|Year : 2015 | Volume
| Issue : 1 | Page : 3-6
Mindfulness-based hypnotherapy for common psychological disorders
Shaunak Ajinkya1, Pradeep R Jadhav2, Deepali Ajinkya3
1 Department of Psychiatry, Mahatma Gandhi Mission`s Medical College and Hospital, Navi Mumbai, Maharashtra, India
2 Department of Pharmacology, Mahatma Gandhi Mission`s Medical College and Hospital, Navi Mumbai, Maharashtra, India
3 Department of Hypnotherapy, Master Your Mind Institute of Clinical Hypnosis, Navi Mumbai, Maharashtra, India
|Date of Web Publication||23-Jul-2015|
Dr. Shaunak Ajinkya
Bandra Shelter Apartments, Gr. Floor, 145, Manuel Gonsalves Road, Bandra, Mumbai - 400 050, Maharashtra
Source of Support: None, Conflict of Interest: None
'Mindfulness' is an essential element of Buddhist meditative practices. It is paying attention to the present moment and to what we experience. Hypnosis is a state of a state of increased suggestibility with constriction of peripheral awareness and increased focal concentration on task at hand. Thus there are many similarities between hypnosis and mindfulness and they are, many a times, complementary. This review article focuses on the applications and evidences for using mindfulness- based hypnotherapy in the management of psychological disorders.
Keywords: Hypnosis, hypnotherapy, mindfulness, psychological disorders
|How to cite this article:|
Ajinkya S, Jadhav PR, Ajinkya D. Mindfulness-based hypnotherapy for common psychological disorders. Eur J Psychol Educ Studies 2015;2:3-6
|How to cite this URL:|
Ajinkya S, Jadhav PR, Ajinkya D. Mindfulness-based hypnotherapy for common psychological disorders. Eur J Psychol Educ Studies [serial online] 2015 [cited 2019 Oct 22];2:3-6. Available from: http://www.ejpes.org/text.asp?2015/2/1/3/161414
| Introduction|| |
Mindfulness is the heart of Buddhist philosophy. The term 'Mindfulness' is derived from the Pali word 'Sati', an essential element of Buddhist meditative practices. 'Sati' means a conscious awareness or skillful attentiveness.  More than 200 years ago, Buddha attributed human suffering to a tendency to cling on to thoughts, feelings and ingrained perceptions of reality along with habitual ways of acting in the world. Afraid of remaining in direct, open and unguarded contact with the totality of subjective experiences, many people engage in experiential avoidance, habitually striving to avoid what is unpleasant and experience only that which is pleasant.  Buddha proposed that mindfulness, the radical and unmitigated attention to pleasant as well as unpleasant experiences, is the means of counteracting experiential avoidance and alleviating human suffering. According to Lama Surya das mindfulness is a 'relaxed, open, lucid, moment to moment present awareness'.  Kabat-Zinn (2003) defined mindfulness as a purposeful, non-judgemental attention to the unfolding of experience on a moment to moment basis. So mindfulness is paying attention to what we experience and not what we would like to experience. 
Hypnosis is a state of a state of increased suggestibility with constriction of peripheral awareness and increased focal concentration on task at hand.  Under hypnosis, the critical censor relaxes and allows material to move in and out of your subconscious mind more easily. Thus hypnosis can be used to reprogram the subconscious mind. 
| Similarities between Hypnosis and Mindfulness|| |
- Both can be used as a psychological process that can produce outcomes or can be an outcome by itself
- Both begin with attempts to relax and training the mind by focusing attention 
- In both, clients are told to listen receptively and are taught to be non-judgmental to suggestions in order to let themselves get deeply absorbed in their internal experiences 
- Both, by inducing relaxation → reduce anxiety and autonomic arousal 
- Both are means of promoting positive personal growth, transform personal experiences and change ones perceptions 
- Both help to build new response sets over the old habitual maladaptive response patterns. 
| Mindfulness and Hypnosis are Complementary|| |
- Mindfulness can de-automatize the response sets to certain events and create the workspace for the formation of new ones with the help of hypnotic suggestions e.g. imagining the mind as the sky and thoughts/feelings/sensations as cloudsin that sky which come and go 
- Hypnotic suggestions can be given to promote the acceptance of mindfulness, e.g.
- To learn ways to accept that which cannot be changed
- To be tolerant to certain specific troublesome feelings
- Appreciating the fact that any kind of feeling is impermanent and that it will eventually be replaced by a different feeling. 
| Use of Mindfulness in Psychotherapeutic Interventions|| |
Mindfulness is a skill which allows one to be less reactive, helps one to not get entangled in past/future, focuses ones attention to the task at hand, helps one to be non judgmental and develop acceptance towards things just as they are. The integration of mindfulness into various psychotherapeutic techniques has led to multi-component treatment protocols and exercises such as mindful breathing, mindful eating and other ways of mindful attention. 
