RAPID SELF-HYPNOSIS: a SUGGESTION METHOD for SELF-CONTROL Antonio Capafons Universitat De Valencia

RAPID SELF-HYPNOSIS: A SUGGESTION METHOD FOR SELF-CONTROL Antonio Capafons Universitat de Valencia

Auto-hipnosis rápida: un método de sugestión para el auto-control. Se describe un método estructurado de auto-hipnosis “despierta” -auto-hipnosis rápida-, creado desde una vertiente cognitivo-comportamental y validado empíricamente. Se detallan algunas de sus aplicaciones clínicas desde una perspectiva de habilidades generales de afronta- miento y auto-control. En ellas se enfatiza la utilización de las sugestiones en la vida co- tidiana, mientras la persona realiza su actividad, con los ojos abiertos y estando activo. Se evitan referencias a estados alterados de conciencia, trance o aspectos esotéricos de la hipnosis.

A structured self-hypnosis method -rapid self-hypnosis- is described. This method has been created from a cognitive-behavioral perspective, and has received empirical validation. Some clinical applications of rapid self-hypnosis are shown from a coping skills and self-control orientation. From this perspective, the use of the method in everyday activities are emphasized. Clients can use suggestions while keeping their eyes open and being active. Mention to altered states of consciousness, trance o esoteric ideas is absolutely avoided.

Role of hypnosis and self-hypnosis The tendency to include hypnosis within in cognitive-behavioral interventions psychological treatments is prevalent in the other advanced countries (Capafons, The interest on hypnosis as an area of re- 1995a). The rejection of hypnosis among search, has burgeoned in the last decades at some psychotherapists can only be explai- a level only comparable to that at the end of ned by myths and wrong beliefs (Capafons, the last Century. Only lack of specific 1998). It is also true, nonetheless, that a knowledge can bring about the rejection of change in this attitude is exemplified by the a series of procedures that are proving to be prominent manuals of behavior modifica- of considerable importance as adjuncts to tion published recently in Spain (e.g., Caba- psychological treatments, particularly cog- llo, 1991; Labrador, Cruzado & Muñoz, nitive-behavioral ones (Lazarus, 1973; 1993; Vallejo & Ruiz, 1993). They include Kirsch, Montgomery, & Sapirstein, 1995). chapters on hypnosis although, paradoxically, only one is written from a cognitive- Correspondencia: Antonio Capafons behavioral perspective, in contrast with the Facultat de Psicologia main approach of such manuals. Blasco Ibáñez, 21 46010 Valencia (Spain) Hypnosis is a very efficient way to use E-mail: [email protected] suggestion, but not the only one (Amigó,

