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Vol.
6 No. 2 September 1985
The Use of Hypnosis with Rational Emotive Therapy (Ret)
Allbert Ellis, Ph.D.
Institute
for Rational-Emotive Therapy
New York, U.S.A.
The
International Journal of Eclectic Psychotherapy 3 (2) November 1984
(P.1 5) Reprinted with kind permission.
ABSTRACT
This paper discusses several aspects of rationale and technique
in combining hypnosis with Rational Emotive Therapy. A transcript
of a hypnosis - RET session is given.
DISCUSSION
Rational Emotive Therapy (RE7) is often used in conjunction with
hypnosis and has been shown to work effectively in several controlled
outcome studies (Reardon & Tosi, 1977; Reardon & Gwynne,
1978; Stanton, 1977; Tosi & Marzella, 1977; Tosi & Reardon,
1976.) There are several reasons why RET and hypnosis can be effectively
combined.
1.
Many authorities, such as Barber (1961, 1966), Bernheim, (1886,1947),
and Coué (1921) believe that therapeutic hypnosis itself
largely works through suggestion and mainly consists of giving clients
strong positive statements and inducing them to internalise and
act on these self-statements. RET particularly teaches people how
to dispute and challenge their negative self-statements. (Ellis,
1962, 1971, 1973; Ellis & Whiteley, 1979). But it also stresses
(as do other forms of cognitive behaviour therapy) the use of repeated
and powerful positive or rational coping statements (Ellis &
Abrahams, 1978; Ellis & Becker, 1982; Ellis & Grieger, 1977;
Ellis & Harper, 1975; Griger & Boyd, 1980; Walen, Di Giuseppe
& Wessler, 1980; Wessler & Wessler, 1980).
2.
Autohypnosis and regular hypnosis assume that humans upset themselves
with ideas, images, and other cognitions and that they can be taught
and trained to change these cognitions and thereby significantly
change their feelings and actions (Araoz, 1983). RET strongly posits
and implements this same assumption.
The
International Journal of Eclectic Psychotherapy 3 (2) November 1984
(P.1 5) Reprinted with kind permission.
3.
Hypnosis and RET are both highly active-directive methods and differ
significantly from many other passive and non-directive therapies,
such as psychoanalytic and client-centred therapies.
4.
RET and hypnosis both emphasize homework assignments and in vivo
desensitisation and frequently urge clients to do the things they
are afraid of and to work against their feelings of low frustration
tolerance and their self-defeating addictions.
Because
some of the basic theories and practices of hypnosis and RET significantly
overlap, I have combined RET and hypnosis since the early 1950's;
and one of my first published papers on RET was "Hypnotherapy
with Borderline Psychotics" (Ellis 1958; expanded version,
Ellis, 1962.) At first, I had several sessions with clients with
whom I used hypnosis, so that they could be trained to go into a
moderate or fairly light trance. I noticed, however, that a number
of clients who only achieved light trance states - or states of
deep relaxation but hardly hypnosis - did just as well or better
with the RET I taught them as did clients who achieved deep or "true"
hypnotic trances.
I
therefore created a new hypnotic method which saved me and my clients'
hours of therapy time. Using this method, I put the clients in what
is usually a light hypnotic (or deeply relaxed state), employing
a modified version of Jacobsen's (1938) progressive relaxation technique
which takes only about ten minutes to effect. I follow this with
ten minutes of RET instruction, designed to show the clients that
they have a few specific irrational beliefs (iBs) with which they
are creating some major problems (e.g., anxiety, depression, rage,
or self-downing) and that if they keep actively and strongly disputing
these iBs (as I have previously taught them to do in several non-hypnotic
sessions), they will change their beliefs - and thereby also change
appreciably their self-defeating feelings and behaviours that stem
from and that reinforce these iBs.
