HANDBOOK OF

ELKINS
MEDICAL AND PSYCHOLOGICAL
HYPNOSIS
F O U N D AT I O N S , A P P L I C AT I O N S , A N D P R O F E S S I O N A L I S S U E S

GARY R. ELKINS, PhD, ABPP, ABPH

HANDBOOK OF

MEDICAL AND PSYCHOLOGICAL

MEDICAL AND
EDITOR

A unique, state-of-the-art, interdisciplinary resource on clinical

hypnosis in psychology and medicine

T his is the only up-to-date, comprehensive interdisciplinary resource on clinical hypnosis research and
PSYCHOLOGICAL

HANDBOOK OF
applications in psychology and medicine. Authored by hypnosis experts worldwide, it encompasses state-of-
the-art scholarship and techniques for hypnotic treatments along with hypnosis transcripts and case examples for

HYPNOSIS
all major psychological disorders and medical conditions. In easily understandable language, this desk reference

HYPNOSIS
addresses theories, neurophysiology of hypnosis, hypnotherapy screening, measurement of hypnotizability,
professional issues, and ethics. Individual chapters present hypnotic inductions to treat 70 disorders including
anxiety, depression, pain, sleep problems, phobias, fibromyalgia, irritable bowel syndrome, menopausal hot
flashes, Parkinsons disease, palliative care, tinnitus, addictions, and a multitude of other common complaints.

The guide also examines the history and foundations of hypnosis, myths and misconceptions, patient screening,
and dealing with resistance to the use of hypnosis. It examines a variety of hypnotherapy systems ranging from
hypnotic relaxation therapy to hypnoanalysis. With each application the text includes relevant research, specific
induction techniques, and an illustrative case example. Additionally it covers professional issues, certification,
hypnosis in the hospital, and placebo effects.
F O U N D AT I O N S , A P P L I C AT I O N S ,
KEY FEATURES:
P
 resents state-of-the-art hypnosis research and applications for a wide range of
AND PR OFESSIONAL ISSUES
psychological and medical disorders
E
 ncompasses information on 70 disorders with relevant research, intervention techniques,
and case examples
A
 uthored by an international cadre of experts
P
 rovides an interdisciplinary perspective of both the mental health and medical communities
A
 ddresses certification, ethics, and other professional issues

