1993
Kraft, Tom (1993). Using hypnosis with cancer patients: Six case studies. Contemporary Hypnosis, 10, 43-48.
Hypnosis can be used in a number of different ways for helping patients suffering from cancer. As well as pain relief, hypnosis may be used to correct insomnia that does not respond to sleeping tablets; for the reduction in skin irritation and dyspnoea when these are due to organic causes, and for treatment-related over-eating. Some patients will use hypnosis in a symbolic way. When this occurs, just as in dream interpretation, it is important to ask the patient for associations, so that these symbols can be understood. Hypnosis can be an extremely useful addition to the medical armamentarium, and should be employed as an adjunct to standard forms of cancer treatment. This paper reports six case studies in which hypnosis was used to help cancer patients.
Saperstein, Guy; Montgomery, Guy; Kirsch, Irving (1993, August). Cognitive-behavioral hypnotherapy: A meta-analysis. [Paper] Presented at the annual meeting of the American Psychological Association, Toronto, Canada.
Meta-analysis was used to compare the effectiveness of cognitive-behavior therapy (CBT) to that of cognitive-behavior therapy with hypnosis (CBHT). A review of the literature revealed 18 studies in which 20 hypnotic treatments were compared to similar non-hypnotic treatments and in which sufficient data were presented for the calculation of effect sizes. Effect sizes were weighted for sample size and then averaged. This resulted in a mean effect size of 1.37 standard deviation units, indicating that the average client receiving cognitive-behavioral hypnotherapy is better off than 90 percent of clients who receive the same treatment in a nonhypnotic context. Substantial variance in effect sizes was found, indicating the presence of a moderator variable. Further analyses indicated that this variance was limited to treatments in which obesity was the presenting problem. The mean effect size for the addition of hypnosis to treatments of obesity was larger (M = 1.98) and more variable (variance = 4.10) than that for the addition of hypnosis to treatments for other presenting problems (M = .52; variance = .06). Also, studies of clinical samples yielded larger effects (M = 1.72) than analogue studies with college student samples (M = .07). The effect of hypnosis was independent of whether relaxation training was included in the nonhypnotic treatment or whether the hypnotic treatment included suggestions that were not included in the nonhypnotic treatment. Consistent with response expectancy theory, these data indicate that the substantial positive effect obtained was due to labeling the treatment ‘hypnosis,’ rather than to any substantive change in clinical procedure. (ABSTRACT from Bulletin of Division 30, Psychological Hypnosis, Fall 1993, Vol. 2, No. 3.)
1992
Levitt, Eugine E. (1992, August). Hypnosis in the treatment of obesity. [Paper] Presented at the annual meeting of the American Psychological Association, Washington, DC.
The literature dealing with the hypnotherapy of overweight and weight control is comprehensively reviewed. In general, the more recent reports are methodologically more sophisticated than earlier ones. Specific techniques employed include direct and aversive suggestions, imagery, ego-enhancement, self-hypnosis and a variety of behavior modification tactics. Most hypnotherapy is carried out in groups and most subjects/patients have been female. Twenty reports providing group data summarized. All but one report weight reduction at close and at follow-up. Of eight reports using control groups, six found that the group treated by hypnotherapy lost significantly more weight than some or all of the control groups. Hypnosis with behavior modification appears to be the most effective approach. Analysis suggests that hypnosis effectuates behavioral techniques after the close of treatment. Eleven reports presenting correlations between weight loss and hypnotic susceptibility differ sharply depending upon the year of publication. Only one of seven reports published prior to 1982 found a relationship between weight loss and susceptibility. Three of four reports since 1985 found a positive relationship. It is concluded that hypnotherapy for weight control can be effective and that it is probably maximally effective with high susceptibility persons. (ABSTRACT from the Bulletin of Division 30, Psychological Hypnosis, Fall, 1992, Vol. 1, No. 3.)
Rhue, Judith W.; Lynn, Steven Jay; Kvaal, Steven; Mare, Cornelia (1992, October). Hypnosuggestive procedures in the treatment of anorexia nervosa. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington, VA.
NOTES
Much of this information can be applied to the treatment of bulimic clients. The incidence of eating disorders has increased, and hypnosis has been added to the arsenal of treatments. The literature is sparse, but there is general agreement that hypnosis is useful. See article in Journal of Contemporary Hypnosis.
Define one’s role as a guide with this population. Define the hypnosis procedure as Self Hypnosis with this population. Use in vivo treatments for countering resistance to treatment.
Do not use hypnosis until weight is stabilized to a minimum acceptable level by a physician (possibly involving hospitalization). Premature use of hypnosis will panic an anorexic patient.
