International Journal of Clinical & Experimental Hypnosis

A recent survey conducted by the Society of Clinical and Experimental Hypnosis Task Force for Efficacy Standards in Hypnosis Research found that clinicians reported using one or more of several different styles of hypnosis in their work. The most common of these was Ericksonian, used by over 2/3rds of clinicians, followed by hypnotic relaxation therapy and traditional hypnosis. Surprisingly, a little less than a 3rd of respondents indicated using the evidence-based practice of hypnotherapy. The present paper discusses these findings from the perspective of optimal survey methodology, examines areas of differences and overlap among response options, and considers the question of the evidence base for the practice of clinical hypnosis.

An online survey of 691 clinicians who use hypnosis was conducted in 31 countries to gain a broad real-world picture of current practices, views, and experiences in clinical hypnosis. Among 36 common clinical uses, stress reduction, wellbeing and self-esteem-enhancement, surgery preparations, anxiety interventions, mindfulness facilitation, and labor and childbirth applications were the most frequently rated as highly effective (each by ≥70% of raters) in the clinicians' own experience. Adverse hypnosis-associated effects had been encountered by 55% of clinicians but were generally short-lived and very rarely judged as serious. The most common hypnosis approaches used were Ericksonian (71%), hypnotic relaxation therapy (55%), and traditional hypnosis (50%). Almost all respondents reported regularly using other therapeutic modalities alongside hypnosis. Among a range of client variables potentially affecting therapy, most clinicians rated hypnotist-client rapport (88%) and client motivation (75%) as very or extremely important factors for successful hypnotherapy. The majority of respondents had conducted hypnosis treatment via teletherapy, and 54% of those estimated it to be as effective as in-person treatment.

Rumination is a clinical phenomenon that causes significant distress in clients who suffer from various psychological and physical disorders. It also has a deleterious impact on both therapeutic process and outcome. One approach that holds promise to manage rumination is mindfulness meditation in combination with clinical hypnosis. This article: (1) reviews the concept of and techniques to manage rumination in the Buddhist psychological framework, (2) introduces 2 simple mindfulness-based techniques to deal with rumination, i.e., mindful thought detachment and mindful dereflection, and (3) describes 2 case studies in which these strategies were applied successfully. Hypnosis-informed clinicians are encouraged to integrate these approaches in their practices.

Previous research has shown promising results in using hypnosis to treat various symptoms and side effects of medical treatments. The objective was to identify studies that use hypnosis as an adjuvant to evidence-based treatments to evaluate its benefits in patients with cancer. The search identified 873 articles published between 2000 and February 2021, of which 22 were selected using the principles of the PRISMA. Apart from 1 study, all studies showed that interventions improved the measured variables compared to a control group. Most studies showed that hypnosis has positive effects on reducing anxi-ety, pain, nausea, fatigue, drug use, and length of hospital stays. Hypnosis also improves depressive symptoms, insomnia, hot flashes, well-being, and quality of life, and helps increase adherence to treatment. When used by qualified professionals as an adjuvant to well-established treatments, hypnosis improves symptoms caused by oncological interventions and the disease itself. In addition, hypnosis has no side effects.

The insertion of a nasogastric (NG) tube is often a difficult experience for both patients and caregivers. This often results in a high failure rate of NG insertion. This pilot study aimed to evaluate the effectiveness, tolerance, and acceptability of hypnoanalgesia to assist self-insertion of an NG tube. Patients undergoing high-dose chemotherapy for autologous or allogeneic hematopoietic stem cell transplantation (HSCT) or acute leukemia and with high risk of aplasia were included in the study. A total of 38 patients were included during 6 consecutive months. They all achieved successful NG tube self-insertion. The NG tube remained in place during hospitalization in 32 cases for an average duration of 15 days. Six patients rejected the NG tube during vomiting but they all voluntarily attempted it again later on and succeeded. The discomfort related to NG-tube insertion was mild. This pilot study suggests that NG tube self-insertion assisted by hypnoanalgesia may be effective, well-accepted, and well-tolerated in patients. These promising findings will need further confirmation.

