Vol6no2

Vol. 6 No. 2 September 1985
The Use of Hypnosis with Rational Emotive Therapy (Ret)
Allbert Ellis, Ph.D.
Institute for Rational-Emotive Therapy
New York, U.S.A.

The International Journal of Eclectic Psychotherapy 3 (2) November 1984 (P.1 5) Reprinted with kind permission.

ABSTRACT
This paper discusses several aspects of rationale and technique in combining hypnosis with Rational Emotive Therapy. A transcript of a hypnosis - RET session is given.

DISCUSSION
Rational Emotive Therapy (RE7) is often used in conjunction with hypnosis and has been shown to work effectively in several controlled outcome studies (Reardon & Tosi, 1977; Reardon & Gwynne, 1978; Stanton, 1977; Tosi & Marzella, 1977; Tosi & Reardon, 1976.) There are several reasons why RET and hypnosis can be effectively combined.

1. Many authorities, such as Barber (1961, 1966), Bernheim, (1886,1947), and Coué (1921) believe that therapeutic hypnosis itself largely works through suggestion and mainly consists of giving clients strong positive statements and inducing them to internalise and act on these self-statements. RET particularly teaches people how to dispute and challenge their negative self-statements. (Ellis, 1962, 1971, 1973; Ellis & Whiteley, 1979). But it also stresses (as do other forms of cognitive behaviour therapy) the use of repeated and powerful positive or rational coping statements (Ellis & Abrahams, 1978; Ellis & Becker, 1982; Ellis & Grieger, 1977; Ellis & Harper, 1975; Griger & Boyd, 1980; Walen, Di Giuseppe & Wessler, 1980; Wessler & Wessler, 1980).

2. Autohypnosis and regular hypnosis assume that humans upset themselves with ideas, images, and other cognitions and that they can be taught and trained to change these cognitions and thereby significantly change their feelings and actions (Araoz, 1983). RET strongly posits and implements this same assumption.

The International Journal of Eclectic Psychotherapy 3 (2) November 1984 (P.1 5) Reprinted with kind permission.

3. Hypnosis and RET are both highly active-directive methods and differ significantly from many other passive and non-directive therapies, such as psychoanalytic and client-centred therapies.

4. RET and hypnosis both emphasize homework assignments and in vivo desensitisation and frequently urge clients to do the things they are afraid of and to work against their feelings of low frustration tolerance and their self-defeating addictions.

Because some of the basic theories and practices of hypnosis and RET significantly overlap, I have combined RET and hypnosis since the early 1950's; and one of my first published papers on RET was "Hypnotherapy with Borderline Psychotics" (Ellis 1958; expanded version, Ellis, 1962.) At first, I had several sessions with clients with whom I used hypnosis, so that they could be trained to go into a moderate or fairly light trance. I noticed, however, that a number of clients who only achieved light trance states - or states of deep relaxation but hardly hypnosis - did just as well or better with the RET I taught them as did clients who achieved deep or "true" hypnotic trances.

I therefore created a new hypnotic method which saved me and my clients' hours of therapy time. Using this method, I put the clients in what is usually a light hypnotic (or deeply relaxed state), employing a modified version of Jacobsen's (1938) progressive relaxation technique which takes only about ten minutes to effect. I follow this with ten minutes of RET instruction, designed to show the clients that they have a few specific irrational beliefs (iBs) with which they are creating some major problems (e.g., anxiety, depression, rage, or self-downing) and that if they keep actively and strongly disputing these iBs (as I have previously taught them to do in several non-hypnotic sessions), they will change their beliefs - and thereby also change appreciably their self-defeating feelings and behaviours that stem from and that reinforce these iBs.

The unique feature of this RET hypnotic procedure is that I often use it only once, for a single session, to work on a client's main presenting problem. For I record both the ten minutes of hypnotic-relaxation induction plus the following ten minutes of RET instruction on a C-60 cassette and give the cassette to the clients to keep listening to every day, at least once a day, for the next 30 to 60 days. Using this method, I only see the clients for a single 30 minute hypnotic session; but they get 15, 30 or more hour of recorded RET hypnotic therapy at their own home or office for the next month or two; and if they actually use this time as I direct them to, they often develop deeper and deeper trance states, even though during the original live session they develop only a very light trance - or, as many of them report, no real trance state at all.

To illustrate the use of this method, let me report the case of a 33 year old unmarried borderline female who had a 20 year history of being severely anxious about her school, work, love and sex performances and who became classically anxious about her anxiety, had a severe case of phrenophobia, and was sure that she would end up as a bag lady, without any friends, lovers, or money. Actually she was quite attractive, could have 10 to 15 orgasms a week when (which was rare) she felt secure with a love partner, and made a large salary as a sales manager.

