Clinical (C) 2007 Hypnosis Leonard McEwen & Lynn Lambert

Highlander Counselling & Mediation (c) 2007
Clinical Hypnosis
Leonard McEwen & Lynn Lambert
Friday
8:30-9:10 9:10-9:40 9:40-10:00 10:00-10:20 10:20-11:20
Definition History and Theories of Hypnosis Myths and Misconceptions Coffee Assessment, Presenting Hypnosis Hypnotic Phenomena
11:20-12:00 12:00-1:00 1:00-3:00 3:00-3:15 3:15-4:15 4:15-5:15
Induction and Realerting Lunch Induction and Realerting Cont'd Coffee Demonstrations of Inductions Eliciting Hypnotic Phenomena
Saturday
8:30-9:30 9:30-9:45 9:45-10:30 10:30-11:30 11:30-12:15
Susceptibility, Stages of Hypnosis Coffee Self Hypnosis Treatment Planning Managing Resistance
1:15-1:45 1:45-2:15 2:15-3:00 3:00-3:15 3:30-5:00
Hypnotic Susceptibility Scales Ethical Principles, Professional Conduct, Certification Integrating Hypnosis Into Practice Coffee Integrating Hypnosis Cont'd
Sunday
9:00-11:30 11:30-12:30 12:30-2:30 2:30-2:45 2:45-5:00
Integrating Hypnosis Cont'd Lunch Experiential Sessions Coffee Experiential Sessions Cont'd
V2
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Leonard McEwen & Lynn Lambert
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Definitions, History & Theories
Title Page
Slide 7 V2 Handout our practice brochures

VIP, 11/09/2007
MEDIA CLIP
Hypnosis Defined
Hypnosis is a natural state of aroused, attentive focal concentration with relative suspension of peripheral awareness. It involves an intensity of focus that allows the hypnotized person to make maximal use of innate abilities to control perception, memory, and somatic function.
Spiegel & Maldonado, 1999
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As a tool for health may have originated with Hindus of India Sleep temples used suggestion to cure
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Paracelsus (1493-1541) (1493Highlander Counselling & Mediation (c) 2007
Swiss 1st to use magnetic healing
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Valentine Greatrakes (1628-1666) (1628Highlander Counselling & Mediation (c) 2007
"the Great Irish Stroker" Healed people by laying his hands on them and passing magnets over their bodies
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Gassner (1727-1779) (1727Highlander Counselling & Mediation (c) 2007
Catholic priest Believed that disease was caused by evil spirits and could be exorcised by incantations and prayer
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Maximilian Hell (1720-1792) (1720Highlander Counselling & Mediation (c) 2007
Used magnets to heal by applying steel plates to the naked body Franz Anton Mesmer was a student
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Dr. Franz Mesmer (1734-1815) (1734Highlander Counselling & Mediation (c) 2007
Physician from Austria Had an effect he called "animal magnetism" or "mesmerism" In Paris the medical community challenged him
The King put together a Board of Inquiry that included chemist Lavoisier, Benjamin Franklin, and a medical doctor who was an expert in pain control named Joseph Ignace Guillotin Mesmer refused to cooperate with the investigation The commission later declared that Mesmerism worked by the action of the imagination
Mesmerism remained popular Mesmer himself retired to Switzerland in obscurity, where he died in 1815
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Abb Faria Abb

Indo-Portuguese priest Revived public attention Early 19th century Introduced oriental hypnosis to Paris. Gave exhibitions in 1814 and 1815 Faria claimed that it generated from within the mind the by power of expectancy and cooperation of the patient
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Lucid Sleep
Concentration rather than animal magnetism Involuntariness Father of suggestion theory Importance of the subject not the hypnotist
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Marquis de Puysgur Puys

