Hypnotherapy
Today forms of therapy are summarized as hypnotherapy or hypnosis psychotherapy , which u. a. use the existing knowledge about the effects of trance and suggestions therapeutically. In order to promote healing, search and learning processes, either hypnosis in a more formal sense is practiced or everyday trance processes are used for therapeutic work. In addition, hypnotherapy can also be designed as self-hypnosis training or learning (deep) relaxation exercises.
history
In Australia, Ainslie Meares was a pioneer in hypnotherapy.
In the Anglo-American area, hypnosis was first used successfully for behavioral problems, neuroses, psychosomatic illnesses and in medicine. a. by the psychiatrist Milton H. Erickson , who today is considered the founder of the most modern form of hypnosis, hypno (psycho) therapy or clinical hypnotherapy.
Procedure and methods
The scope of therapy is often limited to a few sessions. The treatment is order-oriented: the therapist works with the client to determine goals, which are pursued in further counseling and their attainment is checked at the end. The prerequisite for a successful therapy is the establishment of a trusting relationship in order to pursue the common goals.
As a rule, a distinction is made in the therapeutic context between hypnosis and actual therapeutic work. In this way, deep relaxation and so-called hypnotic trance can be induced by various methods; In the therapeutic part you can work purely hypnotherapeutically, but elements from other psychotherapeutic procedures can also be incorporated.
Characteristic, but not necessary, is the use of suggestion and the introduction and use of a state of consciousness that has been changed by previous deep relaxation, but is in any case awake. This form of wakefulness is called a hypnotic trance . Other meditation techniques such as B. mantra meditation or vocal meditation , which can also lead to trance or trance-like states, are also used today by some trained therapists hypnotherapeutically; one can then also speak of “therapeutic meditation ”.
Erickson's hypnotherapy
Modern hypnotherapy was heavily influenced by Milton H. Erickson . Erickson's hypnosis is a communicative cooperation between therapist and client, whereby the hypnotherapist helps the client to enter a hypnotic trance and to use this state for change work. In the state of deep relaxation, the control exercised by the client's consciousness is more in the background, thereby opening up access to unconscious processes. The hypnotherapist uses, among other things, metaphors, language images, analogies and word games to stimulate new ideas and possible solutions for his problems in the client in trance. The control over which of these ideas he accepts and how he uses them remains entirely with the client.
Erickson had a wider understanding of the unconscious than was customary in psychotherapy in some places. He believed that the unconscious is also a source of resources and creativity, and not, as in the narrower Freudian sense, is primarily the seat of the rejected and repressed. However, he also saw consciousness as a disruptive factor for personality changes and tried to distract the analytical mind with trance inductions in order to give the unconscious space for creative changes in the client.
In the later years of his life, Erickson no longer used classical trance inductions. He was a master of language who stimulated and used natural trance states through stories and metaphors. Erickson's language skills have fascinated many of his students. Ernest Rossi as well as Richard Bandler and John Grinder have tried to make the hypnotic language patterns explicitly learnable in their books. The effectiveness of "Erickson's hypnotherapy" has been tried and tested for many decades. Important American exponents of Ericksonian hypnotherapy are Jeff Zeig , Ernest Rossi, Jay Haley and Stephen Gilligan .
indication
The effectiveness of hypnotherapy has been proven in studies. The following table from 2003 is based on the disorders listed in the ICD-10 . The application has proven itself empirically for the disorders mentioned in the middle column. In the cases listed in the right column, the application is promising, but - so far - without sufficient empirical evidence.