571 RAPID SELF-HYPNOSIS: A SUGGESTION METHOD FOR SELF-CONTROL

1992; Capafons & Amigó, 1993a, 1993b). tients, mainly using an ergonomic bicycle in As with other forms of suggestion deploy- which the patients keep on pedaling to acti- ment, it reduces the effort and time neces- vate the body. To the extent that the patient sary to bring about behavioral change (Ca- can open the eyes, claim Bányai et al., the pafons, 1994; Capafons & Amigó, 1995). potentials of hypnosis can be best utilized. The media, stage shows and literature have Indeed, being able to create a situation in portrayed hypnosis as a method to erase the which the client is open to ÇhypnoticÈ sug- subject’s will. Although this Çrobotic por- gestions, without having to close the eyes or traitÈ is inaccurate, patients typically ask for get ÇsleepyÈ, extends the range of possible this type of methods, because they are una- suggestions, increases the client’s motility ware of the other types. The seminal work (for role playing, in vivo exposures, etc) of Lazarus (1973) showed that fulfilling the and, above anything else, fosters the active clients’ demands and choices with regard to participation of the client in effecting beha- hypnosis enhances therapeutic results. vioral changes. Thus, it is advisable to apply ÇhypnosisÈ Nonetheless, the Bányai methods (Gib- when the patient requests it, after clarifying bons’ hyperempiria does not solve the issue its possibilities, so as to avoid undesirable of closed eyes enough) have their difficul- reactions among the clients (Capafons, ties. For instance, the requirements of an er- 1998). gonomic bicycle or a large room in which Hypnosis can, however, bring about dif- the patients may walk can be difficult or ficulties when dealing with some problems. awkward (Capafons, 1998). In fact it was Such difficulties are mostly centered on the found that about a 30% of experimental par- issues of asking patients to close their eyes, ticipants drop out from the bike method to relax, and to adopt postures conducive to (Cardeña, Alarcón, Capafons, & Bayot, sleepiness, heaviness and muscle flaccidity. 1998). In addition, pedaling may be dange- The therapist often needs to have a rapid rous for some patients suffering from heart communication with the patient, to evaluate illnesses. Pedaling or walking fast can pro- the effect of suggestions and to apply some duce sweating or fatigue, and are difficult to specific therapeutic procedures (e.g., in vi- generalize to everyday life as self-hypnosis vo exposure). This kind of problems methods. brought about the development of Emotio- Although another method is proposed as nal Self-Regulation Therapy (Amigó, 1992; an alternative for solving many of these pro- Amigó & Capafons, 1996; Capafons, 1994, blems (Çawake-alert hypnosisÈ, Capafons, 1995 b; Capafons & Amigó, 1993a, 1993b). 1998), it is not thought as a self-hypnosis This procedures uses ÇwakingÈ sugges- method. Self-hypnosis is necessary when tions, while patients have their eyes open, the therapist needs to generate a sense of are alert, and have an ongoing dialog with self-determination in the patient (as oppo- the therapist. sed to be dependent on the therapist) and/or It is clear that there are other ways to Çin- when additional practice in hypnosis is ne- duceÈ hypnosis, such as expanding aware- cessary. ness (Çhyperempiria,È Gibbons, 1979) or For all of these reasons it was proposed a active-alert methods (Bányai, Zseni, & Tú- procedure that would link hypnosis to self- ri, 1993l; Capafons, 1998). These methods, regulation therapy, in its sense of Çwaking but particularly Bányai’s, emphasize physi- hypnosisÈ. This procedure would satisfy cal and mental alertness. She encourages those patients who want to be hypnotized, muscular activity to ÇhypnotizeÈ the pa- allowing them to be ÇactivatedÈ so as to fo-