The leading approaches are as follows:
- Mindfulness Based Stress Reduction (MBSR) Program: Jon Kabat Zinn  established the Center for Mindfulness (1979) to run the MBSR Program, an 8-10 week training course with multiple applications to physical and mental health for chronic conditions
- Dialectical Behavior Therapy (DBT): Inspired by Zen philosophy, DBT by Marsha Linehan  has become the preferred therapy for borderline personality disorders and is being used, in general, for affect regulation
- Mindfulness based cognitive therapy (MBCT): Designed by Segal, Williams and Teasdale,  MBCT is the application of MBSR to cognitive therapy and depression
- Mindfulness based hypnotherapy: Michael Yapko  combined Hypnosis and Mindfulness.
| Parts of Mindfulness Based Hypnotherapy|| |
- Observation without evaluation - Becoming less identified with certain unpleasant thoughts, and simply noticing with acceptance the event as it is occurring. This desensitizes the client to internal cues such as dizziness, palpitationor low mood 
- Progress is measured by how much one accepts these experiences. Becoming desensitized, they become just the ordinary mental events. 
- Expansion of awareness - The objective of this procedure is to help patients create, amplify and express a variety of negative and positive feelings/experiences. It helps to identify certain maladaptive thoughts, emotions and body sensations 
- Relaxation training under hypnosis- This experience empowers the patients as it boosts their confidence in being able to halt anxiety related thoughts/feelings/sensations. Hence it is a very important component of MBH 
- Use of post-hypnotic suggestions - To counter problem behaviours, negative emotional responses, dysfunctional cognitions and negative self-affirmations, empowering post- hypnotic suggestions are offered as routine towards the end of each MBH session. 
Segments of MBH
The client is advised to make a detailed inventory of body sensations and internal triggers. He is educated about 'mindful attention'which involves awareness, present-centeredness and acceptance He is explainedhow turning away from any experience in order to avoid the emotional pain leads to isolation and withdrawal. He is then helped to enquire "why is the unpleasant experience (e.g., fear) unacceptable in his/her life?" Then the client is introduced to hypnosis with emphasis on relaxation and positive suggestions are given for the practice of mindfulness. 
Awareness of body
Under hypnosis, the client is guided to explore the most recent unpleasant experience. He is then made aware of how the brain raises many false alarms and taught to pay attention to the present moment rather than to past/future thoughts. He is taught Body Scanning exercises in order to focus on present body sensations rather than avoiding/fighting with them. Thus with detailed moment to moment awareness, he is made capable to recognize the false alarms thereby being able to catch the unpleasant emotions/sensations early as a trickle before they become into a torrent! 
Awareness of mind
Under hypnosis client is guided to be aware of thoughts, and stop identifying with them.This prevents reacting in an automatic manner thus weakening habitual responses. Mindfulness guided meditations  are used as hypnotic scripts e.g. "Mind is the sky and thoughts, feelings, sensations are the clouds….see them passing by". The client is then advised to practice this daily. 
Befriending the unpleasant experience
The client is told to practice mindful exposure to events thereby learning that no two moments are same e.g even while in depression one isn't always experiencing the depressed mood. The point is to grow in acceptance of one's body and mind. Self-hypnosis training is given for the practice of positive suggestions. Creative visualizations techniques are used for coping with life's 'difficult situations'. 
The client is taught the method of overcoming the past by understanding and changing his perception of what a particular event means to him. With mindful observation, thisperception is seen merely as a false idea/opinion. 
Maintaining the skill of mindfulness throughout life - Daily practice of self hypnosis with positive suggestions& creative visualizations is suggested. The client is advised to remember the most effective mindfulness skills that have helped him during the above sessions and to practice them repeatedly. So that at the time of an unpleasant experience these can be used to quickly help him in acceptance of the same. 
Applications of MBH in certain psychological disorders
For depressive disorders
Depression involves turning away from experience to avoid emotional pain which leads to isolation and withdrawal. Mindful attention involves awareness, present centeredness and acceptance. Open ended mindful inquiry under hypnosis focuses on the 'What' rather than the 'Why'. What is happening right now? Can you stay with what is happening? Can you handle with what is happening? This helps development of compassionate stance toward the mental experience and emotions  Under hypnosis, the individual is taught to witness the thoughts coming and going without engaging with them. He is taught that thoughts are not facts but just thoughts! This changes the individual's relationship with his thoughts and reduces the frequency of his ruminative thinking.  The individual is also explained that no two moments are same and to mindfully attending to each experience. Thus he/she is not always experiencing depressed mood. This challenges habitual thinking of the depressed person and experiential avoidance. 