Student of Mesmer First described and coined the term somnambulism
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Rcamier
Rcamier was the first recorded use of hypnoanesthesia and operated on patients under mesmeric coma (1821). Carl Reichenbach 1840s and 1850s began experiments to find any scientific validity to "mesmeric" energy, which he termed Odic force. Although his conclusions were quickly rejected in the scientific community, they did undermine Mesmer's claims of mind control. Mesmerism in its later guise of hypnotism contained a clear implication that many saints might be hysterics, leading The Roman Catholic Church to ban hypnotism until the middle of the 20th century.
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James Braid (1705-1860) (1705Highlander Counselling & Mediation (c) 2007
Coined term hypnosis in 1842 Titled the "Father of Modern Hypnotism" Rejected Mesmer's idea of magnetism inducing hypnosis Ascribed the creation of the 'mesmeric trance' to a physiological processthe prolonged attention on a bright moving object or similar object of fixation. He postulated that "protracted ocular fixation" fatigued certain parts of the brain and caused the trance, "nervous sleep" Attempted unsuccessfully to use hypnotism to treat various psychological and physical conditions Others had better results, especially in the use of hypnosis in pain control Braid is credited for writing the first book on hypnosis in 1843 titled Neurypnology
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Dr. John Elliotson (1791-1868) (1791Highlander Counselling & Mediation (c) 2007
English surgeon Reported numerous painless surgical operations using mesmerism in 1834
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Dr. James Esdaile (1805-1859) (1805Highlander Counselling & Mediation (c) 2007
Reported on 345 major operations performed using mesmeric sleep as the sole anesthetic
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Jean-Martin Charcot (1825-1893) Jean(1825Highlander Counselling & Mediation (c) 2007
Neurologist Endorsed hypnotism for the treatment of hysteria. Led to a number of systematic experimental examinations of hypnosis Process of post-hypnotic suggestion was first described in this period. Extraordinary improvements in sensory acuity and memory were reported under hypnosis From the 1880s the examination of hypnosis passed from surgical doctors to mental health professionals. Charcot had led the way and his study was continued by his pupil Hypnosis as apsychopathological, hysterical process
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Pierre Janet
Described the theory of dissociation, the splitting of mental aspects under hypnosis (or hysteria) so skills and memory could be made inaccessible or recovered Provoked interest in the subconscious and laid the framework for reintegration therapy for dissociated personalities.
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Jean Charcol
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July 28, 1847

Decree from the Sacred Congregation of the Holy office (Roman Curia) declared that "Having removed all misconception, foretelling of the future, explicit or implicit invocation of the devil, the use of animal magnetism (Hypnosis) is indeed merely an act of making use of physical media that are otherwise licit and hence it is not morally forbidden provided it does not tend toward an illicit end or toward anything depraved."
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Pope Pius XII (1956)

Approval of hypnosis. He stated that the use of hypnosis by health care professionals for diagnosis and treatment is permitted. In an address from the Vatican on hypnosis in childbirth. The Pope gave these guidelines: Hypnotism is a serious matter, and not something to be dabbled in In its scientific use, the precautions dictated by both science and morality are to be followed Under the aspect of anaesthesia, it is governed by the same principles as other forms of anaesthesia
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American Civil War

The first extensive medical application of hypnosis Introduction of the hypodermic needle and the general chemical anesthetics of ether in 1846 and chloroform in 1847 to America, it was much easier for the war's medical community to use chemical anesthesia than hypnosis
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Ambroise-Auguste Libault (1864-1904) AmbroiseLi (1864Highlander Counselling & Mediation (c) 2007
Founder of the Nancy School Wrote of the necessity for cooperation between the hypnotizer and the participant, for rapport Emphasized, with Bernheim, the importance of suggestibility Hypersuggestability Theory Nancy School with emphasis on hypnosis as a psychological and not a psychopathological state
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1889
First International Congress for Experimental and Therapeutic Hypnotism was in Paris. Attendees included: Jean-Martin Charcot Hippolyte Bernheim Sigmund Freud Ambroise-Auguste Libeault British Medical Association Approval, 1892
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Emile Cou (1857-1926) Cou (1857Highlander Counselling & Mediation (c) 2007
French pharmacist Laws of Suggestion
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Sigmund Freud
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Milton Erickson
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Modern Theorists
Hilgard (1977) Dissociatiion/divided consciousness Ernest Rossi (1980 current) s, Stillness and tranquility - Biophysical theories David Spiegel (1994) Aroused, attentive focal concentration S. Kosslyn (2000) Psychological state of focused attention
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Endorsements
Clinical hypnosis endorsed by the: British Medical Association (1955) American Medical Association (1958) American Psychiatric Association (1961) American Psychological Association (1969)
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Theories of Hypnosis
Neo-Dissociative Social Pychological Psychodynamic Social Learning Ericksonian Atheoretical Approach Multidimensional Formulations
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Hypnotic Response
Multidimensional & Multicausal Hereditary Physiology

Lymbic structures or the amygdala and hippocampus Ultradian rhythms Theta production and right hemispheric dominance
Dissocative Processes Absorption in imagery (imagining ifreduction in reality as ) orientation
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Cognitive, motivational and psychosocial variables (expectations, attidudes, motivations, compliance) Interpersonal environmental variables (quality of relationship, percieved competance, trust, conducive environment)
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Myths & Misconceptions
Title Page
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Major Myths & Misconceptions

