**4.1 Assimilation**

*Hypnotherapy and Hypnosis*

**Persons' Formulation (1989)** *Early Experience*: Negative experience either from teacher, parents or peers. ↓ *Schemas*: Become maladjusted and lead to mistrust. Mistrusts ability to do things. *Core Beliefs*: Negative cognitions result in anxiety leading to behavioural and physiological problems. **↓** *Assumptions*: I know I will feel anxious because it always happens and then I will ........... (becomes a self-fulfilling prophecy). ↓ *Trigger*: Thought of an impending event. **↓** *Vicious cycle*: *Negative Automatic Thought (NAT)*: Negative thoughts of dread, apprehension and failure. **↑ ↓**

*Consequence*: The conceptualised belief regarding the event is realised. *Feeling*: Hopelessness, worthlessness, depression, shame and withdrawal.

*Behaviour*: Decision not to put themselves in that situation again.

Working on the supposition that the way an individual thinks and feels largely determines the outcome of the personal experience, CBT helps to redress negative cognitions. It is reported in the literature that CBT is cognitively orientated to future events, and encourages the association of specific positive thoughts, feelings and behaviour in a particular context [38]. Through changing beliefs and selfhelp, individuals are encouraged to change negativity into positive outcomes [22]. Goal-orientated ideas and suppositions are reiterated, aimed at strengthening the ego, making strong links through visualisation and imaginings. Corrected thoughts enable the handling of situations and feelings in such a way that a positive outcome

However, the literature reports that no theory/therapeutic action is without flaws, and a number of issues have been identified with the CBT approach: the failure to consider experiences in the past in relation to the present in generating anxiety; the effective role that cognition plays on physiological symptoms in the body; the failure to recognise the role of the unconscious mind in overt behaviour; and the failure to recognise that human thought and action are socially embedded [46]. Further to this, evidence from the literature indicates that one of the main drawbacks with CBT is the number of sessions required to effect positive change

Practitioners of hypnosis often employ techniques used by CBT therapists [48]. However, the protocols and procedures adapted by hypnotherapists explore past and present negative experiences in relation to the presenting problem, together with

**↑ ↓**

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is achieved and anxiety reduced [4].

(10 or more sessions in some cases) [47].

The following is evidence from the literature for the potential assimilative practice of hypnosis with CBT.

It has been suggested that as a result of incorporating techniques from another approach into one's own main theoretical domain, the core ideas of the former are integrated into the latter (or 'host' theory), changing both and resulting in a new assimilative integrative model [49]. Multimodal therapy was first used when hypnotic techniques were incorporated into behavioural procedures, and hypnosis was used with psychoanalysis [13]. There are many reasons for assimilating hypnotic techniques with CBT, which are beneficial to both therapists and patients. Change in any one area will lead to changes in other areas as patient and therapist consider thoughts, bodily feelings, emotions and actions [50]. The use of hypnosis can also be used as a means of empowerment in new and creative ways. Social psychological theories of hypnosis suggest that the major mechanism mediating hypnotic response is the increased motivation elicited by the demand characteristics associated with hypnotic techniques [51]. Participants are more highly motivated to engage in the therapist's requests while in the hypnotic state. Enhancing participants' motivation may be beneficial to a degree; it could be suggested that by addressing the unconscious mind, the process of hypnosis establishes positive cognitions that are then acted upon in the conscious state. This process of communication results in positive imaging, memory recall and suggestions for future stressful idiographic encounters (tools used in hypnotherapy). Muscle relaxation and focused breathing used in the hypnotic induction contribute to the reduction of anxiety.