Use graded suggestions. — Relax, feel happy and content — Have a daydream or fantasy accompanied by feelings of relaxation and well being (which underscores the importance of fantasy in treatment) –Go to a favorite place where client feels happy (this is more positive on the affective valence; teaches them to use fantasy as a means of withdrawal from difficult feelings) — Daydream or fantasize about a specific problem or conflict (any arena); can be open- ended and entirely projective; can suggest that you are part of the dream, there to reduce anxiety. Can provide rich material re client’s dependency on you. — Client can imagine in hypnosis that the therapist is providing advice or assistance. — Consult inner advisor who is emotionally detached yet supportive — View conflict from multiple perspectives. Some are resistant to viewing themselves from more than one vantage point. — Imagine possible outcomes of problems or conflicts. Many are paralyzed by decisions. this challenges them to engage in creative problem solving by brain storming. These can be administered in conjunction with the inner advisor suggestions. — Enact in fantasy an interpersonal problem/conflict that involves an antagonist, to dialogue with her own powerful angry self; this may precipitate cathartic expression. — Role play interpersonal conflict in the session — Other techniques like age regression, projecting on a screen — Indirect suggestions to learn to care for the body and the self.
Treatment lasts 6 mos to 9 years. These suggestions serve as general guidelines.
1991
Oettingen, Gabriele; Wadden, Thomas A. (1991). Expectation, fantasy, and weight loss: Is the impact of positive thinking always positive?. Cognitive Therapy and Research, 15 (2), 167-175.
Investigated the impact of expectation and fantasy on the weight losses of 25 obese women participating in a behavioral weight reduction program. Both expectations of reaching one’s goal weight and spontaneous weight-related fantasies were measured at pretreatment before Ss began 1 year of weekly group treatment. Consistent with the hypothesis that expectation and fantasy are different in quality, these variables predicted weight change in opposite directions. Optimistic expectations but negative fantasies favored weight loss. Ss who displayed pessimistic expectations combined with positive fantasies had the poorest treatment outcome. Expectation but not fantasy predicted program attendance. The effects of fantasy are discussed with regard to their potential impact on weight reduction therapy.
1990
Demitrack, Mark A.; Putnam, Frank W.; Brewerton, Timothy D.; Brandt, Harry A.; et al. (1990). Relation of clinical variables to dissociative phenomena in eating disorders. American Journal of Psychiatry, 147 (9), 1184-1188.
Compared 30 female patients (aged 16-39 yrs) with eating disorders with 30 age-matched normal female Ss, using the Dissociative Experiences Scale (E. M. Bernstein and F. W. Putnam; see PA, Vol 74:14407) and additional self-report measures such as the Beck Depression Inventory. The patients demonstrated significantly higher levels of dissociative psychopathology compared with controls. Furthermore, the presence of severe dissociative experience appeared to be specifically related to a propensity for self-mutilation and suicidal behavior. Findings are discussed in light of recent data suggesting that neurochemical systems shown to be abnormal in patients with eating disorders may be key pathophysiologic substrates for dissociative experience.
Groth-Marnat, Gary; Schumaker, Jack F. (1990). Hypnotizability, attitudes toward eating, and concern with body size in a female college population. American Journal of Clinical Hypnosis, 32 (3), 194-200.
In this study we investigated the relationship between hypnotizability and attitudes toward food intake. 102 female college students (mean age 21) completed the Eating Attitudes Test and the Goldfarb Fear-of-Fat Scale, and were assessed for hypnotizability on the Harvard. The results indicated that level of hypnotizability was related to attitudes toward food intake and the fear of becoming overweight. Findings support the thesis that hypnotizability may be one of a variety of predisposing factors in the development and maintenance of extreme attitudes toward eating and weight regulation. Implications for changing these attitudes are discussed.
Vanderlindin, Johan; Vandereycken, Walter (1990). The use of hypnosis in the treatment of bulimia nervosa. International Journal of Clinical and Experimental Hypnosis, 38 (2), 101-111.
NOTES
25 people who were highly hypnotizable were treated. Treatment consisted of three phases: introduction to hypnosis, addressing core issues, and ensuring long term results. The induction included focus on breathing, relaxation, and arm levitation. Subject was told to imagine that she is eating a meal, while concentrating and tasting her food. She is then told to imagine a recent binge and to exaggerate all the negative consequences of binging (weight gain, low self-esteem) and all the positive consequences of binge-free life.
To address Subject’s core issues of why binging started, the Subject is told to separate her ego from her bulimic past, and the therapist then tries to find out why the bulimic past entered the patients’ life. The therapist then tries to ‘negotiate’ with the bulimic past and tries to help the patient find other ways to deal with the problems. Cognitive restructuring and hypnosis techniques are used.
