Article archive / November 1, 2014
Originally published: . Volume 5, No. 15. Source pages: 11, 12.
Who’s Writing What? Integrating Clinical Hypnosis and CBT Treating Depression, Anxiety, and Fears
Robin A. Chapman, PsyD, ABPP Springer, 2014
“My initial fascination with hypnosis began as a child watching movies,” explained Dr. Robin Chapman, “I vividly recall Bella Lugosi’s eyes as he mesmerizes others throughout the movie Dracula. I wondered if that could really happen. Like many, my first impressions of hypnosis were based on movies and books.”
Dr. Robin Chapman, PsyD, is a clinical psychologist and Director of Behavioral Health at St. Thomas Community Health Center in New Orleans. Somewhat new to Louisiana, he has been an instructor of psychology in the Department of Psychiatry at Harvard Medical School. He is board certified in cognitive and behavioral psychology by the American Board of Professional Psychology.
Chapman’s early interests in hypnosis stayed with him, and early in his career he attended a beginners’ workshop at the American Society of Clinical Hypnosis. There he linked up with trainer Mark Oster who suggested he develop a model for integrating hypnosis and cognitive behavior therapy (CBT). Chapman took up the challenge.
“I tracked people down who were doing it,” he told the Times. They were not easy to find, he explained, because the field was so young. But eventually he found a group of expert practitioners in both hypnosis and CBT. From this he produced his 2006 edited text, The Clinical Use of Hypnosis and Cognitive Behavioral Therapy: A Practitioners Casebook.
“The first book presented the ‘why,’” Chapman said. He presented the work at conferences, where it was well received, and discovered something else. “I found that people were interested in how to do it, and less interested in the theoretical,” he said. Clinicians needed a practical guide on how to integrate the two modalities, he explained, and this led him to write Integrating Clinical Hypnosis and CBT.
Much smaller and more user friendly this work is more of a manual, he explained. “I had to reduce chapters and also reduce the theoretical parts. It was meant for both audiences, people who had clinical hypnosis background and those with CBT,” he said.
“It was an interesting tight rope to walk. I wanted to be true to CBT, but not totally reliant on it. I wanted to give the hypnosis people enough also,” he said. “Both of these fields have enough within their areas to keep them busy. I’d be with the CBT people who were not interested in clinical hypnosis and then I’d be with those in hypnosis, who were largely from a psychodynamic orientation,” he said. “I had to work to make both groups comfortable with the other and develop a guide for both.
Integrating provides that guide, in a clear, structured, and detailed approach that walks the reader solidly through the practical steps and stages of how these two approaches can be combined to help clients with the specific challenges of depression and anxiety.
The text will be of benefit to both the experienced and the new clinician, designed in workbook style with step-by-step methods and exercises. It is straightforward and easy to use and understand, as well as rich with examples, explanations, exercises, and handouts that can be shared with the client. All this in a compact and easy to digest 135 pages.
Chapman divides the book into three parts, beginning with “Foundations,” and an introductory chapter on “Clinical Hypnosis and Cognitive Behavioral Therapy.” He covers a brief background and how to use the book with conclusions and future direction. He reminds readers that hypnosis has been part of human history for thousands of years with one of the earliest examples found in an Egyptian papyrus over 3000 years old. He also reminds readers that CBT emerges from learning theory and clinical practice, and that initially the behavioral approach relied on observation of behaviors without significant attention to thoughts and feelings.
In Chapter 2 the author discusses common questions that clients have about hypnosis and he outlines information helpful to the therapeutic relationship. He discusses the common concerns of some about whether the hypnotist has power over the person; whether hypnosis is like sleep; if it is related to mysticism or magic; and what is hypnosis. He also outlines CBT, background of classical and operant conditioning, acceptance and commitment approach, and connection to relational frame theory. “It provides a shift from earlier problem-solving of cognitive therapy to mindful appreciation,” Chapman writes.
In Chapter 3 he sets out information useful to the reader about the assessment for integrated treatment. He provides several ways of gathering clinical information linking with subsequent chapters and specific techniques. He covers behavioral assessment, cognitive assessment, mindfulness-based cognitive behavioral assessment, clinical scales, and the assessment of hypnotizability. He points out that practitioners may choose among several assessment models to formulate a case and that this is a critical component of the treatment approach.
Part II is “Cognitive Behavior and Hypnotic Strategies.” In this section Chapman lays out the majority of the methods and techniques, blending the two methods, the clinical picture, and the ways that various techniques can be helpful.
Chapter 4 provides an “Introduction to Mood Check, Relaxation, and Imagery.” Chapman explains the Subjective Units of Discomfort Scale (SUDS) and outlines methods for relaxation training. This is followed by “Cognitive Strategies,” with a review of the Daily Thought Record and how it can be used with hypnosis. He also describes the use of metaphors, and how stories, fairy tales, and analogies are uses for values, and insights.
Chapter 6 and 7 continue with, “Relaxation Training,” including history, applications, and a step-by-step review of progressive muscle relaxation. This leads into a chapter on “Imagery,” and a discussion of the impact of imagery on emotion as well as use of coping imagery.
Suggestion and suggestibility are discussed in Chapter 8, “Suggestion for Change.” Chapman reviews the background about the use of suggestions and hypnosis providing specific examples, which is followed by “Self- Hypnosis and Imagery.” Here he discusses a method or script for self-hypnosis and also employing cognitive strategies.
Part III provides extensive case studies, in “Clinical Cases Integrating CBT and Hypnosis,” and chapters on “Depression Case Study,” “Anxiety (Panic Disorder) Case Study,” and “Anxiety, Fears, and Phobias Case Study.”
Chapman provides ample client handouts used throughout the text and grouped in the appendix. These include informational handouts on Cognitive Behavioral Therapy and Clinical Hypnosis, and on Mood Check. He provides a Mood Monitoring Sheet, Daily Thought Record, Self- Instruction Sheet, handout on Meditation, Progressive Muscle Relaxation Exercise, Relaxation Tracking Form, Imagery Practice Tracking Form, Self-Hypnosis Protocol, and Self-Hypnosis Practice Tracking Form.
He concludes with a chapter on “Thoughts About the Future of Cognitive Behavioral Therapy and Hypnosis,” where he suggests that the third wave of CBT may well begin to include clinical hypnosis.
What was the writing and publishing process like for Dr. Chapman? “On the positive side,” he explained. “I’ve done both these books with Springer.” But his first proposal was rejected and there was a lot of editing from there. “The initial idea was a lot more global and diffuse,” he said but, “While there was some pain, the editor has been very helpful. She really helped refine and delineate the ideas.”
Dr. Chapman said he enjoys the process of writing, even though he often feels his own work to be lacking. If not for deadlines, he might still be working on these two texts, he said.
Dr. Robin Chapman moved to Louisiana a few years ago from Boston. “I always thought I’d return to the South, growing up in Kentucky,” he said. Proximity to family, work, and warmer weather were his reasons to relocate. “And frankly,” he said, “I don’t miss the Boston winters, or getting up 1-1/2 to 2 hours early to shovel snow.”
Integrating Clinical Hypnosis and CBT is available from Springer and also from major booksellers.
Dr. Robin Chapman, author of Integrating Clinical Hypnosis and CBT. He is a clinical psychologist and Director of Behavioral Health at St. Thomas Community Health Center in New Orleans. (Courtesy photo)
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