Hypnosis and Mindfulness: The Power of Suggestion to Transform Experience
A book review by Tim Brunson, PhD
If hypnosis is viewed as a process, which enhances selective thinking, and mindfulness regarded as a here-and-now space/time orientation, then their relationship needs little further intellectual consideration. However, if you follow the line of reasoning that hypnosis is a state characterized by focused awareness, dissociation, or trance while keeping the opinion that mindfulness is also a state, there is indeed an obvious opportunity to contrast the two. Contrary to my frequent comments maintaining that the initial view is the more scientifically supported and the most operational, 30 year veteran psychologist Michael D. Yapko, PhD, uses his new book Hypnosis and Mindfulness: The Power of Suggestion to Transform Experience as an exhaustive exercise to accomplish the latter. In his introduction he sets forth that his purpose is to "show the relevance of hypnosis to the effective utilization" of what he calls guided mindfulness meditation – for which he creates the acronym "GMM." After carefully reading this book, I don't feel that his objective was met. Somehow I was left with the impression that this book serves little productive purpose.
I must admit that when I learned that his highly acclaimed book had been published, I anxiously awaited a copy. Nevertheless, once I began laboriously examining his numerous statements and claims, I must point out that in this case the emperor's new clothes are not what they seem. Clearly Dr. Yapko displays that he knows a considerable amount about hypnosis. Yet, somehow I was left thinking that his views indicate that he lacks the correct framework needed to truly understand the phenomenon. Yes, there is a lot of useful information. However, those gems are too often surrounded by efforts to indoctrinate rather than educate his readers. Interesting facts were unnecessarily interspersed among rather strong opinions. Frankly, when writing an academic or professional piece, I would prefer presenting information and respecting that my readers are competent enough to draw their own conclusions.
In this book the author appropriately mentions the relationship between mindfulness and Buddhism. Unfortunately, although this fashionable trend in psychotherapy was inspired by a few Westerners, who spent time as ordained monks, the general approach among therapists is to mistakenly view Buddhism as a rather simplistic philosophy that focuses only on mindfulness and compassion. Even though those concepts are extremely important, one must realize that Buddhism is a very deep and complex set of concepts and practices with many more implications. Additionally, the ex-monks to whom I am referring are practitioners of a very basic form of Buddhism – which is a fact that belies the true value of the religion when it comes to any form of therapy. It is important to understand that the implications of the full breadth of Buddhism on hypnotherapeutic practices are much more profound than the level of understanding referred to by Dr. Yapko. (Note: On page 3, he states that the Sanskrit word "shamatha" generally translates as concentration. This is not correct. Shamatha means calm abiding. Concentration permeates all Buddhist meditative practices. Thus, it should not be looked at as being separate from the vipassana/insight concept. This flaw runs throughout the book.)
I am also troubled by that this book is plagued by numerous inconsistencies. In the introduction he makes a clear statement about what he considers the weakness of direct suggestions. And, he clearly shows his distain for their more intense forms, which he calls authoritarian suggestions. Thus, he rather strongly states that such suggestions can be disrespectful to a client. Yet, on pages 90 through 110 he presents an insightful analysis as to how direct and authoritarian suggestions can be positively used by presenting excerpts of several passages written by recent mindfulness authors as well as in samples of his hypnosis scripts. Likewise, he implies that GMM and hypnosis are two distinct concepts. Then on page 176 he finally admits that in his opinion "GMM is a form of hypnosis." Ironically, if that is true, then the only value that this book has is as random musings of a long-term practitioner.
Essentially, the main problem with this book is the inadequacy of his theoretical framework in regards to hypnosis. While off-handedly admitting that there are several approaches to hypnosis – which he labels as traditional, direct, and even the "appalling" stage hypnosis – his expertise is apparently limited to the ideas – albeit brilliant – of Milton H. Erickson, MD, who developed a unique approach to psychotherapy around the middle of the last century. However, by thus restricting his perspectives and not fully understanding why the techniques that he is dismissing often work – and do so in many cases when Ericksonian methods fall far short – he fails to demonstrate that he actually understands hypnosis. His approach is much akin to attempting to explain the alphabet using only three random letters.
