Hypnoanalysis and analytic psychotherapy: a comparative study.

Abstract

A comparison of the procedures of analytic psychotherapy with the procedures of hypnoanalysis reveals that they share many qualities and that most of the operatively important features of hypnoanalysis can also be found in non-hypnotic analytic therapy. Though there is no proof that hypnoanalysis offers any distinct advantage over analytic psychotherapy, the possibility that some such advantage might occur under specific circumstances cannot be excluded. One such possibility is that for some patient-therapist combinations it could be more expedient to establish such a working therapeutic contract based on hypnoanalysis, while they might be unable to form a contract of analytic psychotherapy. This should be the subject of further investigation. The therapeutic contract is most important in determining the subsequent behaviour of the patient (and the therapist) in treatment. Much of the characteristic behaviour of the hypnotized subject can be attributed to the contract and its concomitant effects. Both treatments under consideration here are conducted in circumstances that minimize external distracting stimuli. The hypnotic induction procedure serves as a symbol of the patient-therapist contract, a token of the therapist's involvement, and as direct reinforcement of the patient's motivation. It also serves to select the more co-operative patients. All these goals can be reached by alternative techniques. Psychophysiological data tend to show no special state of consciousness characteristic of hypnosis. The therapeutic techniques of anamnestic exploration, suggestion, abreaction, manipulation, clarification, and interpretation can be used effectively in any well-conducted psychotherapy. Hypnosis does not offer any special advantage in this respect. The conclusion that most of the therapeutically useful ground covered by hypnoanalysis is adequately covered by analytic psychotherapy should not be surprising. Since both psychoanalysis and analytic psychotherapy grew out of hypnotic therapy, it is conceivable that in the course of their development they retained the clinically useful features of hypnotherapy, while discarding some of its redundant aspects. This process of selection seems to have been acting on the techniques of psychotherapy, sometimes deliberately but often unwittingly. This would account for the fact that in spite of theoretical interest hypnosis is not very widely used in the practice of psychotherapy.