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    Cognitive Hypnotherapy. an Integrated Approach to the Treatment of Emotional Disorders

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    © All Rights Reserved
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    484 views155 pages

    Cognitive Hypnotherapy. An Integrated Approach To The Treatment of Emotional Disorders

    Uploaded by

    diegowildberger
    Cognitive Hypnotherapy. an Integrated Approach to the Treatment of Emotional Disorders

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    | COGNITIVE HYPNOTHERAPY ‘An Integrated Approach to the Treatment of Emotional Disorders Assen Alladin John Wiley & Sons, Ltd Goprhto205 Khe Vly tee a Te un Sot Cae, Cae et earo a eo Seemann Sang eee eee meer cite rs, Steep ner hero he opie Depa Pens At er moe be a Eee eee ees {216s Penns Department Jan Wy & Sona td, Th Arum Southern Cae Cicer Pet Ee ieiesenarenitefomeepeaoereeon aa Spee eemenetreat arent mene. Ripseertaagegemttemn ae seagate ent ea ‘Spe patasiona shot be ugh ~~ a “rem neyo Jaa a eh 84 Sentra naonee co wcities Daan eg Tt ean ht nt vg asus gene ty aeons om ees naa ems Sane appt of Congres Catalin Pati ate ‘opie een: an aunt oe lee senor _ , Ppt torrente? Copane tcp Alec dees ins 1M MAI Cpe empyema. Hypa WM Ac ti srry Catalin i Peni Dete Actas me riskier fm Bich aay ssausmoewassionit Bovsncocmonses gat) ‘yet np gm Sion vt oy i CONTENTS About the Author. Foreword Preface 11 The Rationale for Integrating Hypnosis and Cogaitive Behaviour Therapy in the Management of Emotional Disorders 2 Cognitive Hypnotherapy Case Formulation . Cognitive Hypnotherapy in dhe Management of Depression 44 Cognitive Hypootherapy inthe Management of Migraine Hesdaches eee 5 Cognitive Hypnotherapy with Post Taumatie Stress Disoader 6 Cognitive Hypnotherapy with Peychocutaneous Disorders. 7 Cognitive Hypaotherapy inthe Management of Somatisation Disorder - " 8 Cognitive Hypnotherapy inthe Management of Chronic Primary Insomnia. a 9 Cognitive Hypootherapy inthe Management of Sexsal Dynfantions i. 10 Future Diretons Appendices References. Index wi a 8 ns Ww Be a1 281 ABOUT THE AUTHOR, ‘DrAssen Alladin ia Clinical Psychologist and Adjunct Assistant Professor at Foothills Medial Cente and Department Psychiatry and Psychology at the University of Calgary Medical Schoo. He has bean practicing an teaching bypass and linia paychology for over 25 years He served as Secretary oF ‘he dssh Society of Experimental and Clinical Hypnosis for many yeas and Currently he the President ofthe Canadian Federation of Clinical Hypo ‘Ars Sockeye wae Fellow of the Royal Society of Medicine and Associte Felon ofthe British Peychalogial Society Dr Alladin has published many chapters and papers on clinical hypnosis fan is the author of Hendiok of Cognit Hymathoapy fr Depression: An Evidence Basel Approach (ippincett, Willams & Wilkins, 2007) and Hyp therpy Expat (Radelile Polishing, 2018). He served ws Guest itor for Special sues in Hypnotherapy for the uma of Preeti Newaogy and Poy ‘hy (190), the Journal of Cote Paychatherapy: An erationl Quarterly (194) andthe ntrationl ural of Clini and Experimenta yprsi (Apri 2007 July 2007), Hes inteested inthe empirical validation of clnial hypnasis and te ints: ‘allo af hypnosis wth ther forms of psychotherapy. He isthe 205 eipiont ‘ofthe Best Reseach Paper from Division 30 ofthe American Psychological Association _DrAlladin comes fromthe sland of Meuritis and becompletd allhisstuis fn England He was inially trained aa Registered Nurse anda Socal Worker before faking Peychology anv Clinkal Psychology: De. Alladin has wo adult children an lives Calgay, Alberta, Canada, He loves teaching, ar travel Ing with his wife of 27 years He has presented addresses and workshops on clinical hypmosis national and international conferences FOREWORD “Many years ago, I had occasion #9 abserve De Aazon T. Back widely con Siete the father of modern cognitive therapy, conduct most interesting therapy seeson with young man who was anaious and depressed. De. Beck ‘encouraged the man to fis recognize errors in his thinking and then del frately and consciously refute the Nood of negative automatic thoughts that, ty nom critically believing them, obviously contributed to fis dificltis, The ‘man responded quite favorably to Dr Beck's instructions e seemed 0p both the ideas ad methods he was being taught for regulating his thoughts tnd fstings Then, Dr Becki something