Hypnosis and Hypnotherapy For Italy
Hypnosis and Hypnotherapy For Italy
Hypnosis and Hypnotherapy For Italy
HYPNOTHERAPY
A Practical Experience
and Odyssey
YOUR INSTRUCTOR
History of Hypnosis
• “Laying on of hands by priests and rulers (the Royal Touch).
• The woman who was healed by touching Jesus’ cloak.
• Paracelsus was able to heal by astral bodies.
• Fr. Maximilian Hell , SJ, obtained cures by applying steel
plates to the naked body.
• Franz Anton Mesmer systematized “animal magnetism” as
a treatment, in large tubs. He was able to obtain somatic
symptom relief and induce convulsions and hallucinations.
He was eventually exposed by a French commission in
1784 which concluded his results were based on the power
of suggestion.
• The Marquis de Puysegur first noted the similarity between
hypnosis and sleep and associated it with clairvoyance.
• James Braid coined the word “hypnosis” and associated it
with the power of suggestion.
History (Continued)
• Hypnosis has been associated with Vampirism.
• Josef Breuer found that symptoms were lessened
when traumatic memories were recovered under
hypnosis. Not all patients responded well to
suggestions for direct symptom removal.
• Sigmund Freud initially used hypnosis but
considered it unwise to remove symptoms that still
had meaning for the patient. He also sensed a
sexual connotation. He discovered that not all
patients could achieve a good hypnotic state.
Eventually he thought it interfered with the
transference and gave it up.
• Milton Erickson gave hypnosis new vigour in the
1930s and beyond, with his method of indirect
suggestion.
Theories of Hypnosis
• State theories – Hypnosis is an altered
and special state of consciousness on
which people differ significantly and
which is relatively unchangeable over
time and in different conditions. Studies
do show that hypnotic susceptibility (or
trance ability/capacity) is relative
invariant and follows a normal
distribution. It is correlated with almost
nothing else.
Theories (continued)
• Socio-cognitive theory (non-state) –
Hypnotic responsiveness is dependent
on social psychological phenomena,
such as expectancies, attitudes,
demand characteristics, imagining and
beliefs, as well as one’s interpretation of
suggestions. Education about hypnosis
is critical as is role-related behaviours.
Models of Hypnotherapy
Psychodynamic Model
• 1. Hypnosis is erotic in nature.
• 2. Uncovering repressed material via
hypnosis.
• 3. Primary (imagery) and secondary
(language-based).
• 4. “Double consciousness” between
observing and participating ego.
• 5. Transference and dependence.
Ericksonian Model
• 1. The unconscious need not be
made conscious.
• 2. Mental phenomena are to be
utilized rather than analyzed.
• 3. Hypnotic suggestions are indirect
rather than direct.
• 4. Most hypnotic work can be done in
a light trance.
Cognitive-Behavioural Model
• 1. The hypnotic situation is explicitly
defined as “hypnosis.”
• 2. Suggestions are made that phenomena
will be experienced non-volitionally or
involuntarily. This has been a definition of
hypnosis.
• 3. Most psychological disturbance is
caused by a negative form of self-hypnosis
in which negative thoughts are accepted
uncritically and without awareness.
Cognitive-Developmental Model
• 1. Hypnosis may be especially useful in
directly accessing and modifying core
cognitions of personal identity, self-
concept and dysfunctional tacit rules.
• 2. Hypnotic imagery and related emotional
processing may be useful in changing tacit
knowledge structures which are often
preverbal and nonverbal.
• 3. Bypass conscious resistance.
• 4. Two major tasks: Identify core cognitive
structures and changing those structures.
Myths of Hypnosis
• 1. Hypnosis is caused and controlled by the
hypnotist and is done TO the subject.
• 2. Hypnosis can make people do things against their
will and reveal secrets.
• 3. Hypnosis is a form of sleep.
• 4. Hypnosis occurs only when a formal induction is
used.
• 5. Hypnosis occurs only when one is relaxed.
• 6. Hypnosis is a therapy.
