Hypnosis in Clinical Practice
eBook - ePub

Hypnosis in Clinical Practice

Steps for Mastering Hypnotherapy

Rick Voit, Molly Delaney

Share book
  1. 192 pages
  2. English
  3. ePUB (mobile friendly)
  4. Available on iOS & Android
eBook - ePub

Hypnosis in Clinical Practice

Steps for Mastering Hypnotherapy

Rick Voit, Molly Delaney

Book details
Book preview
Table of contents
Citations

About This Book

This book is aimed at helping both newly trained and experienced mental health professionals become comfortable and adept in using hypnosis in their clinical practice. Despite dramatic evidence of the effectiveness of hypnosis and its growing acceptance, only a small percentage of psychotherapists employ their hypnotherapy training in their practices. This under-use of hypnosis is due to exaggerated misconceptions about its power and the resultant performance anxiety therapists experience after their training. This text is designed to address therapist performance anxiety surrounding the use of hypnosis by exploring the myths surrounding its power and therapeutic potential. The integration of a straightforward systematic hypnotic approach into therapeutic practice has value both in assessment and treatment. Using clinical anecdotes and personal experience, the authors of Hypnosis in Clinical Practice explain induction style and trance work in a way that is fundamental and highly accessible.

Frequently asked questions

How do I cancel my subscription?
Simply head over to the account section in settings and click on “Cancel Subscription” - it’s as simple as that. After you cancel, your membership will stay active for the remainder of the time you’ve paid for. Learn more here.
Can/how do I download books?
At the moment all of our mobile-responsive ePub books are available to download via the app. Most of our PDFs are also available to download and we're working on making the final remaining ones downloadable now. Learn more here.
What is the difference between the pricing plans?
Both plans give you full access to the library and all of Perlego’s features. The only differences are the price and subscription period: With the annual plan you’ll save around 30% compared to 12 months on the monthly plan.
What is Perlego?
We are an online textbook subscription service, where you can get access to an entire online library for less than the price of a single book per month. With over 1 million books across 1000+ topics, we’ve got you covered! Learn more here.
Do you support text-to-speech?
Look out for the read-aloud symbol on your next book to see if you can listen to it. The read-aloud tool reads text aloud for you, highlighting the text as it is being read. You can pause it, speed it up and slow it down. Learn more here.
Is Hypnosis in Clinical Practice an online PDF/ePUB?
Yes, you can access Hypnosis in Clinical Practice by Rick Voit, Molly Delaney in PDF and/or ePUB format, as well as other popular books in Medicina & Teoría, práctica y referencia médicas. We have over one million books available in our catalogue for you to explore.

Information

Publisher
Routledge
Year
2013
ISBN
9781135951177

CHAPTER 1

Thinking about Hypnosis

HYPNOSIS: ONE TOOL

George was a middle-aged college professor who sought treatment (RV) for long-standing complaints of depression, irritable bowel syndrome, and a dangerously low body weight. He had previously been seen by numerous traditional and homeopathic physicians and several frustrated psychotherapists, but his symptoms persisted. After his exhausting search for someone to rescue him from his misery, he expressed both desperation and doubt in anyone’s capacity to help him. It was clear that his interest in hypnosis was rooted in his wish for an external solution and, perhaps, a magical cure.
George’s life was not lacking in conscious emotional conflicts or external stressors. There were plenty. He disclosed feelings of helplessness due to geographical distance from his aging parents and his inability to help them. Marital communication was suffering and sexual intimacy was nearly nonexistent because of his frail physical condition. He had recently accepted responsibility for a research project that would create even greater demands on his time and energy Perhaps his greatest stressor was also his greatest need: food. During his youth, he had learned that food was his mother’s currency in controlling the family and, by refusing to eat, his means of passive-aggressively controlling her. He was now controlled by rigid beliefs about what he could eat and was unable to tolerate even normal digestive sensation (e.g., indigestion, bloating, etc.).
Our treatment plan would need to incorporate manageable goal setting and waking-state cognitive restructuring to assist him in achieving success with less self-doubt. I introduced George to hypnosis with the intent of helping him to control his gastrointestinal discomforts, to access his existing ego strengths, and, hopefully, to uncover any additional unconscious conflicts that might be creating barriers to improvement.
As his insight grew, his confidence and hope returned as well. We established reasonable goals for helping his parents, communicating with his wife, and organizing his life. He kept a food diary to avoid dissociation from physical hunger and learned self-hypnosis to therapeutically utilize this “talent” for dissociation to relieve pain. Our premise was to replace the helplessness of an external locus of control by establishing personal responsibility for his symptoms. The introduction of hypnosis was but one of several means of achieving this. Otherwise, his was a comprehensive, multimodal treatment plan involving cognitive restructuring, behavioral goal setting, and a psychodynamic interpretation of the family system. Yes, the use of hypnosis enhanced all of these interventions, but it was not the entire treatment. George has gained weight, continues to journal, works assertively with his wife toward a better marriage, and uses self-hypnosis for digestion and pain management. My client was my project, my treatment plan was my design, and hypnosis was but one tool.
An effective therapist might be compared to a seasoned carpenter, a craftsman who is skilled in the use of many tools to build or make repairs. Perhaps the comparison could also be to an artist who uses various brushes to create texture or light in each unique piece of work. It is not the saw that makes a cabinet any more than it is the brush that paints the masterpiece. Rather, it is the creativity and vision of the hands holding these tools. In this way, hypnosis is a tool or brush, albeit a potentially powerful one, in the therapist’s repertoire.
Friends and acquaintances will often ask us, “What types of clients do you treat with hypnosis and how does it help?” Despite our years of training and experience, we find these simple questions difficult to answer. The most accurate and honest response we could offer would be, “We don’t treat people with hypnosis, we treat them with psychotherapy. Sometimes we use hypnosis as a part of that treatment.” Ironically, the more competent and comfortable with hypnosis we have become, the less we consider these interventions to be a distinct mode of treatment. As we sit with our clients and ponder ways in which we can be helpful, it will suddenly become clear to us that hypnosis is our preferred means to accomplish our objectives. Just as the artist would almost instinctively reach for one of her brushes, the psychotherapist introduces hypnosis at appropriate junctures in treatment. As we practice safely within the bounds of our strengths and specialties, the “reach” for hypnosis becomes a logical and fluid extension of our overall treatment strategy.

