Tim Brunson DCH

Welcome to The International Hypnosis Research Institute Web site. Our intention is to support and promote the further worldwide integration of comprehensive evidence-based research and clinical hypnotherapy with mainstream mental health, medicine, and coaching. We do so by disseminating, supporting, and conducting research, providing professional level education, advocating increased level of practitioner competency, and supporting the viability and success of clinical practitioners. Although currently over 80% of our membership is comprised of mental health practitioners, we fully recognize the role, support, involvement, and needs of those in the medical and coaching fields. This site is not intended as a source of medical or psychological advice. Tim Brunson, PhD

Hypnotherapy or medications: a randomized noninferiority trial in urgency urinary incontinent women.

BACKGROUND: Urgency urinary incontinence afflicts many adults, and most commonly affects women. Medications, a standard treatment, may be poorly tolerated, with poor adherence. This warrants investigation of alternative interventions. Mind-body therapies such as hypnotherapy may offer additional treatment options for individuals with urgency urinary incontinence. OBJECTIVE: To evaluate hypnotherapy's efficacy compared to medications in treating women with urgency urinary incontinence. MATERIALS AND METHODS: This investigator-masked, noninferiority trial compared hypnotherapy to medications at an academic center in the southwestern United States, and randomized women with non-neurogenic urgency urinary incontinence to weekly hypnotherapy sessions for 2 months (and continued self-hypnosis thereafter) or to medication and weekly counseling for 2 months (and medication alone thereafter). The primary outcome was the between-group comparison of percent change in urgency incontinence on a 3-day bladder diary at 2 months. Important secondary outcomes were between-group comparisons of percent change in urgency incontinence at 6 and 12 months. Outcomes were analyzed based on noninferiority margins of 5% for between group differences (P < 0.025) (that is, for between group difference in percentage change in urgency incontinence, if the lower bound of the 95% confidence interval was greater than -5%, noninferiority would be proved). RESULTS: A total of 152 women were randomized to treatment between April 2013 and October 2016. Of these women, 142 (70 hypnotherapy, 72 medications) had 3-day diary information at 2 months and were included in the primary outcome analysis. Secondary outcomes were analyzed for women with diary data at the 6-month and then 12-month time points (138 women [67 hypnotherapy, 71 medications] at 6 months, 140 women [69 hypnotherapy, 71 medications] at 12 months. There were no differences between groups' urgency incontinence episodes at baseline: median (quartile 1, quartile 3) for hypnotherapy was 8 (4, 14) and medication was 7 (4, 11) (P = .165). For the primary outcome, although both interventions showed improvement, hypnotherapy did not prove noninferior to medication at 2 months. Hypnotherapy's median percent improvement was 73.0% (95% confidence interval, 60.0-88?9%), whereas medication's improvement was 88.6% (95% confidence interval, 78.6-100.0%). The median difference in percent change between groups was 0% (95% confidence interval, -16.7% to 0.0%); because the lower margin of the confidence interval did not meet the predetermined noninferiority margin of greater than -5%, hypnotherapy did not prove noninferior to medication. In contrast, hypnotherapy was noninferior to medication for the secondary outcomes at 6 months (hypnotherapy, 85.7% improvement, 95% confidence interval, 75.0-100%; medications, 83.3% improvement, 95% confidence interval, 64.7-100%; median difference in percent change between groups of 0%, 95% confidence interval, 0.0-6.7%) and 12 months (hypnotherapy, 85.7% improvement, 95% confidence interval, 66.7-94.4%; medications, 80% improvement, 95% confidence interval, 54.5-100%; median difference in percent change between groups of 0%, 95% confidence interval, -4.2% to -9.5%). CONCLUSION: Both hypnotherapy and medications were associated with substantially improved urgency urinary incontinence at all follow-up. The study did not prove the noninferiority of hypnotherapy compared to medications at 2 months, the study's primary outcome. Hypnotherapy proved noninferior to medications at longer-term follow-up of 6 and 12 months. Hypnotherapy is a promising, alternative treatment for women with UUI.

Am J Obstet Gynecol. 2020 Feb;222(2):159.e1-159.e16. doi: 10.1016/j.ajog.2019.08.025. Epub 2019 Aug 23.

