The Handbook of Brief Psychotherapy by Hypnoanalysis

DEDICATION

To my parents, Ruby Register Scott, and Clarence E. Scott, who provided a loving, consistent and stable environment for us three children, conducive to the kind of family we strive to achieve with our clients.

Contents

DEDICATION

ACKNOWLEDGEMENTS

FORWARD

PREFACE

 CHAPTER 1

 CHAPTER 2

 CHAPTER 3

 CHAPTER 4

 CHAPTER 5

 CHAPTER 6

 CHAPTER 7

 Chapter 8

APPENDIX A

APPENDIX B

APPENDIX C

BIBLIOGRAPHY

ACKNOWLEDGEMENTS

I am deeply indebted to William J. Bryan, Jr., M.D. and Richard Rubottom, M.D. who initiated my interest in hypnoanalysis and who were my mentors.

Marvin Koven, Ph.D., Leo Weisbender, Ph.D., and Jordan Packer, Ph.D., of the California Graduate Institute read early drafts and freely gave helpful advice and counsel.

My colleagues in the American Academy of Medical Hypnoanalysts have contributed much through clinical experience and have provided a forum for presentation and discussion of the various aspects of this study.

I must express my deepest thanks to my wife, Jo. It takes an unusual woman to tolerate a husband who spends most of his adult life going to school and working while she tends to the various needs of three children; then, when the children are gone and the nest is empty, for him to be tied up in research and writing once again. Jo has done it superbly. Furthermore, as an English teacher in the public schools, she has offered much help in all of my writing by proofreading and making many valuable suggestions.

It is with pleasure that I also give credit to my children for their help. My son, John, Jr., Ed.D. (a partner in my profession) has made valuable contributions in thought and editing as well as sharing in the writing of Chapter 7 on age regression to birth. My daughter, Emily Scott-Lowe, Ph.D., and husband Dennis Lowe, Ph.D., have also made helpful suggestions. My son, David R.T. Scott, A. I. A., did the art work.

Ms. Jerry Blair, a friend and former colleague from the staff of Harding Graduate School of Religion, was very helpful as a proofreader.

Finally, I must thank my friend, Hugh McHenry, Ph.D., Professor of Mathematical Sciences at Memphis State University, who took my original disks and somehow assiduously transferred them to an up-to-date computer which could give birth by laser printer to this document.

FORWARD

The American Academy of Medical Hypnoanalysts is pleased to offer the second edition of this handbook that is our textbook. In it is explained the tenets of our methodology which has been refined through more than 60 years of scrutiny and practice. This is the only book that fully explains this unique body of theory and technique. The Academy is continually proactive in its efforts to develop research evidence to demonstrate the strengths of this method but we are mostly practitioners. Therefore this book explains the art of our practice and how it compares to and differs from those others that provided the context within which it was developed.

When the author, Dr. John Scott, Sr., first went to Los Angeles to study under Dr. William J. Bryan, Jr., only medical doctors were deemed qualified to undergo this training. Dr. Scott saw the potential that this methodology held for all mental health practitioners. That was 1971. He persuaded Dr. Bryan that as a minister, counselor and seminary professor he could advance the interests of the American Institute of Hypnosis. However, Dr. Scott was the only non-medical person that Dr. Bryan trained. Partly due to this issue as well as the perceived need for freedom to grow the method and the practitioners, a group of eight of Dr. Bryan’s trainees separated in 1974 to form a new organization, the Society of Medical Hypnoanalysts. Dr. Scott became the ninth member. The Society of Medical Hypnoanalysts is now The American Academy of Medical Hypnoanalysts. The Academy is now proud to be a multidiscipline group. All practitioners who are licensed as therapists in their state of residence are eligible for membership and training. While appropriate training, ethics and credentials are necessary we recognize that being a healer is as much a condition of spirit as of training.

