Intl.

Journal of Clinical and Experimental Hypnosis, 60(4): 397–415, 2012

Copyright © International Journal of Clinical and Experimental Hypnosis
ISSN: 0020-7144 print / 1744-5183 online
DOI: 10.1080/00207144.2012.700613

RELATIONAL HYPNOSIS
Udi Bonshtein1

Western Galilee Hospital, Nahariya, Israel

Abstract: This article provides a meta-theoretical framework, which

can be applied to hypnosis, based on relational (intersubjective) psy-
choanalysis. The relationship between hypnosis and psychoanalysis
is reviewed by describing three splits: (a) psychoanalysis split off
from brain science; (b) psychoanalysis split off from hypnosis; and
(c) splits within psychoanalysis itself. Reintegrations of these three
splits are discussed from a meta-theoretical point of view—through
neuropsychoanalysis and hypnodynamic hypnotherapy (or hypno-
analysis), which combines interpersonal and intrapersonal psychol-
ogy. Evidence of the mutual adjustments of the hypnotist’s style to
the needs of the hypnotized is presented, including the unconscious
interactional mechanisms that enable these adjustments in the context
of relational hypnosis.

Psychoanalysis and Hypnosis

A variety of theoretical perspectives can be used to understand hyp-

notic phenomena. As a therapeutic tool, hypnosis can be used with
diverse therapeutic methods that can be understood by integrating var-
ious disciplines (e.g., psychoanalysis and neuroscience). Each perspec-
tive casts light on some elements, while other elements stay in the dark.
Many theoretical explanations of hypnosis can be organized inte-
gratively in a meta-theoretical framework. Psychoanalysis in particular
provides us with one of the most insightful elucidations of human
behavior and, as such, provides also a profoundly useful and illuminat-
ing framework for understanding the meta-theoretic level of hypnosis.
To construct such a framework, we need to return to the starting point
of psychoanalysis and to begin our journey by taking a close look at the
original complex relations between hypnosis and psychoanalysis.
Psychoanalysis was born out of hypnosis. Sigmund Freud had
acquired an interest in hypnosis as a medical student and engaged in
some clinical applications. He decided to focus on psychiatry because
of its promise of future income. Since this branch of medicine was

Manuscript submitted March 3, 2011; final revision accepted December 5, 2011.

1 Address correspondence to Udi Bonshtein, Child and Family Guide Unit, Western

Galilee Hospital, P.O. Box 21, Nahariya, 22100, Israel. E-mail: udibon@gmail.com

397
398 UDI BONSHTEIN

rather neglected in Vienna those days, he continued his training with

a fellowship at Jean Martin Charcot’s hospital, Salpetrière, in late 1885.
Freud had originally intended to study neuropathology in Paris, but
due to his personal connection with Charcot (the mentor he called his
“great teacher”; Freud, 1914/1957, p. 13), his interest soon shifted to
the psychopathology of hysteria. Freud became interested in Charcot’s
view of hypnosis and, at the same time, he became curious about the
perception of hypnosis proffered by the rival school of Nancy, as led
by Dr. Hippolyte Bernheim. In 1889, Freud visited Bernheim in Nancy,
a visit that enhanced his hypnotic technique; indeed, this visit proved to
be one of the most useful and important journeys of his life (Gay, 1988).
Freud’s meeting with Josef Breuer, a prominent Viennese physi-
cian, led to their coauthored essay “Studies in Hysteria” (Breuer &
Freud, 1895/1937), which is generally considered the formation point
of psychoanalysis, although it was actually a book about hypnosis.

The Three Splits

The development of psychoanalysis since Breuer and Freud’s pio-

neering work reveals three main split-offs (see Figure 1). Two of them
are external: the split between psychoanalysis and brain science and the
split between psychoanalysis and hypnosis. The third divergence was
an internal split (actually, many splits) within psychoanalysis, dividing
it into many factions and schools (Bonshtein, 2009).
Split I (psychoanalysis from brain science) was consciously chosen
by Freud, who preferred to move away from neurology and found a
new discipline. He abandoned brain research in favor of the subjective
viewpoint, thus establishing psychoanalysis. Due to the lack of effective
neurologically based research methods at that time, he chose a different
method of finding out about human subjectivity. Freud saw this split
as temporary, a separation of disciplines only until science acquired

Figure 1. Splits and integration of hypnosis, psychoanalysis, and neuroscience.

