The American journal of clinical hypnosis
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Ego-state therapy is a psychodynamic approach in which techniques of group and family therapy are employed to resolve conflicts between the various "ego states" that constitute a "family of self" within a single individual. Although covert ego states do not normally become overt except in true multiple personality, they are hypnotically activated and made accessible for contact and communication with the therapist. Any of the behavioral, cognitive, analytic, or humanistic techniques may then be employed in a kind of internal diplomacy. Some 20 years experience with this approach has demonstrated that complex psychodynamic problems can often be resolved in a relatively short time compared to more traditional analytic therapies.
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For this Presidential Address, I accepted the challenge to discuss my perception of the future directions of hypnotherapy. I believe that the next decade will bring increased attention to the mind/body relationship and how hypnosis can be most effectively employed in this area. As an oncologist, one of the most exciting areas of current research is in psychoneuroimmunology. ⋯ Training in hypnosis is helpful in recognizing spontaneous trance states which may modify the effects of "nocebos." The use of hypnoanesthesia for surgery would be ideal in third world and developing countries. I believe there will be increased interest in the use of hypnosis in self-care, in the forensic area, and in the use of self-hypnosis by the general population. Finally, I expect that in the next decade the ASCH and SCEH will cooperate more closely in many areas of significance to hypnosis.
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Eighteen clinical trials which employed an intervention using hypnosis, suggestion, or relaxation to facilitate the recovery of surgery patients were critically reviewed. Sixteen studies credit the intervention with facilitating either the physical or emotional recovery of patients following surgery. Two studies failed to document any positive outcome attributable to the intervention. The available literature suggests that hypnosis, suggestion, and relaxation are underutilized techniques which can shorten postoperative hospital stays, promote the physical recovery of patients from surgery, and aid in the psychological and emotional response of patients following surgery.
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Case Reports
Hypnotically assisted preparation of the anxious patient for medical and dental treatment.
Hypnotic preparation of patients for medical or dental procedures has various aspects. It is important to encourage the patient's cooperation in assessing problem areas and determining the order of dealing with those problems. ⋯ The case history presented illustrates one approach for an apprehensive patient who felt a dental experience had triggered her fear of surgery. Self-hypnosis, ego strengthening, and mental rehearsal during the 11 sessions made it possible for the patient to proceed with needed surgery.
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Hypnosis is widely used to relieve pain. Current theory emphasizes its dissociative features. Multiple personality patients can eliminate pain in the primary personality by displacing it into underlying alters. ⋯ Normal individuals, like multiple personalities and "hidden observer" subjects, can displace (dissociate) pain into "covert" ego states. The pain is not eliminated. This suggests that when we remove pain by hypnosis we may not be getting away "scot-free."