**2.4 Communicative component**

In the 1980s during the course of group hypnotherapy in a therapeutic clinic, based on the universal hypnotherapy (UH) technique [10, 11, 17], which has no analgesic suggestions (see below), the author was faced with cases of spontaneous relief of acute (traumatic) pain after the session and opposite cases of the causeless appearance and amplification of patients' bodily pain during a hypnotherapeutic session, with its subsequent reduction in chronic disorders. Repeated cases of spontaneous modulation in hypnosis of pain in cases of acute and chronic pathological processes required explanation; therefore, using a special questionnaire, all such cases were studied. Over the 5 years of observation, the hypnotherapeutic dynamics of pain in acute traumas (15 patients) and in chronic pathological processes (mainly

neurointoxications—167 patients) was studied. This study was clinical-

ing of its mechanisms.

*Hypnotherapy and Hypnosis*

ous hypnotic nociception [10, 11].

and inhibitory control [27].

of hypnotic nociception.

**48**

phenomenological; the dynamics of the severity of pain were correlated with the results of other objectivizing methods of clinical research and the conclusions of relevant specialists. Data ware obtained on patients who received accidental injuries or dental care (bone fractures, sprains, tooth extraction) during an intensive shortterm hypnotherapy of anxiety disorders (10–12 1-h sessions 3–5 times a week). The phenomenon of spontaneous hypnotic nociception became an unexpected, but regularly repeated, finding. Therefore, the question is not in the existence of the phenomenon of spontaneous hypnotic nociception but in the scientific understand-

The author's explanation of the phenomenon of spontaneous hypnotic nociception was based on the model of the structure and function of the nociceptive and vegetative regulation systems [20], according to which the pain impulse on the way from the pathological zone to the cerebral cortex can be damped by the damping system of the brain at three levels (spinal cord, thalamus, cerebral cortex), with the parallel activation of the hierarchical system of vegetative regulation of the pathological zone; this model satisfactorily explains the phenomenon of spontane-

experiment and practice have always been interested in only directed hypnosuggestive analgesia and its mechanisms, which essentially brought the phenomenon

of spontaneous hypnotic nociception beyond the scope of any analysis.

Western hypnology in the last 70 years in its development has paid a considerable attention to the research and practice of suggestive hypnotic analgesia. Researchers in

It should be noted that studies of hypnotic analgesia have become the cornerstone in the development of modern hypnology, since after a long discussion they have led to the recognition that hypnosis is an altered state of consciousness [21–26]. Brain mechanisms underlying the modulation of pain perception under hypnotic conditions involve cortical as well as subcortical areas including anterior cingulate and prefrontal cortices, basal ganglia, and thalami [21]. It is demonstrated that hypnotic analgesia is characterized by a loss of coherence between the brain areas, reflecting "an alteration or even a breakdown of communication between the subunits of the brain" [20, 23, 24, 26]. Recently, in addition to experimental neurophysiological studies of the differences in the brain mechanisms of pain perception by high and low hypnotizable [27], analogous genetic studies have appeared [28]. Due to these studies, it became known that hypnotic assessment may predict lower responsiveness to opioids, and inefficient opioid system may be a distinctive characteristic of highs [29], and modulation of hypnotic pain responses is connected with differential recruitment of right prefrontal regions, which are involved in selective attention

Returning to the phenomenology of spontaneous nociceptive sensations in hyp-

Acute pathological processes are characterized by one-step regressive dynamics

notherapy, we need to note that it is characterized by the following features.

Hypnotization and hypnotherapy can be considered as a goal-oriented communication—the communicative process. The hypnotic communicative process includes two basic components: cultural and interpersonal. The cultural component determines the varying boundaries, volumes, dynamics, and potential effectiveness of hypnotherapy while the interpersonal its specific implementation. The cultural and interpersonal components of hypnotherapy interact typologically, since culture defines historically determined patterns—communication styles that actualize the style sets of cultural and interpersonal components. Communicative styles, formed in the space of everyday communication, are then transferred to hypnotherapy, acquiring specialized features. The historical evolution of cultural communicative styles will generate the evolution of communicative styles of hypnotherapy. However, "within" hypnotherapy, a change in communicative styles will be perceived as an independent, personified process. The evolution of hypno-communication develops from classical and directive to non-directive hypnosis. In Russia, the style of universal hypnotherapy [29, 30] further appeared.

Directive hypnosis is a product of the European nineteenth century, with its class-hierarchical communicative style. Therefore, its communicative, being dominantly authoritarian, is based on the idea of direct "guiding" of "hypnable" patient by the hypnotherapist to a positive therapeutic result.

Non-directive hypnosis appeared in the 1970s, during the cultural heyday of individual rights and freedoms, with a manipulative management style in society. Its communicative style (Erickson's model) is based on the verbal, non-directive, and manipulative management of the patient, taking into account his or her nonverbal reactions, which uses non-directive adjustment and management, and on the idea of finding an adequate use of the resources of the wise unconscious, which uses thematic metaphors and descriptions, as tools for accessing resources.

The communicative style of universal hypnotherapy is built on a biopsychosocial paradigm; takes into account and rebuilds relevant cultural representations about hypnosis in the interests of therapy; uses primary positive cognitive-behavioral models and biological mechanisms of hypnotherapy; actively applies the non-verbal component of communicative interaction during hypnotherapy; attracts and potentiates the patient's recovery activity during the session and the entire course of hypnotherapy; and contributes to the formation of semantic therapeutic, aimed at active recovery and improvement.

A real hypno-communication is inevitably wider and deeper than the prescribed methodological frameworks. But the communicative style forms a therapeutic "core" that determines the initial selectivity, process, and the results of hypnotherapy. **Table 1** compares the communicative styles of directive, non-directive hypnosis and universal hypnotherapy.


The regressive rearrangement of brain functioning to a prepubertal level, caused by hypnosis, sharply increases the subject's learning ability and the assimilation of

The biological effects of hypnotherapy provide broader prospects for its clinical application. The therapeutic effectiveness of hypnotherapy is restricted by the presence and volume of stress-readaptive resources of the subject's organism and psyche. Technically, "correctness" of hypnotherapy is important, but it is not the only condition for treatment success. The absence or reduction of the hypnotherapy biological effect should be expected in patients undergoing a long-term treatment with adrenal hormonal medications and cases when the medication blocks or reduces the hypno-

The integrative theory of hypnosis and hypnotherapy focuses on the basic systemic mechanisms of hypnosis and hypnotherapy, available for verification and concretization. Therefore, the constant accumulation of hypnosis research data (e.g., 3–9, 13, 14) will rather complement and expand its basic positions.

Thus, the default mode network—a large neural structure connecting different parts of the brain—was recently described [28, 31, 32]; its function is to provide a high level of activity even when the person is not engaged in a focused mental work. Recent experiments have described an increase in activity and an increase in the volume of the default mode network when practicing mindfulness meditation [33]

According to the integrative theory of hypnosis and hypnotherapy, hypnosis development results in the reorganization of the brain activation system functioning from distribution to generation of activity. It was supposed that the functions of distribution and generation of activity need to be realized by morphologically different structures of the brain. So, the proposed system of activation generation of the brain activation system now is determined as a default mode network.

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 resourceful-

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

ness) [29, 30] and mindfulness-based psychotherapeutic methods.

transforming the interactions between the underlying levels.

therapy biological readaptation effect (antidepressants, tranquilizers).

suggestive therapeutically significant information.

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

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

**3. The method of universal hypnotherapy**

and yoga [34].

**51**

**Table 1.**

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