**3. The method of universal hypnotherapy**

More than three decades ago, the author developed a new method called universal hypnotherapy, so named because of its efficacy in both individual and group forms of therapy for a wide range of anxiety disorders [10, 11, 16, 23, 30, 35–39]. UH is rooted in the traditions of the Russian school of hypnotherapy, which shares its basic principles with positive approach (concept of resilience and resourcefulness) [29, 30] and mindfulness-based psychotherapeutic methods.

The author understands mental health and mental stability as an active adaptive state and process, which are spontaneously and actively maintained [16], whereas anxiety disorders break down the psyche's natural homeostasis. On the basis of research of therapy outcomes, we had described a model of the Personal System of Psychological Adaptation (PSPA) [11, 16, 29, 30, 40]. PSPA is a spontaneously activated homeostatic dynamic structure which forms during ontogenesis and creates a hierarchy of adaptive mechanisms from the earliest, most simple types to mature, complex, individualized, and personal ones which can be used as coping mechanisms. The hierarchic PSPA can be represented as a spherical multilayered model involving the following components: (1) a concentric structure of layerslevels of the hierarchic organization of adaptation mechanisms that form an expanding sphere around a "center" or the "self," the self who decides which outer layers will be predominantly activated; (2) a system of connections between each of layers-levels of the sphere; and (3) the highest mature level of the hierarchy of multilayer level mechanisms of psychological adaptation that has the capability of transforming the interactions between the underlying levels.

**2.5 Outcomes of the integrative theory of hypnosis and hypnotherapy**

*Communicative styles of directive, non-directive hypnosis and universal hypnotherapy.*

its therapy.

**50**

The conscious use of cultural representations about hypnosis

*Hypnotherapy and Hypnosis*

The use of cultural beliefs about hypnosis

Therapeutic transformation of cultural beliefs about hypnosis

Features of verbal communication

Non-verbal communication

The ratio of activity of the therapist and patient

Using of feedbacks

Therapy limitations

**Table 1.**

Thus, hypnotherapy should be considered as a systemic therapeutic space, which includes four components: a culture-dependent communicative, defining the communicative style of hypnosis and hypnotherapy, which, as a rule, is attributed to the nature of hypnosis; the methodological component; the biological component of hypnosis, with neurobiological, analgesic, and general adaptive effects; and the component of the patient's personal response to the disorder and

approach

**Feature Directive hypnosis Non-directive hypnosis Universal hypnotherapy**

No No Yes

Yes Yes No

No No Yes

Algorithm of non-directive adjustment, management taking into account the trance microdynamics

Mirroring and management reflecting the trance microdynamics

Reliance on the client's internal activity to utilize the resources of the unconscious with the dual activity of a therapist in realization of a client's and

Conscious feedback in the form of adjusting and maintaining tracking mimic reactions, breathing, muscle tone, body postures, with reduced ideomotor feedback

Patient's access to the wise unconscious, its unlimited resources for problems solving + partial use of the principles of the "classical"

Hypnosis resistance Therapy cessation

his own trance

Stimulation of positive directed activity of the patient using feedbacks

Active semantically directed use of non-verbal feedback channel

Hypnotization, dehypnotization, bodyoriented work is completely built on the feedback of verbal and non-verbal levels

Stimulation of the patient's increasing motivational activity during therapy with the creation of a semantic therapeutic space

Stimulation of the patient's active assimilation of the basic positive mechanisms of healthy mental homeostasis