The final phase, which entails a year of followup care, involves helping the patients to become independent from their past. Many bulimic patients are still dependent on their parents, and this may have caused their dependency on food. Therefore, the goal of hypnosis is to allow herself to become emotionally independent and to control her life.
It was estimated that 50% of patients completely recovered and 30% showed great improvement but 20% did not change at all.
1989
Ross, Colin A.; Heber, Sharon; Norton, G. Ron; Anderson, Geri (1989). Differences between multiple personality disorder and other diagnostic groups on structured interview. Journal of Nervous and Mental Disease, 177 (8), 487-491.
The Dissociative Disorders Interview Schedule was administered to 20 Ss with multiple personality disorder, 20 with schizophrenia, 20 with panic disorder, and 20 with eating disorders (mean ages 25.4-38.4 yrs). Findings show that multiple personality could be differentiated from the other groups on variables such as history of physical abuse, sexual abuse, substance abuse, sleepwalking, childhood imaginary playmates, secondary features of multiple personality, and extrasensory and supernatural experiences. Those with multiple personality also differed from the other groups on Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria for multiple personality, psychogenic amnesia and psychogenic fugue. The groups did not differ on the number of Ss who had a major depressive episode.
1987
Baker, Elgan L.; Nash, Michael R. (1987). Applications of hypnosis in the treatment of anorexia nervosa. American Journal of Clinical Hypnosis, 29, 185-193.
Historic and current reports in the literature involving applications of hypnosis with anorectic patients are reviewed and integrated to explicate core aspects of hypnotic interventions in treating anorexia nervosa. A comprehensive hypnotherapeutic approach is delineated which emphasizes the use of hypnotic strategies to reduce tension, enhance self-control, support increased and realistic body awareness, alter distorted body image, and foster appropriate autonomy and individuation. Preliminary data are also reviewed which support the clinical efficacy of this approach.
1986
Cochrane, Gordon; Friesen, J. (1986). Hypnotherapy in weight loss treatment. Journal of Consulting and Clinical Psychology, 54, 489-492.
Investigated the effects of hypnosis in weight loss for 60 females, at least 20% overweight and not involved in other treatment. Six client variables (suggestibility, self-concept, quality of family origin, age of obesity onset, education level, and socioeconomic status) and a process variable of representational systems were analyzed in relation to weight loss. Treatment included group hypnosis with metaphors for ego- strengthening, decision making and motivation, ideomotor exploration in individual hypnosis, and group hypnosis with maintenance suggestions. There were two experimental groups (hypnosis with and without audiotapes) and a control group, assessed immediately after treatment and at 6-month follow-up. Hypnotizability, use of audiotapes, and the other five variables were not predictive of weight loss. But, hypnosis was more effective than a control group (17 vs. .5 pounds on follow-up).
Sands, Steven (1986, August). The use of hypnosis in establishing a holding environment to facilitate affect tolerance and integration in impulsive patients. Psychiatry, 49.
This paper is concerned with the use of hypnosis in establishing a facilitating and holding environment in the treatment of impulsive behavior across a range of diagnoses. The reason for this cross-diagnostic viewpoint is to underscore the common sources of such action and the needs to be met in its treatment. Illustrations from work with two patients are presented: One was a hypomanic and bulimic woman who was successful in her profession; the other was an underemployed and sometimes unemployed schizophrenic man. Both were inclined to self-defeating impulsive action—bulimia in the woman, assault in the man.
Andersen, M.S. (1985). Hypnotizability as a factor in the hypnotic treatment of obesity. International Journal of Clinical and Experimental Hypnosis, 33 (2), 150-159.
The study describes a program of time-limited, relatively uncontaminated hypnotherapy for the treatment of obesity, and explores relationships between degree of objectively measured hypnotizability (by the Stanford Hypnotic Susceptibility Scale, Form A of Weitzenhoffer and E. R. Hilgard, 1959) and success at weight reduction via hetero- and self-hypnosis. Of the 43 male and female adult outpatients of the Morton Prince Center for Hypnotherapy in New York City who entered the program, 30 Ss completed the orientation session, 8 weekly individual treatment sessions, and 12 weeks of follow-up, during which self-hypnosis was practiced. These Ss showed an average weight loss of 20.2 pounds. Results indicated a statistically significant positive association between degree of hypnotizability and success at weight reduction. High hypnotizable Ss were significantly more aided by the treatment program than either medium hypnotizable or low hypnotizable Ss.
Bolocofsky, David N.; Spinler, Dwayne; Coulthard-Morris, Linda (1985). Effectiveness of hypnosis as an adjunct to behavioral weight management. Journal of Clinical Psychology, 41 (1), 35-41.