Furthermore, his rather rigid views also lead him to declare that hypnosis is merely a state of dissociation. Again, a more pervasive understanding of the field would have prevented this key error. It is very disturbing that over the past fifty or sixty years the same mistake has pervaded the works of many respected authors. However, as fully trained hypnotherapists know the value of using associated states in addition to dissociation, that limiting myth should have been discarded decades ago.
If a clinician appreciates and integrates the full breadth of the field of hypnosis, the logical deduction points to the fact that efficient selective thinking is the only significant commonality. Also, just like therapy, hypnosis is also a process. Indeed, it is one, which is intended to enhance selective thinking. As all communication is somewhat suggestive and encourages selective thought, on one end of the spectrum you may find guided imagery – to include guided mindfulness meditation (a concept for which I refuse to accept a relevant distinction). On the other end, there are forceful, authoritarian, direct suggestions. Therefore, I would prefer distinguishing suggestive communication by the degrees of the efficiency of selective thought achieved by the various approaches.
Throughout his book Dr. Yapko vacillates between treating hypnosis as a state caused by an induction and a process, such as in the therapeutic use of hypnosis. It appears that he is struggling to reconcile his experiences with his theories. Additionally, he addresses mindfulness as a state – with the implication that mindfulness meditation is a process. As already mentioned, he spends much of the book trying to make a distinction – before finally admitting in later in the book that hypnosis and GMM are really the same thing. This left me scratching my head and asking why he bothered writing the book in the first place.
I also detected that he is having a considerable problem integrating the relationship between recent neurology discoveries and a client's subjective experience. He brings this up briefly in the introduction and then spends a considerable amount of time discussing it toward the end of the book. While he fairly mentions several instances of ground-breaking research, later he strongly refers to their influence as reductionist and inadequate when operationally performing therapy. Therefore, I was confused by his implications. It seems that he feels that clinicians should shy away from objectively measurable empirical observation and evidence-based hypotheses, such as those frequently presented by prominent neurologists, and favors less scientific, subjective evaluations by therapists and their clients. This seems contrary to the current dogma which states that psychology is the science of the mind. Even though I still see the value of respecting subjective experience, his comments read more like defensive, Procrustean Bed efforts designed to justify his long-held beliefs. Personally, I prefer a more balanced approach, which respects the value of both the objective and subjective phenomena.
Not only do I not recommend this book, it is one that I prefer had never been published. As it is rather rambling and incoherent at times, it reads like a book in need of a purpose. More importantly, it is very unfortunate that in the future this book will likely be cited by subsequent authors, thereby perpetuating way too much misinformation. (Likewise, in this book Dr. Yapko cites at least one previous book, which also has dubious merit.) In summary, Hypnosis and Mindfulness is primarily a collection of observations and opinions, which need considerable more intellectual processing. Therefore, it serves little value for a reader who is looking for specific techniques or more conclusive rational thought. Lastly, although I am in complete agreement with the author that hypnosis needs to be regarded with increased respect, I feel that this will only be achieved with more practical books, which take a more comprehensive and scientific approach.
Alternatively, there are several books that I do strongly recommend. Coping with Trauma-Related Dissociation by Suzette Boon, PhD, Kathy Steele, MN, CS, and Onno Van Der Hart, PhD, is an excellent contribution, which among other nuggets discusses how to use mindfulness in therapy. Although the word hypnosis is not mentioned by the authors, they provide excellent, practical examples of mindfulness meditations. Affect Regulation Toolbox by Carolyn Daitch, PhD, a well-respected Ericksonian-oriented psychologist, is probably one of the best books ever to be written about hypnotherapy. And lastly, for those who wish to get down to the neurological basis of how we think and remember, I highly recommend In Search of Memory by Nobel Prize winning neuroscientist, Eric Kandel, MD. In his semi-autobiographical book, Dr. Kandel explains how he and his fellow researchers discovered much about how our minds process what Dr. Yapko would refer to as subjective experience.
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