Hypnoanalysis

THE HISTORY OF HYPNOANALYSIS

In the last 30 years there has been a surge of interest in Hypnosis. Many people are familiar with such terms as hypnotherapy, autohypnosis, hypnology, analytical hypnotherapy, analytical trance state therapy, clinical hypnosis, therapeutic hypnosis, Ericksonian hypnosis, hypnobehaviour, New hypnosis, hypnogogic images, neuro-linguistic programming, hypnosynthesis, Medical Hypnoanalysis and other terms found their way into the recognition vocabulary of the general public in this field.

The following definition of Medical Hypnoanalysis was formulated by the Society of Medical Hypnoanalysis (now called the American Academy of Medical Hypnoanalysis):

“Medical Hypnoanalysis is dynamic, short term, and directed. It is dynamic in that the treatment approach emphasizes causes rather than symptoms, explanations rather than descriptions, and unconscious forces rather than conscious forces as being the ultimate origin of the psychopathology. It is short term in that in most of the situations thirty or less sessions are required for the completion of treatment procedure. It is directed therapy in that the psychotherapist, upon making a diagnosis, follows a medical model of psychotherapy aimed at alleviating the symptoms by means of resolving underlying unconscious causes.”

“Medical Hypnoanalysis first examines the presenting symptoms of the patient by means of a case history, observing verbal and nonverbal communication, while seeking unconscious clues to the ultimate causes of the symptoms in order to make a psychodynamic diagnosis.

After the patient is introduced to hypnosis, the majority of the therapeutic sessions are conducted with the patient in the hypnotized state. The therapist investigates the unconscious by using the following procedures: 1. A specifically designed word association test, 2. Dream Analysis, 3. Age regressions directed at crucial periods earlier in the patient’s life.”

“Such procedure allows identification and re-interpretation, adjustment or re-evaluation and desensitization of the specific causal events. This procedure is directed at correcting the symptoms and the unwanted behaviour which causes suffering and disease. For example, depressions, phobias, obsessions, psychosomatic disorders, self-destructive and anti-social behaviour and other emotional and psychological problems can be relieved.”

“There are a variety of methods and procedures of applying the basic hypnoanalytical methods. Individual varieties are based on the specific training and treatment circumstances of the clinician.”

THE “MEDICAL HYPNOANALYSIS” TITLE

The Society of Medical Hypnoanalysts was given birth by a group of physicians meeting in Chicago in 1975 (now called the ‘”American Academy of Medical Hypnoanalysists”) and there the name of the procedure was debated.

All present at the meeting were physicians who utilized hypnosis in their practice, and followed a “medical model” of treatment; they felt that the name of the modality as appropriate. They hoped that the name would distinguish this procedure from all other procedures and systems.

It was a sensitive issue when men with Ph.D’s were qualified to join the group due to the use of “Medical” with regard to their status. Due to this, they added Category II to the membership register, and allowed them to practice “Medical Hypnoanalysis” as a psychotherapeutic procedure. This did not imply that those without medical degrees were practicing medicine in the true sense of the word.

In recent years we saw the term “medical” more generally applied; the term being based on a Latin root meaning “to heal” and it is without regard to the use of medications.  It has become more widely accepted that the most important system of health is the brain itself, and we thus see that the line of demarcation between the influence of the physician and the influence of psychology gets thinner.

Barber (1984) said that “ideas can effect the physiological activities of the cells in the human body”. Rossi (1986) and Rossi & Cheek (1988) made even bolder statements than ever concerning the mind-body interrelationship and the vast healing powers of the mind; all backed by scientific evidence regarding the mind-body interrelationship and the vast healing powers of the mind.

When we look at the concept of “healing within the self”, we notice that the body tends to heal itself when the physician acts as a facilitator and helper in order to speed up the process; likewise, the mind also tends to heal itself as the psychotherapist acts as facilitator and helper.

The term “Medical Hypnoanalyst” therefore does not imply that the therapist has a medical degree or dispenses medications. It is rather the title of a particular process of psychotherapy that is duly defined, using hypnosis in a specified manner. Training is usually offered to therapists who have already completed education in psychology, social work or medicine.

The aim of training Medical Hypnoanalysis is to provide the experienced psychotherapist with tools to utilize this effective modality in his clinical practice.

During 1968, Klemperer observed that “it is still too early to determine” whether the modality of psychotherapy called “Hypnoanalysis” will grow from an adjunctive role to a special, autonomous form of treatment.

Historically the term “Hypnoanalysis” was loosely used; it was applied to the general use of hypnosis in direct suggestion for symptom removal and as another extreme in psycho-analysis (from 1947-1950).  Con used the term “hypno-synthesis” with reference to the use of hypnosis in psychoanalysis (1949). Lifshitz and Blair (1960) refer to the resurgence of “abreactive therapy”, meaning the use of hypnosis as it was used in the treatment of war neuroses.

The British Journal of Medical Hypnotism frequently used the term “medical hypnosis”. Barnett’s book Analytical Hypnotherapy saw the light in 1981; he carefully and skillfully combines analytical principles with hypnosis.

