by Joanna Foote Adler, PsyD and Isa Gucciardi, PhD[1]
Depth Hypnosis is a manualized integrative spiritual counseling model that combines elements of transpersonal psychology, hypnotherapy, earth-based wisdom, Buddhist psychology and mindfulness, energy medicine, and exposure therapy. The study examined in this paper provides preliminary efficacy research for the use of Depth Hypnosis in the treatment of the symptoms of Post-Traumatic Stress Disorder (PTSD), depression, and anxiety, as well as the effects of treatment on well-being. Data were gathered pre-, mid-, and post-treatment from subjects engaging in eight sessions of Depth Hypnosis, as well as from a non-randomized wait list control group. Seventy-three participants consented to the study, including 40 in the experimental group and 33 in the control group. The sample was predominately female (92.3%), with an average age of 37.92 years old (SD = 6.77). Treatment and control groups did not differ in terms of age or baseline symptoms, ps > .05. Across all measures, there was a significant main effect for treatment, all ps < .05, indicating that those who received Depth Hypnosis had a significant reduction across all negative symptom sets, and an increase in experience of well-being. The largest effect sizes were seen in the treatment of depression (-1.049) and well-being (.700), with anxiety (-.544) and PTSD (-.464) effect sizes still in the medium range. Preliminary evidence indicates that Depth Hypnosis is effective in treating the symptoms of anxiety, depression, and PTSD and raising well-being. These results suggest that Depth Hypnosis is a promising treatment for a range of disorders, and future research recommendations are discussed.
Depth Hypnosis is a promising new manualized counseling model created by Dr. Isa Gucciardi that combines elements of transpersonal psychology, hypnotherapy, earth-based wisdom, Buddhist psychology and mindfulness, energy medicine, and exposure therapy (Gucciardi, 2004). These elements are used synergistically to support individual processes of growth and healing. The techniques of Depth Hypnosis help clients navigate their unique patterns of distress, change their relationship to past or present stressful events, and shift negative symptomatology. The goal of this research is to introduce the mental health community to Depth Hypnosis and examine its efficacy in the treatment of Post-Traumatic Stress Disorder (PTSD), depression, anxiety, and assess its effect upon subjective well-being.
Background
Transpersonal psychology
Transpersonal psychology is the philosophical theory that unifies the multiple streams of understanding that informs Depth Hypnosis. Transpersonal psychology as a field allows for the consideration of the soul or spirit in the context of healing (Wilbur, 2007). This involves a sense of connectedness with phenomena outside the boundaries of the ego, (Kasprow & Scotton, 1999). In practice, transpersonal psychology integrates psychological theories and methods including meditative states, spiritual experiences, shamanic journeys, and hypnotic states. Transpersonal psychology is the study and understanding of self-transcendence, that expansive sense of identity that is less individuated and more unified with the whole (Gucciardi, 2004). From the standpoint of transpersonal psychology, we can view and understand the theoretical pillars of Depth Hypnosis: hypnotherapy, Buddhist psychology and mindfulness, earth-based wisdom, energy medicine, and exposure therapy.
Hypnotherapy
Hypnosis has been used therapeutically in various forms for thousands of years (Gauld, 1992; Gucciardi, 2004). Hypnosis induces a psychological state that can be used to facilitate insight and change in virtually any psychotherapy process (Strauss, 1986). In fact, many psychotherapies of the 19th and 20th centuries have incorporated hypnotic concepts, including Ego State Therapy of Barabascz (2013), ideomotor questioning (Cheek, 2009), and Psychosomatic Hypnoanalysis as discussed by Elkins (2017).
Significant evidence points to the usefulness of hypnosis in the psychotherapeutic setting, for example in the treatment of PTSD and dissociation (Lynn, Malakataris, Condon, Maxwell, & Cleere, 2012; Wahbeh, Senders, Neuendorf, & Cayton, 2012; Spiegel & Cardeña, 1990; Kluft, 2012). In addition, hypnotherapy appears to significantly improve symptoms of depression (Shih, Yang, & Koo, 2009; Dobbin, Maxwell, & Elton, 2009). Cognitive hypnotherapy shows promise in the treatment of anxiety (Golden, 2012; Weisberg, 2008; Alladin, 2016); however, Pelissolo (2016) argues that more evidence is needed to assess the efficacy of hypnotherapy in anxiety in general. In general, we have a significant body of evidence pointing to the efficacy of hypnotherapy in the treatment of mood disorders, including anxiety, depression, and trauma related disorders.
Regression Therapy techniques, regularly used in hypnotherapy, have been shown to be effective in the treatment of phobias, as well as Tourette’s Syndrome (Freedman, 1995, VanderMaesen, 1998). Regression Therapy is a technique focusing on resolving traumatic past events that interfere with current well-being. The specific integration of regression techniques in Depth Hypnosis will be discussed in detail later in this paper.
