2002 Spiegal – finds changes in blood flow in hypnotised subjects
TYPES OF HYPNOTIC SUGGESTION 1] Implication – A method of indirect suggestion ie – when you hear the sound of the wind and the birds singing – nod your head. The when not if => implication Which of your hands feels lighter. In which of your hands will your unconscious mind develop a lightness Would you like to go into a trance now or later NOT – lets try and hypnotize you now. 2] Truism – Something people have experienced so often they can’t deny it. ‘ Most people .. you already know, … some of us… Everybody… sooner or later everyone…’ 3] Not knowing and Not doing - Facilitates unconscious responsiveness – stop patients trying too hard. ‘ You don ’ t have to think or reply or even concentrate because your unconscious mind will hear everything I say ’ ‘ It isn’t necessary’ ‘It will just happen by itself’ 4 ]Covering all possibilities of response - ‘failsafe’ Defines any response as successful and hypnotic ‘ Shortly your L hand or your R hand will be light or heavy. Perhaps you ’ ll notice something in your little finger movement or sensation. ’ ‘ Important thing is not how it happens but to be fully aware of what happens to that hand’ 5] Questions – Help to concentrate, stimulate associations , in duce trance. DON’T – communicate doubt with ‘ is your hand getting numb?’ BUT be positive with ‘ And the numbness, do you notice it beginning? ’ @ Dos your hand float up to our face? ’ Can you Notice Do you Sense And would you like to Feel Does Hear, taste smell Will (it your) Listen Are you aware of Remember See Experience Choose Let yourself, Let your 6] Contingent suggestions - connect suggestion to ongoing or inevitable behavior. – ‘ As your hand lowers – you will find yourself going back to a time when ’ [ More difficult to reject chained suggestions ] ‘ and when, ’ ‘ as soon as ‘ ‘ if… then…until… [ NB Inevitable cues ie ‘ tying shoe lace, lying down, brushing teeth]. ‘ As you feel … you recognise ’ 7] Implied Directive – 3 parts 1. A time binding introdcution 2. An Implied suggestion for an internal response 3. A behavioural response to show it has been accomplished. Eg (1)‘ As soon as ’ (2)your mind has identifed when the problem developed (3)your hand will float up 8] Apposition of opposites – Balancing of opposites eg ‘ As your arm becomes more rigid your body becomes more relaxed. ‘ ‘ As your head is warmer your body is cooler ‘ Wet/dry Tense /relaxed light/heavy difficult /easy anasthesia/hyesthesia 9] Insterspersal of suggestions and metaphors - insight / motivation / bypass resistance change. Deeding an idea – if given prior to explanation eg ‘ scar – remaining – not painful – metaphor for someone how was once bereaved / raped etc Types – 1. From own experience 2. Truisms – re nature / life experiences 3. Tailored to pts situation – Can be brief. Don’t overuse 10] Symbolism and metaphoric imagery – eg Imagine what your pain looks like and change it analgesia 11] Phrasing of suggestions – Rework for oneself – Rhythm and pauses – slow down during induction Unless resistant patient – when speeds up to stop too careful analysis 13] Negatives to discharge resistance ‘ You will – will you not? ‘ You can – can you not? You do – don’t you 14] Bind of comparable alternatives -2 things sounding like options but in fact the same. – illusion of choice ‘ would you rather go in a trance sitting up Or lying back ’ Would rather to into a light OR medium Or deep trance’ ‘ You can be aware of just the sound of my voice or simply ignore everything else’ ‘ Numbness more in the R or L hand 15] Conscious / Unconscious double bind ‘ If your unconscious mind is ready to go into a trance your R hand will lift up. If not your L will lift up.’ 16] Confusional Suggestion – ‘ Depotentiates conscious mental sets ’ therefore liberating unconscious process eg. 1] shock and surprise – ‘and what the hand is doing next will amaze and surprise you’ ‘it would be a disaster if you didn’t change direction and arrived where you are currently going. 2] Double dissociation double bind ‘ In a moment you can awake as a person but it isn ’ t necessary for your body to awaken or your can awake only with your body, but without being aware of your body ’
Process of suggestions in facilitating phenomena 1]Focus Attention – ‘ Something is beginning to happen to one yof your hands but you don ’ t know what – its is yet ’ curiosity or directly ‘ I want you to listen carefully ’ 2]Enhancing awareness of immediate experience - ‘ and you can simply tell me which hand feels lighter ‘ ‘ and notice the texture of your trousers, and the sensation s being picked up by your ‘ = PACING – activity NOT suggested , seeks to increase current awareness 3]Noting and accepting any new aspect of the experience or leading the subject -Suggestion to create expectation ‘ and one of your hands will feel lighter than the other and you ’ ll notice a tendency to movement on one hand and then a finger will twitch and move and then start to float up ’ ‘ and I don’t know if you’ll begin to notice the numbness in your fingers, or in the palm or in the back of your hand first. But when you notice the numbness beginning nod your head ( pause 30 secs) . do you notice the numbness yet?’ 4Indroduceing the immediate goal of the suggestion ‘ and as that lightness increases, soon the entire hand and arm will begin to float up off your lap [GOAL] Use THAT hand not your hand – is dissocitative 5]Repetition of suggestion . Reinforce partial response ‘ and that hand is getting lighter and lighter ( said during inhalations) lifting lifting that ’ s rights ( r einforcing small twitches) You can really enjoy the way it effortlessly floats up 6]Encourage Dissocaition and involuntary response ‘ Use The hand , its floating up, just allow that hand all by itself , all at its own pace 7]Build anticipation and expectation ‘ and soon you’ll become aware of the tendency for movement’ ‘ and first one finger then another , will Begin to develop a lightness. And before long you’ll sense a finger twitch or move and the hand will begin to lift’ ‘ And something ’ s beginning to happen to one of your hands, and soon you ’ ll become aware of what it is. 8]Accepting patient’s pace of response Can increase with other suggestions – ‘ huge helium balloon pushing up under the palm ’ Failure to Respond – options 1] Accepts – that’s oK – then move on or better 2] ‘ Whole remaining deep in a trance tell me verbally what you are experiencing ’ -If says feel something in a finger v but it dos not want to move – say OK when feel voluntarily indicate with finger says often occurs. Reduce perceptions of failure.
