Compliance, Suggestibility and Hypnosis

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Hypnosis and Suggestibility in Practice: You’ve done a great session. You’ve spent time getting to know your client and their presenting issue; you’ve established a good rapport with them; you’ve given careful attention to helping them to understand what hypnosis is, and you’ve shown them that they can experience trance and respond to suggestion

You’ve been really brave, and integrated an undeniable ratification of trance into your formal hypnosis work together – neither you nor your client have any reason to believe they were not “hypnotised” because they complied with your ratification suggestion.  

Two weeks later you get a call, and your client tells you that they didn’t get the outcome they came to see you for, and they therefore don’t believe they were hypnotised after all – commonly phrased as “it didn’t work”. 

It is likely they are:

  1. Equating hypnosis with suggestibility; and 
  2. Equating suggestibility with compliance; and
  3. Equating suggestibility with a ‘successful’ therapeutic outcome. 

The question is: Are you doing this, too? If so, then you might need to examine your thinking about what it is about what we do that enables people to achieve a successful therapeutic outcome. 

SOME THOUGHTS FROM OTHERS:

Erik Wright on choice and free will in hypnosis says: “Clients need to understand that the hypnotized person remains capable of higher mental processes, such as forming judgments, making decisions, and guiding his or her own behaviour” (in Wright & Wright, 1987, p. 14).

Brent Geary on expectation of success says: “Expectancy is a tremendously powerful factor in the manner in which patients respond to treatment and this is especially true of hypnosis…however, patients’ expectations regarding hypnosis present a double-edged sword” (in Geary & Zeig, 2002, p. 4).

Douglas Flemons on suggestibility says: “Some hypnosis theorists would say that as I talked, you became more “suggestible”. Others would say that your “suggestibility” is a stable trait, a “hypnotizability” capacity that distinguishes you from people who can’t be hypnotized and aren’t suggestible. I’m not fond of either characterisation, as each places “suggestibility” inside of you as a localizable thing … what happens in hypnosis has to do with changes in relationship” (2002, p. 22)

Michael Yapko on hypnotic capacity says: “Personally, I am most aligned with the view of hypnotic capacity as a potential that can only emerge under the right personal, interpersonal, and contextual conditions…the test score is less important than the clinical response. Thus, I assume the inevitable presence of suggestibility on the part of my client.” (2003, p. 148)

Joseph Barber on trance as distinct from suggestion says “if we blur the distinction between suggestion and hypnosis…the special meaning of hypnosis is lost” (1996, p.p. 7-8). What he was referring to is the tendency to group persuasive speech (or as he refers to it “invitations to experience”) with hypnotic suggestion. The “special meaning” of hypnosis he refers to is the presence of trance – of an altered state of consciousness, and the opportunities that state provides for.

Helen Erickson on managing expectation says: “When clients come for help, they expect something to happen; either they will get help or they won’t …The way we build on this natural state – a state of expecting that something is going to happen – depends on how we communicate with our clients and what we communicate” (in Geary & Zeig, 2001, p. 303).

Milton Erickson on hypnosis as a natural phenomenon said: “Hypnosis does not change people nor does it alter their past experiential life. It serves to permit them to learn more about themselves and to express themselves more adequately”. (in Erickson, Rossi & Ryan, 1992, p.p. 27-28).

SOME QUESTION TO CONSIDER: 

  1. Have you given any thought to these ideas about suggestion, suggestibility and compliance? What do you think about these ideas?
  2. Have you considered that a person may experience a good trance, and yet still not respond to (comply with) the suggestions you offer?
  3. What importance do you place on the relationship between you and your client? Does mutual positive regard contribute to a successful outcome, or is rapport all about the trance you are able facilitate?
  4. Considering all of these thoughts, and the scenario outlined in the introduction, what might your next steps with that client be? 

REFERENCES

Barber, J. (1996). Hypnosis and suggestion in the treatment of pain (1st ed.). New York: W. W. Norton & Company.

Erickson, M., Rossi, E., & Ryan, M. (1992). Creative choice in hypnosis. New York: Irvington Publishers.

Flemons, D. (2002). Of one mind: the logic of hypnosis, the practice of therapy. New York [etc]: W.W. Norton.

Geary, B., & Zeig, J. (2002). The handbook of Ericksonian psychotherapy. Phoenix, AZ: Milton H. Erickson Foundation Press.

Wright, M., & Wright, B. (1987). Clinical practice of hypnotherapy. Guilford Press.

Yapko, M. (2003). Trancework (3rd ed.). London: Brunner-Routledge.

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