Much of hypnotherapy in the 20th century has focused on the suggestion hypnosis techniques as taught by Milton Erickson (Bandler & Grinder, 1975, Rossi & Ryan, 1998)). Suggestion hypnosis is the process of offering an idea or action that may be helpful to the client, while the client is in a quiet, receptive state, bypassing conscious defenses, and allowing the ideas to seat themselves more deeply and easily in the psyche. Depth Hypnosis harnesses the techniques of suggestion hypnosis and expands them significantly as will be discussed in more detail below.
Buddhist psychology
Buddhism, in essence, is a non-dogmatic formula for the transformation of the core negativity and pain that prevents us from being at peace (Surya Das, 1997; McLeod, 2002). The Buddha was referred to as the great physician, and made it his goal to identify, understand, and end human suffering, through proper modes of living (Diller & Lattal, 2008) and a deepening in our understanding of our own existence (Aich, 2013). Although Buddhist practices can be integrated into modern psychotherapy with a focus on cultivating mental balance and well-being, the practices point to profound philosophical truths (Sugamura et al., 2007), which aim to achieve ideal states of being (Rapgay et al. 2000).
Depth Hypnosis brings this understanding into the heart of the therapeutic process with clients. Depth Hypnosis draws upon the Buddhist understanding that healing involves holding all phenomena with compassion (Thurman, 1999). In fact, it is understood that it is only through holding one’s difficult experiences with compassion that true healing occurs (this theory of change lies at the heart of Depth Hypnosis). In Buddhism, this change is accomplished through the connection to one’s Buddha Nature, which can be described as the essential goodness, or loving, kind nature, that lies at the center of each person’s being. It is the part of the self that is connected to wisdom and compassion in an unbroken way (Gucciardi, 2017). Much of the practice of Depth Hypnosis is designed to help people return to a felt and lived sense of their Buddha nature: thus transforming their internal negativity into compassionate awareness.
In Buddhism, there are four key Immeasurables, or elements of Buddha Nature. These are loving-kindness, compassion, equanimity, and sympathetic joy. These four are the attitudinal qualities one can cultivate to achieve a life free from suffering. Loving-kindness and compassion have been studied in particular and are known to have a positive effect on emotional response and regulation (Hofman, Grossman, & Hinton, 2011; Kearney, Malte, McManus, Felieman, & Simpson, 2013). The four Immeasurables are all specifically cultivated in Depth Hypnosis.
Mindfulness meditation
Perhaps the most commonly understood principle of Buddhism in the West is mindfulness. Mindfulness skills have been associated with improvements in the symptoms of anxiety, depression, PTSD substance abuse, chronic pain, enhancement of immunity, improvement in sleep, and borderline personality disorder (e.g., Baer, 2006; Hofmann et al., 2010; Kabat-Zinn et al., 1985; Lynch et al., 2007; Parks et al., 2001; Dunn et al., 1999; Zou et al., 2016; Bormann, Thorp, Wetherell, Golshan, & Lang, 2013; Orsillo & Batten, 2005; Follette & Vijay, 2009; Niles, Klunk-Gillis, Silberbogen, & Paysnick, 2009). Mindfulness also has been positively related to various indices of well-being (e.g., Brown & Ryan, 2003; Vujanovic, Bonn-Miller, Bernstein, McKee, & Zvolensky, 2010. Mindfulness based treatments have been shown to consistently outperform active controls such as relaxation training and supportive psychotherapy in the treatment of anxiety and depression (Hofman & Gomez, 2017).
Mindfulness based skills overlap with those of hypnotherapy, with the two having distinct yet complementary skill sets (Otani, 2016; Holroyd, 2011; Lynn, Barnes, Deming, & Accardi, 2010) demonstrating evidence for integrative approaches like Depth Hypnosis. Mindfulness-based skills are integrated within a hypnotherapy framework in Depth Hypnosis to strengthen the client’s ability to face distressing internal states, like those seen in anxiety, depression, or trauma reactions.
Earth-based wisdom
Earth-based wisdom is a term used to describe the healing and spiritual practices of indigenous, shamanic cultures. From the perspective of these cultures, disease and psychological imbalance are caused by processes known as power loss, soul loss, and energetic interference (Harner, 1980). In the conditions of power loss and soul loss, it is understood that crucial parts of the self that provide life and vitality are lost (Ingerman, 1991). With energetic interference is understood that energy that is non-native to an individual’s psyche takes root there (Gucciardi, 2004), akin to a psychological introject. The application of these principles in a modern therapeutic context is discussed in the methodology section.
Exposure therapy
Exposure therapy is used in behavioral and cognitive-behavioral paradigms for clients experiencing anxiety or PTSD. Clients are exposed to a feared object or experience, either in vivo or in a guided meditation. Exposure therapy has been shown to reduce many symptoms of PTSD and anxiety (Feinstein, 2008; Feinstein, 2010; Schwartz & Daloupek, 1987; Kaczkurkin & Foa, 2015; Rauch, Eftekhari, & Ruzek, 2012; Foa & McLean, 2016), and symptoms of depression also appear to recede as PTSD symptoms are treated with exposure therapy (Aderka, Foa, Applebaum, Shaftran, & Gilboa-Schectman, 2011).