109 17-67 year olds completed a behavioral treatment for weight management either with or without the addition of hypnosis. Results show that, at the end of the 9-week program, both interventions resulted in significant weight reduction. However, at 8-month and 2-year follow-ups, the hypnosis Ss showed significant additional weight loss, while those in the behavioral-treatment-only group exhibited little further change. More Ss who used hypnosis also achieved and maintained their personal weight goals. It is suggested that hypnosis may have been an effective motivator for Ss to continue practicing the more adaptive eating behaviors acquired during treatment. Findings support the utility of employing hypnosis as an adjunct to a behavioral weight management program. (25 ref)
Morris, Don M.; Nathan, Ronald G.; Goebel, Ronald A.; Blass, Norman H. (1985). Hypnoanesthesia in the morbidly obese. Journal of the American Medical Association, 253 (22), 3292-3294.
The advent of chemical anesthesia relegated hypnosis to an adjunctive role in patients requiring major operations. Anesthesia can be utilized with acceptable risk in the great majority of patients encountered in modern practice. But an occasional patient will present–such as one with morbid obesity–who needs a surgical procedure and who cannot be safely managed by conventional anesthetic techniques. This report describes our experience with such a patient and illustrates some of the advantages and disadvantages of hypnoanesthesia. The greatest disadvantage is that it is unpredictable. Close cooperation between the patient, hypnotist, anesthesiologist, and surgeon is critical. However, the technique may be utilized to remove very large lesions in selected patients. Hypnoanesthesia is an important alternative for some patients who cannot and should not be managed with conventional anesthetic techniques.
Pettinati, Helen M.; Horne, Robert L.; Staats, Julia M. (1985). Hypnotizability in patients with anorexia nervosa and bulimia. Archives of General Psychiatry, 42 (10), 1014-1016.
Examined the hypnotic capacity at hospital admission of 65 patients with anorexia nervosa and 21 with bulimia, as diagnosed by DSM-III criteria. Anorexics were divided into the subgroups of 19 abstainers and 46 purgers. Ss received 3 standardized hypnosis scales consisting of induction, suggestions, and multiple measures of hypnosis. Analyses showed that hypnotic capacity was significantly higher in bulimic patients than in anorexics or normal, age-matched controls. Anorexic Ss who purged had higher hypnotic capacity than the normal population, although as a group they were not as highly hypnotizable as Ss with bulimia. It is suggested that anorexic and bulimic patients with high hypnotic capacity may be able to reduce their distorted body image with the aid of hypnosis. (26 ref).
1984
Bushnell, John A. (1984). Hypnosis and single case experimental design: Some ruminations on a theme. Australian Journal of Clinical Hypnotherapy and Hypnosis, 12 (1), 1-8.
Attempts to study psychotherapeutic interventions have traditionally used a between-groups experimental design which has required large numbers of subjects in order to provide homogeneity of clinical conditions. The practical problems associated with such a method of research are such that rigorous evaluation of hypnosis has most often not been undertaken. Single case design, especially multiple baseline, offers an alternative research strategy which has significant advantages in hypnosis research, enabling proper account to be taken of ethical considerations whilst focussing on clinical rather than statistical significance. Furthermore, single case design enables variability to be interpreted as useful data rather than being lost as error; and it offers a strategy for establishing the existence of treatment effects due to interventions using hypnosis. The application of a multiple baseline research design within routine cinical practice is discussed in the case of a young woman with an unusual eating disorder.
NOTES
The patient “complained of regurgitating all food repeatedly after every meal. This occurred about eight times after breakfast, ten times after lunch, and up to 15 times following the evening meal” (p. 3). “The food was rechewed, swallowed and about 5 minutes later the pattern would repeat itself” (p. 3).
Pettinati, Helen M. (1984, October). Differential hypnotic response in anorexia nervosa and bulimia: An item analysis. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Antonio, TX.
NOTES
Because bulimics are thought to be dissociative, congruent with their symptoms, it was predicted that they would score higher on the dissociative items of the hypnotizability scales. Previously published data shows:
N Mean Score College students 203 5.07
Bulimics 21 7.71**
Anorexic Purgers 46 6.13*
Anorexic Abstainers 19 5.00
* & ** = higher than norms
Hilgard’s 3 factors of hypnotizability scales were scored. Bulimics scored higher than norms on the cognitive dissociation factor but not on the motor and motor challenge factors, and purging anorectics also scored higher on this factor. The cognitive dissociation factor consists of neither the easiest nor the most difficult items on Form C, so this doesn’t represent item difficulty.
Item analysis: 1. Bulimics score higher on taste hallucination, arm rigidity, dream, age regression, arm immobilization, & hallucinated voice. 2. Purgers score higher on arm rigidity, dream, and arm immobilization 3. Abstainers evidenced no difference from norms.