Loss of control Surrender of will Loss of consciousness
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M:
The person being hypnotized will be under the control of the hypnotist, and can be made to do or say anything the hypnotist wants.
F:
This is not true. No matter how deeply hypnotized you become, you will remain in control throughout the session. You cannot be made to do anything you do not want to do, or anything that you are uncomfortable doing.
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M:
Hypnosis is something that is done to people, rather than something that they can do for themselves.
F:
This is not true. Hypnosis is a skill you can learn. It is a tool you can use to help yourself feel better.
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15
M:
People become trapped in hypnosis and cannot come out it when they want to. of
F:
This is not true. People can end hypnosis whenever they want.
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M:
People have to be very hypnotizable or suggestible or gullible hypnosis to work. for
F:
This is not true. Research has indicated that the vast majority of people can benefit from hypnosis. Furthermore, being hypnotizable or choosing to be responsive to suggestions means only that you have the ability to use hypnosis effectively. It is not at all related to being gullible or weak-willed.
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M:
During hypnosis, people are unconscious.
F:
This is not true. During hypnosis, people are not asleep or unconscious. Although they may feel very relaxed, they are active participants in the hypnosis session.
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Hypnosis vs. Relaxation
Title Page
Hypnosis Relaxation is not necessary for hypnotic induction.
Relaxation Relaxation is being in a relaxed state.
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Hypnosis Hypnosis can produce analgesia and anaesthesia.
Relaxation Relaxation does not produce analgesia and anaesthesia.
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Hypnosis Hypnosis can significantly reduce or abort acute pain.
Relaxation Relaxation has no significant effect on acute pain.
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Hypnosis Major surgery tolerated under hypnosis.
Relaxation Major surgery cannot be tolerated under relaxation.
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Hypnosis Hypnosis prevents inflammation and swelling in acute burn cases.
Relaxation Relaxation does not suppress inflammation and swelling in acute burn cases.
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Hypnosis Hypnosis produces dissociation, hallucinations and delusions.
Relaxation Dissociation, hallucinations and delusions occur as epiphenomenon.

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Hypnosis Hypnosis produces de-realisation and depersonalization.
Relaxation Derealisation and depersonalization can occur.
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Hypnosis Hypnosis induces dreams.
Relaxation Dreams can occur.
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Hypnosis Hypnosis produces trance logic .
Relaxation There is no trance logic .
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Hypnosis Hypnosis can easily produce amnesia.
Relaxation Amnesia can occur by chance.
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Hypnosis Somato-sensory changes easily produced under hypnosis.
Relaxation Somato-sensory changes can occur as a function of parasympathetic dominance.
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Hypnosis & Memory

Its imperfect nature Trauma memory Accurate recall Forensics
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Hypnosis & Creation of Pseudomemory

Highly Hypnotizable subjects more prone Prehypnotic and hypnotic suggestions must create a neutral atmosphere as to whether of not further or accurate information will be revealed
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Assessment, Presenting Hypnosis
Title Page
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Standard Psych/Medical evaluations and diagnostics should be completed prior to using hypnosis All hypnosis is really self hypnosis Everyday trance Everyday absorption experiences
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Informed Consent
Name hypnosis don t use synonym Discuss the imperfection of memory and the need to corroborate hypnotically obtained memory Caution about the use of hypnosis and the ability to testify in court
Handout
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Hypnotic Phenomena
Title Page
22
Media Clip
Research on phenomena associated with hypnosis Suggestions for eliciting phenomena Applications of hypnotic phenomena
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Ideomotor Phenomena
Hands moving together Eye closure Ideomotor signals Arm catalepsy, levitation Autonomic movements Finger lock Eye catalepsy
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Ideosensory Activities
Dissociation Analgesia Anasthesia Hypnotic dreams Post hypnotic suggestions
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Hyperamnesia & Age Regression

Partial regression Revivification
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Amnesia & Time Distortion

Hidden Observer (ego-state phenomena) Negative and positive hallucinations

Olfactory Gustatory Kinesthetic Auditory Visual
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Frequency
Difficulty of facilitating phenomena Classic suggestion effect of experiencing phenomena
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Induction, Re-Alerting Re& Suggestions
Title Page
Steps In Facilitating Induction

Importance of removing suggestions and realerting clients 6 principles of induction and suggestion 4 types of suggestions
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Handouts
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Facilitating Induction
Preparing and educating the client Fixation of attention and deepening of involvement Facilitating involuntary or unconscious involvement Realerting
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Media Clip
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Eliciting Hypnotic Phenomena
Hypnotic Phenomena Demonstrated

Hands moving together Eye closure Ideomotor signals Arm catalepsy, levitation Autonomic movements Finger lock Eye catalepsy
Dissociation Analgesia Anesthesia Hypnotic dreams Post hypnotic suggestions
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Hypnotizability
Title Page
Stages of Hypnosis
Advertising Pre-Session Waiting Room Client Interview Office Presentation
Induction Deepening Session Alerting Debriefing
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Intentional Practice
Set the stage for hypnosis Feed the clientexpectation s Call for an appointment
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Pre Session
Advertisement - CSCH Membership Use of Hypnosis as an adjunct
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Waiting Room
Brochures Receptionist distributes client information form which includes hypnosis related questions
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Client Interviews
What was said to client when appointment was booked?
Are your colleagues aware that you use hypnosis and that you accept referrals on that basis?
What forms were filled out in the waiting room?
What was learned in the first session?