GARY R. ELKINS
ISBN 978-0-8261-2486-9

EDITOR
11 W. 42nd Street
New York, NY 10036-8002 9 780826 124869 Compliments of Springer Publishing Company, LLC
www.springerpub.com
Presenting Hypnosis to Patients
Joseph Meyerson
Hypnosis is a special word to which patients attri-
bute contradictory meanings and expectations. On
the one hand, hypnosis seems to invite a person to
set out on an enchanting journey of self-explora-
tion, self-healing, and self-empowerment along the
yellow brick road escorted by the Wizard of Oz
(the hypnotherapist). On the other hand, hypno-
sis threatens participants with a loss of their grasp
on reality, a weakening of their self-control, and
a sense of being operated and manipulated by a
wicked sorcerer (the hypnotherapist). When first
introduced to hypnosis, patients often bring with
them this mixture of amazement and fear. Based
on the assumption that appropriate expectations
are a very important element in the effective imple-
mentation of hypnosis, the way in which hypnosis
is presented to patients is crucial for maximizing
therapeutic results and minimizing complications
(Benham, Woody, Wilson, & Nash, 2006; Kirsch,
2011). Appropriate preparation for hypnosis ses-
sions must take into consideration patients moti-
vation to be treated using hypnosis, the problem
to be treated, the hypnotherapist's model and the
field of hypnosis implementation, patients atti-
tudes toward and expectations from hypnosis and
the hypnotherapist, and patients cultural baggage
concerning hypnosis (the myth of hypnosis).
PATIENTS MOTIVATIONS FOR SEEKING
TREATMENT THROUGH HYPNOSIS
Patients have diverse motivations for considering
hypnosis as a treatment modality. Some consider
it to be a last resort after previous unsuccessful
attempts at treatment. Some see it as an effective
adjunct treatment to conventional therapy. Some
are driven by the positive results they have seen in
relatives or friends who have undergone hypno-
sis. And some are attracted to hypnotic therapies
Copyright Springer Publishing Company, LLC
4
C H A P T E R
by misconceptions and unrealistic expectations.
It is also important to mention patients who are
brought to hypnotherapists by proxy motivators,
such as friends and family members. Each of these
motivations must be addressed accordingly. I usu-
ally consider motivational issues during preliminary
telephone conversations, which can help in initial
advance screening. These conversations should
include simple questions such as, How did you
handle this problem previously?, What caused
you to decide to seek help from me?, and What
caused you to decide that hypnosis would be use-
ful for you?Such questions can help a therapist
discover patients motivations and act accordingly.
In this initial stage of treatment, adjusting patients
motivations and expectations of hypnosis and the
hypnotherapist are very important. The rule of
thumb is to use this telephone screening to educate
patients and/or to refer those motivated by major
misconceptions concerning hypnosis to other treat-
ment modalities. Among these misconceptions is
the belief that hypnosis is a lie detector that can
help a patient know all about his spouses infideli-
ties, or the notion that hypnosis is a one-session
treatment that can change someones personality or
chronic health problems dramatically and forever.
Generally speaking, during the first contact with
patients, it is obligatory to give them a realistic pic-
ture of hypnosis while at the same time arousing
their hope, involvement, and curiosity.
PROBLEM TO BE TREATED AND THERAPEUTIC
MODEL OF HYPNOSIS IMPLEMENTATION
Professionals who use hypnosis in their clinical
practice acknowledge that hypnosis is characterized
by numerous levels and dimensions. It is impracti-
cal, and even impossible, to provide patients with
all the data we have today concerning hypnosis.
30 n I:FOUNDATIONS OF MEDICAL AND PSYCHOLOGICAL HYPNOSIS
Ericksons seeding techniques (Battino, 2005)
can serve as a good guiding principle in present-
ing hypnosis to patients based on the problems that
need to be treated. As a rule, patients seeking psy-
chotherapeutic help should be informed about the
relevant accessing and regulating aspects of hyp-
nosis that can be manifested with regard to behav-
iors, thoughts, memories, emotions, associations,
fantasies, and other mental elements. Patients with