The information in this presentation has been compiled to provide information and education about stress, the effects of stress, and the most popular stress management and relaxation techniques that are being used today. This information could be helpful for people who want to learn how to react to stress in a more constructive, proactive way. The basic premise of this presentation is that the benefits of stress reduction and relaxation techniques can be best noticed after they have been practiced regularly over a period of time.
Hypnotherapywhat is it and how did it evolve?Phil Green Dip.H, MNCH(Lic),LAPHP,LHSRegistered Clinical Hypnotherapistwww.HypnoFix.co.ukadvice@HypnoFix.co.uk
What Is Hypnosis ? Altered state – not sleep Motorway hypnosis Books and TV Exercise Day dreaming Hynpnogogic (Hypnagogic imagery is often auditory or has an auditory component. Like the visuals, hypnagogic sounds vary in intensity from faint impressions to loud noises)and Hypnopompic (The hypnopompic state is the transition state of semi consciousness between sleeping and waking. For some people, this is a time of visual and auditory hallucination.)state
The Trance State Light hypnosis – 90%+ Eye closure Fluttering lids Stillness Breathing slows – diaphragmatic Features flatten Swallowing Smiling Bradycardia (resting heart rate of under 60 beats per minute)
The Trance State Medium hypnosis – 70%+ Head drops Eyelid catalepsy Flushing or pallor Responds to suggestions Feeling of lethargy, heaviness Some analgesia – dentistry , dressings IMR (ideo-motor-response (IMR) is an exploratory method of uncovering repressed material that has been used extensively) May feel as though in trance
The Trance State Deep hypnosis 20% – somnambulism 5% Amnesia Anaesthesia Direct logic ‘ can you tell me your name’ Out of body dissociation (floating sensation) +ve /-ve hallucinations Trance with eyes open
Hypnotic Phenomenon Motor IMR (ideo-motor-response (IMR) is an exploratory method of uncovering repressed material that has been used extensively Catalepsy(indefinitely prolonged maintenance of a fixed body posture; suspension of sensation, muscular rigidity, fixity of posture) Automatic writing Swallowing REM (Rapid Eye Movement)
Uses of Hypnotherapy Psychosomatic disorders Migraine Hyperventilation Stammering Irritable bowel or bladder Eczema
Uses of Hypnotherapy Pain control Chronic Acute Terminal care Obstetric Dental
Uses of Hypnotherapy Other Sports – motivational Criminal investigation Recovery of lost objects - memories
History Of HypnosisWho, when, where and why?Phil Green Dip.H, MNCH(Lic),LAPHP,LHSRegistered Clinical Hypnotherapistwww.HypnoFix.co.ukadvice@HypnoFix.co.uk
History of Hypnotherapy 3000BC – ancient Egyptians Ancient Greeks Indian Sanskrits Hindu fakirs Celtic druids African witch doctors Jesus’s miracles?
History of Hypnotherapy 1500 Paracelsus Swiss doctor discovered mercury as cure for syphilis Passed magnets over patient to effect cure 1600 Valentine Greatrakes The ‘ great Irish Stroker’ – again stroked magnets to cure
History of Hypnotherapy 1725 Maximilian Hehl Jesuit priest – using magnets to heal Franz Anton Mesmer was his student
History of Hypnotherapy (1734-1815 )Franz Anton Mesmer Father of hypnosis Found he could stop bleeding with a stick and therefore postulated ‘ animal magnetism’
History of Hypnotherapy Franz Anton Mesmer(cont.) ‘De Planatorium influxu’ – magnetic fields pervade nature Cured patient of paralysis and temporary blindness Cured Maria Theresa Paradies – protégé of empress of blindness. Angering parents Moved from Vienna to Paris Mozart was a fan
History of Hypnotherapy Franz Anton Mesmer(cont.) Developed the ‘baquet’ Asked Louis XVI for a board of enquiry in 1784 Benjamin Franklin, Guillotine, Lavoisier Found all due to the imagination !