The
unique feature of this RET hypnotic procedure is that I often use
it only once, for a single session, to work on a client's main presenting
problem. For I record both the ten minutes of hypnotic-relaxation
induction plus the following ten minutes of RET instruction on a
C-60 cassette and give the cassette to the clients to keep listening
to every day, at least once a day, for the next 30 to 60 days. Using
this method, I only see the clients for a single 30 minute hypnotic
session; but they get 15, 30 or more hour of recorded RET hypnotic
therapy at their own home or office for the next month or two; and
if they actually use this time as I direct them to, they often develop
deeper and deeper trance states, even though during the original
live session they develop only a very light trance - or, as many
of them report, no real trance state at all.
To
illustrate the use of this method, let me report the case of a 33
year old unmarried borderline female who had a 20 year history of
being severely anxious about her school, work, love and sex performances
and who became classically anxious about her anxiety, had a severe
case of phrenophobia, and was sure that she would end up as a bag
lady, without any friends, lovers, or money. Actually she was quite
attractive, could have 10 to 15 orgasms a week when (which was rare)
she felt secure with a love partner, and made a large salary as
a sales manager.
I
had 13 sessions with this severely anxious woman and at times she
used the main message of RET - that you largely feel the way you
think - and notably decreased her feelings of her terror of failing
in love, sex, and business. But a few weeks later she would fall
back again almost to zero and make herself exceptionally upset -
especially about her anxiety itself. After hearing that one of her
friends was helped to stop smoking by hypnotherapy, she asked me
if I used it along with RET and I said I sometimes did but that
I often didn't encourage clients to resort to it because they thought
of it as a form of magic and used it instead of working at the RET.
I
agreed, however, to try it with her and used it once. Here is a
transcript of my first and only hypnotic session with her.
First
loosen your toes and then tense them up. Just tense your toes. Now
relax them. Relax. Relax. Now I'm going to put you through a series
of relaxation exercises like the one you just did with your toes,
but emphasizing the second part - focusing on physical relaxation.
I want you to relax your toes and only focus on relaxing them. Then
relax the rest of the muscles of your feet - all your sole, instep,
heel and ankle muscles. Let all your feet muscles sink into a nice,
easy, free, relaxed state. Relax the soles of your feet, your ankles,
your heels, your whole feet. Just relax, relax, relax, relax.
Then
relax the calves of your legs, let both calves relax - easy, free,
warm, nice and relaxed. Then relax your knees, let your knee muscles
go - nice, free, flexible, warm, relaxed. Then your thighs: Relax
your thigh muscles, focus on those thigh muscles, and relax, relax,
relax them. Relax them, relax them, relax them. Now your hips, let
your middle region, your hips, relax, relax, relax. And now go back
to your toes again and let your toes, your feet, lower legs, your
calves, your knees, your thighs, and your hips, relax, relax, relax.
All of them relax. Let the whole lower part of your body relax,
relax, relax, relax, relax. Now your stomach muscles. Think of you
stomach muscles, focus on your stomach muscles, relax all those
stomach muscles, relax them, let them go easy, nice, warm flexible,
and free.
And
now your chest muscles. Breathe easily - in and out, in and out,
let go, relax your chest muscles, let your whole chest, as well
as your stomach, your legs, and your feet, relax, relax, relax.
Now
your shoulder muscles. Let go your shoulder muscles and relax them.
Let them sink, sink, sink into themselves. Let them sink, sink,
sink into any sofa bed or chair you are resting on. Just let them
go. Let them relax. And now your upper arm muscles, let them go
- easy, warm, free, relaxed. And your elbows, let your elbow muscles
relax, relax, relax. And your forearm muscles - let them go, let
them go. Warm, free, easy, relaxed. And let your wrist muscles relax.
Easy, free, relaxed, flexible, warm. And the muscles of your fingers
and your hand. Let them go flexible, free, nice, warm, easy, relaxed.