572 Psicothema, 1998 ANTONIO CAPAFONS llow suggestions quickly, certainly and in a Ruch (1975), Fromm (Fromm & Kahn, concealed way. The purpose is to include 1990), Johnson (Johnson, 1979), Brown, hypnosis as one of the procedures for the Forte, Rich and Epstein (1982-83), and Or- active management of stress (Denney, ne and McConkey (1981). 1983), particularly in the frame of the tea- Paradoxically, self-hypnosis is systemati- ching of applied relaxation of Hutching, cally used either as an adjunct to Çhete- Denney, Basgall and Houston (1980). Ac- rohypnosisÈ treatments, or as the basic pro- cording to the logic of these procedures, the cedure of other ÇhypnoticÈ procedures for a patient learns how to relax, usually as a va- great variety of alterations and problems riation of Jacobson’s (1938) progressive (Ganer, 1984; Martínez-Tendero, 1995; muscular relaxation, so that later on the pa- Sanders, 1993). Nonetheless, as mentioned tient can relax quickly in order to handle there are very few structured self-hypnosis stress. The approach of Hutchings et al. al- induction methods, specially awake self- so emphasizes the use of relaxation in the hypnotic methods. Only those of Wollman patient’s everyday life by adapting the exer- (1978) and H. Spiegel & D. Spiegel (1978) cises to the needs of the clients so that they have a very detailed and structured format. can do them without anybody else noticing. The majority of these self-hypnosis induc- In this way, the person can relax Çin situÈ tion methods, including that of Spiegel & (whenever there is a problem), which allows Spiegel, are variations of heterohypnotic for in vivo shaping of the relaxation. The methods, which makes them similar. This person will also perceive this as an active similarity carries the limitations we have technique to reduce stress. mentioned: closed eyes, have to practice at Thus, the self-hypnosis method had to home in a particular context, intense use of fulfill the following requirements: 1) Use imagery and meditation, etc. In addition, so- rapid Çself-hypnotizingÈ so as to allow it to me forms of self-hypnosis are just post-hyp- be maximally used in the everyday activi- notic suggestions in which the client is gi- ties of the clients. 2) Alongside with the pre- ven a cue that needs to be activated to again vious point, the exercises should be done in ÇenterÈ into the Çhypnotic state.È a ÇconcealedÈ way, also keeping the eyes Only the method by H. Spiegel and D. open, so that they would not be noticed by Spiegel (1978) attempts to adapt self-hypno- others. 3) Finally, the exercises should opti- sis exercises to the needs of the patient. Des- mize the likelihood that people would have pite this, the client must keep the eyes clo- certain experiences than could be easily sed. Other problem are the requirements of though of as ÇhypnoticÈ (Capafons, 1998; asking the client to roll the eyes upwards, Capafons & Amigó, 1993b), while interfe- which is difficult or bothersome for many ring minimally with everyday tasks. For this people, and requesting arm levitation, which reason, the use of Çgoal-directed fantasyÈ many people find difficult because when (Spanos, 1971) should be minimized becau- they are relaxed they feel their arms to be he- se not everyone can imagine vividly and in- avy rather than light. Last, empirical rese- tensely, and vividness of imagery is not arch (Martínez-Tendero, 1995) shows that highly correlated with the ability to respond 60% of the people who used the Spiegels’ to hypnosis. method needed to use their imagination to Much of the literature on self-hypnosis experience a floating sensation after closing is, and has been, concerned with the process the eyes and exhaling, and 76.6% of partici- of self-hypnosis, not with induction met- pants were really able to have that sensation. hods. Some examples include the work of Only 26.6% of participants were able to sen-

Psicothema, 1998 573 RAPID SELF-HYPNOSIS: A SUGGESTION METHOD FOR SELF-CONTROL se a floating sensation at the end of the pro- sis. It consists in shaping a behavior through cedure. By the same token, it was found out successive approximations to a goal, verbal that 76.6% needed to use imagery to expe- explanations, modeling, and the chaining of rience arm levitation; thus, people with little behaviors. The various steps are taught in imagination have an additional burden. Furt- isolation and then they are linked, with the hermore, 74.4% of the participants did not assumption that reinforcements are social experience flotation, necessary, according to (provided by the therapist), proprioceptive the Spiegels’, to produce relaxation, and (the successful experiencing of reactions fo- 63.4% did not really show arm levitation, llowing therapeutic suggestions) and self- one important response to persuade clients administered (clients’ self-efficacy). The that they are ÇhypnotizedÈ. Some of the par- ability to respond is then generalized to new ticipants complained about having to roll the therapeutic suggestions, without the need eyes upward, as they experienced dizziness, for further shaping exercises. tremor, pain in the eyes when lifting them The whole procedure is akin to a process and even headaches. Finally, 13% had diffi- of stimulus fading and generalization. The culties in keeping the eyes rolled upwards therapist’s instructions, the instigating exer- while they lowered the eyelids. cises and the sensations of heaviness are fa- Considering the dearth of structured self- ded, although the last two can still be used hypnosis methods that are applicable to to maintain the habit and optimize overlear- every day circumstances in an unobtrusive ning, or when relaxation is needed. way, and the need to link hypnosis to self- regulation therapy, I decided to create a new Steps of rapid self-hypnosis procedure that we called rapid self-hypnosis (RSH), which is now described. Before learning the steps, the therapist must explain the logic of the method more The rapid self-hypnosis method (RSH) or less as follows: Ç There are many ways to induce hypnosis very rapidly, in a matter of The rapid self-hypnosis method has three seconds. We are going to use two of them. I very structured steps. All of them, but parti- have chosen them because they are very po- cularly the first two, are designed to instiga- werful and can be used in such a way that te sensations of relaxation, heaviness and they will go unnoticed in everyday life. We immobility. The behaviors suggested in this will use hand-shaking and falling back- method are ways to obtain these reactions, wards (assuming that the client’s susceptibi- so that the client will not only not ÇdoubtÈ lity to hypnosis has been ascertained th- that they are ÇtricksÈ but, on the contrary, rough the exercises of falling backwards will have the certainty that the exercises are and fingers-interlacing; see Capafons & indeed muscular ÇtricksÈ to get the reac- Amigó, 1993a, 1993b). When I measure tions suggested by the therapist. This frame- your hypnotic susceptibility, we did an exer- works seeks to ensure the collaboration of cise in which I suggested that you would the clients to promote responses to sugges- fall backwards, and another one in which I tions. The therapist must indicate that the asked you to interlace your fingers and no- exercises seek to obtain natural reactions tice a sensation of paralysis, that you could and that the clients are our allies in making not separate them. Do you remember them? the therapeutic suggestions work. Well, these two exercises can be modified The Method to train self-hypnosis is ba- into fast methods to induce hypnosis. And sed on Applied Functional Behavior Analy- that is what we will do next, only now as a