Development and Validation of a Turkish Hypnotic Suggestibility Scale.

OBJECTIVE: To construct a scale for testing hypnotic suggestibility for Turkish-speaking adults that may be quick and convenient, and to test its reliability and validity. METHODS: The study was conducted at the hypnotherapy outpatient clinics of Atatürk University Acupuncture and Complementary Medicine Application and Research Centre. Erzurum, Turkey, from June to August 2017, and comprised aged 18-60 years. As the first step in the preparation of the scale, a panel of 15 experts was founded. The draft was pilot-tested. Incomprehensible suggestion templates in the pilot study were abolished, and the templates were reduced to four which were put to test as the Tastan Suggestibility Scale. Stanford Hypnotic Clinic Scale was also used on the same subjects, and the results were analysed using SPSS. . RESULTS: Of the 61 subjects, 38(62.3%) were females and 23(37.7%) were males. The overall mean age was 34.21±9.9 years. Cronbach alpha internal reliability coefficient of the scale was calculated to be 0.53. Correlation between the Tastan Suggestibility Scale and Stanford Hypnotic Clinic Scale total scores was high (p<0.001). Mean duration of the application of the scale was 5.0±1.2 minutes. CONCLUSIONS: Tastan Suggestibility Scale was found to be a new, reliable, and rapidly applicable scale.

J Pak Med Assoc. 2019 Sep;69(9):1236-1330.

The Efficacy of Hypnotherapy in the Treatment of Functional Dyspepsia.

BACKGROUND: Functional dyspepsia (FD) is one of the most frequent functional gastrointestinal disorders and is defined using the Rome IV criteria as any combination of the following symptoms: postprandial fullness, early satiety, epigastric pain, and epigastric burning that are severe enough to interfere with the usual activities and occur at least 3 days per week over the past 3 months with an onset of at least 6 months before the presentation. The purpose of this systematic review is to analyze all the relevant studies in the literature that investigate the efficiency of hypnotherapy in FD. AREAS OF UNCERTAINTY: FD refractory to conservative treatment is a therapeutic challenge, and alternative treatment options are needed. Gut-oriented hypnotherapy has been reported an effective treatment for irritable bowel syndrome, but poorly tested in FD. DATA SOURCES: We performed a search in 6 bibliographic databases (PubMed, Embase, Cochrane Library, Web of Science, Scopus, and LILACS) using customized search strategies for each engine. The search strategy included the following terms: (hypnosis, hypnotherapy, hypnotherapies, hypnogenesis, hypnotism, hypnotist, hypnotical suggestion, suggestion, and mesmerism) and {[functional and (dyspepsia or dyspeptic)] or FD}. RESULTS: Taking the aforementioned criteria into account, the result was a review of 4 articles analyzing the efficacy of hypnotherapy in the treatment of FD, published in the past 20 years. The initial search identified 398 articles, of which 37 potentially appropriate articles were reviewed. Of these 37 articles, 4 articles were included in the review. The benefits observed by numerous studies go beyond the field of digestive pathology, patients describing a general improvement in physical and mental health. CONCLUSIONS: Current studies analyzing the efficacy of hypnotherapy in FD provide encouraging data, but additional randomized controlled trials are needed before a firm position on the effectiveness of hypnosis in FD.

Am J Ther. 2019 Nov/Dec;26(6):e704-e713. doi: 10.1097/MJT.0000000000001033.

Psychotherapeutic Interventions in Irritable Bowel Syndrome.

Irritable bowel syndrome (IBS) is a frequent functional gastrointestinal disorder. The patients complain about various symptoms like change in bowel habits, constipation or diarrhea, abdominal pain, and meteorism leading to a great reduction in quality of life. The pathophysiology is complex and best explained using the biopsychosocial model encompassing biological, psychological as well as (psycho)social factors. In line with the multitude of underlying factors, the treatment is comprised of a multitude of components. Often, patients start with lifestyle changes and dietary advice followed by medical treatment. However, also psychotherapy is an important treatment option for patients with IBS and should not be restricted to those with psychiatric comorbidities. Several evidence-based psychotherapeutic treatment options exist such as psychoeducation, self-help, cognitive behavioral therapy, psychodynamic psychotherapy, hypnotherapy, mindfulness-based therapy, and relaxation therapy which will be discussed in the present review.