Energy medicine
Energy Medicine practices have been found in cultures around the world and are becoming modern mainstream treatments in setting such as pain centers, surgical centers, and private practices (Anderson and Taylor, 2011). Energy medicine is a treatment in which energetic and meditative processes are used to support health and healing. Energy medicine is an evidence-based treatment that meets the APA Division 12 criteria as a probably efficacious treatment (Feinstein, 2008). Energy therapies such as Healing Touch and Reiki have been found to reduce pain in both adults and children (So, Jiang & Qin, 2013). Some studies show significant benefits to Reiki clients reported at the p< 0.0001 level (Vandervaart, 2009).
In Depth Hypnosis, Energy Medicine processes are used to support exposure treatments. In this context, clients are brought into contact with internal resources that are introduced as: a part of yourself that has your highest good as its sole intent. These resources may be experienced in the form of a plant or animal, angel, mythic being, human being, or a ray of light or a sound, or something else that has particular meaning to the client. These internal resources create a positive and compassionate energetic experience for the client. While deeply connected in this way, the client may be exposed to difficult memories, past negative or traumatic experiences, or objects of phobia that the client needs help navigating, allowing for deep support in the process of changing one’s relationship to pain. In this way, Depth Hypnosis energy medicine techniques are used to create internal resources that support and amplify traditional exposure-based treatment protocols.
Depth Hypnosis spiritual counseling – differentiation and integration
Depth Hypnosis is different from traditionally practiced hypnotherapy in that it assimilates the above modalities into one integrative spiritual counseling model, creating the ability to access multiple kinds of knowing and the different interventions that arise from them. Here we will address some of the specific ways that Depth Hypnosis can be differentiated from other hypnotherapeutic practices, as well as specific integration strategies.
Depth Hypnosis synthesizes and expands on traditional hypnotherapy techniques stemming from sources such as Guided Imagery, Strength-Based approaches, Ericksonian Hypnosis, and Suggestion Hypnosis, as Depth Hypnosis takes all of these techniques farther down the field. In guided imagery, the images used are generally imposed from a specific set of images selected by the therapist. This is antithetical to Depth Hypnosis, which is designed to evoke imagery directly from the mind stream of the client. This allows the client to understand how to navigate their own inner landscape rather than aligning with someone else’s imagery. This kind of technique demands much more from the client and seeks to educate them about their own inner experience in a way that traditional guided imagery does not. Depth Hypnosis connects the subject to their own inner experience of strength (as is done in Strength-Based approaches) but expands on this approach by encouraging clients to plumb the areas of weakness within themselves while connected to their experience of strength, thus allowing for a transformation of the weakness. The subject’s strengths and capacities support this transformation but are not the primary focus. Ericksonian theories are not emphasized in Depth Hypnosis; however, a few Ericksonian techniques are borrowed. One of these is the Ericksonian redirect, which is used in induction scripts to help the conscious mind relax and allow the client to drop into a deeper level of inner focus. Another Ericksonian technique integrated here is the anchor, which is used to emphasize and affirm change during a regression or deep transformative process (Adler, 2016). Many people are familiar with the Suggestion Hypnosis technique of offering positive and supportive suggestions while the client is in an altered state (Hickman, 1983). Depth Hypnosis takes this technique farther by offering suggestions that connect the client with their own highest good. The part of the self that understands the highest good for oneself and others is called Buddha nature in Buddhism, and in transpersonal psychology this is known as the higher self.
Deepak Chopra defines the higher self as the awareness that is possible once you cultivate an accepting attitude of love and appreciation for yourself (Carver, 2017). This deeply compassionate approach to one’s pain, which is experienced internally rather than just through a relationship with a counselor, allows the client to feel empowered in their approach to healing. The ability to feel internally supported, through one’s own compassionate awareness, while accessing difficult memories, experiences, or patterns of behavior increases the client’s tolerance for those experiences, and changes one’s relationship to those experiences, facilitating healing. It is thus the application of an internal experience of compassion and loving kindness, which Depth Hypnosis posits as the mechanism for the transformation of suffering. This theoretical model for the mechanism of the transformation of negative emotional states is consistent with research conducted on Loving Kindness and Compassion Meditation, which demonstrates the positive emotional changes acquired through Loving Kindness and Compassion practice (Hofman, Grossman, & Hinton, 2011; Kearney, Malte, McManus, Felieman, & Simpson, 2013).
In addition, to systematically integrating the deep support of energy medicine, which adds its own particular layer of strength and internal reorganization, Depth Hypnosis works with regression therapy techniques in an innovative way. It combines elements of Buddhist understanding with the power of shamanic catalytic healing techniques within the regression process. Because of the Buddhist underpinnings of the model, the idea of reincarnation is inherent in the way that time is approached. Within this context, karmic patterns are understood to be drivers of both the client’s presenting symptoms and the way individuals approach and react to their symptoms, as well as holding information about their generation. Karmic patterns, by their nature, are understood to move across lifetimes and throughout a person’s current lifetime and can drive imbalance. The regression process is designed to locate where the strongest triggers to the current imbalances lie within the karmic pattern so they can be accessed and healed.