 RELATIONAL HYPNOSIS 399

adequate tools to investigate the mind, and he believed that eventu-

ally neuroscience would provide empirical support for psychoanalysis
(Freud, 1915).
Split II (psychoanalysis from hypnosis) was officially explained by
Freud as a development of his work with defense mechanisms and his
desire to encourage the emergence of transference. He preferred to do
this by using free associations. Of course, one may ask if lying on a couch
and offering free associations is not in fact a variation of hypnosis. One
can ask the same thing about transference, since transference emerges
very powerfully during the process and experience of hypnosis.
However, Freud was not sure about his qualifications as a hypnotist,
which was another reason for his official abandonment of this method
in favor of psychoanalysis. This choice is nevertheless surprising,
since Freud seems to have been a creative therapist who was actu-
ally very successful in hypnotizing his hysteria patients. As I see it,
Freud never actually abandoned hypnosis, only its authoritative style,
replacing it with a more permissive form of hypnosis, which he called
psychoanalysis.
Despite his announced abandonment in 1896 of hypnosis as a clini-
cal technique, Freud maintained an interest in it throughout his career
(Gravitz, 1991; Gravitz & Gerton, 1984), as is fully evident in his
later writings, “Jokes and Their Relation to the Unconscious” (Freud,
1905/1957) and “Group Psychology and the Analysis of the Ego”
(Freud, 1921). Hypnosis is used as an explanatory resource of these
works. Moreover, in a well-documented comment, Freud wrote that “It
is very probable . . . that the large-scale application of our therapy will
compel us to alloy the pure gold of analysis freely with the copper of
direct suggestion” (Freud, 1919, pp. 167–168).
In fact, hypnosis and psychoanalysis have more similarities than dif-
ferences. Like hypnosis, psychoanalysis is saturated with suggestive
processes, including free association, the therapeutic setting (lying on
the couch, the therapist’s tone of voice, the fixed time), and the theory
itself (Bonshtein, 2003). Moreover, the theory and practice of hypnosis
developed in parallel with psychoanalysis, using psychoanalytic con-
ceptualizations such as transference, resistance, defense mechanisms,
and the like, which are important to every hypnotist’s training and daily
work.
In essence, according to Freud, the hypnotic subject plays a passive
but dependent role. In 1890, he compared hypnosis to the relationship
between parent and child (Freud, 1890/1953). It was this parent/child
dynamic, he asserted, that facilitated the subject’s acceptance of the
therapist’s suggestions. Freud further maintained that hypnosis is a
manifestation of libidinal regression in which the patient undergoes
temporal regression to an infantile, dependent relationship (Freud,
1905/1953). For Freud (1921), then, the effects of hypnosis derive from
400 UDI BONSHTEIN

what is basically a transference phenomenon. As he stated clearly in

1910, “Transference . . . can give you the key to an understanding of
hypnotic suggestion” (Freud, 1910/1957, p. 51).
This split between psychoanalysis and hypnosis, like the previ-
ous split between psychoanalysis and brain science, facilitated the
development and consolidation of psychoanalysis as an independent
discipline.
Split III (divergences within psychoanalysis itself) occurred because
different practitioners defined the borders of the field differently.
These splits served a necessary developmental function. Klein’s object-
relations theory clarifies this developmental function. Melanie Klein
posited that, in the healthy development of an infant, the infant must
split its external world, its objects, and itself, into two categories: good
(i.e., gratifying, loved, loving) and bad (i.e., frustrating, hated, persecu-
tory). This splitting makes it possible to introject and identify with the
good. In other words, splitting in this stage is useful because it protects
the “good” from being destroyed by the “bad.” Later, when the ego has
developed sufficiently, the bad can be integrated, and ambivalence and
conflict can be tolerated (Klein, 1946). From a meta-theoretical and evo-
lutionary point of view, we can see how these splits are essential for
growth and development.
One of the main lines of development in psychoanalysis has been
the shift from intrapersonal (“one-person”) psychology to interpersonal
(“two-person”) psychology (Aron, 1990).
During the past 25 years there has been a vast change in psychoanal-
ysis. This change has taken the form of a broad movement away from
classic psychoanalytic theorizing grounded in Freud’s drive theory,
toward models of mind and development grounded in object relations.
In clinical practice, there has been a corresponding movement away
from the classic principles of neutrality, abstinence, and anonymity
toward an interactive vision of the analytic situation that places the ana-
lytic relationship, with its powerful, reciprocal affective currents, in the
foreground.
While the goal of psychoanalysis in Freud’s day was rational under-
standing and control (secondary processes) over fantasy-driven, con-
flictual impulses (primary processes), the goal of psychoanalysis today
is most often described as the establishment of a richer, more authen-
tic sense of identity (Mitchell, 1993; Ogden, 1986). What the patient
needs, according to Mitchell, is not clarification or insight so much as a
sustained experience of being seen, personally engaged, and, basically,
valued and cared about. What today’s analysis provides is the oppor-
tunity to freely discover and to playfully explore one’s own subjectivity
and one’s own imagination.
What is happening nowadays with the three splits described in this
article? As in human development, according to Klein’s object relations
 RELATIONAL HYPNOSIS 401