| Categories according to ICD-10 | Disturbance areas with empirically proven effectiveness | Other indicated fault areas |
|---|---|---|
| Affective disorders (F3) | Depression, hypomania | |
| Anxiety disorders (F40, 41, 42) | Phobias | Panic attacks, obsession |
| Stress disorder (F43) | acute stress, post-traumatic stress, adjustment disorder | |
| Dissociative, conversion, somatoform disorders (F44, 45, 48) | somatoform pain, irritable bowel syndrome, fibromyalgia, etc. a. | autonomic dysfunction, conversions, hypochondria, dissociative identity disorder, amnesia, fugue, stupor |
| Eating disorders (F50) | Binge eating, body image in eating disorders | Bulimia, anorexia |
| Other behavioral disorders with physical disorders (F51, 52, 21) | Sleep disorders, sexual disorders | |
| Mental and social factors in somatic diseases (F54) | Surgical pain, birth pain, cancer pain, migraines, etc. a. | Tinnitus |
| Personality disorders (F60) behavioral disorders (F63–69) | Abnormal habits, sexual identity and preference disorders, early structural disorders | |
| Addiction and substance abuse (F1, 55) | Nicotine addiction | Alcoholism, abuse of psychotropic drugs |
| Schizophrenia and delusional disorders (F29) | Schizophrenia with no intellectual disability | |
| Organic brain disorders | Paralysis after insult, infarction, in MS | |
| Additionally | Obesity | |
| Children and young people | Pain control, enuresis, nausea, and vomiting in cancer | Tics, attention disorders, conduct disorders |
Contraindication
Absolute contraindication is usually in acute psychosis , psychotic states ( mania , schizophrenic episode ) and paranoid ideas . Since a fundamental motivation for therapy is necessary, antisocial personality disorders can hardly be influenced by hypnosis.
Relative contraindications are usually present when there is a risk of loss of rapport during hypnosis, as in severe borderline and narcissistic disorders . The cause is the changed reality orientation in the hypnotic trance, which can only be used if the rapport is maintained.
Its use in histrionic personality disorder is controversial. On the one hand, there is usually a high suggestibility in the patient, but on the other hand, the risk of " acting out " is suspected.
There is no direct contraindication for traumatized people, but in these cases a high degree of empathy is required. Especially in the case of victims of abuse, the situation of hypnosis with the mostly asymmetrical distribution of roles can arouse the feeling of powerlessness in the patient who is being treated therapeutically. If it is assumed that non-memorable childhood trauma triggers the symptoms, it should be noted that there is a risk of incorrect memories and induced distortions.
Recognition as a psychotherapy method
In Germany, hypnotherapy was recognized by the Scientific Advisory Board on Psychotherapy in 2006 as a scientific psychotherapy method within the meaning of Section 11 of the Psychotherapists Act for adults in certain areas of application. In Austria, hypnotherapy - under the name of "hypnosis psychotherapy" - is a legally recognized direction of psychotherapy based on depth psychology .
Recognition as a scientific psychotherapy method within the meaning of § 11 of the German Psychotherapists Act extends to the following areas of application and can therefore be taken over by the statutory health insurance companies on request:
- For adults: psychological and social factors in somatic illnesses as well as addiction and abuse (smoking cessation and methadone withdrawal).
- In children and adolescents, there is currently no area of application in which it is scientifically recognized in this sense. However, the short-term effectiveness of hypnotherapy in children and adolescents for better coping with chemotherapy for cancer and other stressful medical interventions has been proven.
Furthermore, it is not recommended as a method for in-depth training to become a psychological psychotherapist and child and adolescent psychotherapist in accordance with Section 1, Paragraph 1 of the Training and Examination Regulations for Psychological Psychotherapists.
The use of hypnosis in medicine and psychotherapy is regulated by law. It is one of the services recognized by the German health insurance companies and is also used as a supplement to many conventional methods.
In Austria, long-term training as a hypnopsychotherapist is regulated by law. It is based on scientific, psychoanalytic and depth psychological theories or approaches in connection with behavioral approaches.