History of Hypnotherapy 1727-1779 Father Gassner Contemporary of Mesmer Suggestion as faith healing 1787 Marquis de Puysegur Student of Mesmer Magnetised elm trees Somnambulism
History of Hypnotherapy 1815 Abbe Jose Castodi de Faria Fixed gaze method first to coin word ‘sleep’ Previously focus was on the "concentration" of the subject In Farias terminology the operator became "the concentrator" and somnambulism was viewed as a lucid sleep
History of Hypnotherapy 1791 John Elliotson Professor at University London Became interested via a student of Faria 1837 Surgery under hypnosis – angered other doctors as pain ‘ needed for healing’ Expelled from university hospital
History of Hypnotherapy 1795 – 1860 James Braid Scottish surgeon coined term ‘ hypnosis’ Developed suggestions method Saw Mesmer and was eventually convinced Changed term to ‘ monoidiesm’ ‘Nervous sleep’ acting on subject whose suggestibility is increased’
History of Hypnotherapy 1808-1859 James Esdaile Scottish doctor Reports in 1846 That 300 major operations conducted using hypnosis Reduced post op mortality from 505% due to shock reaction being reduced
History of Hypnotherapy 1864 Nancy school of Hypnosis Ambrose-Auguste Liebeault – ‘ de la suggestion’ Hippolyte Bernheim Freud studied here Initially enthusiastic – eventually discounted hypnosis
History of Hypnotherapy 1878 Jean Martin Charcot – Started the school of Saltpierre Pathological theory Stages of hypnosis Lethargy Catalepsy Somnambulism
History of Hypnotherapy Dave Elman 1950’s Stage Hypnotist Studied Hypnosis for years Taught doctors exclusively Quick inductions Deepening techniques
History of Hypnotherapy 1929-1980 Milton Erickson Indirect approach Metaphor Utilization
Theories of Trance Suggestion Theory Bernheim 1886 – suggestions bypass concious mind Modified Sleep Abbe Faria – a type of sleep BUT thought would always amnesia Pathological Theory Charcot – BUT 90% hypnotisable NOT equivalent to hysteria
Theories of Trance Dissociation Janet ‘ splitting of consciousness into two’ BUT not always amnesia – can remove amnesia by suggestion Neo Dissociation Some cognition continuous throughout Psychoanlanalytic Freud – libidinal gratification Ferenczi – parent/child BUT mirrors metronomes may hypnotise
Theories of Trance Conditioned response Pavlov to word ‘ sleep’ BUT not sleep, metronomes, quick awakening Role Playing R White – goal directed striving Atavistic Regression Ainslie Meares to a primitive level – primitive man accepted ideas by suggestion
Theories of Trance Neurophysiological Barry Wyke – voice blocks other sensory input [like gate theory] Hemispheric Specificity L verbal/voluntary/language speech R nonverbal/emotional/submissive/art music/imagination Meszaros – induction L brain R brain
Suggestibility Tests Magnetic fingers Handclasp Heavy and light hands Postural sway Chevreul’s pendulum
The Hypnotic Session Introduction Induction Deepening Posthypnotic suggestion Awakening
The Hypnotic Session Introduction Explanation of hypnosis Remove fears Control issues Amnesia Reassurance Not trying
The Hypnotic Session Induction Intermediate Vogt’s fractionation- (is to discover the personal experience of the subject as they begin to enter trance and then to feed back this information to take them deeper. Subjects are relaxed into the early stages of trance and then roused and questioned for their particular experience of hypnosis and this information is then used to help the subject to go deeper still. So in a very real sense the subject is describing the best way that they personally should be hypnotized! ) Hand levitation Authoritative Eye to eye Mind body dissociation
The Hypnotic Session Induction Other Tactile Rhythmic eye movement Hand rotation Post hypnotic
The Hypnotic Session Deepening Balcony Early learning set ‘Now’ Countdown Limb catalepsy Hand levitation Minds eye Hand rotation
The Hypnotic Session Suggestions Establish rapport Create expectancy Will – not maybe never ‘try’ Law of concentrated attention Repetition of something result Law of reversed effect Try and bend your arm Law of dominant effect Strong emotions replace weaker
The Hypnotic Session Suggestions Positive – unconscious ignores negatives Positive reinforcement Yes set Specific Multiple senses Implied – less directive Unambiguous
The Hypnotic Session Suggestions Utilization Of patients world – what are their :- interests , preferences, preferred modality – visual, kinaesthetic Current experience – ‘ feel the chair’
The Hypnotic Session Types of suggestion Implication When your hand begins to lift – NOT if Trance now or later Truism Everybody knows how to… Not knowing and not doing You don’t have to try to hard
The Hypnotic Session Types of suggestion Covering all response – failsafes Your hand will be lighter or heavier Questions Can you, do you, does, will it See , sense, feel Contingent suggestions As your hand lowers so you find yourself back in time
The Hypnotic Session Types of suggestion Implied directive Time binding introduction Implied suggestion for internal response Behavioural response showing completed As soon as your mind has identified when the problem developed your hand will float up