This pilot study provides evidence regarding the efficacy of Depth Hypnosis as a treatment for reducing the symptoms of PTSD, anxiety, and depression, and raising well-being. Depth Hypnosis teaches the client to tolerate distressing experiences through the application of a personalized internal experience of compassion and support, allowing the client to access their pain without re-traumatization. This process fortifies the client for the healing journey by cultivating experiences of powerful internal resources. The client is then gently brought into contact with the root causes of their suffering in order to transform suffering at its source (Gucciardi, 2004).
Method
Participants
Participants were recruited for both experimental and control groups through flyers, classes, and waitlists at the Foundation of the Sacred Stream, and by Depth Hypnosis practitioners in their private practice settings as new clients sought counseling.
In the experimental group, a total of 40 participants consented to the study. The final sample was predominately female (92.3%), with an average age of 37.92 years old (SD = 6.77). One participant had a manic psychotic episode during treatment, and therefore was disqualified from the study, leaving 39 total participants in the experimental group.
Data were also collected for comparison from a wait-list control group of 33 participants. Participants in the control group filled out all measures at the same time intervals as the experimental group and were offered Depth Hypnosis treatment after the control group data were gathered, making this a quasi-experimental research design. Contact with the control group was limited to initial data gathering, mid-point data gathering at week 4, and end point data gathering at week 8. Examination of the treatment and control groups found that the groups did not differ in terms of age or baseline symptoms, ps > .05.
Potential subjects were told their choice to participate in the research would not affect their ability to receive treatment, and that they could end their participation in the research at any time without termination of treatment. Participants were offered a $25 gift certificate towards a class at the Foundation of the Sacred Stream as compensation for their participation.
The safety of participants was considered paramount. Written consent was obtained from all participants through an informed consent document detailing the study and the voluntary nature of their participation. The consent stated that the personal material that would be discussed could be challenging and emotional. Participants were given access to support from their own Depth Hypnosis Practitioner as well the principal investigator in case of problems.
Procedures were in place to record and report adverse events and their follow up. Participants were screened for suicidal ideation at intake and again at the 4th and 8th sessions. No participants experienced significant suicidal ideation. Confidentiality was maintained at all times.
This study was approved and monitored by an independent human subjects research review board at Copernicus Inc.
Eligibility
Participants were between 18 and 80 years of age, and although some had received psychotherapy in the past, this was their first experience with Depth Hypnosis. Pregnant women were accepted into the study (this was an initial point of contention with the human subject review board, but with much discussion it was agreed that hypnotherapy posed no known risks to pregnant women). Participants could take concomitant psycho-pharmaceutical medications, provided they had been on a stable dosage for a minimum of three months and no medication changes were made during data gathering.
Eligible subjects were identified through a positive screening for depression, anxiety, or PTSD with the measures listed below.
Exclusion criteria included active suicidal ideation, psychotic symptoms, and significant substance abuse use, which were assessed through the Beck Depression Inventory, and through the structured clinical interview (SCID). Any subjects exhibiting significant suicidal ideation, psychotic symptoms, or substance abuse at initial assessment were disqualified from study participation.
Procedure
The experimental treatment consisted of eight sessions of Depth Hypnosis. The sessions were 60 to 75 minutes in length and were conducted on a weekly basis. The PI supervised practitioners to ensure that techniques were delivered in a standardized fashion, consistent with the Depth Hypnosis Manual.
The treatment sessions were conducted by seven certified Depth Hypnosis Practitioners, in private practice settings. Depth Hypnosis certification involves a two to three year (1000+ hours) study of hypnotherapy, Buddhist psychology, transpersonal psychology and counseling, energy medicine, and applied shamanism, and includes training and supervision at the Foundation of the Sacred Stream.
Measures
Symptoms of depression, anxiety, PTSD and well-being were measured three times during the study. The structured clinical interview and four standardized self-report measures used are detailed below. Participants filled out the measures before their first session, again at session four, and again at session eight.
Depression. Depressive symptoms were assessed using the Beck Depression Inventory, II (BDI-II; Beck, Steer, & Brown, 1996; Beck, 1988; Beck & Steer, 1984). The BDI-II is a brief (21-item), yet reliable measure of depressive symptoms. The BDI-II assesses multiple domains of depression, including lack of interest in pleasure activities, sad mood, and changes in sleep and eating patterns. Higher scores on the BDI-II are indicative of greater depressive symptoms. The BDI-II is sensitive to change over relatively brief periods of time (Holcomb, Stone, Lustman, Gavard, & Mostello, 1996). Participants scoring 14 or above on the BDI were considered eligible for the study.