For anxiety disorders
The individual is taught to be less identified with the thoughts and simply noticing the event, as it is occurring, with a sense of acceptance. This desensitizes the individual to internal cues such as dizziness or palpitation. Progress is measured by how much the individual is able to accept anxiety and fears which then become just the 'ordinary' mental events. 
For chronic pain
One of the first systematic mindfulness program was designed for the management of chronic pain by Jon Kabat Zinn in 1982.  The individual is made aware of the role their cognitions and emotions play in pain. They are explained that worrisome thoughts are result of misinterpretation of symptoms.  Hypnotic suggestions are given to the individual to help increase his tolerance to chronic pain.  Mindfulness helps by decreasing identification with worrisome thoughts that are a result of misinterpretation of symptoms and learning that pain does not equal to suffering - i. e., pain sensations are distinct from our aversion responses. It brings attention to the present moment and thereby the anticipatory anxiety that feeds the pain cycle is reduced. 
For substance use disorders
Hypnosis helps by creating motivation through suggestions, changing the meaning the substance has to the individual, reprogramming the mind with healthier choices and learning to handle ones feelings without the help of the substance. In difficult cases, hypno-aversion can be used (under hypnosis, pairing of thoughts/feelings/sensations associated with the substance with unpleasant experiences).  Mindfulness helps the individual to become more aware of his urges/cravings without identifying with them and reacting in automatic habitual manner. This weakens the individual's habitual responses.  The individual is also made aware of the triggering factors which lead to substance use and dealing with them. 
In conclusion, our review indicates that mindfulness based hypnotherapy has promise in the treatment of a variety of psychological disorders. Nevertheless more research is required in order to delineate its various other applications.
| References|| |
Germer CK, Siegel RD, Fulton PR. Mindfulness and psychotherapy. 1 st
ed. New York: Guilford Press; 2005. p. 5-187.
Hayes SC, Wilson KG. Mindfulness - Method and process. Clin Psychol Sci Pract 2003;10:161-5.
Das LS. Awakening the Buddha within. 1 st
ed. New York: Broadway Books; 1997. p. 1-10.
Kabat-Zinn J. Mindfulness based interventions in context - Past, present and future. Clin Psychol Sci Pract 2003;10:144-56.
Ahuja N. A short textbook of psychiatry. Ch. 18. 7 th
ed. Psychological treatments. New Delhi: Jaypee Brothers Medical Publishers Pvt Ltd; 2011. p. 217-8
Elman D. Hypnotherapy. Why I started teaching hypnosis. Ch. 2. 1 st
ed. Glendale: Westwood Publishing Company; 1964. p. 16.
Jay Lynn S, Surya Das L, Hallquist MN, Williams JC. Mindfulness, acceptance, and hypnosis: Cognitive and clinical perspectives. Int J Clin Exp Hypn 2006;54:143-66.
Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. Gen Hosp Psychiatry 1982;4:33-47.
Linehan MM. Cognitive behavioural treatment of borderline personality disorder. 1 st
ed. New York: Guilford Press; 1993. p. 199-220.
Segal ZV, Williams JMG, Teasdale JD. Mindfulness Based Cognitive Therapy for depression: A new approach to preventive relapse. 1 st
ed. New York: Guilford Press, 2002. p. 1-5.
Yapko M. Trancework. 3 rd
ed. New York: Brunner-Routledge; 2003. p. 2-11.
Alladin A. Evidence-based cognitive hypnotherapy for depression. Contemp Hypn 2009;26:245-62.
Gendlin ET. Focusing-Oriented Psychotherapy: Manual of the experiential Method. 1 st
ed. New York: Guilford Press, 1996. p. 57-75.
Williams JM, Teasdale JD, Segal ZV, Soulsby J. Mindfulness-based cognitive therapy reduces overgeneral autobiographical memory in formerly depressed patients. J Abnorm Psychol 2000;109:150-5.
Allen LA, Woolfolk RL, Escobar JI, Gara MA, Hamer RM. Cognitive-behavioral therapy for somatization disorder: A randomized controlled trial. Arch Intern Med 2006;166:1512-8.
Roelofs K, Hoogduin KA, Keijsers GP, Näring GW, Moene FC, Sandijck P. Hypnotic susceptibility in patients with conversion disorder. J Abnorm Psychol 2002;111:390-5.
Elkins G, Marcus J, Bates J, Hasan Rajab M, Cook T. Intensive hypnotherapy for smoking cessation: A prospective study. Int J Clin Exp Hypn 2006;54:303-15.
Marlatt GA. Buddhist philosophy and the treatment of addictive behaviour. Cogn Behav Pract 2002;9:44-9.
Groves P, Farmer R. Buddhism and addictions. Addict Res 1994;2:183-94.