The Hypnotic Session Types of suggestion Apposition of opposites As your arm becomes more rigid your body becomes more relaxed Wet/dry tense/heavy difficult/easy Interspersal of metaphors Own experience Truisms Tailored
The Hypnotic Session Types of suggestion Symbolism and imagery Imagine what the pain looks like Negatives - to discharge resistance You can - can you not You will - will you not Double bind If you are ready to go into trance your R hand will lift otherwise your L hand will lift
The Hypnotic Session Techniques to facilitate trance Focus attention Enhance awareness of immediate experience Note and accept new aspects of the experience Introducing immediate goal Repetition – reinforcing partial response Encourage dissociations and involuntary response Build anticipation expectation
The Hypnotic Session Belief +Imagination + Conviction + Expectation = Hypnosis [ Roy Hunter] Critical faculty is bypassed and selective thinking established[David Elman]
History Of HypnosisTherapy for Psychological DisordersPhil Green Dip.H, MNCH(Lic),LAPHP,LHSRegistered Clinical Hypnotherapistwww.HypnoFix.co.ukadvice@HypnoFix.co.uk
Introduction• Psychotherapy: An interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living.• Goal: to increase individual sense of well-being and reduce subjective discomforting experience.• Techniques: based on experiential relationship building, dialogue, communication and behavior change. theoretically-based psychotherapy was• Psychotherapists: psychologists, marriage and probably first developed in family therapists, licensed clinical social the Middle East during the workers, licensed associate professional 9th century by the Persian counselors (lapc), licensed professional physician and counselors (lpc), psychiatric nurses, and psychological thinker, psychiatrists. Rhazes.• Only psychiatrists may administer medical treatments outside of the scope of psychotherapy such as psychosurgery, prescribe medications or give electroshock treatments.
• Treatment of mental illnesses can take various forms:• medication,• talk-therapy,• a combination of both, and can last only one session or take many years to complete.The core components of psychotherapy remain the same.Psychotherapy consists of the following:9. A positive, healthy relationship between a client or patient and a trained psychotherapist10. Recognizable mental health issues, whether diagnosable or not11. Agreement on the basic goals of treatment12. Working together as a team to achieve these goals
The main broad systems of psychotherapy:PsychoanalysisThe first practice to be called a psychotherapy. It encourages the verbalization of all the patients thoughts, including free associations, fantasies, and dreams, from which the analyst formulates the nature of the unconscious conflicts which are causing the patients symptoms and character problems.Cognitive behavioralbased on cognitions, assumptions, beliefs, and behaviors, with the aim of influencing negative emotions that relate to inaccurate appraisal of events.Psychodynamic Albert Ellis, founder of Rational Emotivea form of depth psychology, the primary focus is to reveal the Behavior Therapy unconscious content of a clients psyche in an effort to alleviate psychic tension. Although it has its roots in psychoanalysis, psychodynamic therapy tends to be briefer and less intensive than traditional psychoanalysis.
The main broad systems of psychotherapy:Existentialbased on the existential belief that human beings are alone in the world. This aloneness leads to feelings of meaninglessness which can be overcome only by creating ones own values and meanings. Starting in the 1950s Carl Rogers: Person-centered psychotherapyHumanisticconcerned with the human context of the development of the individual with an emphasis on subjective meaning, a rejection of determinism, and a concern for positive growth rather than pathology.It posits an inherent human capacity to maximise potential, the self- actualing tendency.The task: to create a relational environment where this tendency might flourish.
The main broad systems of psychotherapy:Brief therapyan umbrella term for a variety of approaches to psychotherapy.differs from other types of therapy: it emphasizes a focus on a specific problem and direct intervention. solution-based rather than problem- oriented.Systemic Therapyto address people not at an individual level, but as people in relationship, dealing with the interactions of groups, their patterns and dynamics, including family therapy & marriage counseling.Somatic Psychotherapyalso referred to as body psychotherapy, is a field in which the therapist uses touch in some way as part of therapy process.
The main broad systems of psychotherapy:Transpersonal Psychotherapya school that studies the transpersonal, the transcendent or spiritual aspects of the human experience.Hypno-Psychotherapyundertaken with a subject in hypnosis.Psychodrama / Dramatherapyexplores, through dramatic action in groups , the problems, issues, concerns, dreams and highest aspirations of people.