Many perspectives in society have changed since this book was written and first published. Hypnosis and Medical Hypnoanalysis have evolved as well. As you read these pages you will notice that this book reflects much from a previous time. Dr. Scott did most of the writing of this book in the 1980s. His wordings, citations and illustrations are expressive of his time and his training. We ask that you overlook these to see the beauty and opportunity expressed in the theory and practice of this unique modality. These perspectives are just as fresh and exciting in today’s world as they were when Dr. Bryan and his colleagues were developing them in the 1950s. In fact, listening to the subconscious will seem new and exciting in every generation. For just as good taste is never the common standard, so also, listening to the deep meanings of life and living will never be the common mode of communicating. Healing requires that we find those deep conflicts and resolve them so that life may rediscover its purpose. It is our hope that you find the enduring content of this work. We have found these principles to offer real answers in both our practices and our lives.

John A. Scott, Jr., Ed.D.

For the editorial board, AAMH.

PREFACE

A THERAPY WHOSE TIME HAS COME

THE AGE OF HYPNOSIS

In the last ten years there has been a surge of interest in hypnosis. Its techniques and procedures have become so widely familiar that such terms as hypnotherapy, autohypnosis, hypnology, analytical hypnotherapy, clinical hypnosis, therapeutic hypnosis, Ericksonian hypnosis, hypnobehavior, New Hypnosis, hypnogogic images, neuro-linguistic programming, hypnosynthesis, Medical Hypnoanalysis and others have found their way into, at least, the recognition vocabulary of the general public. The interest is so great that a growing number of organizations are promoting hypnosis in one form or another. On any given weekend, one need not travel very far to find a class, seminar, or lecture being held on the subject.

Furthermore, I would venture to say that the number of books published on Hypnosis in the last ten years far exceeds the total output of all such subject-related material printed during the past fifty years. Certainly recent publications have been more scientific, and have taken into consideration the progress that has been made in related fields such as behavior modification, metapsychology, biofeedback and relaxation control. The subject has also been approached from a variety of perspectives, including the diagnostic, therapeutic, experimental, and analytical, not to mention the vernacular quest.

Personal Frustrations With Therapy

Frankly, by 1971 I had become frustrated and discouraged with both individual psychotherapy and marriage counseling. As I look back, in spite of the fact that part of my time was spent teaching at the graduate level and part in private practice, I probably was suffering from burnout. A part of the problem, as I saw it at that time, was that not enough patients in individual therapy were having the degree of success that I had anticipated they would, or achieving that success as quickly as I thought they should. Perhaps my standards for them were too high. Perhaps my standards for myself were too high. Perhaps my techniques were not what they should have been.

Preface

Another issue was financial. Were the fees which I collected for the services rendered justified? In analyzing my situation, I found I had a certain amount of guilt, a certain amount of frustration, a touch of obsession-compulsion mixed with a mild case of fatigue and monotony. It was at this time that I first became acquainted with Medical Hypnoanalysis.

Medical Hypnoanalysis As A Solution

My theoretical background, which includes psychoanalytically oriented psychotherapy, psychiatry and a mixture of Rogerianism and TA, made me a receptive candidate to this new procedure. I had had a speaking acquaintance with hypnosis, but, like many professionals, I used it only in exceptional circumstances, and, as I think now, not very effectively. After a few years of training and practice, I inaugurated Medical Hypnoanalysis into my private practice as a treatment modality for neurotic disorders. I was so highly gratified by the successful results achieved with this method of therapy that I made plans to discontinue marital therapy as such and concentrate on hypnoanalysis with individuals in psychotherapy.

Basically, the procedure was directed, short term, and analytically oriented. And the results with patients were gratifying. I could see more patients, achieve more positive results in a shorter period of time, and thus have a greater degree of satisfaction within myself.

SHARING THE PROCEDURE

The time has come to share the procedure with a broader segment of the professional community than those who appear at weekend seminars. Yet, in order to share this procedure, it becomes necessary to start with a description of Medical Hypnoanalysis as a modality used in individual therapy. In so doing I provide this with the expectation that my professional colleagues will have an opportunity to verify my own conclusions, and at the same time, I am confident, to make adaptations and improvements which will be profitable to society at large.

