructive psychological process that moves clients in the direction of change. Thus, suggestions during trance may be either direct or indirect (or both), but they often do not target the symptom as the immediate site of intervention; instead they target the psychological infrastructure of the cognition, affect, or memory supporting it. Certainly, there are many exceptions to this. Cases where direct suggestion to give up the symptom is the most prudent intervention include those with hypervigilant, controlling clients who will accept therapy only if every step of the way is immediately decipherable and logical to them and those involving response-ready clients who offer negligible resistance to change. An example of the latter would be a traumatized woman psychologically ready to put behind her the disturbing, ruminative memories of a brutal assault. It could be suggested that she “…let go of, forget those thoughts, and allow the space left open by their leaving be usurped by better ones, more joyous ones, ones of warmth and succor…even touches of humor once again, perhaps….” An anxious test-taker can be encouraged to “…become aware of ever-increasing degrees of relaxation, now…and then…there, seated for the exam…taking note(s)…of how easy it is to become relaxed, composed, assured….”

The internal psychological process leading clients toward desired change can take many different forms. For some, it will be a train of relevant thoughts and associations (Zeig, 1988) that mobilize new perspectives, feelings, or behaviors. For others, change comes from the mobilization of an individual's association processes and mental skills in certain, healthier directions (Erickson & Rossi, 1981). An example is an individual who has allowed work considerations to dominate his personal life to great detriment and who is guided in trance toward such concepts as balance and perspective and then led to recall prior occasions in life where a shift in priorities reaped great reward. For yet another, it will be a change in the meaning of the symptom, as in the case of an acting-out teenager who begins to experience his behavior as out of control rather than as controlling of others as previously construed. And for a different one still, it will be plainly and simply a behavioral response to an idea or concept introduced at an unconscious level of thought by the therapist. My (JSE) most poignant recognition of the power of the latter was my utterly inadvertent making of decaffeinated, rather than caffeinated, tea right after doing a hypnosis workshop demonstration with a subject who had wanted to decrease her caffeine consumption.

Clinicians new to hypnosis often harbor one other misconception about the use of hypnosis in psychotherapy: that its effects are superficial and short-lived. Hypnosis involves changing the client's phenomenal world, the way that individual experiences his or her own self and that self in relation to the world. It is a dynamic and active form of therapy, and the effects of new experiences inside one's head often are very powerful, resonating at many levels of emotional functioning.

PERMISSIVENESS

The excitement about the Ericksonian approach to hypnosis has much to do with the revolutionary philosophy underlying its use. Erickson departed from the traditional use of hypnosis in a number of important ways. We have already described his pioneering use of indirect suggestion. Another significant departure was his conception of the hypnotherapist as permissive rather than authoritarian in the induction of the hypnotic trance (O'Hanlon, 1987). Thus, rather than definitively telling the clients what they will or will not do or experience during the trance, the therapist offers up any number of possibilities for change.

The approach uses permissive verbs such as “can” and “may,” in contrast to the classical hypnotherapist's more frequent use of authoritarian verbs such as “will” and “must.” This changes hypnosis from being somewhat dictatorial to being more of a democratic and cooperative endeavor. This permissive stance on the part of the therapist is especially useful when working with the more oppositional or rebellious client for whom an authoritative suggestion provides prized opportunities to resist the therapist's effort to help.

THERAPY CLIENTS AS ACTIVE AND RESOURCEFUL

Another aspect of the Ericksonian approach to hypnosis and psychotherapy that distinguishes it from the more classical approach is a change in the conceptualization of the client. Traditional hypnotherapists tend to see themselves as putting something into the client from outside. However, Ericksonian hypnotherapists emphasize the resourcefulness within clients and their inherent capacities for productive change. They therefore gear their hypnotic suggestions to these heretofore undeveloped or latent abilities. Once these unconscious or even conscious resources, are mobilized, they can be applied to the presenting problem or problems (Zeig, 1987). An example would be the parent who has difficulty allowing a college-bound child to separate and leave home; this parent's therapy would be organized around resources used previously that successfully allowed him or her to separate from the child earlier in life, such as for kindergarten or summer camp. The hypnosis thus becomes an evocative process, geared toward evoking and utilizing existing mental and physiological functions rather than programming or suggesting a specific course of action for a client (Rossi, 1980c).

TAILORING

A third important distinction between traditional hypnosis and Ericksonian hypnosis is the degree to which hypnotic inductions and suggestions are tailored to the individual needs, values, and personality structure of the client (Zeig, 1987). In the traditional approach, the clients (and experimental subjects) are often recited a standard script of a hypnotic induction and then proffered generic suggestions for symptomatic change. The change agent is thus seen as being something or someone extrinsic to the client, a perception that mitigates his or her feelings of empowerment and leaves the person feeling dependent on the therapist for the maintenance or generalization of change. Semitraditional and especially Ericksonian approaches emphasize the tailoring of induction formats and suggestions to fit each client. This not only enhances receptivity and responsivity to interventions, but expands the range of clients for whom hypnosis would work. It has been our clinical experience that hypnotizability is directly proportional to the degree to which the hypnosis is custom-fitted to the client.

