Hypno-psychotherapy by Richard Cross

A Brief History
Unlike most comparable therapies, hypnotherapy measures its history not in years or decades but in centuries. The usually acknowledged forerunner of modern hypnotherapy, Franz Mesmer (1734-1815), believed in the existence of a universal fluid, an imbalance of which caused illness. However, Mesmer's contemporaries attributed his undoubted successes to his manipulation of a patient's imagination. During the 19th century, this theme was followed by several doctors who used hypnosis successfully, not only to treat psychological illness but also as an anaesthetic for surgical operations.

Hypno-Psychotherapy
Although the development of chemical anaesthetics displaced the use of hypnosis in surgery, and Freud's use of psycho-analysis began to displace it in psychotherapy, the benefits and uses of hypnotherapy are such that it remains a popular and adaptive form of therapy. Hypnotherapy may be used on its own, as simple relaxation therapy, or it may be integrated with any of the great schools of psychological thought. This integrative approach, in which hypnosis is used as an adjunctive approach within psychotherapy has very wide therapeutic applications.

If only simple relaxation therapy is required, then someone with a basic hypnotherapy training should be able to help. However, more complex emotional, psychological or psychosomatic problems may require the help of a psychotherapist who uses hypnosis as just one psychotherapeutic intervention and who will have the skills to recognise and treat a wide range of disorders and conditions.

To illustrate this I will give an overview of how hypnosis can be used as an approach to the treatment of trauma and dissociative disorders:

Hypnosis: Chronic trauma and dissociation

There is a wide range of literature concerning the use of hypnosis and the treatment of chronic trauma and Dissociative Identity Disorder. Hypnosis is a facilitator of treatment, not a treatment in and of itself. Clinicians should always be adequately trained in any adjunctive modalities – especially hypnosis – that they are using in the treatment of a particular patient.

If one is interested In this area I would encourage individuals to look at my links page at appropriate professional societies e.g. ISSD, ESTD.

One just needs to look even at the early the pioneering work of Pierre Janet in the area of dissociation (1859-1947). His thesis L'automatisme psychologique brought together a wealth of related clinical information on a variety of abnormal mental states related to hysteria and psychosis.

Dividing such states into total (involving the whole personality) and partial (part of the personality split from awareness and following its own psychological existence) automatisms, Janet employed automatic writing and hypnosis to identify the traumatic origins and explore the nature of automatism.

Multiple personalities, which Janet called "successive existences," and the experience of possession were treated as partial automatisms.

Although careful to avoid direct discussion of the therapeutic implications of his work in a non- medical dissertation, Janet laid the foundations for his own and Freud's later therapeutic approaches through his demonstration of the origins of splitting in psychic traumas in the patient's past history.

Accordingly, many hypnotic techniques have been developed to assist with DID treatment. DID experts generally agree that hypnotic techniques can be useful both in session and between sessions if patients are taught autohypnosis.

Since, as a group, DID patients are highly hypnotizable, many techniques developed for use with hypnosis can be used without the formal induction of trance utilizing patients' auto hypnotic abilities.

Hypnotic techniques can be used for ego-strengthening, symptom exploration and relief, anxiety relief, accessing alternate identities and restoring adult identities when immature or dysfunctional identities are in control at a session's end, containment of flashbacks, containment and control of both spontaneous and facilitated expressions of strong feelings and abreactions, stabilizing the patient or particular identities between sessions, exploration and relief of painful somatic expressions of traumatic materials, restabilising and restoring mastery, cognitive rehearsal and skill building, facilitating communication within the alternate identity system, and in fusion rituals.

There is little controversy about the use of hypnosis for supportive and ego strengthening interventions, resolving crisis, stabilization, and promoting integration. Hypnosis may also be used to provide a relaxed state and to better facilitate modulation and titration of affect while working on already recalled traumatic memories in Phase 2 therapy (e.g., placing traumatic images on a mental “screen” to see them at more of a distance, etc.). The impact of using these techniques on memory material itself has not been studied and it is unclear to what extent, if any, these hypnotic techniques influence the patient's recall (Brown, Scheflin, & Hammond, 1998).

As with any other specialized technique, the therapeutic use of hypnosis should be conducted with appropriate informed consent provided to the patient concerning its possible benefits, risks, limitations, and current controversies concerning hypnosis and delayed recall of trauma as well as for the use of hypnosis for the diagnosis and treatment of DID and other trauma disorders. Informed consent should include possible limitations on the permissibility of testimony in legal settings concerning recollections obtained under hypnosis based on the statutes and judicial rulings of the jurisdiction in which the therapist practices (American Society of Clinical Hypnosis, 1994)'.

A safe form of therapy
In the right hands, it is a safe and beneficial therapy. There are some instances where the use of hypnosis is not recommended, or where it should only be used with care. A competent psychotherapist will be aware of such contra-indications and may recommend an alternative form of psychotherapy or modify their technique.

What should you look for in deciding on a Hypno-psychotherapist?
These days, the general public is ever more aware of what should be expected from psychotherapy practitioner. When they are looking for a reputable hypno-psychotherapist people will, increasingly, need to be assured that the practitioner has completed an accredited training and belongs to a recognised professional association which requires members to adhere to a Code of Ethics and carry appropriate insurance.

The informed potential client will know that a well regulated professional body should have a complaints procedure and will require members to be in ongoing supervision/peer supervision.

The training available
I have undertaken a training by The Centre International Training School for Hypnotherapy and Psychotherapy. There training provide a thorough, integrated training in hypno-psychotherapy, with comprehensive coverage of the fundamentals of hypnotherapeutic techniques and various types of psychological approach such as Behaviourism, Ericksonian, Freudian, Gestalt, Rogerian and their modern equivalents. A good quality training will be externally accredited and recognised by one of the major independent bodies such as the UK Council for Psychotherapy (www.psychotherapy.org.uk) by which I am registered as a psychotherapist or the European Association for Psychotherapy (www.europsych.org) by which I was granted the ECP - go to web site and search for holders of ECP.