Spelling out prescriptive

Spontaneous use to support directive management

The dominant activity of the therapist

Intuitive, for the regulation of directive management

overcoming by suggestion of alternative positive states, positive conditioning

Non-hypnability, hypomania

Goal setting Local restrictions

text

PSPA dynamics may express themselves in regressive, reactivating, or progressive (forming) transformations. In the case of regressive dynamics, the underlying levels, ontogenetically antecedent to it, become primarily active and assume the role of regulatory functions overriding more advanced functions; this results in the reorganization of the system of radial and spherical connections and development of new clusters not present at the previous stages of PSPA ontogenesis. Reactivation dynamics involves the reconstruction of the function initially of the top layer level of psychological adaptations and of PSPA "normal functioning" which has been disturbed by its previous regressive dynamics. The formation of PSPA dynamics is possible through the development of a higher layer level which would overcome the insufficiency and defectiveness of previous psychological adaptations of underlying levels. In cases of anxious maladaptation, weakening in the higher level of adaptive mechanisms causes the lower level of adaptive mechanisms to acquire greater behavioral significance. According to our model [11, 16, 21, 29, 38], psychotherapeutic interventions are especially suitable for cases of anxiety disorders in which there is a regressive activation of early ontogenic adaptation mechanisms.

maintained by continuous encouragement of the patient's activity within the course

Positive dynamics, commencing with the hypnotic induction, can be enhanced by showing the patient changes in symptoms, from session to session, based on a self-evaluation utilizing a graphic linear scale (ranging from the most negative to the most positive state); this allows for a comparison of results between sessions and identification of interim and general dynamics. Any increase in a patient's motivation for recovery and its behavioral manifestations is acknowledged and emphasized, during and at the end of therapy, as his or her tangible achievement in the process of positive adaptation. Furthermore, hypnosis is used to facilitate change. Our understanding of hypnosis is that it leads to functionally regressive stages in brain functioning that trigger prepubertal imaginative thinking [10, 11, 29, 30] and promotes the reverse transformation in a regulatory hierarchy in which the meaning of words dominates over feelings, mental states, and perceptual experiences. Such a reorganization makes it possible in hypnosis to elicit actual feelings and mental states which could be utilized for positive transformation (i.e., confidence, calmness, freedom, self-efficiency and self-sufficiency, etc.) enabling the patient to

One of the most effective technique in dealing with specific symptoms includes somatic projective catharsis which requires awareness of personal control and limitations, along with the recognition of positive change in a person's condition, even though it may not be consciously known how it was achieved. The highest level of conscious differentiation occurs in the visual domain; it is less in the auditory and

From a practical clinical perspective, catharsis is achieved after a client is informed that the perception of any event in one domain may also be reflected in another perceptual domain. Subsequently, it is proposed to the patient to become aware of anything unpleasant, negative, and painful that is a result from past experiences—memories, feelings, and also any feelings in his or her breast (i.e., heaviness or tension which occurs when a person is offended or derogated); if a person begins experiencing such a feeling, it is suggested to him or her to breathe it out. When after some attempts, the unpleasant feeling is diminished and each subsequent inhaling becomes easier, it is suggested that also the remaining part of the feeling can be breathed out. Breathing out the unpleasant sensation (i.e., heaviness or tension) is assigned to a client as a task to be carried out independently and to be continued until the maximum liberation from this unpleasant feeling is

Yet another technique utilizes visualization. The author's research [10, 11, 41] into the impact of color sensations and images induced in hypnosis was a stimulus for its integration with hypnotherapy for anxiety disorders. We have experimentally shown [10, 11, 37] that for the purposes of relaxation, the imaging of a blue color is the most suitable approach. That is why repeated blue color induction (with an interval of 1–2 minutes) is used during hypnotherapy sessions for the creation of

Experimental data has shown that in mild and deep hypnosis, color inductions have a direct psycho-vegetative and emotional impact on a human being, and this impact is different from the one in the waking state because of the intensification of the activating potential of colors and the reduction of their sedative effect. The visualization of colors, induced in hypnosis, is accompanied by three phenomena of a neurophysiologic and psychological nature. The first one is achromatic transformation, when following hypnotic suggestion, chromatic colors (blue, green, yellow, red) are seen as achromatic (i.e., gray, black, brown). According to our experimental and clinical investigations, achromatic transformation phenomenon is the

of therapy, but also directly during the sessions of UH at all its stages.

