Hypnosis in psychotherapy, psychosomatics and medicine. A brief overview.

Aspects of hypnosis and its application in psychotherapy, psychosomatics and medicine are examined and contextualized in the 250-year history of hypnosis. Imagination as an essential element of hypnotic treatments appeared as early as 1784 as an argument rejecting the theory of animal magnetism of Franz Anton Mesmer. In somnambulism of German romanticism, another proto-form of hypnosis after 1800, concepts of the mind-body problem were dealt with, which still characterize the understanding of unconscious mental processes today. Hypnosis was at the beginning of psychoanalysis, but was not pursued further by Sigmund Freud from 1900 onwards. Nevertheless, there were some hypnoanalytical approaches in the 20th century, as well as attempts to integrate hypnosis into behavior therapy. Techniques of imagination and relaxation combine both; in particular findings from cognitive psychology explain processes of both hypnosis and cognitive behavioral therapy. The influence of social psychology brought a new perspective to the debate about the nature of hypnosis, which continues to this day: is hypnosis to be understood as a special state of consciousness or is it a completely normal, mundane interaction? The experiments that were carried out to support one side or the other were also dependent on the hypnotizability of the subjects involved, as the more difficult hypnotic phenomena such as paralysis, hallucinations or identity delusions can only be demonstrated by highly hypnotizable subjects. The fact that these are not mere compliance reactions has now been proven by many studies using imaging techniques. But even those who are moderately hypnotizable benefit from hypnosis rituals. Variables postulated by socio-cognitive hypnosis researchers, such as motivation and expectation, are relevant, as is a good "hypnotic rapport." Practical application of hypnotherapy today is characterized by the innovative techniques and strategies developed by Milton H. Erickson. Research into the effectiveness of hypnosis in the field of psychotherapy and psychosomatics still leaves much to be done. The situation is different in the field of medical hypnosis, where there are considerably more studies with a satisfactory design and verifiable effects. However, the impact in practical application in everyday medical practice is still low. Newer developments such as virtual reality and artificial intelligence are being looked at with critical interest.

Personality Styles of Hypnosis-Practicing Dentists: A Brief Report.

This cross-sectional study used the Personality Style and Disorder Inventory (PSDI) via the internet to examine personality styles of random hypnosis society sample groups (German Society of Dental Hypnosis [DGZH, n = 418] and Milton Erickson Society of Clinical Hypnosis Germany Listserv [MEG, n = 490]) and compared these data of hypnosis practitioners (HYP samples) with 2 control samples of persons not interested in hypnosis (NONHYP samples): 1,027 psychotherapists from DACH countries (Germany, Austria, and Switzerland) and 3,392 people of the normal population of Germany. Results show that HYP-DGZH dentists were much more intuitive/schizotypal (p < .001), unselfish/self-sacrificing (p < .001), charming/histrionic (p < .001) and optimistic/rhapsodic (p < .001) than the HYP-MEG sample. All HYP-DGZH dentists also showed significantly elevated levels in these four personality styles compared with the levels of the NONHYP-DACH psychotherapists (p < .001), and elevated levels in intuitive/schizotypal, unselfish/self-sacrificing, and optimistic/rhapsodic compared with the NONHYP normal population. The intuitive/schizotypal values of the HYP-DGZH dentists were predominant. Within the limitations of the study, the presence of a specific personality profile in random samples of dentists who use hypnosis and are members of a professional hypnosis society suggests that a "homo hypnoticus" might also exist among dentists. However, this needs to be investigated in more detail.

"How obsessive are dentists?"--A personality styles & disorder inventory based prospective, controlled study.