Anxiety. Anxious symptoms were assessed using the Beck Anxiety Inventory (BAI; Beck & Steer, 1993; Beck, Epstein, Brown, & Steer, 1988). The BAI is a brief (21-item), yet reliable measure of symptoms of anxiety. Higher scores on the BAI are indicative of greater anxious symptoms (Beck & Steer, 1993). The BAI consists of twenty-one questions about how the subject has been feeling in the last week, expressed as common symptoms of anxiety (such as numbness and tingling, sweating not due to heat, and fear of the worst happening; Beck et al., 1988). Participants scoring above a 10 on the BAI were considered eligible for the study.
PTSD. Two measures were used in conjunction to measure post-traumatic stress disorder: the Life Events Checklist for DSM-5 (LEC-5) and the PTSD Checklist – Civilian Version (PCL-C; Norris & Hamblen, 2004). The LEC-5 checklist is a self-report measure designed to screen for potentially traumatic events in a respondent’s lifetime (Weathers et al., 2013). The LEC-5 generates a score for the number of events experienced, number of events witnessed, and number of events learned about. The LEC-5 is the precursor inventory to the PTSD Checklist. The LEC-5 was only administered at baseline, as it was only necessary to document past traumatic events at the beginning of treatment. All clients testing above the PCL-C cut off scores met the criteria for a criterion A event on the LEC-5.
PTSD symptoms were assessed using the PCL-C, which is a short (17-item), reliable measure of PTSD symptoms that assesses symptoms across the main clusters of PTSD symptomatology, including hyper-vigilance, intrusive thoughts, avoidance, and changes in mood and cognition. Higher scores on the PCL-C indicate higher PTSD symptoms. This is an easily administered self-report rating scale for assessing the 17 DSM-IV symptoms of PTSD (Weathers, Litz, Herman, Huska, & Keane, 1993). The cut off score used to determine a positive PTSD score was 36, with at least one ‘B’ item, 3 ‘C’ items, and at least 2 ‘D’ items, corresponding to DSM-IV symptom criteria.
Well-Being. The Flourishing Scale (Diener et al., 2010) was used to assess well-being. The Flourishing Scale is a brief eight-item summary measure of the respondent’s self-perceived success in important areas such as relationships, self-esteem, purpose, and optimism. The scale provides a single psychological well-being score (Diener et al., 2010).
Suicidality, substance abuse, and psychosis. The Structured Clinical Interview for DSM-4 (SCID-1) is a semi-structured interview guide for making Axis I diagnoses (First, Spitzer, Gibbon, and Williams, 1996). The SCID-1 can be used with study populations to ensure that subjects meet particular diagnostic criteria including psychotic disorders, and to exclude subjects with a history of substance use disorder in the past 12 months. The SCID was used to assess addictive behavior as well as to corroborate data on suicidality with the BDI, and to rule out psychotic disorders. The SCID interview was used to gather information only at baseline and was not repeated during the study.
The BDI, BAI, PCL, and Flourishing Scale were administered together at baseline, and again at the fourth and eighth sessions.
Treatment with Depth Hypnosis
The protocol for the eight sessions of Depth Hypnosis used in this research project was taken directly from the manualized treatment procedures that Depth Hypnosis Practitioners follow in their first phase of work. Practitioners were supervised to confirm their adherence to the protocol.
In the first session, in addition to using a structured clinical interview (SCID) and the Beck Depression Inventory to assess the participants functioning and rule out significant suicidal ideation, substance abuse, and psychotic disorders, the practitioner asked a series of questions about the client’s history and belief systems that reveal what is called the client’s emotional biography. Additionally, a biography of the presenting problem was taken (Sample emotional biography and biography of the presenting problem questions in Table 1). When the first appointment was made, clients were asked to begin writing down their dreams. Depth Hypnosis incorporates many elements of Carl Jung’s dream theory (Jung, 1989), and dreams are considered to be an important source of information not only about the genesis of the presenting issues but also regarding potential resolutions of the presenting problem. All of this information helps the Depth Hypnosis practitioner chart the course of treatment.
The second session was generally the clients’ first exposure to working in an altered state. Clients were brought through a guided meditation to connect with their own personal experience of higher self. (As a reminder from the introduction, Deepak Chopra defines the higher self as an awareness that is possible once you cultivate a loving attitude of acceptance and appreciation for yourself (Carver, 2017). In Depth Hypnosis, this focused awareness is understood to be an inner resource that will act as an anchor or guide to the more intensive work of subsequent altered state sessions. In order to make this connection, clients are brought in a guided meditation to an awareness of ‘the part of yourself that has your highest good as its sole intent’. They are told that they may experience this inner resourcing ‘as a teacher in animal or plant form, or a mythical or angelic being, or a human being or a light or a sound, or in any other way that is particularly significant to you’. This verbiage creates enough structure to help the client understand what they may be looking for, while not dictating the client’s experience.
For this study, any two of the subsequent six sessions were required to be altered state sessions where the client is guided into an altered state of consciousness with hypnosis. This altered state work could focus in three areas: power retrieval, regression/soul retrieval, or the removal of energetic interference.