Unfortunately objective research is currently minimal. Only one comparative study has been completed (Scott, Jr., 1991). But with the publication of this material there will surely be others who will take up the challenge and produce for the professional community further studies and experiments which will aid all of us in our joint quest for improvement in individual and couple psychotherapy.

A DEFINITION OF MEDICAL HYPNOANALYSIS

Since there is diverse terminology used in the literature on hypnosis it will perhaps be helpful to the reader to have a working definition of Medical Hypnoanalysis presented early. The following was formulated by the Society of Medical Hypnoanalysts (Now called the American Academy of Medical Hypnoanalysts).

"The practitioner of Medical Hypnoanalysis requires a training background in the basics of psychology, developmental psychology, psychopathology, and psychotherapy as well as in hypnosis.

"Medical Hypnoanalysis is dynamic, short term, and directed. It is dynamic in that the treatment approach emphasizes causes rather than symptoms, explanations rather than descriptions, and unconscious forces rather than conscious forces as being the ultimate origin of the psychopathology. It is short term in that in most of the situations thirty or less sessions are required for the completion of treatment procedure. It is directed therapy in that the psychotherapist, upon making a diagnosis, follows a medical model of psychotherapy aimed at alleviating the symptoms by means of resolving underlying unconscious causes.

"Medical Hypnoanalysis first examines the presenting symptoms of the patient by means of a case history, observing verbal and nonverbal communication, while seeking unconscious clues to the ultimate causes of the symptoms in order to make a psychodynamic diagnosis. After the patient is introduced to hypnosis, the majority of the therapeutic sessions are conducted with the patient in the hypnotized state. The therapist investigates the unconscious by using the following procedures: 1. A specifically designed word association test, 2. Dream analysis, 3. Age regressions directed at crucial periods earlier in the patient’s life.

"Such procedure allows identification and re-interpretation, adjustment or re-evaluation and desensitization of the specific causal events. This procedure is directed at correcting the symptoms and the unwanted behavior which causes suffering and disease. For example, depressions, phobias, obsessions, psychosomatic disorders, self-destructive and anti-social behavior and other emotional and psychological problems can be relieved.

There are a variety of methods and procedures of applying the basic hypnoanalytical method. Individual varieties are based on the specific training and treatment circumstances of the clinician.

Hypnoanalysis is therefore receptive to various theoretical approaches but is best viewed as a truly eclectic modality.

THE MEDICAL HYPNOANALYSIS TITLE

An additional word is necessary regarding the use of the word Medical in the title Medical Hypnoanalysis since there are some who could be confused by its use. The Society of Medical Hypnoanalysts was given birth by a group of physicians meeting in Chicago in 1975 (now called the American Academy of Medical Hypnoanalysts) and there the name of the procedure was debated. Inasmuch as all present were physicians who utilized hypnosis in their practice, and followed a medical model of treatment, they felt the name was appropriate. Their hope was to distinguish this procedure from all other procedures and systems and give it a name which evidenced this individuality.

When men with Ph.D.’s were qualified to join the group there was some sensitivity to their membership because of the use of Medical with regard to their status. Thus Category II in the membership roster was added, and they were permitted to practice Medical Hypnoanalysis as a psychotherapeutic procedure. This is without any intention of implying that those without medical degrees are practicing medicine in the literal sense of that word.

In recent years the term medical has been more generally applied. Actually, the term is based on a Latin root meaning to heal and this is without regard to the use of medications. Since it is becoming more widely accepted that the most important system of health is the brain itself, the line of demarcation between the influence of the physician and influence of psychology gets thinner. Barber (1984) bluntly states, ideas can effect the physiological activities of the cells in the human body. And Rossi (1986) and Rossi & Cheek (1988) are making bolder statements than ever, backed by scientific evidence, concerning the mind-body interrelationship and the vast healing powers of the mind. Ornish’s program for reversing heart disease claims to be scientifically proven and much of it is based on mental-emotional processes (Ornish, 1990).

