Client-Centred Hypnotherapy - Old Concept - New Application.

Abstract

The concept proposed in this paper combines the methodological approach of hypnosis
with the client-centred counselling approach of Carl Rogers (Rogers,
1946). The concept of Client-Centred Hypnotherapy proposes that increased benefits
are achieved if the hypnotherapist uses the client's reality as the foundation
for the therapeutic intervention. The paper outlines the perceived benefits
and limitations of the Client-Centred Hypnotherapy approach within the
structure of current hypnotherapy training.

Full text

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Client-Centred Hypnotherapy – Old Concept - New Application
Leon W Cowen
Clinical Hypnotherapist, Sydney
Abstract
The concept proposed in this paper combines the methodological approach of hypnosis with the
client-centred counselling approach of Carl Rogers (Rogers, 1946). The concept of Client-Centred
Hypnotherapy proposes that increased benefits are achieved if the hypnotherapist uses the client’s
reality as the foundation for the therapeutic intervention. The paper outlines the perceived benefits
and limitations of the Client-Centred Hypnotherapy approach within the structure of current
hypnotherapy training.
Introduction
This paper’s objective is to put forward a model of Client-Centred Hypnotherapy (CCH) for
exploration and further discussion. Client-Centred Hypnotherapy is a style of hypnotherapy in
which clients retain responsibility for their change within a supportive therapeutic environment. The
skill sets required to implement the CCH model are based in hypnotherapeutic counselling and
hypnotherapy. The proposed CCH model is an adaptation of the Client-Centred Therapy model
developed by Carl Rogers, using many of the same concepts proposed by Rogers, posited within the
hypnotherapy paradigm.
The CCH model also has the capacity to be assimilated into various hypnotherapeutic models, for
instance the authoritarian or permissive approaches. Using the CCH model brings client benefits
such as increased rapport, respect, and automatic acknowledgment of the client’s representational
system. These benefits are heightened as the therapist moulds the consultation from within the
client’s often incongruous reality. As with all models, there are limitations, such as a lack of client
insight, or the refusal of the client to take responsibility for him/herself.
Discussion
CCH differs from traditional hypnotherapy. Traditional hypnosis training has primarily adopted the
authoritarian model (Heap & Aravind, 2002) which promotes direct suggestions given by the
hypnotherapist to achieve the subject’s goal. The derivation of the suggestions is based on the
hypnotherapist’s perception of the client’s condition, and his or her evaluation of what is required to
achieve the client’s goals. CCH differs in application and methodology. Devising questions from

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the client’s own words, gestures, and signs is a primary skill. The hypnotherapist is careful to not
insert his or her own words or belief systems. Questions are primarily derived from the client’s
previous statements with emphasis on refining the exact meaning of these specific words, gestures,
and signs which are called id-entity(ies).
The term ‘id-entity’ was devised by the author to identify the unique qualities of innate words,
vocalisations, gestures and signs which denote each client’s issues. The term is comprised of two
components; the first being ‘id’, which in Freudian psychoanalytical theory is the part of the
personality which contains our basic instincts (Heap & Aravind, 2002), primitive instincts and
energies which all psychic activity (Corey, 2005)underpin . ‘Entity’ refers to that fundamental
aspect of the individual which is a constituent part of self (Sleeth, 2006). The use of the Freudian
term id does not in any way reflect CCH as based upon Freud’s theories. The word ‘identity’ (from
which id-entity is gleaned) is a common word, but when hyphenated, as in id-entity or id-entities, is
intended to denote the conduits to the deepest issues which come from the basic instincts or core of
the client.
Hypnotherapeutic counselling is integral for CCH. It is important to acknowledge that the CCH
model may use reflective listening but attunes to id-entities. The term id-entities refers to the innate
key vocalisations, integrated gestures and signs which are explicit to the client at that particular
time. They have direct meaning to the client and may be utilised during any aspect of the
hypnotherapeutic intervention. For example, they could be referenced when giving suggestions or
as a means of regression during hypnoanalysis. Since hypnotherapy is an agent of change it is vital,
before the id-entity is used in a follow-up consultation, to determine that its specificity is still
active. Identifying the id-entities during the consultation’s counselling phase is a key component in
determining the client’s reality.
The CCH model presupposes that the client has the capacity to take responsibility for his or her
reality and choices (Boeree, 2006). The premise is that if individuals feel free they will accept
responsibility, and participate in every aspect of their lives. If autonomy, (freedom with
responsibility), is what you the therapist are helping a client to achieve, then they will not achieve it
if they remain dependent on you (Boeree, 2006). The therapist’s task is to be congruent within the
therapeutic relationship, often using reflective listening to mirror unconditional positive regard
(Samstag, 2007). The outcome of the therapeutic relationship is to assist the client to gain insight
and understanding (Rogers, 1957). CCH shares some primary principles with Rogers’ Client-
Centred Therapy (Rogers, 1946). The shared principles are:
• the individual is basically responsible for himself or herself,