574 Psicothema, 1998 ANTONIO CAPAFONS form of self-hypnosis. Don’t worry, the difficult to exhale slowly, the therapist can exercises we will practice are designed so ask him/her to imagine a candle 25 cms. that you won’t fall to the floor and get hurt.È away from the mouth. As the client exhales, the flame must move but not go out. That is Hand-clasping how softly the exhalation must be. If the patient cannot imagine that, or cannot exhale After explaining the steps, the therapist slowly, the therapist can use a real candle so clasps his or her hands without interlacing that the patient will learn to move the flame the fingers and without pressing them without turning the candle out. Once this against each other. The client is told that has been achieved, it is time to continue to «This way is useful so that I won’t get hurt go to the next exercise, after verbally rein- if I wear rings or jewelery. It is also helpful forcing the patient: ÇVery good, you are le- with individuals who suffer from rheuma- arning very fast. This is a good sign that you tism, arthritis, etc.È can use this method successfully. Now we Next, the therapist takes a deep breath are proceeding to the next step, falling back- and during the exhalation lightly presses wards.È each hand against the other. At that moment, the patient is told ÇPay attention. It is Falling backwards very important to just exert a light pressure as you very slowly exhale. It is not appro- Here the therapist models the exercise priate to exhale abruptly or to use much and says the following: Ç I am now recli- pressure. It is not a matter of using a lot of ning into the sofa so that I will be comforta- pressure, but only enough to notice later on ble. This is the position that I will be in the sensation of heaviness in the arms. Ma- when I let myself fall backwards. Next I king them feel tired in this exercise, it will will lean forward, separating my back from be easier later on to notice their heaviness as the back of the sofa some 10 cms., and then we do an exercise of arm immobility. Slow I will let myself fall backwards, in a similar breathing will help us notice general sensa- way as what I would do if I were sitting tions of heaviness and relaxation. Remem- upright and I wanted to be more comforta- ber that we will use anything that will help ble. (The therapist lets him/herself fall back- us experience those sensations. Now, I am wards twice of thrice). When I do this, I no- going to repeat the exercise twice, without tice a sense of muscle relaxation (by being relaxing the hands as I inhale (the therapist more comfortable) and of momentary pa- demonstrates). You must now do the exerci- ralysis. This light paralysis is a natural reac- se. (the client does the exercise, as the the- tion. This is not a ÇhypnoticÈ reaction but a rapist helps and corrects as necessary).È biological response that will help us evoke a It may be useful to be very clear with the later response, which is very important to patients that with each exhalation they must activate our mind and enter self-hypnosis. very lightly press each hand against the Now you should repeat this exercise. You other, so that by the third exhalation there is will see that it is not difficult or uncomfor- a level of pressure that is mild but strong table, but you must practice so that you can enough to notice heaviness in the arms and end up in a comfortable position and in such hands when they are suddenly dropped on a subtle way that no one will notice anyt- the legs. hing. (The client repeats the exercise a num- On the other hand, some people exhale ber of times). All right, now we are going to too rapidly or abruptly. If the client finds it link both steps. Afterwards, I will give you