Lewith, in The British Medical Journal (1985), referred to people seeking treatment by alternative medicine and included such treatments as acupuncture, manipulative medicine, homoeopathy, clinical ecology, biofeedback, psychotherapy, the Alexander technique, and hypnosis. Thus it is clear that medical includes a broad spectrum of healing or treatment modalities for the curative process.

More and more schools of medicine and schools of psychology are including departments or chairs of behavioral medicine. Courses and books are taught and written on the interdisciplinary characteristics of physiology, medicine and the psychological components of the curative process and health. It is common knowledge that the foremost medical problem in our culture is the adverse influence of stress which is as much, or more, psychological than physiological, but in any case is medical. This brings us to another facet of this interesting subject.

Eniatric healing concerns healing within the self. Just as the body tends to heal itself while the physician acts as a facilitator, director and helper so as to speed the process, likewise, the mind tends to heal itself (and protect itself with a myriad of defense mechanisms), while the psychotherapist acts as facilitator, director and helper.

Thus the term Medical Hypnoanalyst does not imply, per se, that the therapist has a medical degree or dispenses medications. Rather, it is the title of a particular process of psychotherapy, duly defined and registered, utilizing hypnosis in a specified manner. Training is provided for those who already have completed their education in social work, psychology or medicine.

The major purpose of this work is to describe the use of hypnosis for the clinician, rather than to stimulate laboratory and experimental work on the phenomena of the trance. Therefore, I have avoided becoming involved in discussions on susceptability of persons to the trance state as well as depth levels etc. These details along with subjects of motivation for hypnosis and whether or not the hypnotic state can be emulated are details which are fascinating for the theoretician and researcher, but not apropos to my purpose here. As is characteristic of the Hilgards, they tell the relationship story beautifully in a few words: the experimental findings will undergird the work of the clinician (Hilgard & Hilgard 1983,xi). See Barber (1958); Chaves (1968);Dalal (1966); Hilgard (1979); Orne (1971) Spanos (1970)

OVERALL PLAN OF BOOK

It is the aim of Volume One to describe Medical Hypnoanalysis clearly enough for the experienced psychotherapist, who has a background in dynamic psychology, to apply the method in his clinical practice with a minimum of additional training. Volume Two will describe the modification of hypnoanalysis for the treatment of marital dysfunction.

I have used a variety of terms in reference to the practitioner of hypnoanalysis in order to cover the range of professionals who employ it in their practice, as well as to prevent monotony to the reader. Such terms are: therapist, analyst, hypnoanalyst, clinician.

Out of respect for the policy of fair treatment of individuals and groups, I have made an effort to avoid writing in a manner which reflects role prejudice or sex bias. Yet I have endeavored to avoid awkwardness in using pronouns; consequently, he, and she, are used in a variety of ways. But unless there is a specifically named antecedent, ambiguity of gender is implied.

August 1996

Memphis, TN

CHAPTER 1

HISTORY OF HYPNOANALYSIS

INTRODUCTION

Obviously, in delving into the use of the term hypnoanalysis, a history of hypnosis is implied. But, because there are so many excellent summaries of the history, it does not fall into the province of this chapter to repeat what has already been done by so many capable scholars. Rather, the purpose of this section is to narrow the historical quest to the particular use of hypnosis as an adjunct to analytical therapy. In 1968, Klemperer observed that it is still too early to determine whether one day the modality of psychotherapy, known as hypnoanalysis, will grow from an adjunctive role to a special and autonomous form of treatment. I believe that day has now come. Like the converging of many streams and rivulets, the theoretical input and clinical experiences of many scholars and clinicians have been merging and the confluence of these experiences serve as a foundation which may now be laid for recognizing hypnoanalysis as not just an adjunct to another form of therapeutic procedure, but as a specialized and autonomous form of therapy.

