Short Psycho-Therapy and Hypnosis

This thesis comprises I. an Introduction in which three topics are discussed:-(a) Hypnosis - with particular reference to its present status in this country and abroad: the psychological emphasis here, the physiological stress on the Continent. (b) The relations between hypnosis and psycho-analysis, from their early divergence to the present period in which there are signs of a resynthesis. (c) Certain trends within the body of psycho-analysis : the development of schisms : the divergence from the views of Freud : the concentration by one school (in Chicago) on short psychotherapy in the light of certain views which concern particularly the significance of regressive material. The need for a short but effective psycho-therapy is emphasised. II. Observations on a series of 28 cases. Of that number, 23 were treated by the writer : the treatment varying from reassurance (Ross (1941)) or direct hypnotic suggestion to two attempts at hypno-analysis. The length of treatment varied from 1 interview (5 cases) to 160 interviews - in 12 months (2 cases). Hypnosis was employed in the treatment of 18 cases : in 5 it was not used. In the 5 cases which were not treated by the writer, hypnosis was used in one (0) as a diagnostic measure, in a second no useful level of hypnosis could be obtained, (X) : a third patient is reported because of the effects of hypnosis induced by a stage hypnotist (V) : a fourth (M) because of the spontaneous outburst of traumatic memories which followed induction : a fifth (E) because of a narcoleptic phenomenon perhaps related to hypnosis. Many of the patients treated were very severely ill. D. for example - an intelligent officer with an excellent war record - when first seen was immobilised in bed because of his fear of death. R. had a history of hallucinations and suicidal tendencies apart from his extremely severe addiction to alcohol (and to various drugs). The 5 patients whose treatment at length was attempted are noteworthy in this respect. S. had been driven into hospital repeatedly by her acute panics. T. and U. similarly faced the psychiatric ward - willingly - rather than face the fears associated with the outside world. The patients 1 and 2 had already been admitted to hospital when first seen by the writer. The patient 1 had at that time already spent some months in hospital, and was seen to weep copiously at times. He had not worked for a year and had once spent a year in bed because of his chronic neurotic symptoms. Patient 2 had been unable to leave the hospital - even for the briefest space of time - for 4 years, prior to which hospital admission on account of psychological symptoms had been frequent : clinically, she was psychotic. Of these 5 patients, three (S,T,1) had already failed to respond more than temporarily if at all, to treatment by other psychotherapists. The patient 1 had in fact undergone 9 months of analysis by a psychotherapist who had not only been fully trained in Jungian methods, but had had a full Freudian training analysis. It is not proposed to analyse all the therapeutic techniques and results, but it is at once obvious that neither attempt at hypno-analysis constituted the equivalent of a full Freudian analysis though in each case treatment was continued for 12 months. Nor did the results approach anything like a complete cure, though in Case 2 especially a marked, and so far lasting, social improvement was obtained. Among the shorter cases the positive results regarded by the writer as being significant are the following: (1) the marked relief of symptoms by the Ross (1941) technique : (a) after one half-hour interview - A. (b) after 3 brief interviews - with the emergence of buried memories-B. (c) in a few weeks treatment of a very severe neurosis - D. But follow-up was inadequate in all three (some months in Case A). (2) (a) The cure-of stammering-which followed the use of direct hypnotic suggestion and the hypnotic eliciting of childhood memories (Case L.) The total treatment time was about 5 hours. The follow-up showed him to be symptom-free nearly three years later. (b) The partial relief of hysterical symptoms for at least 5 years in a case of amnesia and fugue. The treatment, which was as in Case L., occupied less than one hour. (Case H.) In these two cases superficial insight was gained, but (c) in cases I and K., no insight whatsoever resulted. Treatment was by direct hypnotic suggestion : it occupied 6-7 hours (less in Case I.) The results, though probably temporary, were of great value to both patients. (3) It appears that the lasting improvement in Q., after one non-hypnotic interview can best be explained in the terms of Alexander and French (1946). (4) The similar lasting improvement in Case U. was perhaps best understood as a transference cure, in the sense of French (1946ab). III. Discussion: the material provided by the writer's observations is reviewed, with reference to the literature. Certain main conclusions are summarised below