Type of PsychotherapyTreatment Approaches.When describing talk therapy or psychotherapy:• First and foremost is empathy. It is a requirement for a successful practitioner to be able to understand his or her clients feelings, thoughts, and behaviors.• Second, being non-judgmental is vital if the relationship and treatment are going to work. Everybody makes mistakes, everybody does stuff they arent proud of. If the therapist judges the patient, the patient doesnt feel safe talking about similar issues again.• Finally, expertise. The therapist must have experience with issues similar to yours, be abreast of the research, and be adequately trained.
Treatment Approachesthe same ultimate goal: to help the client reduce negative symptoms, gain insight into why these symptoms occurred and work through those issues, and reduce the emergence of the symptoms in the future.The three main branches include Cognitive, Behavioral, and Dynamic.• cognitive branch looks at dysfunctions and difficulties as arising from irrational or faulty thinking.• behavioural models look at problems as arising from our behaviors which we have learned to perform over years of reinforcement.• The dynamic or psychodynamic camp stem more from the teaching of Sigmund Freud and look more at issues beginning in early childhood which then motivate us as adults at an unconscious level.• Most mental health professionals nowadays are more eclectic in that they study how to treat people using different approaches. These professionals are sometimes referred to as integrationists.
Treatment Modalities• Therapy is most often thought of as a one-on-one relationship (individual therapy) between a client or patient and a therapist.• can also take different forms: group therapy where individuals suffering from similar illnesses or having similar issues meet together with one or two therapists. The power of group is due to the need in all of us to belong, feel understood, and know that there is hope. It can be overwhelming in a very positive way and continues to be the second most utilized treatment after individual therapy.• Therapy can also take place in smaller groups consisting of a couple or a family, with the issues centered around the relationship, with often an educational component, e.g. to encourage the couple to work together as a team rather than against each other.
Treatment Modalities• Sometimes therapy can include more than one treatment modality. For example: for a person with depression, social anxiety, and low self- esteem, individual therapy may be used to reduce depressive symptoms, work some on self-esteem and therefore reduce fears about social situations. Once successfully completed, this person may be transferred to a group therapy setting where he or she can practice social skills, feel a part of a supportive group, therefore improving self- esteem and further reducing depression.The treatment approach and modality are always considered, along with many other factors, in order to provide the best possible treatment for any particular person.
Therapy ProvidersThere are many different types of physicians and there are many non- physicians who treat medical illnesses, the same holds true for mental illness.Although medication for mental illness is prescribed by a medical doctor, typically a psychiatrist, the vast majority of psychotherapy is performed by non-physician professionals.These mental health professionals typically have a minimum of a Masters Degree and complete internships, residencies, and state and federal testing just like all direct-care providers.
Therapy ProvidersThere are four most common mental health providers, including required education and training, and the populations with whom they typically work.Psychologist• A doctoral degree which means a minimum of four years of graduate training beyond the bachelors degree is required in most states, as well as one year of internship and at least one year of post-graduate residency.• Typically psychologists complete core coursework in therapy, assessment, and research and are required to pass competency exams and complete a dissertation prior to receiving their degree. To be licensed, psychologists must pass a national and state examination.• School psychologists usually work in Social Worker
Therapy ProvidersSocial workers• must hold a bachelors degree in social work although many complete a Masters program.• often referred to as the liaison between the patient or client and the community.• The Occupational Outlook Handbook (1998-1999), "Social work is a profession for those with a strong desire to help people. Social workers help people deal with their relationships with others; solve their personal, family, and community problems; and grow and develop as they learn to cope with or shape the social and environmental forces affecting daily life. Social workers often encounter clients facing a life-threatening disease or a social problem requiring a quick solution. These situations may include inadequate housing, unemployment, lack of job skills, financial distress, serious illness or disability, substance abuse, unwanted pregnancy, or antisocial behavior. They also assist families that have serious conflicts, including those involving child or spousal abuse."
Therapy ProvidersMental Health Counselor• typically have a Masters degree in psychology, social work, counseling, mental health counseling or related field and pass a state exam in order to be licensed.• can practice independently in some states, although most are employed in clinics and hospitals.• They perform individual, couples/family, and group therapy, and may assist psychologists with testing and other forms of treatment.Marriage and Family Therapist• a Masters degree is typically the minimal requirement.• They receive special training in the dynamics of families and relationships and often treat couples who are having marital or relationship difficulties and families struggling with dysfunctional interactions.• Many are provided more general training, allowing them to perform individual and group therapy as well for a variety of mental health related issues.