*The Integrative Theory of Hypnosis in the Light of Clinical Hypnotherapy*

*DOI: http://dx.doi.org/10.5772/intechopen.92761*

experience positive personal states and values.

even less in the proprioceptive modalities [10, 11, 38, 39].

obtained, which is typically associated with a sense of peace.

a color-relaxing background to accompany the verbal suggestions.

**53**

Our empirical research on hypnotherapy outcomes [10, 11, 16, 29] has revealed that the dynamics in cases of efficient hypnotherapy with complete improvement in anxiety disorders is consistent with the mechanism of reactivation and, for organic disorders, with the mechanism of PSPA formation; in cases of partial improvement, the psychological dynamics for anxious disorders corresponds to PSPA incomplete reactivation, and for organic disorders it corresponds to PSPA incomplete formation.

#### **3.1 Basic principles of universal hypnotherapy**

UH method is based [10, 11, 16, 29, 30, 35–37, 39–41] on the activation of hypnotherapy biological healing potential leading to readaptation and to physiological and psychological self-regulation; more specifically, this includes stimulation of positive personal states and values and further depends on an individual's holistic positive engagement in recovery and in future steady adaptation. This process should lead to the creation of a positive goal-oriented semantic field enabling clients to act on hypnotic suggestions which should shape positive behaviors and therapeutic transformations.

UH is built on positive stimulation of patient's self-holistic activity all over hypnosis session: from hypnosis induction to therapy and final dehypnotization.

The specific techniques include distancing from stressogenic experiences and negative states, along with utilizing projective transformations and visualization of color. One of the most important hypnotherapeutic goals refers to the stimulation of a holistic personal positive activity that would promote recovery and future steady adaptation. In this respect, the strength of a patient's motivation to recover and to improve his or her state has a direct impact on the outcome. That is why stimulation of positive therapeutic motivation (PTM) to improve one's condition and to recover is considered, in universal hypnotherapy, to be its main therapeutic objective. Work with a patient's PTM starts on the first diagnostic session and becomes the foundation of the therapeutic contract; such motivation is maintained during the course of therapy and is acknowledged when the course is finished.

During the diagnostic session, after discussing the clinical diagnosis and possible prognosis of therapy and establishing a confidential relationship, a patient's motivation and wish to recover and/or to actively achieve the desired psychotherapeutic outcome are reviewed. Motivation for improvement, or for recovery, is directly or indirectly stimulated and maintained during the course of subsequent therapy, both within and outside of the hypnotherapy format. Indirect stimulation of the PTM is

### *The Integrative Theory of Hypnosis in the Light of Clinical Hypnotherapy DOI: http://dx.doi.org/10.5772/intechopen.92761*

maintained by continuous encouragement of the patient's activity within the course of therapy, but also directly during the sessions of UH at all its stages.

Positive dynamics, commencing with the hypnotic induction, can be enhanced by showing the patient changes in symptoms, from session to session, based on a self-evaluation utilizing a graphic linear scale (ranging from the most negative to the most positive state); this allows for a comparison of results between sessions and identification of interim and general dynamics. Any increase in a patient's motivation for recovery and its behavioral manifestations is acknowledged and emphasized, during and at the end of therapy, as his or her tangible achievement in the process of positive adaptation. Furthermore, hypnosis is used to facilitate change.

Our understanding of hypnosis is that it leads to functionally regressive stages in brain functioning that trigger prepubertal imaginative thinking [10, 11, 29, 30] and promotes the reverse transformation in a regulatory hierarchy in which the meaning of words dominates over feelings, mental states, and perceptual experiences. Such a reorganization makes it possible in hypnosis to elicit actual feelings and mental states which could be utilized for positive transformation (i.e., confidence, calmness, freedom, self-efficiency and self-sufficiency, etc.) enabling the patient to experience positive personal states and values.

One of the most effective technique in dealing with specific symptoms includes somatic projective catharsis which requires awareness of personal control and limitations, along with the recognition of positive change in a person's condition, even though it may not be consciously known how it was achieved. The highest level of conscious differentiation occurs in the visual domain; it is less in the auditory and even less in the proprioceptive modalities [10, 11, 38, 39].