This systematic review aims to identify current protocols involving the use of hypnosis during the perinatal period and to examine its effects on mothers' well-being. Seven electronic databases were searched for articles published from 1960 to April 1, 2021, that assessed the effectiveness of hypnosis during the perinatal period. All published randomized, controlled trials and nonrandomized, controlled trials studies assessing the effectiveness of hypnosis used during the perinatal period with healthy adult women were included. The quality of the included studies was assessed using the Risk of Bias in Nonrandomized Studies of Interventions or the Revised Cochrane risk-of-bias tool for randomized trials. Article screening, methodological-quality assessment, and data extraction were performed by 2 independent reviewers. Twenty-one articles, corresponding to 16 studies met inclusion criteria. Apart from 2 studies, all included studies reported the benefits of implementing a hypnosis intervention during the perinatal period. However, methodological limitations relative to intervention implementation and assessment methods might have led to the observed variability in results across studies. Future studies should consider a more standardized methodology.

When individuals score high on hypnotizability, they usually report experiencing an altered state of consciousness, physiological changes, and attentional shifts during hypnotic induction procedures as well. We hypothesize that a better interoception of such internal changes is also relevant for accurate sleep perception. We compared subjects scoring high versus low on hypnotizability to the accuracy of their estimations of Sleep Onset Latency (SOL) time awake, and sleep depth and explored their objective sleep. We sampled seven studies performed in our sleep labs across a midday nap or a night resulting in n = 231 subjects (aged 30.11 (SD = 17.02) years, range 18-82 with 15.2% males). Hypnotizability did not influence the accuracy of the perception of time needed to fall asleep or time spent awake. However, the reported sleep depth correlated significantly with the measured amount of slow-wave sleep in high hypnotizables. This pattern appeared across a nap as well as a whole night's sleep studies. We did not find any significant differences in objective sleep patterns depending on hypnotizability. Probably, high hypnotizables benefit from a better interoceptive ability for their perception of their sleep depth.

The purpose of this study was to investigate the feasibility, acceptability, and potential effect of a novel hypnotherapeutic intervention, informed by positive psychology, to enhance well-being in college students. The present study investigated adapting hypnotic relaxation therapy for enhancing well-being (denoted as HRT-WB). Twenty-seven college students were enrolled in a 5-week intervention of HRT-WB and instructed in daily home practice of HRT-WB self-hypnosis using audio recordings. Participants completed baseline and endpoint measures of well-being and symptoms of psychological distress. Results showed participants who received the HRT-WB intervention experienced improvements in subjective well-being as well as reductions in psychological distress. At endpoint, 71% of the participants who completed the HRT-WB intervention were categorized as experiencing high levels of well-being, or flourishing. In addition, HRT-WB is a feasible intervention, with high rates of retention, compliance with home practice, and satisfaction. Based on these promising results, further research into HRT-WB is warranted. HRT-WB could be a well-accepted, easily administered, and effective means of addressing well-being and enhancing flourishing.

Until now, there has been an acute shortage of valid and reliable tools in Russia for making an accurate and highly differentiable assessment of hypnotizability. However, numerous studies confirm the high efficiency, reliability, and accuracy of the Elkins Hypnotizability Scale (EHS), allowing it to claim the title of the new gold standard for assessing hypnotizability. In the present study, the original English-language version of the EHS was translated into Russian. One hundred and five volunteers from Moscow (42% male; 58% female), aged 19 to 44, underwent a hypnotizability assessment procedure according to the EHS protocol. The Russian version of the EHS, like the original, requires an average of 28 minutes to administer and score by a trained assessor. The results showed that the Russian version of the EHS has good internal consistency and does not contain unnecessary elements. Alpha Cronbach values (0.76), and the item-total correlations (rs = 0.44-0.64) are satisfactory.

Hypnosis interventions have too often failed to disseminate, in part because of the relatively few high-quality, randomized clinical trials. The Task Force proposes efficacy guidelines, which are intended to improve the quality of clinical hypnosis research and thereby increase dissemination of beneficial hypnosis interventions. However, the Task Force, in muddying the focus on efficacy with opinions about moderation and mediation, proposes guidelines that are likely to: (1) weaken efficacy findings; (2) increase participant mistrust; (3) make efficacy trials more cumbersome; and, (4) treat hypnosis as though it were something other than a time-honored form of talk therapy. While applauding the Task Force's intentions, the current recommendations could be changed to better accomplish their goal of increasing hypnosis dissemination and implementation.