physiological difficulties should be educated of the
possibilities that hypnotized subjects can uncover
and use to become more sensitive to and purpose-
fully influence autonomic physiological processes
that are usually beyond conscious control. Patients
with psychosomatic disorders should be told about
the dissociative qualities of hypnosis that may help
them differentiate somatic soreness from somato-
form expressions of emotional conflicts and prob-
lems and learn to handle each of these accordingly.
The model of therapeutic integration of hypnosis
in clinical practice can also play a role in introduc-
ing hypnosis to the patient. We can usually identify
four major clinical models in the field of contempo-
rary hypnotherapy (Meyerson, 2012). One of the
best known models is the classical, script-oriented
suggestibility model, in which hypnosis aims at
reducing patients analytical and critical thinking
and at increasing their acceptance of the thera-
pists therapeutic suggestions (Allen, 2004; Gafner,
2010). Another perspective on hypnosis imple-
mentation is the eclectic, or adjunct, and tool-ori-
ented use of hypnosis, which offers the therapist
grounded in different theoretical orientations (e.g.,
behavioristic, dynamic, existential) the option to
import instruments and insights from parallel clini-
cal and theoretical orientations under the umbrella
of hypnosis (Heap, 2012; Kroger, 2007). The third
common clinical perspective is the magnifying
glass orientation, which sees hypnosis as a mag-
nifier of familiar techniques and processes (Green,
Barabasz, Barrett, & Montgomery, 2005). Finally,
the integrative model, which this author commonly
adopts in his clinical work, relates to hypnosis as a
basic and natural process that is essential for self-
healing and can serve as an infrastructure for any
therapeutic procedure regardless of the theoreti-
cal orientation and professional specialization of
the professional using it (Alladin, 2008; Erickson,
Rossi, & Rossi, 1976; Voit & DeLaney, 2004).
Explaining and presenting the working model to
patients in simple and clear language, and telling
Copyright Springer Publishing Company, LLC
patients what they can expect from the hypno-
therapeutic process, will increase patient coop-
eration and dramatically reduce resistance and
complications.
Finally, the therapist must clearly delineate the
borders of his expertise in hypnosis, not only for
ethical reasons but also in order to help patients
develop appropriate expectations and desired
results from the therapeutic process. For instance,
patients seeking treatment for dental phobia some-
times covertly expect to be treated for all phobic
reactions disrupting their lives. Those patients
should be guided to expect that the treatment will
be oriented specifically toward future dental inter-
actions with the goal of converting them to rela-
tively safe experiences (Meyerson & Uziel, 2014).
As for referrals from other psychotherapists, for
reasons of professional responsibility and concern
for patient well-being, this author usually does not
accept patients for hypnotic psychotherapy if they
are undergoing psychotherapy with a psychothera-
pist who does not use hypnosis. This is especially
true if the referral was intended merely for specific
and seemingly focused interventions (only to treat
this phobic reaction; only to refresh memories
from past traumatic experience; only to help
with converting insights to actions). From the
authors point of view, a hypnotic psychotherapist
is like a surgeon and cannot be responsible only for
opening the abdominal cavity using the scalpel of
hypnosis and at the same time not take responsibil-
ity for the operation as a whole.
PATIENTS ATTITUDES TO AND EXPECTATIONS
OF HYPNOSIS AND THE HYPNOTHERAPIST
Patients attitudes toward and expectations from
hypnosis and the hypnotherapist are usually
derived from several basic sources: personal and
interpersonal experiences, large group or local/
national events, and the historicalculturalmythi-
cal arena (Meyerson, 2014). Positive attitudes can
usually be used as a powerful therapeutic impetus
but should be realistically grounded and adapted
to the current therapists hypnotherapeutic meth-
ods and take the patients present circumstances
into account.
Problematic expectations that develop on the
personal and interpersonal levels are usually