Front Psychiatry. 2020 Apr 30;11:286. doi: 10.3389/fpsyt.2020.00286. eCollection 2020.

Clinical Hypnosis for Chronic Pain in Outpatient Integrative Medicine: An Implementation and Trainin

Full title: Clinical Hypnosis for Chronic Pain in Outpatient Integrative Medicine: An Implementation and Training Model.

Introduction: Clinical hypnosis for pain management cultivates specific skills to enhance general self-regulation and address pain. Hypnosis is well suited to integrative medicine settings; however, questions persist about its feasibility. This article describes a financially viable hypnosis practice model implemented in an integrative medicine clinic, providing initial feasibility data about rates of referral, participation, reimbursement, and provider retention. The specific processes required to establish and implement hypnosis services were detailed, including instruction in billing, reimbursement data, and a training model to enhance reach of services. Materials and methods: Insurer reimbursement data and operational costs were examined from three hypnosis groups conducted between September 2017 and March 2018. Furthermore, information on referral patterns and enrollment in treatment was collected from program initiation in September 2017 to January 2019. Provider retention in training with the expansion of supervision in the program's second year was also examined. Results: Of 258 individuals referred to hypnosis, 124 (48%) enrolled in group treatment. Analysis of insurer reimbursement over a subset of enrollees from three completed groups (N?=?26) indicated an average collection of $95.85 per patient per session, equating to $706.86 per patient for the eight-session treatment. This extrapolates to $4,926.82 in total per seven-person group for the entirety of the eight-session treatment. After an annual training workshop, provider retention significantly increased (to 81% of eligible trained providers) with the initiation of twice-monthly clinical supervision focusing on transitioning from training to practice. Conclusion: This analysis indicates that a training- and practice-based research model of clinical hypnosis is feasible and financially sustainable in an integrative medicine setting.

J Altern Complement Med. 2020 Feb;26(2):107-112. doi: 10.1089/acm.2019.0259. Epub 2020 Jan 3.

Non-pharmacological interventions for adult ADHD: a systematic review.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a common developmental disorder, often persisting into adulthood. Whilst medication is first-line treatment for ADHD, there is a need for evidence-based non-pharmacological treatment options for adults with ADHD who are either still experiencing significant symptoms or for those who have made the informed choice not to start medication. METHODS: We systematically searched PsycINFO, MEDLINE (Ovid), EMBASE, CINAHL and CENTRAL for randomised controlled trials of non-pharmacological treatments for ADHD in adults. After screening of titles and abstracts, full text articles were reviewed, data extracted and bias assessed using a study proforma. RESULTS: There were 32 eligible studies with the largest number of studies assessing cognitive behavioural therapy (CBT). CBT consisted of either group, internet or individual therapy. CONCLUSIONS: The majority found an improvement in ADHD symptoms with CBT treatment. Additionally, mindfulness and cognitive remediation have evidence as effective interventions for the core symptoms of ADHD and there is evidence for the use of group dialectical behavioural therapy and hypnotherapy. However, evidence for these is weaker due to small numbers of participants and limitations due to the lack of suitable control conditions, and a high risk of bias.

Psychol Med. 2020 Mar;50(4):529-541. doi: 10.1017/S0033291720000069. Epub 2020 Feb 10.

Clinical Hypnotherapy in Grief Resolution - A Case Report.

Grief is one's reaction to any loss, and the coping mechanisms during grief either deplete or become maladaptive. One of the common ways to cope with grief is alcohol or substance intake. The course and resolution of grief vary depending upon many factors. Hypnotherapy has been useful and effective in addressing grief reactions as well as associated manifestation, such as sleep problems, depressive features, or post-traumatic stress disorder. It might be a good choice of treatment while dealing with patients having underlying issues or maladaptive coping mechanisms. This is a single case study design hypothesized to indicate maladaptive coping of increased alcohol consumption to deal with the death of a young son. The case had been treated as alcohol dependent syndrome with multiple hospitalizations without addressing underlying grief. The treatment approach was changed, and grief was addressed using hypnotherapy. Clinical hypnotherapy helped address grief and facilitated the index case to accept the loss. This resulted in minimizing hospitalizations, abstinence and improved day-to-day functioning along with the use of adaptive mechanisms to cope with the loss. Clinical hypnotherapy is an effective intervention to deal with underlying conflicts or issues that may not be addressed directly in a therapy setting.

