The Social Side of Depression
Depression is about much more than "bad chemistry"--and it's contagious. How you can help stop the spread.
Michael D. Yapko, Ph.D.
Published on January 4, 2010
Happy New Year! This first blog of the new decade is all about developing the kind of focus that can not only help you feel better, but be better. I have much more than a casual interest in the topic of how your focus influences your life experience: For nearly three decades, I have focused on two primary domains of professional interest: Applying clinical hypnosis in short term psychotherapies, and treating depression in individuals, couples and families. I have written many times on depression already, but a blog on the merits of clinical hypnosis is long overdue.
The field of clinical hypnosis has undergone a quiet revolution from seemingly being little more than a party gimmick to an established and vital component of behavioral medicine programs in the finest academic and clinical institutions you can name, including Harvard, Yale and Stanford. There are sophisticated scientific journals dedicated solely to advancing clinical practice on the basis of research into hypnotic phenomena. There are national and international meetings devoted entirely to the subject of how hypnosis informs clinical practice and illuminates complex mind-body relationships. Someone unfamiliar with hypnosis might be surprised to discover that hypnosis has been subjected to a wide variety of empirical investigations, particularly clinical and neuroscientific ones, attempting to better understand how a clinician’s words can become the basis for seemingly remarkable experiences in a focused client.
Hypnosis involves selective attention, a narrowing of focus and an increased absorption in suggested experiences. Contrary to popular mythology, people absorbed in the experience of hypnosis are fully aware of what’s going on and are fully in charge of themselves. But, they are deeply focused on listening to and absorbing the therapeutic ideas the clinician introduces, taking them in and using them at more profound levels than they otherwise might. Hypnosis isn’t magic; Hypnosis simply amplifies what goes on in any good therapy when a skilled clinician introduces new possibilities to a client seeking positive change.
Hypnosis is not generally regarded as a therapy in and of itself. Rather, it is considered a therapeutic tool for creating a more relaxed, focused and attentive context for absorbing the therapy. Thus, the salient question to ask is not, “How does hypnosis compare to cognitive-behavioral therapy(CBT) (or some other specific form of therapy) in treatment success rates?” Rather, the appropriate question is, “If CBT is performed withouthypnosis and CBT is performed with hypnosis, does the addition of hypnosis enhance the efficacy of the treatment?” The evidence is substantial that the answer is yes. (Clinicians reading this blog may be interested in a detailed review of the status of hypnosis as an empirically supported treatment for a variety of medical and psychological disorders which were published in the April and July, 2007, special issues of theInternational Journal of Clinical and Experimental Hypnosis.) No treatment is successful with all people, of course, but the ability of hypnosis to enhance treatment results in most individuals is impressive.
Hypnosis sessions are most effective when structured according to the unique profile of the client. This includes things like the client’s goals for the session, attentional capabilities, cognitive style, and personal interests. Generally, hypnosis sessions are about 20-30 minutes in length, embedded within the larger therapy session. Hypnotic procedures typically involve directing the client to close his or her eyes, relax, focus intently on the clinician’s words, and actively engage in the internal process of adapting the ideas and perspectives the clinician offers into a meaningful approach to resolving or changing the specific problems or symptoms under consideration. As a common example, a clinician might suggest to a client in hypnosis the idea that he or she be more deliberate about gathering objective information(“reality testing”) beforejumping to an erroneous and self-damaging conclusion, an unfortunate but typical cognitive pattern often associated with depression. Of course, this is the same sensible idea a clinician might suggest without the benefit of hypnosis, but the client’s absorption of the message is considerably more rapid and intense when focused in hypnosis.
Most interestingly, responses occur at levels outside of the client’s awareness that further intensify the hypnotic experience. Suggesting to a client in pain, for example, that he or she can, “detach from your body and allow a comfortable sense of numbness to gradually replace the discomfort” is not a rational suggestion to offer. But, to the person in hypnosis, it is one he or she can absorb and respond to with the development of an analgesia sufficient to even withstand surgical procedures done without the use of chemical anesthetics. That’s remarkable! How this change in sensory awareness occurs is poorly understood at this time. There are neuroscientific studies going on all over the world employing sophisticated scanning technologies with hypnotized research subjects to try and understand how the mind in hypnosis can influence the brain in such extraordinary ways.
Anyone who practices clinical hypnosis does so with the firmly entrenched and therapeutically invaluable belief that people have many more abilities than they consciously realize. Hypnosis creates an amplified experience for people to explore, discover, and use more of their innate abilities. Hypnosis also makes it easier to learn new skills. Hypnosis isn’t the therapy, and hypnosis itself cures nothing. Rather, hypnosis is the vehicle for empowering people with the abilities and realizations that ultimately serve to help them. It isn’t the experience of hypnosis itself that’s therapeutic, it’s what happens during hypnosis in terms of developing new and helpful associations.
There are many ways to use hypnosis in treating depression including building positive expectations to counter hopelessness, reframing emotion-laden memories, enhancing perceptual flexibility, instilling better coping skills, and increasing self-efficacy. Hypnosis as a subject of serious study, both in clinical and neuroscientific domains, is already reaping great dividends, and as new applications emerge, hypnosis has great potential to help people in ways they may never have considered before. If you want to learn more about hypnosis, you can visit my website: www.yapko.com for materials and educational links.
One piece of advice: I’m obviously encouraging the use of hypnosis as an established means of helping people feel and be better. But, I am strongly advocating that you only seek hypnosis from a well trained clinician. You may ask how to determine if someone is qualified and my answer is that the person must be qualified to do therapy without hypnosis before they are qualified to do therapy with hypnosis. In other words, only someone with a formal academic degree who is state licensed to provide health care. The practice of hypnosis is not regulated, and so there are many people out there who do hypnosis with only titles (such as “certified hypnotherapist” ) despite having no degrees or licenses appropriate to conduct therapy. If you want a local referral, a good place to start is by visiting the website of the American Society of Clinical Hypnosis at www.asch.net or by calling your local medical or psychological associations. There you’ll find a referral list of professionals for you to interview as possible therapists to consult.