Psicothema, 1998. Vol. 10, nº 3, pp. 571-581 ISSN 0214 - 9915 CODEN PSOTEG Copyright © 1998 Psicothema 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 met- hod has been created from a cognitive-behavioral perspective, and has received empiri- cal 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 every- day 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, paradoxi- cally, 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 «hypnotic» sug- subject’s will. Although this «robotic por- gestions, without having to close the eyes or trait» is inaccurate, patients typically ask for get «sleepy», 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 «hypnosis» 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 («awake-alert hypnosis», Capafons, 1995 b; Capafons & Amigó, 1993a, 1993b). 1998), it is not thought as a self-hypnosis This procedures uses «waking» 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 «in- when additional practice in hypnosis is ne- duce» hypnosis, such as expanding aware- cessary. ness («hyperempiria,» 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 «waking but particularly Bányai’s, emphasize physi- hypnosis». This procedure would satisfy cal and mental alertness. She encourages those patients who want to be hypnotized, muscular activity to «hypnotize» the pa- allowing them to be «activated» 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 «hete- Denney, Basgall and Houston (1980). Ac- rohypnosis» treatments, or as the basic pro- cording to the logic of these procedures, the cedure of other «hypnotic» 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 «in situ» 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 «self-hypnotizing» 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 «enter» into the «hypnotic state.» a «concealed» 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 «hypnotic» (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 «goal-directed fantasy» 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.