Hypnoanalysis as a term, historically has been loosely used. It has been applied to the generalized use of hypnosis in direct suggestion for symptom removal on one extreme and as an adjuvant in psycho-analysis at the other extreme (Brenman & Gill, 1947). Buckley (1950) refers to a process of hypnotic analysis as a relatively untried technique. Conn (1949a) used the term hypno-synthesis in reference to the use of hypnosis with psychoanalysis. Then Lifshitz and Blair (1960) refer to the resurgence of abreactive therapy by which they mean the use of hypnosis as it was used in the treatment of war neuroses. Kline (1955) published a book on Hypnodynamic Psychology in reference to the use of hypnosis within the framework of psychoanalytic treatment. Hypnoidal psychotherapy is used by Steger (1951); Schneck (1954) alludes to scientific hypnosis. And of course, there is the British Journal of Medical Hypnotism, with frequent use of medical hypnosis. One of the latest and finest works on the subject is Barnett’s Analytical Hypnotherapy (1981), in which a system of combining analytical principles together with hypnosis is very skillfully done.

Such a state of affairs can only lead to confusion. It depends on which newspaper one reads as to what meaning one derives from the practice or use of hypnoanalysis. In view of such confusion it is no wonder that Gill and Brenman (1959) came to the conclusion that hypnotherapy was a misleading term and should be abandoned; and the term ‘hypnoanalysis’ is sufficiently lacking in specificity as to be useless (p.355f).

In the last 15 years a growing number of clinicians have gravitated to the practice of hypnosis, in an analytic context, as a full time specialty called Medical Hypnoanalysis. While the theory and practice has been dynamic in that it has been evolving and developing, it has also been crystallizing as an autonomous psychotherapeutic procedure. An organization of professionals interested in such a specialty has now been functioning since 1975. It is my purpose in this chapter to summarize the history of the use of hypnosis as an adjunct in analytic psychotherapy, thus enabling us to get a more objective perspective on where we are currently.

Admittedly, the task I have set before me is no easy one. Since scholars who specialize in the use of hypnosis cannot even agree on a definition, and greatly differ among themselves on what takes place when one is hypnotized - and even question if such a state exists - it is not going to be simple to bring order out of such confusion. However, I do not expect this work to achieve completely such a high goal. Rather, I am sending up a trial balloon which may, perchance, serve as a basis for further investigations and contributions from others in the field. At a time when short-term therapy is the order of the day, it is certainly apropos to utilize a procedure which all authorities recognize as being a means to shorten psychotherapy. Yes, hypnoanalysis is a procedure whose time has come.

HISTORY OF THE USE OF HYPNOANALYSIS

The prefix hypno- was apparently used for the first time for a number of words describing what we now call the hypnotic state in 1821 by a Frenchman, Entienne Felix d’Henin de Cuvillers (Gravitz & Gerton, 1894).

As far as I can determine, Brenman and Gill (1947) are accurate in attributing to Hadfield the origin of the hyphenated term hypno-analysis. Hadfield verified this in a personal communication to Crichton-Miller stating that he invented the term in the First World War to describe the method of using hypnosis as a means of reviving forgotten and repressed experiences, mainly in amnesia cases. However, he also used it as an alternative method to free association and dream interpretation (Ambrose & Newbold, 1958). But this refers to the use of the term hypno-analysis. The history of hypnosis in analysis goes back much further than this.

THE FREUDIAN PERIOD

In Mesmer’s pioneering efforts he, of course, made many mistakes in a trial and error procedure, but he must be given credit, as Chertok does (1978a), for a scientific approach to the study of hypnosis. He maintained that the magnetic fluid which he supposed people to have, was not due to divine or evil influences. It was for Mesmer’s pupil, Marquis de Puysegur, to make the first analytic discovery, and as Conn (1982) states, mark the emergence of dynamic hypnotherapy. In 1784 de Puysegur hypnotized a shepherd named Victor, who, when he awoke, did not remember the events which occurred during his session. De Puysegur concluded that we have two independent memories. Thus, the unconscious was recognized for the first time (Chertok, 1978a). The concept of the unconscious continued development in nineteenth century French discourse and had an influence on Freud (Chertok, 1978b).

The use of hypnosis during this early period was primarily for suggestion, which prompted Bernheim in 1888 to observe that all was suggestion (Bernheim, 1888).

