Editorial

American Journal of Clinical Hypnosis,  Oct 2004  

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Assessing Hypnotizability for case Reports

During the 20 years since I started editing the Journal I have frequently discussed the issue of assessing hypnotizability in the clinical setting, particularly for case reports. Shortly after I reviewed the Spiegel's recent second edition of Trance and Treatment (2004) for this issue of the Journal, I was reviewing a submitted case report. In describing the first interview with the patient, the author mentioned that in the first interview he did a first induction. He then commented that he did not assess hypnotizability because the patient was eager to get ahead with the treatment. If he really wanted to assess hypnotizability, he could have used the Hypnotic Induction Profile (HIP) described in the Spiegel's book as the first induction.

I assume that many clinicians do not consider the possibility of using the HIP as their first induction because in their training it was never taught or considered as a first induction. I was fortunate to have attended Herbert Spiegel's course early in my training in hypnosis, and for the next (and last) 30 years of my practice I always used the HIP as the initial induction. In the many hypnosis courses I taught over the years at the University of Maryland Medical School, I always taught the HIP, as well as several other inductions.

Most, but not all, of the clinical research now being done includes assessing hypnotizability by some method. case reports, on the other hand, rarely include any assessment of hypnotizability. The most that is ever said is that the patient was a "good" hypnotic subject or some similar statement. In the guidelines for writing case reports (1986) I wrote, "To aid in determining the effective factor in therapy using hypnosis, data collection should include some assessment of hypnotizability. This is especially important because hypnosis may not be present even though an induction has been performed." Unfortunately, many, if not most, clinicians do not assess hypnotizability routinely. Then if they find an interesting and instructive case that they want to publish, they do not have the information available. Although I believe there are many good reasons for clinicians to assess hypnotizability routinely, my major point here is that it enhances a case report when the information is available.

I think it would also be useful to have this information when discussing patients in workshops. Often there is no mention or instruction in assessing hypnotizability in clinical workshops or courses in hypnosis. This leaves the students with the impression that assessing hypnotizability is not important. It is my opinion that every basic workshop should teach the clinical assessment of hypnotizability by some method. Most of the reasons many clinician do not assess hypnotizability do not seem to apply to the nonobtrusive clinical assessment tools such as the HIP and the Pekala's PCI/HAP (1995).

References

Mott, T. (1986) Guidelines for writing case reports for the hypnosis literature. American Journal of Clinical Hypnosis, 29, 1-6.

Pekala, R.J. (1995). A short unobtrusive hypnotic induction for assessing hypnotizability level: I. Development and research. American Journal of Clinical Hypnosis, 37, 271-283.

Spiegel, H. & Spiegel, D. (2004). Trance and treatment: Clinical uses of hypnosis (2nd Edition). Washington, DC: American Psychiatric Publishing.

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