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

Once upon a time: Narrative storytelling, hypnosis, and the brain

The article explores the nature of narrative, its impact on key neural circuits in the brain, and the role of those activated circuits as drivers of hypnotically guided personal change. The author views clinical hypnosis as a form of interactive reciprocity that engages clients' neuroplastic potential (i.e. trance). This emergent potential is evoked during the therapeutic interaction between a client and clinician. Furthermore, the author describes clinical hypnosis as using forms of suggestion to facilitate change to the self-reinforcing narratives to which clients subscribe. Suggestions themselves are viewed as activating non-consciously mediated aspects of the self, which are perceived by the conscious mind as non-volitionally facilitating the desired change. The author draws on research supporting the view of the self as a construct maintained by an internalized narrative that remains capable of revision, though not always easily or without external assistance. That self-narrative revision entails the change that hypnosis seeks to enable and enact. The article concludes that deliberate incorporation of forms of narrative, including the use of metaphors, for example, constitutes the essential fuel without which the engine of hypnotic change efforts can languish. This is because narrative processes occupy an indispensable role in energizing - neurologically, psychologically, and socially - the outcomes that hypnosis is intended to evoke. The article uses excerpts from different fictional narrative sources to illustrate the article's main thesis.

Why all child clinicians should be hypnosis-informed. Advantages, benefits, creativity, & development: ABC's & D

This paper advocates for all child clinicians to learn hypnosis skills as a distinct advantage to enhance their understanding of child development in the treatment of children. It examines the interface of child development and hypnosis. Clinical hypnosis with children follows the child's developmentally determined self-expressions. The clinician must tend to the way in which the child expresses a "problem," structuring treatment goals and pace, and evoking and utilizing opportunities for therapeutic suggestion. This article defines hypnosis as a set of skills and principles. It defines trance as psychoneurobiological plasticity. Eight variables, shared across therapeutic interventions, are explored in the context of working hypnotically with children and adolescents. These are 1) Relationships, rapport, attachment; 2) Attention, absorption, focus; 3) Use of language and therapeutic suggestions; 4) Expectations; 5) Resources; 6) Dissociation and Unconscious; 7) Trauma parallels with trance; 8) Development. Becoming hypnosis-informed is the ABC's, & D, for child clinicians. A case illustrates the application of skills, principles, and variables.

The "well-sibling" syndrome: Hypnosis for the siblings of special needs children

Often overlooked by caregivers because of their ability to adapt to a challenging home life by making few demands themselves, the siblings of special needs children have unacknowledged needs of their own. They often are reluctant to participate in therapy because of their self-concept of having to be the "normal" or "perfect" child. Therapy with these children requires non-pathologizing and attuned rapport building focused on creative self-exploration without requests for change. Two composite case vignettes illustrate the power and versatility of clinical hypnosis to facilitate new learning about becoming visible in the therapeutic relationship and beyond.

Things that go bump in the night

Sleep disturbances take many forms. Negative health consequences are associated with nearly all of them. Insomnia, the most common sleep disturbance, can present as an inability to initiate sleep or to maintain sleep such that the restorative benefits of sleep are limited. This case report describes a client in her 60s who sought treatment for early morning awakening that persisted for four years despite the use of sleep-inducing medications. Her successful course of treatment utilized hypnotic suggestions and interactions that targeted distinctive features of the sleep cycle as well as her daily transition from wakefulness to sleep to early morning reawakening. The article highlights the coordination of neurophysiological features of sleep, psychological dynamics at play while awake and in her dream sleep, and how attention to their interplay utilizing hypnosis enabled the client to reestablish restorative sleep patterns in a treatment process spanning less than a dozen treatment sessions.

The role of hearing and listening in hypnotic responsiveness

The hypnosis literature emphasizes features of suggestion, induction, and communication that are described as evoking heightened responsiveness on the part of the subject or client. This article explores what is often overlooked: to have an effect, the subject must not only hear the suggestion but listen to it. The process of listening is described across multiple levels ranging from the acoustic signal to its transduction into a meaning-filled and motivationally enriched message that spurs action. That journey traverses challenging terrain, with numerous obstacles that serve to maintain past habits and response patterns, despite a client's stated desire for adaptive change. The article highlights those obstacles and then provides descriptions of five language structures that can reach the client consciously or non-consciously, but always in ways that increase the odds that the therapeutic messaging is packaged in a manner that optimizes it being "heard," absorbed, and enacted. Applications of each language structure are provided using relevant clinical case examples.

Impairment of Hypnosis by Nocebo Response and Related Neurovegetative Changes: A Case Report in Oral Surgery

This article presents the third molar removal in a highly hypnotizable patient, who had been successfully submitted to oral surgery with hypnosis as stand-alone anesthesia in previous sessions. Unexpectedly, hypnosis initially failed, as a result of a nocebo response due to a previous dentist's bad communication; two complaints made by the patient were associated with increased sympathetic activity (as defined by increased heart rate and electrodermal activity and decreased heart rate variability). After deepening of hypnosis, the patient achieved a full hypnotic analgesia allowing for a successful conclusion of the intervention, an event associated with decreased heart rate, electrodermal activity, and increased heart rate variability. Hence, the initial failure was paralleled by a decreased parasympathetic activity and increased sympathetic activity, while hypnotic analgesia was associated with the opposite pattern. The patient's postoperative report indicated that the initial failure of hypnosis depended on a strong nocebo effect because of a previous dentist distrusting hypnosis and persuading her that it was not enough to face a third molar removal.

Hypnosis and Hypnotic ability between old beliefs and new evidences: An epistemological reflection

The history of hypnosis has been marked by its effectiveness paralleled by prejudicial refusal, due to its ostensible incompatibility with the ruling Weltbild (picture of the world). Its interpretation has been mainly based on concepts like suggestibility, dissociation, hallucination, impairment of sense of agency, and free will. Nevertheless, little evidence and agreement has been reached so far on the nature of hypnosis and hypnotic ability, an uncertainty enhanced by the wide range of meanings and ambiguities of the used terms. This article analyzes the main epistemological implications involved in the topic.

Preserved critical ability and free will in deep hypnosis during oral surgery

Free will is a complex construct that includes critical reasoning, sense of ownership, and agency. The whole history of hypnosis has been linked to suggestibility. Little agreement has been reached, however, on exactly what we mean by suggestibility, and its role in hypnosis, despite the abundance of studies, hypotheses, and theories published to date. We report on a highly hypnotizable patient with a previous allergy to lidocaine and paradoxical reactions to pharmacological sedation, who underwent oral surgery with mepivacaine for local anesthesia, and hypnosis for sedation. During the procedure, she felt some pain and the hypnotist recommended bupivacaine to ensure lasting anesthesia. While remaining under deep hypnosis, the patient refused to change anesthetic and decided autonomously to continue with mepivacaine (for which she had previously been tested for allergy). Our case clearly shows a preserved, exemplary reasoning and ability to make autonomous decisions diverging from the hypnotist's advice while under deep hypnosis.