The process, whatever it may be called, of using hypnosis in a general framework of psychoanalysis was used by Breuer and Freud by 1895. Breuer had discovered that hypnosis could be used to enable an hysterical patient to recall the events which were the ultimate cause of her hysteria. Thus the case of Anna O. became the basis for what Freud later called the cathartic method, and which, of course, became the foundation for later psychoanalysis. Breuer and Freud (1893,1939) introduced periods of hypnosis at intervals during analysis and soon conceived the mechanism of repression, another fundamental principle of psychoanalysis. Gruenewald (1982) points out that Freud recognized hypnosis as a means to assist in the revival of memories of the past while the patient was in a state of increased suggestibility.

In addition, the use of hypnosis led to Freud’s discovery of transference. He observed that in hypnosis there is a real encounter between two persons. When Breuer and Freud hypnotized women, Mrs. Breuer and Martha (Freud’s fiancee) were jealous. It is assumed that, because of the libidinal aspects of hypnosis, Freud dropped its use in favor of developing psychoanalysis (Chertok, 1968; Gruenewald, 1982). Undoubtedly there was more to the decision than that, but Kline (1958) verifies that Freud was sensitive to the fact that hypnotic behavior involved an intense emotional relationship between the hypnotist and the patient. And he (Freud) admitted some confusion and ambivalence regarding hypnosis. But Kline sees Freud’s abandonment of hypnosis for reasons that are more complex. He sees subjective motives and objective motives.

The subjective motives include: (a) Freud’s involvement in non-hypnotic psychoanalysis and the extension of free-association technique; (b) he felt a sense of failure in being unable to obtain a somnambulistic state in enough patients; (c) he was sensitive to the development of a libidinal relationship between therapist and patient.

The objective grounds for Freud’s discarding the use of hypnosis are: (a) hypnotic suggestion failed to produce lasting results; (b) hypnosis conceals all insight into the play and interplay of mental forces and psychodynamic interaction; (c) hypnosis covers over the patient’s resistances and thus inhibits effective psychotherapy; (d) hypnotic techniques give the patient the impression of a laboratory experiment and in this respect interfere with the setting for psychotherapy (Kline, 1958, p. 5). In Kline’s evaluation he rightly observes that Freud’s subjective reasons are understandable and justified. But his objective reasons have not proved to be valid.

Kline (1958) observes that since Freud abandoned the use of hypnosis, it fell into disuse in the formal psychoanalytic movement simply because Freud was looked upon as an authority figure. Yet the reasons he rejected its use are no longer valid.

Freud does give credit to his contemporaries, Charcot, Breuer, and Bernheim, ... and acknowledges their effective use of hypnosis. There is, however, no evidence that hypnosis was used more than occasionally in their treatment. This proved to be the case for many years to come. Thompson (1950) makes an interesting observation in pointing out that in the evolution of Freud’s clinical practice, psychoanalysis grew out of the use of hypnosis, then hypnosis was dropped from his practice in preference for free association.

Except for a few allusions to the analytic use of hypnosis (for example, Sidis, 1902, who appears to be one of the earliest to utilize it in the study of the dynamics of personality) its use at the turn of the century was primarily confined to direct suggestion. It is as if the psychoanalysts went their way and the hypnotists went their way. (The International Journal of Psycho-Analysis does not have a single full length article on the use of hypnosis in an analytical context through 1982. There are a few references to hypnosis and some book reviews, but the subject is largely ignored.)

The dichotomy present between psychoanalysis and hypnosis at the turn of the century is reflected in the writings of Ferenczi (1926). In 1913 he stated that hypnosis is nothing else than a temporary return to this phase of infantile self-surrender, credulity, and submission. At any rate the analysis of such cases usually exposes mockery and scorn concealed behind the blind belief. In 1915 he bluntly said, I think the difference between hypnotism and analysis is this: hypnotism is like the beater that beats the dust farther into the clothes, but analysis is like the vacuum cleaner; it sucks out the symptoms. It is said of Freud that he compared hypnosis and analysis to the technique of painting and sculpture as characterized by Leonardo da Vinci (Ferenczi, 1926).

