1979
Senk, M. (1979). Neuropsychology, bioethics and hypnosis. In Burrows, G. D.; Collison, D. R.; Dennerstein, L. (Ed.), Hypnosis 1979 (pp. 239-246). Amsterdam: Elsevier/North-Holland Biomedical Press.
NOTES 1:
Most of the chapter deals with brain neurology and the developmental psychology of morality (e.g. L. Kohlberg). The last part treats of hypnotherapy:
“Hypnopsychotherapy … is a suggestion treatment and suggestion is a process of adopting a proposition in the absence of critical thought which would normally occur. This is achieved in hypnosis by gradual reduction of the tone of the central nervous system. This triggers off a chain reaction composed of four basic steps:
1. Inhibition of muscle tone leading to akinesia;
2. Reduction of autonomic activity seen in slowing down of pulse, lowering of blood pressure and so on;
3. Inhibition of cortical activity with diminished degree of alertness and therefore, volition;
4. Reduction of affective response characterized by detachment from emotional involvement;
The brain as a whole is involved in the induction of hypnotic trance and as a whole it must be involved in the therapeutic endeavour. Simple symptom removal without wholistic approach will have doubtful results” (0. 243).
1961
Farber, S. M.; Wilson, R. H. L. (1961). Control of the mind. New York: McGraw-Hill. (Reviewed in American Journal of Clinical Hypnosis, 1964, 7, 2)
NOTES: Contains papers presented by multidisciplinary group at a symposium. Covers broad areas of: 1. The mind and its integration. 2. The influence of drugs on the individual. 3. The mind and society 4. The effect of technology on the mind 5. Restrictions and freedom of the mind.
1948
MacCorquodale, Kenneth; Meehl, Paul E. (1948). On a distinction between hypothetical constructs and intervening variables. Psychological Review, 55, 95-107.
NOTES
Among other things, the authors distinguish between intervening variables and hypothetical constructs. _Intervening variable_ is used for abstractions from a set of data that are not assumed to have existential status, whereas _hypothetical construct_ pertains to entities that are assumed to have existential status. The description of hypothetical constructs consists of both data statements and “surplus meaning” which incorporates information about the way the hypothetical construct exists. Generally, hypothetical constructs are portrayed as existing only in the sense of physiological entities.
Phobia
2002
Ginandes, Carol (2002). Extended, strategic therapy for recalcitrant mind/body healing: An integrative model.. American Journal of Clinical Hypnosis, 45 (2), 91-102.
The development of the power therapies, behavioral medicine, and short term interventions have reported such success even with trauma cases that it is relevant to question the justification for lengthy psychotherapy. Yet some patients with complex mind/body conditions impervious to medical treatment/hypnosis may require extended, multi-modal, integrative therapy. This paper details a single complex case of paruresis as a prototype for illustrating a holographic treatment model for recalcitrant conditions: Component features of the proposed model presented include: 1) the sequential utilization of hypnobehavioral and analytic approaches; 2) uncovering work providing access to the somatic ego state associated with the illness condition; 3) the extended treatment time frame required for deep psycho-physiological change; and 4) the stages of counter-transference expectably evoked by such patients (e.g. urgency, exuberant optimism, frustration, discouragement), and the transformation of such reactions to achieve maximum therapeutic efficacy.
NOTES 1:
Paruresis is a social phobia involving urinary retention and “thought to affect some 17 million or 7% of the American population” (p. 92). Also known as “bashful bladder.”
1997
Van Dyck, R.; Spinhoven, P. (1997). Depersonalization and derealization during panic and hypnosis in low and highly hypnotizable agoraphobics. International Journal of Clinical and Experimental Hypnosis, 45 (1), 41-54.