This retrospective study was a nonrandomized comparison of exercisers’ (runners and participants of a spinning class) states of consciousness with subjects of active-alert hypnosis (AAH) and students in a class (control). Three hundred and seventy-five participants completed the Phenomenology of Consciousness Inventory (PCI). Runners, spinners, and participants of AAH scored higher on the altered experience and altered state of awareness dimensions of the PCI than the control group. Runners scored higher than participants of AAH and the control condition on the rationality dimension, and spinners scored higher than participants in the AAH condition. The AAH group scored lowest on the self-awareness dimension. On the volitional control dimension, the spinning and control groups scored significantly higher than the runner and AAH groups. The results suggest that exercise may lead to states of consciousness similar to AAH and thus increase responsiveness to a coach’s training suggestions.

Increasing evidence suggests that the gut-brain axis may play a key role in health and disease via a bidirectional communication network involving neural and immunoendocrine pathways. This complex interplay deeply influences both gut microbiota and brain behavior. Pathobiome or gut dysbiosis is relevant for the pathogenesis of functional gastrointestinal disorders, such as IBS, chronic pain syndromes, and neurological and mental disorders. As a consequence, targeting the gut microbiota is emerging as a novel, effective therapeutic perspective. Among many treatment options, psychological interventions, including hypnosis, have been used to target the so-called psychobiome and its hypnotic analogue, i.e., hypnobiome, referring to their potential efficacy to modulate the mind-gut axis in IBS patients. A narrative review of the recent literature is provided and circumstantial evidence suggests that hypnobiome may represent a new promising frontier of hypnotherapy.

The abeyance of self-consciousness (SC) during hypnosis has been discussed as a central aspect of hypnosis, yet dispositional SC has been very rarely evaluated as a correlate of hypnotizability. In this study (N = 328), the authors administered the Harvard Group Scale of Hypnotic Susceptibility (HGSHS), the Inventory Scale of Hypnotic Depth (ISHD), and the Self-Consciousness Scale-Revised (SCS-R). Women tended to score higher than men on the HGSHS, besides experiencing greater ISHD automaticity. The Discontinuity (with everyday experiences) subscale of the ISHD correlated with the Public Self-Consciousness scale of the SCS-R and with the Private Self-Consciousness subscale (using simple, quadratic, and cubic regressions). Being concerned about the perception of others related to experiencing hypnosis as discontinuous with everyday life, which also related to being more introspective and interested in subjectivity at the middle range of scores. The article concludes with suggestions on how to pursue the implications of these results, including testing for nonlinear relations. ARTICLE HISTORY

Meditation and hypnosis have both been found to attenuate pain; however, little is known about similarities and differences in the cognitive modulation of pain. Hypnotic and meditative states (e.g., mindfulness) reduce pain by sharing and overlapping multiple neuro-cognitive mechanisms, but they differ in many respects. While there are overlapping brain networks involved, the nature of these effects seems different. Both phenomena involve frontal modulation of pain-related areas. The role of the dorsolateral prefrontal cortex appears to depend, in hypnosis, on the type of suggestion given and, in meditation, on the level of practice. Whereas the anterior cingulate cortex seems to be a key node in both hypnosis and meditation, the dorsolateral prefrontal cortex appears to engage in hypnosis as a function of suggestion and, in meditation, as a function of proficiency.

Stomatodynia is an oral dysesthesia with a psychosomatic component. Twelve consecutive patients with stomatodynia were offered hypnosis sessions. Measures of anxiety, depression, and pain were administered before the first and after the last hypnosis session. Pain severity was assessed with a Numeric Rating Scale (NRS). Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS). The data were collected retrospectively from medical records on the 12 patients. The difference between NRS pain ratings and HADS scores before and after hypnosis was significant (p < .05). Six patients reported receiving treatment for stomatodynia before hypnotherapy; 3 of them stopped treatment for stomatodynia before completion of the hypnosis intervention. Results provide support for potential positive effects of hypnosis intervention for stomatodynia and point to the need for additional research on this issue.

Three experiments studied recognition during posthypnotic amnesia (PHA) employing confidence ratings rather than the traditional yes/no format. As the criterion for recognition was loosened, an increase in hits was accompanied by an increase in false alarms, especially to distractor items that were conceptually related to, or semantically associated with, targets. Nevertheless, hits exceeded false alarms at every level of confidence. In addition, amnesic subjects had difficulty identifying the particular list on which recognized items were presented for study or the correct order in which targets appeared on the study list. Taken together, these findings support the conclusion that successful recognition during PHA is more likely to be mediated by a priming-based feeling familiarity than conscious recollection.