Psicothema, 1998 575 RAPID SELF-HYPNOSIS: A SUGGESTION METHOD FOR SELF-CONTROL some suggestions so that you can focus on rapid self-hypnosis felt great heaviness, of sensations of heaviness and paralysis. which only 43% also had to use imagery to You know that if you do not interfere you achieve heaviness. Hence, if the patients will notice the reactions that I will propose state that they do not feel heaviness, the the- to you. You will also know that if you do not rapist must interrupt the session and find out like them, you can interrupt them any time what the problem is. It could be fear of hyp- and without difficulty, so I will ask you to nosis, disbelief about what the person is ex- collaborate as much as possible.È periencing, fear of being hurt, or disap- pointment that the method is not powerful Chaining of the two steps or ÇesotericÈ enough. Until those fears and doubts are eliminated, the therapist should As with the other two, the therapist mo- not proceed to the following step (cf. Capa- dels this exercise, separating from the back fons, 1998). If the client does not succeed of chair, shaking the hands and inhaling. At event after exploring fears and inhibitions, the moment of exhalation, the therapist another procedure such as emotional self- lightly will press the hands against each regulation or non-suggestive therapies may other and will exhale slowly. Next he or she be applied. does it again twice, without relieving the Once the client dominates the previous pressure on the hands with each inhalation, sequence, the therapist goes to the following as we mentioned above. When the therapist stage: body immobility. has finished shaking the hands with the last exhalation, he or she abruptly lets the hands Body immobility fall on the legs and the back on the back of the chair, while explaining to the client what ÇNow - says the therapist- you will re- is happening. peat the sequence you just learnt, and when Next, the therapist asks the client to do you have “fallen backwards”, I will give the same, assisting and correcting the client you suggestions to feel your hands more in a kind and encouraging way, while ex- and more glued to your legs. When it beco- plaining what reactions should be occu- mes very difficult to separate the hands rring. ÇAs you may have seen, the hands are from the legs, or you feel so heavy and rela- very heavy, actually all of your body is hea- xed that you feel too lazy to try to separate vier and you notice that you are lightly rela- them, you will have activated your mind xed. (Some people get very relaxed at this and your brain, and you will be able to pro- stage; if this occurs, the therapist should duce some enriching and useful responses show surprise and indicate that this is a go- to your problem. Remember that at any od signal of what is to come). This allow us point you can interrupt those reactions. to stimulate the reactions of the following What matters here is that you may be able to step (i.e., the sensation of relaxation instiga- use them so that you can self-administer the tes a sensation of immobility).È therapeutic suggestions in a very efficient If the clients indicate that they do not ex- way, and wherever and whenever you want. perience anything of what we have descri- Is that all right?È bed, we should suspect that they are interfe- Once the client has again practiced sha- ring, since the exercises are designed to let king the hands and falling backwards, the anybody experience heaviness and relaxa- therapist begins the suggestions: ÇNow, clo- tion. Martínez-Tendero has shown experi- se the eyes, if you wish, and focus on your mentally that 90% of the people that used hands. One or both of them will feel heavier