I had 13 sessions with this severely anxious woman and at times she used the main message of RET - that you largely feel the way you think - and notably decreased her feelings of her terror of failing in love, sex, and business. But a few weeks later she would fall back again almost to zero and make herself exceptionally upset - especially about her anxiety itself. After hearing that one of her friends was helped to stop smoking by hypnotherapy, she asked me if I used it along with RET and I said I sometimes did but that I often didn't encourage clients to resort to it because they thought of it as a form of magic and used it instead of working at the RET.

I agreed, however, to try it with her and used it once. Here is a transcript of my first and only hypnotic session with her.

First loosen your toes and then tense them up. Just tense your toes. Now relax them. Relax. Relax. Now I'm going to put you through a series of relaxation exercises like the one you just did with your toes, but emphasizing the second part - focusing on physical relaxation. I want you to relax your toes and only focus on relaxing them. Then relax the rest of the muscles of your feet - all your sole, instep, heel and ankle muscles. Let all your feet muscles sink into a nice, easy, free, relaxed state. Relax the soles of your feet, your ankles, your heels, your whole feet. Just relax, relax, relax, relax.

Then relax the calves of your legs, let both calves relax - easy, free, warm, nice and relaxed. Then relax your knees, let your knee muscles go - nice, free, flexible, warm, relaxed. Then your thighs: Relax your thigh muscles, focus on those thigh muscles, and relax, relax, relax them. Relax them, relax them, relax them. Now your hips, let your middle region, your hips, relax, relax, relax. And now go back to your toes again and let your toes, your feet, lower legs, your calves, your knees, your thighs, and your hips, relax, relax, relax. All of them relax. Let the whole lower part of your body relax, relax, relax, relax, relax. Now your stomach muscles. Think of you stomach muscles, focus on your stomach muscles, relax all those stomach muscles, relax them, let them go easy, nice, warm flexible, and free.

And now your chest muscles. Breathe easily - in and out, in and out, let go, relax your chest muscles, let your whole chest, as well as your stomach, your legs, and your feet, relax, relax, relax.

Now your shoulder muscles. Let go your shoulder muscles and relax them. Let them sink, sink, sink into themselves. Let them sink, sink, sink into any sofa bed or chair you are resting on. Just let them go. Let them relax. And now your upper arm muscles, let them go - easy, warm, free, relaxed. And your elbows, let your elbow muscles relax, relax, relax. And your forearm muscles - let them go, let them go. Warm, free, easy, relaxed. And let your wrist muscles relax. Easy, free, relaxed, flexible, warm. And the muscles of your fingers and your hand. Let them go flexible, free, nice, warm, easy, relaxed.

Now your whole body's sinking into a totally, nice relaxed state from the tip of your toes to your neck. Your shoulders and your arms are getting more and more and more relaxed. Now focus on your neck muscles. Let them go. Let those neck muscles, which are sometimes tense, relax, relax, relax. And now your jaw muscles. Let your mouth hang slightly open. Let your jaw muscles relax, relax, relax. And you can even relax your cheek muscles. You can let them go a little, let them get flabby and relaxed, more than they normally are. And the muscles of your mouth, your lips - relax, relax them, relax them, relax them.

And now the top of your head, your scalp muscles - wrinkle your scalp a little and let the muscles relax, relax, relax. And especially your eye muscles, which are now tense. Let those eyes relax, relax. Easy, free and flexible. You now want to let your eyes close into a nice, relaxed, easy state. And you focus on letting those eyes relax, relax. And they're closing. Easy and free, warm and relaxed. They're getting tired. They want to relax, and you want them to relax. Along with your whole body, you especially want to let your eyes relax, let go. They're closing, getting tired, tired and getting more and more relaxed. And now your eyes are closing and becoming more and more relaxed. You really feel the relaxation in your eye muscles. They're closing, closing - becoming more and more relaxed. You want to go, you want to let yourself go and feel fully calm and relaxed. You want to sink into a totally, totally relaxed state.

Your eyes are getting heavier and heavier and you want to let yourself sink, your trying to let yourself sink, into a deeper, deeper, relaxed state. You want to let your whole body, especially your eyes, go deeper and deeper and deeper into a totally free, warm, nice, flexible, relaxed state. And now you’re letting yourself go deeper, deeper, deeper, deeper. You want to fully relax and get your body out of your way and go deep, deep, down deeper, down deeper, into a fully, fully, fully free and easy relaxed state. You're only listening to the sound of my voice, that's all you're focusing on, that's all you want to hear - the sound of my voice. And you're going to do what I tell you to do, because you want to, you want to do it. You want to stay in this relaxed state and fully aware of my voice and do what I tell you to do because you want to do it. You want to stay in this relaxed state and be fully aware of my voice and do what I tell you to do because you want to do it, you want to be relaxed. You want to rid yourself of your anxiety and you know that this will help you relax and listen, relax and listen, go into a fully free and relaxed state.