OBJECTIVES: The aim of this study was to examine the typical personality traits of dentists and to discuss critically their influence on the necessary characteristics for a good dentist-patient relationship. METHODS: Two groups were invited via e-mail to participate the study in 2015-2020. One group consisted of German dentists (DENT N = 580). The other group was formed by German speaking psychotherapists from Germany, Austria and Switzerland (DACH N =  1.027). The Personality Styles and Disorder Inventory was used in its short form (PSDI-S) via online survey. The normalization sample (NORM N = 3.392) of the PSDI-S was used to compare the results with a normative sample. RESULTS: Dentists differed in 10 out of 14 personality styles from the normalization sample (NORM), and in 13 out of 14 personality styles compared with the psychotherapists (DACH). Female dentists differed in 7 out of 14 personality styles to their male colleagues. CONCLUSIONS: The most significant differences in personality styles were willful (PN), spontaneous (BL), reserved (SZ), ambitious (NA), optimistic (RH) and conscientious (ZW), which seem to be necessary for a good dentist-patient relationship and dental procedures. The expression of personality styles is most likely to influence the choice, delivery and cost as well as patient perception of treatment. CLINICAL SIGNIFICANCE: Dentist's personality has an important impact on the interpersonal, which influences the dentist-patient relationship and its therapeutic outcome.

Personality Styles of Dentists Practicing Hypnosis Confirm the Existence of the Homo Hypnoticus.

Several publications with healthcare professionals, such as psychotherapists, have shown a significant difference in personality styles in practitioners using hypnosis compared to those not using hypnosis. To investigate differences in personality styles, dentists were contacted to participate in a personality-inventory [Personality Style and Disorder Inventory (PSDI)] online survey. Dentists using hypnosis (HYP DGZH) (n = 418) were compared to dentists not using hypnosis (NONHYP DENT) (n = 162). Results show that hypnosis-practicing dentists score significantly higher in the intuitive/schizotypal ST personality style (p < 0.001) compared to non-hypnosis-practicing dentists. Female dentists scored significantly higher in intuitive/schizotypal ST and unselfish/self-sacrificing SL in the HYP DGZH sample but only in unselfish/self-sacrificing SL in the NONHYP DENT sample. The percentage of women was similar in both samples (68.2%; 67.3%). Intuitive/schizotypal ST was found to be the predominant personality style of men who are interested in or use hypnosis, metaphorically so-called "homo hypnoticus." Within the limitations of this cross-sectional non-interventional observational online-questionnaire study, results expand this notion to the so-called "homo hypnoticus dentalis." However, further research on the subject is needed to investigate and confirm this personality type in other than the German-speaking DACH countries.

Hypnotizability Norms may not be Representative of the General Population: Potential Sample and Self-Selection Bias Considerations.

The analysis of the methods sections of 66 normalization tests of hypnotizability scales reveals that out of 33,338 subjects, 58.57% were college and university students, and the majority of these were students of psychology. Of all subjects, 7.45% were younger school children, 27.63% were patients treated with hypnosis, and out of these, 85.26% were patients of 1 single therapist. Only 0.51% were trainees of dental or nursing schools, 0.13% were prisoners, and 5.71% were other adults. These figures suggest a sample-selection bias. As 83.08% of these subjects were told beforehand that they were to undergo a hypnosis study, a self-selection bias is also implied in the data. It can be presumed that those interested in hypnosis participated, whereas others who had no interest in hypnosis may have refrained. It is concluded that some of the published norms of hypnotizability tests may not be adequately representative of the general population. Many hypnosis studies, whether clinical or experimental, which are based on hypnotizability, may be afflicted by these biases.

Replication Studies on Significant Differences in Personality Profiles of Securely and Insecurely Attached Psychotherapists and Dentists.

