Book Review: Clinical Applications of Hypnosis

George Gafner works in Arizona teaching both hypnosis and family therapy and has written a number of other well received books in the field of hypnosis, most notably the 'Handbook of Hypnotic Inductions' and 'Hypnotic Techniques.' This further volume focuses more explicitly on typical clinical uses of hypnosis.

The book is divided into three parts: (i) principles of unconsciously directed psychotherapy; (ii) general techniques for the practitioner and (iii) treatment approaches to common clinical problems. There are also five appendices outlining more of Gafner's case material and treatment sessions.

Part one of the book outlines the model of hypnotic understanding presented in the book. Essentially Eriksonian in nature, the focus is on accessing the unconscious through the use of metaphor and suggestion and how the elliptical nature of language is used to create a change in the client. Gafner calls this 'perturbation' and sees this 'stirring up' as a necessary element of change. Differing however from some traditional schools of psychotherapy, Gafner argues that perturbation occurs most usefully after some form of ego strengthening. Thus, Gafner wants to build on solid foundations, rather than knocking down what exists in order to build again. Whether this model can effectively break through our neurotic defences or coexist alongside them requires further exploration.

Part two of the book is an overview of the practical considerations needed for hypnotic work. Although this will be of less use to practitioners already using hypnosis, it does contain an extremely interesting chapter on the neglected topic of the hypnotic voice. Gafner states 'In trance the client may communicate verbally or nonverbally, but the therapist communicates only with her voice. Hypnotic language and key suggestions drive hypnosis, but that vehicle goes nowhere without a good voice.' What, though, is a good hypnotic voice? Gafner suggests that it is one that will have less pitch and volume and be melodic and smooth, this to me sounds very much like the poetic voice. As such, it is something that has to be developed and worked on and Gafner is clear that the voice is an instrument that needs to be practiced: few are automatically gifted.

Part three focuses on three common clinical problems, anxiety; depression and gastrointestinal disorders. Hypnosis is recognised as an adjunctive procedure that clinically enhances outcomes for other validated therapies, most notably CBT. The three chapters, although brief, do give some idea as to how typical sessions may be undertaken with clients. They would not, however, be a sufficient guide for such work. This perhaps highlights the main problem with the book. Even though it is very readable, I am not sure who the intended audience really is. As a clinical psychologist who has undertaken further training in hypnosis I found it hard to disagree with and it reminded me of a number of things I had forgotten. However, without this background I think I would have found the coverage of each area too brief. The wider audience for this book, therefore, may be those who are interested in an overview of hypnosis both in theory and practice prior to undertaking further training themselves.

R G Hill