caused by previous negative or unprofessional
experiences with hypnosis or hypnosis-like expe-
riences, such as meditation, guided imagination,
and stage hypnosis (Battino, 2007). Such expecta-
tions alsocan be acquired by proxy and based on
stories told by relatives, friends, or acquaintances.
Information from the theater, books, movies, or
other sources can also affect these misconcep-
tions acquired on the personal and interpersonal
levels (Barrett, 2006; Pintar & Lynn, 2008). Local
large groups or national false beliefs about hyp-
nosis usually emerge from fabled and well-known
events entrenched in the local/national memory
(Kleinhauz, Dreyfuss, Beran, Goldberg, & Azikri,
1979; Meyerson, 2014). Cultural and mythical ele-
ments influencing public views of hypnosis can be
partially attributed to the historical roots of mod-
ern hypnosis. Pioneers, such as Mesmer, Braid, and
Charcot, have developed and used applications
and theories and have created an appropriate plat-
form for such historically rooted impressions (for
review, see Rosenfeld, 2008). Some of the cultural
mythical elements responsible for misconceptions
about hypnosis seem to also serve as symbolic
descriptions of hypnosis and of trance phenom-
ena. Moreover, as proposed by French structural
anthropologist and myth researcher Claude Lvi-
Strauss, these descriptions may function as popular
science that enables humans to understand abstract
things about the world around them (e.g., hyp-
nosis) on an observable and sensible level (Lvi-
Strauss, 1966; Segal, 2004).
In preparing patients for their first hypnosis
session, modern hypnotherapists strive to change
patients misconceptions concerning hypnosis
that are usually related to apprehensions about
losing autonomous and intended functioning
(Yapko, 1994, 2012). The clinician can usu-
ally relieve these worries through rational and
apparently scientic explanations using everyday
examples and stories from the recent and ancient
history of hypnosis (Capafons et al., 2005). This
approach is even more effective when veried by
helping patients try hypnosis on themselves using
short and safe exercises (Voit & DeLaney, 2004).
Before the first hypnosis session, the author
finds it very useful to tell the patient the follow-
ing: During this hypnosis session you are free
to remember, to be aware of the process and to
emerge from hypnosis independently whenever
you wish, simply by opening your eyes.
Copyright Springer Publishing Company, LLC
4:PRESENTING HYPNOSIS TO PATIENTS n 31
This hypnoeducational approach is effective
in negating misconceptions rooted on the per-
sonal, interpersonal, and local/national levels.
Nevertheless, culturalmythical elements must
be treated by the complementary approach of
remythification of the hypnosis myth (Meyerson,
2014).
REMYTHIFICATION OF THE HYPNOSIS MYTH
According to the hypnosis myth, hypnosis is a very
powerful and dangerous enterprise with almost
miraculous short-term consequences that can be
devastating in the long run. The myth depicts the
hypnotherapist as cruel and manipulative and
the hypnotized patient as weak, dependent, and
defenseless. This myth has been reinforced in mov-
ies, novels, and plays, and is sometimes exploited
and empowered by stage shows demonstrating
hypnosis (Barrett, 2006). Social scientist Judith
Pintar states in her in-depth study of the history of
hypnosis and the hypnosis myth that the popular
view of hypnosis has remained almost unchanged
for at least the last three centuries despite demys-
tification efforts by the scientific community of
hypnotherapists during this period. According to
Ericksons utilization strategy, the mythical ele-
ments of these persistent sociocultural misconcep-
tions concerning hypnosis in contemporary society
must be treated not by eliminating the myth, but
rather by renewing it through a process known as
remythication (Meyerson, 2014). This process
involves strengthening the positive, useful, and
constructive elements of the myth and reducing its
negative, non-useful, and incongruent elements.
Taking into account the culturalanthropological
view of leading myth researchers such as Barthes
(1972) and Lvi-Strauss (1966), we can conclude
that even today contemporary society needs mythi-
cal explanations of complex phenomena like
hypnosis, and that myths constantly mutate and
are reformulated based on social needs. If in the
modern society of the 20th century clinicians and