Power retrieval is an earth-based wisdom technique that is used in shamanic cultures to address the loss of vitality that is at the root of most imbalances. This technique has been adapted in Depth Hypnosis to be accessible in a modern hypnotherapy setting. Practitioners can focus on the retrieval of the client’s power in the form of strength, energy, and vitality using suggestion hypnosis interventions in which positive and supportive suggestions for change are offered to the client while in a deeply altered state. Suggestions might include guiding the client to connect viscerally with their own resourced experience of higher self (for example the light, or angel, etc. that was found in the first trance). As the Depth Hypnosis practitioner is offering suggestions and guidance, the practitioner is also using energy medicine techniques to support the client in accessing their own particular experience of power retrieval. It is understood here that one of the reasons that people do not heal is because they do not have effective mechanisms for accessing and directing their own internal energy and power. Power retrieval corrects this deficit and provides an engine for healing.
Regression techniques are integrated with traditional shamanic earth based wisdom soul retrieval techniques in Depth Hypnosis to address the effects of trauma. These processes not only locate a source of trauma in the past (this could be in the current life, prenatal time, or experiences of a past life), but also shift the client’s relationship to that trauma through the application of various tools of acceptance, compassion, loving kindness, healing and re-integration (soul retrieval) of any parts of the self that were experienced as having been hurt or split off during a trauma.
The regression process begins by helping the client move into an altered state of awareness with hypnotic suggestions. The emotions surrounding the current imbalance are located through the physical sensations they create within the body – and then the sensations are followed to the place within the karmic pattern where the trigger is strongest. This can bring the client’s focus to an experience in a past life, within the prenatal environment or to a time within the current lifetime. Once the strongest trigger has been located, shamanic techniques (most often soul retrieval) are applied to that situation. In this way, there is a fundamental catalytic shift in the client’s relationship to the original situation that was driving the current symptoms of imbalance. This weakens the grip of the presenting symptoms. So, it is the combined techniques of regression and soul retrieval that together locate the trauma in the psyche and then provide an effective intervention to shift clients’ relationship to that trauma, healing any internal splitting or dissociation that may have occurred.
The understanding of energetic interference also originates in earth-based wisdom and can be defined as a form of psychic or energetic introject that is not native to the client (for example an inner critic that was acquired from a parent). Energetic interference can be recognized, understood, and released through a process of guided suggestions, allowing for the redefinition of personal boundaries and reorganization of the individual’s psyche.
Sessions that do not involve altered state work include insight inquiry, dream interpretation, and integration processing. Insight inquiry is a process of interactive questioning adapted from traditional Buddhist self-directed Vipassana meditation techniques. Here, the formulation of the practitioner’s questions relies solely on the client’s previous responses. This provides a strong, flexible support to the process of discovering the issues underlying presenting symptoms. Dream interpretation involves exploring the dreams the client has had from multiple points of view. Integration processing sessions assist the client in integrating insights gained in the altered-state sessions into their everyday understandings of their history, experience, relationships, and sense of self.
These techniques are applied in whatever sequence appears most helpful to the client, with the goal of reducing presenting symptoms in the most expedient and thorough way possible. The sequence of application is dependent entirely on where the client’s particular emotional, spiritual, mental, or physical needs lie.
Data analysis
Prior to conducting primary analyses, preliminary analyses were conducted to assess the nature of the obtained data. Data were tested for the assumptions of parametric testing, including examination of normality. There were no signification violations of the assumptions of parametric testing. In order to assess for differences in symptoms over time and by group, a series of two-way (group by time) analysis of variance (ANOVA) tests were conducted. Due to differences in ranges across symptom scales, separate ANOVA models were conducted. All analyses were conducted in SPSS v. 21, and significance was set at the .05 level.
Results
A summary of results is outlined in Table 2. Across all measures, there was a significant main effect for treatment, all ps < .05 with many at ps < .01, indicating that those who received Depth Hypnosis had a significant reduction of all negative symptoms, and a significant increase in well-being. These differences were seen across each time point, indicating significant reductions in symptoms from baseline to mid-treatment, and mid-treatment to final.
Results also revealed significant interactions effects for treatment by time across all measures, all ps < .05, with many at ps < .01. Post hoc analyses revealed that at the final time point, those who received Depth Hypnosis had lower levels of depression, anxiety, and PTSD, as well as higher well-being scores. To assess the magnitude of these differences, Cohen’s d was computed using the guidelines described by Cohen (1988). When looking at the difference between posttest scores across treatment groups, moderate to large effect sizes were found across all measures. The effect was largest for Depressive Symptoms (-1.049), however all indices were significant with a medium-large effect size for well-being (-.700), and medium effect sizes for anxiety (-.544), and PTSD (-.464).
Control group symptom scores did not change significantly at any time point across any of the measures, indicating that those who did not receive treatment had stable symptomatology across time points.