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• simple behavioural limits are set
• there are no attitudinal limits and the environment is non-judgemental (de Carvalho, 1999)
• the therapist uses only those procedures and techniques which a) promote deep
understanding of the emotionalised attitudes expressed, and b) are accepted by the client.
The CCH model uses several additional principles. These are:
• the client’s reality is the only reality which exists
• the client’s id-entities are vital as conduits to issues in therapy
• the client wants to change
• the client’s aim is self-acceptance
• the therapist challenges the client’s reality from within the client’s reality.
For the purpose of the CCH model, the client’s reality is comprised of all the information contained
within the client. Using the client’s reality promotes a relationship with the client. The client feels
acknowledged, heard, respected, and empowered. The client’s opinion matters even though it may
be challenged by the therapist. Because the hypnotherapist is using the client’s id-entities (exact
words gestures and signs), communication is enhanced, and the client’s frame of reference as well
as his or her representational system is acknowledged (visual, auditory, or kinesthetic). The social,
cultural, personal, and interpersonal influences that coalesced into the construction of the client’s
belief systems are a constantly changing aspect at both the conscious and subconscious levels. It
would not be expected that the scope of the client’s awareness would be totally conscious. Clients
must, by definition, have issues with their reality or they would not be seeking a therapeutic
intervention. Clients explain their subjective perceptions of reality in their id-entities. It is these id-
entities which the hypnotherapist uses for the counselling and hypnotherapeutic intervention. This is
contrary to the medical model which deals with objective experience. In the medical model
objective tests and assessments lead to medical assessment on which treatment is based. The client-
centred model has no capacity to make these objective assessments. The practitioner must rely on
the client’s subjective perceptions and, by following the CCH principles, the therapist then discerns
and challenges the client’s paradoxes and incongruities.
Challenging the client’s perspective is a basic tenet of Client-Centred Hypnotherapy. If a
contradiction manifests, the methodology demands that the hypnotherapist challenges the client’s
belief system in accordance with the contradiction. The challenge maintains the client’s reality by
relating the challenge to the client’s subjective experience. Skilful challenging of the client’s reality
crystallises the client’s experience and allows the hypnotherapeutic intervention to be precise. A
challenge to “I can’t get to sleep” could be as simple as “How do you keep yourself awake?”
Clients can also be challenged by being offered an alternative behaviour whilst being allowed to

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maintain their own reality. A challenge to “I can’t get to sleep” could be “What would happen if
you did?” This maintains the client’s reality yet reframes his or her perspective and encourages him
or her to seek a new awareness. If the client responds to a posed question with “I don’t know”, the
challenge could be, “If you did know, what would it be?” This again supports clients whilst they
consider alternatives to their current realities. The primary criterion is that the hypnotherapist uses
the client’s id-entities within the therapeutic challenge and does not impose his or her reality onto
the client. This demonstrates respect, underlines the client’s responsibility for himself, and affirms
the client’s reality.
Leading is explicitly in contradiction to the Client-Centred Hypnotherapy model. Leading is defined
as giving the client more or different information than that which they have supplied pertaining to
their personal structure or situation. An example of leading would be defining the client’s problem
by imposing the therapist's reality onto the client's reality. The id-entities cannot be considered as
leading because they were introduced by the client. Micro-skills such as paraphrasing, empathy, and
advanced accurate empathy, which are used extensively within counselling, may change the client’s
exact words (Ivey, Ivey, & Simek-Morgan, 1993) and id-entities. If this happens, the precise
meaning and emotional content of the id-entities will not be retained. As the use of id-entities is a
focal point of the CCH model, any methodology which promotes any variation of the client’s id-
entities, contravenes the Client-Centred Hypnotherapy model.
Client-Centred Hypnotherapy also assumes that clients have:
• the ability to perceive their own realities, conditions, and symptoms
• the ability to perceive alternatives to their conditions and symptoms
• the ability to take responsibility for themselves
• the ability to choose the best alternative to their conditions and symptoms
• the ability to implement the chosen alternatives to their existing conditions and symptoms.
It is acknowledged that many clients require professional assistance to accurately perceive, choose,
and implement their alternatives. Therefore the CCH model requires that the hypnotherapist must
have the requisite proficiencies to assist the client. The implementation of the CCH model would
therefore involve proficiencies of counselling, psychotherapeutic concepts, and methodologies
derived from learning, psychodynamic, existentialist/humanistic, and interpersonal paradigms
within the overall concept of hypnotherapy and the client-centred approach. The hypnotherapist
needs to assist the client to understand his or her own sensations surrounding the issue. Without this
clarity the hypnotherapist cannot use the id-entity(ies) in a meaningful intervention. If the client
lacks the capacity to fulfil the assumptions, then a different therapeutic model would be required.