The primary aim of the present study was to investigate the association between spontaneous experiences of depersonalization or derealization (D-D) during panic states and hypnosis in low and highly hypnotizable phobic individuals. Secondarily, the association among level of hypnotizability, capacity for imaginative involvement, and severity of phobic complaints was also assessed. Sixty-four patients with panic disorder with agoraphobia according to the DSM-III-R (American Psychiatric Association, 1987) criteria participated in the study. Proneness to experience D-D during hypnosis was positively related to hypnotizability, but only for agoraphobic patients who had already experienced these perceptual distortions during panic episodes. Correlations of level of hypnotizability and capacity for imaginative involvement with severity of agoraphobic complaints were not significant. These findings suggest that hypnotizability may be a mediating variable between two different, although phenotypically similar, perceptual distortions experienced during panic states and hypnosis. Implications for both theory and clinical practice are discussed. — Journal Abstract
1995
Holroyd, Jean (1995). Handbook of clinical hypnosis, by Judith W. Rhue, Steven Jay Lynn, & Irving Kirsch (Eds.) [Review]. International Journal of Clinical and Experimental Hypnosis, 43 (4), 401-403.
& Irving Kirsch (Eds.) [Review]. International Journal of Clinical and Experimental Hypnosis, 43 (4), 401-403
NOTES 1:
“This is a book for the thinking clinician” (p. 401). “The editors are to be congratulated for making this volume much more coherent than most edited books” (p. 402). “My impression is that the book is best suited for an intermediate or advanced course on hypnotherapy, or for people who are already using hypnosis in treatment. Although there is some material on the basics of hypnotic inductions and a few introductory sample scripts for inductions, a beginners” course should probably use a different book, or this book could be accompanied by an inductions manual. … I recommend it very highly” (p. 403).
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.
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.
Culbert, Timothy P.; Reany, Judson B.; Kohen, Daniel P. (1994). Cyberphysiologic strategies for children: The clinical hypnosis/biofeedback interface. International Journal of Clinical and Experimental Hypnosis, 42 (2), 97-117
This article presents an in-depth discussion of the integrated use of self-hypnosis and biofeedback in the treatment of pediatric biobehavioral disorders. The rationale for integrating these techniques and their similarities and differences are discussed. The concepts of children’s imaginative abilities, mastery, and self-regulation are examined as they pertain to these therapeutic strategies. Three case studies are presented that illustrate the integrated use of self-hypnosis and biofeedback in the treatment of children with psychophysiologic disorders. The authors speculate on the specific aspects of these self-regulation or “cyberphysiologic” techniques that appear particularly relevant to positive therapeutic outcomes.
Stanton, Harry E. (1994). Self-hypnosis: One path to reduced test anxiety. Contemporary Hypnosis, 11, 14-18.
Describes a self-hypnosis technique and its efficacy in reducing test anxiety. Forty high school students were matched on sex and anxiety scores and randomly allocated to an experimental group (receiving two 50-minute sessions, a week apart, to learn the self-hypnosis technique), and a control group (receiving two 50-minute sessions focused on ways of reducing test anxiety). Students were retested after the two sessions, and 6 months later. Results showed a significant reduction in anxiety scores only for the hypnosis group, which was maintained at 6-month follow-up.
Wormnes, Bjorn (1994, October). Hypnosis in integrated treatment of dental fear. [Paper] Presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, San Francisco.
Research reports from different countries estimate the proportion of adult dental phobic patients to be between 5% to 10%. It represents a large health problem. Helping patients to continue regular treatment by their local dentist and experience it as tolerable is the main treatment goal in our program. The main treatment method is a flexible and integrated exposure training. The psychotherapist works in cotherapy with the dentist. Using hypnosis in the dental chair is of great help, and patients are normally found to be very susceptible and easily hypnotized. Hypnosis helps the patient to experience increased tolerance of treatment and also to perform better than expected in the treatment situation.
1993
LaGrone, Randy G. (1993). Hypnobehavioral therapy to reduce gag and emesis with a 10-year-old pill swallower. American Journal of Clinical Hypnosis, 36, 132-136.
A 10-year-old child experienced severe nausea and psychogenic vomiting that resulted in refusal to take oral medication in pill form. The youngster was treated with hypnobehavioral therapy consisting of mental imagery, relaxation, direct suggestion, adaptive self-talk, self-monitoring, and self-reinforcement. The child’s parents were instructed to reinforce approximations of successful pill swallowing while withdrawing attention for avoidance, whining, gagging, and vomiting. A one-year follow-up revealed successful pill swallowing without significant distress.
Distress.
1992
Somerville, Wayne R.; Jupp, James J. (1992). Experimental evaluation of a brief ‘ideodynamic’ hypnotherapy applied to phobias. Contemporary Hypnosis, 9, 85-96.