Now
your whole body's sinking into a totally, nice relaxed state from
the tip of your toes to your neck. Your shoulders and your arms
are getting more and more and more relaxed. Now focus on your neck
muscles. Let them go. Let those neck muscles, which are sometimes
tense, relax, relax, relax. And now your jaw muscles. Let your mouth
hang slightly open. Let your jaw muscles relax, relax, relax. And
you can even relax your cheek muscles. You can let them go a little,
let them get flabby and relaxed, more than they normally are. And
the muscles of your mouth, your lips - relax, relax them, relax
them, relax them.
And
now the top of your head, your scalp muscles - wrinkle your scalp
a little and let the muscles relax, relax, relax. And especially
your eye muscles, which are now tense. Let those eyes relax, relax.
Easy, free and flexible. You now want to let your eyes close into
a nice, relaxed, easy state. And you focus on letting those eyes
relax, relax. And they're closing. Easy and free, warm and relaxed.
They're getting tired. They want to relax, and you want them to
relax. Along with your whole body, you especially want to let your
eyes relax, let go. They're closing, getting tired, tired and getting
more and more relaxed. And now your eyes are closing and becoming
more and more relaxed. You really feel the relaxation in your eye
muscles. They're closing, closing - becoming more and more relaxed.
You want to go, you want to let yourself go and feel fully calm
and relaxed. You want to sink into a totally, totally relaxed state.
Your
eyes are getting heavier and heavier and you want to let yourself
sink, your trying to let yourself sink, into a deeper, deeper, relaxed
state. You want to let your whole body, especially your eyes, go
deeper and deeper and deeper into a totally free, warm, nice, flexible,
relaxed state. And now youre letting yourself go deeper, deeper,
deeper, deeper. You want to fully relax and get your body out of
your way and go deep, deep, down deeper, down deeper, into a fully,
fully, fully free and easy relaxed state. You're only listening
to the sound of my voice, that's all you're focusing on, that's
all you want to hear - the sound of my voice. And you're going to
do what I tell you to do, because you want to, you want to do it.
You want to stay in this relaxed state and fully aware of my voice
and do what I tell you to do because you want to do it. You want
to stay in this relaxed state and be fully aware of my voice and
do what I tell you to do because you want to do it, you want to
be relaxed. You want to rid yourself of your anxiety and you know
that this will help you relax and listen, relax and listen, go into
a fully free and relaxed state.
You're
focusing only on my voice and you're going to listen carefully to
what I'm telling you. You're going to remember everything I tell
you. And after you awake from this relaxed, hypnotic state, you're
going to feel very good. Because you're going to remember everything
and use what you hear - use it for you. Use it to put away all your
anxiety and all your anxiety about your anxiety. You're going to
remember what I tell you and use it everyday. Whenever you feel
anxious about anything, you're going to remember what I'm telling
you now, in this relaxed state, and you're going to focus fully
on it, concentrate on it very well, and do exactly what we're talking
about - relax and get rid of your anxiety, relax and get rid of
your anxiety.
Whenever you get anxious about anything, you're going to realise
that the reason you're anxious is because you are saying to yourself,
telling yourself, I must succeed! I must succeed! I must do this,
or I must not do that." You will clearly see and fully accept
that your anxiety comes from your self-statement. It doesn't come
from without. It doesn't come from other people. You make yourself
anxious, by demanding that something must go well or must not exist.
it's your demand that makes you anxious. It's always you and your
self-talk; and therefore you control it, and you can change it.
You're
going to realise, I make myself anxious. I don't have to keep making
myself anxious, if I give up my demands, my musts, my shoulds, my
oughts. If I really accept what is, accept things the way they are,
then I won't be anxious. I can always make myself unanxious by giving
up my musts, by relaxing - by wanting and wishing for things, but
not needing, not insisting, not demanding, not musturbating about
them."
You're
going to keep telling yourself, I can ask for things, I can wish.
But I do not need what I want, I never need what I want. There is
nothing I must have; and there is nothing I must avoid, including
my anxiety. I'd like to get rid of this anxiety, I can get rid of
it. But if I tell myself, 'I must not be anxious! I must be unanxious!'
then I'll be anxious.
"Nothing
will kill me. Anxiety won't kill me. Lack of sex won't kill me.