Risks
The main risks involved in using hypnosis are:
- Nonspecific side effects e.g. B. Headache
- Retraumatisation through reactivated stressful memories in trance
- Decompensation and triggering of masked depression, mania, psychosis
In addition, hypnotic regression can cause harm by implanting false memories in those affected , which arise from the therapist's ideas and whose acceptance by the client can have negative consequences for the client and his environment. A large number of experimental and clinical studies have shown that actual memories obtained under hypnosis cannot be reliably differentiated from pseudo-memories generated during the hypnotic process. ( Hippolyte Bernheim already knew this phenomenon as “retroactive hallucination ”.) Many experts believe that such a distinction is fundamentally impossible; The experience reports obtained through hypnotic or hypnosis-like procedures therefore appear to them generally questionable with regard to their reality content. Highly hypnotizable people generally consider hypnotically induced pseudo-memories to be true. The phenomenon of hypnotically generated memory distortions occurs more frequently than was previously assumed and is apparently determined by contextual factors. It is typical of this type of pseudo-memories, and this is essential, that the memory material prior to hypnosis is also influenced.
See also
- Hypnoanalysis , Katathymes picture life
- Psychotherapy , humanistic psychology
- Solution-oriented short therapy
- Reparenting
literature
- Walter Bongartz , Bärbel Bongartz: Hypnotherapy. Hogrefe-Verlag, Göttingen 2000, ISBN 3-8017-1321-0 .
- Stephen G. Gilligan : Therapeutic Trance. Carl-Auer-Verlag, Heidelberg 2008, 5th edition, ISBN 978-3-89670-485-6 .
- Dietrich Langen : The stepped active hypnosis, a guide to the methodology and clinic. Georg Thieme Verlag, Stuttgart 1979, ISBN 3-13-368805-7 .
- Georg Milzner : The Poetry of Psychoses. For hypnotherapy of madness. Psychiatrie-Verlag, Bonn 2001, ISBN 978-3-88414-270-7 .
- Burkhard Peter : Introduction to Hypnotherapy. Carl-Auer-Verlag, Heidelberg 2007, ISBN 3-89670-467-2 .
- Dirk Revenstorf , Burkhard Peter: Hypnosis in psychotherapy, psychosomatics and medicine. Springer-Medizin-Verlag, Heidelberg 2009, 2nd edition, ISBN 978-3-540-24584-1 .
- Dirk Revenstorf: Expertise on the scientific evidence of hypnotherapy 2003. Expertise for the Scientific Advisory Board on Psychotherapy. Tübingen, January 2003 ( available online , accessed December 11, 2013).
- Gunther Schmidt : Introduction to hypnosystemic therapy and counseling. Carl-Auer-Verlag, Heidelberg 2005, ISBN 3-89670-470-2 .
- Lewis R. Wolberg : Hypnoanalysis , 2nd edition. Grune & Stratton 1964
Web links
- German Society for Medical Hypnosis and Autogenic Training (DGAEHAT)
- Austrian Society for Medical and Dental Hypnosis
- Hypnosis Umbrella Association Switzerland ( DHS )
Individual evidence
- ^ Revenstorf et al .: Expertise on the scientific evidence of hypnotherapy 2003. Expertise for the Scientific Advisory Board on Psychotherapy. P. 31. (PDF) Milton Erickson Society for Clinical Hypnosis (MEG), January 2003, accessed July 10, 2014 .
- ^ Opinion on the scientific recognition of hypnotherapy, March 27, 2006
- ↑ [1] ÖGATAP Austrian Society for Applied Depth Psychology and General Psychotherapy, specialist subject hypnotherapy
- ↑ Scientific Advisory Board Psychotherapy: Report on the scientific recognition of hypnotherapy
- ^ D Revenstorf: Damage through hypnosis. Z f. Hypnosis and Hypnotherapy 2011, Vol. 6, pp. 141-160
- ^ Hans-Christian Kossak : Hypnosis. Textbook for psychotherapists and doctors. Belz Verlag, Weinheim, Basel 3. Corr. 1997 edition. ISBN 978-3-8289-5270-6 , pp. 573-574.
