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ASSEN ALLADIN AND ALISHA ALIBHAI
Montgomery, and Sapirstein (1995), and Schoenberger (2000) that
hypnosis in combination with CBT produces greater clinical improve-
ments than CBT alone in the treatment of emotional disorders. As
there were several hypnotherapeutic components included in CH, at
this point it is not possible to indicate which of the components were
most responsible for the differential treatment effect between CH and
CBT. A dismantling design is likely to answer the question. For the
present discussion, the possible role of the following hypnotherapeutic
components,
hypnotic induction
,
ego-strengthening, expansion of aware-
ness
,
positive mood induction
,
posthypnotic suggestions
, and
self-hypnosis,
included in CH are examined.
Hypnotic induction.
The rationale for inducing hypnotic trance was to
produce relaxation, somatosensory changes, and a sense of control. The
majority of the patients from the CH group was intrigued that for the
first time in their lives they were able to relax completely, replace their
depressive feeling with good feeling, and felt empowered to realize that
their “mind is so powerful.” Hypnotherapists routinely observe such
changes in their patients. This is succinctly recorded by Yapko (2003):
I have worked with many people who actually cried tears of joy or relief
in a session for having had an opportunity to experience themselves as
relaxed, comfortable, and positive when their usual experience of them-
selves was one of pain and despair. (p. 106)
DePiano and Salzberg (1981) believe these could be partly related to
the rapid and profound behavioral, emotional, cognitive, and physio-
logical changes brought on by hypnosis.
The relaxation experience might have been particularly helpful to
the anxious depressives. Many depressives experience anxiety;
approximately 50 to 76% of depressives have comorbid anxiety disor-
der (see Dozois & Westra, 2004).
It is also possible that the hypnotic induction could have created
positive expectancy, a placebo effect. Positive hypnotic experience,
coupled with the beliefs that one has the ability to experience hypnosis
and use hypnosis to alter symptoms, gives one an expectancy of self-
efficacy, which can enhance treatment outcome. Lazarus (1973) and
Spanos and Barber (1974, 1976) have provided evidence that hypnotic
trance induction procedures are beneficial for those patients who
believe in their efficacy. Bandura (1977) believes expectation of self-
efficacy is central to all forms of therapeutic change. There is a consid-
erable body of evidence that those patients’ positive attitudes and
beliefs about a treatment can have profound therapeutic effect in both
medical and psychological conditions (Harrington, 1997). Such obser-
vation led Kirsch (1985, 2000) to develop the sociocognitive model of
hypnosis, known as the response set theory. Kirsch provided consider-
able empirical evidence to support the hypothesis that the positive effect
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