The Role of Clinical Hypnosis in the Treatment of Eating Disorders

Hypnotizability in eating disordered populations can be viewed as a personality trait as well as ability. In addition to hypnotic performance, in the literature hypnotizability correlates with eating disorders. In eating disordered populations, bulimics are significantly more hypnotizable than anorexics; anorexics of the purging subtype generally are more hypnotizable than restricting anorexics.

In one study, researchers found that 73% of 30 bulimic patients were moderately to highly hypnotizable. They also studied hypnotizability in bulimic populations and confirmed previous findings of hypnotizability in this population. In another study of bulimic patients, researchers found that bulimics were highly hypnotizable when compared with other psychiatric patients and show high dissociative ability. High hypnotizables are hypersensitive to psychological and physiological changes. They generally have superior sensory memory and have a superior ability to transfer information from sensory memory to short term memory. This ability could be used to rapidly learn and retain operant anxiety. This is the possible reason that bulimics find strong emotion or feelings intolerable for them.

In 1986 H. M. Pettinati reported that having the ability to experience dissociation may be a relevant factor in regards to the high hypnotizability found in bulimic patients. Clinicians have compared the acts of binge eating and purging to dissociative experiences.

In another group of 30 bulimics, 75% had experienced dissociation. Dissociation has not been found to be a feature of anorexia nervosa of the restricting type. Researchers found higher scores in bulimics and purging anorexics on the Dissociation Questionnaire (DIS-Q. They reported that hypnotizability and dissociation can be related to body image distortion which is common in both anorexia and bulimia nervosa. An individual who is highly hypnotizable can easily absorb or internalize the messages from society that promote a slim body shape as the ideal. This is the factor that is known as suggestibility. Internalization of the thin body ideal leads to body dissatisfaction.

Both anorexics and bulimics have been found to have equivalent body image disturbances; both populations overestimate their body size. This population utilizes restrained eating as a strategy to meet society’s ideal and also to reduce negative affect.

Many anorexics are of low hypnotic ability and as a result they frequently demonstrate a hyposensitivity to psychological and physiological changes, a tendency to deny psychological causation of behavior, and a propensity to remain in denial of the severity of their illness. The anorexic that is low in hypnotic ability is subject to stress disorders because he or she is relatively insensitive to or deficient in attention to relationships between psychological states and physiological states. They have a psychological insensitivity to changes in mood and feelings. They have a lack of proprioceptive or interoceptive awareness which means they lack the ability to discriminate between different feeling states in the body, such as being hungry and being full. Many anorexics are alexithymic, meaning they have no words for moods.

Clinical hypnosis can be one of the most effective interventions in the treatment of eating disordered clients. Rapport must first be established as clients can view hypnosis as something that is going to take away their perceived control. Relaxation is the best place to start. Teaching relaxation techniques while the client is in an altered state is not only effective but also helps the client intensify the transference with the clinician. Hypnosis can be used to build ego strength and used in ego integration, to modify eating disordered behaviors, to alter body distortion, to teach sensitivity to being hungry and full, and age progression. Age regression should be used rarely and then only by an experienced hypnotherapist as many underlying issues may surface before the client is ready to deal with them.

The addition of clinical hypnosis by a skilled professional greatly enhances the treatment of an eating disordered client. Clients find that hypnosis actually helps them regain control and maintain a healthy weight.

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