Some specific approachesPsychoanalysis• developed in the late 1800s by Sigmund Freud.• explores the dynamic workings of a mind understood to consist of three parts: the hedonistic id, the rational ego, and the moral superego.• the majority of these dynamics are said to occur outside peoples awareness, Freudian psychoanalysis seeks to probe the unconscious by way of various techniques, including dream interpretation and free association.• Freud maintained that the condition of the unconscious mind is profoundly influenced by childhood experiences. So, in addition to dealing with the defense mechanisms employed by an overburdened ego, his therapy addresses fixations and other issues by probing deeply into clients youth.
Psychoanalysis• free association: patients are asked to continually relate anything which comes into their minds, regardless of how superficially unimportant or potentially embarrassing the memory threatens to be. This technique assumes that all memories are arranged in a single associative network, and that sooner or later the subject will stumble across the crucial memory.• Defence mechanism: psychological strategies brought into play by various entities to cope with reality and to maintain self-image.• Fixation: a state in which an individual becomes obsessed with an attachment to another person, being or object. Freud theorized that humans may develop psychological fixation due to: A lack of proper gratification during one of the psychosexual stages of development, or Receiving too strong of an impression from one of these stages, in which case the persons personality would reflect that stage throughout adult life.
Psychoanalysis---Variations in technique‘Classical technique’ best summarized by Allan Compton, MD:• instructions (telling the patient to try to say whats on their mind, including interferences)• exploration (asking questions)• clarification (rephrasing and summarizing what the patient has been describing)• confrontation (bringing an aspect of functioning, usually a defense, to the patients attention)• dynamic interpretation (explaining how being too nice guards against guilt, e.g. - defense vs. affect)• genetic interpretation (explaining how a past event is influencing the present)• resistance interpretation (showing the patient how they are avoiding their problems)• transference interpretation (showing the patient ways old conflicts arise in current relationships, including that with the analyst)• dream interpretation (obtaining the patients thoughts about their dreams and connecting this with their current problems)• reconstruction (estimating what may have happened in the past that created some current day
Psychoanalysis---Variations in techniqueAs object relations theory evolved, techniques with patients who had more severe problems with basic trust and a history of maternal deprivation led to new techniques with adults, sometimes called ‘interpersonal, relational, or corrective object relations techniques’:• expressing an experienced empathic attunement to the patient• expressing a certain dosage of warmth• exposing a bit of the analysts personal life or attitudes to the patient• allowing the patient autonomy in the form of disagreement with the analyst• explanations of the motivations of others which the patient misperceives
Psychoanalysis---Variations in techniqueego psychological concepts of deficit in functioning led to refinements in supportive therapy. These techniques are particularly applicable to psychotic and near-psychotic patients:• discussions of reality• encouragement to stay alive (including hospitalization)• psychotropic medicines to relieve overwhelming depressive affect• psychotropic medicines to relieve overwhelming fantasies (hallucinations and delusions)• advice about the meanings of things (to counter abstraction failures)
Some specific approachesBehavior therapy• used to treat depression, anxiety disorders, phobias, etc.• philosophical roots: the school of behaviorism, which states that psychological matters can be studied scientifically by observing overt behavior, without discussing internal mental states.• Without holding inner states as causal, Skinners radical behaviorism accepted internal states as part of a causal chain of behavior, but continued to hold that the only way to improve the internal state was through environmental manipulation.• Scientific basis: the principles of classical conditioning developed by Ivan Pavlov and operant conditioning developed by B.F. Skinner. (confusions remain here)
Behavior therapy---Systematic desensitization• used to help effectively overcome phobias and other anxiety disorders.• a type of Pavlovian therapy / classical conditioning therapy.• one must first be taught relaxation skills in order to control fear and anxiety responses to specific phobias.• Then use the skills to react towards and overcome situations in an established hierarchy of fears. The goal: an individual will learn to cope and overcome the fear in each step of the hierarchy, which will lead to overcoming the last step of the fear in the hierarchy.• Systematic desensitization is sometimes called graduated exposure therapy.
Behavior therapy/ Behavior modification ---Aversion therapy• in which the patient is exposed to a stimulus while simultaneously being subjected to some form of discomfort.• Principle: punishment of operant conditioning, intend to cause the patient to associate the stimulus with unpleasant sensations in order to stop the specific behavior.• The major use: currently for the treatment of addiction to alcohol and other drugs• For example: pairing the use of an emetic with the experience of alcohol; or pairing behavior with electric shocks of various intensities. placing unpleasant-tasting substances on the fingernails to discourage nail-chewing• Key points: the stimulus is always available to the specific behavior; the stimulus indeed causes definite aversion; the therapy continues until the specific behavior disappears completely; reinforcement
Behavior therapy/ behavior modification ---operant conditioning, Positive reinforcement• Set up new social behavior via e.g. reward, a stimulus immediately following a response.• Method, e.g. token economy, the original proposal for such a system emphasized reinforcing positive behavior by awarding "tokens" for meeting positive behavioral goals.• "Patients earn tokens, which they can exchange for privileges, such as time watching television or walks on the hospital grounds, by completing assigned duties (such as making their beds) or even just by engaging in appropriate conversations with others"• Early during the program, a participant would be required to spend all of his or her tokens daily to emphasize the reinforcement activity early, and as time passed and success was made, participants would be allowed (or required) to accumulate their tokens over the course of longer time periods. This, as a variable-rate scheduling system, helped prevent extinction of the behavior after the programs termination.
