Abstract

The role of the patient in hypnotherapy can be underestimated by both the therapist and the patient. This is likely due to the focus the hypnosis literature has had on the role played by the hypnotist/therapist and less on the phenomenological control (control over subjective experience) applied by the patient. Whilst early approaches to hypnosis and hypnotherapy included concepts such as autosuggestion and self-hypnosis, the role of the self has been largely overlooked. Here we aim to highlight the importance of the self in hypnotherapy and hypnosis by considering the concept of self-hypnosis and how it relates to hetero-hypnosis. We will show that: 1) historically the self was an important component of the concept of hypnosis; 2) extant theories emphasise the role of the self in hypnosis; 3) self-hypnosis is largely indistinguishable from hetero-hypnosis; 4) self-hypnosis is as effective as hetero-hypnosis. We also argue that highlighting the role of the self in hypnotherapy and hypnosis could increase feelings of self-efficacy, especially given that it can be considered a skill that can be advanced and implies self-control and not “mind-control”. Highlighting the role of phenomenological control by the patient could also increase the uptake of hypnotherapy as treatment for various disorders.

The early development of self-hypnosis

Gravitz [ 31 ] reported the potential first use of self-hypnosis, by Franz Anton Mesmer, as a method of self-magnetization for a “blockage in the lower body”. Hypnosis historians [ [32] , [33] ] consider mesmerism a precursor of hypnosis, operating on similar principles. However, Braid [ 34 ] was the first investigator to systematically explore the phenomenon of self-hypnosis, using it to aid in his own health issues. Braid’s later work, Observations on Trance or Human Hybernation [ 35 ], provides what is one of the earliest accounts of self-hypnosis. He describes how he successfully used self-hypnosis to deal with the pain of a rheumatism attack by following all the protocols and instructions he gave his hypnosis patients. Braid reported that he went on to be free of his rheumatism for six years and highlighted that a hypnotist was not necessary. Coué [ ۳۶ ] later supported Braid’s approach by conducting a number of demonstrations of individuals experiencing hypnosis, and displaying hypnotic phenomena, without any direct involvement of or intervention from another person. Coué is seen by many as an influential figure in the development of self-hypnosis, despite his system not being referred to as self-hypnosis. Rather, he taught a process of waking self-suggestion named ‘autosuggestion’, which became a globally recognized self-help methodology at the beginning of the 20th century. Coué taught active imagination experiments to develop ‘hypnotic phenomena’, such as arm levitation and catalepsy, by simply teaching his students to affirm suggestions to themselves while engaging in vivid mental imagery with a depth of meaning, belief, and volition ([ 36 ]; 1923).

Conclusions and directions for future research

Highlighting the role of the self in hypnotherapy potentially provides an opportunity to change the commonly held view that hypnosis involves giving up control to another; a perception that has likely caused a barrier for the uptake of hypnosis in clinical settings, despite strong evidence for its efficacy.

The added potential benefits of self-hypnosis for self-efficacy, perceiving suggestibility as a skill to be developed (and the inevitable reduced financial commitment for treatment) seem to provide a strong motivation for continued application and study of self-hypnosis. With that in mind we recommend that in future clinical applications and hypnotherapeutic encounters a participant or patient is encouraged, on a number of occasions, to self-regulate the hypnotic experience without the direct input from a hypnotist/therapist (after initial education and instruction from a specialist, in person or via audio recordings). Hypnosis should eventually be a self-induced, self-directed experience without the need for verbal direction from another person. This involves using one’s own cognitions and mental imagery to communicate with oneself in a goal-oriented way with a positive, expectant attitude with all the benefits in perceived self-efficacy that brings.