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Office & Presentation

Comfort Subdued lighting Music Bathroom
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90
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Induction
Your Chair
Comfort Head support
Your Technique
Voice Pace
Your Office Finishing

Color Comfort
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Deepening
Voice and timing Image Sound
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Session
Directive Metaphor use Post hypnotic suggestion
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Example
Removing suggestion effects and realerting
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Example
Rapport and cooperative relationship
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Example
Creating positive expectancy
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Emile Cou and the Laws of Suggestion Cou

CouLaw s If imagination and will are in conflict, imagination always wins. In other words you can not will yourself to do anything that you can not imagine yourself doing. The Law of Concentrated Attention Whenever attention is concentrated on an idea over and over again, it spontaneously tends to realize itself. The Law of Reversed Effect The harder one tries to do something, the less chance one has of success. The Law of Dominant Effect A strong emotion/suggestion tends to replace a weaker one.
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Example
The principle of using positive suggestions
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Example
Principle of trance ratification
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Example
Value of careful observation
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Example
EricksonPrinciple of Individualization and utilization of client s s interests, needs, talents and motivations
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Direct vs indirect suggestions

Who wins... Neither
Truisms and contingent suggestions Use of questions, implication covering all possible responses Interspersing suggestions, use of analogies or metaphores Double Binds
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Hypnotic Induction
Four basic induction techniques Eye fixation Arm drop Hands moving together Eye roll Coin technique Progressive relaxation Imagery Conversational
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Hypnotic Susceptibility
Long Term Stability of Hypnotic Response Genetic? Trait involvement (dissociative)? Situational and contextual variables
Burn victims
No one theory accounts for responsiveness
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Responsiveness
Is responsivity modifiable? Do efforts produce only compliance but not increase responsivity? Age and responsiveness Two populations with above average responsiveness
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Personality Factors
No specific positive correlation exists between hypnotic responsiveness and scores on tests such as: MMPI Thurstone Personality Schedule Rorschach Thematic Apperception Test California Psychological Inventory
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Imaginative Ability, Fantasy Proneness & Hypnotizability
Hypnotizable person capable of deep imaginative involvement and almost total immersion in the activity of: Reading Listening to music Experiencing nature Engaging in absorbing adventures of body or mind
See Hilgard Personality and Hypnosis (1970) s,
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As applied to developmental experiences such as: Early deep involvement with a noncompetitive experience that challenges the imagination (reading) Willingness to submit to impartial authority (history of punishment of parent) Strong history of identification with opposite-sexed parent
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Absorption & Hypnotizability

The capacity for absorbed and self-altering attention Highly correlated with attention See Tellegen and Atkinson, 1974
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Expectancy & Hypnotizability

Erickson was a master at combining psych and physiological phenomena into expectancy
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Gender & Hypnotizability

No difference Spiegel and Spiegel 2004
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Age & Hypnotizability

Peaks early and slowing declines Images not relaxation with children
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Mental Status & Hypnotizability

Depends upon researcher/writer Note Yapko
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Enhancing Hypnotizability
If you read Yapko Yes If you read Spiegel and Spiegel set the context to allow for ease of attainment
Spiegel and Spiegel or Yapko
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Hypnotizable Clinical Populations

High (Affective/Mood) Axis I

Dissociative/conversion Dysthymia MDD Brief Psychotic
Axis II
Histrionic dependant
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Medium (Mixed) Axis I

Impulse Control Dysthymia MDD Bipolar
Axis II
Borderline Antisocial
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Low (Cognitive) Axis I

OCD Schizophrenia
Axis II
Paranoid Schizoid Schizotypal OCD Narcissistic Avoidant
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Suggestibility In Hypnosis
Openness to accept new ideas Willingness to accept new information or perspectives A focused capacity to translate ideas into suggested responses
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Therapist Power
Coercive (derived from the ability to punish) Reward (derived from the ability to give rewards psychological) Legitimate (derived from position) Expert (derived from knowledge) Referent (derived from personal characteristics)
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Need for Acceptance

Client feels deficient or incomplete in some way Given this, our clients are concerned about whether we will accept them when they disclose their deficiencies Reward and punishment and become a considerable forces in the process
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Client Expectations
Self-fulfilling prophecy The ideas that a person has about his future experiences will guide his or her current experiences in that direction
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Client Need for Internal Harmony

Expectations and the need for cognitive consistency Client who has been to every therapist in town and has not been helped. Expectation and cognitive consistency have client believing that they are a hopeless case and that they will go to great lengths to prove it
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Effects Upon Suggestibility

Let clients know that you use hypnosis as an adjunct Tell them that hypnosis often forms a part of your practice Have hypnosis brochures in your waiting room Discuss it in the first session
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Examples
How many have had a positive hypnosis experience? How many expected to experience hypnosis here? How many considered their willingness to volunteer? How many are willing to volunteer now?
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Need for Critical Thought

