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ALASTAIR DOBBIN ET AL.
The use of positive affect—particularly the recollection of situations of
mastery to help current or remembered traumatic situations—could be
seen as a form of retrospective immunization as discussed previously
(Williams & Maier, 1977).
Whatever the neurological or psychological operative correlates of
the state of hypnosis, relaxation induction is associated with an uncou-
pling of the amygdala/hypothalamus linkage, which reduces sympa-
thetic arousal (Gruzelier, 1998). This state can be used successfully as a
platform for successful psychotherapy, such as desensitization; disso-
ciation under hypnosis removes the inevitable autonomic retraumati-
zation that would often otherwise occur (Eisenhardt & Menzel, 2006).
The added understanding of the action of negative triggers outside of
conscious awareness (Whalen et al., 1998), the inability of depressives
to suppress the negative effect of such triggers (Fales et al., 2007), and
the ability of negative subliminal priming to diminish performance (as
demonstrated by Horton et al., 2008; Levy, 2003; Shih et al., 2002)
suggest that hypnosis may be a powerful vehicle for the delivery of
effective therapeutic change working through implicit and subliminal
positive suggestion, Additionally, as decentering and reappraisal are
positively correlated (Fresco et al., 2007), it may be that the decentered
perspective of hypnosis may improve the delivery and uptake of
reappraisal as a strategy. Given that the effective component of CBT
has been recognized to be the decentered stance (Teasdale et al., 2002)
and that the cognitive component of CBT utilizes reappraisal, then it
may be that using self-hypnosis to deliver standardized mental tools
may be a more cost-effective option in the treatment of depression.
Dobbin, Faulkner, Heaney, Selvaraj, and Gruzelier (2004) showed that
self-hypnosis directed at ego strengthening is popular and effective in
primary-care mental health; such self-hypnosis has been shown to
raise self-esteem and to improve the Becks Depression Index-II (BDI-II;
Laventure, Kumar, & Pekala, 2002). Recorded hypnosis material can
also employ the powerful effect of positive words and concepts. It has
also been shown that a hypnotic visualization of white blood cells as
dolphins significantly reduced recurrence of herpes simplex infections
and improved the Hospital Anxiety and Depression Scale scale in clin-
ical studies that used taped hypnosis (Gruzelier et al., 2002); self-hyp-
nosis using taped material is as effective as hetero-hypnosis (presence
of a hypnotist) (Unestahl, 1973). Along with the potential for increased
engagement due to a reduction in stigma, access, and literacy prob-
lems, these factors constituted the central justification for our study.
We wanted to examine the acceptability and efficacy of a self-
hypnosis/self-help treatment for depression in primary care by comparing
it to antidepressant treatment. The “gold standard” randomized con-
trolled trial (RCT) cannot allow patient treatment choice and so does
not take into account a naturalistic “real-life” practice; patients offered
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