This study used a test-retest design to investigate the effectiveness of a brief ‘ideodynamic’ hypnotherapy which notionally located and reformulated memories in the treatment of simple phobia disorder. Subjects were 19 phobics randomly assigned to treatment (n = 10) and waiting control groups (n = 9). Rapid, significant, and sustained relief from phobic fear and avoidance was reported by 50% of treatment subjects. A number of symptoms and therapy process variables were correlated with treatment outcome. These included a negative association with hypnotizability and a positive association with hypnotic depth estimates. The ramifications of these and other associations are discussed and it is concluded that the ‘ideodynamic approach’ investigated may have contributed a therapeutic effect beyond the operation of treatment non-specific factors.
NOTES
Treatment consisted of: 1. Hypnotic induction. 2. Establishment of ideomotor signals described to clients as a means of communicating with the ‘inner unconscious mind’. 3. Beyond the first therapy session, a review of work done in previous sessions. 4. Gaining signaled permission from clients to work on their problem and for the ‘inner mind’ to review relevant memories. 5. Location of the ‘earliest critical event’ by the ‘inner mind’. 6. Review of the located memory by the ‘inner mind’. 7. Establishing age at the occurrence of the ‘critical’ event. 8. Ideomotor signaling indicating suitability of a visual imagoic processing of the event.
If visual processing was chosen, the dissociated viewing procedure (step 9A) was used next, otherwise the ego-state procedure (step 9B) was employed.
The authors describe each treatment step in detail. Each subject received at least two sessions of therapy, or a maximum of three sessions if signaling indicated the presence of further unresolved memories after two sessions.
They present a case illustrating that the approach is possible with minimally hypnotizable subjects, in the apparent absence of imagoic experience, ‘desensitization’, catharsis, unpleasant affect, talking through or ‘insight’.
“There was a positive correlation between changes in phobic fear and capacity for mental imagery which suggests that this may be one relevant variable in predicting response to memory reformulating therapy.
“There was a negative correlation between changes in fear and hypnotic responsiveness. So, successful therapeutic outcome was obviously not limited to highly hypnotizable subjects. Hypnotizability was assessed in a careful and standardized manner but testing was conducted 10 weeks following therapy. This meant that subjects had a substantial experience in hypnotherapy at assessment. Furthermore, at the time of assessment subjects were aware of the outcome of therapy and of the kinds of memories located during therapy. it has been suggested that an association between level of hypnotizedness achieved during treatment and outcome rather than an association between degree of hypnotizability possible during therapy and outcome, taps an hypnotic effect (Spiegel & Spiegel, 1978).
“All therapy sessions were of equal duration and, as the inductions were standardized, all subjects had an approximately equal opportunity to engage in memory reformulation. However, there were individual differences in the number of memories located and a strong significant association was found between reduced fear and the number of these critical memories that were dealt with. This result suggests that the therapeutic effect may have derived either from factors specific to the therapy cycle or from differing levels of motivation among subjects to undertake the necessary ‘work’.
“Maximum discomfort experienced during session two of treatment was negatively correlated with relief from phobic fears. This relationship may again reflect the influence of unresolved problematic memories on subjects who had not achieved relief by that time. It is clearly consistent with relief not being associated with painful abreaction.
“The therapy permitted a pervading privacy through the options of non- imaginative processing of recalled material (which was used by a substantial minority of subjects) and conscious withholding of the content of memories from the therapist (which was employed to a large extent by all subjects). Their reports indicated that this ‘privacy’ was seen as attractive by both successfully and unsuccessfully treated subjects. Taken with other results mentioned above these process findings suggest that the treatment studied stood up quite well against other brief but highly stressful exposure treatments for phobia currently in use (e.g. Ost, 1989).
“Further research needs to address the complex question as to what are the necessary and sufficient features of this procedure in producing therapeutic change. Unsolicited comments by subjects about their experience during treatment suggested that some of them were surprised by the ‘involuntary’ nature of their ideomotor signaling while others said that signaling was under their voluntary control. Some expressed surprise at the nature of the memories that came to them ‘suddenly’ during therapy. Some memories were of traumatic childhood experiences that were unexpected and considered to have ‘nothing to do with my phobia'” (pp 93-94).