American Society for Clinical Hypnosis
More radical approaches Yapko Some of the following is from Michael Yapko, PhD In the next section, some of the information is offered by Yapko
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Susceptibility - Biology or Learning

Inconclusive no studies indicating that susceptibility is learned or inherited Poor subjects tend to remain poor subjects and good subjects tend to remain good subjects over time Age and Hypnotizability
Children can be and often are highly susceptible Cannot apply traditional definitions of hypnosis They often fidget and appear restless Inactivity (catalepsy) as evidence of hypnosis not likely Of minor value in determining susceptibility Of consideration in choosing induction and utilization (ages and stages)
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Intelligence
No known correlation Intelligence = hypnotizability if this exists it might be due to ability to concentrate
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Mental Status
Psychotics and hypnosis assumed in past to be poor but indirect work can prove results if not rushed Must allow for clientstate and building of rapport s Bipolar in manic phase unlikely Drug induced psychosis difficult to overcome Clients with senility can be worked with
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Self-Esteem SelfHighlander Counselling & Mediation (c) 2007
What you view as possible for your self A major component Seems to be learned The conclusions which you draw from your experiences Enhancing self-esteem is any usual goal of hypnosis
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Fantasy Proneness, Imagination & Hypnosis

Concrete or abstract Concrete requires more detail Factor in responsiveness Factor in approach to use with the client
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ClinicianResponsibility s Clinician
Discover under what circumstances, internal and external, a person is most responsive to new information and suggested perspectives
Building Therapeutic Alliance
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Relationship Factors & Hypnotizability

Understanding and trust Cooperative relationship Collaborative relationship Hypnosis can be viewed as a naturally arising It responds within a special kind of relationship, one of mutual responsibility and accountability
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High Hypnotic Ability

Children (9-12) Bulimics PTSD Dissociative disorders
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Light Trance
Slow deeper breathing Progressive feelings of lethargy Observable relaxation Inhibition of voluntary movements Eyelid catalepsy Limb catalepsy
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Medium Trance
Glove anesthesia Partial posthypnotic anesthesia Partial amnesia Partial age regression Some degree of time distortion Good mental imagery and ability to have dreamlike experience Aware of external noises but they do not seem to matter
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Deep Trance (Somnambulism)

Full age regression (revivification) Positive and negative hallucinations Extensive anesthesia Post-hypnotic anesthesia Spontaneous amnesia Responds to suggestions for amnesia
Ability to open eyes without affecting the trance Decrease in spontaneous mental activity Very responsive to posthypnotic suggestion Perceptual distortions and body dissociation Lip Pallor for about 1 cm beyond the mucocutaneous margin
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Plenary Trance (Stuporous) (Stuporous)

Time ceases to be a meaningful concept No awareness of physical body Loss of awareness of ordinary identity and feeling the potential to be anything or anyone Feeling of oneness with the universe Vary significant decrease in pulse and respiration rate Spontaneous mental activity ceases No awareness of the external world except the very distant voice of the facilitator (Corydon Hammond, 1988)
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Deepening
Title Page
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Deepening
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Points to Remember
What you learned in the client interview may be useful in deepening What is the clientcurrent relaxation practice? s Have they had previous positive experience with hypnosis? What areas are there that are contraindicated because of previous experience?
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Points to Remember
What to avoid if it has been associated with trauma white light and rape waves of relaxation drowning down, down and falling Others
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Many of the deepening techniques can also be used for induction.
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Methods of Deepening
Title Page
Counting
3
Miller, 1979
2 1
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Counting downwards (implying "going down" deeper into hypnosis) while offering suggestions of relaxation and come forward between numbers
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If As If Method
Generally a good method for more difficult clients No direct suggestion to client to respond in a particular way Suggestion to act "as if" he or she were responding in the way suggested Suggesting that the client act "as if" he or she is comfortable, relaxed, thinking about a happy moments, paves the way for the client to really experience the suggestions without any actual personal demands being made Grinder and Bandler, 1981
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The Stairs/Elevator Going Down

The client is told to imagine (that is, see, hear, feel) himself or herself at the top of a flight of "special stairs" or on a "special elevator" As he or she experiences herself going down the stairs at one relaxing step at a time he or she can go down deeper into hypnosis Or, as each floor is passed in the descending elevator, he or she can experience himself or herself going deeper into hypnosis
(Smith and Wester, 1984)
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Compounding/Chaining
Tying of one suggestion to another according to the formula "as you X, you can Y" (that is, "as you read this, you can begin to understand compounding") Verbal compounding serves as a deepening or by continually building new responses on the framework of passed responses thus intensifying the hypnotic experience "Manual compounding" is the tying of verbal suggestions to physical experience As a deepening it can take the form of offering suggestions of going deeper into hypnosis while experiencing physical sensations that reinforce the suggestion (that is, "as your arm drops slowly to your side, you drop more deeply into hypnosis")
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The MindEye Closure s Mind

