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To build bridges between hypnosis and contemporary psychoanalysis, this article addresses how hypnosis, when used in psychotherapy, facilitates curative action through its relational essence. The author's extensive experience with hypnosis, psychotherapy, and psychoanalysis orient the narrative toward the unconscious patient-therapist interaction, with particular attention paid to the ethics of the inherent hypnotic seduction. Whether used primarily in relief-oriented ways or geared toward more transformative therapeutic aims, powerful unconscious factors are in play for both patient and therapist and are explicated to illustrate the interactive and frequently unformulated, intersubjective factors that facilitate effective, psychotherapeutic hypnosis. Consequently, therapists attuned to such intersubjective dynamics can make use of their own internal mental activities to understand a patient's current state of mind and level of developmental functioning, and thereby subsequently formulate mutative interventions. For instance, because hypnotizability reflects the ability to play in imaginative space, the regression promoted in hypnotherapy may activate both an illusion of omnipotence and its optimal disillusionment through the relational context. This requires going beyond more traditional, procedural ways of bifurcating hypnotic interventions as being either direct or indirect and instead further distinguish hypnotic interventions in accordance with their maternal and paternal relational dimensions. Arguably, then, the skillful hypnotherapist needs to maintain a coupling interplay between the maternal, maximally receptive and the paternal, more active modes of functioning within hypnotic play space.

Over the years, the field of hypnosis has often given more attention to the state and procedural factors of hypnosis than the relational ones. In an attempt to address this imbalance, the 60th annual meeting of the American Society of Clinical Hypnosis (ASCH) had as its theme "Hypnosis and the Treatment Relationship." A centerpiece of this meeting was a collegial discussion among a panel of psychologists with expertise in relational hypnotherapy. The panel addressed several pertinent questions: (1) What are the healing qualities of relationship in psychotherapy? (2) What makes hypnosis relational in nature? (3) How do relational factors of hypnosis resemble healthy attachment processes and recapitulate stalled developmental maturation? (4) How does relationally informed hypnotherapy influence and strengthen the relationship, process, and outcome of psychotherapy? This article summarizes the factors that led to the creation of this panel; provides an edited transcript of this panel discussion, along with additional commentary on several key points raised; and concludes with a summary of the main themes and recommendations for further clinical practice and study.

Psychoanalytic treatment is often indicated when trauma and its psyche/soma companion, dissociation, severely disrupt symbolic functioning and associative linking. After Freud’s initial thinking on these matters, repression replaced rather than supplemented dissociation (which occasions segregating units of experience) as the primary defensive response to severe trauma. Because psychoanalysis had “repressed” the salience of dissociation as actively motivated (though passively experienced), an unnecessary schism has occurred between trauma theories and mainstream North American psychoanalysis, and within psychoanalysis itself. To fully restore dissociation’s role in primitive mental states and provide a more integrated approach to technique, it is necessary to comprehend the triadic nature of trauma, which entails economic/drive, structural conflict and deficit, and object-relational factors. For a treatment model that addresses defensive dissociation in the here and now, primary and secondary dissociation must be distinguished, with each differentiated from splitting and repression. Technique requires addressing unconscious, repressed fantasies associated with the “trauma,” object-relational patterns that interfere with linking, and psycho-economic issues that have disrupted ego functioning. A clinical example illustrates both the analyst’s persistence in suffering the dead, eerie space of dissociated trauma and efforts to find language that helps structure the patient’s somatic and enacted expressions (and accompanying dissociative and repressive processes) by which traumatic experiences are registered and conveyed.

This paper argues that recovering the "missing" paternal function in analytic space is essential for the patient's achievement of mature object relations. Emerging from the helpless infant's contact with primary caregivers, mature intimacy rests on establishing healthy triadic functioning based on an infant-with-mother-and-father. Despite a maternocentric bias in contemporary clinical theory, the emergence of triangularity and the inclusion of the paternal third as a separating element is vital in the analytic dyad. Effective technique requires the analyst's balanced interplay between the paternal, investigative and the maternal, maximally receptive modes of functioning-the good enough analytic couple within the analyst-to serve as the separating element that procreatively fertilizes the capacity for intimacy with a differentiated other. A clinical example illustrates how treatment is limited when the paternal function is minimized within more collusive, unconsciously symbiotic dyads.

