Treating Depression

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ences, and (f) provides access to nonconscious psychological processes. However, the focus of the first two hypnotic sessions is on (a) relaxation (to prove the client can relax), (b) somatosensory changes (to reinforce the idea that the client can have different feelings and sensations), (c) demonstration of the power of the mind (via eye and body catalepsy), and (d) increasing confidence in self-hypnosis. As this session is audiotaped, the Counting Method (see Gibbons, 1979) of induction and deepening is used. When a satisfactory deep level of trance is achieved, a modified version of Hartlands (1971) ego-strengthening suggestions is given. Ego-strengthening is a way of exploiting the positive experience of hypnosis and the therapist-patient relationship in order to develop feelings of confidence and optimism and an improved self-image (Alladin & Heap, 1991, p. 58). However, to ensure credibility and acceptance of the ego-strengthening suggestions, it is of paramount importance to first create a positive feeling and a pleasant state of mind, and the egostrengthening suggestions need to sound logical to the client. For example, rather than stating every day you will feel better, it is advisable to suggest: as a result of this treatment and as a result of you listening to your tape every day, you will begin to feel better. This set of suggestions not only sounds logical, but improvement becomes contingent on continuing with the therapy and listening to the self-hypnosis tape daily. Moreover, ego-strengthening suggestions should be seen as a component of a comprehensive approach to the treatment of depression. Alladin and Heap (1991) warn we have here a useful procedure which may augment a carefully constructed programme of therapy, but it is not the therapy itself and if it is used as such, then disappointment and even disaster may ensue (p. 58). After the first hypnosis session, the client is provided with an audiotape of self-hypnotic procedure for creating a good frame of mind, offering ego-strengthening suggestions, and providing posthypnotic suggestions. The homework assignment provides continuity of treatment between sessions and offers the client the opportunity to learn self-hypnosis. While in a deep hypnotic trance and in a nice frame of mind, Bob (see Case 3 later in this chapter) was offered the following ego-strengthening suggestions. Day by day, as you listen to your tape, you will become more relaxed, less tense, and less depressed.