theory (1946), the stage dominated by splits is eventually replaced by a

stage of integration that allows for ambivalence and even conflict.

Healing the Splits

Psychoanalysis and brain science are meeting once again. We can see
the subjective and objective points of view join together in the interdisci-
plinary field called neuro-psychoanalysis (see Figure 1). Brain researchers
are now using psychoanalytic concepts to investigate human subjectiv-
ity, and psychotherapists are using empirical findings to advance theo-
retical and clinical work (e.g., Bernstein, 2011; Kandel, 2005; Northoff,
2011; Solms & Turnbull, 2002). Moreover and specifically related to
hypnosis, a recent volume of Neuropsychoanalysis offers some excel-
lent articles on the interrelatedness of suggestion, psychoanalysis, and
neuroscience (Casoni & Brunet, 2010; Goldberg, 2010; Naccache, 2010;
Raz & Wolfson, 2010; Torem, 2010).
Though the rift between hypnosis and psychoanalysis has not
entirely healed, the healing process between the two has begun.
Interestingly, while psychoanalysts have generally become more antag-
onistic toward hypnosis over the years, some hypnotists have become
more favorably disposed toward psychoanalysis (e.g., Nash, 2008;
Watkins & Barabasz, 2008). In fact, the essential developmental path-
ways of psychoanalysis are reflected in the theory of hypnosis and its
clinical implications. Present psychoanalytic objectives seem to fit in
with some modern approaches to hypnosis.
The healing of the rifts within psychoanalysis was achieved by
adopting a meta-theoretical point of view, which combines interper-
sonal and intrapersonal psychology. This is happening right now.

One More Step of Integration

Fully integrating these three healing paths into hypnosis will rely on
new evidence about the neurological basis of hypnosis and on the view
of hypnosis as a mutual process between two subjects: the hypnotized
person and the hypnotist. More detailed information on this topic can
be found in Balugani (2008) and Jamieson (2007). Here I focus on one
relevant and promising discovery of recent years: mirror neurons.
A mirror neuron is a neuron that “mirrors” the behavior of another
animal or human, by firing both when the animal (or human) itself
acts and when it observes the same action performed by another. These
neurons were first discovered by Giacomo Rizzolatti and his research
team in Italy in the early 1990s, while they were investigating primate
motor cortex (see Rizzolatti & Craighero, 2004; Rizzolatti, Fadiga,
402 UDI BONSHTEIN

Gallese, & Fogassi, 1996). In the human brain, mirror neurons have been
found in the premotor cortex and the inferior parietal cortex. Some sci-
entists believe that mirror neurons might be very important in imitation
and language acquisition. It is generally accepted that no single neuron
can be responsible for any phenomenon. Rather, a whole network of
neurons (neuronal assembly) is activated when an action is observed.
These neurons may be important for understanding the actions of other
people and may contribute to our theory of mind (ToM) skills. The term
theory of mind refers to the ability to attribute mental states of others or
of oneself, including their beliefs, feelings, intentions, and knowledge
and to account for their behavior. Some preliminary evidence connects
ToM and hypnosis by demonstrating that the same brain regions and
modules are involved in both (Bonshtein, 2012).
Although this radical view of the mirror system allowing action-
understanding by means of an inner simulation mechanism has been
criticized by some researchers (e.g., Bonshtein, Leiser, & Levine, 2006;
Fonagy, Gergely, & Target, 2007), while others believe in the importance
of embodied processes and simulations (e.g., Gallese, 2007).
The mirror neuron system can contribute to our understand-
ing of some central elements in psychoanalytical technique such
as projective identification, empathic mirroring, affective attunement,
and transference-countertransference interactions (Gallese, Eagle, &
Migone, 2007). The mirror neuron system can also contribute to our
comprehension of hypnotic psychotherapy, especially Ericksonian ther-
apy (Balugani, 2008). Embodied simulation is the functional mechanism
underlying the following experiences: action execution, action recog-
nition, empathy, and mental imagery. Inside hypnotic therapy, each of
these human experiences frequently occurs. Phenomena such as ideo-
motor and ideosensorial responses, pacing and leading, or shaping and
modeling are other examples.
Rossi and Rossi (2006) proposed that mirror neurons may function
as an interface mediating among the observing consciousness, the gene
expression/protein synthesis cycle, and brain plasticity in therapeutic
hypnosis and psychosomatic medicine.
Linking absorption together with empathic, introspective, and reflec-
tive functions to hypnosis leads us closer to the relational perspective on
hypnosis. Hypnosis, in this view, is a process involving two active part-
ners, like psychoanalytic relationships. I will expand on this relational
approach and its implications for hypnosis in the following section.