Hypnosis and Therapeutic Orientation

Who hasn’t lain on a beach or in a field and imagined what the passing clouds might resemble? The images we attribute to these clouds are creative projections of ourselves. We might also describe the beach experience itself in terms that reflect our memories or sensory strengths. An otherwise universal experience is influenced by our individuality. Not only do we tend to prefer a particular sensory system, but also no two individuals will see, feel, or hear a shared experience identically. Like our fingerprints, our projections and the way we receive information are unique to each of us.
It is likely that any of our clients and their symptoms would be described quite differently by various therapists depending on their clinical belief systems and their personal experiences. A psychodynamic therapist would certainly have focused upon George’s family history and unresolved developmental conflicts. The behavioral therapist might ostensibly disregard those issues while placing more emphasis on changing eating habits and learning a healthier lifestyle. Whatever your therapeutic frame of reference—psychodynamic, humanistic, behavioral, etc.—you conceive of humans and their strengths and challenges in a certain way This frame of reference becomes the basis for a treatment plan that reflects your own clinical interpretations, thus allowing you greater comfort and confidence with the hypnotic applications.
While you maintain your preferred orientation, hypnosis will become a new tool in your toolbox. You are not required to think or even behave in a new way. You simply must work from your roots, with a solid understanding of your professional limits. You are not expected to change, only grow.
As you read the story of George, no doubt you were forming your own ideas as to how you might have approached his symptoms. In my work with him, hypnosis was utilized toward several goals, including insight development, ego strengthening, and behavioral change. Additionally, the increasingly obvious benefits of its use facilitated greater trust and positive transference from my client. The essential point is that, regardless of your frame of reference, hypnosis can provide a valuable ingredient to your treatment plan while facilitating a more fluid conception and implementation of that plan. It might be helpful to briefly examine a few theoretical orientations and identify how hypnosis might come into use.
As a psychodynamic therapist, you might use hypnosis to correct neurotic patterns of behavior that began in childhood but are no longer “necessary” as an adult. Making use of hypnotic projections and recovered memories, a client might realize a long-awaited corrective experience that can allow for a healthier definition of himself.
For example, one client (MD) recovered through hypnosis a childhood of petting and playing with baby chicks in her backyard as her mother hung laundry on a clothesline. She recalled becoming distressed when one of the chicks stopped moving. Her mother quickly realized the chick had died, commenting, “I guess you loved it too much.” This offhanded, accidental empathic failure apparently contributed to the client’s belief that her affections were dangerous. Although this incident had not been the foundation for all of her fears and guilt associated with being playful or intimate, the recovery of this particular memory was significant. It helped her to realize where some of her long-standing barriers to love and self-esteem had developed. Traditional psychoanalytic therapy without hypnosis would likely have taken much longer to reach such a breakthrough.
A cognitive therapist might use hypnosis to help her client more easily integrate new and more constructive ways of thinking and behaving toward life’s encounters and demands. Rigid, ineffective belief systems are deeply integrated into perception and are possibly more readily accessed with hypnotic communication with the unconscious. Much of our thinking, our belief system “filter,” operates unconsciously as we interpret the world into feelings and actions. For example, one gentleman (MD) who was hypersensitive to criticism in his primary relationships with women was able to identify the introjections of his mother’s negativity and, instead, create a greater awareness of his achievements and strengths. While typical cognitive therapy is itself considered a “brief therapy,” it also requires consistent, frequent challenging of these beliefs in order to interrupt and alter their effect. Hypnosis can more efficiently identify and replace irrational, self-destructive thinking.
A humanistic therapist might use hypnosis to help a client more easily recognize his intrinsic goodness and thus enhance his overall functioning. The trusting intimacy of the hypnotic relationship itself can be validating and comforting in the communication of compassion and acceptance. Even our own nurturing voices and positive attitudes encourage hope and well-being. In treating low self-esteem, we might use a positive affect bridge to recover the experience of success from earlier achievements. We believe that every hypnotic intervention should include ego-strengthening affirmations, a hallmark of humanistic approaches.
Marjorie, a hospice nurse, remained in an abusive marriage, believing that this was her lot in life. It wasn’t until she was diagnosed with a life-threatening disease that she sought treatment (MD). Her history was replete with instances of abuse, both emotional and sexual, as well as the concomitant shame experiences. By using a combination of ego strengthening, cognitive restructuring, and the integration of her own words into hypnosis, the client began to assert her own desires and aspirations as well as believe she was worthy of achieving these dreams. She had become mobilized to battle her illness as well as to become more assertive in her marriage. When it became obvious to her that her husband had no desire to preserve their relationship, she sought freedom from her marriage. Now, several years later, she believes that therapy saved her life.
A behavioral therapist could include hypnosis in treatment in order to build confidence, identify resistance, or clarify goals toward behavior change. For example, in the treatment for smoking cessation, post-hypnotic messages that promote health, healing, and ego strength might be introduced to the unconscious. The therapist can suggest cues or attachments in her client’s environment to reduce craving or reinforce a learned response to predictable internal or external events. Internal cues such as cravings for nicotine could be paired with a wish to deeply breathe in fresh air. Each of these deep breaths could be paired with a renewed sense of commitment to the client’s goal of being free and feeling proud of his decision. The external cue of seeing other people smoke could be paired with a sense of relief that he is no longer a victim of this deadly habit.
As therapists, our effectiveness would be severely limited if we were to maintain a narrow clinical orientation regardless of the diver sity of people we treat. In fact, as our careers progress, we find it increasingly difficult to identify or label exactly what our “approach” might be. It has been our experience that, however well hypnosis can be effectively integrated into an orientation, it also offers an opportunity for creativity and unique options while remaining loosely within that orientation.
I (RV) recently consulted with a colleague who was treating a child afflicted with facial tics. Consistent with her family systems orientation, this psychologist viewed this symptom as a reflection of developmental conflicts, enabling the child to receive attention from doting but emotionally unavailable parents. I introduced the notion that the tic was also dissociative and regressive in nature (both hypnotic phenomena). Her treatment plan will now include an effort to “associate” this girl with her symptom and find healthier means of expressing and managing her conflicts. While hypnosis broadens its scope, the orientation can remain the same.

