The Dilemma of Treating Relatives, Friends and People Known Socially to a Therapist in Hypnotherapy

HypnosisAustralia, May 2002

By Dr Tracie O'Keefe DCH, Clinical Hypnotherapist, Psychotherapist & Counsellor
Editorial Director of HypnosisAustralia Online.

One of the prime considerations for any therapist using any kind of hypnotic treatment is the assessment of the psychodynamic relationship between the hypnotist and the hypnotic participant. This consideration is present in the relationship between all kinds of clinical treatments and psychotherapeutic contexts.

For some disciplines it is considered inappropriate for a clinician to take on a patient who is member of their family, a friend or a person known socially to the clinician prior to treatment. The relationship dynamics involved can lead the clinician not to have a clear objective perspective of the patient and their situation, and may lead to some form of emotional involvement with the outcome of the case. Very high on any clinician's list of priorities must be objectivity and clarity of thought as the patient comes into treatment, because their own subjective view is clouded and they are unable to see the best way for the client to go forward.

Although a lot of experimental literature including that of Erickson and the Hillgards contain reporting on work done with people familiar to the hypnotist, in today's clinical ethical climate it is considered preferable that the closeness of relationships can cloud any outcome. In experimental reporting, often undertaken by academics, university staff, and students, people taking part in the experiment are often known to the operator due to the convenience of collecting data from close proximity university communities. This is, however, properly recorded in the criticism of any study as a factor that is likely to load the results.

Clinicians also may often treat colleagues, staff or members of the community known to them if they are in an under-populated area or if they are the only specialist in a field available. Again the problems of undue influence due to the extra dynamics in the hypnotic relationship may arise. In these circumstances not only can lack of objectivity propose a danger but also the personal interest of the outcome for the clinician. But there are realistically times when a clinician can find themselves as the only help available.

Many supervisors and professional associations do advise clinicians to refer on potential patients for hypnotic treatment to another hypnotist if they know them. They also advise that an individual should never treat a spouse, child or sibling.

There is also the matter that if the treatment does not succeed, the patients will have to contend with the altered relationship between operator and hypnotic participant outside the clinical perspective. This can be very embarrassing to the client and can cause the reduction of the social space. They can have thoughts like: "I'm a failure and the clinician knows it and every time I see them I will be reminded of that fact"; "I'm so afraid that everyone else will know I tried to work with this kind person and I failed."

Thus it can be extremely uncomfortable for the patient to have to share space with another person who will know their most intimate secrets or have seen them at a social disadvantage.

In considering the boundaries between clinician and patients it is in the interest of all parties concerned if a client were referred on if they are known to the clinician if at all possible. Because the psychodynamics of hypnosis can to some people seem authoritarian and submissive, those dynamics need to be confined to the treatment context only.

©HypnosisAustralia, May 2002