Indian J Psychol Med. 2020 Mar 9;42(2):193-197. doi: 10.4103/IJPSYM.IJPSYM_476_19. eCollection 2020 Mar-Apr.

The Effectiveness of Group-based Cognitive Hypnotherapy on the Psychological Well-being of Patients

Multiple sclerosis is a chronic, demyelinating disease of the central nervous system mainly affecting young adults. In addition to physical problems, the patients suffer from many psychological problems affecting their psychological well-being. The aim of the present study was to determine the effectiveness of group-based cognitive hypnotherapy on the psychological well-being of patients suffering from multiple sclerosis. This study was designed as a clinical trial with a pretest-posttest control group. From 60 patients diagnosed with multiple sclerosis referred to Beheshti hospital in Yasuj, Iran, 45 patients who met the inclusion criteria were selected by the convenience sampling method. The patients were randomly assigned to intervention (23 individuals) and control (22 individuals) groups through stratified random allocation. After completing the Ryff Scales of Psychological Well-Being, the intervention group attended eight sessions of group-based cognitive hypnotherapy on a weekly basis. The control group did not attend any intervention sessions. At the end of the eight intervention sessions, both groups completed the Ryff's Scale of Psychological Well-being again. The collected data were analyzed using the SPSS software (Version 23). Analysis of Covariance (ANCOVA) and two-way Analysis of variance (ANOVA) tests were used in order to compare the groups. The results indicated that cognitive hypnotherapy had a significant effect on the total score of psychological well-being (F (45, 1) = 6.07, p = .018, ?2 = 0.12) and the dimension of environmental mastery (p < .05). Therefore, it is recommended to use hypnotherapy to promote the psychological well-being of patients suffering from multiple sclerosis.

Am J Clin Hypn. 2020 Apr;62(4):364-379. doi: 10.1080/00029157.2019.1709149.

Toward a Relational Theory of Hypnosis.

Despite ongoing efforts by clinicians, researchers, and theorists to resolve fundamental disagreements about what hypnosis is and how it works, a diversity of theories and approaches remains. For example, experts still disagree about whether hypnosis constitutes a special or altered state, whether hypnotizability is best conceived of as a stable trait, and whether the clinical application of hypnosis is appropriately conceptualized as hypnotherapy. Drawing on the ideas of Gregory Bateson, Daniel Siegel, and others, the author articulates a relational characterization of mind and self as a vantage from which to reexamine common assumptions about hypnosis and to reconsider several questions still animating the field.

Am J Clin Hypn. 2020 Apr;62(4):344-363. doi: 10.1080/00029157.2019.1666700.

Early Hypnotic Intervention After Traumatic Events in Children.

Post-traumatic stress disorder is a debilitating condition that can develop after exposure to any potentially traumatic event (natural disaster, physical assault, and car accident). This study focused on four pediatric patients presenting with an early stress response after a motor vehicle accident who were offered early therapeutic and a preventive management by hypnotherapy shortly after exposure to the traumatic event. All patients improved after one or several sessions of hypnosis. The results indicate that hypnotherapy can immediately help patients during the early period following a traumatic event.

Am J Clin Hypn. 2020 Apr;62(4):380-391. doi: 10.1080/00029157.2019.1659128.

Mindful Hypnotherapy to Reduce Stress and Increase Mindfulness: A Randomized Controlled Pilot Study.

