Hypnotic Techniques for Standard Psychotherapy and Formal Hypnosis

Hypnotic Techniques for Standard Psychotherapy and Formal Hypnosis

Phillips, Maggie

Hypnotic Techniques for Standard Psychotherapy and Formal Hypnosis. George Gafner & Sonja Benson. New York: W.W. Norton (2003). 224 pages, $40. Reviewed by Chuck Mutter, M.D., Aventura, FL.

The authors have designed a text that is compelling for clinicians who use indirect and metaphoric techniques in psychotherapy. This reviewer experienced flashbacks of his experiences with Milton Erickson and his disciples.

The book is divided into various chapters including examples of metaphors, story telling, and specific techniques used for different pathological conditions. Chapters include sections on therapeutic communication, ways of accessing unconscious resources, facilitating unconscious process, age regression and progression, problem solving techniques, and the treatment of pain, anxiety disorders, depression, and Posttraumatic Stress Disorder. A number of case histories are presented.

This text is a natural resource for the therapist who uses metaphors and indirect techniques for theraputic purposes. Many examples are cited and the psychodynamics are discussed. The reviewer takes exception to one example (p. 261) where the authors describe a man with post-traumatic disorder whose fiance died just before their wedding. This event in itself does not constitute criteria for this type of diagnosis, and the authors were remiss in not including more clinical information to support their assessment.

Nevertheless, the text is also an excellent reference for clinicians who do not use metaphors in therapy. It would be useful as well for the neophyte who is learning to enhance skills in the theraputic process. Gafner and Benson separate chapters for specific pathology and cite metaphors used in treating that pathological condition that also reflect how age regression and progression were used. They include a rich resource of bibliographical references along with a glossary of terms. This reviewer would recommend this book as a useful reference for those clinicians using this form of therapy.

Handbook of Hypnosis for Professionals, Second Edition. Roy Udolf, J.D., Ph.D., Northvale, NJ: Jason Aronson (1995). 531 pages, $70. Reviewed by David S. Alter, Ph.D., Minneapolis, MN.

Not a week goes by in which patients coming to my office don’t raise predictable reservations whenever the subject of hypnosis and its role in addressing their presenting concerns is introduced. Those reservations arise regardless of whether I or the patient first suggest that hypnosis may be woven into a treatment plan. These reservations are “teachable moments”, providing wonderful opportunities for further understanding each person’s presenting concerns, character, and motivation for change. In addition, they offer opportunities for education and the building or deepening of therapeutic rapport.

There are numerous books that have been written with an eye toward the practicing clinician interested in learning how to apply hypnosis to a variety of presenting concerns. A number of them provide a cursory review of the nature of hypnosis and quickly progress into provision of scripts for induction techniques or hypnotic suggestions directed toward specific presenting problems. It is too often the case that clinicians are more interested in “how to” than they are in learning “when to”, or even the more basic question of “why” one approach as opposed to another might make sense when working with a particular patient.

Dr. Roy Udolf’s book, Handbook of Hypnosis for Professionals, Second Edition, distinguishes itself from others in the hypnosis field because of the depth and breadth of its explication of the nature of hypnosis, hypnotic phenomena and the wide range of contexts in which hypnosis has a demonstrated practical application. As the author says in his preface to the book, “The goal of this book is to acquaint readers with the factual basis and techniques of hypnotism and to suggest some of the practical applications of this phenomenon in a variety of fields, clinical and otherwise” (p. xiv). Udolf goes on to say that his intention in writing the book is to describe the field of hypnosis and hypnotic phenomena, but not to write a book on “hypnotherapy” per se.

It is one of the strengths of the book that the author assiduously sticks to his stated intentions, but it is also, perhaps unavoidably, one of its drawbacks. For example, it is not until Chapter Five (page 181 of this 500 plus page textbook) that Dr. Udolf begins to describe the practical applications of hypnosis. Chapter One of the book provides a concise and informative history of hypnosis, with appropriate albeit brief attention to the major figures that influenced the development of the field of hypnosis. He goes on to describe common misconceptions about hypnosis (which echo the concerns raised by my patients) in a manner similar to other authors who address this issue, such as Michael Yapko, Ph.D., in Trancework (1990, 2003 revised).