• 7. Only some people can be hypnotized.
• 8. Hypnosis can be used to help people accurately
recall what has happened in the past.
Myths (Continued)
• 9. Hypnosis is dangerous!
• 10. Hypnosis works only with gullible or weak-
minded people
• 11. Women are more hypnotizable than men
• 12. Hypnotized people may not be able to be
dehypnotized
• 13.Hypnotized people “lose consciousness”
• 14. The hypnotist must be charismatic or “weird”
Levels of Hypnosis
•
Indications for hypnosis success
• 1. Treatment of pain
• 2. Smoking cessation
• 3. Anxiety disorders
• 4. Stress-related physical disorders and
medical conditions (e.g. hypertension,
ulcers, bruxism)
• 5. Dermatological conditions
• 6. Asthma
• 7. Obesity and eating disorders
Contraindications
• 1. OCD clients are less hypnotizable
• 2. Psychotic decompensation
• 3. Paranoid level of resistance or control
• 4. Borderline personality
• 5. Clients’ experiences with authority
figures, sexual transference, cultural
history
• 6. Dissociative disorders
General Hypnosis Assessment
Hypnotic Induction
Preparation
• 1. Dispel myths
• 2. Assess reasons and motivation
• 3. Assess prior experience with
hypnosis
• 4. Assess one’s own motivation
• 5. Develop therapeutic rationale
Assessment of hypnotic
susceptibility/trance capacity
• 1. Eyelid fluttering
• 2. Head nodding
• 3. Deeper breathing
• 4. Client posture
• 5. Trance literalness
• 6. Subsequent memory
• 7. Weight/balloon technique
Hypnotic Induction Techniques
• 1. Eye fixation and closure
• 2. Relaxation-based techniques
• 3. Arms rising and falling
• 4. Arm levitation
• 5. Confusion technique
• 6. Counting technique
• 7. Self-induction
Deepening Techniques
• 1. Staircase, elevator or diving
• 2. Repeating the induction
• 3. Challenges (e.g. eye closure, hand
clasp, arm catalepsy)
• 4. Deeper breathing technique
• 5. Suggesting greater “depth”
• 6. Arm rotation
• 7. Counting backwards by odd numbers
Hypnosis in Cognitive Therapy
Cognitive Contents
The words and sentences we use; what are called
automatic thoughts (A.T. Beck), irrational thoughts (Ellis)
or the internal dialogue (Meichenbaum).
Ex: “This audience won’t like what I’m saying” or “I’m doing
a terrible job!’ Daniel Araoz refers to this as “negative
self-hypnosis.”
Cognitive Structures
1. Rejection
2. Punitiveness
Treatment of Anger
A Buddhist Perspective
1. Take responsibility for your anger. Not
easy because angry individuals tend to
be externalizers
2. Become aware that anger is a result of
our frustrated desires
3. Understand the dynamics of anger – it
reduces our sense of danger,
helplessness and humiliation.
Treatment (Continued)
4. Ask the client to reflect on his anger as it
arises
1. “What did I want that I wasn’t getting?
2. “What was I getting that I didn’t want?
5. Client decision – The commitment not to
act out anger, not to repress it, but to
become aware of it and reflect upon it.
6. The client gradually turns his mind to
alternatives to anger
Pain Management
Pain is a complex, multifaceted
phenomenon. High hypnotizables tend to
benefit more.
1. Physical factors. The specificity approach
proposes that pain sensations result from
the stimulation of pain receptors. But this
cannot account for variations in pain
perception. Melzack and Wall’s Gate
Control Theory suggests that neural
mechanisms in the spinal cord increases
or decreases the flow of nerve impulses.
Pain Management
2. Attention paid to pain sensations tends to
increase pain. Attention diverted from
pain tends to decrease pain sensations.
This can be increased for people who
have little to do.
3. Cognitive factors. People with pain tend to
catastrophize. They can engage in
imagery that is incompatible with the
experience of pain. They can think about
pain in a more detached way. They may
dissociate.