leaders in the field of hypnosis employed demystifi-
cation and scientific orientation in the remythifica-
tion of hypnosis, the cultural needs for relativism,
authenticity, and spirituality in the postmodern
society of the 21st century dictate that we must
reestablish the remythification process. We can do
this by examining the dichotomies, multilevel and
32 n I:FOUNDATIONS OF MEDICAL AND PSYCHOLOGICAL HYPNOSIS
multilateral explanations in theoretical, empiri-
cal, and clinical approaches to hypnosis and hyp-
notherapy (Lynn, Rhue, & Kirsch, 2010; Nash &
Barnier, 2008) utilizing mythical and culturally
influenced patterns.
PRACTICAL CONSIDERATIONS
Contemporary hypnotherapists formulating a new
contemporary myth narrative during initial patient
interviews must not to be afraid to refer to hyp-
nosis as a trance state. Even though distinctions
between the conscious and the unconscious
parts of the mind as well as left brainright
brain terminology are not strictly scientifically
based and are still the subject of academic debate,
hypnotherapists must not hesitate to use these dis-
tinctions for explaining hypnosis (Lilienfeld, Lynn,
Ruscio, & Beyerstein, 2009; Raz, Schwartzman, &
Guindi, 2008). Metaphorical and poetic language
grounded in the patients experiences and values
can be useful as well.
To demonstrate and clarify this proposed pro-
cess of remythification for dealing with the hyp-
nosis myth, I use the questionanswer format
used elsewhere (for thefull version, see Meyerson,
2014). Dialectically phrased answers to questions
can serve as proper remythification tools. Generally
speaking, answering patients questions is a very
effective way of informing them about hypno-
sis and dealing with misconceptions and myths.
Questions typical of patients troubled by control
issues are as follows:
QQ: Isnt hypnosis a powerful way of control-
ling people?
AA: Although hypnosis is not about control, a
special kind of alliance is certainly formed
between the hypnotherapist and the person
hypnotized. Each individual involved in
the hypnotic process is more attuned to the
other and also to himself (Meyerson, 2014,
p.387).
QQ: Can one do or say anything contrary to
ones will while under hypnosis?
AA: Hypnosis cannot force you to do or to
say anything against your core values, but
humans have diverse and, at times, contrast-
ing wills. During hypnotherapy, the will that
guides you to improved health and enhanced
Copyright Springer Publishing Company, LLC
wellbeing can be heard more clearly, and
even be empowered.
Patients also have questions regarding the long-
term outcomes of hypnotic interventions, such as
the following:
Q:Is hypnosis a dangerous procedure?
Such questions can provide the therapist further
opportunities for remythification.
A:Hypnosis is a powerful therapeutic instru-
ment and in the hands of an experienced clini-
cian can do a great deal of good. So, as with
anything, it is important to choose the right per-
son for the right job (Meyerson, 2014, p. 387).
CONCLUSION
Although hypnosis is considered to be a natural
everyday phenomenon, it, at the same time, con-
stitutes a powerful and potent therapeutic entity.
Bearing this in mind, in this chapter I have pro-
posed that the preparation of patients for hyp-
notic procedures should not be taken lightly.
Appropriate patient screening based on the motiva-
tions for seeking hypnotherapy, the patients prob-
lems and needs, the therapists area of expertise,
and the model of hypnosis implementation is ethi-
cally required, and should be considered the point
of departure for the preparation phase. Patients
attitudes toward and expectations from hypnosis
and from the hypnotherapist should be examined
and considered using proper explanations that take
into account personal, interpersonal, and large
group experiences. Finally, deeply rooted mythical
aspects and misconceptions should be treated using
remythification strategies.
In summary, adequate explanations supported
by demonstrations and a remythification approach
to patients sociocultural baggage can save a lot of
time in preparing for hypnotherapy by preventing
complications, reducing resistance, and helping to
make the hypnotherapeutic process more effective,
satisfying, and fascinating for both the hypnother-
apist and the patient.
REFERENCES
Alladin, A. (2008). Cognitive hypnotherapy. Chichester,
UK: John Wiley & Sons.