576 Psicothema, 1998 ANTONIO CAPAFONS and heavier, glued to the legs ... (in a slow ve ones (i.e., low blood pressure) show hea- and rhythmic voice), heavier and heavier, viness and sleepiness even after the Çhyp- glued, heavier and glued, as if they were fu- noticÈ situation is over. These responses sed to the legs. To help you achieve that, should be attributed to the individuals’ ta- and if you so wish, you can use images of a lent to use the method. Next, they are soft rope that binds your hands to your legs, simply asked to close their eyes and count or of a very powerful glue that glues your to three. If they still have some difficulties, hands to your legs, or of a very heavy object they should practice imagining, for instan- that does not allow you to lift the hands. If ce, running to catch a bus, a train, or to get you notice these reactions, you will notice a sip of water when they are very thirsty on that in a moment it will be very difficult to a Summer day. lift the hands, and they feel even more glued Once this motor task challenge is over, to the legs. You know that, if you wish, you clients should be interviewed to find out can lift your hands at any point, but if you their reactions (Capafons, 1998). This infor- put your mind in action, if you let your brain mation will allow us to adapt the exercises be sufficiently activated, you will notice in future sessions to the characteristics and that you cannot separate your hands from preferences of the client. We have mentio- the legs. Furthermore, the more you try to ned that a very high percentage of people separate them, the more difficult it will be to has the awareness of this challenge item lift them and the more they will feel glued even without using imagery; if such aware- to the legs. Try it and you will notice how ness is not present in our patients, we should difficult it is to detach the hands from the suspect interference or we must do other legs (the client tries to do it and ÈcannotÇ). exercises based on sensory recall to impro- Very well, excellent, I notice that you are ve the response to suggestions (Bayot, Ca- able to control your mind so that it can fo- pafons, & Amigó, 1995). llow your instructions. Now, focus on your On the other hand, clients will be told hands. They will feel lighter and lighter, and that it is important to repeat the method th- will recover their usual sensation .. that’s ree times in a row during the morning, af- right, you could separate them now. They ternoon and at night. Clients are also advi- are lighter and lighter . .. That’s it. I will sed to practice in various places, in accord now count to three and you will Çcome outÈ with the principle of stimulus generaliza- of self-hypnosis, you will open the eyes (if tion. the patient closed them) and your mind will Finally, our research shows that our par- be active, clear, with a desire to work on the ticipants deem rapid self-hypnosis as so- problem, calm and relaxed. All right, 1..., mewhat noticeable by others. Participants 2... and 3 How are you feeling?È gave an average score of 4.2, in a scale from The percentage of people who feel the 0 to 10, to the item Çit is not noticed by ot- hands heavy and glued is very high: 93% hers.» The Spiegels’ method got a score of were able to do it, and only 54.4% needed 4.1 in this same scale (Martínez-Tendero, imagery to do it (Martínez-Tendero, 1995). Capafons, & Cardeña, 1996). So the partici- This shows that the method really instigates pants did not think that either method was the reactions and may increase suggestibi- covert enough to go unnoticed by others. lity, although this last point needs experi- For that reason I added a variation in which mental corroboration. patients are told that the goal is to eliminate On the other hand, some patients, after the steps learnt when they need to use self- our own experience, particularly hypotensi- hypnosis and self-administer suggestions,

Psicothema, 1998 577 RAPID SELF-HYPNOSIS: A SUGGESTION METHOD FOR SELF-CONTROL so as to decrease how noticeable the steps fic images, feelings or emotions. Even are. We should remember that the goal of though time may go by, when we listen to or rapid self-hypnosis is to give the patient a smell certain stimuli, we automatically evo- method of self-control, to increase the sense ke the reactions we associated to them. The- of mastery and responsibility to self-regula- se reactions are not an exact copy of what te. From this perspective, to implement a we experienced, but they are a similar and post-hypnotic signal that will increase sug- particularly valuable copy nonetheless. If gestibility through hetero-hypnosis is not the activated or evoked reactions are distas- the best solution. On the contrary, the pur- teful, we tend to avoid those stimuli; if they pose is to have the client use a self-adminis- are pleasant, we will not avoid those stimu- tered procedure that will ÇenableÈ him/her li but will likely try to preserve them. To ta- to direct the use of hypnosis. So, the client ke advantage of our sensory recall, we must is told to generate a response that will work train and control our mind so that it can evo- as a ÇsignalÈ to initiate the suggestive abili- ke or reproduce (although not as a Çcarbon ties. The client is introduced to the concept copyÈ) the reactions (behaviors, images, of sensory recall (Kroger & Fezler, 1976) in sensations, emotions, etc.) that we experien- approximately these terms: ÇWhen you ha- ced beforehand and that we are interested in ve mastered the steps you have learnt, you reproducing at a particular time. To achieve will be able to self-hypnotize in public in an this, you will not need to repeat all the steps ever faster and unobtrusive way, because I have taught you. You need only focus on you will not need to shake the hands or fall your arm, and when the sensory recall of he- backwards. You must only focus on one of aviness and immobility are activated, your the arms (the one whose hand achieved the arm will become heavy and immobile. You greatest paralysis) and you will start noti- know that you can stop these sensations at cing how it becomes increasingly heavier any point. What matters is that when you and glued to the body. You are activating find moving it to be very difficult, you will your sensory recall at that time, that is, you have activated your mind enough to start gi- are turning on your capacity to reproduce ving yourself suggestions. You will be able many emotions, sensations, feelings and be- to keep the eyes open and hold a conversa- haviors that you have ever experienced and tion, while simultaneously being able to re- that are stored in your brain (notice that lax, become active, anesthetized, or whate- when one hears a song that was associated ver you need. Do you understand what I am to some event a long time ago, even if you saying?È had not heard it for a long time, one expe- Even though we are now beginning a re- riences feelings and sensations that were search on the efficacy of these instructions, once associated to the song even though one our clinical experience suggests that almost had believed that those experiences had be- anybody can achieve that response. When en forgotten). Nonetheless, our memory is you have obtained arm immobility, you can not like a tape recorder. Although memory do other exercises that will let the patient is not a faithful and exact recording of what experience various experiences that we has happened, it can nonetheless preserve want to effect through hypnosis (e.g., rela- the important and necessary parts of our re- xation, alertness, anesthesia, changing actions or of what occurs in the environ- body temperature) so that they will be con- ment. Sometimes, however, we store infor- vinced that they are Çself-hypnotizedÈ. Be- mation in an involuntary way, without our sides, by using this last chain (arm disso- having any special interest in keeping speci- ciation), we are chaining hypnosis to self-