This paper aims to restore the father and paternal function to their rightful place alongside the mother and maternity in order to counter the prevailing matricentric, dyadic bias in psychoanalytic theory and technique. The author contends that both the symbolic and the actual, flesh-and-blood father are necessary to optimize his child's development. The paternal function inevitably operates in a triadic matrix; thirdness is always psychically in existence-with the father ever present in the mother's unconscious mind-and the paternal third is necessary to open up symbolic space. As an embodied other, the actual father, both as a separating agent and an attracting object, is called upon to recognize his child's otherness throughout the inescapable father-child rivalries, neglect, and desire.

Reaching beyond the Oedipus prototype to address the unrepresentable vulnerability founded on the boy's infantile helplessness in contact with the mother's body, the author aims to identify the inherent tensions and enigmas of being male. He proposes that both the repudiation of femininity and the overvaluation of phallicity are unconsciously constructed to withstand the fundamental deficiency grounded in the asymmetry of the boy's prephallic relation with his primary object. This bodily based primordial vulnerability, marked by absence and lack, remains elusive-an unsymbolizable experience that provides the archaic matrix for adaptive and defensive phallicism, the oedipal complex, and genital progression. A clinical vignette is presented to illustrate these concepts.

In addressing the central challenges of developing and maintaining the analyst's psychoanalytic mindedness, this paper focuses on two particularly challenging core components of clinical effectiveness not so easily developed despite the rigors of the tripartite training model. The first is the analyst's receptivity to unconscious communication, which entails the analyst's curiosity, acceptance of human nature, doubt, restraint, narcissistic balance, and integrity. A brief clinical vignette illustrates this. The second factor is recognizing and managing the inherent disappointments and narcissistic challenges in working psychoanalytically. The author maintains that the ability to lose and subsequently recover one's analytic mind entails discipline, courage, and faith that only experience can provide.

A model of masculine gender identity development is presented that demonstrates how a male's sense of his masculinity and the ambiguities of his gender are being reworked throughout his life. Of factors shaping the boy's sense of masculinity early on, particular emphasis is placed on the role of the involved father, the nature of the parental relationship, and the mother's recognition and affirmation of her son's maleness. While healthy masculine gender identity is founded predominantly on the boy's unique struggles in separating from his mother, it does not result from what has been traditionally viewed as the boy's disidentification from her (and from the feminine more generally). Indeed, boys who need to violently repudiate their identifications with their mother are more susceptible to a fragile, rigid masculine identity and narcissistic psychopathology. A case example of a young adult man illustrates the impact of identifications with both parents. The interplay of early masculine identity development and later life challenges confronting the adult male is briefly noted. "Masculine" ego ideals shift across developmental junctions until, ultimately, a more mature sense of masculinity emerges: the phallic wish to deny differentiation and maintain unlimited possibility is renounced and mourned and certain real limits concerning sex, gender, and generational differences are accepted. This reshaping of the "masculine" ego ideal consequently involves the transformation of a man's previously adaptive "phallicism" into more realistic, "genital" ego ideals-an achievement involving interplay between masculine and feminine identifications and the integration of antithetical elements no longer so unconsciously gendered.

This paper reflects upon the essential components of male identity that commonly are reworked in middle age. The author argues that healthy masculine gender identity involves an ongoing, plastic process of destabilization and reconstruction at various pivotal developmental stages, particularly during middle adulthood. In essence, a man's mature transformation of his sense of masculinity results when finite concepts of gender identity are superseded by an awareness of the complexity of one's multiple, early and diverse gender identifications. A clinical case provides insight into how psychoanalytic treatment can contribute to a new experience of masculinity. The case illustrates how a maturing man, meeting an altered sense of identity in mid-life, relies less on gender splitting and more on reuniting previously antithetical intrapsychic elements. Why this more pluralistic, polythreaded masculinity frequently must wait until mid-life is further clarified. Specific importance is attached to the early development of male gender identity as it is founded on the boy's unique struggles in separating from his mother. The foundation for male gender identity formation is reconsidered as the author questions the 'dis-identification' model while explicating how the boy's striving for narcissistic completion shapes the gendered masculine ego ideal. Classically termed 'phallicism' is understood both to facilitate and obstruct a man's adult development, while the concept of 'genitality' is augmented by the postclassical notion of 'interiority'. At mid-life, 'phallic' ego ideals (resting on omnipotence, desires for narcissistic completion and gender splitting) are transformed into more realistic, 'genital' ego ideals (synthesizing autonomy and connection). The achievement of a mature, less sharply gendered 'masculine' ego ideal (revitalizing the foreclosed dimensions of both the early maternal and paternal imagos) occurs as the balance of forces shifts in the direction of true genitality rather than defensive phallicism.