Stanton, Harry E. (1992). Brief therapy and the diagnostic trance: Three case studies. Contemporary Hypnosis, 9, 130-135.
NOTES
He reviews very brief hypnotherapy, then writes, “A systematic way of encouraging people in the use of their inner resources to solve problems, the ‘diagnostic trance’, has been outlined by Havens and Walters (1989). People sit quietly, eyes closed, physically relaxed, concentrating upon the unpleasant sensations or feelings associated with their problem. By turning inward in order to focus upon these internal events, they tend to drift into a trance state.
“While mentally observing these unpleasant sensations, they describe, in a somewhat detached manner, the thoughts and images which are present in their minds. They make no effort to control these in any way, simply allowing associated memories to surface quite spontaneously. Usually they reveal a pattern of thinking, a series of images, or even a specific memory which is creating the problem. Sometimes these are in the form of visual images of previously forgotten incidents, usually of a traumatic nature. On other occasions thy may take the form of a voice repeating a particular negative statement.
“Once people have been able to identify the source or sources of their unpleasant feelings, they attempt to find a thought or image which is sufficiently powerful to remove or displace the negative material. On many occasions, people find that they have the inner resources needed to solve their problem but, until given the opportunity provided by the diagnostic trance, they were unaware that they possessed these resources. However, the diagnostic trance procedure appears to encourage the spontaneous emergence of creative solutions” (p. 131).
unaware that they possessed these resources. However, the diagnostic trance procedure appears to encourage the spontaneous emergence of creative solutions” (p. 131).
Of the 103 patients with whom he used the procedure, “approximately 70% reported that it had helped them resolve the specific problem for which they had sought therapeutic assistance. … In addition to being effective, the diagnostic trance is enjoyable, even when used to process past experience of an unpleasant nature. In its simplicity lies its strength. Patients find it easy to learn and, once they have gained confidence in its value as a problem-solving tool, often teach it to family members and friends” (p. 134).
1991
Bodden, Jack L. (1991). Accessing state-bound memories in the treatment of phobias: Two case studies. American Journal of Clinical Hypnosis, 34, 24-28.
Two cases of simple phobia demonstrate the inadequacies of both behavioral and psychodynamic theories. These cases and their treatment outcomes provide support for the state-dependent memory and learning theory. Hypnosis and ideomotor signaling proved to be not only effective treatments but also useful means of illuminating the role and nature of symptom function. Issues of symptom removal and substitution are also discussed in relation to these cases
NOTES
The authors state that Rossi and Cheek (1988) summarize a number of experimental studies on animal memory that demonstrate that different information substances are involved in different learning situations. For example, ACTH and cortisol are involved in avoidance learning while angiotensin is involved in operant conditioning. In hypnosis, state dependent memory seems to be implicated. “Hilgard (1977) interpreted the state-dependent memory studies by Overton and others as entirely consistent with and supportive of his theory of hypnosis. Milton Erickson (1948) has also strongly suggested that it is the altered levels of arousal and affect that are responsible for the encoding and recall of stress-related problems with hypnosis” (p. 26).
“Affective experiences are apparently stored independently from their intellectual counterparts, or the emotional unit form one set may attach itself to a constellation of cues that make up a totally different cognitive set. Hypnosis may facilitate recall by providing relevant cues during an altered state of consciousness” (p. 27).
“In commenting upon [one of Erickson’s cases], Rossi (1986) states that Erickson was effective because he helped the patient access state-bound memories by reviewing the context and sensory-perceptual cues that surrounded their original acquisition” (p. 27).
“When traditional behavior therapy fails it may be because the original fear stimulus is state bound or unconscious. What is conscious to the patient are those stimuli that are similar in some important respect to the original phobic stimulus and are acquired by stimulus generalization. Desensitization may reduce the patient’s reactivity to the associated or acquired stimuli but cannot desensitize the original stimulus until it can be accessed consciously” (p. 27).
“The two main psychological explanations of phobic behavior are psychodynamic and behavioral. The psychodynamic approach is built upon the early writings of Freud (1956) on the traumatic basis of neurosis. Freud speculated that the intense anxiety (psychic pain) associated with the emotional trauma lead to dissociation, repression, and amnesia. Symptoms represented a dissociated or symbolic vestige of the repressed (‘forgotten’) trauma.