The Relational Approach

Adopting a relational (intersubjective) perspective in psychoanalysis

means giving up what Stolorow and Atwood (1992) call “the myth of
 RELATIONAL HYPNOSIS 403

the isolated mind.” Intersubjectivity is the sharing of subjective states

by two or more individuals. It is very close to my view of hypnosis as a
shared subjective state and to Winnicott’s potential space, which I discuss
in more detail below.
Relational psychoanalysis began in the 1980s as an attempt to inte-
grate the detailed exploration of interpersonal interactions and ideas
about the psychological importance of internalized relationships with
other people. Relationalists argue that personality emerges out of the
matrix of early formative relationships with parents and other figures.
Whereas in traditional psychoanalytic thought (such as Freudian the-
ory) human beings are motivated by sexual and aggressive drives,
relationalists argue that the primary motivation of the psyche is to be
in relationships with others. As a consequence, early relationships, usu-
ally with primary caregivers, shape one’s expectations about the way
one’s needs are and will be met.
Therefore, motivation is affected in significant ways by the systemic
interaction of a person with his or her relational world. Individuals
attempt to re-create those early learned relationships in current relation-
ships that may have little or nothing in common with the early ones.
This re-creation of relational patterns serves to satisfy the individual’s
needs in a way that conforms with what was learned as an infant. This
re-creation is called enactment.
It is important to state that the ideas outlined above are not new;
they were explored already in the 1950s. Racker (1968) examines
the relation between transference and countertransference phenom-
ena. These phenomena involve the reactivation (enactment) of the
“there-and-then” in the “here-and-now.” Racker uses an interactional
point of view to describe the totality of the therapist’s responses
to the client. Racker distinguishes concordant and complementary
countertransference reactions. In concordant countertransference, the
therapist feels an emotional experience that the client is avoiding or res-
onates empathically with the client’s felt experience. Complementary
countertransference occurs when therapists experience feelings that
complement patients’ feelings (as parent to child, or child to
parent).
In the perspective of relational analysts, there are two subjects in the
treatment room, the patient and the therapist, each of whom is bringing
his or her unconscious to the situation, in a mutual (but not symmetric)
relationship. The therapist’s subjectivity and specific encounter with the
patient’s subjectivity is crucial in this approach. In the postmodern age
in particular, there is a place for more than one truth, since truth is rela-
tional and context-dependent—as demonstrated in Figure 2, where one
may see an old woman or a young lady, depending upon one’s per-
spective at the moment of viewing. And what one sees, of course, may
change at any moment.
404 UDI BONSHTEIN

Figure 2. Old woman or young lady?

The Hypnotist’s Style and the Hypnotized’s Needs

In this section, I will review some evidence about the mutual adjust-
ments of the hypnotist’s style to the needs of the hypnotized. This
discussion will be followed by a review of some unconscious interac-
tional mechanisms that enable these adjustments. Lastly, I will connect
these phenomena to relational hypnosis.
Sandor Ferenczi (1909/1965), who considered hypnosis an interac-
tional framework, hypothesized a distinction between maternal and
paternal hypnosis. Bányai (1998) further identified two different work-
ing styles of hypnotists: a physical-organic style characterized by prox-
imity, warmth, and being very personal with the subject, which she
likened to Ferenczi’s description of a maternal hypnotist, as opposed
to an analytical-cognitive style, characterized by distance and reason,
which she likened to Ferenczi’s description of a paternal hypnotist.
Bányai (2002) also described two additional styles of hypnosis: sibling
style and lover-like style. In sibling style, hypnosis is based mainly on
equality. The hypnotist almost wishes to participate in the realization of
the desires and ideas of the hypnotized subject and accepts the subject’s
independent initiatives. The hypnotist places emphasis on togetherness,
 RELATIONAL HYPNOSIS 405