1983
Spiegel, David (1983). Hypnosis with medical/surgical patients. General Hospital Psychiatry, 5, 265-277.
The role of hypnosis as a tool in the treatment of problems commonly encountered among medical and surgical patients is examined. Hypnosis is defined as a change in state of mind far more akin to intense concentration than sleep. Diagnostic implications of differences in hypnotic responsivity are explored, and scales suitable for use in the clinic are examined. Uses of hypnosis in treating anxiety, pain, childbirth, psychosomatic symptoms, seizure disorders, neuromuscular dysfunction, and habits are described and evaluated. The phenomenon of hypnosis is presented as a means of exploring the mind-body relationship in a controlled fashion, providing information of diagnostic importance while at the same time allowing hypnotizable patients to intensify their concentration and interpersonal receptivity in the service of a therapeutic goal.
1981
Goldstein, Y. (1981). The effect of demonstrating to a subject that she is in a hypnotic trance as a variable in hypnotic interventions with obese women. International Journal of Clinical and Experimental Hypnosis, 29 (1), 15-23.
In order to investigate the question of whether or not Ss experiencing a phenomenon during trance which would be very unlikely to occur outside of trance improves the efficacy of hypnotic treatment for obesity, a S pool of obese women was divided into 3 groups: a non-hypnotic behavior modification group, a hypnosis group without any special phenomenon structured into it, and a hypnosis group with such a phenomenon (hand levitation). Weight-loss data were collected 4 weeks and 6 months after the start of treatment. All treatments resulted in at least moderate weight loss. Statistically significant differences were found between the hypnosis-with-hand-levitation treatment effect and the other treatment effects. Possible reasons for the treatment effects adn the differences obtained are discussed.
Wadden, Thomas A.; Flaxman, J. (1981). Hypnosis and weight loss: A preliminary study. International Journal of Clinical and Experimental Hypnosis, 29 (2), 162-173.
The purpose of this study was to determine both the efficacy and the active treatment components of a hypnotherapeutic program for weight loss. 30 Ss at least 10% over their ideal weight were randomly assigned to 1 of 3 conditions: (a) hypnosis, (b) covert modeling, or (c) relaxation-attention control. At the end of 7 weeks all of the groups showed weight losses comparable to those achieved by behaviorally oriented reduction programs, but there were no differential losses among the groups at post-treatment or at 6- and 16-week follow-up assessments. The findings suggest that the efficacy of hypnosis as a weight-reduction strategy is attributable to factors shared in common with a minimum treatment condition, including positive expectancy, weekly participation in a reduction program, relaxation training, and limited dietary counseling. Consistent with previous findings, no relationship was found between hypnotic suggestibility and weight loss. The need to examine both different treatment techniques and overweight populations is discussed.
1980
Bornstein, Philip H.; Devine, David A. (1980). Covert modeling-hypnosis in the treatment of obesity. Psychotherapy: Theory, Research and Practice, 17 (3), 272-276.
Investigated the efficacy of a covert modeling/hypnosis treatment package in the control of obesity. 48 overweight female volunteers (who had been administered the Harvard Group Scale of Hypnotic Susceptibility, Eating Patterns Questionnaire, and Rotter’s Internal-External Locus of Control Scale) were randomly assigned to 1 of the following groups: (a) covert modeling/hypnosis, (b) covert modeling, (c) no-model scene control, and (d) minimal treatment (where Ss received a shortened version of the covert modeling/hypnosis procedure following an 8-wk no-treatment period.) Results indicate a significant effect for weight loss from pretreatment to follow-up across all groups combined. Proportion weight loss measures indicated significantly greater weight loss only for the covert modeling/hypnosis group as compared to the no-model controls. Implications for combining behavior therapy and hypnotic techniques are discussed. (30 ref).
Deyoub, P. L.; Wilkie, R. (1980). Suggestion with and without hypnotic induction in a weight reduction program. International Journal of Clinical and Experimental Hypnosis, 28 (4), 333-340.
Identical suggestions for the control of obesity were administered to a group receiving hypnotic induction and a group receiving task-motivational instructions. A no-treatment control group was also included. The only significant finding was greater weight loss by Ss in the task-motivational group than Ss in the control group. Much of the difference was attributed to weight gain of Ss in the control group. Within groups, highly suggestible Ss lost more weight in the hypnotic group, while suggestibility was unrelated to weight loss in the task-motivational group. The possibility that task-motivational and hypnotic Ss approached treatment with different mental sets and expectations was discussed. The role of hypnotizability in the hypnotic treatment of obesity was discussed.
1955
Hershman, Seymour (1955). Hypnosis in the treatment of obesity. Journal of Clinical and Experimental Hypnosis, 3 (3), 136-139.
