Existential
Philosophy, Hypnosis and Hypnotherapy: Reflections.
Existential
Hypnotherapy by King and Citrenbaum was published in 1993 and was
one of the first studies which focused on the relationship between
hypnosis, hypnotherapy and existential philosophy.i
It offers an introduction to the main central themes in existential
philosophy covering the concept of Being (Dasein), Letting Go
(Gellasenheit), Anxiety (Angst), Will and Power, and
the use of metaphor in psychotherapy.
King
and Citrenbaum were both trained in Ericksonian Hypnosis and they
also have written on the use of hypnosis for habit control.
The
study from the perspective of existential analysis attempts to
integrate existential concepts with the practice of psychotherapy and
in particular the modality of hypnosis.
In
developing the Ericksonian approach the study highlights that it is
an oversimplification to characterise the Ericksonian method as only
an indirect approach to therapeutic communication in light of the
existential themes which are apparent in Ericksonian psychotherapy.
In this respect attention is brought to bear on existential ontology
or the study of Being qua Being, in particular the Sartrean
account of ontology developed by Jean Paul Sartre in Being and
Nothingness: An Essay on Phenomenological Ontology. (1943)ii
Sartre
in his phenomenological ontology develops the Husserlian concept of
intentionality and the Heideggerian concept of Being (Dasein)
as expressed in the phrase “Existence precedes essence.”
The
onto-theological tradition derived from Classical Philosophy and the
Christian appropriation of Greek philosophical ideas prioritises
'essence' over 'existence'. In this respect from the therapeutic
perspective the existential use of hypnosis does not focus on
personal essences, ego strengthening or personality typologies. The
therapeutic focus informed by existential analysis centres upon life
as it is actually lived and experienced, as Life-world (Lebsenwelt),
a person's existential reality.
Hypnosis
is situated with the historical research developments on the nature
of hypnosis. In particular, the experimental research which was
undertaken in the post world war II period, much of this being
experimental – laboratory research carried out in the USA. For
instance, the altered state theory of hypnosis in the work of Hilgard
is regarded as an anti-existential theory since it relies on a
pre-conceived theory and distinct phenomenological hypnotic state
which is then applied to the therapeutic subject.iii
The existential approach to hypnosis places significance on the
experience of trance as a form of focused attention which occurs in
the therapeutic alliance created in the therapy session. In this
respect King and Citrenbaum reject the Ericksonian notion that all
hypnosis is auto-hypnosis. Trance work and experience are understood
as part of a dialectical and dialogical relationship between the
therapist who uses hypnosis and the client who experiences trance.
Thus, hypnosis is understood as a co-operative process between two
persons which seeks to have beneficial results for the client who
engages in an 'I' and 'thou' relationship.(Martin Buber)
Hypnosis
is a therapeutic modality within a wider therapeutic context and
experience. From the existential viewpoint the understanding of the
nature of hypnosis as focused attention thus describes trance as a
process and not a thing and in such a process there is
the opportunity for making constructive behavioural and perspectival
change.
In
a more detailed application of existential analysis to hypnosis three
existential concepts are of significance. These are the concepts of
co-constitutionality, self concept and diagnostic labelling.
The
concept of co-constitution is derived from the thought of the
father of modern phenomenology, Edmund Husserl. In the Logical
Investigations and in The Crisis of European Sciences
and Transcendental Phenomenology Husserl situates the human
subject as having three aspects, the person, the situation in which
the person finds themselves and the relationship between these two
aspects – the self – world relationship.
Husserl,
following the work of his teacher, Brentano insisted that the
epistemological relation of the subject to the world is a matter of
intentionality. That is, all knowing is in its nature intentional
between the subject of knowing and the object known. Subject and
object are already related in the self – world relation.
Consciousness is always already conscious of something.
This
philosophical theory stands in distinction to the description of
being and personal identity as developed by Descartes and further
developed in the Cartesian tradition. The Cartesian analysis of the
self as denoted in the dictum “Cogito ergo Sum,” “I think
therefore I am.” is in contradistinction to the reality of the
external world which leads to a radical dualism between the ego as
thinking and the external world as physical extension. (Res
Exstensa).
This
leads modern philosophy in a dualistic direction whereby the
self-world relation becomes characterised by a radical dichotomy so
much so that the philosophical problematic becomes a matter of the
proof of the external world's existence and the existence of the
isolated individuality of the ego. Cartesianism creates a split
between the subject and object. So in the therapeutic context the
problematic becomes the question of a radically separate experience
of the self. So instead of approaching the self-life-world relation
in terms of 'Who am I?', the self is situated as a primordial
relational knowing. In the therapeutic context negative self concepts
are not considered in terms of essences which are immutably given but
in terms of the person, world and self relation as intentionally
co-constituted. The question posed in the frame as “Who am I?” in
the Cartesian sense implies an 'objective contingency across
situations' whereas in terms of co-constitution and intentionality
the question of identity places the subject and world together. Thus,
the more proper description of the ego becomes “Who am I – Where,
When and with Whom, and with What.” This perspective becomes
relevant to therapeutic practice in which psychological disturbance
needs to be situated in the context of person and life-world.
