Age regression: tailored versus scripted inductions

REVISITING THE SAFE PLACE:Method and Regulatory Aspects in Psychotherapy when Easing Allostatic Overload in Traumatized Patients

Safe-place inductions are considered important altered states of consciousness (ASC) to be (re)installed during trauma-informed psychotherapy. Coregulation aimed at changing implicit relational knowing and increasing integration and coherence through relational work and hypnotic techniques is crucial, as clients' abilities to self-soothe and regulate have become seriously impaired. Thus, resource-oriented metaphors as inner strength imagery is advocated. Also, methods such as creative-arts therapy and neurofeedback will induce ASCs, as most methods used with complex traumatized clients, due to their high hypnotizability. When positive or soothing imagery or relationally held suggestions for changed attentional focus are added to both psychodynamic psychotherapy and CBT, a hetero-hypnosis will be induced-a prerequisite for phase-specific trauma therapy aimed at changing inner schemas and scripts.

Effects of Hypnosis on Regression to Primary-Process Thinking

The authors tested the hypothesis that hypnotic age regression produces a shift from secondary- to primary-thought processing in hypnotizable participants. Thirty participants were tested for hypnotizability using the Elkins Scale of Hypnotizability (EHS). Participants were exposed to a tailored hypnotic arm-levitation induction and a hypnotic suggestion to age regress to 5 years of age and to have a dream. Primary-process thinking was assessed using the Primary-Process Thinking Scale. An independent t test with 2 levels of hypnotizability (middle and high) showed high hypnotizables demonstrated higher ratings of primary thought processing than those in the middle group.

Induction Technique: Beyond Simple Response to Suggestion

The hypnotic induction is intended to induce hypnosis. This implies that what is sought is intended to go beyond what might be wrought by mere suggestion, expectancy, and social influence. The experimentally controlled research showing that the induction makes a difference and how small changes in wording of suggestions can produce orthogonal responses is briefly reviewed. This article explains the principles of induction and three critical phases of hypnotic induction in detail. An arm levitation scripted protocol demonstrating how to respond to the patient using the three phases to maximize responses to hypnotic suggestions is presented.

Resistance to Healing the Wounded Self: A Psychodynamic Rationale for a Targeted Treatment

The purpose of this article is to shed light on the psychodynamic complexities of the resistance encountered in treating the wounded self. Conceptualized on the basis of ego state therapy it offers a rationale for the use of precision-targeted abreactive hypnosis to treat these patients. Grounded in evidence-based efficacy research, the authors also briefly explain how to target treatment in wounded-self patients.

Tossing the baby with the (magnetized) bathwater: commentary on jacobson and colleagues

This article critiques two studies conducted by Jacobson and colleagues whose findings indicated that hypnosis hinders encoding and might not be useful in education. While their findings provide important information about hypnosis and its possible uses in teaching and learning, there are several important methodological and interpretive shortcomings that limit the applicability of the study. It is argued that the authors conflated some components of hypnotic phenomenology, as measured by the Phenomenology of Consciousness Inventory, and consequently failed to assess the hypnotic experience properly. This article argues that the encoding deficits produced by hypnosis may have resulted from the way hypnosis was used and other contextual factors, and highlights some additional concerns with the statistical analyses. This article suggests some more effective uses of hypnosis and suggestion in improving the learning process in light of prior research, and offers some ideas for future research.

Factors that contribute to the willingness to try "street hypnosis"

This study takes a context-specific approach to examine people's willingness to try hypnosis under various conditions and the factors that contribute to their willingness. It examined 378 participants, who completed a web-based hypnosis survey. The results showed that people's willingness to try hypnosis varies by context. Specifically, people are more willing to try hypnosis when it is framed as "peak focus" rather than "hypnosis" and when they perceive the environment as being safer. Moreover, factors including participants' demographics, hypnotists' demographics (relative to the subjects'), participants' control bias, and knowledge of hypnosis affect people's degrees of willingness to try hypnosis, depending on the specific context. The results suggest further analysis of hypnosis occurring in public contexts and the effects it may have on attitudes and therapeutic outcomes.

Evidence based abreactive ego state therapy for PTSD

A single 5-6 hours manualized abreactive ego state therapy session has recently been subjected to two placebo-controlled investigations meeting evidence-based criteria. Ego state therapy was found to be a highly effective and durable treatment for posttraumatic stress disorder. Apparently, ego state therapy works because it is emotion focused, activates sub-cortical structures, and because the supportive, interpretive therapist reconstructs the patient's personality to be resilient and adaptive. In this article the author reviews the treatment procedures and presents the findings of both studies.

Efficacy of single-session abreactive ego state therapy for combat stress injury, PTSD, and ASD

Using abreactive Ego State Therapy (EST), 36 patients meeting DSM-IV-TR and PTSD checklist (PCL) criteria were exposed to either 5-6 hours of manualized treatment or placebo in a single session. EST emphasizes repeated hypnotically activated abreactive "reliving" of the trauma experience combined with therapists' ego strength. Both the placebo and EST treatment groups showed significant reductions in PTSD checklist scores immediately posttreatment (placebo: mean 17.34 points; EST: mean 53.11 points) but only the EST patients maintained significant treatment effect at 4-week and 16- to 18-week follow-ups. Abreactive EST appears to be an effective and durable treatment for PTSD inclusive of combat stress injury and acute stress disorder.