particulary teresting eins tecthemantoclorehiseyesand engageinaneserse a inugintion. Thema trastoltovsualizehimeeltina variety of situations hatha previous been ‘resful. Dr- Bock sugested that hese himselt i these fai ssions thinking and doing things different focusing om how his newly corre tec! thoughts and revised elalk would led hm to handle the previously troublesome situations skilfully and successflly. The young man absorbed Dr Beck's suggestions t associate new thoughts and feelings to thse sit ‘ions and reported eling that he cold nove handle those stastions inna inmproved ways His brovd smile and apparent comfort sugested he a5 sincere in saying tis Following this session, {asked Dr Beck about the ast step of his interven- tion, asked him what he called this wnualiation procedure He replies Success imagery Tasked him, Was this hyprosis” He replied that edi’ dohypnoss Someone grounded inthe dynamics of cic hypnosis might well ave termed ts "sucess imagery” procedute an “age progression Teenique, exprewia, ot only cogaiive, evlentation to Ue future that encouraged the ‘lien to develop an aseciation betwen aspecifisetof thoughts feelings and ‘behaviors, anda particular contest. Clinicians employing hypaosis routinely make ise of age progression aswell as‘post hypnotic suggestions for exaclly this teason-roestablish nk Le, associations) between desired responses and peclccontets, Such goal-oriented suggestions are ypc welllaborated fd carefully delivered with the intention of making the inks as tong a5 possible. FOREWORD “These is something quite special about the experience of hypnosis. Hyp ross allo fora enhanced sende of personal conto (ea eater infer focus of contol) and greater feb in esponcing in mult-imenstonal trays, Particularly relevant, though, i how hypnosis encourages a grester Ulomatcty ia responding, meaning a qualty of resporse that is theca- jeutically valuable tat seems 10 are quite effortlessly in the hypnotized person. ‘ell before they were called ‘automatic thoughts’ by cognitive therapists, ‘Such non-vlitinal and typieally nonconscious responses were called ideo Cognitive responses, While ideniying negative automatic thoughts has ‘etome a major focus in CBT, clinicians studying bypnosis were developing iovative ways to encourage poste ikongon Is the goal of treatment to reduce negative or distorted thinking or nerease postive or cls thinks ‘ng? Should therapy besimed at r-raning the conscious mind to recognize fe coret cognitive distortions or simed at unconscious processes that can frlp meblize more effective iformation processing and reflexive postive sponses? These are tantalizing questions to consider, and how one ansers them no doubt shapes one’ clinical tye and methods. “The hypnosis Iterature is replete with examples of succesfll integrated “bggeatonstochangethesqshity and deco ofon’sthnking Furthermore, the use of hypnosis to rece arty and ease the leaeing process has made for easier and better = therapy. In particular, there is a growing body of Seletfc iterate attesting to he fact tat hypnosis enfances CBT; in fat, ‘cof hs itertureis selerenced an ertcally reviewed inthis substantive book “Through this impressive volume, which introsices the reader to Dr, Assen Alloda's Cogntiee Hypnateapy (CH) model, we get a wellthought oxt fnswer tothe question many of us ask: How ight we enhance the mens (Of CDT? The eazance of the answers itgate hypnosis nthe ete pre {se Dr Alladin takes on the challenge of presenting theoretical foundation {or integrating hypnosis with CBT, and Re provides a structured means fF doing co wih he cieformulation guidelines. He offers detaled and i mminuting examples of spec intervention stategics, an he even provides & nib tempat for ways other models of psychotherapy may be combined. trith methods of linia Kypnosis De Alladin s uncomnenon in his having ane foot in the world of paychother py athe other foot inte world of research His expertise in both domains Comes shining through in these pages. He strives to not only solve problems, burteach proten-slving He sees beyond the limitations of oneimensional prosere and offers ws varity ofhypnotic methods that reachbeyoad con- EBs minds and go into ares where more typical CBT techniques jst don’t tually go. He emphasies the merit of hypnosis as ameans of empowering people tose ther minds ia new and creative ways that can enhance thee 5 FOREWORD lives. And, Dr Allain provides us wilh the empisical evidence we ned that {heres good reason 0 absorb what hess eaching us tis my psivilege to write the Foreword to this volume. Lhope you wil ad i te instructive, ntellgen, interesting and practical a1 di “Michael D.Yapko, PD. Fallbrook, CA Februaey 12,2008 ‘ww yapka.can, ee PREFACE {n wsling this book, Ihave addressed thee mai concems about hypno- therapy Bat have evolved in sny 7-year career a a practioner ond teacher Df linea hypnosis Fst, many writers advocate that hypotherspy is very ‘ete in the treatment of various disorders, but prove ite or no empit Tealresearchto support theirelams Second, they deride mumerous hypnotic techniques thateanbe tized witha variety of mia and paychelogialcon- ditions: However itis not made clear how thes ecriques cfr fam other foxms of psychotherapy what are the empirical bases for using them and how they modify the underlying pathology. The reader soften oft withthe impr ‘sin that hypnotic techniques are ublizd without giving much consideration torment advances in tology and treatments. Third, most books emphasize the adjunctive roleofhyprotheray, butthey dont describe in detail the ma timodal strategies within which hypnotic techniques are incorporated. Most ‘often single modality hypnotic approich is described Considerngthat mast Clinical dsceders are complex and compounded by comorbid factor issu prising that some authors take a single-modalty approach to treatment, On [Rother hand, some witers have sade steps to intgrat hypotic tech igus with other forms of paychoterapy (eg. cognitive behavior therapy OF ‘Peyehodyamic therapy), Dut they havent provided theoreti orscente ‘ational for integration. “Ths book takes a multimodal approach to understanding and treating emo tional disorders is writentoencourage evidence-based clinical practice ad resacch in hypnotherapy: It provides iections on how #0 asilate By ‘esis with cogrtive baavor therapy (CBI) in the management of vious ‘motional disorders tlys down a seid theoretical foundation for integrating, Inypnosis with CBT i the management of emotional disorders. Furthermore, cognitive hypnotherapy ssconceptualized as an assimilative model of psycho therapy. The srimilative approach to payhatherapy is the latest integra psychotherapy model describe inthe iterate I is considered to Be the ‘est enode fr integrating both theory and empirical findings to achieve max linus flesblity and eflecuveness under 8 guiding theoretical framework EEvidelly cognitive hypnotherapy mest criteria for asiniative model of prychotherapy. Hypastherspy ean now be formally recognized as valid Adjunct to cognitive psychotherapy. This i an important recognition forthe Field of lineal hypoosis. sv PREFACE Unlike other books on hypnotherapy this book advocates a ase formulation Spprosh toca prt, Sue a model of practice allows the assimilation ‘Shlechaigues tbe based on empirical ndings ater than sing techniques Fphavarly in a hit and mis fashion. Evidence suggests that matching of {retest to particular patent characteristics increases outcome, Each clinical chapter fcuseson a particular emotional disorder and offers ‘etal step by sep treatment protocol. The teatment proto} based on Iatest empirical evidence, provides a ator desig for studying he ait I elect of hypnosis, The eaten protools are speiiclly designed in ‘aructure way to allow validation ofthe circa efficacy of adding «| hypnotherapy component to CHT Am adc design involves a strategy iit th tcament to be ested is added wo another tetment to determine Uthetter the tetment olde produces an icremental improvement ove the fit treatment ‘Moreover. the book provides template for integrating other forms of py ‘Hothorapy’ with hypnotherapy. Cognitive bypoetherapy as an assimiative ‘node! of paychalogiealintevention, chooses CBT a the host psychotherapy for Intgeston ecruse CHT muea criteria for sclentife theory tis empir Tenly validated and it constitutes @ unifying theory of psychotherapy and ehopathology Theory fs essential to clini! practic; without theory the edcieeofpoychotherapy becomes a purely technical exercise, devoid of ny Petite bass Although cognitive hypnotherapy meets erieria for an ssi lative mel of psychotherapy it nt to be seen as a finished product ‘put ss an evolving process. It requires further empirical validation without aipsica validation it st posable to etablsh whether the importation of the hypnotic fechques into CBE positively impact therapy, especialy when {he tamiqucs ave decontetunlized and placed nv a