Behavior therapy/ behavior modification ---Modeling (observational learning)Albert Bandura (social learning modeling): people can learn new information and behaviors by watching other people.Three basic models of observational learning:6) A live model, which involves an actual individual demonstrating or acting out a behavior.7) A verbal instructional model, which involves descriptions and explanations of a behavior.8) A symbolic model, which involves real or fictional characters displaying behaviors in books, films, television programs, or online media.Four conditions required for a person to successfully model the behavior of someone else:12) Attention to the model: a person must first pay attention to a person engaging in a certain behavior (the model)13) Retention of details: Once attending to the observed behavior, the observer must be able to effectively remember what the model has done14) Motor reproduction: the observer must be able to replicate the behavior being observed.15) Motivation and Opportunity: the observer must be motivated to carry out the action they have observed and remembered, and must have the opportunity to do so.
Some specific approachesCognitive therapy• developed by psychiatrist Aaron T. Beck in the 1960s, seeks to identify and change "distorted" or "unrealistic" ways of thinking, and to influence emotion and behavior.• the way in which the clients perceived and interpreted and attributed meaning—a process known scientifically as cognition—in their daily lives was a key to therapy.• Schema-Focused Therapy, clinical depression is typically associated with negatively biased thinking and irrational thoughts---a patient acquire a negative schema of the world in childhood and adolescence through negative events. When encounters a situation that resembles the conditions in which the original schema was learned, the negative schemas of the person are activated.• a negative triad: A negative schema helps give rise to the
• Schema-Focused Therapy, clinical depression is typically associated with negatively biased thinking and irrational thoughts---a patient acquire a negative schema of the world in childhood and adolescence through negative events. When encounters a situation that resembles the conditions in which the original schema was learned, the negative schemas of the person are activated.• a negative triad: A negative schema helps give rise to the cognitive bias, and the cognitive bias helps fuel the negative schema.• depressed people also often have the following cognitive biases: arbitrary inference, selective abstraction, overgeneralization, magnification and minimization.
Cognitive therapy /The ABCs of Irrational BeliefsA major aid in cognitive therapy is what Albert Ellis called the ABC Technique of Irrational Beliefs.The first three steps analyze the process by which a person has developed irrational beliefs:• A - Activating Event or objective situation. The first column records the objective situation, that is, an event that ultimately leads to some type of high emotional response or negative dysfunctional thinking.• B - Beliefs. In the second column, the client writes down the negative thoughts that occurred to him or her.• C - Consequence. The third column is for the negative disturbed feelings and dysfunctional behaviors that ensued. The negative thoughts of the second column are seen as a connecting bridge between the situation and the distressing feelings. The third column C is next explained by describing emotions or negative thoughts that the client believes are caused by A.
Cognitive therapy /THE A-B-C-D-E THERAPEUTIC APPROACHThe therapeutic interventions referred to by D are three parts of disputation. When irrational beliefs are disputed, the client will experience E, a new effect. In essences, the client will have a logical philosophy that allows her to challenge her own irrational beliefs.Disputing irrational beliefs is the major therapeutic technique, often done in three parts:1) Detecting – the client and therapist detect the irrational beliefs that underlie activating events.2) Discriminating – the therapist and client discriminate irrational from rational beliefs.3) Accepting 1 and 2, knowing that insight does not automatically change people, and working hard to effect change.• E (Effect): Developing an effective philosophy in which irrational beliefs have been replaced by rational beliefs.
Some specific approachesClient-centered therapy• developed by the humanist psychologist Carl Rogers in the 1940s and 1950s.• The basic elements: to have a more personal relationship with the patient to help the patient reach a state of realization that they can help themselves. Carl Ransom Rogers(1902 -1987)• is used to help a person achieve personal growth and/or come to terms with a specific event or problem they are having.• based on the principle of talking therapy and is a non-directive approach. The therapist encourages the patient to express their feelings and does not suggest how the person might wish to change, but by listening and then mirroring back what the patient reveals to them, helps them to explore and understand their feelings for themselves. The patient is then able to decide what kind of changes they would like to make and can achieve personal growth.
Some specific approachesMorita therapy (Japanese psychiatrist Shoma Morita)• People from different times and cultures actually do think differently.• Shinkeishitsu (an anxiety-based disorder), a world of which most of us at one time or another are living in, where we become lost in a stress, pain and the aftermath of trauma. Morita Therapy Methods (MTM) is structured for the person who needs a guide for self-rescue. It helps patients find, and use, a well of inner strength deep within themselves that enables them to make powerful changes in their life.• Simple acceptance of what is, allows for active responding to what needs doing.• aims at building character to enable one to take action responsively in life regardless of symptoms, natural fears, and wishes.
