 Magazine
for Hypnosis and Hypnotherapy
HYPNOSIS WITH SUBSTANCE ABUSERS (continued) DISCUSSION Since prehistoric time, people have used central nervous system intoxicants to alter states of consciousness, relieve physical or mental pain, and produce euphoria. Although the most popular drug has been nicotine (Davison & Neale, 1978), alcohol, opium, and cannabis have been universally used. In contemporary times, synthetic drugs like barbituates and amphetamines have become available. Only when drugs produce behavior unacceptable to the community or cause serious health problems to those who use them does the problem of substance abuse arise and the need for treatment is identified. Because the abuse of any of the drugs is assumed, at least initially, to be under the voluntary control of users, abuse is learned (Wadden & Anderton, 1982). Whether abuse or addiction is best understood as an impulse disorder (Spiegel & Spiegel, 1978) or as neurotic symptoms (LeCron & Bordeaux, 1949), we think about substance abuse as pathological dependence and a habit. Habits can be altered by hypnotic intervention depending upon the motivation of the patient and the appropriateness of the hypnotherapeutic work engaged in by both the hypnotherapist and patient. The extent of pathology present in any patient can easily influence outcome and may explain successful treatment of smoking cases and the paucity of reported successes in other substance abuse cases. We have found that hypnosis as medical treatment has the advantages of shortening the time needed to establish a therapeutic relationship, helping in ego building, benefiting the learning of relaxation techniques, increasing suggestibility, and promoting behavioral methods such as aversive conditioning. We have been successful in achieving cessation of smoking behavior in our patients. One indicator of a positive outcome is patient motivation. We believe that hypnotherapy can enhance motivation but it cannot create it. We will not begin to hypnotize a patient unless we are convinced that he or she is motivated. Positive expectations are also extremely important. Mr. B, the patient in the case described, responded well to hypnosis although the initial induction required more time than usual. He believed it to be important "to be seeing one of the best" practitioners of hypnotherapy. His elation on his success at being able to be hypnotized certainly had a positive therapeutic effect. The importance of individualizing or tailoring the hypnotherapy experience cannot be overemphasized. It is the knowledge of intimate details that often precedes a successful experience. For example, in Mr. B's case, we were able to utilize his childhood experiences creatively during the age regression. Happy childhood memories and vivid recollections of sensory experiences formed a positive anchor. The life progression technique is most effective when it is done in depth and in as detailed a way as possible. For Mr. B, the sense of smell was keen and vivid. The olfactory senses had special meaning for him. In the life progression, smell was used as the other senses would be. This is bound to vary from patient to patient. We saw Mr. B five times. There are patients who would benefit from lengthier treatments and should be seen more often if it is indicated by their excessive anxiety. We recommend some changes when the model is applied to alcohol and drug abuse. We feel that lengthier treatment is indicated and that these patients should initially be in an intensive treatment program while going through withdrawal and detoxification. Tobacco dependence and hypnotherapy has received more attention in the literature than either drug or alcohol abuse in conjunction with hypnotherapy. Perhaps this is because it is easier to obtain a population to work with, and this population may tend to remain available for the duration of the study. It should be noted, however, that we do get conflicting results in the research that has been done, which makes it difficult to assess the efficacy of using hypnotherapy with the addictions. On the other hand, we have had successful results when certain guidelines have been followed. We concur with Wadden and Anderton (1982) that research in clinical hypnosis is in its infancy and should be pursued with increased vigor. REFERENCES:
This article is reproduced by kind permission of Guilford Press, who produce a selection of quality books on the subject of hypnotherapy. This particular article has previously appeared in the book, 'Case Studies in Hypnotherapy' edited by E.Thomas Dowd and James M.Healy. It contains 24 essays by leading practitioners and researchers in this field. ISBN 0-89862-652-8 |
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