There are lots of unpleasant things in the world, that I don't like,
but I can stand them. I don't have to get rid of them. If I'm anxious,
I'm anxious too damn bad! Because I control my emotional destiny
- as long as I don't feel as I have to succeed at anything. That's
what destroys me the idea that I have to be sexy or I have to succeed
at sex. Or that I have to get rid of my anxiety." In your regular
life, after listening to this tape regularly, you're going to think
and to keep thinking these things. Whenever you're anxious, you'll
look at what you're doing to make yourself anxious, and you'll give
up your demands, and your musts. You'll dispute your ideas that
I must do well! I must get people to like me! They must not criticise
me. It's terrible, when they criticise me!" You'll keep asking
yourself, why must I do well? Why do I have to be a great sex partner?
It would be nice if people liked me, but they don't have to. I do
not need their approval. If they criticise me, if they blame me,
or they think I'm too sexy or too little sexy, too damn bad. I do
not need their approval. I'd like it but I don't need it. I'd also
like to be unanxious but there's no reason why I must be. Yes there's
no reason why I must be. It's just preferable. None of these things
I fail at are going to kill me.
"And
when I die, as I eventually will, so I die! Death is not horrible.
It's a state of no feeling. It's exactly the same state as I was
in before I was born. I won't feel anything. So I certainly need
not be afraid of that!
"And
even if I get very anxious and go crazy, that too isn't terrible.
If I tell myself, 'I must not go crazy! I must not go crazy!' then
I'll make myself crazy. But even if I'm crazy, so I'm crazy! I can
live with it even if I'm in a mental hospital. I can live and not
depress myself about it. Nothing is terrible - even when people
don't like me, even when I'm acting stupidly, even when I'm very
anxious! Nothing is terrible! I can stand it. It's only a pain in
the ass!"
Now
this is what you're going to think in your everyday life. Whenever
you get anxious about anything, you're going to see what you're
anxious about, you're going to realise that you are demanding something,
saying, It must be so! I must get well! I must not do the
wrong thing! I must not be anxious!" And you're going to stop
and say, "You know, I don't need that nonsense. If these happen,
they happen. Its not the end of the world! I'd like to be
unanxious, I'd like to get along with people, I'd like to have good
sex. But if I don't, I don't! Tough! It's not the end of everything.
I can always be a happy human in spite of failures and hassles.
If I don't demand, if I don't insist, if I don't say, 'I must, I
must!' Musts are crazy. My desires are all right. But, again, I
don't need what I want!" Now this is what you're going to keep
working at in your everyday life.
You're
going to keep using your head, your thinking ability, to focus,
to concentrate on ridding yourself of your anxiety - just as you're
listening and concentrating right now. Your concentration will get
better and better. You're going to be more and more in control of
your thoughts and feelings. You will keep realising that you create
your anxiety, you make yourself upset, and you don't have to, you
never have to keep doing so. You can always give your anxiety up.
You can always change. You can always relax, and relax, and relax,
and not take anyone, and not take anything too seriously.
This
is what you're going to remember and work at when you get out of
this relaxed state. This idea is what you're going to take with
you all day, everyday: I control me. I don't have to upset myself
about anything. If I do upset myself, too bad. I may feel upset
for a while but it won't ruin my life or kill me. And I can be anxious
without putting myself down, without saying, 'I must not be anxious!'
At times I will make myself anxious, but I can give up my anxiety
if I don't demand that I be unanxious."
And
you're going to get better and better about thinking this rational
way. You'll become more in control of you. Never totally in control
because nobody ever is totally unanxious. But you'll make yourself
much less anxious and be able to live with it when you are anxious.
And if you live with it, it will go away. Nothing is terrible, not
even anxiety. That's what you're going to realise and to keep thinking
about until you really, really believe it.
Now
you feel nice and free and warm and fully relaxed. In a few minutes
I'm going to tell you to come out of this relaxed, hypnotic state.