Morita therapy: The Four Areas of Treatment• Phase one: the “rest phase”, a period of learning to separate ourselves from the constant assault on our senses and thought processes by a loud and intrusive world.• Phase two: “light and monotonous work that is conducted in silence”. One of the keystones of this stage of self-treatment is journal writing. Our thoughts and feelings come to us in indistinguishable waves and flood our minds. Writing in our personal journals helps us learn to separate our thoughts from our feelings and define their different effects on our lives. In this phase we also go outside.• Phase three is one of more strenuous work. Dr. Morita had his patients engage in hard physical work outdoors. This is what we call the “chopping wood” phase.• Phase four is when Morita would send patients outside the hospital setting. They would apply what they had learned in the first three phases and use it to help the with the challenge of reintegration into the non-treatment world.
Some specific approachesHypnotherapy• therapy that is undertaken with a subject in hypnosis (means "sleep of the nervous system“), a wakeful state of focused attention and heightened suggestibility, with diminished peripheral awareness.• According to the American Psychological Associations Division 30, hypnosis may bring about Asklepios, Greek god of "...changes in subjective experience, alterations in medicine, healing, and perception, sensation, emotion, thought or behavior.“ hypnosis, was said to oversee the treatment of sick people in "dream• The hypnotic state may also facilitate change in the healing temples." body: it has been successfully used as a treatment for irritable bowel syndrome.
Some Specific schools and approachesHypnotherapy• Skeptics point out the difficulty distinguishing between hypnosis and the placebo effect, proposing that the state called hypnosis is "so heavily reliant upon the effects of suggestion and belief that it would be hard to imagine how a credible placebo control could ever be devised for a hypnotism study.“• Self-hypnosis is popularly used by people who want to quit smoking and reduce stress, while stage hypnosis can be used to Professor Charcot (left) of Paris persuade people to perform unusual public Salpêtrière demonstrates feats. hypnosis on a "hysterical" patient, "Blanche" (Marie) Wittman, who is supported by Dr. Joseph Babinski.
Relaxation and HypnosisMany internal and external factors affect how we think, feel, and behave.The internal factors influencing state of mind: relaxation and hypnosis.Relaxation a focusing on the mind and a relaxing of the bodys muscles. being too tense and/or living with too much stress has significant negative impacts on lives: physical illnesses and many psychological issues. different forms of relaxation: breathing exercises, deep muscle relaxation, imagery, meditation, yoga, etc. with the main goal to relax the bodys muscles and focus the mind. Since the body and the mind cannot be separated, both of the components must be present for any relaxation technique to work.
Hypnosis similar to relaxation: the same two components of physical and mental must be addressed together. a very deep state of relaxation where your mind is more focused and the connection between your thoughts, emotions, and behaviors are more clear. a hypnotherapist is typically a licensed professional who uses hypnosis as part of a treatment regimen for certain psychological disorders. most beneficial when used with relaxation and talk-therapy for a more rounded therapeutic approach. many factors affect individual susceptibility: belief in hypnosis, trust for the therapist, etc. and the absence of external factors such as noise, uncomfortable temperature, and physical comfort. the key to successful hypnosis: the ability to focus on your body and mind and to trust and believe in your therapist.
Some specific approaches Biofeedback therapy• providing the user access to physiological information about which he or she is generally unaware, allows users to gain control of physical processes previously considered an automatic response of the autonomous nervous system.• measuring a subjects quantifiable bodily functions (blood pressure, heart rate, skin temperature, muscle tension) conveying the information to the patient in real-time, which raises the patients awareness and conscious control of their unconscious physiological activities.
Some specific approachesDeep brain stimulation (DBS)• a surgical treatment involving the implantation of a medical device called a brain pacemaker, which sends electrical impulses to specific parts of the brain.• remarkable therapeutic benefits for otherwise treatment-resistant movement and affective disorders such as chronic pain, PD, tremor and dystonia.• Despite the long history of DBS, its underlying principles and mechanisms are still unclear.• directly changes brain activity in a controlled manner, its effects are reversible (unlike those of lesioning techniques) and is one of only a few neurosurgical methods that allows blinded studies.• has been used to treat various affective disorders, including major depression.• there is potential for serious complications and side effects.
Thank you for listening I hope you enjoyed the presentation Safe Journey Home That Presentation wasHypnotherapyWho, when, where and why?What is it and how did it evolve?Therapy for Psychological DisordersPhil Green Dip.H, MNCH(Lic),LAPHP,LHSRegistered Clinical Hypnotherapistwww.HypnoFix.co.ukadvice@HypnoFix.co.uk
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