Discussion
This pilot study provides preliminary evidence of the efficacy of Depth Hypnosis in the treatment of mood disorders. Following the eight week intervention, clients reported significant shifts in mood including lower levels of depression, anxiety, and symptoms of trauma, as well as an increase in their experience of well-being. To ensure that the effects that were found were the result of the treatment with Depth Hypnosis, a control comparison group completed the same self-report inventories at the same pre-, mid- and post-intervals. Clients in the treatment group had significantly lower symptom scores post treatment compared to the control group. The preliminary results indicate that this spiritual counseling model may be an effective treatment for symptoms of anxiety, depression, and PTSD, and increasing well-being.
Although this is a small pilot study, the findings are significant and support the studies of Bernardi et al. (2001), Wachholtz & Pargament (2006, 2008), Hook et al. (2010) and Pearce et al. (2018), and Propst et al. (1992), which espose the benefits of spiritually-based counseling. In fact, in PTSD, it is understood that spiritual factors may actually be predictive of symptom severity (Currier et al. 2015), suggesting that addressing spiritual factors may be crucial for recovery.
In this study, post-test scores demonstrated medium to large effect sizes across all measures. The biggest effect sizes were seen in the depression and well-being scores, with large and medium-large effect sizes respectively. Anxiety and PTSD effect sizes fell in the moderate range. This is highly significant when we compare these effect sizes to those seen in meta-analyses for cognitive behavioral therapy (CBT), which many see as the gold standard of current psychotherapeutic treatment. Hofman et al. (2012) report in a large-scale meta-analysis that CBT is generally found to have medium effect sizes in the treatment of depression, and medium to large effect sizes in the treatment of various anxiety disorders. Ehring et al. (2014) report in a meta-analysis generally seeing medium effect sizes in in the treatment of PTSD. These data suggest that Depth Hypnosis is as effective as CBT in the treatment of PTSD and anxiety, and possibly stronger than CBT in the treatment of depression.
Why is Depth Hypnosis effective?
Depth Hypnosis draws from Buddhist psychology in its understanding that problems occur when one twists away from one’s authentic higher self, or Buddha nature. This twisting away can happen if one disavows parts of the self that feel impossible to tolerate on one’s own. In Depth Hypnosis, wholeness is cultivated through connection to one’s own experience of higher self (the part of yourself that has your highest good as its sole intent). It is through the connection to the higher-self nature that clients are able to access the wisdom that allows them to tolerate and have compassion for parts of themselves that are hurt, split off, or no longer needed. These processes correspond to the techniques of power retrieval, soul retrieval, and removal of energetic interference discussed in detail above.
The emphasis in Depth Hypnosis is on the relationship clients create with their own inner guidance, leaving clients feeling empowered to effect change and more likely to own the positive effects of their efforts to change. A sense of agency is created as clients co-participate in tracking the roots of their own unique problems and changing their relationship to them. Because clients are not passive in the therapeutic process and because they are helped to develop inner resources to address their imbalances, they learn to rely on themselves knowing that they have the key to healing within them. Thus, Depth Hypnosis techniques bring clients back into the innate state of wholeness that exists within everyone (Gucciardi, 2004).
The use of the altered state. In order to heal, clients are gently guided into an altered state and encouraged to rest in their own higher-self experience of compassion and loving-kindness. This allows them to step into a new, kinder way of understanding of who they are, as they go beyond their previous limited definitions of themselves. They are challenged to redefine themselves as something other than a separate being in opposition to the world, as they allow themselves to feel deeply and positively connected to themselves and all that exists around them. The presentation of imbalance in the presenting symptoms then becomes a vehicle for the complete redefinition of the self in relationship to the world surrounding it.
The imbalance holds the key. In Depth Hypnosis, clients are encouraged to view the exploration of the roots of their symptoms as a process of self-discovery and empowerment. This weakens the roots of imbalance and allows the journey toward healing to be a movement toward wholeness. The counseling, then, is not just about the resolution of presenting symptoms, but becomes a progression through spiritual evolution and an opportunity for self-transformation. It is understood here that it is engagement with the wholeness, something greater than one’s own individual self, that heals.
Depth Hypnosis provides a non-dogmatic path back to wholeness. At no time are clients required to accept definitions of spirituality that are not resonant with them. This also allows those with nihilist or cynical views to access spiritual power without a problematic confrontation of their value systems. Through the Depth Hypnosis approach, clients are able to recover their trust in the goodness of themselves and the world that is fundamental to all healing.
Self-transformation as a therapeutic goal. Ultimately, the success of Depth Hypnosis lies in the intention and understanding of change that informs it—the understanding that the transform of suffering occurs through compassionate self-awareness. Clients come away from the encounter with the many therapeutic processes of Depth Hypnosis with the understanding that the path they take to relieve their suffering not only offers relief of their symptoms but rewards them with greater meaning and understanding of their life and their place in the cosmos.
Limitations and future directions
Our findings should be interpreted in light of several limitations that make it difficult to make absolute conclusions. The lack of a randomized control group creates a challenge in interpreting the data. We hope that subsequent studies will be better funded allowing for a randomized control group and clearer comparisons across groups. In addition, because the wait-list control group only received contact at weeks 1, 4, and 8, subsequent studies would benefit from comparing Depth Hypnosis with other counseling models, where participants in both groups receive counseling and contact at the exact same intervals. In addition, the vast majority of the study subjects were female, making the ability to draw conclusions across gender lines unclear.