The feasibility of mindful hypnotherapy (MH) intervention for stress reduction was investigated in a randomized trial. Forty-two college-age participants with elevated stress were randomized into MH intervention or wait-list control condition. MH participants completed an 8-week intervention with 1-hour individual sessions and self-hypnosis audio recordings for daily mindfulness. Results indicated excellent feasibility, determined by participant satisfaction, treatment adherence (84% compliance rate), and low rate of adverse events (4.5%). There were significant differences between the MH and control groups postintervention, with the mindful hypnotherapy intervention resulting in significant and large decrease in perceived distress, p < .001, 15.35 (1.54), Hedge's g = - 1.14, and increase in mindfulness, p < .001, 50.07 (2.04), Hedge's g = 1.36. This study indicates that MH is a feasible intervention for stress reduction and increasing mindfulness.

Int J Clin Exp Hypn. 2020 Apr-Jun;68(2):151-166. doi: 10.1080/00207144.2020.1722028.

Integration of hypnotherapy with brief cognitive behaviour therapy (CBT) for treatment of depression

The current study was planned to assess how the integration of brief cognitive behaviour therapy (CBT) with hypnotherapy can be productive for a client's quick progress in treatment. It illustrates the effectiveness of two methods of treatment integrated to make better prognosis in the treatment of a depressed Pakistani housewife aged 25 years, who had been suffering for a year. The sessions included hypnotic induction, teaching self-hypnosis with positive suggestions, mood monitoring, use of imagery and relaxation techniques along with specific strategies of brief CBT. Predominant feature of her clinical presentation was the belief of being unloved, and the negative thoughts of being devalued by the husband. Hypnotherapy contributed to achieving remarkable therapeutic progress in a relatively short time. At initial presentation, the depressive symptoms were extremely high as demonstrated by psychological assessment tests and Beck Depression Inventory (BDI). Subsequent test results indicated that she had returned to normal level of functioning (81-90) as assessed through the Global Assessment of Functioning Scale (GAFS). At the time of reporting the case, she was in the follow-up phase. The case highlights the value of hypnosis as a tool of empowerment especially important to diminish depression when used as an adjunct with cognitive behaviour therapy.

J Pak Med Assoc. 2020 Apr;70(4):719-723. doi: 10.5455/JPMA.23735.

The Opinion of Oncologists on the Practice of Hypnosis among Cancer Patients in Lebanon.

INTRODUCTION: Medical hypnosis has received an increasing attention during the past decades. Various applications of hypnosis can be incorporated into the oncology field. This study aims to assess the knowledge of Lebanese medical oncologists on the use of hypnosis in the management of cancer patients. MATERIAL AND METHODS: An anonymous questionnaire was sent to all Lebanese medical oncologists to assess their knowledge, opinion and understanding of hypnosis and its use in oncology, as well as the obstacles facing its application in Lebanon. RESULTS: Hundred and three Lebanese medical oncologists responded to the survey, with a response rate of 65%. The findings revealed that most oncologists had little or no knowledge about hypnosis, but recommended it due to the benefits they believed it provided for the patients in improving chronic pain, invasive procedures, chemotherapy-induced nausea and anxiety. Around 40% of participants were interested in receiving a training in hypnosis. Lebanese oncologists also described many obstacles to the practice of hypnosis, mainly the lack of training for this technique and the lack of financial resources. CONCLUSION: Despite all obstacles, the majority of Lebanese oncologists would recommend hypnosis to their patients in order to improve their quality of life.

Complement Ther Med. 2020 Sep;53:102534. doi: 10.1016/j.ctim.2020.102534. Epub 2020 Aug 12.

Effect of Lifestyle Factors on Outcomes in Patients With Inflammatory Bowel Diseases.