Pain Management
4. Emotional factors. People become very
anxious while in pain, especially when it
cannot be predicted. It can lead to
“anxious anticipation.” People tense which
increases the experience of pain. It is
difficult to know which comes first; anxiety
or pain. Anxiety can generalize to pain-
associated phenomena (e.g. physicians).
Pain Management
5. Behavioural factors. People exhibit “pain
behaviours” when in pain. They begin as
expressions of pain but can become cues
for pain and can increase the perception of
the pain itself; a vicious cycle.
6. Interpersonal factors. The experience of
pain can become socially reinforcing;
secondary gain. Sometimes monetary gain
occurs as long as one is in pain. They may
end up with Socially Legitimized
Dependency.
Types of Pain
1. Acute pain. It declines by itself and
usually relaxation and anxiety reduction
are sufficient.
2. Chronic pain. Recurrent, intense and
intermittent pain. Direct suggestions for
pain reduction or relaxation can help.
3. Chronic, intractable, benign pain. Usually
present, varies in intensity. Psychological
factors and secondary gain are
important. Example is lower back pain.
Types of Pain
4. Chronic, progressive pain. A primary
example is cancer. Anxiety is a prominent
feature. It is difficult to treat because the
constant attempts are exhausting and only
partially helpful. Psychological factors and
secondary gain are usually not present.
Distraction, relaxation, positive imagery all
may help.
Hypnotherapeutic Treatment of
Pain
1. Hypnotic relaxation. It can reduce the
anxiety and tension and provides a
coping strategy and hope.
2. Direct suggestions for pain reduction. It
may work for highly motivated clients
with moderate to high hypnotizability. But
it may not work if the pain intensity is
great and it does not provide coping
strategies. One should do a “medical
rule-out” first.
3. Indirect suggestions. It does not challenge
the client to resist. It does not use the
word “pain;” rather words like comfortable,
relaxed, letting go, and peaceful.
4. Transformation of pain. There are two
kinds: A. the pain is actually moved to
another part of the body less central to the
client’s activities. It may work in cases of
chronic, intractable, benign pain. B. pain
can be transformed into other sensations,
such as itching, tingling.
Hypnotic Analgesia and Anesthesia
1. Analgesia is a dulling of sensation and is
produced by suggestions of numbness –
can be achieved by most people.
2. Anesthesia is a loss of sensation –
achievable only by high hypnotizables.
3. It can be used for chronic pain; intractable
and progressive as well as psychogenic
pain. Clients can keep only as much pain
as they wish.
Dissociative Techniques
1. Instructing clients in a trance to detach
and dissociate from their bodies; look at
themselves from the outside.
2. The “Telescope technique” asks clients to
see their pain through the wrong end of a
telescope.
3. The “bag of pain” approach asks clients to
imagine their pain wrapped up in a bag.
Distraction Techniques
1. The client is asked to visualize a
pleasant or happy scene and then
concentrate on it and the pleasant
feelings. It can be used for acute and
chronic pain and teaching the client a
coping strategy.
2. The client is asked to focus on another
part of his body.
Cognitive Restructuring
1. Reduce negative catastrophic thoughts.
2. Reduce hopeless thoughts.
3. Reduce angry thoughts.
4. Increase self-coping statements.
Smoking Cessation
The research evident indicates that
hypnosis is at least as, if not more,
effective than alternative treatments. But it
can be difficult to untangle the effects of
hypnosis from the behavioural and
educational interventions. It can be a brief
package.
Treatment Components
1. Hypnosis as self-hypnosis. Requires that
clients actively participate in their
treatment.
2. Cognitive and behavioural skills. Uses
techniques such as minimizing negative
self-talk, increasing self-reward.
3. Education component. Describes smoking
as a learned behaviour response. Ask
clients to generate positive reasons to be
a non-smoker.
4. Assessing and enhancing motivation. “Do
you want to quit or want to want to?”
Includes positive suggestions for
increased control and mastery, keeping
healthy and alive.
5. Helping clients to define themselves as a
nonsmoker. “I am a nonsmoker!” This is
predictive of success.