Accessing All Resources

Because you are likely drawn to a certain theoretical orientation because it makes some kind of personal sense, it might be beneficial to have a firm grasp of the personal and historical elements to your clinical style. Developing insight into your values, beliefs, and biases can prevent you from projecting them intrusively into any treatment approach. Discovering your strengths, weaknesses, and blind spots will only make your hypnotic work richer. Awareness of where your talents begin and end allows for a more seamless and ethical integration of hypnosis into your therapeutic repertoire.
As with the practice of all psychotherapy, integrating hypnosis into your work becomes a product of all you are and all you know. In this regard, it is important to view your personal life experiences, your interests and passions as a rich mine from which you can uncover new and creative initiatives. You probably intuitively draw on your associations, images, remembrances, and thoughts in your present clinical work. In the practice of hypnosis, these are especially helpful resources, as so many of our own associations spring to mind during our unconscious connection with clients. Just about every clinician can tell you of the times when they felt totally in sync with their clients. Associations flow and the resulting interventions are rich and spontaneous. We have found that these occurrences become even more frequent with the use of hypnosis, as you are likely connecting more intimately with your own as well as your client’s unconscious processes.
In all of our work, we depend heavily upon our own experiences, how we feel in our own skin. Thus, it is extremely useful to study as a “scientist” our own trance experiences. For example, if you accept the premise that trance is a naturally occurring event that is universally experienced, you should be able to ascertain when your own trance behaviors take place. Indeed, if consciousness is a wavelike pattern (Rossi, 1993), you should be able to become aware of those varying experiences within yourself. It is likely that many of those moments you have heretofore identified as “fatigue” are rather the door opening to your own spontaneous trance. Can you likewise take these moments as an opportunity to go into trance and allow yourself to reenergize? Having done so, can you identify the impact of utilizing these spontaneous trances?
It is important for the therapist to become intimately familiar with his own trance experience. In many ways, insights gained from being the hypnotic subject can provide the raw material from which we build our empathic hypnotic connection with clients. For example, I (MD) used hypnosis while undergoing treatment for a medical condition that required several surgeries. As is common with surgical clients, the use of hypnosis not only alleviated my anxieties about the procedures, but also minimized my need for pharmacological anesthesia and lessened my recovery time. In fact, with my last outpatient surgery, the medical staff was astounded when I was ready to be discharged an hour after awakening from anesthesia. Hypnosis significantly relieved my experience with surgery, while subsequently influencing my pre-surgical work with clients. By experiencing firsthand the tremendous help hypnosis could be for me, I became impressed with its potential benefits for others. I often relate these types of experiences to clients both in and out of hypnosis as a form of suggestion, a metaphor to indicate the possibilities they can as well achieve with hypnosis.
As a scientist it is important for you to study both your clients and yourself as the principal ingredients in creating effective psychotherapy. Whether you notice it or not, your clients are spontaneously experiencing trance during your sessions. Trance behavior may be elicited by their biological need to experience a daydream, or it may be evoked by the work that is taking place in the session. In either case, it is a moment in time that is replete with possibilities.