Various lifestyle factors including physical activity and obesity, stress, sleep, and smoking may modify the risk of developing inflammatory bowel diseases (IBDs). In patients with established IBD, these lifestyle factors may significantly impact the natural history and clinical outcomes. Recreational exercise decreases the risk of flare and fatigue in patients with IBD. In contrast, obesity increases the risk of relapse and is associated with higher anxiety, depression, fatigue, and pain and higher health care utilization. Obesity also modifies pharmacokinetics of biologic agents unfavorably and is associated with a higher risk of treatment failure. Sleep disturbance is highly prevalent in patients with IBD, independent of disease activity, and increases the risk of relapse and chronic fatigue. Similarly, stress, particularly perceived stress rather than major life events, may trigger symptomatic flare in patients with IBD, although its impact on inflammation is unclear. Cigarette smoking is associated with unfavorable outcomes including the risk of corticosteroid dependence, surgery, and disease progression in patients with Crohn's disease; in contrast, smoking does not significantly impact outcomes in patients with ulcerative colitis, although some studies suggest that it may be associated with a lower risk of flare. The effect of alcohol and cannabis use in patients with IBD is inconsistent, with some studies suggesting that cannabis may decrease chronic pain in patients with IBD, without a significant effect of biological remission. Although these lifestyle factors are potentially modifiable, only a few interventional studies have been conducted. Trials of structured exercise and psychological therapy including mindfulness-based therapies such as meditation and yoga and gut-directed hypnotherapy have not consistently demonstrated benefit in clinical and/or endoscopic disease activity in IBD, although may improve overall quality of life.

Am J Gastroenterol. 2020 Jun;115(6):832-840. doi: 10.14309/ajg.0000000000000608.

Efficacy of psychological therapies for irritable bowel syndrome...

Full title: Efficacy of psychological therapies for irritable bowel syndrome: systematic review and network meta-analysis.

OBJECTIVES: National guidelines for the management of irritable bowel syndrome (IBS) recommend that psychological therapies should be considered, but their relative efficacy is unknown, because there have been few head-to-head trials. We performed a systematic review and network meta-analysis to try to resolve this uncertainty. DESIGN: We searched the medical literature through January 2020 for randomised controlled trials (RCTs) assessing efficacy of psychological therapies for adults with IBS, compared with each other, or a control intervention. Trials reported a dichotomous assessment of symptom status after completion of therapy. We pooled data using a random effects model. Efficacy was reported as a pooled relative risk (RR) of remaining symptomatic, with a 95% CI to summarise efficacy of each comparison tested, and ranked by therapy according to P score. RESULTS: We identified 41 eligible RCTs, containing 4072 participants. After completion of therapy, the psychological interventions with the largest numbers of trials, and patients recruited, demonstrating efficacy included self-administered or minimal contact cognitive behavioural therapy (CBT) (RR 0.61; 95%?CI 0.45 to 0.83, P score 0.66), face-to-face CBT (RR 0.62; 95%?CI 0.48 to 0.80, P score 0.65) and gut-directed hypnotherapy (RR 0.67; 95%?CI 0.49 to 0.91, P score 0.57). After completion of therapy, among trials recruiting only patients with refractory symptoms, group CBT and gut-directed hypnotherapy were more efficacious than either education and/or support or routine care, and CBT via the telephone, contingency management, CBT via the internet and dynamic psychotherapy were all superior to routine care. Risk of bias of trials was high, with evidence of funnel plot asymmetry; the efficacy of psychological therapies is therefore likely to have been overestimated. CONCLUSIONS: Several psychological therapies are efficacious for IBS, although none were superior to another. CBT-based interventions and gut-directed hypnotherapy had the largest evidence base and were the most efficacious long term. TRIAL REGISTRATION NUMBER: The study protocol was published on the PROSPERO international prospective register of systematic reviews (registration number CRD 42020163246).

Gut. 2020 Aug;69(8):1441-1451. doi: 10.1136/gutjnl-2020-321191. Epub 2020 Apr 10.

Pain Neuroscience Education for Children with Functional Abdominal Pain Disorders...

Full title: Pain Neuroscience Education for Children with Functional Abdominal Pain Disorders: A Randomized Comparative Pilot Study.