Useful for turning off the clientinternal dialogue s Involves offering suggestions about the presence of the "mind s eye" as that part of the mind of that remains active in thinking and imaging as the induction progresses. With suggestions for the mindeye lids s similar to the fixation eye suggestions of the lids eye getting heavy the client can slowly closeout stray thoughts and images and experience a deeper state of hypnosis
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Silence
you can now have some quiet time to enjoy the experience of hypnosis."
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Posthypnotic Suggestions & Re-Induction ReHighlander Counselling & Mediation (c) 2007
Involves giving the client already in hypnosis a posthypnotic suggestion that the next time that hypnosis is re-induced, he or she can go into hypnosis both more deeply and more quickly Clinician then guides the person in and out of hypnosis several times within the same session (Gilligan, 1987; Warner, 1984) good for those with short attention span (attention deficit disorder, physical pain, depression, or other condition that impairs clientability to focus) s
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ClientExperiences & Office Situation s Client

you may find yourself listening to the sounds outside the office and with each sound you hear you find yourself being drawn further into your trance
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Fan
as the breeze from the fan touches you, you will go deeper and deeper into relaxation...
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Ring of A Phone
with each ring of the phone, you will find yourself drawn into your own special trance
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Rocking Chair
with each rock of the chair you will go deeper and deeper into your own hypnotic trance
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Other Deepenings
Clientbreathing s Each time you exhale you will feel yourself drawn into a more and more relaxed state.
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Revolving Wheels Fantasy

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Patient Motivation & Needs

Motorcycle Example
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Visual Imagery
may choose to picture a pendulum swinging. Now you may you notice that with each stroke of the pendulum you are going further and further into your own hypnotic trance.
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Metronome
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Self Hypnosis
Benefits of Self Hypnosis

Between session change Continuation of therapeutic focus Long term maintenance Situation or Crisis management
Yapko and Depression

Give a sleep tape in the first session
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Applications
Pain Asthma Gastrointestinal problems Wound healing Anxiety disorders Sleep disorders Sexual dysfunction Stress Bereavement
Bruxism Dental procedures Childbirth Flying and other phobias Learning Habit control Smoking others
Teaching Self-hypnosis SelfHighlander Counselling & Mediation (c) 2007
In your office:
Post Hypnotic Suggestion for trigger
Two fingers Eyes closing Others
Practice
The client6 steps to self-hypnosis s client selfHighlander Counselling & Mediation (c) 2007
Plan the suggestion before going into hypnosis Use your entry cue Count backward from 100-95 slowly, don t think of suggestion 100,99,98,97,96 Give the suggestion as you wrote it at 95 Count 94, 93, 92, 91, 90 don t think about or criticize the suggestion When count reaches 90 give the exit or alert cue
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Treatment Planning
Applications
Pain Asthma Gastrointestinal Problems Wound Healing Anxiety Disorders Sleep Disorders Sexual Dysfunction Stress
Bruxism Dental Procedures Childbirth Flying and Other Phobias Learning Habit Control Smoking Others
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Eyes Open Application

Work Environment
Before meetings Stressful situations Performance related situations
Other
Performance related (relationships, sports)
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Habit Control
Nail Biting Smoking Weight Others
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Phobias
Flying Elevators Others
17 0
Dermatological Conditions
Anxiety, depression, shame, embarrassment Reduce rubbing and scratching Alleviation of warts Pruritis Acne, psoriasis
17 1
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Media Clip
Asthma
Desensitization against anticipatory triggers, anxiety, panic Suggestion of relaxation, ego-strengthening Provoking and alleviating an attack (control training)
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Gastrointestinal Disorders
Oesophageal spasm, swallowing problems Desensitization against triggers Gastric secretion reduced by imagery Habitual reflex vomiting IBS (Whorwell, IBS Treatment Unit)
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Gut-Directed Hypnotherapy GutHighlander Counselling & Mediation (c) 2007
Extremely effective 12 one hour sessions weekly for a three month period Substantial improvement in symptoms and quality of life (81% maintained improvement over 5 years), Gonsalkorale et al. (2003).GUT, 52(11), 1623-1629.
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Erections & Irritable Bowel Syndrome

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Burns
Stop inflammation and swelling Reduce pain and distress Debridement of tissues and changing dressings
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Media Clip
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Cancer
Pain, anxiety, depression, feelings of hopelessness, sideeffects NIH study of 10-year follow-up of 86 patients with metastatic breast carcinoma Patients with self-hypnosis and group therapy had 50% less pain and survived 18 months longer, Kogan et al. (1997). Cancer, 80, 225-230
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Chronic Pain
Nobody wants to hurt, and pain interferes with healing, so it is no wonder that one of the most rewarding uses of hypnosis is its ability to influence the perception of pain.
Barabasz & Watkins, 2005, p.231
18 0
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Headaches & Migraines