NOTES
Three case histories are presented for patients treated for obesity using hypnotherapy. The procedure in hypnosis involved: (1) visualizing person on a stage who is unhappy, depressed, followed by a person who is happy, content; (2) discussing diet with indirect suggestions that adherence would lead to the happy, contented feelings and vice versa for non-adherence; (3) giving permissive suggestions regarding behavior change (e.g. “Perhaps it is only _certain_ foods that should be distasteful and not the eating of ‘allowed’ foods” (p. 137). Patients were seen weekly for 4-6 weeks, then bi-weekly or monthly for several months, and then only occasionally. “The easier acceptance of the therapy in the hypnotic state cannot be too strongly emphasized. … rapport is established more quickly and easily, and the feeling of participation on the part of the patient convinces him that the therapy will be successful” (p. 139).
EDUCATION
1998
Oster, M. I. (1998). A graduate school curriculum in clinical hypnosis. American Journal of Clinical Hypnosis, 41 (1), 65-74.
This paper describes a formal, integrated curriculum in clinical hypnosis that is offered through a psychology graduate school. An integrated program offers students and practicing professionals the opportunity to learn hypnosis in an environment that offers ongoing supervision and support of their long term development. Program development and recognition; program philosophy, objectives, and curriculum; and course description and content are described. (PsycINFO Database Record (c) 2003 APA, all rights reserved)
Walling, David P.; Baker, Jeffrey M.; Dott, Sharon G. (1998). Scope of hypnosis education in academia: Results of a national survey. International Journal of Clinical and Experimental Hypnosis, 46 (2), 150-156.
The present article examines the current status of hypnosis training and the attitudes of program chairs toward inclusion of such training in doctoral education. A brief survey on hypnosis training was sent to all psychology doctoral programs accredited by the American Psychological Association (n = 218) as well as 24 nonaccredited doctoral programs. Twenty-six percent of responding programs (n = 44/170) report offering either required or elective coursework in hypnosis. Of those programs offering a course in hypnosis, the mean semester credit hours earned was 3. Although many program directors support opportunities for hypnosis education in doctoral education, other constraints (e.g., available faculty, required coursework) limit its availability.
1996
Cheri (1996). Therapist sexual feelings in hypnotherapy: Managing therapeutic boundaries in hypnotic work. International Journal of Clinical and Experimental Hypnosis, 44 (1), 20-32.
This article elaborates ways that using hypnosis may create special vulnerability for the clinician, not only to experiencing sexual feelings toward patients but also to becoming confused about the meaning of these feelings and their relevance to treatment, as well as about the maintenance of appropriate patient-clinician boundaries. Special qualities of the hypnotic experience and relationship likely to generate erotic feelings and impulses in patients and clinicians alike are addressed. A clinical case example illustrates many possible meanings of therapist sexual feelings and the impulses to avoidance or acting out they may provoke. Clinically appropriate and inappropriate ways of managing boundaries in the presence of sexual arousal and of using sexual feelings to deepen clinical understanding and direct treatment interventions are discussed.
Walling, David P.; Baker, Jeffrey M.; Dott, Sharon G. (1996). A national survey of hypnosis training — its status in psychiatric residency programs: A brief communication. International Journal of Clinical and Experimental Hypnosis, 44 (3), 184-188.
Hypnosis training in psychiatric residency programs has not previously been well documented in the literature. This article examines the extent of such training in residency programs and the attitudes of residency directors to training and the use of hypnosis. A brief survey requesting information on hypnosis training was sent to all psychiatric residency directors in the United States. Sixty-three percent of responding program directors (n = 154) report offering either required or elective coursework in hypnosis. Of programs offering hypnosis training, the mean number of hours was 8, suggesting that many psychiatrists have only limited exposure to hypnosis during residency. The authors conclude that hypnosis training is widely variable within psychiatric residency programs and is dependent on the faculty and training director interests within individual programs.
Wark, David (1996). Teaching college students better learning skills using self-hypnosis. American Journal of Clinical Hypnosis, 38 (4), 277-287.
Reports the effects of self-hypnosis used by 51 college students enrolled in a 10-wk course on efficient learning skills. All Ss were administered the Creative Imagination Scale (CIS). Subsequently, they learned to enter and deepen alert self-hypnosis. They gave themselves personal suggestions and then studied in hypnosis. They reported their depth of hypnosis and satisfaction with each session. Grades were collected the quarter before, during and after the course. Satisfaction and depth data indicated the Ss were involved throughout the course. Statistical testing showed that Ss who scored highest on the CIS had the lowest initial GPA, improved most during the course, and significantly increased their GPA in the quarter after.
1994
Brown, Gail W.; Riddell, Rodney; Summers, David; Coffman, Brent (1994, August). Use of hypnosis by practitioners in the school setting. [Paper] Presented at the annual meeting of the American Psychological Association, Los Angeles.