Allen, R. P. (2004). Scripts and strategies in
hypnotherapy: The complete works. Carmarthen,
Wales; Williston, VT: Crown House Publishing.
Barrett, D. (2006). Hypnosis in film and television.
American Journal of Clinical Hypnosis, 49(1), 1330.
doi:10.1080/00029157.2006.10401549
Barthes, R. (1972). Mythologies (Lavers,A. Trans.).
London, UK: Farrar, Straus and Giroux.
Battino, R. (2007). Guided imagery: Psychotherapy and
healing through the mind-body connection. Bancyfelin,
Carmarthen, UK: Crown House Publishing.
Battino, T. L. S. R. (2005). Ericksonian approaches:
A comprehensive manual (2nd ed.).Bancyfelin,
Carmarthen, UK:Crown House Publishing.
Benham, G., Woody, E. Z., Wilson, K. S., & Nash, M. R.
(2006). Expect the unexpected: Ability, attitude, and
responsiveness to hypnosis. Journal of Personality and
Social Psychology, 91(2), 342350. doi:10.1037/0022-
3514.91.2.342
Capafons, A., Cabaas, S., Alarcn, A., Espejo, B.,
Mendoza, M. E., Chaves, J. F., & Monje, A. (2005).
Effects of different types of preparatory information on
attitudes toward hypnosis. Contemporary Hypnosis,
22(2), 6776. doi:10.1002/ch.25
Erickson, M. H., Rossi, S. I., & Rossi, E. L. (1976).
Hypnotic realities: The induction of clinical hypnosis
and forms of indirect suggestion.North Stratford, NH:
Irvington Publishing Inc.
Gafner, G. (2010). Techniques of hypnotic induction (1st
ed.). Carmarthen, Wales: Crown House Publishing.
Green, J. P., Barabasz, A. F., Barrett, D., & Montgomery,
G. H. (2005). Forging ahead: The 2003 APA Division
30 definition of hypnosis. International Journal of
Clinical and Experimental Hypnosis, 53(3), 259264.
doi:10.1080/00207140590961321
Heap, M. (2012). Hypnotherapy: A handbook. New
York, NY: McGraw-Hill International.
Kirsch, I. (2011). The altered state issue: Dead or alive?
International Journal of Clinical and Experimental
Hypnosis, 59(3), 350362. doi:10.1080/00207144.20
11.570681
Kleinhauz, M., Dreyfuss, D. A., Beran, B., Goldberg,
T., & Azikri, D. (1979). Some after-effects of
stage hypnosis: A case study of psychopathological
manifestations. International Journal of Clinical
and Experimental Hypnosis, 27(3), 219226.
doi:10.1080/00207147908407563
Copyright Springer Publishing Company, LLC
4:PRESENTING HYPNOSIS TO PATIENTS n 33
Kroger, W. S. (2007). Clinical & experimental hypnosis:
In medicine, dentistry, and psychology(2 Har/
DVD).Philadelphia, PA:Lippincott Williams &
Wilkins.
Lvi-Strauss, C. (1966). The savage mind. Chicago, IL:
University of Chicago Press.
Lilienfeld, S. O., Lynn, S. J., Ruscio, J., & Beyerstein,
B. L. (2009). 50 great myths of popular psychology:
Shattering widespread misconceptions about human
behavior (1st ed.). West Sussex, UK: Wiley-Blackwell.
Lynn, S. J., Rhue, J. W., & Kirsch, I. (2010). Handbook
of clinical hypnosis (2nd ed.). Washington, DC:
American Psychological Association.
Meyerson, J. (2012). Hypnotic psychotherapy. Presented
at the Hypnosis in Clinical, Medical and Rehabilitative
Psychology, Tel Aviv.
Meyerson, J. (2014). The myth of hypnosis: The need for
remythification. International Journal of Clinical and
Experimental Hypnosis, 62(3), 378393. doi:10.1080/
00207144.2014.901090
Meyerson, J., & Uziel, N. (2014). Application of hypno-
dissociative strategies during dental treatment of
patients with severe dental phobia. International
Journal of Clinical and Experimental Hypnosis, 62(2),
179187. doi:10.1080/00207144.2014.869129
Nash., M. R., & Barnier., A. J. (2008). The Oxford
handbook of hypnosis. New York, NY: Oxford
University Press.
Pintar, J., & Lynn, S. J. (2008). Hypnosis. Oxford, UK:
Wiley-Blackwell.
Raz, A., Schwartzman, D., & Guindi, D. (2008).
Hemihypnosis, hypnosis, and the importance of
knowing right from trend. American Journal of
Clinical Hypnosis, 51(2), 201208. doi:10.1080/00029
157.2008.10401665
Rosenfeld, S. M. (2008). A critical history of hypnotism:
The unauthorized story. Bloomington, IN:Xlibris.
Segal, R. A. (2004). Myth: A very short introduction. New
York, NY:Oxford University Press.
Voit,R., & DeLaney,M. (2004). Hypnosis in clinical
practice: Steps for mastering hypnotherapy. New York,
NY: Routledge.
Yapko, M. D. (1994). Essentials of hypnosis (1st ed.).
New York, NY: Routledge.
Yapko, M. D. (2012). Trancework: An introduction to
the practice of clinical hypnosis (4th ed.). New York,
NY: Routledge.