Correspondence (letter to the editor): Stepwise Active Hypnosis

In their work on “The Efficacy, Safety, and Applications of Medical Hypnosis,” the authors have thankfully reminded us about procedures that have been lost from view in psychotherapy for decades (1). In such a retrospect, the “stepwise active hypnosis” from Ernst Kretschmer (1949) comes to mind (2). “Stepwise” means that the hypnosis uses mild suggestion, such as in “autogenic training” (J. H. Schultz, 1960), which is then graduated to reach a moderate hypnotic state (3). After each step, all experienced sensations and ideas are discussed, and this is used as the basis for hypnosis exercises. The patient is then encouraged to carry out these exercises at least once daily in self-hypnosis.

As part of the “two-pronged standard protocol,” these hypnosis exercises are linked to a so-called “analytical process,” in which the patient works on both the traits to be acquired with psychotherapy and those to be lost. This analytical process aims for a “formula-based resolution development.” This formula includes on the one hand the desired traits and, on the other hand, ignorance (usually using the word “indifferent”) about the traits to be lost. Both types of traits are linked with identifying words, which the patient (not the therapist) has deemed associative. Thus, the formula-based resolution development is stated out loud and termed suggestively by the therapist during the hypnosis of the patient.

The “two-pronged standard protocol” is thus a form of both external and self-induced hypnosis, together with target orientation with respect to one’s own experiences and behavior.