Developed from established psychoanalytic knowledge among different psychoanalytic cultures concerning unconscious interpsychic communication, analysts' use of their receptive mental experience--their analytic mind use, including the somatic, unconscious, and less accessible derivatives--represents a significant investigative road to patients' unconscious mental life, particularly with poorly symbolized mental states. The author expands upon this tradition, exploring what happens when patients unconsciously experience and identify with the analyst's psychic functioning. The technical implications of the analyst's "instrument" are described, including the analyst's ego regression, creation of inner space, taking mind as object, bearing uncertainty and intense affect, and self-analysis. Brief case vignettes illustrate the structure and obstacles to this work.

(2000). The long and winding road from concept to practice: International Journal of Clinical and Experimental Hypnosis: Vol. 48, No. 1, pp. 70-85.

“Judy,” a professional writer, asked me to use hypnosis to help her “fill in the gaps” in her knowledge of certain periods in her youth. As she was so keen, getting her into trance was relatively easy. I asked a few questions and she answered in a slurred voice. Then, after a few minutes, she said that she wasn't hypnotized. “Not to worry, Judy, I'll bring you out” was my reply. With that, a flood of memories, absolutely unstoppable for approximately 4 minutes, came pouring forth. There-after, I asked questions relating to an earlier period in her life. Again came the statement that she wasn't hypnotized, and I replied as before. With that, a second flood of unstoppable experiences poured forth. Later, on coming out of trance, she was able to recall all she'd spoken about while in trance and often punctuated her recollections with “I didn't know that they punished me at 6 by locking me in the cupboard under the stairs!”

The ubiquitous interactional basis of hypnosis remains neglected and poorly understood. Vignettes from clinical practice and research are presented to illustrate the significance of hypnotic relational factors and their internal representations. A descriptive theoretical framework is formulated enumerating 4 relational dimensions: (a) transference phenomena in which previous object relationships are enacted; (b) a goal-oriented working alliance comprised of “rational” and “irrational” expectations about the efficacy of hypnotic procedure and its participants; (c) a symbiotic or fusional alliance in which the hypnotist is experienced as a purely internal figure; and (d) a realistic contemporary relationship. Each dimension is considered as it subjectively operates within hypnosis, and a case example is employed to compare the psychotherapeutic operation of these diinensions in waking and hypnotic contexts. Implications of the interactional framework are discussed and further empirical and clinical...

Hypnotists can vary in their ability to produce meaningful trance experiences. Certain hypnotists produce more meaningful trance experiences than do others. Therapeutic hypnosis is regarded as a “dual phenomenon” occurring within an intense interpersonal relationship. This interactive dimension is important as is the unique contribution made by the hypnotist. A brief historical survey demonstrates the causal attribution of hypnotic effects. The theoretical literature on the reciprocal nature of hypnotic experience emphasizes the importance of the interpersonal functions of hypnosis, the hypnotic relationship per se, and the impact of the hypnotist. Recent research investigating interactional parameters supports these conclusions and suggests future empirical directions. Finally, an emergent interactional theoretical framework is presented which views hypnotherapeutic skill primarily as a function of the hypnotherapeutic ability to create a facilitating “holding” environment for the patient's inte...

