Practical Session

Hypnosis relaxation
Elective Block
Psychosomatic Medicine
Dept of Psychiatry
Faculty of Medicine
Gadjah Mada University
2014

Topics
Why we use Hypnosis/Relaxation on
Psychosomatic ?
Kind of hypnosis?
How is the mechanism of hypnosis
on treatment of psychosomatic
Basic training
Practice

Ketrampilan Dasar

Learning Objectives
After completing this session,
students should be able to :
Understand basic of hypnosis
Understand relaxation in hypnosis
Apply relaxation for stress management

Why we use
hypnosis on
psychosom
atic?

 Specific medication to specific

medical illness
Psychopharmacology
Psychotherapy
Psychosocial intervention

Kind of hypnosis
Hypnosis is one of the
psychotherapies
Hypnotherapy
Dental and Medical Hypnosis
Entertained Hypnosis

Mechanism of Hypnosis in
Psychosomatic Treatment
Cognitive
Characteristics
Relaxation
Concentration
Increased
suggestibility
Hypermnesia/Amnes
ia
Increased control of
physiologic
responses
Perception of
different states
Concrete thinking

Physical Characteristics

Muscle relaxation
Twitching
Lacrimation
Fluttering eyelids
Eye closure
Eye movements beneath
lids
Changes in respiratory
rate/depth
Changes in pulse
Jaw relaxation (drooling)
Catalepsy (suspended
animation)
Decreased postural tone

Problems that respond

Acute and chronic pain
Anxiety associated with procedures or
illness
Asthma
Attention deficit disorder
Cerebral palsy
Conditioned nausea and vomiting
Diabetes mellitus
Dysfluency

Encopresis
Enuresis
Facial tics
Habit coughs
Insomnia
Migraine
syndromes

Nail biting
Nightmares
Performance anxiety
Pruritis
Psychogenic seizures
Thumb sucking
Tongue thrusting
Tourette syndrome
Trichotillomania

Basic Training
Rules for Using Hypnosis
Never treat a condition you are not
qualified to treat without hypnosis
Never use authoritarian symptom
removal
Do not use for entertainment

Hypnosis is contraindicated when:

It would lead to physical
endangerment
It may aggravate existing problems
or create new ones
It is used for fun or entertainment
The problem is more effectively and
appropriately treated with a different
treatment modality (e.g. medication
or family therapy)

Objectives of hypnosis

Areas of application
Medical
Asthma
Burns
Enuresis
Hypertension
Childbirth
Migraine

Minor Surgical Procedures

Obesity
Pain Control
Gastro-intestinal
Disorders
Warts

Areas of application
Psychological Practice
& Psychiatry
Anxieties
Apathy and lack of
Motivation
Confidence Problems
Eating Disorders
Depression
Nail-biting
Fears and Phobias

Psychosomatic
Syndromes
Panic Attacks
Sleep Disorders
Sexual Dysfunction
Thumb-sucking
Stuttering

Areas of application
Dentistry
Anaesthesia
Anxiety /
Apprehension
Bleeding Control
Bruxism
Dental Phobia
Denture Problems

Gagging
Nausea
Pain-control
Restlessness
Salivation-control
Tempro-mandibular
Joint Dysfunction

Areas of application
Education
Concentration and
Attention problems
Exam Fears/Phobias
Motivation training
Memory Training
Study habit problems

Sports
Attitude Change
Confidence Building
Co-ordinate Mind &
Body
Fear of Success
Fear of Failure
Maximise Potential
Improve Concentration
Performance Anxiety
Motivation Training
control

Procedural Stages of
Hypnotherapy
1. Preparation (e.g. removing misconceptions,
assess interests that may be incorporated in
procedure)
2. Assessment of hypnotisability (capacity for
concentration and imagery, suggestibility)
3. Induction procedure
4. Deepening stage
5. Trance ratification
6. Utilisation of trance for therapeutic purposes
7. Post-hypnotic suggestions including selfhypnosis instructions
8. Termination of the trance

Relaxation Technique
Pre-hypnosis Testing
Test of the imagination.
Hypnosis and Balance

Progressive Relaxation
Technique

Relaxation Training

Dr. Bob Carey

Preliminary Steps
Check that individual is suitable for
relaxation response
Ensure conducive environment
Ensure staff/caregiver support is
available
Gear the relaxation training to the
level of functioning

Types of Relaxation therapy

Deep Breathing
(Jacobsen) Progressive Deep Muscle
Cognitive Imagery

Deep Breathing
Gear to level of functioning
Use teaching techniques role
playing, behavioural rehearsal,
positive reinforcement
Dont do too much at once
Break tasks into small parts and use
lots of practice and repetition

Deep Breathing - continued

Long - Slow Deep breaths
Each breath as long as possible
aim for 10 seconds or longer
Try to hold breath on inhale for 3-4
seconds
Practice for 10-15 minutes
Practice with individual and do
together

Deep Muscle Jacobsen

technique
Tension release exercises
Modified for persons with intellectual
impairment
Ensure proper positioning
Teach/instruct in technique first
Practice one muscle group at a time
Use modelling, instruction, and some
verbal and physical cues/prompts

Deep Muscle - continued

Remember to script for success talk
about the importance of learning this
new skill
Muscle groups to practice hands,
forearms, biceps, calf, thigh,
stomach, shoulders, neck/jaw/cheek,
forehead/eyes.

Deep Muscle - continued

Focus on the difference between tension
and feelings of relaxation notice the
difference
Therapist voice modulation flat, little
intonation, relaxing, pacing is slow, breaks
in sentences dont talk too much
Allow for 30 to 40 minutes depending on
individual
Lower functioning shorter duration
focus on relaxed posture/appearance

Cognitive Imagery
Develop this with individual prior to
starting find out what works for
them
Use descriptive phrases/scenarios
that employ all five senses