Successful Repeated Hypnotic Treatment of Warts in the Same Individual: A Case Report

American Journal of Clinical Hypnosis, Apr 2005 by Goldstein, Robert H

Discussion

Several factors are of interest in this case. First, it is noteworthy that the patient was able to achieve rapid regression and disappearance of two separate outbreaks of warts, each of which had been present for at least 6 years. The possibility of spontaneous regression after this extended a course would appear to be quite low since spontaneous regression is generally reported to occur over a shorter period of time (Lynch, 1982). The patient had, in each instance, been receiving conventional medical treatment; in the first instance, for a period of 1 year and, in the second, for 10 months prior to the hypnotic intervention. While the rapid response occurred immediately following the hypnotic intervention, one cannot rule out the possibility of 1) a delayed response to the medical treatment or 2) an interaction between the hypnotic procedure and the medical treatment, which allowed the medical treatment to become more efficacious.

Secondly, on both occasions, the patient appeared to have a low level of belief in the efficacy of the hypnotic intervention. Thus, the hypothesis that "believed in efficacy" plays a central role in hypnotic treatment of warts (Johnson & Barber, 1978) is not supported by this case. It has been reported that high expectancy of successful hypnotic treatment of warts is not necessarily predictive of a positive treatment outcome, but that low expectancy is associated with a negative outcome (Spanos, 1988). In the present case, the patient felt that cognitive factors (i.e., "positive thinking") could be expected to produce beneficial results, but she did not specifically attribute these results to the hypnotic procedure. It is, of course, possible that her belief in the use of "positive thinking" may have played a significant role in the positive results achieved.

Third, although no extensive formal assessment of the patient's level of hypnotic capacity was undertaken, the clinical impression was certainly that, despite her skeptical attitude and her low eye-roll score, she was able to experience an adequate level of trance depth. The reports available on the relationship between hypnotizability and successful treatments yield mixed results. Studies that used nonstandard measures of hypnotizability have found a relationship between hypnotizability and wart loss (Asher, 1956; Sinclair-Gieben & Chalmers, 1959; Ullman & Dudek, 1960 ), while those that have assessed hypnotizability by more rigorous means have not found any such relationship. (Spanos et al., 1988; Surmanetal., 1973).

All the limitations of single case reports are also obviously present in this case, but it could be argued that somewhat greater significance could be attributed to this case because of the unique opportunity to conduct a second and apparently equally successful trial of the hypnotic procedure in the same subject following an interval of 7 years. In that sense, one might consider this to have been an instance of a within-subject repeat measures model of single subject research.