It is possible that subjects recruited for treatment with Depth Hypnosis may be more spiritually oriented than the general population. Therefore, future research should focus on accessing a more general pool of subjects for treatment. This can be further evaluated with larger scale, randomized trials.
To develop the understanding of what is most potent and effective in the model, researchers are encouraged to examine the particular techniques of Depth Hypnosis. Future studies might look at only power retrieval or only soul retrieval for example, in order to understand the effects provided by these different techniques within the model. Future studies utilizing component analyses may be helpful in evaluating this.
Future researchers are encouraged to use these tools judiciously with dissociative disorders (although hypnotherapy can be an ideal way to treat dissociation, it can also exacerbate dissociative symptoms when used inappropriately) (Gucciardi, 2018), and with borderline personality disorder (as individuals with borderline presentations have been known to mistakenly strengthen negative patterns of interaction). Future recommended research would also include a follow up study to assess the efficacy of Depth Hypnosis longitudinally.
Conclusion
Our study provides insight into the breadth of change available through the manualized spiritual counseling model of Depth Hypnosis. We provide preliminary evidence into the strength and power of Depth Hypnosis methodology in the treatment of depression, anxiety, and PTSD, and in increasing well-being. Future researchers are encouraged to study these techniques with other disorders including addiction and other mood disorders. Our expectation is that the model will be quite effective with many different kinds of imbalances, as it is through the experience of our own wholeness that healing of any kind can occur.
Table 1
Scripts for Emotional Biography and Biography of the Presenting Problem
| Protocol | Questions |
| Emotional Biography | What stories have you been told about your birth?
How were you feeling most days before you started school (ages 0 to5)? What was your understanding of God and Universe as a young child? In elementary school, how were you feeling most days? As a young child, how did you feel about your mom, dad, and siblings? How were you feeling most days in junior high? In junior high how did you feel about your mom, dad, and siblings/other members of the household? How were you feeling most days in high school? In high school how did you feel most days about your mom, dad, siblings, etc? When you began having intimate relationships, was it easy or hard for you to get emotionally close? How did you feel most days after high school or in college? What is your understanding of God and the universe now? Have you had any serious illnesses, accidents, surgeries or injuries? Do you have any involvement with any kind of addictive process? How do you feel most days now?
|
| Biography of the Presenting Problem | When did this first start?
What were the circumstances in your life at that time? What were you hoping to do by (engaging in the presenting problem)? What has triggered this problem in the past? What are the current triggers of this problem? How does your body feel when you (engage in presenting problem)? What effect does this problem have on your life at the present time?
|
Table 2
Summary of Findings
______________________________________________________________________________
| Control | Treatment | Interaction Effect | ||||||||||
| n | M | SD | n | M | SD | F | p | Cohen’s d | ||||
| BDI | 46.37 | <.001 | ||||||||||
| Base | 33 | 14.82 | 9.76 | 27 | 18.22 | a | 7.47 | |||||
| Mid | 33 | 15.15 | 8.77 | 27 | 11.93 | b | 5.27 | |||||
| Final | 33 | 15.12 | 9.09 | 27 | 7.59 | c | 3.64 | -1.049 | ||||
| BAI | 32.80 | <.001 | ||||||||||
| Base | 33 | 13.45 | 10.54 | 25 | 21.24 | a | 9.12 | |||||
| Mid | 33 | 14.12 | 9.41 | 25 | 14.60 | b | 8.28 | |||||
| Final | 33 | 13.67 | 9.60 | 25 | 9.16 | c | 6.31 | -.544 | ||||
| PCL | 23.93 | < .001 | ||||||||||
| Base | 33 | 30.67 | 12.62 | 19 | 39.79 | a | 15.90 | |||||
| Mid | 33 | 30.97 | 12.23 | 19 | 32.00 | b | 8.22 | |||||
| Final | 33 | 30.70 | 12.30 | 19 | 25.89 | c | 7.32 | -.464 | ||||
| Flourish | 25.15 | < .001 | ||||||||||
| Base | 33 | 45.63 | 7.55 | 39 | 43.56 | a | 8.01 | |||||
| Mid | 33 | 45.09 | 7.43 | 39 | 46.26 | b | 6.18 | |||||
| Final | 33 | 44.69 | 7.43 | 39 | 49.15 | c | 4.78 | .700 | ||||
Note. Means and standard deviations in boldface were significantly greater across column, p < .05; Means with differing superscripts varied significantly between rows, p < .05.
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[1] Joanna Foote Adler, PsyD and Isa Gucciardi, PhD, Foundation of the Sacred Stream, Berkeley, California. The authors received no financial support for the research, authorship, and/or publication of this article. Correspondence concerning this article should be addressed to Joanna Adler, 33 Mount Foraker Dr., San Rafael, CA 94903. Email: [email protected] and [email protected]