A novel hypnotherapeutic procedure is described wherein the client reverses roles and serves as hypnotist for the therapist. Relevant theoretical processes are discussed as are mutual hypnosis, modeling, and the uncommon techniques of Erickson (1964). 3 case illustrations are presented and implications discussed. It is hypothesized that the “client-as-hypnotist” may in certain special situations further hypnotherapy by: (a) increasing client motivation; (b) enhancing therapeutic rapport; (c) increasing both client trust and skills in utilizing unconscious processes; (d) overcoming resistance and increasing hypnotizability; (e) providing a useful psychodiagnostic and behavior assessment index; (f) presenting a role “model” for dealing with feelings, alterations in consciousness, and self-control; (g) providing a client-centered framework for subsequent therapeutic interventions; (h) increasing client self-esteem, mastery, and ego strength; and (i) increasing client self-control skills. Potential r...

Previous research has shown that the effect of attitudes on attraction is independent of the prestige or status of the stranger expressing the attitudes. It was hypothesized that in the absence of additional information, attraction toward a stranger is a positive function of his occupational prestige and that attraction is a positive function of assumed attitudinal similarity between stranger and S. Ss were 139 Stanford students who were given either occupational information, attitudinal information, or both types of information about a stranger. It was found that either occupational information alone ( p < .02) or attitudinal information alone ( p < .001) influences attraction. When the two types of information are combined, as in earlier research, Ss respond only to attitude similarity ( p < .001). There was support for the proposed relationship between attraction and assumed similarity ( p < .01), but variations across conditions suggest caution in interpreting this finding.

A study was conducted into the role played by vividness of imagery and inner experiences in the ease with which SS can be hypnotized. Hypnotizability correlated positively with vividness of imaging as measured by the shortened version of the Bette Questionnaire upon Mental Imagery Scale (Bheehan, 1967) and with ego-permissivenem as measured by the Taft Ego PermiSgiveness Inventory (Taft, 1969, 1970). The highest codation occurred on the Dissoaiated Experiences sub-scale of the latter. There were few sex differences in the correlations. The results are discussed with respect to previous research and the role played by the control of inner processes. The role of hypnoskpecific attitudes and behaviors aa moderator variables in prediction equations is considered along with the tentative nature of the findings and the need for cross-validation studies.

The “essence” underlying Milton Erickson's unique style and uncommon technical maneuvers inheres in his uncommon skill at eliciting patients' archaic involvement. Archaic involvement, as characterized by perspectiveless overvaluation, is explicated and America's beloved tale, The Wonderful Wizard of Oz, is used to evoke further perspectives. The importance of such regressive object-representations are noted. Erickson's uncanny ability to access archaic involvement and thereby profoundly influence his client is analyzed in terms of his: (a) relationship style; (b) therapeutic “persona”; (c) theoretical orientation; and (d) specific micro-techniques and interventions. Clinical findings derived from a case transcript and videotaped work are employed throughout to substantiate the argument that Erickson fosters regressive interpersonal shifts. Implications of this skill are discussed, and further avenues for investigation are suggested.

2 major ways of construing increases in hypnotic responsivity are suggested. Both the trait viewpoint and the skill-learning model are discussed as are a number of issues differentiating the two approaches. The controversy concerning the roles played by both aptitude and attitude is highlighted. It is argued that the skilllearning position is plausible and the nature of skill-based approaches to training is considered. Empirical findings consistent with the skill viewpoint are summarized. Methodological deficiencies and suggestions for future directions in modification research are discussed. The concluding section specifies 3 probable core components in successful modification procedures including optimal learning factors, attitudinal and set factors, and cognitive strategy factors.

In the last century, psychotherapists trained in clinical hypnosis have made a number of unique contributions to the psychotherapeutic endeavor, particularly in the areas of psychotherapeutic theory, technique, and practice. Nine factors indexing the contribution of hypnotherapists are discussed. They are: 1) communication focus; 2) maximizing expectation and belief; 3) mind-body emphasis; 4) handling of resistance; 5) employing trance phenomena; 6) using archaic levels of relationship; 7) stressing healthy, adaptive ego functions; 8) using therapist trance; and 9) permitting responsible creativity. Each factor is considered as it pertains to hypnotic technique and phenomena as well as how it is manifested in clinical treatment.