Shown to be efficacious with headache and migraine Relatively brief and cost effective Virtually free of the side effects, risks of adverse reactions, and ongoing expense
Hypnosis should be recognized by the scientific, health care, and medical insurance communities as being an efficient evidence based practice.
Hammond (2007)
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Surgery
Esdaile (1957) reported 345 major operations performed in India with hypnosis Hilgard and Hilgard (1975) reported 14 different types of surgeries, hypnosis used as sole anesthetic Multiple case studies (1955-1992: 24 cases reported) Surgery Dental hypnosis (hypnodontia)
18 2
Media Clip
18 3
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Phobia
Dentistry Spaces Birds Injections
Media Clip
Hypnotherapy With Pain

Meta-analytic review of 18 articles and 27 effect sizes indicated that hypnotic suggestions relieve pain for 75% of 933 subjects across different types of pain (Montgomery, DuHamel & Redd, 2000). Lynn et al (2000) concluded that hypnosis can be considered a well-established treatment for pain.
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Review by Brannon & Feist (2004) indicated effectiveness with headache, cancer pain, burn pain, childbirth discomfort, dental pain, surgery pain, low back pain, experimental pain, and pain from sickle cell disease.
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Elkins et al. (2007) reviewed 13 studies, excluding studies of headaches, that compared outcomes from hypnosis for the treatment of chronic pain to either baseline data or a control condition. Hypnosis interventions consistently produced significant decreases in pain associated with a variety of chronic pain problems such as:
Cancer Low back pain Arthritis pain Sickle cell disease Temporomandibular pain Disability-related pain
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Hypnosis is now the pain-control method of choice for interventional radiological procedures at Harvard Medical SchoolBeth Israel Deaconess Medical Centre in Boston. s Recoveries are faster, patients are more satisfied, and the hospital saves considerable sums of money while reducing risk exposure.
Lang et al., 2000, Lancet, 355, 1486-1490

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Yapko & Depression

Give a sleep tape in the first session
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Indications for Hypnosis

Has requisite hypnotizability Co-operative with procedure Problem shown to be effective with hypnosis Condition diagnosed/adjunct No florid psychotic symptoms Absence of mania Not under the influence of illicit drugs or alcohol Not actively suicidal Not with certain personality disorders
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Contraindications
Low score on hypnotizability Uncooperative with procedure Problem shown not to be effective with hypnosis Condition not diagnosed Presence of florid psychosis During mania During intoxication with illicit drugs or alcohol Actively suicidal Borderline, narcissistic, and antisocial personalities
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Self Hypnosis
Define self hypnosis Teaching self hypnosis to clients Therapeutic applications of self hypnosis in practice
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Establishing self hypnosis induction cues Post hypnotic suggestion In session practice Recordings The value of individualized audio tapes Medical (pain, asthma, GI, wound, dermatological) Psychiatric (Sleep, ego-strengthening, sexual dysfunction)
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Treatment Planning
Suggestive and insight oriented hypnotic approaches Hypnosis indicated or contraindicated Types of strategies or therapeutic goals
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Consider symptom complexity and intensity Level of hypnotic talent and responsivity Client expectations or preferences Degree of psychological-mindedness and impulse control Personality, dominant defence coping style Diagnosis Stage in change process
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Rapport Degree of resistance Locus of control
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Managing Resistance
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Strategies
Enhancement of insight Abreaction or emotional facilitation Perceptual change Reduction or alteration of affect Facilitation of behavioral change Facilitation of physiological change
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Source of Resistance
Sources of Resistance Patient Therapist Environmental
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Resistance to Hypnosis
Education about myths and misconceptions Separating hypnosis from the presenting problem Creating healthy therapeutic alliance Aligning patient/therapist goals Accepting and using patient responses Shifting to indirect permissive techniques Exploring the resistance consciously and with insight oriented hypnotic techniques
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Obtain the clients feedback, critique and discussion of what interfered with responsiveness Recall of previous successful induction Modeling a successful subject
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Advantages
Advantages Objective method of evaluating responsivity to hypnosis and who is likely to benefit Gain info about hypnotic talents and boost therapist confidence Modelling for clinicians in how to elicit phenomena
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Disadvantages
Disadvantages Tend to be directive and may result in objections Provide only one sample of responsiveness (not always predictive)
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Hypnotic Susceptibility Scales
Hypnotic Susceptibility Tests

Barber Suggestibility Scale (Barber, 1976) Carlton University Responsiveness to Suggestions Scale (Spanos, Radtke, Hodgkins, Stram and Bertrand, 1983) Creative Imagination Scale (Wilson and Barber, 1977) Davis-Husband Scale (Davis and Husband, 1931) Field inventory (Self-report) (Field, 1965)
Handouts
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"The debate continues over just how useful clinical scales are in treatment. Their value in research is beyond question. However, it is unclear how relevant and responsive to standardized, therefore not individualized, a test item is to eventual clinical results obtained."
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Susceptibility Assessment Tools

