Cognitive Behavioural Hypnotherapy
At First Step Hypnosis we offer cognitive behavioural hypnotherapy (CBH) to help clients to overcome their issues and start to live the life they want.
CBH is the integration of hypnosis with the theories and techniques of cognitive behavioural therapy. It is based on years of research and studies from around the world and it is a safe, natural and effective treatment for many conditions including, stress, anxiety, pain management, weight loss, IBS, unwanted habits and addictions.
Is It All Just A State Of Mind...?
Scientists and researchers have still to decide on a definitive definition of hypnosis but most theories fall into one of two camps. Many hypnotherapists will describe hypnosis in terms of an “altered state of consciousness” or a “hypnotic trance”. To them hypnosis is seen as being a very distinct psychological or physiological “state” that is different to our usual waking or sleeping states. Many also believe that during this state the hypnotherapist is able to bypass the critical nature of the conscious mind and to communicate directly with the unconscious mind, implanting new ways of thinking. Unfortunately, there is no real evidence that this altered state of consciousness really exists or that the brain has parts of it that can be identified as conscious or unconscious. These ideas should really be viewed as metaphors to explain the process rather than as fact.
The cognitive behavioural theory of hypnosis (Barber, Spanos & Chaves, 1974) on the other hand proposes that instead of being a special state, hypnosis is merely the utilisation by the client of a positive cognitive mindset made up of everyday psychological traits that can be summed up in the acronym TEAM, devised by Araoz (1982) :
Trust – the client must have trust in the hypnotherapist and their own abilities
Expectation – the client must know what to expect in hypnosis and what their role is.
Attitude – the client must maintain a positive attitude to the suggestions and the treatment
Motivation – the client must be self motivated and ready to make a change
The client can therefore be helped to develop their mindset with the assistance of the hypnotherapist and to increase the effectiveness of the treatment.
Look Into My Eyes...
Long gone are the days of hypnotherapy being associated with swinging watches and Svengali-type hypnotists. Most hypnotherapists today subscribe to the idea that “all hypnosis is self-hypnosis”, meaning that the locus of control is always with the client. The client can decide whether to go into hypnosis or not, they can disregard any suggestion that they chose (for example any unethical suggestions) and they can come out of hypnosis whenever they wish (you can’t get stuck in hypnosis).
When describing what hypnosis is there are two concepts that are worth considering. The first is hypnotic susceptibility, which is how responsive the client is to the suggestions that the hypnotherapist gives. It is proven that the population have varying degrees of hypnotic susceptibility and this can be measured (for example the Stanford Hypnotic Susceptibility Scale). Hypnotic susceptibility is usually considered static (it can be measured many years apart and remain the same) however evidence shows that hypnotic skills training can lead to an increase in susceptibility (for example the Carleton Skills Training programme). Research also shows that levels of susceptibility do not affect the outcomes of treatment, in other words even if you are not very susceptible hypnotherapy can still be effective for you. There are no known characteristics which identify someones hypnotic susceptibility and there is very little difference between the susceptibility of men and women.
The other concept is suggestion, or the process of the hypnotherapist guiding the thoughts, feelings or behaviours of the client. Common suggestions might be to feel more relaxed, to imagine an image or idea, to picture the future or to remember the past. Suggestions are usually formed through the words the hypnotherapist says and how they say them.
Therefore, during hypnosis a hypnotherapist will usually “induce” hypnosis by asking the client to close their eyes and focus on an idea or thought. For example, to focus on their breathing, or to imagine their hand is getting lighter or their eyes are getting heavier. If the client is susceptible (and using the TEAM concept clients can be better prepared before being hypnotised) and follows the suggestion given then they can very easily become hypnotised. If the client refuses to follow the suggestions or simply doesn’t want to then there is nothing the hypnotherapist can say that will hypnotise them. Therefore, because the client has the choice to be hypnotised or not we consider it self-hypnosis.
But Does It Work?
Hypnosis is one of the most active areas of clinical research. There are over 13,000 citations on the website PubMed which includes clinical research and academic papers on the use of hypnosis across many areas including physical conditions, emotional conditions and even issues such as sport performance. Overall the research for hypnosis is positive. The British Psychological Society report “The Nature of Hypnosis” (Heap et al, 2001) concludes:
“Enough Studies have now accumulated to suggest that the inclusion of hypnotic procedures may be beneficial in the management and treatment of a wide range of conditions and problems.”
They go on to list the conditions that hypnosis has been proven to help including:
- Stress, Tension & Anxiety
- Tension headaches & migraines
- Irritable bowel syndrome
- Eczema & psoriasis
- Weight reduction
So What is Cognitive Behavioural Therapy?
Cognitive behavioural therapy is a talking therapy that, like hypnosis, is clinically proven to treat emotional and physical health conditions. Cognitive behavioural therapy is offered by the National Health Service and the The National Institute for Health and Care Excellence recommends it to treat anxiety and depression. As opposed to other forms of therapy which focus on the past or on clients feelings and where they come from, cognitive behavioural therapy is very much centred on helping the client to change their thoughts and behaviours, which in turn changes the way they feel about themselves and the world around them. For example psychologist and researcher Dr. Albert Ellis created the ABC model which explains how our feelings about an event are mediated by our thoughts:
A is the activating event—the situation or event
B is our belief—our explanation or thoughts about why the situation happened
C is the (emotional) consequence—the feelings and behaviours that our belief causes
If we have irrational or maladaptive beliefs they create negative feelings and behaviours.
Common interventions in cognitive behavioural therapy include:
- setting realistic goals and learning how to solve problems
- learning how to manage stress and anxiety
- identifying situations that are often avoided and gradually approaching feared situations
- identifying and challenging negative thoughts
- keeping track of feelings, thoughts and behaviours to become aware of symptoms and to make it easier to change thoughts and behaviours
The Best Of Both Worlds
Cognitive behavioural hypnotherapy can therefore be defined by the three features we have covered,
- The cognitive-behavioural theory of the nature of hypnosis, which basically rejects the notion of hypnotic “trance”.
- Cognitive behavioural therapy and hypnotherapy interventions delivered within hypnosis
- A broadly cognitive behavioural theory of people’s problems, which attempts to explain issues such as anxiety using specific evidence-base models such as Ellis’s ABC model
In 1995 research conducted by Irving Kirsch et al. proved that for between 70-90% of clients, cognitive behavioural therapy was more effective when integrated with hypnosis, i.e., that for the vast majority of clients cognitive behavioural hypnotherapy is superior to Cognitive behavioural therapy alone.
A meta-analysis was performed on 18 studies in which a cognitive-behavioural therapy was compared with the same therapy supplemented by hypnosis. The results indicated that the addition of hypnosis substantially enhanced treatment outcome, so that the average client receiving cognitive-behavioural hypnotherapy showed greater improvement than at least 70% of clients receiving non hypnotic treatment. (Kirsch et al., 1996)