Harm in Hypnosis: Three Understandings From Psychoanalysis That Can Help

Abstract

Over 50 years of empirical data demonstrate unequivocally that psychotherapy can cause harm as well as good. Two therapist factors increasing harm risk are inadequate assessment of patients’ vulnerabilities and certain attitudes/affects. Adding hypnosis as a technique within psychotherapy heightens risk for harm because: (a) trance can unexpectedly expose patient vulnerabilities (through loosening reality orientation, lessening structure, generating unfamiliar sensations and perceptions, and intensifying access to interior information such as emotions and imagery); and (b) trance can unexpectedly increase porousness to therapist’s attitudes/affects (through heightening mental receptivity to the internal states of others). A century of clinical data from psychoanalysis offers guidance for protecting against such risks. Concepts of structure, interiority, and countertransference are explicated and translated into practical clinical suggestions for harm prevention.

Keywords:

• hypnosis
• psychoanalysis
• psychotherapy
• harm
• countertransference
• personal therapy
• assessment

Notes

¹ The key to extending our grasp of complexity is to integrate (not replace) truths already learned, with knowledge newly discovered. New does not always mean better (or new).

² Deterioration was operationally defined as a worsening of symptoms/well-being from before therapy began to when it ended, measured by a statistically valid and reliable patient self-report instrument—the CORE-OM (Barkham, Gilbert, Connell, Marshall, & Twigg, 2005).

³ (Henry, Schacht, & Strupp, 1986); (1990); (Piper et al., 1999); (Wile, 1984).

⁴ (Greenson, 1967); (Henry et al., 1986); (1990).

⁵ (Hill, Mahalik, & Thompson, 1989).

⁶ (Bateson, Jackson, Haley, & Weakland, 1956); (Henry et al., 1986); (1990).

⁷ (Henry et al., 1986); (1990); (Schore, 1996).

⁸ (Beutler, Blatt, Alimohamed, Levy, & Angtuaco, 2006).

⁹ (Henry, Strupp, Butler, Schacht, & Binder, 1993).

¹⁰ (Christianson, 1991); (Hilliard, Henry, & Strupp, 2000).

¹¹ Synchronous, thus, originates from the Greek words, chronos (time) and syn (same, common).

¹² Earlier discussion of unconscious did not use that term, but spoke, within philosophical, religious, or artistic frames, about a nonmaterial human dimension that lay outside conscious awareness and yet held important information and aspects essential for personal expansion. Such discussions were as early as Plato (5th century BC), through St. Augustine (4th century AD) and even Montaigne (1572/1958).