Susceptibility Assessment Tools

Barber Stanford Hypnosis Susceptibility Scale Hypnotic Induction Profile HIP Modified
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Hypnosis Induction Profile

A measurement tool and an induction
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Ethics
Ethics
Ethical and Legal Issues and standards of professional conduct Certification requirements in Clinical Hypnosis The unfolding of CFCH
Handouts
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Informed consent Adherence to guidelines and cautions Memory work Only using it to treat what one is qualified to treat with non hypnotic methods Professional registration requirements Power imbalance in the counselling room CFCH, ASCH, ASCEH
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Integrating Hypnosis Into Practice
Examples
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Small Group Practice

Each person will have three opportunities to be a subject and a therapist using hypnosis Small group leaders will not demonstrate techniques or answer questions during this time Small group leaders will provide feedback and brief modelling of alternate verbalizations
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Certificates Presented
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Clinical (C) 2007 Hypnosis Leonard McEwen & Lynn Lambert

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Clinical (C) 2007 Hypnosis Leonard McEwen & Lynn Lambert

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Highlander Counselling & Mediation (c) 2007

8:30-9:10 9:10-9:40 9:40-10:00 10:00-10:20 10:20-11:20

Highlander Counselling & Mediation (c) 2007

11:20-12:00 12:00-1:00 1:00-3:00 3:00-3:15 3:15-4:15 4:15-5:15

8:30-9:30 9:30-9:45 9:45-10:30 10:30-11:30 11:30-12:15

Highlander Counselling & Mediation (c) 2007

1:15-1:45 1:45-2:15 2:15-3:00 3:00-3:15 3:30-5:00

9:00-11:30 11:30-12:30 12:30-2:30 2:30-2:45 2:45-5:00

Leonard McEwen & Lynn Lambert

Please remember to sign in for each session

Highlander Counselling & Mediation (c) 2007

Definitions, History & Theories

Slide 7 V2 Handout our practice brochures

Highlander Counselling & Mediation (c) 2007

Paracelsus (1493-1541) (1493Highlander Counselling & Mediation (c) 2007

Swiss 1st to use magnetic healing

Valentine Greatrakes (1628-1666) (1628Highlander Counselling & Mediation (c) 2007

Gassner (1727-1779) (1727Highlander Counselling & Mediation (c) 2007

Maximilian Hell (1720-1792) (1720Highlander Counselling & Mediation (c) 2007

Highlander Counselling & Mediation (c) 2007

Abb Faria Abb

Marquis de Puysgur Puys

Student of Mesmer First described and coined the term somnambulism

James Braid (1705-1860) (1705Highlander Counselling & Mediation (c) 2007

Jean-Martin Charcot (1825-1893) Jean(1825Highlander Counselling & Mediation (c) 2007

July 28, 1847

Pope Pius XII (1956)

American Civil War

French pharmacist Laws of Suggestion

Multidimensional & Multicausal Hereditary Physiology

Dissocative Processes Absorption in imagery (imagining ifreduction in reality as ) orientation

Highlander Counselling & Mediation (c) 2007

Highlander Counselling & Mediation (c) 2007

Myths & Misconceptions

Major Myths & Misconceptions

Loss of control Surrender of will Loss of consciousness

Highlander Counselling & Mediation (c) 2007

Highlander Counselling & Mediation (c) 2007

Highlander Counselling & Mediation (c) 2007

Highlander Counselling & Mediation (c) 2007

People have to be very hypnotizable or suggestible or gullible hypnosis to work. for

Highlander Counselling & Mediation (c) 2007

During hypnosis, people are unconscious.

Highlander Counselling & Mediation (c) 2007

Hypnosis vs. Relaxation

Highlander Counselling & Mediation (c) 2007

Hypnosis Relaxation is not necessary for hypnotic induction.

Relaxation Relaxation is being in a relaxed state.

Highlander Counselling & Mediation (c) 2007

Hypnosis Hypnosis can produce analgesia and anaesthesia.

Relaxation Relaxation does not produce analgesia and anaesthesia.

Highlander Counselling & Mediation (c) 2007

Hypnosis Hypnosis can significantly reduce or abort acute pain.

Relaxation Relaxation has no significant effect on acute pain.

Highlander Counselling & Mediation (c) 2007

Hypnosis Major surgery tolerated under hypnosis.

Relaxation Major surgery cannot be tolerated under relaxation.

Highlander Counselling & Mediation (c) 2007

Hypnosis Hypnosis prevents inflammation and swelling in acute burn cases.

Highlander Counselling & Mediation (c) 2007

Hypnosis Hypnosis produces dissociation, hallucinations and delusions.

Relaxation Dissociation, hallucinations and delusions occur as epiphenomenon.