Just as there are a great number of ways of inducing heterohypnosis, thereis also almost no limit to the varieties of autohypnotic techniques. Some of the works listed in the References and Bibliography of this book that were addressed to lay audiences provide an idea of this variety. It is improbable, however, that even a good subject would be successful in inducing self-hyp- nosis as a result of reading a book. What is generally required is personal training by a hypnotist, and this always includes some degree of heterohyp- nosis, whether in the form of a formal trance induction or in the form of helpful suggestions and supervision. An example of a self-hypnosis training procedure that the author has found effective (and which the reader may modify as he desires, to meet the requirements of his own personality and the needs of his patients) will now be described.
If a subject is to be trained in self-hypnosis by means of heterohypnosis, this should be taken into account in the selection of the heterohypnotic in- duction procedure. Specifically, hypnosis should be attempted in the most permissive manner possible and the subject's own role in producing all of the hypnotic phenomena emphasized. Following the induction phase, time should be spent in deepening the trance as much as possible so that the subject can experience the subjective feelings accompanying hypnosis. These feelings should be suggested to be pleasant and positive ones. The fact that the subject is always in control of what he thinks, feels,and does and is in no way under the control of the hypnotist should also be made clear. After the subject has had a chance to experience and enjoy the deep relaxation of the hypnotic state and his fears of the new experience have been allayed, he should be told that he can reproduce this pleasant, secure, relaxed state whenever he desires, without the aid of the hypnotist, by going through an induction ritual that he is then taught.
The particular ritual described is not important. Few subjects will be able to go into a self-hypnotic state instantly on a posthypnotic signal, and it is preferable to give the subject an induction ritual that permits him to enter the state gradually. For example, he may be told to say to himself: "When 1 reach the count of 10, I will be in a very deep, relaxed, hypnotic state," and then to start counting. Whatever posthypnotic quality may result from giving these instructions under hypnosis will aid the subject in his early efforts, but the method does not depend on posthypnotic suggestion and could be taught to a waking subject as well. Even in the latter case, however, a previous hyp- notic induction is desirable to permit the subject to experience the state he is trying to produce.
The subject should also be instructed, while still under hypnosis, to per- form all self-hypnosis in a quiet, private place and to sit or lie comfortably in a position appropriate for heterohypnosis before commencing. The subject should be told that following the self-induction, he can make the same kind of deepening suggestions to himself that the hypnotist has used. One or two of these techniques should be described to him. He should be told that each time he Induces hypnosis, it will be easier, and he will go deeper than the last time. A good practice is to train a subject in a self-induction technique related to the one by which he has been successfully hypnotized since he will have experience and confidence in such a method. Thus, if heterohypnosis was induced by an arm levitation, the subject can be trained to levitate his arm to induce hypnosis. In the initial induction, the hypnotist will elect the method he or she believes will be easiest for the subject, and, if it is successful, will use it as the basis of the self-induction method to be taught. If the hyp- notist had difficulty with the method originally attempted and had to switch to another technique to induce a trance, then he or she will also have to modify the self-induction procedure taught.
The subject should be told that following self-induction and deepening, he will be able to make any desired suggestions to himself, just as an external hypnotist could. He is then told that when he is finished making the sugges- tions, he is to awaken himself by the use of a simple formula, such as counting to 3, to ensure a comfortable and gradual return to the waking state. It should be suggested that he will never experience any unpleasant after effects of hypnosis, such as headache, muscle cramp, or a feeling of numbness, and that if any emergency occurs while he is under hypnosis, he will instantly awaken and be able to deal with the situation. Just how effective this latter suggestion is, or whether the same result would not occur without it, is un- certain, but it is never a mistake to err on the side of caution. Just making such a suggestion may have the effect of putting some of a subject's unspoken fears to rest.
After explaining the procedure to the subject under hypnosis and ensuring that he understands what is required of him, the subject should be returned to the waking state. Any additional questions he may have should be an- swered, and then he should immediately be given the opportunity to try out the procedure with the hypnotist present. The subject should be told to go ahead and induce the hypnotic state by himself, enjoy the pleasant, relaxed feeling for a few minutes, and then awaken himself. It is useful to tell him to raise his hand when he has attained a state as deep as or deeper than that induced by the hypnotist so that the instructor-hypnotist can gauge the sub- ject's progress.
The immediate practice of the self-hypnotic procedure makes it most likely to succeed because it capitalizes on the subject's heightened expectancy pro- duced by the successful heterohypnosis. It also permits any misunderstand- ings or problems to be corrected while the hypnotist is present to supervise the procedure. If the patient reports he is unable to produce hypnosis by himself it may be helpful to point out to him that he has already proved that he can do it (under heterohypnosis), for he and not the hypnotist was re- sponsible for whatever effects were obtained.
Following the successful completion of this exercise, the subject should be told that he must practice the procedure one or more times daily to attain proficiency in it and to reinforce the therapeutic suggestions that he has been instructed to make to himself. These will be specific to the patient's treatment plan but may additionally include general positive suggestions of well-being. These final instructions give the hypnotist the opportunity to repeat his sug- gestion, this time while the subject is in the waking state, that with each sub- sequent induction, the subject will go deeper. (For examples of other vari- ations in the teaching of patients to induce or utilize self-hypnosis, see Garver, 1984, and Sacerdote, 1984),
If self-hypnotic suggestions are part of a patient's treatment plan, the pa- tient should always be the one to induce the trance state, even in hetero- hypnotic sessions in the therapist's office. The therapist can thus monitor the patient's technique, and it motivates the latter to do his homework, for in effect.he is being tested on his performance.
Once a patient masters the generation of an autohypnotic state, he is free to modify it in a variety of useful ways. For example, he can leam to induce this state with his eyes open and without any external indications of being hypnotized. He can then induce a brief trance in a public place without at- tracting attention to himself, a useful skill should he have a need for an im- mediate, supportive self-suggestion, such as one to diminish a desire he may be experiencing to smoke a cigarette while trying to stop smoking (Spiegel, 1974a).
If a patient is unable to learn self-hypnosis because he is unwilling to de- vote the time necessary for practice (or for any other reason) but is a good enough subject for heterohypnosis, some of the advantages of self-hypnosis (such as the daily repetition of therapeutic suggestions) may be attainable by making a tape recording for the patient to listen to at home. These tapes should be tailor-made for the requirements of a particular patient, and ideally they should be made during an actual hypnotic session with the patient so that suggestions may be timed in response to the patient's reactions. If the issue of control is important to a patient, it may be worthwhile to have him prepare the tape himself from a script. This sort of tape may lack the profes- sional quality of one made by the therapist and may not be optimally timed, but it has the advantage of requiring a patient who resents being controlled by others to follow no one else's suggestions but his own.
Much of the potential of self-hypnosis or heterohypnosis to benefit a pa- tient may reside in the opportunity it affords him to detach himself from the external world and devote his full attention to a consideration of the positive ideas and suggestions presented. Not only are these ideas focused on in- tensely, but, because of their careful selection in consultation with the ther- apist, they are less likely to be the trivial or negative type of ideation that Barber claims is typical of most people's routine thought processes.
In addition to teaching a patient how to induce self-hypnosis, the therapist must train him or her in the preparation of the suggestions to be employed in this state. In general, these should be carefully thought out and planned by the patient prior to the induction (just as heterosuggestions should) to avoid disruption of the trance state. They should emphasize the benefits being sought rather than the negative aspects of the symptom and should be made with an attitude of belief and expectancy. Self-hypnosis provides more than the opportunity to reinforce suggestions made during heterohypnotic session.