Role of Behavior Therapy Theories in Clinical Hypnosis - Essay Example

? Evaluate the Role That Behaviour Therapy Theories Have To Play In Clinical Hypnosis By of [Word Count] Introduction The general slow response to various types of clinical and non-clinical therapies offered by medical professionals among patients led to the mergence and spread of cognitive and behavioural hypnotherapies, which emphasis unconscious and patient-focused change (Cullen & Doran, 2006). In clinical hypnotherapy, the expected outcomes are mainly changes in patients’ responses to treatment, their attitudes, behaviours, thoughts and feelings. Behavioural therapies are often implemented for subjects in hypnosis, a situation in which a patient’s psychological state and features are seemingly similar to sleep. In addition, such a condition is characterised by an individual’s functioning at consciousness levels appearing lower than in ordinary states of wakefulness. In a hypnotised person, there is a noticeable increased propensity to suggestibility and sensitivity (Sundberg, 2001). To effectively treat and manage hypnosis in clinical settings, a therapy called cognitive behavioural hypnotherapy (CBH), which incorporates psychological therapies that use clinical hypnosis and cognitive behavioural therapy (CBT) is often used (Hofmann, 2011). Evidences show that a combination of CBT and hypnotherapy is a rather effective treatment for unwanted behaviours and anxiety or psychological disorders. The effectiveness of this combined approach stems from the fact that hypnotism is caused by psychological factors such as motivations, appropriate attitudes, active imagination and expectations (Jacobson et al., 2001). Consequent to this notion of hypnotism, the phrase "cognitive-behavioral" has been extensively used to define and describe the non-state nature of hypnotism (Boyle, 2006). Further, because of its non-state characteristic, the applicability and importance of various theories of behavior therapy theories has been largely studied. This paper explores and evaluates the role that behaviour therapy theories play in clinical hypnosis with specific reference to CBT theories such as classical and operant conditioning, extinction, desensitisation, reciprocal inhibition, and learning theories. The Role of Behaviuor Therapy Theories in Clinical Hypnosis Recent times have seen a rapid rise in the use of behavioural psychological theories and concepts in clinical hypnosis. This expanded application of behavioural therapies and theories in clinical hypnosis has made the closer integration of hypnotherapy with various cognitive and behavioral therapies rather easy (Flora, 2007). According to most of the behavioural therapy theories, psychological illnesses are caused by maladaptive learning and certain symptoms of psychological illness are not indications of a single primary disease. What is more, behaviorism theories postulate that people learn their behaviours and attitudes from their surrounding with the classical and the operant conditioning leading to the acquisition of most symptoms of psychological disorders (Martin & Pear, 2007). While classical conditioning refers to the learning achieved via association, operant conditioning theory asserts that learning is achieved through reinforcement such as punishment and rewards (Corrigan, 1997). Whereas classical conditioning has been used to explain most cases of phobias, operant conditioning is believed to cause abnormal behaviours such as eating disorders. The argument proposed by these behavioural therapy theories is that once a feeling, attitude, thought and behaviour is learnt, it can be unlearned by undoing the process or circumstances that caused it (Krijin, 2004). As mentioned above, according to the classical conditioning theory, faulty learning or conditioning from one’s environment results in abnormal or unwanted behaviours. Thus, in clinical hypnosis, the classical conditioning plays the role of conditioning a patient to learn the correct and acceptable feelings, thoughts and behaviours (Davison & Neale, 2001). Like the other theories, the classical conditioning theory of behaviour therapy centers on the immediate problems and behaviours of a patient (Block & Wulfert, 2000). It also focuses on attempts to eliminate or reduce the signs and symptoms of unwanted behaviours and anxieties. This feature of behavioural therapy contradicts with that of psychodynamic therapy, which focuses on identifying unresolved conflicts from a person’s past, especially childhood. The classical conditioning theory also postulates that all emotional traits and responses of an individual are patterns of one’s responses to environmental stimulus or different learning experiences (Block & Wulfert, 2000). Through this theory, a clinician can teach their clients new and positive behaviours by way of association. There are three critical phases of classical conditioning –based hypnotherapy: before conditioning, during and after conditioning (Wong, 2006). The BT theory of operant, also known as instrumental conditioning was first described by Psychologist B. F. Skinner. In clinical hypnosis, this theory can be used to reward patients. However, it is important that the link between the reward or punishment and the behaviour sought or achieved is quite clear to the patient (McLeod, 2008). Like the other BT theories, the operant conditioning theory believes in the influence of the external and observable factors on human behaviour, attitudes, feelings and thoughts. Besides classical and operant conditioning, the other behaviour therapy theories are systematic desensitisation, aversion therapy, extinction, reciprocal inhibition and learning theories. The other theory of behavioural therapy, the systematic desensitisation theory, is an approach to clinical hypnosis that is based on the fundamentals of the classical conditioning theory (Klein, 1999). Developed in the 1950s, this