Hypno-Therapeutische Kommunikation: Kernelement einer auf Resonanz basierten Medizin ("Resonance Based Medicine") in: Hypnose-ZHH, 12: 173-202 (2017)
Hypno-Therapeutic Communication: Core element of a Resonance Based Medicine
Summary: Interactions between health care professionals and their patients should focus on carefully-chosen goals and appropriate means to achieve those goals. Arguments for or against particular diagnostic and therapeutic measures will need to be continuously evaluated. In this respect not only objective findings but also discussions as well as personal assessments can prove decisive. An atmosphere of reciprocal resonance between the caregiver and the careseeker creates the optimal conditions for the application of professional expertise. System-theoretical theses regarding the regulation within complex, self-referential systems – and among such systems – can serve as a map that offers orientation in an unknown territory. Therapeutic communication is an exchange that focuses on the potential benefits it can yield for the stated goal. Here, a posture of confident expectation will prove constructive and effective. This quality of intersubjective resonance has proven itself helpful and effective in both counseling and psychotherapy, as well as in medicine. Moreover, using hypnosis and self-hypnosis demonstrates that trance phenomena can also be utilized as resources (Milton H. Erikson) within the context of an adequate complete therapeutic concept.
„Resonance Based Medicine“(RBM) is a concept that refers to the fundamental significance of intersubjective resonance for all interactions in the service of health. It is a proposal that invokes the scientific application of an analogy to physical resonance as encountered in disciplines such as systemic theory, psychology, philosophy and sociology. „Resonance Based Medicine“ is an understanding of medicine that treats intersubjective communication and relationship as the basis of all diagnostic consideration and therapeutic action. The onomatopoeic similarity to „Evidence Based Medicine“ (EBM), the scientific gold standard today, is intentional. Both concepts, EBM and RBM, can and should complement each other. Viewed from the perspective of interventions the cause and effect relationship (pathogenesis) requires a perspective on interrelation that features resources and growth potential in order to call upon the inherent possibilities of the individual (salutogenesis). Both aspects are characteristic for a clinical medicine in which patient-centered communication is practiced. Both must be unconditionally respected in the face of chronic illness with its complex structure of objective and subjective factors. The professional challenge of fostering an atmosphere of growth for the patient is particular valid for the relationship between physician and patient; hypnotherapeutic communication emanates from an attentiveness and receptivity that makes it a particularly suitable core element here.
Keywords: resonance, Resonance Based Medicine (RBM), Evidence Based Medicine (EBM), intersubjective resonance, patient centered communication, therapeutic communication, hypnotherapeutic communication, biopsychosocial approach, salutogenesis
„Resonanz" - Bei langjährig chronifizierten Schmerzen braucht es einen Wechsel der Perspektive. Ein Fallbericht in: Hypnose-ZHH, 11: 233-245 (2016)
„Resonance“. With long lasting chronic pain a change of perspectives is needed – Case Report.
Summary: Over a period of 10 years Mr. K. (64 yrs.) has tried to “fight” his pain (goal of avoidance). This fight has lead him deeper and deeper into a feedback loop of pain, resignation and depression: Inspite of high-dosed medication his attention focused continuously on pain as the sole explanation for his suffering. Through intense cooperation of both “experts” – Mr. K. as an expert for his experience of being ill and the author as an expert for the treatment of chronic pain (illness) – decisive changes could be achieved. Multiple experiences of self efficacy in different realms (attainable, rewarding goals) enabled Mr. K. to reorganize his focus of attention on progressing (progress?) step by step instead on continuous failing (failure?). Over a period of 2 years, altogether 35 sessions (some of them together with Mrs. K.), a change of perspectives – away from pain to aiming at a better quality of life – was successfully realized by means of a therapeutic concept based on systemic approaches. “Intersubjective resonance” opened up rooms for change. Interpersonal interactions were shaped by “therapeutic communication”.
Keywords: resonance, chronic pain, therapeutic communication, resources, self efficacy, solution orientation, “resonance based medicine”
Hypnose und Selbsthypnose als wesentliche Elemente der therapeutischen Kommunikation mit chronisch Kranken in: Hypnose-ZHH, 5: 199-216
Hypnosis and self-hypnosis as key-elements of therapeutic communication with the cronically ill
Summary: Major theme: Utilizing hypnosis techniques, hypnotic phenomena, and self hypnosis for treatment of the chronically ill requires an intensive subjective exchange over a period of time. Patient and therapist embark as traveling companions on a journey together through uncharted territory. Development of the theme: This journey of mutual experience and learning cannot be substituted by mere suggestion. Therapeutic communication focuses on the promotion
of change, self-efficacy and coping strategies by drawing on the intrinsic resources of the patient. Author’s point of view: Within this treatment context the patients are enrolled as coplanners and decision makers. Their active participation in determining treatment steps is of the utmost necessity, simply because all the information necessary is carried within the pa -
tients themselves. Even though it cannot be foreseen whether the ensuing changes in the patient's experience will be decisive or not, there are indeed reasons to proceed with optimism (case examples). Conclusions: Hypnosis and self hypnosis are invaluable tools for dealing with symptoms of chronic illness (e.g. pain), as well as diverse psychological issues (e.g. helplessness) - furthermore (in the frame of psychotherapeutic approaches) to access the individual code of life experiences and conflicts. The patient alone has the capacity to decipher his or her own code, reformulate it or create a new one.