As the artist, you can create suggestions or metaphors that will be received with little conscious resistance. By becoming attuned to your client’s and your own natural rhythms you create opportunities for rapid intervention that could otherwise be missed. Unfortunately, therapists sometimes view their client’s “inattention” as boredom or resistance when in fact it has been the client being absorbed in a trance experience triggered by the therapy.
Likewise, by deliberately evoking your own trance, you can not only minimize the tendency so many therapists have toward succumbing to “empathic fatigue,” but also facilitate the growth of your hypnotherapy skills. Personal experience with our own trance phenomena teaches us much about the potentials of hypnosis beyond what we learn by simply performing our skills.
Imagine Cro-Magnon man who is considered to have possibly been the first to create art. These ancestors apparently had a wish to leave permanent renderings of what they saw and, perhaps, how they felt. There were no finished tools or brushes to buy or prior creation from which to learn. Instead, they utilized what they had. Their imagination provided inspiration, pigmented earth and perhaps animal blood were their media, and crude instruments and their hands were their only tools. Having little else with which to work, they used the very fabric of their lives in leaving their mark on unwritten history.
A career in hypnotherapy is painted in much the same way Our personal histories and interpersonal styles create the background. Our clinical training determines the subject of our work as we emulate the innovations of our mentors. We then add detail using whichever methods and tools we have learned to favor. Finally, we discover that hypnosis can bring a greater depth of color and texture to our work. We are not changing a thing about ourselves, our visions, or our styles. All of these influences continue to contribute as they previously had. Rather, we have added one tool, one very helpful and effective tool, in completing each and every masterpiece.

The Role of Hypnosis

To further underscore the suggestion that hypnosis is but a therapeutic tool and not a treatment approach per se, we remind the reader that hypnosis can be either the central focus of therapy or an adjunct to other modes of treatment As a major intervention in therapy, hypnotherapy can paint a new, more hopeful background for life in the foreground. It can rebuild an old, tattered ego structure into a more secure and functional existence. Hypnosis can be a dramatic method for helping our clients to move forward with their lives, often with less resistance and psychological pain than is common in more waking-state therapies. We can reconstruct belief systems, redefine memories, and establish new confidence (Erickson et al., 1978; Gilligan, 1987; Yapko, 2003). We can help the client to experience a greater sense of efficacy and empowerment with an improved sense of entitlement and confidence. As an adjunct to treatment, hypnosis might be used to help the client develop health-promoting relaxation skills, manage physical or emotional pain, improve performance, or encourage the unconscious to work between sessions of a waking-state mode of treatment (Hammond, 1990). In George’s case, hypnosis became both the primary intervention for ego reconstruction as well as a means of treating specific symptoms. As a broad brushstroke, I helped him to develop a more functional self-image while also addressing the “detail” of physical experience and daily functioning. With our therapeutic relationship as the canvas, we used all tools, all brushes, to achieve a successful and satisfying outcome.
All that being said, we offer one very important caveat. You will occasionally be asked to see other therapists’ clients for smoking cessation, performance anxiety, or pain management interventions while the core of psychotherapy is to remain the domain of your referring colleagues. Considering that hypnosis is practiced by medical professionals in just such an isolated format, an adjunct role for a psychotherapist could certainly work without any difficulty. However, as you likely already know, we never know the full complexity of a presenting symptom until we actually encounter its sufferer. I (RV) recall one particular client who was referred by a practice partner. My co...

Table of contents