6. Relapse prevention. Identify triggers for
smoking. Develop coping responses.
Avoid high risk situations.
Bruxism
• Physicians don't completely understand
the causes of bruxism. Possible physical
or psychological causes may include:
• Anxiety, stress or tension
• Suppressed anger or frustration
• Aggressive, competitive or hyperactive
personality type
• Abnormal alignment of upper and lower
teeth (malocclusion)
• Changes that occur during sleep cycles
• Response to pain from an earache or
teething (in children)
• Growth and development of the jaws
and teeth (for children)
• Complication resulting from a disorder,
such as Huntington's disease or
Parkinson's disease
• An uncommon side effect of some
psychiatric medications, including
certain antidepressants.
The Case of S.C.
1. S.C. was 33 years of age and was self-
referred for a 20 year history of teeth-
grinding in her sleep. The problem had
remained constant. She wore a mouth
guard which she had to replace every six
months or so.
2. She had oral surgery on one joint. She
exercises regularly She kept a diary to
attempt to determine if life events were
causing this. Her home life (husband and
two children) was happy.
Psychological Profile
1. S.C. was above average intelligence. She
had a good self-concept. She was trustful
and optimistic. She had one younger
brother.
2. S.C. was not experiencing psychological
turmoil. There was a tendency for her to
deal with stress and anger in an indirect or
passive way to avoid upsetting others.
There may be a hidden hostility in her.
First Session
1. I conducted a “medical rule-out.” Her
dentist had prescribed a mouth guard
and she wore out several.
2. She had jaw surgery several years earlier
which had had a slight effect. She could
open her mouth wider. The problem had
existed about 20 years.
3. Her physician ruled out physical causes.
4. Her pain was only on the left side of her
jaw.
First Session
5. Her relationship with her husband was
good.
6. She reported she had no anger in her life.
Eventually she said she sometimes felt a
little anger but preferred to call it
frustration.
7. She reported no aggression but when
things don’t go well she feels “deflated”
(drained).
8. I asked her to reflect upon what happened
20 years ago for next session.
Second Session
1. In response to my assignment she talked
about her volatile parents. She reported
she was always the family peacemaker.
2. She wanted hypnosis and I conducted a
session around themes of allowing
herself to let go and learn new things
about herself.
3. In the subsequent discussion she became
quite emotional and said she has always
wanted to let go. She has devoted much
of her life to “having it all together” and
therefore not being vulnerable.
Second Session
4. Being vulnerable is scary. She has
somaticised her “holding it all together”
into her jaw, next and head.
5. We discussed the paradoxical nature of
trying to let go versus allowing it to
happen.
6. We identified a theme in her life; always
being in control to avoid anxiety.
Third Session
1. She reported “something worked!” She
had not woken up with a sore jaw and
she was sleeping better.
2. She had a revelation; she no longer
wanted to be the peacemaker.
3. I discussed the nature of transformational
versus conservational changes.
4. I conducted a hypnotic routine around
themes of shedding old roles and
discomforts (pain).
Third Session
5. She wished to practice shedding old roles
with her mother, second with her brother.
6. Her mother’s reactive and volatile nature
is a major stressor for her. She reported
(emotionally) being afraid she would act
like her mother towards her daughter. In
the area of emotional reactivity S.C. has
been trying to be the opposite of her
mother.
Fourth Session
1. S.C. was excited because she slept 10
hours!
2. She has learned: a. therapy is going really
fast, b. she stood up to her mother on an
issue and her mother backed off, c. she
only had jaw pain on two mornings, d. a
co-worker told her she “put up walls,” e.
she was able to let go of a small piece of
control. She felt tension escaping.
Fourth Session
3. I asked what the walls were protecting her
from. She replied, “Afraid of being hurt?,
afraid of other seeing who she really is,
afraid of receiving?”
4. I conducted a hypnotic routine around
themes of making new connections among
her thoughts, feelings and actions as she
grows and develops. These connections
will go under, over and through her walls,
gradually crumbling them.