Ferenczi appears to reflect the general view of hypnosis by psychoanalysts at the time (1908) when he states (Ferenczi, 1926, pp.27f):

I will only touch briefly here on the question of hypnosis and suggestion, and remark forthwith that some successes are to be achieved by these means. Charcot already explained that hypnosis is a kind of artificial hysteria, and psycho-analysis further supported this by confirming that suggestion, whether employed during hypnosis or in the waking state, merely suppresses the symptoms, i.e. it employs the method in which the hysteric failed in his wish for self-cure. The ideational group occasioning the disease remains untouched by the treatment in the unconscious of the neurotic whose symptoms we strangled by hypnotism. Indeed in a certain sense it is enlarged, that is, the hitherto existing symptoms are now joined by a new one that can certainly, for a time, prevent the expression of pre-existing symptoms. When the force of the suggested prohibition weakens [and for this it suffices that the patient leave the doctor’s environment], the symptoms may immediately man themselves again. I regard hypnosis and suggestion as usually safe and harmless methods of treatment, but as holding out little promise of success, and their employment, moreover, is much circumscribed by the fact that only quite a small number of people can really be hypnotized.

These issues, as bases for controversy, were to continue for decades to come.

In another context, Ferenczi, in 1921, makes an analytical observation which is not without merit. He states that in

father-hypnosis the subject performs all that one asks him to do, as by that means he hopes to escape from the danger threatened by the dreaded hypnotist; in mother-hypnosis he does everything to ensure to himself the love of the hypnotist.

Meanwhile Keller (1917) is given credit by Brenman and Gill (1947) for one of the early attempts to combine hypnosis with the techniques of psychoanalysis.

Thus, at the turn of the century there were, for the most part, two camps. In the one were the hypnotists who dealt with direct suggestion for symptom removal; and in the other were the psychoanalysts who, as a group had not yet utilized hypnosis in therapy. Some analysts had enough of a professional curiosity to observe or practice hypnosis on occasion and as a result voiced some opinions and began to formulate theoretical concepts; but too little was known about the possibilities of hypnosis at that time to utilize it effectively enough for it to be widely accepted and practiced in psychotherapy. Nevertheless, the foundation had been laid. As the dark clouds of war spread over Europe, so the discoveries in psychotherapy were broadening and were finding new impetus with the onset of war.

THE PERIOD OF WORLD WAR I

Reference has already been made to the fact that Hadfield first used the term hypno-analysis as a process of using hypnosis in treating amnesias in war shock cases. The procedure, which had been used in earlier cases, was to revive forgotten and repressed experiences in hypnosis as an alternative method to free association and dream interpretation (Ambrose & Newbold, 1958).

The period of World War I gave some stimulation to the uncovering techniques available with hypnosis. The pressure on the army hospitals was to treat the patients in the shortest possible time. Traumatic war experiences, which frequently involved amnesia, lent themselves particularly well to treatment by hypnosis (Hadfield, 1920; Brown, 1921; Simmel, 1921). Take note that Brown is the first to call attention to the fact that usually more than one event of a similar type was involved as the traumatic basis for the production of the patient’s symptoms. His point was that frequently it took more than one traumatic event to weaken the psyche and precipitate the neurosis. Wingfield (1920) had already demonstrated the value of going back to some earlier period in life in seeking the ultimate source of symptoms.

Paul Schilder and Otto Kauders (1927) are given credit for writing the first book of its kind attempting to explain the phenomenology of hypnosis from the psychoanalytical point of view (Bryan, 1928, p. 05). Their statement appears to be the best summary available at this time:

We consider this method (psycho-analysis) to be a royal remedy in the treatment of serious neurotic troubles, regardless of whether they result in organic symptoms or not. Hypnosis is the only method for easy and medium cases and so may have great symptomatic value even in the treatment of serious cases.