This study contributes to the therapist variable in general and the personality profile of securely and insecurely attached psychotherapists and other healthcare professionals in particular. In a preceding study, it has been found that insecurely attached psychotherapists differ in nine personality styles from securely attached ones. The aim of the present study was to replicate these findings and to investigate whether they also apply to other health professions such as dentists. About 891 subjects from two German professional societies for hypnosis were surveyed online with a personality questionnaire [Personality Styles and Disorder Inventory (PSDI)] and an attachment questionnaire [Relationship Scale Questionnaire (RSQ)]. Since these subjects were interested in hypnosis and used it in their practice (HYP), 150 dentists without a hypnosis context (NONHYP) were studied as a control group with the same survey. The results of the preceding attachment study could be replicated: Insecurely attached healthcare professionals differed significantly from securely attached ones in the same nine (plus one, i.e., 10) personality styles if they use psychological methods including hypnosis. If they do not use psychological methods (like the NONHYP dentists), they differ in half of the personality styles. No within-sample and no between-sample differences have been found in the assertive/antisocial (AS) personality style. No within-sample differences have also been found in the conscientious/compulsive (ZW) and the intuitive/schizotypal (ST) personality styles. However, large between-sample differences were obvious in ZW and the ST. Both of the samples of the dentist were much more compulsive than the two psychotherapeutic samples. In addition, both of the HYP samples were much more schizotypal than the NONHYP samples. The latter is the general signature of those individuals who are interested in hypnosis and were metaphorically termed homo hypnoticus. It seems that AS, ZW, and ST are independent of attachment.

German Norms of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) and Proposal of a 5-Item Short-Version (HGSHS-5:G).

The Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A), is commonly used to test hypnotizability. There is still some controversy about what exactly hypnotizability is and whether and how it can be measured, especially by the HGSHS:A. Furthermore, a wider clinical use is limited, requiring a testing time of more than 1 hour. We analyzed the German HGSHS:A version for its factorial structure, item contribution, and item difficulty based on test data from six studies, including 1276 persons, to propose a shorter version of the HGSHS:A. We hereby present a 5-item version of the HGSHS:A (HGSHS-5:G), consisting of the challenge items, that was compared with an 11-item version (highly variable posthypnotic amnesia omitted). Age- and gender-specific norms was generated. The HGSHS-5: G showed high validity, reliability, and classification agreement. It reduces test time to 30 minutes thus facilitating wider use of hypnotizability testing.

Does the Homo Hypnoticus Exist? Personality Styles of People Interested in Hypnosis.

It may be that individuals who are interested in hypnosis will volunteer for hypnosis experiments or practice hypnosis. Do these "hypnosis-prone" individuals differ from hypno-neutral, nonhypnosis-prone individuals? If so, could one speak of a personality type, the homo hypnoticus? This study reports on 3 samples of individuals where there was no indication of hypnosis or no interest in hypnosis (NONHYP: N = 1426) and 4 samples of individuals who were interested in hypnosis (HYP: N = 1048). Using the Personality Styles and Disorders Inventory, we calculated contrast analyses for the contextual effect of HYP vs. NONHYP and gender effects. Results suggested there may be a homo hypnoticus personality style with the characteristics of intuitive-schizotypal, rhapsodic-optimistic, and charming-histrionic. These distinctions appear mostly in women.

Significant Differences in Personality Styles of Securely and Insecurely Attached Psychotherapists: Data, Reflections and Implications.

This is a contribution to the research on the therapist variable aiming to improve effectiveness of psychotherapy. It is shown that attachment styles shape personality styles of psychotherapists in a favorable or unfavorable manner. Data on personality (PSDI) and attachment (RSQ) styles was collected from 430 psychological psychotherapists of the DACH countries using an online survey. The 88 insecurely attached psychotherapists differed significantly from their 342 securely attached colleagues in 9 of 14 personality styles: They were - even though well within normal range - more paranoid, borderline, schizoid, dependent, negativistic, self-sacrificing, avoidant, and depressive, as well as less optimistic. This corresponds to results of other researchers. Data regarding their effectiveness was not available. It is argued that a secure attachment style predispose to be a good psychotherapist. Yet, insecurely attached psychotherapists possibly compensate their adverse traits through self-therapy, continuous education, and supervision.

Personality Styles of German-Speaking Psychotherapists Differ from a Norm, and Male Psychotherapists Differ from Their Female Colleagues.