NOTES
Hypnosis is a therapeutic procedure that is appropriate for some school-age clients. Through the use of hypnosis that utilizes metaphors and imagery, children can be empowered to find unique solutions to their problems. Children enjoy the feeling of power and mastery that they have when able to perform hypnotic phenomena. They like to play magic and can be told that a finger or other body part will become numb. Because a major goal of hypnotherapy is to teach a child to be an active participant in his or her own behalf, the focus is on creating solutions and mastering the situation rather than enduring the problems. Four case studies demonstrate the utility of hypnosis in the treatment of phantom pain and nausea, sleep terror disorder, school phobia, and spider phobia. In each case, treatment goals were realized. Because the solutions were self- generated, the behavioral changes maintained over time and situation.
Case #1: Hypnosis was used to help alleviate phantom limb pain and nausea during chemotherapy following amputation of the right leg at the knee due to cancer in a thirteen- year-old male. The client had indicated that he loved nature and enjoyed the mountains. The metaphor described a young tree that has just begun to grow small silvery leaves. The spring floods tear the limbs and branches from the stump. The deep roots and stump of the tree are all that remain. The tree is not the same as before the flood. Its roots are stronger, its base more sturdy compared to the branches and limbs. The young tree has withstood the catastrophe of the torrent of waters and is even stronger than before. To counter the nausea and vomiting associated with chemotherapy a switch mechanism metaphor was used. The client was adroit with computers and had no difficulty picturing a switch located in his brain which could “turn off” the nausea from chemotherapy. A room contained all the unpleasant feelings that were being experienced. In this room is a light of a particular color that represents all the unpleasant sensations. Press the key on the computer that controls the switch to turn off the colored light in that room. Suggestions for healing were also given. Your body has known for years how to heal. Visualize the battle between good and bad cells and the victory of the good cells.
Case #2: Hypnosis was used to alleviate sleep terror disorder in a ten-year-old female. The onset of the subject’s parasomnic symptomatology appeared to coincide with her starting kindergarten and her family’s relocation shortly before. The initial treatment consisted of progressive relaxation, deep breathing, and the visual image of her “secret safe place.” An induction utilizing a variety of images was presented. Hiking barefoot on a cool moss covered mountain trial, sitting in a an alpine meadow on a warm summer afternoon, and flying proved most effective in facilitating trance. The participant was told to “Visualize all your anxiety and tension as hard grey rocks. Pick up these rocks and place them in your pockets. Go to the front porch of your “secret safe place and on the porch is a “magic hefty bag.” Place your hard grey rocks that contain all your anxiety and tension in the magic bag. Once in the bag, the rocks will no longer weight you down, you will be free of any feelings of stress or tension. Your bed is magic; it is covered with a special glue which will keep you in a reclining position until you are fully rested and ready to awaken.”
Case #3: Hypnosis was used in the treatment of school phobia in a nine-year-old male. The student experienced intense anxiety whenever separation from the primary caretaker occurred. The teacher stated that this boy experienced frequent absences and crying spells that were only relieved by phone calls to his mother or the presence of his mother next to him in class. In preparation for the intervention, the student was asked to draw a picture of how he felt inside during a panic attack. He drew a fire. He also said that only his mother could put that fire out. This information was utilized in creating a metaphor that described a house in a small town. “The mother had left, and a young boy was left alone. While at home, the boy looked out the window and saw several boys trying to burn a neighbor’s yard! Acting quickly, he called the fire department, grabbed the fire extinguisher and unraveled the garden hose. He was able to extinguish the fire. The neighbors and friends were very happy and praised the boy’s performance. When his mother heard the good news, she quickly returned home and held a celebration in his honor.” Following the metaphor, hypnotherapy continued with suggestions about fire extinguishers that the subject could use to put out emotional fires.
Case #4: Hypnosis was used in the treatment of spider phobia. Diagnosis of phobia was made in this eleven-year-old female when the fear or avoidance behavior was distressing. The child’s strained facial expressions occurred even at the thought of seeing what she described as “a creepy, crawly creature with 8 legs.” Preparatory to her first induction the participant was read the story of Charlotte’s Web (White, 1980) to facilitate the imagery for future hypnotic work. In the following session systematic desensitization was accomplished using characters from the story of Charlotte’s Web. During the third session the subject was age regressed to the first time she remembered seeing a spider. She recalled playing in the woods outside her family home on an island and seeing a large web stretched between two trees with a very large spider in the center of its web. She was then asked to remain at that place to look closely at that spider as it was most likely Charlotte or one of Charlotte’s family. Upon closer investigation she saw not only Charlotte but “teeny-tiny babies.” The event was reconstructed as a happy experience. The imagery provided by Charlotte’s Web permitted the subject to fantasize her previous frightful experience and reframe spiders as cute little “teeny-tiny” babies with admirable human qualities.
