Acceptance of persuasive communications of therapy
The suspension of critical thinking in the hypnotic state may make the patient more susceptible to accepting the persuasive communications of therapy. McConkey has written:
Clients who typically make critical and negative comments towards therapeutic communications are essentially required by the hypnotic context to listen to persuasive messages from the therapist in a way that they may not ordinarily do so; this process of attending and listening, without. commenting, may make the clients more accessible to the content of the therapist’s message. (p. 80).
Additionally, alterations in cognitive processes may help patients to accept alter-native interpretations of events, their significance, the patient’s coping abilities and skills and the expected outcome. The restructuring of cognitive processes maintaining the anxiety disorder is a major goal of therapy.
Increased reality acceptance of fantasy experiences
Many psychotherapies utilize imagery and fantasy to facilitate the process of change. Certain patients in hypnotically assisted therapies may more readily respond to imagery and fantasy as reality, since the hypnotic process provides a powerful way of enhancing imagery. Specifically, hypnosis may enhance a variety of interventions applied to the treatment of anxiety.
1. Systematic desensitization remains one of the most common treatments for specific phobic disorders. Lang showed that patients who benefit from systematic desensitization have a greater ability to generate emotional responses to the imagined items from a hierarchy. The more realistic the experience of the imagined situation, the more likely are such responses to be generated. Hypnosis offers an adjunct to desensitization that is potentially extremely powerful, since the attribution of realism to imagined events is a characteristic of the hypnotic state.
2.The effectiveness of coping rehearsal may similarly be aided by the reality attributions effected through hypnosis. With the increased realism of fantasy rehearsal, andsthe uncritical acceptance of the implied message that this will oc-cur, patients’ expectations and motivations to expose themselves to the anxiety- provoking situation may be heightened. In the absence of self-defeating thoughts that maintain anxiety, successful coping may become a viable outcome.
Increased sense of control of bodily processes associated with anxiety
Arousal reduction and relaxation may be enhanced using hypnotic procedures. When patients are able to use self-hypnotic arousal reduction and relaxation it adds to their confidence in coping and their sense of self-control. When patients are able to influence what they previously thought unalterable, a shift in their locus of control and sense of self-efficacy is effected. Such a change in perceived self-efficacy in dealing with the anxiety-provoking situations may oc-cur either through behavioral control perceptions (being able to do things to reduce the anxiety) or cognitive control perceptions (the belief that they can manage the anxiety-producing situations).
Dissociation from feared situations
‘Patients with anxiety disorders frequently become absorbed in the fear state. Their anxiety responses generate further cognitions concerning the danger posed by the symptoms and their inability to cope. Dissociation via hypnosis can provide an adaptive and useful method of reducing this reactivity to the anxiety-producing situation and to the symptoms that may follow.