There is no indication of a widespread interest during the period prior to World War II, but there are glimpses of individuals who manifested some curiosity about the use of hypnosis in an analytical setting. And, if the publication of a journal is any evidence, the place of greater interest seems to be Great Britain. For examples see Speyer and Stokvis (1938), Bramwell (1921), Hadfield (1919, 1920). Others of this era were Hull (1933), Janet (1925), Platonow (1933), Eisenbud (1937). Of course, the grand old man of hypnosis, M.H. Erickson, was the leading figure in hypnosis during this period. Although he did not practice psychoanalysis with it, he utilized analytical principles along with hypnosis and in so doing laid the groundwork for a more advanced utilization later (1933, 1938a, 1939b; Erickson & Kubie, 1939, 1940).

Erickson (1937) demonstrated that, at least in some cases, apparent unconsciousness could develop while reliving a traumatic experience in hypnosis.

Kubie, as an analyst, must be given great credit for pioneering work at his time (1939, 1943a, 1943b etc.). He made many contributions in conjunction with Erickson, in demonstrating, for example, that it is even possible to alter memories in hypnosis (1941).

It was a significant disclosure when Kubie observed (1939) that the essence of all neurosis was that a command had been repeated many times in the child’s mind by an authority figure. Such repetitions must occur because of the resurgent instinctual demands. This appears to be the substance of what we now call negative hypnotic suggestions related to what Araoz (1981) calls negative self-hypnosis. Kubie (1943b) also recognized that hypnogogic reverie could produce and clarify unconscious material.

Another example (in addition to Erickson) of a non-psychoanalyst utilizing psychoanalytical methods at this time was Berg (1941). He gave a popular description of the psycho-analytical method for the lay public.

The challenge had been thrown by now and the cudgels of debate had been taken up. For example, Young (1940) discusses the issue of whether age regression was fact or artifact. And Winn (1940) thought it necessary to attack psycho-analysis in order to provide a scientific foundation for the study of hypnotism.

Zenkin (1948, p. 54) gives an apt summary for this early period. He states:

Freud’s refusal to continue his investigations with this method (hypnosis) caused it to fall rapidly into disrepute. Although on the continent many psychiatrists and physicians continued to employ it, in our country it was relegated to the limbo of stage tricks, cracks and cranks.

Before going further it will be helpful to summarize some of the psychoanalytic principles which had been utilized with hypnosis by the period immediately preceding World War II. 1. Hypnosis was used to revive forgotten and repressed memories. 2. Hypnosis was used in dream interpretation. 3. It was possible to produce post-hypnotic amnesia. 4. Hypnosis led to an awareness of a subconscious mind in addition to the conscious mind. 5. When hypnosis was used in regression to previous traumatic experiences, catharsis could be produced, and this was extremely helpful in curing the patient. 6. The use of hypnosis led to the recognition that the mind may repress unpleasant experiences from the consciousness. 7. Hypnosis led to the discovery of the principle of transference. 8. The use of hypnosis led to the recognition that a plurality of events of a similar nature make up the etiology of the symptoms.

These discoveries were made over a period of some 50 years and by therapists in scattered environments. There is no evidence that any one utilized all or even most of these principles in clinical practice during this time.

It took the trauma of the Second World War to bring about a true resurgence in the use of hypnosis as an adjunct to analytical psychotherapy.

THE PERIOD OF WORLD WAR II

Erickson and Kubie (1941) further stress the value of abreaction in the recall of childhood experiences by the use of hypnosis in describing the cure of a case of acute hysterical depression. The patient was first deeply hypnotized and then given some protective suggestions concerning hypnosis, and, it was noted, that the hypnotist had a permissive attitude. It was clear to the therapists that the patient had several previous traumatic experiences, severe enough so that, in order to soften the readjustment and to avoid guilt or fear, post-hypnotic amnesia was produced. This was destined to become a procedure used later by some therapists.

Erickson and Kubie recognized that there was some repression of insight from the age regressions, but otherwise they refer to the treatment as the usual psychoanalytic technique. For example, many repetitions were used. An observation was made that the patient was cured with only rudimentary insight, that is, there were insights, conscious and unconscious, which were never understood or clarified to either patient or therapists. These two authors further observe that the patient’s behavior in age regression corresponds