To us, and most others of an Ericksonian bent, it seems axiomatic that the macro- and microtailoring of trancework is the key to effectiveness. No other technique of psychotherapy assumes a standardization of interventions, in particular of verbal injunctions; why would or should hypnosis be so limited in its conceptualization and/or application? Consider the hypnotic treatment of a cigarette smoker who needs to remove all memory and evidence of smoking from his or her life in order to successfully quit, compared to a different smoker who needs to actively mourn the loss of cigarettes by vividly remembering the last smoking experience, the smell, the feeling of exhalation, and so on. Or consider someone who overeats. A treatment approach consistent with Ericksonian tenets of individualizing the therapy would include a thorough assessment of the presenting problem and of that person's personality style. This would guide the therapist's development and delivery of the therapy. Therefore, it could be possible that for one client, issues of passivity, boredom, or depression reign prominently in relation to the problem and need to be addressed either directly or indirectly; for another client, maladaptive pleasure in the kinesthetic feeling of fullness or even “stuffed-ness” becomes the primary psychological site of intervention.

Directing interventions to the most relevant symptom-maintaining aspects of a problem, or, alternately, where you believe you will find the most plasticity in the symptom complex, are but two of innumerable ways to individualize this kind of therapy. Decisions are based upon the therapist's clinical judgment regarding the most fruitful and expedient path of intervention. Method of intervention, degree of directness or indirectness, language patterns, word choice, and story settings pose other means by which a therapist can tailor the hypnotic work.

MULTILEVEL COMMUNICATION

Ericksonian approaches to psychotherapy stamp the hypnosis done by Ericksonian practitioners with other characteristics that distinguish it from classical hypnosis. Multilevel influence communication is one such characteristic. It is a way of talking to people at multiple levels of meaning and influence, with the goal of indirectly causing some change in behavior, feeling, or attitude. These indirect, “psychological level” communications are not apparent in the overt content of the communication and are designed to effect responses without the subject being fully aware (Zeig, 1985b). This is how anecdotes, metaphors, word plays, and seemingly irrelevant (and irrational!) task assignments find their way into therapy.

A wonderful illustration of the role and power of multilevel influence communication is Erickson's work (Haley, 1973) with a very conservative couple who had never sexually consummated their marriage. The treatment consisted wholly of Erickson talking at length about the proper and most luxurious way to eat a fancy dinner, all the while em-phasizing sensory and mucous membrane stimulation. The unconscious transfer of sensory stimulation to the sexual realm was evident in the follow-up letter sent by the couple a short time after the consultation!

UTILIZATION

Utilization of client attributes previously thought irrelevant or even troublesome is another essential aspect of Ericksonian hypnosis (Zeig, 1985b; Zeig & Rennick, 1991). This is apparent, for instance, in the therapeutic use of amnesia (i.e., forgetting about overeating, forgetting about chronic pain) for someone who forgets frequently. The utilization concept of Ericksonian therapy dovetails with another fundamental principle of this approach, that of the therapy being naturalistic. This means that it is the client's naturally occurring behavior in the here and now that is used to absorb attention, redirect it inward, and induce trance. No external devices or stimuli are needed to facilitate the development of trance; rather, those natural facets of internal experiences (images, memories, affects, experiences in the body) are the basis of treatment (Erickson & Rossi, 1980a).

Whereas a more rigidly traditional hypnotherapist might find a client's obsessional self-vigilance during a first hypnosis experience to be a hindrance to developing trance, a utilization approach would allow for the use ofthat client's self-consciousness as the very means by which he or she enters into a trance. By suggesting that the client become more and more absorbed by self-consciousness, the therapist can help the client become inwardly focused without “fighting” against his or her natural tendency to be obsessionally self-aware. Such a client could have been labeled “resistant” or a “low-hypnotizable”; however, in this therapeutic framework, utilization of the client's presenting behavior without trying to change, eradicate, or suppress it affords a smoother and more efficient therapy, as well as the application of hypnosis t...

Table of contents

• Cover
• Half Title
• Full Title
• Copyright
• CONTENTS
• Foreword by Jeffrey K. Zeig, Ph.D.
• Acknowledgments
• Introduction
• PART I. PRELUDES
• PART II. HYPNOTIC PHENOMENA FOR INTERVENTION
• PART III. APART FROM INTERVENTION: OTHER USES FOR HYPNOTIC PHENOMENA
• References
• Name Index
• Subject Index