Introduction And Literature Review

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A review of the recent literature on eating disorders, including anorexia nervosa and bulimia, reveals a remarkable silence on the utilization of hypnosis as a therapeutic tool. It is evident, for example from the book chapters by Walsh (1997) and Yager (1994), as well as journal articles devoted to eating disorders such as that of Doyle (1996), and a whole issue of the Psychiatric Clinics of North America (edited by Yager, 1996) that includes 13 scientific articles on eating disorders. In this special issue, to my surprise, the subject of hypnosis or guided imagery is not even mentioned as a viable option in the treatment of eating disorders. The publications that have appeared in the past decade on the efficacy of hypnotic techniques in the treatment of eating disorders are not even mentioned or cited; the subject of hypnosis does not exist in this special issue. This phenomenon reflects a level of ignorance on this subject reminiscent of the old adage 'The eye sees only what the mind is prepared to comprehend'; in this case, modified to 'The traditional doctor writes only about what his mind is prepared to comprehend.' Nevertheless, the effectiveness of hypnotic interventions in patients with eating disorders has been recorded in the literature over and over again since the time of Pierre Janet (1907, 1919).

Numerous publications have pointed out the usefulness of hypnosis in the treatment of patients with eating disorders. Vanderlinden and Vandereycken (1988, 1990) provide a comprehensive and excellent review of the literature on the use of hypnosis with eating disorders. Janet (1907, 1919) described how by using hypnotic techniques he was able to change the patients' dissociative, fixed ideas about eating and their body image, and to promote a general mental synthesis. Janet also used cognitive restructuring techniques that were successfully augmented by hypnosis. The hypothesis that many patients with eating disorders may suffer from dissociative episodes, has been supported by the research of Pettinati, Horne and Staats (1982, 1985), as well as by Council (1986) and Torem (1986a, 1990). These studies

International Handbook of Clinical Hypnosis. Edited by G. D. Burrows, R. O. Stanley and P. B. Bloom © 2001 John Wiley & Sons, Ltd found that patients with bulimia were significantly more hypnotizable than patients with anorexia nervosa. Griffith (1989) reported the successful use of a hypnobeha-vioral model in the treatment of bulimia nervosa, and Gross (1984) reported the successful use of hypnosis in the treatment of patients with anorexia nervosa, thus indicating that patients bearing the diagnosis of anorexia nervosa should not automatically be ruled out as candidates for hypnotherapy.

This chapter will describe specific issues involved in effective assessment of the patient with an eating disorder before the decision to utilize hypnosis is implemented. Then follows a description of a variety of hypnotherapeutic techniques and their utilization in the treatment of patients with eating disorders.

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