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Prehypnotic Suggestion in Psychotherapy Jerome M. Schneck M.D. Published online: 20 Sep 2011.
To cite this article: Jerome M. Schneck M.D. (1975) Prehypnotic Suggestion in Psychotherapy, American Journal of Clinical Hypnosis, 17:3, 158-159, DOI: 10.1080/00029157.1975.10403734 To link to this article: http://dx.doi.org/10.1080/00029157.1975.10403734
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THE AMERICAN JOURNAL OF CLINICAL HYPNOSIS
Volume 17, Number 3, January 1975 Printed in U.S.A.
Prehypnotic Suggestion in Psychotherapy JEROME M. SCHNECK, M.D.
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New York, New York 1
The term "prehypnotic suggestion" is proposed to describe deliberate, organized, goal-directed suggestion prior to formal hypnotic induction with the view that the hypnosis which follows is to promote therapeutic gain and reinforce issues incorporated into the prehypnotic suggestion. A case involving a fear of flying is used to illustrate one way in which prehypnotic suggestion has been employed.
I proposed the term "prehypnotic suggestion", not long ago, to signify suggestion used prior to formal hypnotic induction (Schneck, 1970). Such suggestion is by implication, or accompanied by direct statements, employed with the view that the hypnosis which follows should promote (in the case of clinical settings) therapeutic gain and reinforce the issues incorporated into such suggestion. Prehypnotic suggestion differs from traditionally and 'widely used posthypnotic suggestion which is administered during the hypnotic state, with effects to manifest themselves, as applies also to prehypnotic suggestion, following the termination of hypnosis. The example reported here has been selected because of its simplicity and effectiveness in illustrating one type of instruction within the category of prehypnotic suggestion. So far as the nature of suggestions and their mode of delivery are concerned, many variations may of course be introduced in keeping with differences among patients and their problems. CASE REPORT
A 45 year old woman requested hypnotherapy for fear of flying. She had been referred by a former patient who had been 1
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successfully treated for the same problem. The present patient revealed that while she managed to fly, her considerable fear and anxiety were increasing and were associated with all aspects of her trips. Consciously she feared a crash and death. She had come to the consultation from a great distance and was due to embark on a vacation trip to Europe just a few hours after this one combined consultation and therapy session that could last only forty-five minutes. When asked to describe her problem, the patient alluded at first not to her fear of flying, but to her "disturbed relationship" with her husband, the fact that she felt she was alcoholic, and that her husband was too. Then she commented on family matters and the family business situation. Her present vacation was "to get away from all my troubles." Because of the limited time available, the procedure decided on was as follows. The patient was told that she would be given certain helpful suggestions following which the hypnosis would be induced. The latter was described to her as a procedure that would stress relaxation and comfort, initiated by a simple count of letters of the alphabet, with termination of the hypnosis by a simple count of numbers. The prehypnotic suggestions were that prior to the induction she would think about how she 158
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wished to feel physically and psychologically throughout all aspects of her travel pre-embarkations and fI ights. She would not verbalize her thoughts. When she was ready after a few moments, the hypnosis would be induced and the hypnotic induction and the hypnotic relaxation would themselves automatically reinforce her silent instructions to herself regarding how she wished to feel during this trip. When she indicated her understanding of the instructions and suggestions, she remained silent awhile and then said she had thought through the details as indicated. Hypnosis was induced easily and smoothly. She was given a few moments for deep, comfortable relaxation in hypnosis and then it was terminated. No verbalization was sought or ventured during the procedure. She revealed she had responded well and comfortably. There was time to repeat the entire procedure - prehypnotic suggestions for thinking about how she wished to feel, suggestions that she would be able to achieve this goal, suggestions to the effect that the hypnotic procedure, without verbalization on her part, would automatically reinforce the intent of the prehypnotic suggestions and enable her to reach her goal, and then the hypnosis itself. The patient's husband had accompanied her to the office, but was not present during the procedure. When she was leaving he asked" Did you get her on the plane?" The patient had said both she and her husband felt they needed help for their problems, and that he was interested in noting what she achieved through this visit. Several weeks later, the patient's husband telephoned, said his wife's trip was "great," and proceeded to make an appointment for psychotherapy for himself. Immediately thereafter he entered treatment. He mentioned that following this first trip his wife had successfully taken a second trip involving air travel.
When administering prehypnotic suggestions, manner, repetitions and tone are adapted to conjectured requirements of patients. Prehypnotic suggestion is desirable at times for patients who strongly resist induction or in whom such resistance is anticipated, and, as in the present case, to counteract the possible occurrence or strength of such resistance. The resistance may relate to many things including fear of the impact of suggestions anticipated during hypnosis for their immediate hypnotic or posthypnotic effect. Prehypnotic suggestions, in line with concurrent clinical judgment and conjecture, may be used also when inductions are easy, but are followed by anxiety in the patient about actively participating in hypnotherapeutic procedures. The extent to which prehypnotic suggestion is employed, and the emphasis on it during the course of treatment, should vary with each patient in keeping with his attitude toward and response to hypnosis, goals to be achieved, and the patient's psychological status at the point of hypnotic contact. My view of prehypnotic suggestion implies a deliberate, organized, goal-directed effort, in contrast to similar suggestions which are virtually inherent in any hypnotherapeutic procedure. Posthypnotic, rather than prehypnotic, suggestion has always been part of hypnotic literature, especially the classic writings. (Moll, 1890). Prehypnotic suggestion may also be used as part of psychotherapy, entailing hypnotic methods, ranging from short to long term treatment. REFERENCES MOLL, A. Hypnotism. London: Walter Scott, 1890. SCHNECK, J. M. Prehypnotic suggestions. Perceptual & Motor Skills, 1970,30, 826.