All these terms and ideas lead to much confusion; it is no wonder that Gill and Brenman (1959) came to the conclusion that “hypnotherapy” was a misleading term and “should be abandoned” and that “the term “Hypnoanalysis” is sufficiently lacking in specificity as to be useless” (p.355f).

Over the last 30 years we saw that a growing number of clinicians gravitated to the practice of hypnosis and eventually to a fulltime speciality called “Medical Hypnoanalysis”. The theory and practice has been so dynamic that it evolved and developed as an “autonomous” psychotherapeutic procedure. There are organizations and professionals interested in this field since 1975.

The prefix “hypno-“ was apparently used for the first time in 1821 by the Frenchman, Entienne Felix d’Henin de Cuvillers for a number of words describing what is now called the “hypnotic state”. (Gravitz &  Gerton, 1894).

Brenman and Gill (1947) attributed the origin of the hyphenated term “hypno-analysis) to Hadfield. Hadfield verified this in a personal communication to Crichton-Miller saying that he invented the term during the First World War to describe the method of using hypnosis in order to revive ‘forgotten and repressed’ experiences, especially in amnesia cases. He also used it as an alternative method to free association and dream interpretation (Ambrose & Newbold, 1958). However, this refers to the term “hypno-analysis”; the history of hypnosis in analysis goes back much further.

Although Mesmer made many mistakes in his trial and error procedures during his time of pioneering in this field, he must be given credit for his “scientific approach” to the study and application of hypnosis.

He maintained that the “magnetic fluid” that he supposed people have, was not due to divine or evil influences.  Mesmer’s student, Marquis de Puysegur actually made the first “analytic” discovery, which marked the emergence of dynamic hypnotherapy.

In 1784 Marquis de Puysegur hypnotized a shepherd by the name of Victor who did not remember the events which occurred during his session when he came out of trance. De Puysegur then concluded that we have two independent memories; thus the unconscious was recognised for the first time! The concept was further developed in the nineteenth century and had an influence on Freud.

In the beginning hypnosis was primarily used for suggestion, which prompted Bernheim in 1888 to observe that “all was suggestion”.

The process of using hypnosis in a general framework of psychoanalysis was used by Breuer and Freud by 1895. Breuer discovered that hypnosis could be used to enable an hysterical patient to recall events that was the actual initial cause of the hysteria. This lead to the case of Anno O, which became the basis for what Freud later termed the “cathartic method”, which later became the foundation for psychoanalysis.

Breuer and Freud (1893, 1939) introduced periods of hypnosis at intervals during analysis. Gruenewald (1982) points out that Freud recognized hypnosis to assist in the revival of memories of the past when the patient was in a state of “increased suggestibility”.

The use of hypnosis led to Freud’s discovery of transference. He observed that there is a real encounter between two people during hypnosis. Mrs. Breuer and Martha, Freud’s fiancé became jealous when they hypnotized women, and it is assumed that Freud dropped the use of hypnosis due to the libidinal aspects of hypnosis and focused on the development of psychoanalysis. There must have been more behind the story, but Kline (1958) verifies that Freud was sensitive to the fact that hypnotic behaviour involved an intense emotional relationship between the hypnotist and the patient. Freud admitted some confusion and ambivalence regarding hypnosis, but Kline believes that the Freud’s reasons for abandoning hypnosis is far more complex.

The Work of William J. Bryan, Jr.

The American Institute of Hypnosis in Los Angeles was started in 1955 by William J Bryan, an MD, whose background was medicine and psychiatry, rather than psychoanalysis and psychology; the purpose being to teach “Medical Hypnotism” to doctors, dentists, psychologist and nurses.

In an effort to keep the therapy brief it became a directed therapy rather than using free association.  The procedure starts with taking a detailed case history, after which a plan for therapy is outlined.

The expectation is that the therapist, after taking such a comprehensive history, knows the diagnosis, the Etiology, and has a fairly good picture of the course of therapy, working towards a cure. We thus see that this is a medical model. To be able to confirm the diagnosis and therapy plan, the practitioner does a Word Association Test and analyses a dream; both are done under hypnosis.

Therapy proceeds where hypnosis is used in a series of age regressions to the time and events which caused, or contributed to the cause of the symptoms.  The aim is not to psychoanalyze the patient’s personality, but rather to determine the cause of the presenting symptoms in order to eliminate them. After doing this, the analytical phase is over and a tape is made summarizing the analysis.

The next phase of treatment is reinforcement and readjustment; while using re-education as part of therapy all through the sessions. The tape is used for conditioning and reinforcement of suggestion.

We see now that there are two main streams of hypnoanalys flowing parallel to each other. One consists of those who practice the essence of psychoanalysis, where they use hypnosis as an adjunct at particular times during therapy in order to achieve an immediate goal.

The other is Bryan’s independent method of utilizing and combining many principles from the fields of hypnotherapy and dynamic psychology into an organized system, independent from other systems.

The Handbook of Brief Psychotherapy by Hypnoanalysis
John A Scott, Sr. Ph.D

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