“Behavioral explanations (e.g., Rimm & Masters, 1974) are built upon classical and operant conditioning models of learning. Classical conditioning explains how a neutral stimulus (e.g., a bridge) can acquire reactivity and elicit a fear response. Avoidant behavior, which preserves the phobia, is acquired and maintained by operant conditioning. Treatment apparently involves gradual extinction of the fear response.
“Behavioral explanations (e.g., Rimm & Masters, 1974) are built upon classical and operant conditioning models of learning. Classical conditioning explains how a neutral stimulus (e.g., a bridge) can acquire reactivity and elicit a fear response. Avoidant behavior, which preserves the phobia, is acquired and maintained by operant conditioning. Treatment apparently involves gradual extinction of the fear response.
“These two divergent explanations have spawned quite different therapeutic approaches, with the behavioral approach (systematic desensitization) demonstrating greater empirical support for its effectiveness (Kaplan & Sadock, 1986). The problem is made complex theoretically by the fact that desensitization doesn’t always work, even when applied in a competent fashion” (p. 25).
“Freud’s early work on the traumatic basis of neurosis pointed to but offered an incorrect explanation of phobias whose origins were unconscious or state bound (i.e., not available to recall during the normal conscious state)” (p. 25).
Migaly, Peter, M. D. (1991). Hypnotic pain control and patient management in dentistry. Hypnos, 18 (3), 127-32.
NOTES
The value of brief psychological and hypnotic techniques in dentistry is discussed from the point of view of an anesthesiologist. The paper deals with three important areas in general and pediatric dentistry, namely the hypnotic pain control, the management of dental anxiety and phobia and the use of hypnosis as adjunct to chemoanesthesia. Two cases are also presented.
1990
Clark, Duncan B.; Agras, W. Stewart (1990). The assessment and treatment of performance anxiety in musicians. American Journal of Psychiatry, 148 (5), 598-605.
94 adults with a performance anxiety problem were recruited by mass media announcements and were seen in a university-based outpatient psychiatric clinic. Assessments were questionnaires for all 94 ss, diagnostic interview of 50 ss, and laboratory performance of 34 ss. Treatment conditions were 6 weeks of buspirone, 6 weeks of placebo, a five-session group cognitive-behavior therapy program (CBTP) with buspirone, or the CBTP with placebo. All Ss fulfilled criteria for Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) social phobia. Of the 15 full-time professional musicians, 10 had tried propranolol and 3 had stopped performing. Most Ss had substantial anxiety and heart rate increases during lab speech and musical performances. CBTP resulted in significant reductions in subjective anxiety, improved quality of musical performance, and improved performance confidence.
1989
Abelson, James L.; Curtis, George C. (1989). Cardiac and neuroendocrine responses to exposure therapy in height phobics: Desynchrony within the ‘physiological response system’. Behaviour Research and Therapy, 27 (5), 561-567.
Monitored subjective, behavioral, cardiovascular and neuroendocrine responses in 2 men (aged 19 and 34 yrs) with height phobias over a full course of exposure therapy and at 6 and 8 month follow-up. Both Ss showed rising cortisol responses and stable, nonextinguishing norepinephrine responses to height exposure over the course of treatment, while
-rine responses to height exposure over the course of treatment, while improvement occurred in subjective and behavioral response systems. They had differing heart rate responses. Despite desynchrony among anxiety response systems and within the physiological system at treatment conclusion, Ss had successful outcomes with general measures of change (phobia rating scales, the Fear Survey Schedule, and the SCL-90) showing substantial improvement for both Ss. These outcomes were preserved at follow-up.
Owens, Mark E.; Bliss, Eugene L.; Koester, Peri; Jeppsen, E. Alan (1989). Phobias and hypnotizability: A reexamination. International Journal of Clinical and Experimental Hypnosis, 37 (3), 207-216.
25 phobic Ss were administered the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) of Weitzenhoffer and E. R. Hilgard (1962). The mean SHSS:C score was 3.5 (S.D. = 2.6), which was lower than that obtained by comparison groups. The results are in direct opposition to previous results and the predictions of Frankel (1974; Frankel & M. T. Orne, 1976). Potential explanations for the discrepancy in results are discussed, including the possibility that previous studies used unrepresentative samples of phobics. It is suggested that hypnosis may sometimes play a role in the production of phobic symptoms but that other processes must be considered as well.