578 Psicothema, 1998 ANTONIO CAPAFONS regulation therapy (Amigó, 1992; Capafons should talk about some object that is appa- & Amigó, 1995). That is, we can use «hyp- rently dangerous, but when used in a proper noticÈ suggestions, without a traditional way can help to clients to cope with pro- formal ÇhypnoticÈ induction. All of this has blems in everyday life. This object can be- the great advantage of generalizing to come in a cue for activating these coping everyday life what has been achieved in skills, and clients should understand that therapy. This really allows us to use the lo- self-hypnosis is a tool for enhance the ef- gic of the training in applied relaxation as fects of effort and perseverance on the re- proposed by Hutchings et al. (1980), but duction of their problems. with the advantage that hypnosis increases the effect of cognitive-behavioral treat- Conclusions ments, as found by Kirsch, Montgomery and Sapirstein (1995). Rapid self-hypnosis is a new method that Finally, we can use an additional proce- links experimental research on hypnosis, dure to increase the patient’s understanding made from a cognitive-behavioral perspec- of the role and usefulness of hypnosis, spe- tive, to clinical practice. Its aim is to impro- cifically self-hypnosis. Parting from the lo- ve the efficiency of self-hypnosis methods, gic of training in anxiety management allowing to clients to activate suggestive (Suinn, 1990) a metaphor can be designed processes almost in every situation and cir- for helping the patients understand how cumstance. From this point of view, rapid they can use self-hypnosis. Suinn reports self-hypnosis tries to reduce the clients’ de- that when patients are confronted with mo- pendence, encouraging them to conceptuali- derate or high stress situations that might or ze hypnosis as a general coping skill. Rapid might not be related to their specific fear, self-hypnosis is an adjunt to psychological the patients noticeably improved through intervention that, like hypnosis, tries to en- guided practice. The patients needed to hance their effectiveness. think of relaxation as an active way to handle stress, and they also needed to interpret Acknowledgements the signs of anxiety as a discriminative stimulus to activate their abilities to handle the The author thanks Etzel Cardeña his transla- situation. Therefore, the metaphor should tion of the manuscript into English and his help- include stressful scenes, so that clients can ful comments in the preparation of this article. activate their anxiety responses, and recog- The author thanks, also, Irving Kirsch and Ste- nize them as cues for activating the self- ven J. Lynn for their comments and clarifica- hypnosis skills. Besides, the metaphor tions.

Referencias

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