International Handbook of Clinical Hypnosis - E-Lib FK UWKS

8 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
Current controversies in hypnosis research and their applications to clinical
practice raise major issues. Dr Bloom stresses the danger of accepting as literally
true uncorroborated claims of perinatal and prenatal memories and recollections
from past lives. The problems of accepting recovered memories of early childhood
sexual abuse are of universal concern. While such abuse certainly does occur, there
is the possibility that these memories may be due more to an artifact of the
hypnosis than an indication that the abuse occurred. There are guidelines to aid the
clinician in using hypnosis in uncovering memories of sexual abuse Bloom, 1994),
but in the ®nal analysis, it is the clinician's own judgment with a particular case on
how to proceed.
Dr Linden's chapter outlines a four-step process for establishing the hypnotic
relationship with a client: evaluation, education of client, assessment of hypnotizability,
and the teaching of self-hypnosis phase, during which time positive
expectancies about hypnosis and motivation of the client are enhanced. As the
author points out, the public is more open to and more educated about
hypnosis than in the past. Moreover, the criteria for patient selection have
altered with increased understanding of the interactive nature of the treatment
process and its relation to the doctor±patient partnership. Case histories reveal
that often the client wants help not with the presenting problem but with an
entirely different concern. Therefore diagnostic skills are no less important than
hypnotic skills.
Several important but widely differing issues for concern may be mentioned
here. Before initiating hypnotic intervention, the nonmedical clinician is advised to
inquire of clients as to whether any medical evaluation of their condition has been
performed. Many common presentations to the hypnotherapist may have organic
etiologies which require surgical or pharmaceutical treatment. In obtaining the
trauma history the clinician must be capable of dealing with abreactive material
which may surface as normal psychological defenses are evaded. And when inquiry
into childhood physical and/or sexual abuse is being made, it is crucial to avoid
suggestive or leading questions which may compromise the validity of activated
memories.
Some clinical presentations which are poorly suited to hypnotic intervention are
listed. Forensic subjects also can pose a particular challenge to clinicians. Finally,
when a client's presenting problem is outside the clinician's ®eld of expertise the
client should be referred elsewhere.
Chapter 4, on memory in hypnosis, is especially important in view of controversies
about repressed memories. The author attempts to give unbiased consideration
to the complexity of memory itself, as well as complications introduced by the
interaction between client and therapist. The use of hypnosis provides no guarantee
to assessing veracity; a degree of con®dence both in hypnosis and in the waking
state) should in no way be taken as a reliable indicator of accurate memory. This
chapter examines the association between hypnosis and memory by ®rst exploring
brie¯y the nature of both hypnosis and memory, and then looking speci®cally at