From a practical clinical perspective, catharsis is achieved after a client is informed that the perception of any event in one domain may also be reflected in another perceptual domain. Subsequently, it is proposed to the patient to become aware of anything unpleasant, negative, and painful that is a result from past experiences—memories, feelings, and also any feelings in his or her breast (i.e., heaviness or tension which occurs when a person is offended or derogated); if a person begins experiencing such a feeling, it is suggested to him or her to breathe it out. When after some attempts, the unpleasant feeling is diminished and each subsequent inhaling becomes easier, it is suggested that also the remaining part of the feeling can be breathed out. Breathing out the unpleasant sensation (i.e., heaviness or tension) is assigned to a client as a task to be carried out independently and to be continued until the maximum liberation from this unpleasant feeling is obtained, which is typically associated with a sense of peace.

Yet another technique utilizes visualization. The author's research [10, 11, 41] into the impact of color sensations and images induced in hypnosis was a stimulus for its integration with hypnotherapy for anxiety disorders. We have experimentally shown [10, 11, 37] that for the purposes of relaxation, the imaging of a blue color is the most suitable approach. That is why repeated blue color induction (with an interval of 1–2 minutes) is used during hypnotherapy sessions for the creation of a color-relaxing background to accompany the verbal suggestions.

Experimental data has shown that in mild and deep hypnosis, color inductions have a direct psycho-vegetative and emotional impact on a human being, and this impact is different from the one in the waking state because of the intensification of the activating potential of colors and the reduction of their sedative effect. The visualization of colors, induced in hypnosis, is accompanied by three phenomena of a neurophysiologic and psychological nature. The first one is achromatic transformation, when following hypnotic suggestion, chromatic colors (blue, green, yellow, red) are seen as achromatic (i.e., gray, black, brown). According to our experimental and clinical investigations, achromatic transformation phenomenon is the

PSPA dynamics may express themselves in regressive, reactivating, or progressive (forming) transformations. In the case of regressive dynamics, the underlying levels, ontogenetically antecedent to it, become primarily active and assume the role of regulatory functions overriding more advanced functions; this results in the reorganization of the system of radial and spherical connections and development of new clusters not present at the previous stages of PSPA ontogenesis. Reactivation dynamics involves the reconstruction of the function initially of the top layer level of psychological adaptations and of PSPA "normal functioning" which has been disturbed by its previous regressive dynamics. The formation of PSPA dynamics is possible through the development of a higher layer level which would overcome the insufficiency and defectiveness of previous psychological adaptations of underlying levels. In cases of anxious maladaptation, weakening in the higher level of adaptive mechanisms causes the lower level of adaptive mechanisms to acquire greater behavioral significance. According to our model [11, 16, 21, 29, 38], psychotherapeutic interventions are especially suitable for cases of anxiety disorders in which

there is a regressive activation of early ontogenic adaptation mechanisms.

reactivation, and for organic disorders it corresponds to PSPA incomplete

UH method is based [10, 11, 16, 29, 30, 35–37, 39–41] on the activation of hypnotherapy biological healing potential leading to readaptation and to physiological and psychological self-regulation; more specifically, this includes stimulation of positive personal states and values and further depends on an individual's holistic positive engagement in recovery and in future steady adaptation. This process should lead to the creation of a positive goal-oriented semantic field enabling clients to act on hypnotic suggestions which should shape positive behaviors and

UH is built on positive stimulation of patient's self-holistic activity all over hypnosis session: from hypnosis induction to therapy and final dehypnotization. The specific techniques include distancing from stressogenic experiences and negative states, along with utilizing projective transformations and visualization of color. One of the most important hypnotherapeutic goals refers to the stimulation of a holistic personal positive activity that would promote recovery and future steady adaptation. In this respect, the strength of a patient's motivation to recover and to improve his or her state has a direct impact on the outcome. That is why stimulation of positive therapeutic motivation (PTM) to improve one's condition and to recover is considered, in universal hypnotherapy, to be its main therapeutic objective. Work with a patient's PTM starts on the first diagnostic session and becomes the foundation of the therapeutic contract; such motivation is maintained during the course of