new framework. Is ‘nly through empirical validation that inefectve and idiosyncratic asi Mon can be avoid. The book offers several structured and welldescribed {Cognitive hypotherepy protocols tht can be easly validated empirically. ‘Considering modern hyposis hasbeen around for over a quate of cen tury the eelaive empiri foundation of lca hypnosis snot very slid Sad nypnotherapy is far fom being recogeized as mainstream psychother- Shy. Tanerene reba utaation of eral hypo He empirical ds of hypnotherapy needs to be widely established, There faa imme ‘enced for more eearch evaluating the fiacyof hypnotherapy with both ‘medical and psychological conditions, ether asx single treatment or pat of ‘l-teatnent modality” Once tis efficacy is established, the utilization Srhypnotheray wil be inceased and the demand fri services as anon holegic entre willbe augmented Is hoped that this book by formally ‘oogatzing hypnotherapy asa vali adjunct to psychotherapy, wll serve asa “Springbonn fr further aditve studs of cna hypnosis. tis also hoped thax mers wil find the asimation of some ofthe treatment techniques {lescibe in the book both innovative and cially ensiching, For example, PREFACE Captr5.tyimegrating BT typnotherapy and imagery escpting er {th prvides a mutated, ager focaed,evitence ved entment for reducing PTSD symptoms altering negative bis a eaancing the {puma survivors ability fo sles sllmurtre Chapter 6 dicts Aheinteracebetween pychntry and destatology and proves amework Ioeatiingcoeitive hypotherpy within the new eld of payne mci. Chapter 9 desetes the aplication of cogive Wypacterspy fo {rol ttn he en he, gan cae ifnovatve nay of delvering tentment for ele dstoncton win context of sexual medicine, ™ ve Assen Alladin Calgary, Alberta, Canada February 2008 CHAPTER 1 THE RATIONALE FOR INTEGRATING HYPNOSIS AND COGNITIVE BEHAVIOUR THERAPY IN THE MANAGEMENT OF EMOTIONAL DISORDERS INTRODUCTION “Thisbook adopts the potion that her an ence in reste fect ‘hen cognitive behaviour therapy (CBT) integrated with hypnosis in the ‘management of emotenal disorders. Although many clinicians have blew ded hypnosis with various psjchotheapies, the approach to integration hes ‘ranged from being arbitrary and idiosyncratic to very systematic aor than ‘riven by coherent integrated theory. As hypnosis snot a school of therapy ‘nd does ct provide a theory of personality, paychopathalogy or behaviout ‘Shang, bypootherapste have combined ther techniques witha varity of peychotherapes, for example CBT (eg. Alladin, 1994, 2006, 20078; Bryant {fal 2005; Golden, 200), multimodal therapy (Lazar, 1973), prychoana- lysis (eg Prom & Nash, 196) and eational emotive behaviour therapy (6 Elis, 1986, 1993, 1996) To my knawledge none ofthe writers has developed 4 coherent integrative model of psychotherapy that assimilates hypnosis with CHT, 1 developed » theoretical of working model called the Cognitive Disscatine ‘Mosel f Depression (Alladin, 1954, 2006, 2007), which provides the rationale for combing hypnosis with CBT in the management on. From this model evolved Cogtie Hypnotierpy, a multimodal approach for tea Jing depression, mainly consisting of CBT and hypnotic tchnoques (Alladin, 1954, 206, 20072). The cognitive hypnotherapy approach to integration |s similar to the peychodyramically based integrative therapy developed and deserbed by Gold and Stricker (201, 2006) Gold and Stricker (200, 2006) have developed an assimlaive model of psychotherapy that inte rates standard poychodynaanie methods with other therapies when called 2. COGNITIVE HYPNOTHERAPY foc in onder ‘advance certain peychodyamic goals as wll address see nen eee (Cold Scher 20, p12 In thi chapter he EEE Gornerapy i concepoalsed as an assimiative mode of pacar Cognitive hypretherapy uses CT a he ase theory fo itgztin becnse saree hetncory pies auniying ncory of pchoterapy and prychon aa tee ints theory ar inl practice. Absence Patrol a came piglet ik hay fo ak conceal er ee Ficiain Carel, 998, Another distinguishing crater of CBT Sa chetey eclecte,Although most ofthe ecigues wise in A Eaiioural ar ‘cogntve foul combines ekaguey om ar hotherpic- ifort nd Beck (987, p90) write ‘ay cial Tap Eiht oun tobe wel nfcating the empires vesigaion TS Malad interpretations and conclusions may be incorpo of ga hie prvtie of cet therapy” However, bn COT the cee in chotehdne haphazaay, Tey ae selected in the context of Meee cas formulation at ls wed to guide the pracce of CBT for ae vidal ese (Needleman, 2009; Persons 1987, Feros & Davidson ‘Sor; Perera Dvidson Temp, 201) Evidence suggest hat matching senna io patctar patent chractersts erases outcome (Beules ARE pong, S00) allord and Bock 0987, p91) oe further way: “the echnsly selene of cogative therapy has ben dese pre Tea Perils By working wit the fameork of Te copie mode SAA Ramdas ns fe] eapeube approch according the se SR UAE ta ven poet st = poco ine Thus the Meas my SErirate cates heap even though he ws preominany TTR Seve femeton wlan) techniqes (Beck eal 12 ett) ges canbe sce fom ober poyhaheapeat approach, de ste owing cers remot) Tmahode re conae ih Prov apy primp ante ely read to the ory of her Sar ange ihe Gace of cigues bseed ona comprehensive se Fea eaten ea takes inte acct fhe pins characteris (aro se fac, pbiemsaleing sits, ce 0) clabnntve emp Fe ahd ducer ane complete standard intervista Pesach gue Stogly ais the standard oma (Gos, 510, [As CBT is technically eclectic and adopts nultiple approaches to case form ‘Rusnand tutment offers an excellent ramework fr integrating hypnotic Aponte stuatgis witha wait of yedromes Its hope that he ites ‘ited approach describe in this chapter will prove a clear understanding, ‘fw fo ue hypaoti fehniques to enkance treatment effect and how t INTEGRATING HYPNOSIS ANO COGNITIVE BEHAVIOUR THERAPY 2 use hypnosis as an adjunct treatment in the context of CBT: Refre discuss ing the rationale for integrating hypnosis with CBT in the management of ‘emotional disorders, theeies of psychotherapy integration ae reviewed 10 ‘provide readers with some background information on the prychotheapy {ntegation movement. PSYCHOTHERAPY INTEGRATION MOVEMENT. For decades the field of psychotherapy was marked by deep division and Segregation of theories and method This sentiments eloquently described by Gold and Sticker 2006, pp. 3-4) " chat ration anh atehno e goes Out calecive behavior semsts have ben governed by» power Senophob er and lnhing that couse smc an done al of “ppc to oye ht wee dif thanneson When pyc ‘Kept fone onenan dist atiake note ofthe wont anther col ch popciapy: thy play dso with dan ard hotly The cin [search trate ee compl penal wth pore eant de State tate wer prefered bran of pycetherapy cay outperormed ‘Ser rar eater sey wart boxe tort acy Srdsophisiton Fortunately, there have been some pioncers inthe field who tre to inte rate dtferent forms of psychotherapy For example, French (1953) attempted to synthesis ideas fom classical cond ‘hin psyehoanalyie the ‘ry Dolla and Miler (1980) integrated the central ideas abot unconscious ‘tivation and cont with the concepts drawn from lneing thers and ‘Wacktat (1977 integrated psychoanalysis with behaviour therapy. Dating the lst decade ofthe 200% century, interest in the psychotherapy Integrae tion movement was ais peak and it culminated In the formation ofthe Society forthe Explraton of Paychotherapy Integration, the founding of the Journal of Pychotienpy Integration in 1951, andthe palliation of to Ihanboaks an psychotherapy ington: Handbook of Pspeotnapy Integr Hon (Noreen e Goldie 1982) and Camprelensine HandbokofPschthempy Integration (Sticker & Gold, 1955). Theve handbooks covered most of the important integrative therapies availabe at that time and went beyood the «excuse focus onthe synthesis of psychoanalytic and behavioural models. ‘The current wend in intaratve therapies isto ‘combine cognitive, human Istc, experional, and famly systems models with each ether and th Sophisicated psychoanalytic, behavioural and humanistic components of lecntment in ever more complex permatatons (Gold & Stricker, 200, p. 8) ‘Tis chaptr blends hypnont with CBT and proposes cogutcehprotirepy san assmilative model of peychotherapy forthe management of emotional ‘sorders 4 COGNITIVE HYPNOTHERAPY Norcros and Newman (1992) have identified eight facorsthathave promoted Pavehotherapsntegation nthe past 20 years 4, Therehas ena proliferation inthe amber of schosts of pycoterpy ETT MSpace “ompisat support far te sopennsy of ary see sR any peychotecapy theory to completely exphin and prot pychopsthols Se etal inensinshor erm poctherapcs aaa marzo teen cis ad sl eee gr pptoterpy fe repay paves i mmm ao ail pycherapes al ae rae to 1 SRS juny conferences and profesional ergaiatins dete Yo paychterapy ination MODELS OF PSYCHOTHERAPY INTEGRATION mccoy integration can be fins the seh fo a uy of he eae EL anus nas or model of pjehorapy

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