International Handbook of Clinical Hypnosis - E-Lib FK UWKS

HYPNOSIS AND DEPRESSION 131
THE DEFINITION OF HYPNOSIS
Yapko 1992) argues that the discrepancy in opinion about the value of hypnosis in
the treatment of depression can, in part, be understood by variations in the model
of hypnosis being utilized. He describes three general models: traditional, standardized,
and utilization. Other workers distinguish between directive and nondirective
or Ericksonian techniques. The opposition to the use of hypnosis in
depression is primarily associated with the traditional, standardized or directive
approaches and hence Yapko 1992) argues that the association is a function of the
model of hypnosis used rather than of hypnosis per se. This point of view suggests
the empirical question of whether one approach to working with depressed
individuals is more useful than another.
THE GOALS OF HYPNOTIC INTERVENTIONS
Examination of published accounts suggests that, in addition to differences in
hypnotic techniques, there is a great deal of variation in what therapists actually do
with hypnosis in the management of depression. A review of the available
documented case material indicates that there are a range of therapeutic goals
either speci®cally stated or implied by the model of therapy associated with the use
of hypnosis. Hypnosis is a tool, not a therapeutic model, and has been used to
facilitate a range of different therapeutic approaches. The bulk of the published
literature consists of case reports, often providing minimal detail of actual
therapeutic practice and no objective documentation of outcome.
THE SUGGESTION OF SYMPTOM REMOVAL
Very few clinicians describe a direct, symptom removal approach to the management
of depression. Crasilneck & Hall 1985) state that `we are careful to avoid a
symptom removal approach' p. 323). Yapko 1992) considers that suggesting a
symptom away is valid as it serves as `pattern interruption' but is inappropriate
therapy unless it is also accompanied by `pattern building', the establishment of
new choices and behaviours p. 52).
Milton Erickson's described by Alexander, 1982) approach to the management
of suicidal depression in a young woman is an elegant, indirect approach allowing a
suggestion about the relief of pain to generalize to `the much more profound and
deeply disturbing depression' p. 219).
BEHAVIOR CHANGE OR SKILLS ENHANCEMENT
One of the most comprehensively described treatment strategies which includes
these aspects is Alladin's 1994) Cognitive Dissociative Model of non-endogenous