How To Integrate Hypnotherapy Into Psychotherapeutic Practice by Nina Bingham

This article reviews three journal articles about how Hypnotherapy can be integrated into different psychotherapeutic situations, including: treating adult survivors of sexual abuse, post-traumatic stress, and learning disabled children. I chose to research the use of how hypnotherapy can be an asset to the mental healthcare field because I have been a practicing Clinical Hypnotherapist since 2003. I saw firsthand the successful application of this technology, and how it can compliment the way therapist of all modalities are practicing.

I was curious to see what research had to say about applying Hypnotherapeutic methods to Psychotherapeutics, because I am a Clinical Hypnotherapist and counselor, and had the good fortune of practicing in a group integrated medical practice where both Eastern and Western medicine was offered, and where I collaborated with medical and psychological physicians daily. I learned a lot from them, but they learned something from me, too. The clinical Psychologist on staff had not been trained in hypnosis and was naturally skeptical of its therapeutic value. When a patient of his inquired about my services for insomnia, since he hadn't been successful in resolving his patient's sleep problem, he asked me how I would treat insomnia. I explained that hypnosis deeply relaxes the body and mind, so that moving from the waking brainwave of Beta down to the deep sleep brainwave of Delta occurs easily and naturally. He referred his patient and I instructed him in self-hypnosis, so that when he was home he could put himself to sleep. It was such demonstrations that made a believer out of my colleagues.

However, as with any therapeutic tool, hypnosis has limited applications, and is not a magical panacea for all conditions. Since hypnosis employs Guided Imagery, or visualization as its main approach, its application is most effective and immediate for anxiety disorders, post traumatic stress, eating disorders, stress, and distorted cognition. I selected two articles that applied hypnotherapeutic techniques to adult survivors of childhood sexual abuse, and to children with developmental delays. The third article was written by Dr. Sperry who describes five techniques that psychotherapsists can incorporate into their practices with no formal hypnosis training.

In the first study, Hypnotherapy and Disabled Children (Johnson et al.,1977), three university scholars applied group hypnosis, and self-hypnosis on learning-disabled children. 15 children participated for 6 weeks of hypnotic training sessions and daily self-hypnosis, which made suggestions of improved academic performance and self-esteem. The study showed a marked improvement in self-esteem for the experimental group, but no academic improvement in reading, spelling and math. However, two additional studies suggest a relationship between self-perception and academic achievement. Jones and Stowic (1968) and Jones and Grieneecks (1970) showed that a student's self-concept of ability predicted grade-point averages more than did measures of intelligence and aptitude in both high school and college. Van Koughnett and Smith (1969) state, "For a child to achieve, he must view himself as able to achieve." How then does a clinician alter a self-perception?

One potential direction in changing self-perception is the use of suggestion to directly altar a belief system. The methodology of this approach would be hypnosis. Hypnotherapy has been used as an adjunct therapy to improve self-concept in children by suggestions of reduced anxiety, increased motivation, images of success, and increased confidence. Kroger (1963) describes its use with intellectually deficient children to increase motivation and conviction that they can learn" (Johnson, 1977).

The second report examines treatment techniques for survivors of sexual abuse. The author lists hypnotherapy and Guided Imagery techniques as suitable for them. Combined with inner-child work, adult survivors experience many negative and overwhelming emotions such as: "Anxiety, depression, self-blame, self-hatred, guilt, shame, fear, helplessness, sexual problems, memory loss, and some will suffer with suicidal ideation or attempts, self-mutilation, and unsatisfactory relationships. The child blames herself, internalizing the guilt and shame" (Pearson, 2001). Miller (1986) combined hypnotherapy with inner-child work to facilitate healing in a woman sexually abused by her father. "Often used in combination with inner-child techniques, much literature advocates using hypnotherapy and guided imagery with adult survivors of childhood sexual abuse" (Pearson, 2001). Why hypnosis in such cases? It provides a soothing, relaxing, and comfortable atmosphere for the client, a haven of safety. In the above-mentioned case, Miller (1986) "Combined hypnotherapy with inner-child work for several purposes; uncovering incest memories and associated feelings, helping the client make connections between the incest and current issues and behaviors." Norris (1986) stated, "Hypnotherapy may be the technique of choice when clients resist memories...it is an alternative technique for uncovering repressed material related to the incest." Rencken (1989) suggested that relaxation in and of itself can be therapeutic. "Relaxation can be useful for redeucing anxiety when survivors are exploring and discussing the details of abuse. Relaxation combined with Guided Imagery can improve recall of these threatening memories" (Norris, 1986).

The third article is a how-to manual for therapist who have no formal training in hypnotherapy. The first technique suggested is the Somatic Bridge, and is utilized when a client is having difficulty identifying his feelings. He is directed to turn his full attention to his bodily sensations, including mental images, memories and associations. It is a way of assisting the client to become more aware of his unspoken feelings, expressed somatically. Dr. Fritz Perls, creator of Gestalt Therapy, would ask the client, "If your tense tummy could talk right now, what would it say to you?" In this way the body serves as a bridge to the person's previously unspoken emotions.The second technique is the Emotional Bridge. The therapists directs the client to "stay with" and not resists the emotion, and see if it acts as a bridge to past memories that evoked the same feeling. The third technique is the Dissociate Technique. The therapist helps the client to see they are not the negative thoughts, actions or emotions they are experiencing, and asks them to identify and articulate the new part of herself that she is discovering. The fourth technique is Story-Telling. Milton Erickson was a famous hypnotherapist who created amazing and powerful therapeutic metaphors to tell his clients. Metaphor is an indirect method of therapy, appealing to the unconscious. The fifth and final technique is Reframing. Reframing is commonly used in both psychoanalytical and hypnotherapeutic practice. It is a way of "turning negatives into positives, assigning good intentions to participants, to change the climate, to disengage power plays, and to provide encouragement in place of discouragement" (Shermann and Dinkmeyer, 1987).

Although I can cover only a few mental disorders that respond positively to hypnotherapy, research has shown it is a therapeutic option that if used skillfully, can yield healing results. As is true with any therapeutic method, the practitioner must discern in which situations Guided Imagery and hypnosis would be helpful. It is not advisable or appropriate to treat all mental illnesses or disorders with hypnosis. Some conditions will fail to respond, yielding disappointing results. In some cases the application of hypnosis could make a bad condition even worse. Therefore, it is indicated for a psychotherapist to receive professional instruction in hypnotherapy, which includes the necessary instruction in: progressive relaxation, deepening techniques, structured suggestions or questions, post-hypnotic suggestion, and so on. If more mental healthcare professionals were trained in hypnotherapy, I believe they would regularly use this healing tool with great results, because it is a valuable additional resource to have in certain therapeutic situations.

References:

Johnson, L.S., Johnson, D, Lamont, D., Olsen, M.R., Newman, J.P. (1977). Hypnotherapy and disabled children. Journal of Clinical Psychology, 7, 12-20. Retrieved from: WWW.ebscohost.com.library.pcc.edu

Pearson, Q.M. (2001). Treatment techniques for adult female survivors of childhood sexual abuse. Journal of Counseling & Development, September/October 1995, Volume 73. Retrieved from: WWW.ebscohost.com.library.pcc.edu

Sperry, L. (1990). Incorporating hypnotherapeutic methods into ongoing psychotherapy. Individual Psychology, Vol. 46, No. 4. Retrieved from: WWW.ebscohost.com.library.pcc.edu