Reassessment of Hypnotic Symptom Removal By Freud and Bernheim

Abstract

As demonstrations of clinical efficacy, cases reported by Freud and Bernheim reveal an intrinsic advantage of hypnotic symptom removal over therapies requiring extended periods to achieve significant outcomes. They also lend support to Weitzenhoffer's survey of therapeutic results achieved during the classical (pre-1900) period.

Zusammenfassung:

Die von Freud und Bernheim berichteten Fälle machen einen intrinsischen Vorteil der hypnotischen Symptombeseitigung gegenüber Therapien deutlich, welche längere Zeiträume benötigen um signifikante Ergebnisse zu bewirken. Sie unterstützen außerdem Weitzenhoffers Übersicht bezüglich der therapeutischen Resultate während der klassischen Periode (bis 1900).

Ralf Schmaelzle University of Konstanz , Konstanz , Germany

Résumé:

À titre de démonstration de l’obtention de résultats cliniques positifs, les cas relevés par Freud et Bernheim soulignent l’avantage intrinsèque de la suppression des symptômes par l’hypnose sur les thérapies s’étendant sur une longue période. Ces cas appuient également l’étude de Weitzenhoffer sur les résultats thérapeutiques obtenus durant la période classique (avant 1900).

Johanne Reynault C. Tr. (STIBC)

Resumen:

Como demostraciones de eficacia clínica, los casos descritos por Freud y Bernheim dan a conocer una ventaja intrínseca de la eliminación hipnótica de síntomas sobre terapias que requieren períodos extensos para lograr resultados importantes. También prestan apoyo a la encuesta de Weitzenhoffer de los resultados terapéuticos logrados durante el período clásico (pre-1900).

Etzel Cardeña University of Lund , Lund , Sweden

Notes

³ Borckardt and Nash (2002) offer extremely important guidance, encouragement, and support for the working clinician's pursuit of single-case research. They also review recent hypnosis studies based on this rationale (also see Pinnell & Covino, 2000). As the preceding cases by Freud and Bernheim illustrate, temporary clinical relapses, when followed by a successful hypnotic intervention, may yield the scientific equivalent of a conventional, preplanned withdrawal design. Thus, an initial clinical disappointment may yield a unique research opportunity. Also note that in the case of hypnotic symptom removal, since the patient's symptom may be static (100%) prior to treatment, the baseline could be established solely through historical verification. The treatment effect may be equally definitive. When present, these features simplify data collection, verify the validity of the dependent variable, and eliminate the statistical complication of auto correlation.

¹I wish to thank Eve Pecchenino and Dean Alexander for helpful suggestions made during the writing of the manuscript.

⁴ Barlow and Hersen (1984) noted that Breuer did not define his independent variables. Breuer admitted that he did not know what component or components of his treatment were responsible for success.

⁵For an excellent review of Freud's relevance to hypnosis, see Bachner-Melman and Lichtenberg (2001).

⁶Freud's and Bernheim's patients both presented with symptoms consistent with a present-day diagnosis of functional dyspepsia. For a recent report on hypnotherapy for functional dyspepsia, see Calvert et al. (2002).

⁷Freud's and Bernheim's interventions had to be repeated after extended periods in which their patients were free of symptoms. Nonetheless, they were highly effective when considered in the light of cost-effectiveness. It seems very likely that a modern PPO or HMO would welcome results such as those achieved in the present case examples.

⁸In his survey of work prior to 1900, Weitzenhoffer (2002) noted, “We do not know . . . what else the clinicians involved have said and/or done that might have had suggestive effects upon patients (e.g., indirect suggestions)” (p. 131). According to Amundson, Alladin, and Gill (2003), this problem of controlling for nonspecific factors persists to the present day. Yet even in the case of nonspecific factors, the advantage of the extremely limited time interval required for some hypnotic symptom-removal interventions should facilitate research into these very factors. An approximate analogy could be found in the difference between the analysis of a single frame from a motion picture as opposed to the scrutiny of an entire scene.