Recent studies have suggested that mindfulness meditation and hypnosis are similar, but there is a lack of empirical data to support this claim. In this current study, college students were randomly assigned to a hypnosis or mindfulness meditation condition, and they were tested on the Waterloo Stanford Group Scale of Hypnotic Susceptibility, Form C. Results from this study suggest that, while under hypnotic induction and after engaging in mindfulness meditation, participants experienced similar results on the WSGC. That is, participants experienced the same bodily feelings and reactions regarding a standardized hypnotic suggestibility test.

This study aimed to assess the feasibility of Attention Restoration Theory (ART)-driven hypnotherapy to address cancer-related fatigue (CRF). Six participants with CRF completed the study. Participants completed measures of fatigue and pain pre- and posttreatment of 5 sessions of ART-driven hypnotherapy, each of which followed a treatment manual. Results indicate that participants experienced reductions in fatigue, fatigue bothersomeness, and pain following the intervention. Additionally, participants reported high levels of treatment satisfaction. This innovative intervention of ART-driven hypnotherapy appears to be feasible and warrants further study in a controlled trial with a larger sample.

Emotional distress, communication, and dyadic coping difficulties are common among cancer patients and their partners. Hypnosis-based interventions can improve emotional distress in patients. We designed a group intervention combining self-hypnosis and self-care techniques. We hypothesized an effect of the intervention on emotional distress, conjugal communication, and dyadic coping, considered in patients and their partners. Our exploratory controlled study included 55 women with cancer and 55 partners. Participants completed questionnaires before and after the intervention, which was delivered to patients only. No significant effect of the intervention was revealed for patients or partners. Positive correlations between patients' and partners' communication and dyadic coping were revealed. However, to address couples' or partners' difficulties, interventions specifically designed for couples or partners must be tested.

This case study examined the effects of a clutch-based hypnotic intervention on the performance and experience of a senior PGA tour golfer. The intervention encompassed hypnosis, regression imagery, a trigger control technique, and a preshot routine. Golf performance data were analyzed using a single-subject design. The results indicated that the player's mean stroke average decreased from baseline to postintervention. The qualitative data suggests that the hypnotic intervention may help golfers regulate emotions, thoughts, feelings, and perceptions associated with a clutch state experience.

Dysphagia, the perceived impediment to swallowing food, is a common postsurgical symptom that can have debilitating consequences. This study presents the successful treatment of severe esophageal dysphagia with a problem-focused and patient-centered approach to hypnosis, informed by long-term empirical follow-up. The authors describe a case history involving significant and persistent difficulty swallowing for which no medical or surgical treatment could be found. Over the course of 10 sessions, the patient was assessed, treated with imaginal exposure, and instructed in self-hypnosis. Outcomes were measured at treatment conclusion, and 6-, 9-, and 18-month follow-ups. Following hypnosis, the patient exhibited significant and reliable change (RC) in visceral hypersensitivity (RC = −3.16, p = .002), emotional distress (RC = −2.21, p= .03), subjective well-being (RC = 4.14, p< .0001), and posttraumatic symptoms (RC = −3.33, p= .001). Gains were maintained at 18-month follow-up.

Pain is common in patients with multiple sclerosis. This study evaluated self-hypnosis for pain control in that population. A randomized clinical trial was conducted on 60 patients, who were assigned to either a control group or to a self-hypnosis group, in which patients performed self-hypnosis at least 10 times a day. All patients were trained to score the perceived pain twice daily on a numerical rating scale and also reported the quality of pain with the McGill Pain questionnaire. Repeated-measures analysis showed a significant difference between the groups; pain was lower in the self-hypnosis group but was not maintained after 4 weeks. Self-hypnosis could effectively decrease the intensity and could modify quality of pain in female patients with multiple sclerosis.

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.

The division of cognition into primary and secondary processes is an important part of contemporary psychoanalytic metapsychology. Whereas primary processes are most characteristic of unconscious thought and loose associations, secondary processes generally govern conscious thought and logical reasoning. It has been theorized that an induction into hypnosis is accompanied by a predomination of primary-process cognition over secondary-process cognition. The authors hypothesized that highly hypnotizable individuals would demonstrate more primary-process cognition as measured by a recently developed cognitive-perceptual task. This hypothesis was not supported. In fact, low hypnotizable participants demonstrated higher levels of primary-process cognition. Exploratory analyses suggested a more specific effect: felt connectedness to the hypnotist seemed to promote secondary-process cognition among low hypnotizable participants.