5. We discussed her “spectatoring.”
Fifth Session
1. She reported that her mother is backing
off more as she is more assertive.
2. She has noticed she “spectators” when
she thinks she will be judged by others.
3. Her jaw pain was noticeable only three
mornings.
4. I interpreted the MMPI for her. I reminded
her that she had denied being angry but
the results showed she was. After a
moment, she said, “I really AM angry!”
Fifth Session
1. Who hurt S.C.” And when and how?
2. Before the next session I asked her to:
a. do something different for herself
(something she had not done), and b.
meditate each day upon her anger.
Sixth Session
1. This session lasted about 1 ½ hours.
2. S.C. combined both assignments and had
constructed a double-sided drawing. On
one side were all the things she felt
typified her; good and bad. On the other
side were all the things that made her
angry.
3. Some friends she had earlier in her life
had hurt her.
Sixth Session
1. In her exploration, several things stood out: a.
her lack of assertion in relationships, b. she
doesn’t know who she is, c. her difficulty
expressing strong emotions, d. the fear that
governs her life.
2. Her jaw pain has mostly disappeared and she
can now eat nuts.
3. The hypnotic routine was around themes of
“letting go;” connecting letting go of her fear
with letting go of her jaw pain.
Seventh Session
1. What had she learned?
A. How much anger she has at herself (mostly) and
others.
B. How to let go of her anger.
C. The connection between her emotional state and
her jaw pain.
D. The anger directed at her by an old acquaintance
was hers, not S.C.,s.
2. Her church’s sermon was about the need to forgive
and let go of grievances and she was able to relate it
to herself.
3. Her husband has described her as more playful.
Follow Up
1. After a year I talked to S.C. She reported
her jaw pain had disappeared and stayed
gone.
2. Her relationship with her husband had
improved.
3. She was doing things she had not done
before (and about which we had not
talked), such as returning to school.
Reconstruction of Memories
The Case of Arnold
1. Arnold had few childhood memories,
describing it as a “barren wasteland.”
2. He said he didn’t really “begin to live” until
after High School graduation; everything
before was a “dead loss.”
3. He saw himself as a “loner” and his
memories may have been developed
and elaborated to reflect this self-image.
Enhancing Optimism:
Sherry’s failed marriage
1. It is my fault that my marriage failed
a. I should have made my husband happy
b. It is my fault he was unhappy and left
c. I wasn’t a good wife; I’ll never be
d. I will never have a successful marriage
e. I will be alone for the rest of my life
2. I am a failure with all men
a. Men will always leave because I can’t make
them happy
b. No man will ever love me
c. I can’t believe or trust any man
Sherry (Continued)
3. I’m not good enough; there is something
wrong with me
a. I’m not attractive enough
b. I’m not smart; I’m stupid
c. I’m not interesting; I’m boring
4. Cognitive Distortions: Personalization,
catastrophizing, emotional reasoning,
overgeneralization
Sherry (Continued)
5. Early Maladaptive Schemas:
Disconnection and rejection
a. Abandonment/Instability
b. Emotional Deprivation
c. Defectiveness/Shame
Addressing Defectiveness
You feel abandoned, alone, deprived, don’t you [speaks to
EMS]? You feel somehow deficient, don’t you? But let’s
look at who is really alone…you or your ex-husband?
Who’s really defective – deficient? You or him? …after all,
he couldn’t love you. Perhaps he’s the one who is
deprived…will he ever find a woman who can love him?
Didn’t you love, cherish him? Isn’t that good? Can’t you use
that knowledge of how to truly care, truly care, for a man –
to develop new relationships? Perhaps you now know that
because something happens once doesn’t mean it will
happen again…It all depends…
Increasing Goal-Directed
Behaviour: Ed’s stagnation
Ed’s beliefs about himself:
1. I should have snapped out of it by now.
2. I can’t do anything else.
3. I have lost everything.
4. I can’t cope/I will never be able to cope.
5. Things will never get any better.
6. Why did this happen to me?
7. My life is over.