1986
LeBoeuf, Alan (1986). Relaxation-induced anxiety in an agoraphobic population. Perceptual and Motor Skills, 62, 910.
Two groups of 14 agoraphobic patients with anxiety attacks were randomly assigned to suggestion-imagery (like hypnosis) and progressive relaxation (with muscle tensing and release). The progressive relaxation group showed greater drop in subjective anxiety, but there was no different between groups with regard to heart rate. Following the experience, the suggestion-imagery group had more negative responses to : Did you experience anxiety? Did you ever fear losing control? Did you experience any strange sensations during the session? Was the session aversive?
1985
Domangue, Barbara B. (1985). Hypnotic regression and reframing in the treatment of insect phobias. American Journal of Psychotherapy, 39 (2), 206-214.
Presents the case histories of 2 women (aged 30 and 38 yrs) with insect phobias, who were treated with therapies that combined constructs and strategies from psychodynamic, cognitive, and behavioral approaches with hypnotic interventions. In one case, hypnotic regression to the original trauma resulted in reframing. In the other case, hypnotic regression was indirectly introduced through a childish story.
1984
Kelly, S. F. (1984). Measured hypnotic response and phobic behavior: A brief communication. International Journal of Clinical and Experimental Hypnosis, 32 (1), 1-5.
A prospective replication of Frankel and M. T. Orne’s (1976) finding that phobic patients scored higher on measures of hypnotic response than did patients wishing to use hypnosis to control smoking was carried out. 112 patients with a variety of complaints were compared to 22 phobics. The latter scored significantly higher on hypnotizability.
Nugent, William R.; Carden, Nick A.; Montgomery, Daniel J. (1984). Utilizing the creative unconscious in the treatment of hypodermic phobias and sleep disturbance. American Journal of Clinical Hypnosis, 26 (3), 201-205.
An Ericksonian hypnotherapeutic procedure is designed to access and direct creative unconscious processes toward the creation and implementation of satisfactory solutions to recurrent problem behaviors. The use of the procedure is described in 3 cases. Two of the cases involve treatment of severe hypodermic needle phobias. The third case involves use of the procedure in treatment of a somnambulistic sleep disturbance. Possible curative forces tapped by the procedure, suggestions for its continued use, and suggestions for further investigation of the procedure are also discussed.
NOTES
The procedure involved: 1. Pretrance discussion of unconscious mental processes 2. Hypnosis, followed by “Now your unconscious mind can do what is necessary, in a manner fully meeting all your needs as a person, to insure that [desired therapeutic outcome], and as soon as your unconscious knows that you will [desired therapeutic outcome] it can signal by [appropriate ideomotor signal]” 3. Post-ratification.
Example: “‘Now your unconscious mind can do what is necessary, in a manner fully meeting all your needs as a person, to insure that you remain comfortably awake and alert anytime you receive an injection in the future, and as soon as your unconscious knows you will remain comfortably awake and alert when receiving an injection it can signal by lifting your right hand into the air off the chair.’ This suggestion was [their] communicative effort to access and direct unconscious processes to the creation and implementation of altered behavioral responses to injections. Three minutes after the suggestion, B’s right hand lifted jerkily into the air. She was then awakened and experienced a complete amnesia for the trance period” (p. 203).
“[They] then carried out a procedure to ratify the therapeutic change. This process presumably further develops expectancy of change, confirms change at the unconscious level, and puts doubt into any conscious beliefs contrary to positive change. This step is standardly carried out as was done with B. [They] had B sit with her hands resting on the arms of the chair. [They] told her they would ask her unconscious mind a question that only it would know the answer to. It could answer ‘yes’ to the question by lifting her left hand, ‘no’ by lifting her right hand, and ‘I don’t know’ or ‘I don’t want to answer’ by lifting both hands. Then the question was asked, ‘In the future, will B remain comfortably awake and alert anytime she receives an injection or a blood test?’ After a few minutes her left hand jerked momentarily into the air. After some discussion about the ideomotor response and her trance experience they dismissed her with the prescription to ‘await the surprising results'” (p. 203).