This article explores the effectiveness of a newly developed Pain Neuroscience Education program for children (PNE4Kids) with functional abdominal pain disorder (FAPD). Children (6-12 years) with FAPD were randomly assigned to 1) the experimental group (n = 14), participating in one hypnotherapy session (i.e., usual care) and one additional PNE4Kids session, or 2) the control group (n = 14), participating in two hypnotherapy sessions. Parental pain catastrophizing, the child's functional disability (parental-proxy), pain-related fear (parent-proxy) and pain intensity, were assessed at baseline and one and three weeks after each therapy session. Pressure algometry and a conditioned pain modulation paradigm were performed at baseline and three weeks after completion of the last therapy session. Parents from both the experimental as well as the control group showed significantly less parental pain catastrophizing (p < 0.01). Children showed significantly less functional disability (p < 0.05), pain-related fear (p < 0.01) and local pressure pain sensitivity (p < 0.05) at short-term follow-up (three weeks after last intervention) in both groups. No significant (p > 0.05) between-group differences were found. Hypnotherapy combined with PNE4Kids did not result in better clinical outcomes compared to hypnotherapy alone. Study limitations include the application of one single PNE4Kids session and the short follow-up time.

J Clin Med. 2020 Jun 9;9(6):1797. doi: 10.3390/jcm9061797.

Marital Hypnotherapy: A Session with Milton Erickson with Commentary.

Hypnosis has primarily been used to treat individual problems. Occasionally, it has been applied to couples' problems such as infertility. We present a transcript of a treatment session of Dr. Milton Erickson in which he works with a married couple and interpret his techniques. We emphasize the following principles. Dr. Erickson's assessment was brief, just long enough to determine a general target. He used hypnotic induction to build responsiveness. He used evocative communication. He seeded ideas that, when presented later, had a powerful impact. He moved in small, strategic steps. The main intervention was designed to elicit dormant resources and adaptive states. He followed through, providing suggestions on how to use these resources. In presenting this case and our analysis of it, we highlight some of Dr. Erickson's methods and conceptualization of several intervention techniques.

Int J Clin Exp Hypn. 2020 Jul-Sep;68(3):263-288. doi: 10.1080/00207144.2020.1762493. Epub 2020 Jun 12.

Gazing Back, Playing Forward: Contemporary Psychoanalytic Musings...

Full title: Gazing Back, Playing Forward: Contemporary Psychoanalytic Musings on the Relational Essence of Hypnotherapeutic Action.

To build bridges between hypnosis and contemporary psychoanalysis, this article addresses how hypnosis, when used in psychotherapy, facilitates curative action through its relational essence. The author's extensive experience with hypnosis, psychotherapy, and psychoanalysis orient the narrative toward the unconscious patient-therapist interaction, with particular attention paid to the ethics of the inherent hypnotic seduction. Whether used primarily in relief-oriented ways or geared toward more transformative therapeutic aims, powerful unconscious factors are in play for both patient and therapist and are explicated to illustrate the interactive and frequently unformulated, intersubjective factors that facilitate effective, psychotherapeutic hypnosis. Consequently, therapists attuned to such intersubjective dynamics can make use of their own internal mental activities to understand a patient's current state of mind and level of developmental functioning, and thereby subsequently formulate mutative interventions. For instance, because hypnotizability reflects the ability to play in imaginative space, the regression promoted in hypnotherapy may activate both an illusion of omnipotence and its optimal disillusionment through the relational context. This requires going beyond more traditional, procedural ways of bifurcating hypnotic interventions as being either direct or indirect and instead further distinguish hypnotic interventions in accordance with their maternal and paternal relational dimensions. Arguably, then, the skillful hypnotherapist needs to maintain a coupling interplay between the maternal, maximally receptive and the paternal, more active modes of functioning within hypnotic play space.

Am J Clin Hypn. 2020 Jul-Oct;62(1-2):12-30. doi: 10.1080/00029157.2019.1580558.

Hypnosis and The Therapeutic Relationship: Relational Factors of Hypnosis in Psychotherapy.

Over the years, the field of hypnosis has often given more attention to the state and procedural factors of hypnosis than the relational ones. In an attempt to address this imbalance, the 60th annual meeting of the American Society of Clinical Hypnosis (ASCH) had as its theme "Hypnosis and the Treatment Relationship." A centerpiece of this meeting was a collegial discussion among a panel of psychologists with expertise in relational hypnotherapy. The panel addressed several pertinent questions: (1) What are the healing qualities of relationship in psychotherapy? (2) What makes hypnosis relational in nature? (3) How do relational factors of hypnosis resemble healthy attachment processes and recapitulate stalled developmental maturation? (4) How does relationally informed hypnotherapy influence and strengthen the relationship, process, and outcome of psychotherapy? This article summarizes the factors that led to the creation of this panel; provides an edited transcript of this panel discussion, along with additional commentary on several key points raised; and concludes with a summary of the main themes and recommendations for further clinical practice and study.