Keywords: Hypnosis, Self hypnosis, chronical illness, coping, therapeutic communication
Why therapeutic hypnosis? A conversation between Mark P. Jensen and Hansjörg Ebell
Ebell, H., Jensen, M.P., in: Contemporary Hypnosis, 27(2): 137-147 (2010)
This article summarizes the key points of a conversation between Mark P. Jensen and Hansjörg Ebell, M.D., in which Dr. Ebell discussed his views of hypnosis and what he has learned to be most important and most effective as a clinician using hypnosis in his practice. His practice focuses on individuals seeking psychotherapy who also have significant medical illnesses. He finds it essential for effective hypnosis to be sure that the patient is the focus of attention in an intersubjective exchange in the context of a therapeutic relationship. To help facilitate the benefits of this, Dr. Ebell observes the patient very closely, while both following and leading the patient through the steps of therapy. Dr. Ebell believes that it is important to also maintain the patient’s (and his own) curiosity – curiosity about how things will change and get better. He believes that true change primarily comes from inside the patient, so he begins therapy by enlisting the patient’s help. He has found that significant change and healing can occur spontaneously and sometimes very quickly, so he seeks to facilitate this when possible. The article ends with an illustration of how he works - utilizing ideomotor signaling as major technique - with a case history of a patient with contracture due to Complex Regional Pain Syndrome Type I after elbow fracture.
The Therapist as a Travelling Companion to the chronically Ill: Hypnosis and Cancer related Symptoms in: Contemporary Hypnosis, 25(1): 46-56 (2008)
Summary: The complex interaction of pain, other symptoms and suffering in cancer patients requires a treatment approach that integrates psychological as well as pharmacological interventions. The supplementation of a pharmacological pain treatment concept based on WHO-guidelines by the use of self hypnosis was examined in a controlled clinical follow up study: 61 of 342 patients with cancer related pain referred to the Interdisciplinary Pain Unit of Munich University Clinic were included. In a cross-over design they were randomly assigned to two different successions of treatments after a 2-week period of establishing optimal medication: either AB (‚A‘/using self hypnosis and analgesics, followed by ‚B‘/pharmacological treatment alone, 4 weeks each) or BA (‚B’ continuing pharmacological treatment alone and then ‚A‘/using additional self hypnosis). Patients themselves evaluated therapeutic effectiveness with the help of visual analogue scales (VAS) in a ‚pain diary‘ for a total of 10 weeks. On account of a carryover-effect caused by the beneficial effects of self-hypnosis the ‘cross-over’ did not show statistical significance. Using a parallel design we found a statistically significant reduction of pain and suffering after the first 4 weeks for treatment A (with self hypnosis) in comparison to treatment B (without self hypnosis). The utilization of hypnosis requires an intensive subjective exchange over a period of time between the patient and the therapist, who embark as travelling companions on a journey through uncharted territory. Three case reports serve as an example for three different ‘time windows’ of this travelling companionship of therapists and patients: short term / crisis intervention, cooperation for several weeks / coping enhancement, and long term / psychotherapy.
Key words: self-hypnosis, hypnotherapy, pain, cancer, controlled trial
Hypnosis and Cancer Pain: Ericksonian Approach Versus Standardized Suggestibility Testing in: Ericksonian Monographs Number 10 (“Difficult Contexts for Therapy”), Lankton, S.R. & Zeig, J.K. (Eds.), Brunner/Mazel Publishers New York: 1-8 (1995)
Summary: Pharmacological treatment based on WHO-guidelines is standard treatment for the symptomatic relief of cancer pain. Hypnosis can supplement reduction of pain and suffering by tapping individual coping resources. A topical overview of pertinent publications is augmented by the presentation of data concerning a controlled clinical study at Munich University Clinic. The relationship between an Ericksonian approach (audiotaped standardized induction, person to person instructions) and standardized suggestibility testing (Stanford Hypnotic Clinical Scale/Adults) will be discussed.
Ebell, H., Beyer, A. Pain Management in Cancer Patients. Jehn, U., Berghof, H. (Eds.) Supportive Measures in Oncology. Georg Thieme Verlag, Stuttgart New York (1995)
Can Hypnosis Play a Part in a Diversified, Comprehensive Therapeutic Concept for the Treatment of Cancer Related Pain in: “Hypnosis: 175 Years after Mesmer - Recent Develop-ments in Theory and Application”, Bongartz, W. (Ed.). Universitätsverlag Konstanz: 393-95 (1992)
Summary: A longitudinal research design of single case studies employing time series analysis could be a promising approach in the research of chronic pain syndromes, and cancer pain in particular. Wether or not group statistical evaluation substantiates, in 1991, the efficiency of self-hypnosis as we have applied it in our prospective, randomized, cross-over study, clinical experience has already convinced us that it is a valuable tool.
Key words: cancer pain, hypnotherapy, self hypnosis, pain diary, taped instructions.