This chapter describes and illustrates the use of waking hypnosis based on the Valencia Model and applied to clinical cases considered difficult and/or emergencies. Due to their nature, these cases represent a major challenge for professionals. As we have pointed out, the application of hypnotic techniques and procedures may be an important instrument to help these patients. Notwithstanding, the aim is not to apply techniques on their own without the support of a planned psychological intervention. On the contrary, according to our point of view, hypnotic techniques are, above all, psychological procedures based on psychological variables and fitting into a set of therapeutic procedures that psychologists can use.
Waking hypnosis has a great advantage compared with the so-called traditional approach:
It does not put forth the existence of a mental or cognitive discontinuity between a normal consciousness and an altered state of consciousness. Therefore, it allows an easier approach in which there is no need for giving explanations to the patient24. In point of fact, hypnotic techniques can be integrated easily in the intervention and, overall, patients are not afraid of losing control over themselves or being in a trance state. In the case of the VMWH, there are some additional advantages: It is standardized in a protocol of procedures established in stages, and these stages are so clear and simple that its use becomes very appealing for those using it in their clinical work.
It was from the clinical experience with the model that its application to difficult cases and emergencies arose. In these kind of cases, the VMWH cannot be used as it was initially put forth and described, but it is still possible to apply and adjust its principles and its philosophy, in a way that some appealing and elegant intervention models can be obtained and offered to those patients in need of help. The resulting models are specific versions of the VMWH for very specific cases.
From a clinical/therapeutic point of view, what are the most interesting aspects of the models described in this chapter that could be emphasized? Most of all, their parsimony and simplicity are very important. The intervention is focused directly on the clinical aspects using hypnotic procedures that are simple, interesting, and, oftentimes, surprising for the patients. Another characteristic is that the models are quick. The VMWH itself is quick, but the variants presented here are even faster in responding to the demands of these kinds of cases. Likewise, our view is that this rapidity is an element of the surprise itself. On the whole, the quick involvement of patients in the rapid inductions of these models lead also to quick changes in the patients’ psychological state in a positive way (helping to produce calm, motivation, hope, courage, etc.).
Another interesting aspect is the easy integration of the logic of these models in a cognitive-behavioral psychological approach. It allows, for one, that the therapist can work these aspects integrated into his/her usual professional work insofar as it is not necessary to resort to concepts that, at least for the patients, could appear as mysterious (such as the idea of trance); on the other hand, it allows the patients to integrate more easily what they are
learning from a self-regulatory or a self-control point of view. Likewise, this is also one of the essential aspects of the VMWH.
Obviously, the cases described here are only illustrative, since these models can be applied to the majority of psychological disorders encountered in the clinical practice.
Together with the therapeutic arsenal that psychological therapies represent nowadays, hypnotic techniques and, in particular, those characterizing waking hypnosis according to the Valencia Model, constitute another instrument that can be very useful to help patients.
Empirical evidence supporting these models is recently increasing, along with the evidence coming from clinical practice (Ludeña and Pires, in press). We consider that the dissemination of these techniques, more modern and psychologically integrated, will constitute in future a relevant research field and an important set of clinical interventions (Agostinho, in press).
R
EFERENCESAgostinho, M. (In press).(Re)Definindo a Perturbação de Stresse Pós-Traumático: Revisão da literatura sobre Avaliação, Diagnóstico, Tratamento Psicológico e tendências actuais incluindo o uso de hipnose. (Redefining Post-Traumatic Stress Disorder: Review of the literature on assessment, diagnosis, and psychological treatment, and current tendencies, including the use of hypnosis.) Psychologica.
Alarcón, A., & Capafons, A. (2006). El modelo de Valencia de hipnosis despierta: ¿técnicas nuevas o técnicas innovadoras? (The Valencia Model of Waking Hypnosis. Are these new or innovative techniques?) Papeles del Psicólogo, 27, 70-78.
Barlow, D.H. (2002). Fear, Anxiety, and Theories of Emotion. In D.H. Barlow (Ed.). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). New York:
Guilford Press.
Bentall, R. (2007). Halucinatory experiences, In Cardeña, E., Lynn, S. & Kripper, S. (Eds.).
Varieties of anomalous experiencies: Examining the scientific evidence, 4ª edition.
Waschington, DC: American Psycological Association.
Blankfield, R.P. (1991). Suggestion, relaxation, and hypnosis as adjuncts in the care of surgery patients: A review of the literature. American Journal of Clinical Hypnosis, 33, 1782-1786.
Capafons, A. (1998a). Hipnosis clínica: una visión cognitivo-comportamental (Clinical hypnosis: A cognitive-behavioral perspective). Papeles del Psicólogo, 69, 71-88.
Capafons, A. (1998b). Rapid self-hypnosis: A suggestion method for self-control.
Psicothema, 571-581.
Capafons, A. (2001). Hipnosis (Hypnosis). Madrid, Spain: Síntesis.
Capafons, A. (2004a). Clinical applications of “waking” hypnosis from a cognitive-behavioural perspective: From efficacy to efficiency. Contemporary Hypnosis, 21, 187-201.
Capafons, A. (2004b). Waking hypnosis for waking people: Why from Valencia?
Contemporary Hypnosis, 21, 136-145.
24 The referred explanations are, above all, those related to popular beliefs and misconceptions about hypnosis.
Capafons, A., Alarcón, A., & Hemmings, M. (1999). A metaphor for hypnosis. Australian Journal of Clinical and Experimental Hypnosis, 27, 158-172.