Am J Clin Hypn. 2020 Jul-Oct;62(1-2):118-137. doi: 10.1080/00029157.2019.1599319.

Dancing in the In-Between: Hypnosis, Transitional Space, and Therapeutic Action.

This article develops the idea that hypnosis is an interactive phenomenon occurring in a relational matrix. A tripartite model for explicating this relational matrix is presented, which includes a discussion of transference, contemporary relationship factors, and the interaction of these to produce a sense of therapeutic alliance. These relationship factors are central to the therapeutic action of hypnosis as a vehicle to potentiate change and growth. The unique and specific contribution of each of these factors to the process of hypnotherapy and to therapeutic action is examined. Phenomenologically, this relational interaction is conceptualized as occurring in transitional space, shaped by processes of regression and attunement. From this perspective, the hypnotherapist is viewed as a kind of transitional object whose empathic presence contains and facilitates those interactive phenomena which evoke and balance the transferential and contemporary aspects of the relationship and which allow for uniquely evocative developmentally focused interventions in trance work. Several examples are presented from an ongoing case that demonstrate how these relational variables shape the hypnotherapeutic process and how they can be used for uncovering and self-examination, for structural maturation, for affect regulation, and for emerging ego mastery. The therapeutic action demonstrated relies on hypnotic interventions rooted in the various components of the relational matrix made possible by the clinician's awareness of and attunement to these and by hisor her informed and sensitive management of them and of his or her own intersubjectivity. Specific strategies are presented via these examples to effectively utilize this experience in the service of treatment goals.

Am J Clin Hypn. 2020 Jul-Oct;62(1-2):31-59. doi: 10.1080/00029157.2019.1585328.

Effects of Hypnotherapy on Weight Loss...

Full title: Effects of Hypnotherapy on Weight Loss and thus on Serum Leptin, Adiponectin, and Irisin Levels in Obese Patients.

Objective: This study aimed to investigate effects of hypnotherapy on weight loss and thus on leptin, adiponectin (ADP), and irisin levels in obese patients who presented to the psychiatry outpatient clinic to participate in hypnotherapy sessions to develop a healthy and balanced diet. Methods: The study sample included 32 individuals with a body mass index (BMI) of ?30 and who completed the 10-week hypnotherapy. First, the Personal Information Form was handed out to the participants and then each participant's weight (in the morning on an empty stomach) and height were measured and BMI was determined. Five-milliliter blood samples were drawn before the first session, and then irisin, leptin, and ADP levels were measured using the enzyme-linked immunosorbent assay method. Then, they participated in hypnotherapy sessions once a week for 10 weeks. At the end of the 10-week hypnotherapy, 5?mL of blood was taken again and the aforementioned biochemical analyses were performed. BMIs were measured again. Results: The mean BMI values of the patients were 33.43?±?5.28 and 31.45?±?4.98 at the beginning and end of the hypnotherapy sessions, respectively. Serum leptin, ADP, and irisin levels, which were 9.48?±?5.48, 6.73?±?3.27, and 1.43?±?1.14, respectively, at the beginning of the hypnotherapy sessions, were 6.47?±?2.69, 7.68?±?3.34, and 1.53?±?1.21, respectively, at the end of the hypnotherapy sessions. The results showed that BMI and serum leptin levels decreased significantly after the hypnotherapy sessions, whereas serum ADP and irisin levels increased significantly. Conclusions: This study indicates that hypnotherapy in obesity treatment leads to weight loss in obese patients and thus to considerable changes in leptin, ADP, and irisin levels. Hypnotherapy is easy to apply, cheap, and effective; has no potential for side effects; and can be applied both alone and in combination with other treatments. However, to confirm its effects, further studies should be conducted on this issue.

J Altern Complement Med. 2020 Nov;26(11):1047-1054. doi: 10.1089/acm.2020.0104. Epub 2020 Jul 21.

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