You will then have a good day. You will feel fine when you come
out of this state. You will experience no ill effects of the hypnosis.
You will remember everything I just said to you and you will keep
working at using it. And you will play this tape every day for the
next 30 days. You will listen to it every day until you really believe
it and follow it. Eventually you will be able to follow its directions
and to think your way out of anxiety and out of anxiety about being
anxious without the tape.
You
will then be able to release yourself from anxiety by yourself.
You can always relax and use the anti-anxiety technique you will
learn by listening to the tape. You can always accept yourself with
your anxiety and can stop telling yourself, I must not be anxious!
I must not be anxious!" Just tell yourself, I don't like anxiety,
I'll work or give it up. I'll conquer it. I'll control myself, control
my own emotional destiny. I can always relax, make myself feel easy
and free and nice, just as I feel now, get away from cares for awhile
and then feel unanxious. But I can more elegantly accept myself
first with my anxiety, stop fighting it desperately, and stop telling
myself it's awful to be anxious. Then I can go back to the original
anxiety and get rid of it by refusing to awfulize about failing
and vigorously disputing my irrational beliefs, 'I must do well!
I must not be disapproved.
Now
you feel good, you feel relaxed, and in a couple of minutes, I'm
going to count to three and when I count to three you will awaken
and feel quite alive, have a good day, and experience no bad effects,
no headaches, no physical discomfort! Everything is going to be
fine and you'll have a good day. You will remember all this and,
as I said, you will listen to this tape whenever you possibly can,
at least once a day. And you will think and act more and more on
its message. You'll be able to control yourself and reduce your
anxiety appreciably. And when you do feel anxious you'll live with
the anxiety, accept it, and refuse to panic yourself about it. All
right, I'm going to count till three and when I say three, you'll
wake and be fully alive and alert and feel great for the rest of
the day. One, two, three!
My
client used the recording of her hypnotic RET session once or twice
a day for the next 45 days and reported a significant decrease in
her anxiety level, and especially in her anxiety about her anxiety.
She stopped being phrenophobic, convinced herself that if she had
a breakdown and went to the mental hospital it would be highly inconvenient
but not horrible or shameful, and then hardly thought at all about
going crazy. When she did, she was able to feel comfortable within
a few minutes by strongly telling herself, "So I'll be crazy.
Tough! I'm sure I won't stay that way very long - and if I do, that
will just be tougher. But not shameful! No matter how crazy I am,
I'll never be a turd for being that way!"
As
she began to get over her anxiety about her anxiety, this woman's
enormous fears of failure, particularly of sex failure, for awhile
almost completely disappeared. When, weeks later, they reappeared,
they were relatively light and she was almost invariably able to
cope successfully with them. She continued in RET nonhypnotic treatment
for 14 months more, but only had 18 half-hour sessions during that
time. For the last 11 years she has maintained her gains, with occasional
moderate setbacks when a love affair ended, and is now happily married
and unanxiously highly productive. She once in a while still listens
to the original hypnotic tape and believes it was quite instrumental
in helping her make much greater progress than she had previously
made in RET.
I
tend to agree with her, partly because I have used similar taped
sessions to good avail with about 80 other clients (although with
little or no success with 18 others). One important question I have
not yet resolved is: Does the benefit presumably derived from this
type of recorded hypnotic sessions stem from the use of the entire
20 minute tape, including the hypnotic-relaxation instructions,
or would equal benefit stem from the client's listening a number
of times to the 10 minutes of RET instruction on the tape even if
this were heard apart from the hypnotic session? I have tried to
induce several researchers to do a controlled study of this question,
but so far no one, to my knowledge, has done so. I still hope that
this experiment will be done one day. Until then, I shall continue
to use this recorded hypnosis-RET procedure with some amount of
faith in the clinical results I have thus far achieved with it.
REFERENCES
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guide to rational emotive therapy. New York: Oxford.
Wessler, R. A. & Wessler, R. L. (1980) The theory and
practice of rational emotive therapy. San Francisco: Jossey-Bass.
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