Chambless, D. & Ollendick, T. (2001). Empirically Supported Psychological Interventions:
Controversies and Evidence. Annual Review of Psychology. 52, 685–716.
Craske, M. & Barlow, D. (2007). Mastery of your anxiety and panic: therapist guide. New York: Oxford University Press.
De Jong, A.E., Middelkoop, E., Faber, A.W., & Van Loey, N.E. (2007). Non-pharmacological nursing interventions for procedural pain relief in adults with burns: a systematic literature review. Burns, 33, 811-827.
Faymonville, M.E., Meurisse, M., & Fissette, J. (1999). Hypnosedation: A valuable alternative to traditional anaesthetic techniques. Acta Chirurgica Belgica, 99, 141–146.
Frenay, M.C., Faymonville, M.E., Devlieger, S., Albert, A., & Vanderkelen, A. (2001).
Psychological approaches during dressing changes of burned patients: a prospective randomised study comparing hypnosis against stress reducing strategy. Burns, 27, 793-799.
Gonsalkorale, W.M. (2006). Gut-directed hypnotherapy: the Manchester approach for treatment of irritable bowel syndrome. International Journal of Clinical and Experimental Hypnosis, 54, 27-50.
Gonsalkorale W.M., Houghton, L.A., & Whorwell, P.J. (2002). Hypnotherapy in irritable bowel syndrome: A large-scale audit of a clinical service with examination of factors influencing responsiveness. American Journal of Gastroenterology, 97, 954-61.
Gonsalkorale, W.M. & Whorwell, P.J. (2005). Hypnotherapy in the treatment of irritable bowel syndrome. European Journal of Gastroenterology and Hepatology, 17, 15-20.
Healy, D. (2004). Psychiatric drugs explained (4rd Ed.). London, UK: Churchill Livingstone.
Kirsch, I. (2007, November). The Placebo Effect and the Power of Belief. Oral presentation at I Simpósio Ibérico de Hipnose Experimental e Clínica, Coimbra, Portugal.
Lang, E.V., Benotsch, E.G., Fick, L.J., Lutgendorf, S., Berbaum, M.L., Berbaum, K.S., Logan, H., & Spiegel, D. (2000). Adjunctive non-pharmacological analgesia for invasive medical procedures: A randomised trial. Lancet, 355, 1486–1490.
Lang, E.V., Berbaum, K.S., Faintuch, S., Hatsiopoulou, O., Halsey, N., Li, X., Berbaum, M.L., Laser, E., & Baum, J. (2006). Adjunctive self-hypnotic relaxation for outpatient medical procedures: A prospective randomized trial with women undergoing large core breast biopsy. Pain, 126, 3–4.
Ludeña, M. & Pires, C.L. (In press). A inclusão de hipnose nas terapias psicológicas (Hypnosis in psychological therapies). Psychologica.
Montgomery, G.H., David, D., Winkel, G., Silverstein, J., & Bovbjerg, D. (2002). The effectiveness of adjunctive hypnosis with surgical patients: A meta-analysis. Anesthesia and Analgesia, 94, 1639-1645.
Palsson, O.S. (2006). Standardized hypnosis treatment for irritable bowel syndrome: the North Carolina protocol. International Journal of Clinical and Experimental Hypnosis, 54, 51-64.
Patterson, D.R., Everett, J.J., Burns, G.L., & Marvin, J.A. (1992). Hypnosis for the treatment of burn pain. Journal of Consulting and Clinical Psychology, 60, 713-717.
Patterson, D.R. & Ptacek, J.T. (1997). Baseline pain as a moderator of hypnotic analgesia for burn injury treatment. Journal of Consulting and Clinical Psychology, 65, 60-67.
Patterson, D.R., Questad, K.A., & de Lateur, B.J. (1989). Hypnotherapy as an adjunct to narcotic analgesia for the treatment of pain for burn debridement. American Journal of Clinical Hypnosis, 31, 156-163.
Patterson, D.R., Wiechman, S.A., Jensen, M., & Sharar, S.R. (2006). Hypnosis delivered through immersive virtual reality for burn pain: A clinical case series. International Journal of Clinical and Experimental Hypnosis, 54, 130-142.
Pinnell, C.M. & Covino, N.A. (2000) Empirical findings on the use of hypnosis in medicine:
A critical review. International Journal of Clinical and Experimental Hypnosis, 48, 170-194.
Pires, C.L. (2004). A depressão e o seu tratamento psicológico: Guia de auto-ajuda (Depression and its psychological treatment: Self-help guide). Leiria: Editorial Diferença.
Pires, C.L. (2008, April). El uso de la hipnosis en casos difíciles y/o urgentes (Use of hypnosis in difficult cases and/or emergencies). Invited oral presentation for the School of Psychology, University of Valencia, Spain.
Pires, C.L. & Peralta, C. (2008, June). Estudo experimental exploratório do impacto de imagens muito desagradáveis na memória emocional mediada por retenção cognitive.
(Experimental exploratory study on the impact of highly stressful images over the emotional memory modulated by cognitive retention.) Oral presentation at XIII Congress of the School of Education of the University of Coimbra: Current tendencies in Education and Psychology. Coimbra, Portugal.
Weitzenhoffer, A. (2000). The practice of hypnotism, Vol. 1, New York: John Wiley &
Sons.
Woody, S.R., Weisz, J. & McLean, C. (2005). Empirically Supported Treatments: 10 Years Later. Clinical Psychologist, 58, 5-11.
Editors: G. D. Koester and P. R. Delisle © 2009 Nova Science Publishers, Inc.
Chapter 4