During the diagnostic session, after discussing the clinical diagnosis and possible prognosis of therapy and establishing a confidential relationship, a patient's motivation and wish to recover and/or to actively achieve the desired psychotherapeutic outcome are reviewed. Motivation for improvement, or for recovery, is directly or indirectly stimulated and maintained during the course of subsequent therapy, both within and outside of the hypnotherapy format. Indirect stimulation of the PTM is

**3.1 Basic principles of universal hypnotherapy**

therapy and is acknowledged when the course is finished.

formation.

*Hypnotherapy and Hypnosis*

**52**

therapeutic transformations.

Our empirical research on hypnotherapy outcomes [10, 11, 16, 29] has revealed that the dynamics in cases of efficient hypnotherapy with complete improvement in anxiety disorders is consistent with the mechanism of reactivation and, for organic disorders, with the mechanism of PSPA formation; in cases of partial improvement, the psychological dynamics for anxious disorders corresponds to PSPA incomplete

manifestation of a low level of activity of the reticular formation which is the brain activating system [10, 11, 41]. We should note that achromatic transformation is clinically significant; specifically, induced color visualization is restored as the patient's condition clinically improves [10, 11, 41]. The third phenomenon—chromatic transformation of colors induced in hypnosis—manifests as the recognition of another color, not the one which was suggested to the patient to be imagined. According to our data, the phenomenon of chromatic transformation of visualized color is conditional on an individual's personal characteristics associated with personal maturity. Therefore, the phenomenon of induced color chromatic transformation which is typically observed in children is reduced in healthy adults, but is increased in dissociative and somatoform disorders.

"inside head," posterior surface of the neck, shoulders, area of the left half of the breast (from the front), precostal space, and epigastria; suggestion of coolness while inhaling is directed to the nose, temples, and the zones, where it is needed. These suggestions establish experiences of warmth and coolness in the body which replace

*The Integrative Theory of Hypnosis in the Light of Clinical Hypnotherapy*

The process of normalization requires restoration of restful sleep. That is why increasing the quality of sleep is one of the objectives of UH in which suggestion refers to the positive phenomenological model of restful sleep (falling asleep in the evening and in the morning waking up without remembering sleeping itself). Before finishing the session of universal hypnotherapy, the therapist needs to seed suggestions about positive feelings taking place in the following order: body

A session of UH lasts for about 35–40 min, which includes (1) hypnosis induc-

Hypnosis induction in UH is completely based on the realization of motivational activity of the hypnotized person, in the algorithm of bodily feedback with himself and implements the scheme: the hypnotized person is focusing on the desire to enter into hypnosis, mentally saying the phrase: "I want to enter into hypnosis," being ready (if the phrase dominates the person's mind for 20–30 s), giving the signal by raising any hand. The therapist touches the brush, suggesting that if the hand is spontaneously lowered, there happens a transition to hypnosis; the completion of the movement means the completion of the hypnotization. The therapist in immediate feedback briefly describes the characteristics of the movement of the hand and the behavior of the hypnotized, who perceives this as therapist's control of

The given method of hypnosis induction is contrary to cultural beliefs about hypnosis. Therefore, before the first induction, the therapist implements a special connecting script, which transforms the cultural model of hypnosis and allows the hypnotized person to accept fully the proposed method. It is effective in the vast majority of therapy-motivated patients (more than 99%), which allows patients in

The first part of UH therapeutic session is focused on somatic projective cathar-

single and group format to enter hypnotic trance quickly and deeply.

interval of 1–2 min during the whole session

that would shape positive behavior

4.The suggestion of sleep normalization

2.The enhancement of positive mental states and values

sis, whereas the second part of UH session consists of the following steps:

1.The induction of blue color, which is then repeated periodically with an

3.A two-step procedure of distancing from stressogenic experiences and

The third part of the session is represented by body projective work with a periodic induction of blue color. The fourth part of the session basically corresponds to its first part (but does not use projective "breathing"), and additionally the need

resolving negative states or disorders and developing hypnotic self-suggestions

other less pleasant feelings.