The authors cite as a source for their work two books: Erickson, Rossi, and Rossi, Hypnotic Realities, 1976, pp. 226-230; also Erickson & Rossi, Hypnotherapy, 1979.
1983
Baker, S. R; Boaz, D. (1983). The partial reformulation of a traumatic memory of a dental phobia during trance: A case study. International Journal of Clinical and Experimental Hypnosis, 31 (1), 14-18.
A dental patient undertook hypnosis for the modification of a dental phobia. While she was in trance, the disturbing memory was replaced by a nontraumatic memory. After 2 sessions, the dental phobia was significantly reduced.
Flatt, Jennifer R. (1983). What makes therapy work? Thoughts provoked by a case study. Australian Journal of Clinical and Experimental Hypnosis, 11 (2), 63-72.
The case described is offered as illustrating the doubt common to introspective therapists: what _did_ cure the patient? “Francesca’s” presenting problem and the object of the short-term psychological intervention described here, was a fairly circumscribed set of fears related to enclosed spaces. The therapeutic approach adopted was primarily hypnobehavioural, with hypnotically-assisted systematic desensitization and “in vivo” exposure being the main components of the planned programme. However, at the client’s suggestion, one hypnotic session with content planned by the therapist as age regression produced rather dramatic and unexpected results claimed by the patient to effect complete cure.
NOTES 1:
The therapist suggested that “her mind would take her back to a time that was important in understanding her fears and that she would be able to stay calm and relaxed while this past event was revealed to her” (p. 69. She subsequently imagined being in a cave, peaceful and calm. “On being roused from hypnosis, Francesca eagerly described her cave image. She was enthusiastic about the significance of this experience, claiming that it was evidence that in a _previous life_ she had died from being locked into a cave as some sort of punishment and that this pexperience made her fear of enclosed places rational and comprehensible to her” (p. 69).
John, Rodney; Hollander, Barbara; Perry, Campbell (1983). Hypnotizability and phobic behavior: Further supporting data. Journal of Abnormal Psychology, 92 (3), 390-392.
Twenty women who were phobic to snakes, spiders, or rats were individually evaluated for hypnotic susceptibility using the standard audiotaped version of the Harvard Group Scale of Hypnotic Susceptibility, Form A. Consistent with the findings of three earlier studies using the Hypnotic Induction Profile (HIP), 55% of the present sample was found to be highly responsive to hypnosis. An item analysis comparing item pass percentages for the phobic subjects with item difficulties obtained from a normative sample of 357 female college students indicated that the two samples were significantly correlated. The discrepancy between the findings of studies using standard measures of hypnotizability and studies using HIP is discussed.
1981
Epstein, S. J.; Deyoub, P. L. (1981). Hypnotherapy for fear of choking: Treatment implications of a case report. International Journal of Clinical and Experimental Hypnosis, 29 (2), 117-127.
An eclectic hypnotherapeutic approach consistent with Sacerdote’s treatment model was utilized for overcoming the swallowing difficulty of an adult male. Traumatic onset followed an active fellatio experience. Cognitive restructuring preceded symptomatic improvement, and the client was nearly asymptomatic after 56 sessions. Further improvement was evidenced posttherapy on a 3-year follow-up study. The process of change is emphasized, highlighting the broader case management implications of this single case study. Clinical observations are supplemented with psychological test data, providing a richer framework for understanding client and therapy process.
Frutiger, A. Dewane (1981). Treatment of penetration phobia through the combined use of systematic desensitization and hypnosis: A case study. American Journal of Clinical Hypnosis, 23, 269-273.
Systematic desensitization and hypnosis were used in a client with long- standing penetration phobia. Glass test tubes were used in dilation exercises and masturbation instead of more expensive metal catheters. The client was able to have intercourse and adequate sexual adjustment.
Gustavson, John L.; Weight, David G. (1981). Hypnotherapy for a phobia of slugs. American Journal of Clinical Hypnosis, 23, 258-262.
Hypnotic procedures for treating phobias are reviewed. A case of a 21-year- old female with a long-standing phobia of slugs involved hypnotic techniques of dream elicitation, age regression, and directed imagery in therapy. The patient successfully overcame her fear of slugs as well as related problems.