Existential
analysis questions the use of diagnostic psychiatric categories. From
the viewpoint of the existential-phenomenological method working with
the malleability of self concepts arises out of the experience of
alienation and process rather than in static concepts of the self.
This is summed up by King and Citrenbaum in the phrase “The sound
of an ideal self concept is silence.” Intentionality and
co-constitution resists the promotion of the use of negative
labelling by placing the human subject in the self-world relation as
a possibility which is orientated to the present and future.
Metaphorically, it is interesting to ask what would be the sound of
an existential self?
Amongst
the prominent themes in existential analysis is the concept of
anxiety as disclosive of the nature of existence. However, rather
than considering anxiety as a source of psychological distress and
paralysis, anxiety is re-framed in the existential perspective as a
calling to action in the present and future.
Another
prominent theme in existential analysis are the concepts of
individual freedom, and responsibility over and against the crowd,
“The They”, Das Man, the anonymous social group.
The
significance of individual human freedom derives from the philosophy
of action in which the human subject is always capable of free choice
in relation to any circumstance of existence. Freedom and choice are
made in the context of co-constitutionality. This means by its nature
existential choice inevitably means a confrontation with limit
situations, Grenzsituationen, the existentialia of human
boundaries or limit. (Karl Jaspers) One choice inevitably closes off
another possibility which has to be accepted in its facticity.
Equally one choice may open up further possibilities which of its
nature closes others.
The
emphasis on existential freedom in the therapeutic context of
hypnotherapy focuses on the notion of recovery, of situating the
client as being a volunteer who chooses to engage with change
rather than being a passive victim of circumstance.
This is often reflected in subtle changes in the clients use of
language with the emergence of a more directed and confident use of
the first person singular which is similar to Freudian therapeutic
aim of promoting the ego, 'Where Id is, ego shall be.' It is
interesting to note that Bruno Bettelheim in his book Freud and
Man's Soul (1982) which deals
with the dubious translation of Freud from the German into the
Standard English Edition highlights that the translator was prone to
use medical terminology or Latin and Greek terms in order to present
psychoanalysis as more scientific to an Anglo-American audience which
is more influenced by the empirical philosophical tradition. As
Bettelheim says it is one thing to say “My ego won't any longer be
run by irrational anxieties.” and “I
won't any longer be run by my
irrational anxieties.” In the existential perspective it is
important for the person to be responsible for their acts of self
agency and this is entailed in the enunciation of the acting
person....in the first person singular. Furthermore, one can suggest
that an appropriate translation of Freud would show a far more
humanistic-existential account of Freud and his therapeutic work than
would be gathered from the Standard Edition with its empiricist
gloss.iv
Existential
analysis maintains that freedom is a possibility for the human
existent. Freedom can be rejected in the refusal to accept
responsibility in what Sartre denoted as 'bad faith,' Mavais foi.
The
inauthenticity of bad faith is manifest in the refusal to accept
decisions which are implied in being and assenting to the freedom of
decision and choice. This is particularly the case in the context of
personal relations to others. This is manifest in such cases where a
person for example works excessively hard to please others when
ultimately a person is ultimately responsible to themselves.
Human
freedom becomes most apparent according to existential analysis in
the will to power which is the operation of personal power acting in
the world. The sense of empowerment derives from commitment and hard
work which is often misunderstood particularly in the context of
hypnosis where clients often expect instant and quasi-magical results
without prior full commitment to change.
Finally,
existential analysis notes that in human existence there is a
fundamental uncertainty which characterises human life.
Existential
analysis quite correctly situates the modality of hypnosis as a
methodological treatment within the wider aspect of general
psychotherapy. The existential use of hypnosis focuses on the
dialogical relationship between the therapist and client. In the
dialogical relationship where a positive description of the hypnotic
trance is shared with the client, stressing that it is the client who
puts him or herself in the trance process, and thus accentuating the
client's experience of self control. It is by this means that the
client is convinced of the positive and constructive purpose of
entering into the trance experience. The trance is further ratified
by the experience of time distortion, that is the reduction or
extension in the experience of the phenomenological flow of time.