Chapter Two discusses Hypnotic Susceptibility with a well researched description of many hypnotic scales. Even more helpful is his thorough description of some of the challenges to the validity of these various scales due to lack of consensus in the field regarding the differences between susceptibility, hypnotizability, hypnotic capacity and the various factors that impact upon hypnotizability in research, clinical and other settings.

Chapters Three (Induction and Deepening Procedures) and Four (Hypnotic Phenomena) are covered in a manner that enable the reader to come away with an understanding of the nature of these aspects of hypnosis although the writing style is more encyclopedic than narrative. As with the rest of the text, the author succeeds at describing a variety of hypnotic methods or phenomena, but the clinician/reader is left responsible for decision-making as to what might be most appropriate for a given patient. The author’s strength is describing the issues with which one needs to be familiar to have a broad understanding of hypnosis, not on how to use it clinically with a given patient.

By the time the reader arrives at the fifth chapter, a solid foundation for the history and nature of hypnosis has been carefully constructed. In Chapter Five (Practical Applications of Hypnosis) the author provides an alphabetical listing of the types of conditions for which there is research support for the clinical application of hypnosis for concerns ranging from acting out to vaginismus. The chapter digresses from a focus on hypnosis to a cursory review of major therapeutic approaches (e.g. psychoanalysis, client-centered therapy, gestalt therapy, social learning theory, etc.) and then returns to a description of how hypnosis may be used to achieve selected therapeutic goals within each of these various therapeutic conditions. This chapter goes on to include a discussion of the medical and dental applications of hypnosis, as well as applications of hypnosis in non-therapeutic settings (e.g., forensic applications, military applications, hypnosis in advertising and its relevance to sports performance enhancement). Given the range of issues the chapter addresses-whole books are easily devoted to each of these different topics-it isn’t surprising that the depth characteristic of its earlier chapters is missing.

Chapters Six (Self-Hypnosis) and Seven (Psychological, Legal, and Legislative Problems and Alleged Dangers of Hypnosis) follow a similar format to the earlier chapters in that they acquaint the reader with the issues to be aware of with respect to how a subject may respond to hypnosis or how hypnosis is be viewed in other contexts. Learning to appreciate the distinction between hetero-hypnosis as a special case of auto-hypnosis versus formally training a patient in self-hypnosis can sensitize the clinician to ways of enhancing the patient’s ability to extend treatment benefits beyond the treatment setting. Similarly, being aware of how hypnosis is viewed in other contexts, such as the legal context, is a necessary reminder for any clinician working with patients whose presenting concerns have an increased likelihood of intersecting with the legal arena.

Dr. Udolf closes his book with a brief chapter on Hypnosis in Perspective (Chapter Eight). This portion deviates from the rest of the text by focusing on the role of theory in hypnosis and the place/future of hypnosis in the field of psychology as a whole. For the clinician, what matters most is often how well a particular approach is able to help a specific patient resolve a particular set of concerns. While different theoretical approaches may guide the clinician’s choices as to how hypnosis will be used, the “proof of the pudding is still in the eating”: the patient either benefits or doesn’t. Dr. Udolf stresses the importance of continuing to develop theories regarding hypnosis in the belief that this will continue to refine the ability of hypnosis to be helpful to the widest number of people with the broadest possible applications. Having recently attended the ASCH national conference on hypnosis, and repeatedly heard that the time for hypnosis to be more widely utilized has arrived, Dr. Udolf’s book provides a solid base upon which learning to use hypnosis can be built. The experienced clinician will find much in the way of useful reminders about hypnosis from a transtheoretical perspective but will have to look elsewhere for information on the utilization of hypnosis with specific populations or conditions. As an introductory text for the graduate student or the professional interested in understanding the field of hypnosis, the book covers core areas comprehensively, thoughtfully, and scientifically, all in a highly readable manner.

Copyright American Society of Clinical Hypnosis Jul 2003

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