Interview with Helene Helgeland
In the last issue of the Journal of the Norwegian Medical Association (English summary at www.tidsskriftet.no), an update is given on the use of hypnosis in clinical work with child and adolescent patients. They are now educating clinicians in this skill set. The interviewer experienced a déja-vu from the 1980’s and contacted the first author with his immediate questions.
What is the content of the term clinical hypnosis?
Clinical hypnosis is a relational process where hypnosis skills are used in the treatment of medical or psychological conditions. Today, there is an increasing interest in the therapeutic effect of beneficial clinical communication where the fundamental elements of hypnosis are applied. In this perspective, you may say that clinical hypnosis is a communication skill set to promote beneficial change of the patient’s mind through the therapeutic relationship. The purpose is to reduce symptoms and increase the patient’s experience of coping and control.
Today, we have sound documentation of the efficacy of clinical hypnosis in the treatment of a number of medical and psychological conditions. Thus, hypnosis should be part of the established treatment options for many patient groups in different age segments.
It is important to note that clinical hypnosis is not a ritual or procedure. Knowledge about and skills in hypnosis should be deliberately integrated into clinical practice to promote adequate and effective treatment for the good of the patient.
What are the advantages of clinical hypnosis for therapist and patient?
Arguably, we can say that changing the patient’s expectations about the course of symptoms and illness or the experience of control in a given situation is an important part of the treatment. If so, the clinical encounter provides an excellent opportunity. As I see it, deliberate use of hypnotic communication cultivates change, and promotes self-efficacy, resilience and psychobiological health in the patient. This is undoubtedly for the benefit of the patient.
To me as a therapist, clinical hypnosis is a powerful interpersonal communication tool to cultivate therapeutic change. Knowledge about and skills in hypnosis permeates everything I do and say in the clinical encounter – and thus, expands and enriches my therapeutic interactions with the young patients and their families.
Last, but of no less importance – hypnosis is playful and fun! Imagination, creativity and play are all central elements in clinical hypnosis.
Does it influence on the topic of «common factors» in psychotherapy research?
Hypnosis provides rich opportunities to cultivate the therapeutic alliance, positive regard, genuineness and patient expectations for the outcome – “common factors” in psychotherapy. Over the past years, the hypnotic state and the procedural factors have gained more attention than the relationship factors. This has led to a misconception as to what hypnosis is, and thus, limited the use of clinical hypnosis for the benefit of the patients. Fortunately, the pendulum has swung and the relational nature of hypnosis is gaining attention. Hypnosis is definitely an interpersonal phenomenon. Within a hypnotic framework, relational factors – such as transference and countertransference, safety, embodiment, novelty, creativity, respect and trust – combined with hypnosis, nurture therapeutic changes in the patients.
What has made hypnosis clinically relevant in psychiatry again, after some curiosity back in the 1980’s?
Over the years, an increasing evidence base supports that clinical hypnosis is a safe and effective treatment of several conditions – for example acute, chronic and procedure-related pain, irritable bowel syndrome, anxiety, depression and sleep disorders. Clinical hypnosis also appears to increase the effect of other therapeutic approaches, and can be useful as part of a complex intervention in the treatment of complex disorders such as chronic pain. I think this has contributed to increased awareness, knowledge, accept and utilization of hypnosis as a valuable treatment alternative.
I also hope that the increasing awareness of the beneficial effects of clinical hypnosis reflects that the biopsychosocial illness understanding is gaining terrain. Within the frames of an outdated picture of the traditional biomedical illness understanding, the phenomenon of hypnosis is difficult to grasp. □