King
and Citrenbaum raise the point from their perspective that it is a
misunderstanding to characterise the Ericksonian approach using
'magical metaphors' as a technique. Rather Erickson worked also with
psychiatric methods within the greater perspective of overall lived
experience. (Lebenswelt) Moreover, Erickson developed his own deeply
personal existential style which was authentic to himself.
Since
existential analysis describes trance as a process rather than a
state this has significance for the notion of hypnotizability and
susceptibility for hypnotic trance. The capability for trance is
described metaphorically as akin to the human capacity for being
poetic. As to susceptibility it is the clients motivation which
determines the susceptibility for the trance experience.
The
use of standardized scales which are often used in clinical and
research settings thus becomes at best irrelevant to the experience
of the trance process but can be considered as encouraging a negative
outcome for the client entering into the trance experience.
As
to the depth of trance, existential analysis avoids too much emphasis
on the depth of trance. In the dialogical relationship between
therapist and client the therapist utilises the client's 'natural
style' of trance focusing on engagement oriented to the process of
change. It is stressed that each person has his or her own level of
trance, and that in the trance process there is an ebb and flow of
trance experience during the therapeutic session. Existential
analysis regards the notion of depth of trance as having little
significance for the therapeutic engagement. The aim of hypnosis in
therapy is not the depth of trance but the resolution of the
presenting problem or concern.
In
terms of the induction process it is understood to be a detailed form
of focused attention with the use of pacing with the client by
mirroring words and rhythm. This leads to a slowing pace for the
client with the reduction in the experience of anxiety. In focused
attention the client learns to concentrate on the here and now of the
experiential – existential moment. In the trance experience there
occurs the suspension of rumination or critical judgement and the
transformation of the operation of negative images in terms of self
concept. Trance enhances the ability of the client to visualise
positive change.
Existential
analysis uses hypnosis as a therapeutic method to enhance the
personal experience of power and the ability of the client to engage
responsibly with their experience. This involves accepting that human
life is always 'imperfectly human.' In terms of past experience this
involves the recognition that the past is properly past, that there
is nothing I can do about the past as an existential fact or
facticity. In adopting this position in lived experience the
existential concept 'Letting go' is utilised. The letting go of self
representations especially of negative self concepts enables a more
adequate or authentic change in the future. In this way 'being' is
experienced as 'becoming.' (Whitehead) The technical aspects of
hypnosis in the existential perspective of letting go focuses on the
re-organisation of the clients experience in line with the
Ericksonian idea that trance itself is an experience that re-orients
realities. The re-framing of experience involves the creation of new
healthy experiences in response to personal history and motivation in
the present. Trance as the experience of letting go enables the
client to experience the world differently and otherwise.
In
trance work concerning post traumatic experience hypnosis works to
free up dissociated amnesic memories. Here King and Citrenbaum employ
diverse methods ranging from Gestalt, Bodily awareness, Here and Now
awareness exercises and Mock Funerals. Also is significant is the use
of embedded suggestions which register in the unconscious during
trance.
One
aspect of the practice of general psychotherapy is the promotion of
empowerment in the client. This idea is expressed in existential
analysis as the notion of 'will to power.' The will to power means
that the human subject is a locus of will, action and decision in an
inalienable manner. (Frankl) Rather than a scientific or
psycho-analytic notion of cause and effect denoted in for instance
Freud's mechanistic description of the psyche, an existential
analysis is based on a philosophy of personal power and motivation,
action takes priority. The danger of a causal – effect approach to
the freedom of the existential subject is that it promotes a static
ideation that we are caused by x, y or z and so on which in effect
dis-empowers the human person. For example we thus consider ourselves
as the victims of our childhood experience. In this respect
existential analysis is critical of therapies which are based on
'inner child' ideas since the problem risks that focus is given to
situating the existential subject as 'passive.' Moreover, losing
oneself in the crowd to avoid responsibility is a form whereby the
self is isolated in social anonymity. This viewpoint very much
resembles the critique of the Jungian Child Archetype as developed in
the thought of the Archetypal psychologist, James Hillman. In
focusing on the psychological concept of the inner child the problem
arises that we develop a psychological perspective which itself is
infantile and perpetuates a situation whereby the client becomes
stuck in a passive and infantile position. If the self – world
relation, Lebenswelt is one of appropriation, process and
change then we ought to situate the adult as responsive and
responsible for their own relation and response to any life event. In
a sense, the use of the concept of 'the will to power' helps to
identify those early childhood years of socialisation as a form of
childhood hypnosis to transform the feeling of being a
victim of circumstances and events to be replaced by the
will to power in the present and future. We are the agents of our own
act and acting.
Self
hypnosis is explained in the light of the notion of the will to power
whereby the subject uses self hypnosis as an exercise of focusing and
refocusing of attention. In this respect, self hypnosis requires
discipline, engagement and effort.