Single-session manualized ego state therapy (EST) for combat stress injury, PTSD, and ASD, part 1: the theory

Ego state therapy (EST) evolved from a psychodynamic understanding of personality as a product of an individual's ego states to a conceptualization of how ego-energized and object-energized elements are bound together to cope with a traumatic event. Neurobiological studies now substantiate Watkins's war neuroses conceptualizations. Because of their severity, trauma memories are encoded in the subcortical-subconscious brain regions that are accessed by the single-session manualized EST procedure but not by the popular cognitive-behavioral management therapies. The imprint of the trauma is not accessible or resolvable by such top-down verbal understanding or reframing; EST is a bottom-up therapy. Abreactive hypnosis facilitates ego state expression at physiologically and psychologically intense levels sufficient to activate subcortical processes to release affect in the presence of the therapist, who adds ego strength to the patient. This is followed by interpretation and reintegration. The result is a reconstructed personality that is adaptive and resilient.

Efficacy of hypnosis in the treatment of human papillomavirus (HPV) in women: rural and urban samples

This article investigates the effect of hypnosis on immunity and whether this is the key mechanism in the hypnotic treatment of the genital infection caused by human papillomavirus (HPV). HPV is the most common sexually transmitted disease and can lead to cervical and other cancers. Current medical treatments are aimed at tissue assault (acids, freezing, surgery). Medical wart clearance rates are only 30% to 70% and recurrence is common. Our research contrasted hypnosis-only with medical-only therapies, using both urban hospital and rural community samples. Both hypnosis and medical therapy resulted in a statistically significant (p < .04) reduction in areas and numbers of lesions. Yet, at the 12-week follow-up, complete clearance rates were 5 to 1 in favor of hypnosis.

Effects of an affect bridge for age regression

The authors tested tailored hypnotic inductions for age regression with an affect bridge to access meaning-laden events. They used emotional intensity, spontaneity, elaboration, and transitional-object measures to assess the genuineness of the topographic shift to primary process characteristic of hypnotic age regression. An affect bridge was used to access stressful events within the age range of 3 to 6 years. The Stanford Hypnotic Susceptibility Scale, Form C was administered to determine high hypnotizables-reals, (n = 8, scores 9-12) and low hypnotizables-simulators, (n = 8, scores 3 or less). The groups behaved differently on frequency of transitional objects, spontaneity, and intensity but not on elaboration. The hypnotizable-reals but not the simulators produced a plethora of primary-process childlike affective responses that could not be produced by the role-playing simulators.

Long-term outcome of hypnotic-analgesia treatment for chronic pain in persons with disabilities

Data from 26 participants in a case series of hypnotic analgesia for chronic pain were examined to determine the long-term effects of hypnosis treatment. Statistically significant decreases in average daily pain intensity, relative to pretreatment values, were observed at posttreatment and at 3- and 9-month follow-up but not at 6- or 12-month follow-up. The percent of participants who reported clinically meaningful decreases in pain were 27%, 19%, 19%, and 23%, at the 3-, 6-, 9-, and 12-month follow-up points, respectively. Moreover, at 12-months posttreatment, 81% of the sample reported that they still used the self-hypnosis skills learned in treatment. Overall, the results indicate that about 20% of the sample obtained substantial and lasting long-term reductions in average daily pain following hypnosis treatment and that many more continue to use self-hypnosis up to 12 months following treatment.

Heart-rate variability as a quantitative measure of hypnotic depth

The authors investigated whether heart-rate variability can serve as a device for real-time quantitative measurement of hypnotic depth. This study compared the continuous self-rated hypnotic depth (SRHD) of 10 volunteers with heart rate, amplitude, and frequency changes from a time-frequency analysis of heart-rate variability (HRV). The authors found significant linear relationships between SRHD and the high-frequency (HF) component of HRV. Specifically, SRHD was correlated negatively with the frequency of the HF component and positively with the amplitude of the HF component. Unexpectedly, the average temporal trend in SRHD fit well (R(2) = .99) to the step response of a first-order system with a 4-minute time constant. The findings suggest that the reactivity of the parasympathetic branch of the autonomic nervous system reflected in HRV could become part of a real-time, quantitative measure of hypnotic depth.

Adjunctive self-hypnotic relaxation for outpatient medical procedures: a prospective randomized trial with women undergoing large core breast biopsy

Medical procedures in outpatient settings have limited options of managing pain and anxiety pharmacologically. We therefore assessed whether this can be achieved by adjunct self-hypnotic relaxation in a common and particularly anxiety provoking procedure. Two hundred and thirty-six women referred for large core needle breast biopsy to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n=82), or self-hypnotic relaxation (n=78) during their procedures. Patients' self-ratings at 1 min-intervals of pain and anxiety on 0-10 verbal analog scales with 0=no pain/anxiety at all, 10=worst pain/anxiety possible, were compared in an ordinal logistic regression model. Women's anxiety increased significantly in the standard group (logit slope=0.18, p<0.001), did not change in the empathy group (slope=-0.04, p=0.45), and decreased significantly in the hypnosis group (slope=-0.27, p<0.001). Pain increased significantly in all three groups (logit slopes: standard care=0.53, empathy=0.37, hypnosis=0.34; all p<0.001) though less steeply with hypnosis and empathy than standard care (p=0.024 and p=0.018, respectively). Room time and cost were not significantly different in an univariate ANOVA despite hypnosis and empathy requiring an additional professional: 46 min/161 dollars for standard care, 43 min/163 dollars for empathy, and 39 min/152 dollars for hypnosis. We conclude that, while both structured empathy and hypnosis decrease procedural pain and anxiety, hypnosis provides more powerful anxiety relief without undue cost and thus appears attractive for outpatient pain management.