*DOI: http://dx.doi.org/10.5772/intechopen.92761*

**3.2 Structure of session**

the induced movement.

**55**

tion and four (2–5) therapeutic parts.

comfort, lucidity of thinking, and a good mood state.

**3.3 Hypnosis induction in universal hypnotherapy**

The phenomenology of induced color characterizes the depth of hypnosis; in mild hypnosis, visualized color is flat (two-dimensional) and changes sinusoidally; in deep hypnosis, it becomes three-dimensional and remains stable (in both healthy and emotionally disordered people).

The mind's ability to dissociate can be utilized for distancing from stressogenic experiences. It has been shown in psychological research [36, 42] that people's normal experiences proceed through subjective separation or distancing from the events, without cognitive distortion of their essence. Pathological attempts at psychological adaptation lead to events of the past events being confounded by cognitive deformations and distortions of events. Already more than 30 years ago, we noted that hypnotherapy allows for the normal experiencing of events and for subjective distancing while eliminating pathological adaptation mechanisms that distort the experience [3, 4]. To normalize the process of experiencing, we have elaborated a method of two-stage distancing with respect to current and past events; the first step serves for distancing from the current personally stressogenic events, and the second step is designed for distancing and resolving past stressogenic, negative, and traumatic experiences.

The mechanism of normal experiencing of current events presents the basic mechanism for the stable functioning of a healthy psyche; therefore, the author considers the sustainable inclusion of this mechanism in anxiety disorders as a key point in successful therapy. During UH the patient gains the ability to stably distance himself both from the current experiences and their projections into the future and from the past experiences.

Since the 1980s cognitive-behavioral therapy (CBT) has developed techniques based on modifications of ancient Vipassana meditation [43–48]: mindfulnessbased stress reduction (MBSR) [49, 50] and mindfulness-based cognitive therapy (MBCT) [51, 52]. These techniques, producing "the third wave" of CBT evolution, have expanded the range of therapeutic efficacy for anxiety disorders, including generalized anxiety disorder (GAD) [53, 54].

Since these techniques also use the principle of distance experiencing, the author with the co-worker performed a comparative analysis of UH and CBT mindfulnessbased techniques [36, 37], which revealed a significant similarity, consisting of (1) the formation of distancing, metaposition, and positive perception and (2) stimulation of personal integration and self-identity and working with body control and breathing control. UH and mindfulness-based techniques differ in parameter of experiences without judgment, duration of therapy, the need for meditation, and self-hypnosis after the end of therapy. UH explores only the principle of distancing, out of religious-philosophical connotations, it is the most short-term (10–15, rarely up to 20 sessions), and it does not require the continuation of self-hypnosis.

Yet another technique uses an individual's abilities to generate bodily sensations. Indirect suggestions of feelings of warmth (mostly) and coolness (in some areas of the body) are used for projective body work in universal hypnotherapy. Areas chosen for suggestion of warmth are the parieto-occipital zone with projection

## *The Integrative Theory of Hypnosis in the Light of Clinical Hypnotherapy DOI: http://dx.doi.org/10.5772/intechopen.92761*

"inside head," posterior surface of the neck, shoulders, area of the left half of the breast (from the front), precostal space, and epigastria; suggestion of coolness while inhaling is directed to the nose, temples, and the zones, where it is needed. These suggestions establish experiences of warmth and coolness in the body which replace other less pleasant feelings.

The process of normalization requires restoration of restful sleep. That is why increasing the quality of sleep is one of the objectives of UH in which suggestion refers to the positive phenomenological model of restful sleep (falling asleep in the evening and in the morning waking up without remembering sleeping itself).

Before finishing the session of universal hypnotherapy, the therapist needs to seed suggestions about positive feelings taking place in the following order: body comfort, lucidity of thinking, and a good mood state.