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Whilst it could be construed from this that the therapist remains neutral throughout the interaction,
it is clear that, although the hypnotherapist may not incorporate his or her own words or concepts,
the hypnotherapist is anything but neutral. CCH concepts (as described by Rogers (Boeree, 2006))
promote the therapist qualities of Congruence (genuineness, defined as honesty with the client);
Empathy (defined as the ability to feel what the client feels), and Respect (acceptance, defined as
unconditional positive regard towards the client). The therapeutic process is balanced on the
hypnotherapist’s choice of which id-entity (the client’s words/gestures/signs) to use in the therapy
process. The therapist’s choice of which id-entity to use will greatly influence the therapeutic
pathway and this must be based on the therapist’s professional judgement. This single point
illustrates the major, albeit indirect, influence of the hypnotherapist on the relationship.
Client-Centred Hypnotherapy methodology is incorporated into the standard hypnotherapy
consultation model. Using id-entities gleaned from the counselling phase of the consultation, the
hypnotherapist would use the id-entity(ies) as the focus of the suggestions. The application of CCH
in Regression would require the id-entity(ies) to become the focus of the selected Regression. For
example, if the client had a phobia and described the fear as overwhelming, the id-entity would be
‘overwhelming’ plus its associated feelings. The Regression would then be established using
‘overwhelming’ (and the associated feelings) as the process for the technique.
The only mechanism to identify the id-entity is within an actual client scenario. It cannot be role
played or simulated, as the identification of the id-entity involves catharsis (or lack thereof) when
the core issue is accessed. The hypnotherapist does not interpolate the client’s id-entity(ies). The
hypnotherapist uses the unique id-entity (word, tone etc) as a channel to create a pathway from the
id-entity, the client’s core issue. An example of this occurred during a teaching seminar in which
participants were endeavouring to identify the id-entity of a volunteer. All participants were advised
that the exercise could promote real issues and agreed to seek assistance (if required) after the
workshop. As I attended each group to assist in the exercise, one group believed they had
‘identified the client’s id-entity’. The case was of a woman, approximately 40, who was fearful of
hospitalisation for a routine operation. Her fear seemed to link to the fact that on a previous
occasion she had woken from an operation with tubes exiting her body. The group leader believed
that this occurrence was the reason for the existing fear. Whilst this seemed logical, when the client
recounted her story (her distress was obvious) there seemed to be incongruence between her fear
and her distress. The fear seemed to greatly exceed the amount of distress being manifested. Further
questions were required to distil the specific cause. The consequence of these questions was that the
client realised that it was not the various tubes exiting her body which had elicited her fear, but
rather the tube down her throat restricting her speech. Her id-entity was ‘take it out’. These words
linked to her extreme fear as she desperately tried to get the medical staff to remove the

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endotracheal tube. The feelings she demonstrated (and reported) during the additional questioning
demonstrated that the id-entity was achieved. Several days later she contacted me to report that she
had been struggling with this issue for several years. Never before had she been as specific with her
therapist, who had always stopped just prior to the id-entity. By contrast she was now able to
recount the id-entity experience to her therapist, with the result that therapy had a new perspective
and a considerable shift in her awareness of her fear.
The utilisation of the id-entity is dependent upon the therapist’s creative ability to integrate it at
appropriate junctures in the intervention. The hypnotherapist will assess the efficacy of the
intervention by monitoring any changes in the related feelings to the id-entity(ies) used in the
process, and any associated behavioural changes. The effectiveness of the intervention will be
determined by the client’s reaction or lack of reaction to the ‘overwhelming’ id-entity. This will
determine the evolution and sequencing of the consultations.
It must be acknowledged that all models have their benefits and limitations, and the proposed CCH
model is by definition merely analogous. Space limitations preclude in-depth analysis of these
issues but could form the foundation of a further article. Limitations to the efficacy of the CCH
model may occur if:
• the consultation is primarily limited to the client’s topic selection
• the client wants the hypnotherapist to provide the solution to his or her condition
• the client’s reality may be undifferentiated or obscure
• the clients may refuse (or be unable to take) responsibility for themselves
• the client may not want to change
• the client may not have the ability to perceive alternatives
• the client may not respond well to challenges provided by the hypnotherapist
• the client may not want self-acceptance.
If these or other limitations exist, it may result in the client having no capacity to access his or her
own knowledge and resources. This inability can hinder the client’s ability to help her or himself.
At this point the hypnotherapist would be required to choose between maintaining the CCH
approach or using a different therapeutic model. Where the client is a mature, fully-functioning
person, the lack of capacity can be challenged and the model can be maintained. If the client is not a
fully-functional person by way of age or incapacity, then a case can be made for discarding CCH
for a more appropriate model.
Conclusion

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This paper highlights the baseline characteristics that define Client-Centred Hypnotherapy. Client-
Centred Hypnotherapy offers an alternative model of hypnotherapeutic intervention by combining
aspects of hypnotherapy with client-centred therapy. Traditional hypnotherapy training does not
include client-centred therapy. However, it appears that skilled hypnotherapists are already using
this therapeutic combination and have done so throughout their professional careers. The significant
elements of the Client-Centred Hypnotherapy model are increasingly being identified and
described, thus enabling more discussion and research to be undertaken.
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