International Journal of Complementary & Alternative Medicine Review Article Open Access Online hypnotic psychotherapy with distant patients Abstract Volume 13 Issue 6 - 2020 The Coronavirus (COVID-19) pandemic forced many psychotherapists using hypnosis Joseph Meyerson with their patients to venture into unexplored and undiscovered territory. They were Department of Psychology, Bar Ilan University, Israel challenged not only by technologies such as videoconferencing and the written and unwritten codes of online behavior, but also by the primary and well established rules of Correspondence: Joseph Meyerson, Department of hypnotic and psychotherapeutic arts, which became challenging and confusing in the new Psychology, Bar Ilan University, 6 Meron s.t, Kfar Yona 4033537, digital environment. In the current paper, I will present the challenges of online hypnotic Israel, Fax 15336042525, Tel +972544443239, psychotherapy (H-psychotherapy) for professionals. Some practical recommendations Email for H-psychotherapy utilizing teleconference equipment will be offered. Additionally, specific techniques and strategies for the online implementation of hypnosis will be Received: November 04, 2020 | Published: December 29, presented. Subjective and inter subjective factors that have to be addressed during online 2020 H- psychotherapy will be emphasized and discussed. All of the elements mentioned above are essential for working online with hypnosis while helping create and develop a safe, effective, and therapeutic space that can bypass the technological, physical, and psychological barriers. Keywords: hypnotic psychotherapy, online hypnosis, tele-hypnosis, remote hypnosis, distant patient, intersubjective hypnosis Introduction Modern remote hypnosis Social distancing has been used by many countries as a useful Practicing hypnosis with distant patients by phone (tele-hypnosis) measure to address the COVID-19 pandemic. However, it has prevented was initiated approximately fifty years ago and was described as a the world from moving along well-developed and familiar paths. possible and efficient practice.3–7 Two decades have passed since the H-psychotherapy clinics were no exception. Some of the hypnotists first trials using videoconferencing hypnosis (video-hypnosis) were who already used Skype, Zoom, and other videoconferencing software introduced;8 since then, not much has been written about it.8,9 were energized and felt victorious and confident. Nevertheless, most Overall, videoconferencing has been accepted and used in clinicians who routinely applied hypnosis during psychotherapy in many therapeutic fields, including psychotherapy and even face-to-face interactions in their clinics were somewhat confused and psychoanalysis.10–12 It has been designated as a useful instrument challenged. The online therapeutic arena became divided into three for treating a variety of mental health conditions while considering geographically and conceptually distant places: the therapist location, patients’ and therapists’ preferences and limitations.11,13,14 It was found the patient location, and the digital interconnecting space. useful with patients who are located at a distance from their therapists Consequently, well-known principles of hypnotic art were or have relocated, have accessibility issues, or are physically and/ challenged by technological, geographical, and psychological or psychologically challenged. Therapeutic videoconferencing is obstacles. The familiar psychotherapeutic props of empathic and helpful in emergency situations and for busy professionals.8,12 Lately, therapeutic presence and intervention were shaken by online it has filled the geographical and social gap that opened between conferencing procedures and setting intricacies. The present paper patients and their therapists following distancing policies during the will deal with the challenges of converting online H-psychotherapy COVID-19 pandemic.15 It can also grant psychotherapy participants with distant patients into a safe and effective psychotherapeutic freedom from geographical or material stagnation (absence of fixed space and process. In the first section of the paper, I will relate some places of living and working). Against this background, the lack of objective factors of online hypnotic interactions. Those will include scientific and clinical writing concerning online H-psychotherapy is the design and utilization of the therapists’ and patients’ physical even more prominent. locations, computers, and peripheral equipment operation. This disregard can’t be explained only by a rigid clinging to Additionally, the digital space of the internet and videoconferencing traditional ways of conducting therapy, difficulty dealing with software will be considered. In the second part of the paper, more uncertainty, or technology anxiety. Hypnotists are usually out-of- subjective matters will be discussed. The personal preferences of the-box innovators who are not easily intimidated by the unexpected therapists and patients in the context of online H-psychotherapy will and unknown. They aspire to improve their professional performance be addressed. Specific hypnotic strategies and techniques for handling even in the face of being perceived as professionals that use marginal hypnotized distant patients will be presented. Finally, the challenge practices.16,17 The reason for the neglect of online H-psychotherapy is to develop a safe, inter subjective healing space that can bypass the concealed in the fact that H-psychotherapy is a genuinely challenging technological, physical, and psychological barriers during hypnotic task for both the therapist and the patient. In the next sections, the psychotherapy will be addressed, especially by focusing on the challenges mentioned above will be discussed, and some solutions therapist’s ability to ‘hold’ patients when in silence and to ‘contain’ will be presented. patients’ abreactive expressions when online.1,2 Submit Manuscript | http://medcraveonline.com Int J Complement Alt Med. 2020;13(6):238‒242. 238 ©2020 Meyerson. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Copyright: Online hypnotic psychotherapy with distant patients ©2020 Meyerson 239 It should be noted that on-demand, fixed, online hypnotherapy is It seems that beyond the practitioner’s flexibility and creativity in in coincidental use by internet frequenters and is not different from utilizing the patient’s contribution to the setting establishment, some pre-recorded video/audio sessions that have been in use for decades setting rules should be retained. Asking the patient to start a session by therapists.6,18 First-timers can use this kind of hypnotherapy on time, guiding him/her to find a safe and private place without marginally and experientially, and those experienced in hypnotherapy interference from household members, and using sufficient lighting can use it prophylactically and, at times, as self-hypnosis exercise.19 that should be switched on before the evening darkness develops are The current paper will not include this kind of hypnotherapy and will ground rules that should be retained. Additionally, the patient must focus on online interactive H-psychotherapy. prepare a comfortable place, with some pillows and blankets, to sit or lie down in front of the camera during the session. The setting development during online The online space, including peripheral equipment, is the H-psychotherapy interconnecting element of The Venn Clinic. Wi-Fi stability and Face to face H-psychotherapy has agreed upon and specific bandwidth, online cameras, microphones and headsets, computers, characteristics, rules, and roles that can be addressed as a setting.20 screens, and software apps become an essential part of preparing Usually, the therapist is in control of the setting or is at least responsible and creating a therapeutic space in a multi-locational therapeutic for defining and safeguarding it. By doing so, the hypnotist helps environment. Decent quality peripheral equipment, as well as a patients feel protected and to enter safely into an altered state of computer (preferably a large-screen, fast desktop), a good quality hypnosis, allowing effective personal psychotherapy.21–23 It should camera, and quality headphones, enable the therapist to be more be noted that every psychotherapeutic setting, H-psychotherapy confident and prevent burnout when working with multiple patients. included, has concrete and subjective elements.24 I will address these The location of one’s camera is an essential element, as placing elements separately. the camera at eye level creates an atmosphere of person-to-person communication as opposed to the atmosphere created by placing it In the course of preparing this paper, I discussed the problems that above or below eye level—one-down or one-up positions. It is vital to arise during online H-psychotherapy with architects and industrial master the operation of videoconferencing software. As I usually use designers. I explained to them that, during the session, I have to the Zoom app (Video Conferencing, Web Conferencing, Webinars, develop a safe and therapeutic space to work hypnotically with Screen Sharing, n.d.), I won’t expand on its operation, as there is patients by interconnecting three geographically and conceptually useful guidance online. distant areas: the therapist’s location, the patient’s