Variables pertaining to the person of the psychotherapist have been neglected in psychotherapy research for some time. Concerning personality in particular, however, research has mostly focused on its relation with the psychotherapist's choice of method, or differences between the various major therapy approaches. That is, psychotherapists were compared to each other without specifying how exactly psychotherapists are in comparison to "ordinary people." We wanted to know: Are there specific personality styles that distinguish psychotherapists from the norm? A sample of 1,027 psychotherapists from Germany, Austria, and Switzerland filled out the short version of the Personality Style and Disorder Inventory (PSDI-S) via online survey. The PSDI-S is a self-report questionnaire that assesses 14 personality styles, partly related to the non-pathological equivalents of classifiable personality disorders. The psychotherapists were compared to a normative sample of 3,392 people of different professions. The results could be divided into three groups: (1) Large differences in four personality styles that might contribute to relationship skills and may enable psychotherapists to put their own personal opinion aside, show empathy and appreciation, open themselves to the emotional experience of the patient, and provide a trusting relationship. (2) Moderate differences in seven personality styles that are equally indicative of the professional social skills of the psychotherapists, i.e., they were neither submissive nor passive, not excessively helpful, but also not too self-assertive. (3) Hardly any or no differences regarding a charming (histrionic) style, optimism, and conscientiousness. Gender-specific results revealed that male psychotherapists differed from their female colleagues, but they did so differently than men and women in the normative sample do. The main limitations were that we relied on self-report and did not statistically control for gender, age, and education, when comparing to the norm. As a conclusion, German-speaking psychotherapists show personality styles that we interpret as functional for psychotherapeutic practice but this needs corroboration from studies that use different methods and measures.

Norms of German adolescents for the Harvard Group Scale of Hypnotic Susceptibility, Form A.

The Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) has not been explicitly tested on an adolescent population. In this study, the German version of the HGSHS:A was administered to 99 German adolescents aged 15 to 19. In contrast to other studies, the gender distribution was relatively balanced: 57% female and 43% male. Results were comparable to 14 earlier studies with regard to distribution, mean, and standard deviation. Some peculiarities in contrast to the 14 previous studies are pointed out. It is concluded that the HGSHS:A can be used as a valid and reliable instrument to measure hypnotic suggestibility in adolescent samples.

Intelligence and hypnotizability: is there a connection?

Ninety-two high school and 8 secondary school students, aged between 15 and 19 years, were tested for intelligence and for hypnotic susceptibility. No correlations could be observed for the overall sample unselected by sex because the negative correlations for male participants canceled out the positive correlations for the female subsample. These are significant for the total value of intelligence (r = .288) and highly significant for the subcategory verbal intelligence (r = .348), yet nonsignificant for the subcategories numerical intelligence and figural intelligence. Females seem to be more able to imaginatively process semantic contents induced verbally. They also seem to have a higher task motivation than males--at least during adolescence.

Hypnotizability, personality style, and attachment: an exploratory study, part 1-general results.

This article is an exploratory study investigating the relationship between hypnotizability, personality style, and attachment. Data were collected from 99 students by means of the Harvard Group Scale of Hypnotic Susceptibility, Form A; Personality Styles and Disorders Inventory; and Relationship Scale Questionnaire. Results suggest that individual personality styles accounted for a significant amount of variance in hypnotizability in: (a) the whole sample, (b) the securely attached, and (c) the insecurely attached. High hypnotizables among both the whole sample and securely attached individuals shared the unselfish/self-sacrificing personality style as a main predictor of hypnotizability and displayed elevated scores for the charming/histrionic and the optimistic/rhapsodic personality style. Furthermore, two groups were identified among the high hypnotizables that differed mainly according to attachment style: one consists of securely attached, charming/histrionic, and optimistic/rhapsodic people, who are best described by socio-cognitive theories. The other is composed of insecurely attached intuitive/schizotypal people, who are better depicted by dissociation theories.

Hypnotizability, personality style, and attachment: an exploratory study, part 2-results with particular focus on sex.

