International Handbook of Clinical Hypnosis - E-Lib FK UWKS

HYPNOSIS AND DEPRESSION 133
association with corrective imagery and relaxation with a 12-year-old depressed,
asthmatic girl referred after her second suicide attempt.
MANAGEMENT OF ANXIETY
Whilst a reduction in anxiety has been proposed as contributing to an increased
suicide risk for the severely depressed Crasilneck & Hall, 1985; Burrows, 1980),
the use of hypnosis has been advocated for anxiety management for milder forms
of depression. Burrows 1980) suggests that the relief of the patient's anxiety is a
common approach. `Direct suggestions of being able to feel less tense, relaxed, and
ability to cope more realistically are useful' p. 169).
INCREASING SELF-ESTEEM, EMPOWERMENT AND CONTROL
In discussing their clinical use of hypnosis for depression, Crasilneck & Hall
1985) state that `our approach is to increase the patient's ego strength and to
enhance his ability to deal with the problems leading to depression' p. 324). Sachs
1992) describes the use of ego-strengthening achieved by hypnotically enhanced
mental imagery, in conjunction with progressive relaxation in the management of
cancer patients. McBrien's 1990) depression prevention programme utilizes selfhypnosis
to produce an increased con®dence in managing and reducing depressed
feelings. Hypnosis is also used to increase the ability to experience positive
thoughts and feelings that lead to an increase in pleasant events.
RESOLUTION OF UNDERLYING LOSS OR ANGER ISSUES
The postulated relationship between depression, loss and internalized anger has
informed a number of case reports. Abrams 1964), for example, describes the use
of hypnosis to create situations in which the individual could learn to express
unacceptable angry feelings.
MODIFICATION OF SUICIDAL IMPULSES
Despite the concern expressed by some therapists that the use of hypnosis may
increase suicide risk, other workers have attempted to use the technique to modify
suicidal impulses. Hodge 1972, in Hammond, 1990) describes suggestions to deter
suicide. These involve the use of direct suggestions to enter a trance and contact
the therapist in response to suicidal ideation. `In the trance you will be unable to
commit suicide unless I give you permission; the trance itself may be just the factor
you need to break up your suicidal thoughts and to help you to relax and ®nd better
ways to handle your problems' p. 332). Wright & Wright 1987) describe the use
of hypnotic techniques to develop a 'suicide fantasy' in which the suicidal images