Krippner, Stanley (1994, August). Improvement of academic skills for children and adolescents with hypnosis. [Paper] Presented at the annual meeting of the American Psychological Association, Los Angeles.
NOTES
Literature and research in this area are sparse, though there is clinical evidence that hypnosis is useful. My definition of hypnosis is a procedure facilitating a variety of structured goals or procedures in which a suggestion or motivation is enhanced by a mechanical device, another person, or oneself.
There are 3 areas of application in academics:
study habits
test taking
strengthening academic motivation
The hypnotist should know the specifics of academic achievement, because specific suggestions (e.g. “Imagine you are at desk focusing well for 20 minutes,”) are better. Emphasis on the positive is better than negative. Use the words “imagination,” “concentration,” or “imagining pictures,” rather than “hypnosis.” I try to determine what they expect, based in part on what words they use.
In elementary school I focus on attitude and self esteem. I have them imagine reading a story, then how well they feel; that when they notice mistakes they won’t be bothered because everyone makes mistakes.
For high school, I help them develop good habits for time motivation (e.g. suggestions to “make an outline to follow while you study”). At college level, I introduce self hypnosis. I make frequent use of mental imagery, at all levels–especially imagery rehearsal, in which the person is engaged in a particular activity.
In the NSF report on accelerated learning techniques (a project sponsored by the Army), Lozonov’s “suggestopedia” techniques were studied. This review indicated it might enhance training effectiveness and reduce training time.
I have observed the suggestopedia classes in Bulgaria and Hungary. Classes had a relaxed comfortable learning environment. Rather than individual learning, it was group learning. It included preliminary exercises, new material, and a review of what was learned. The first stage used 2/3 of the time. Then suggestions were given by the teacher to promote learning. The presentation phase took one third of the time. The method encourages students to make mental images of the material. In foreign language classes, people take on new roles.
1993
Kokoszka, Andrzej (1993). Occurrence of altered states of consciousness among students: Profoundly and superficially altered states in wakefulness. Imagination, Cognition and Personality, 12, 231-247.
In a questionnaire survey waking altered states of consciousness (ASC) are found to be common among 174 Polish students. The experience of Superficially Altered States of Consciousness (SACS) was reported by 96 percent of subjects and more than half of them had such experiences often. Whereas an experience of Profoundly Altered States of Consciousness (PASC) was confirmed by 75 percent and about one-third of them had them often. The comparison of the experiences accompanying the ASC indicates that SASC are characterized by disturbances in experiencing the reality and oneself combined with positive, pleasant feelings and with quietness. On the other hand, PASC are accompanied by experiences related to an absolute, universal, eternal, and existential or religious matters. PASC are accompanied by extremely strong positive emotions of happiness, total love, etc. and are experienced as more rational than SASC, and with significantly less feelings of cognitive disturbances than in SASC. The comparison of circumstances of the ASC occurrence indicates that SASC occur in usual and common states and situation of everyday life, whereas PASC mainly in the context of religion and nature. The congruence of these findings with an integrated model of the main states of consciousness suggests a natural tendency for a cyclical occurrence of ASC, or more precisely, the differentiated waking states of consciousness.
LaClave, Linda J.; Kronenberger, William G.; Baker, Elgan L.; Morrow, Catherine (1993). Use of hypnosis following training in a psychiatry residency and psychology internship program: A brief communication. International Journal of Clinical and Experimental Hypnosis, 41 (4), 265-271.
Despite growing numbers of internships and residencies offering training in hypnotherapy, no systematic attempt has been made to assess hypnotherapy beliefs and use among former trainees in these settings. This study investigated posttraining hypnotherapy use and effectiveness beliefs in a sample of 77 former psychiatry residents and psychology interns. Over 50% of the study sample had sought additional hypnotherapy training beyond the standard lectures and seminars, and almost 30% had attended external hypnotherapy workshops or presentations. Beliefs in hypnotherapy effectiveness were high, but use of hypnotherapy in clinical practice was very low. Former residents and interns who had received supervised training with patients, who had attended hypnosis workshops, and who had a colleague using hypnotherapy were more likely to use hypnotherapy following training.
1992
LaClave, Linda J.; Kronenberger, William G.; Baker, Elgan L. (1992, October). Use of hypnosis following training in a psychology internship and psychiatry residency program. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, Arlington, VA.
NOTES
Indiana University is embarking on a series of studies of training and characteristics of hypnotherapists.
Study 1
Purpose: generate hypotheses, from retrospective analysis, to design prospective studies.