There is a range of variations to this hypothesis that either individuals with depression are less able to attend or are less hypnotizable.
Spiegel & Spiegel (1978) suggest that: 'Those with serious depressions may be so narcissistically withdrawn and devoid of energy that they cannot attend to the input signals' (pp. 148-149). Others point to the difficulties in concentration and attention associated with severe depression, suggesting that these individuals are unable to focus on the induction process. Yapko (1992) talks about the way in which depression impairs the client's ability to focus. Rather than seeing this phenomenon as a contraindication for therapy, Yapko (1992) spends some sessions 'providing some general relaxation and focusing techniques to help build an attention span adequate to utilize in therapy'. He advocates the repeated use of session tapes as ongoing practice increases ability to focus meaningfully (p. 47).
Studies which compare various clinical populations in terms of level of hypnotiz-ability provide evidence on the question of whether depressed individuals are less hypnotizable. Pettinati, Kogan, Evans et al. (1990) compared hypnotizability on two measures, the Hypnotic Induction Profile (HIP) and the Stanford Hypnotic Suggestibility Scale: C (SHSS: C) for five clinical and one normal college populations. The group with a diagnosis of major depression scored higher on the SHSS: C than the normal population and only marginally lower, although higher than the anorexia nervosa and schizophrenia groups, on the HIP.
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