The relationship between hypnotizability, personality style, and attachment was examined according to sex in 99 student participants. No specific differences for personality and hypnotizability were found in the highly hypnotizable participants according to sex. Similarly, no differences were found between high, medium, and low hypnotizable females, though differences were found among males. For males, the best predictor of hypnotizability was the unselfish/self-sacrificing personality style, which explained 40% of variance. This was in contrast to low hypnotizable males, who were less spontaneous/borderline, self-critical/avoidant, unselfish/self-sacrificing, but more assertive/antisocial. In comparison with females, low hypnotizable males were less intuitive/schizotypal and less loyal/dependent. Within the whole sample and among securely attached high hypnotizables, two peaks were observed for charming/histrionic and optimistic/rhapsodic styles, which suggests a "prone to hypnosis" personality style. Such people are optimistic and charming, and tend to be securely attached. This may suggest a high self-selection bias in hypnosis experiments and potentially creates confounds for the majority of such studies.

The role of tactile support in arm levitation.

How many persons need tactile support à la Milton H. Erickson to achieve arm levitation during hypnosis? How do these differ from those who do not need it? Hypnotic arm levitation was suggested three times consecutively to 30 medium suggestible students. Sixteen succeeded without any tactile support; 7 needed it one or two times; 5 needed it every time; and 2 achieved no arm levitation at all. Participants without any tactile support went more quickly into deeper hypnosis, experienced more involuntariness, less effort, and had higher electrodermal activity. This greater physiological activity seems necessary for hypnotic arm levitation as a form of "attentive hypnosis" in contrast to "relaxation hypnosis." A change in verbal suggestion from "imagine a helium balloon" to "leave levitation to your unconscious mind" revealed no differences. Several issues resulting from this exploratory arm levitation study are discussed. The idea of different proprioceptive-kinesthetic abilities is introduced and the profound need of co-creating an individual suggestion is emphasized.

Electromyographic investigation of hypnotic arm levitation: differences between voluntary arm elevation and involuntary arm levitation.

Thirty-three volunteers were randomly exposed to 3 conditions: hypnotic arm levitation, holding up the arm voluntarily without hypnosis, and imagined arm lifting without hypnosis. Trapezius, deltoid, extensor digitorum, flexor digitorum profundus, biceps brachii, and triceps brachii muscles were measured. Strain and muscle activity during lifting and holding up the right arm for 3 minutes were used as dependent variables. During hypnotic arm levitation, the total muscle activity was lower than during holding it up voluntarily (p < .01); the activity in the deltoid was 27% lower (p < .001). Without hypnosis, the muscle activity showed a positive correlation with strain. However, there was no such correlation in the hypnotic condition. Apparently, it is possible to reduce strain and to objectively measure muscle activity in an uplifted arm through hypnotic arm levitation.

On the history of dissociative identity disorders in Germany: the doctor Justinus Kerner and the girl from Orlach, or possession as an "exchange of the self".

The history of hypnosis is closely linked to the theme of possession; one such link is that the forerunner of hypnosis, animal magnetism, replaced exorcism in 1775 when Franz Anton Mesmer testified against Father Johann Joseph Gassner's exorcism. Modern authors have noted remarkable similarities between states of possession and dissociation. The treatment of possession by animal magnetism and exorcism represents the special romantic-magnetic therapy of the German medical doctor Justinus Kerner in the early 19th century. This article describes the man, his methods, and his thinking and presents one of his most famous case studies, the girl from Orlach, which, by today's standards, was a true case of dissociative identity disorder (DID). This article describes how contemporary principles of treatment were used and controversial issues about the nature and causes of DID were discussed 175 years ago.

Gassner's exorcism--not Mesmer's magnetism--is the real predecessor of modern hypnosis.

Usually, Mesmer is considered to be the real predecessor of modern hypnosis and, consequently, of psychotherapy. The author questions this commonly accepted view and asserts that Gassner's therapeutic approach was much more elaborate and psychologically oriented than Mesmer's. In light of the present understanding of psychotherapeutic and hypnotherapeutic techniques, Gassner's methods can be characterized as a special kind of hypnotic training in self-control. The author describes Gassner's kind of exorcism and its similarities to hypnotherapy and goes into personal and sociocultural factors relevant to the debate surrounding Gassner's theory and procedure. It was the most heated dispute of the Enlightenment that took place in Munich around 1775 with Mesmer as an important part of it. The author discusses whether Father Gassner, rather than Mesmer, is the real predecessor of modern hypnosis.