theory is used in clinical hypnosis to eliminate or reduce fear responses and various types of phobias in patients. In place of fear, the therapy places relaxation responses to the stimuli that cause fear (Cautilli, 2005). In the end, there is a gradual countering of the fearful condition as a patient relaxes. For instance, if a patient fears insects such as wasp or spider, a hierarchy of fear is formed by exposing the patient to the stimulus, from the least fearful to the most fearful scenario. As a patient is exposed to the least fearful stimulus first, he or she practices relaxation techniques until he or she is exposed to the most unpleasant stimulus (Axelrod & Hineline, 2006). Finally, a patient becomes comfortable in the presence of all the fearful stimuli. Thus, the main role of the desensitisation theory is its creation of deep relaxation, which is relatively important in clinical hypnosis. There is also reduced anxiety, making it possible to implement other therapies. Armed with adequate relaxation techniques, a patient has better control of his or her breathing and reduced muscle tension. The other behavioural theory important in clinical hypnosis is the reciprocal inhibition theory, which helps in the realisation of the desired behavioral response in clinical hypnosis. Just like the disensitisation theory, the reciprocal inhibition theory seeks to achieve the desired behaviour, feeling or attitude by exposing a patient to the stimulus that causes fear or phobia such as scary or dangerous animals (Hazlette-Stevens, 2000). The core postulate of this theory and therapy is the positive relaxation effect of sufficient and repeated exposure to stimuli- the unlearning of an old and undesirable conduct or feeling in a patient (Wolpe, 1998). Roles of Behaviour Therapy Theories in Clinical Hypnosis From the principles and functioning of the discussed BT theories, it is evident that they could be really useful in clinical hypnosis. First, these theories offer well defined and thorough techniques for reinforcing favourable behaviours for clinical work (Corey, 2001). Second, BT theories are practical and evidence-based hence useful in evidence-based clinical work. In other words, they are driven by and based on data. Furthermore, BT theories and practices are relevant to the immediate clinical and environmental contexts. Third, BT theories are functional since they focus on positive behavioural consequences (Smith et al., 2004). BT theories also enable clinicians to statistically predict the behaviour of a patient since the techniques are probabilistic (Kanter et al., 2005). Since these theories assess and analyse bi- and multi-directional interactions in patients, they are relational in nature. In the interest and for the benefit of clinical hypnosis, behaviour therapies and theories help modify a patient’s abnormal feelings, thought and behaviours and further helps clinical hypnotherapists to set specific and achievable goals besides multiplying a patient’s response skills and capacity (Hazlette-Stevens, 2000). Further, BT promotes self-management, and builds self-determination in patients. Among the situations in which BT theories have been extensively useful in clinical hypnosis are pregnancy, childbirth to prepare mothers for childbirth and to help reduce the anxiety, discomfort and pain associated with child birth. The other area in which BT theories have been used in clinical hypnosis is in treating bulimia nervosa and in placebo trials. The roles of BT theories can best be studied under the roles and responsibilities of behaviour therapists. The first among these roles is the systematic assessment of clients by behaviour therapists (Parker, 2002). Second, behaviour therapists identify clients’ problems in collaboration with patients and their families. Most importantly, they help create the desired behaviours and attitudes in clients and setting of goals (Kramer et al., 2009). Finally, behaviour therapists assess the effectiveness of the behaviour therapies used and implement modifications if needed. These roles notwithstanding, the most obvious role of BT theories is in the treatment of mental disorders such as depression, panic disorders, generalised anxiety disorder, obsessive-compulsive disorder, eating disorders, hypochondriasis, personality disorder, ADHD, and OCD (Holmes, 2003). BT theories also offer exposure and prevention procedural techniques for clinical hypnosis for patients of anxiety, anger, grieving, fear and phobia disorders. BT also plays a role in shaping and grading tasks and assignments that are used to address suicidal and depression problems (Hopko & Lejuez, 2006). Conclusion For quite some time, cognitive and behavioural therapies have been used in clinical hypnosis with reports indicating better or equal effectiveness to that of medical treatment for psychiatric conditions. However, it is the Behavioural Therapies (BT) that has proved rather effective and useful for managing and treating psychological disorders. There are several theories of and approaches to BT therapies that have been extensively applied in clinical settings. These theories explain anxiety and unwanted behaviours in people on the basis of environmental factors, rather than on mind and consciousness. Examples of the BT theories are classical and operant conditioning, extinction, desensitisation, reciprocal inhibition, and learning theories. These BT theories play several roles in clinical hypnosis. Mainly, they help in the treatment and management of psychiatric conditions such as PTSD, personality disorder, ADHD, OCD, depression and panic disorders. In addition to the above functions, BT induces a hypnotic state in patients, thus increasingly motivating them to change behaviour patterns via hypnosis. BT also promotes consultation between therapists and clients to determine the nature and severity of psychiatric problems. 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