You're focusing only on my voice and you're going to listen carefully to what I'm telling you. You're going to remember everything I tell you. And after you awake from this relaxed, hypnotic state, you're going to feel very good. Because you're going to remember everything and use what you hear - use it for you. Use it to put away all your anxiety and all your anxiety about your anxiety. You're going to remember what I tell you and use it everyday. Whenever you feel anxious about anything, you're going to remember what I'm telling you now, in this relaxed state, and you're going to focus fully on it, concentrate on it very well, and do exactly what we're talking about - relax and get rid of your anxiety, relax and get rid of your anxiety.

Whenever you get anxious about anything, you're going to realise that the reason you're anxious is because you are saying to yourself, telling yourself, I must succeed! I must succeed! I must do this, or I must not do that." You will clearly see and fully accept that your anxiety comes from your self-statement. It doesn't come from without. It doesn't come from other people. You make yourself anxious, by demanding that something must go well or must not exist. it's your demand that makes you anxious. It's always you and your self-talk; and therefore you control it, and you can change it.

You're going to realise, I make myself anxious. I don't have to keep making myself anxious, if I give up my demands, my musts, my shoulds, my oughts. If I really accept what is, accept things the way they are, then I won't be anxious. I can always make myself unanxious by giving up my musts, by relaxing - by wanting and wishing for things, but not needing, not insisting, not demanding, not musturbating about them."

You're going to keep telling yourself, I can ask for things, I can wish. But I do not need what I want, I never need what I want. There is nothing I must have; and there is nothing I must avoid, including my anxiety. I'd like to get rid of this anxiety, I can get rid of it. But if I tell myself, 'I must not be anxious! I must be unanxious!' then I'll be anxious.

"Nothing will kill me. Anxiety won't kill me. Lack of sex won't kill me. There are lots of unpleasant things in the world, that I don't like, but I can stand them. I don't have to get rid of them. If I'm anxious, I'm anxious too damn bad! Because I control my emotional destiny - as long as I don't feel as I have to succeed at anything. That's what destroys me the idea that I have to be sexy or I have to succeed at sex. Or that I have to get rid of my anxiety." In your regular life, after listening to this tape regularly, you're going to think and to keep thinking these things. Whenever you're anxious, you'll look at what you're doing to make yourself anxious, and you'll give up your demands, and your musts. You'll dispute your ideas that I must do well! I must get people to like me! They must not criticise me. It's terrible, when they criticise me!" You'll keep asking yourself, why must I do well? Why do I have to be a great sex partner? It would be nice if people liked me, but they don't have to. I do not need their approval. If they criticise me, if they blame me, or they think I'm too sexy or too little sexy, too damn bad. I do not need their approval. I'd like it but I don't need it. I'd also like to be unanxious but there's no reason why I must be. Yes there's no reason why I must be. It's just preferable. None of these things I fail at are going to kill me.

"And when I die, as I eventually will, so I die! Death is not horrible. It's a state of no feeling. It's exactly the same state as I was in before I was born. I won't feel anything. So I certainly need not be afraid of that!

"And even if I get very anxious and go crazy, that too isn't terrible. If I tell myself, 'I must not go crazy! I must not go crazy!' then I'll make myself crazy. But even if I'm crazy, so I'm crazy! I can live with it even if I'm in a mental hospital. I can live and not depress myself about it. Nothing is terrible - even when people don't like me, even when I'm acting stupidly, even when I'm very anxious! Nothing is terrible! I can stand it. It's only a pain in the ass!"

Now this is what you're going to think in your everyday life. Whenever you get anxious about anything, you're going to see what you're anxious about, you're going to realise that you are demanding something, saying, “It must be so! I must get well! I must not do the wrong thing! I must not be anxious!" And you're going to stop and say, "You know, I don't need that nonsense. If these happen, they happen. It’s not the end of the world! I'd like to be unanxious, I'd like to get along with people, I'd like to have good sex. But if I don't, I don't! Tough! It's not the end of everything. I can always be a happy human in spite of failures and hassles. If I don't demand, if I don't insist, if I don't say, 'I must, I must!' Musts are crazy. My desires are all right. But, again, I don't need what I want!" Now this is what you're going to keep working at in your everyday life.

You're going to keep using your head, your thinking ability, to focus, to concentrate on ridding yourself of your anxiety - just as you're listening and concentrating right now. Your concentration will get better and better. You're going to be more and more in control of your thoughts and feelings. You will keep realising that you create your anxiety, you make yourself upset, and you don't have to, you never have to keep doing so. You can always give your anxiety up. You can always change. You can always relax, and relax, and relax, and not take anyone, and not take anything too seriously.