Anxiety
(Angst) has been considered a fundamental disclosive concept in
existential philosophy. Anguish and anxiety is the presentation of
fear for myself as an existing and finite being in the world. The
concept was classically developed by the Danish philosopher
Kierkegaard as the concept of Dread. Kierkegaard uses the concept of
Angst which places the human person as subject to radical contingency
which can only be resolved by taking a leap of faith in relation to
God. In a non-thesitic manner Heidegger uses the term to denote an
anxiety which structures the whole of human life and which determines
our responsibility to respond to our anxious condition. Sartre uses
the term Angoisse which is used in a similar sense to the
Heideggerian usage.
Whilst
in the therapeutic arena anxiety is often experienced as profoundly
distressing. Existential analysis interprets the experience of
anxiety as an opportunity to exercise human freedom and
responsibility. Again trance of its very nature is used to re-frame,
re-label the experience of anxiety. The human person is not simply
the victim – patient of human experience. Choice and responsibility
are intrinsic to authentic human existence. Here again, the practice
of self hypnosis can be of use with regard to self care and
self-consideration where by the anxieties of the day are given over
in the sense of letting go. Trance itself is inimical to the
experience of anxiety and under proper guidance trance can assist
focused attention on the present thus forestalling anxiety,
rumination, worry and anticipatory anxiety.
It
is interesting to note that existential analysis considers anxiety as
disclosive of being manifesting the potentialities of freedom and
responsibility in our engagement with the world. Anxiety and phobic
anxiety often involves very focused forms of anxious attention and
this is paralleled in the focusing process of trance. So in the
trance state of hypnosis there is an opportunity to educate the
client in the trance-like nature of the experience of anxiety in
order to assist the client to re-focus when confronting anxiety and
to move beyond the trance-like experience of anxiety. More recently,
Michael Yapko has described the trance-like nature of depression
which also parallels the trance process. So in trance work with
anxiety and depression we can re-hearse new ways to experience the
world. The human person is not fated to repeat the past or to
paralysis in the present.
The
therapeutic use of hypnosis in existential therapy also focuses on
the personal meaning of symptoms for the client. Personal symptoms
and concerns occur within the particular instance of a
phenomenological world. Here the existential therapist shows a deep
respect for personal experience and hypnosis is used to enhance the
meaningful engagement with symptomatology. Symptoms are understood to
be meaningful. In this respect hypnosis contributes to the
facilitation of awareness. In cases where the client finds it
difficult to articulate descriptive and meaningful responses to
symptoms it is suggested that the therapist in line with his or her
insight may use multiple choice questioning in order to elicit
meaningful understanding. If this is difficult to verbalise in the
trance process then the technique of ideo-motor responses such as the
raising of the fingers for positive or negative responses to
questioning can be used. Also minimal unconscious cues may well be
noted by the therapist such the nodding of the head.
Following
the significance of Husserlian phenomenology and the later
developments in phenomenological hermeneutics an existential use of
hypnosis seeks to elaborate on the importance of metaphor in the
therapeutic alliance. It is often the case that rather than
discursive – rational interventions in therapy it is the use of
metaphor which can be disclosive for creative change in the client.
Rather than a philosophical discussion about personal responsibility
and human freedom the use of metaphorical phrases such as 'the ball
is in your court,' may lead to greater creative responses.
In
terms of hypnosis the use of metaphor keeps in touch with the clients
own symbolic and metaphorical world which then can be paced and
reflected to the client in their own experience. In this respect
existential analysis understands that the unconscious itself is a
metaphor in the persons own life-world (Lebenswelt) and also a
metaphor operative within the psychoanalytic tradition itself. This
also reflects the Ericksonian idea of the unconscious as a store
house of learning experience which is always there for the
utilisation of the subject. Here the unconscious becomes a
metaphorical reason for behavioural and perspectival change. In a
sense since the unconscious is being used in itself as a metaphor
then questions regarding the epistemological status of the the
unconscious as a psychic existent is thus irrelevant in the
therapeutic dialogue. The unconscious becomes an excuse or rationale
for change.
Edward
Gardner
Heaton
Hypnosis and Psychotherapy Practice
iKing,
M, E. and Citrenbaum. C, M. (1993) Existential Hypnotherapy.
New York and London. The Guilford Press.
iiSartre.
J.P. (1976) Being and Nothingness: An Essay on Phenomenological
Ontology. London: Methuen.
iiiHilgard.E,R.
(1968) The Experience of Hypnosis: A Shorter Version of Hypnotic
Susceptibility. New York and London. Harvest.
ivBettelheim.
B. (1982) Freud and Man's Soul. London. Penguin.
No comments:
Post a Comment
Note: only a member of this blog may post a comment.