This is what you're going to remember and work at when you get out of this relaxed state. This idea is what you're going to take with you all day, everyday: I control me. I don't have to upset myself about anything. If I do upset myself, too bad. I may feel upset for a while but it won't ruin my life or kill me. And I can be anxious without putting myself down, without saying, 'I must not be anxious!' At times I will make myself anxious, but I can give up my anxiety if I don't demand that I be unanxious."

And you're going to get better and better about thinking this rational way. You'll become more in control of you. Never totally in control because nobody ever is totally unanxious. But you'll make yourself much less anxious and be able to live with it when you are anxious. And if you live with it, it will go away. Nothing is terrible, not even anxiety. That's what you're going to realise and to keep thinking about until you really, really believe it.

Now you feel nice and free and warm and fully relaxed. In a few minutes I'm going to tell you to come out of this relaxed, hypnotic state. You will then have a good day. You will feel fine when you come out of this state. You will experience no ill effects of the hypnosis. You will remember everything I just said to you and you will keep working at using it. And you will play this tape every day for the next 30 days. You will listen to it every day until you really believe it and follow it. Eventually you will be able to follow its directions and to think your way out of anxiety and out of anxiety about being anxious without the tape.

You will then be able to release yourself from anxiety by yourself. You can always relax and use the anti-anxiety technique you will learn by listening to the tape. You can always accept yourself with your anxiety and can stop telling yourself, I must not be anxious! I must not be anxious!" Just tell yourself, I don't like anxiety, I'll work or give it up. I'll conquer it. I'll control myself, control my own emotional destiny. I can always relax, make myself feel easy and free and nice, just as I feel now, get away from cares for awhile and then feel unanxious. But I can more elegantly accept myself first with my anxiety, stop fighting it desperately, and stop telling myself it's awful to be anxious. Then I can go back to the original anxiety and get rid of it by refusing to awfulize about failing and vigorously disputing my irrational beliefs, 'I must do well! I must not be disapproved.’”

Now you feel good, you feel relaxed, and in a couple of minutes, I'm going to count to three and when I count to three you will awaken and feel quite alive, have a good day, and experience no bad effects, no headaches, no physical discomfort! Everything is going to be fine and you'll have a good day. You will remember all this and, as I said, you will listen to this tape whenever you possibly can, at least once a day. And you will think and act more and more on its message. You'll be able to control yourself and reduce your anxiety appreciably. And when you do feel anxious you'll live with the anxiety, accept it, and refuse to panic yourself about it. All right, I'm going to count till three and when I say three, you'll wake and be fully alive and alert and feel great for the rest of the day. One, two, three!

My client used the recording of her hypnotic RET session once or twice a day for the next 45 days and reported a significant decrease in her anxiety level, and especially in her anxiety about her anxiety. She stopped being phrenophobic, convinced herself that if she had a breakdown and went to the mental hospital it would be highly inconvenient but not horrible or shameful, and then hardly thought at all about going crazy. When she did, she was able to feel comfortable within a few minutes by strongly telling herself, "So I'll be crazy. Tough! I'm sure I won't stay that way very long - and if I do, that will just be tougher. But not shameful! No matter how crazy I am, I'll never be a turd for being that way!"

As she began to get over her anxiety about her anxiety, this woman's enormous fears of failure, particularly of sex failure, for awhile almost completely disappeared. When, weeks later, they reappeared, they were relatively light and she was almost invariably able to cope successfully with them. She continued in RET nonhypnotic treatment for 14 months more, but only had 18 half-hour sessions during that time. For the last 11 years she has maintained her gains, with occasional moderate setbacks when a love affair ended, and is now happily married and unanxiously highly productive. She once in a while still listens to the original hypnotic tape and believes it was quite instrumental in helping her make much greater progress than she had previously made in RET.

I tend to agree with her, partly because I have used similar taped sessions to good avail with about 80 other clients (although with little or no success with 18 others). One important question I have not yet resolved is: Does the benefit presumably derived from this type of recorded hypnotic sessions stem from the use of the entire 20 minute tape, including the hypnotic-relaxation instructions, or would equal benefit stem from the client's listening a number of times to the 10 minutes of RET instruction on the tape even if this were heard apart from the hypnotic session? I have tried to induce several researchers to do a controlled study of this question, but so far no one, to my knowledge, has done so. I still hope that this experiment will be done one day. Until then, I shall continue to use this recorded hypnosis-RET procedure with some amount of faith in the clinical results I have thus far achieved with it.

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