and the atmosphere is an intimate one. In the lover-like style, hypno-

sis is based mainly on erotic attraction. The feelings and emotions that
the hypnotized person evokes at the hypnotist are of greatest impor-
tance. The hypnotist is almost indifferent to whether the hypnotized
subject’s desires and ideas are realized or not, or whether the hypno-
tized person has independent initiatives. In this style of hypnosis, the
hypnotist emphasizes his or her own feelings. These ideas are similar to
Racker’s “complementary transference” mentioned above, but they are
also empirically grounded.
Bányai and her colleagues (Bányai, 1998; Bányai, Meszaros, &
Csokay, 1985) noticed that similar physiological changes seemed
to appear in the hypnotist and the hypnotized subject, conclud-
ing that the development of the hypnotic process is influenced by
the personal characteristics of both the hypnotist and the subject,
their relationship, and their actual physiological, behavioral, and sub-
jective experiential changes during their mutual interaction. These
findings correspond with the mirror neuron hypothesis described
above.
The interaction synchrony can appear in overt movements (e.g.,
joint movements of the limbs when the subject enacts motor sugges-
tions) and postures (e.g., posture mirroring) or in covert processes
(e.g., breathing and electromyographic activity). These phenomena
are usually involuntary and outside of awareness. When hypnosis is
sufficiently deep, a swaying motion of the hypnotist’s body has been
observed in synchrony with the subject’s breathing. This phenomenon
has been called “joint rhythmic movement” (Bányai, 1998; Bányai et al.,
1985).
Such mutual regulatory functions can be found in parent-infant inter-
actions (e.g., Brazelton, Koslowski, & Main, 1974; Stern, 1985). There
is evidence that social emotions and interactions are accompanied by
marked neurophysiological and hormonal changes in both animals and
humans (Reite & Field, 1985). As Field (1985) states:
Attachment might . . . be viewed as a relationship that develops between
two or more organisms as their behavioral and physiological systems
become attuned to each other. Each partner provides meaningful stimu-
lation for the other and has a modulating influence on the other’s arousal
level. (p. 415)

Different styles of hypnosis may help meet the subject’s various

needs and, in the case of a patient, they may correct various regulatory
deficiencies. Bányai and colleagues’ findings indicate that these styles
are not as stable as they seemed at first. Hypnotists who usually use a
maternal style may sometimes show signs that do not fit into this style.
This is true for paternal hypnotists as well (Gosi-Greguss, Bányai, &
Varga, 1993).
406 UDI BONSHTEIN

In addition to the concept of transference, there are some more

basic psychoanalytic concepts that can be used to explain such psy-
chic synchronicity; these include projective identification, containment,
attunement, enactment, transitional space, and self-disclosure.

Unconscious Interactional Mechanisms

Psychoanalysis offers us some useful concepts. For example, the con-

cept of transitional space is an amalgamation of Winnicott’s notions of
potential space and transitional phenomena (Winnicott, 1971). Potential
space is the overlapping space between two individuals, neither subject
nor object but some of each. In this space, we find transitional objects
and transitional phenomena. For many reasons, hypnosis (as Winnicott
himself thought about psychoanalysis) is a transitional phenomenon
that occurs in a transitional space (Doron & Mendlovic, 1999).
Within this space, some specific processes can be identified. The first
is projective identification. Melanie Klein (1946), who first introduced the
term, considered it an intrapsychic phenomenon, whereas her followers
(especially Bion, 1962) considered it as an interpersonal one. Projective
identification is defined as a phenomenon in which a person projects
a part of himself into another object (not onto it, as occurs in projec-
tion) in such a way that one’s behavior towards those onto whom one
projects part of himself or herself evokes in them the thoughts, feelings,
or behaviors projected. Consequently, projective identification brings
about a change in the psychic reality of the receiver of the projection.
The recipient is influenced by the projection and begins to behave as
though he or she actually has the projected thoughts or beliefs. This is
a process that generally happens outside the awareness of both persons
involved.
What is projected is most often an intolerable, painful, or dangerous
idea or belief about the self that the projecting person cannot accept.
Projective identification is believed to be a very early or primitive psy-
chological process and is considered one of the more primitive defense
mechanisms. Yet, it is also thought to be the basis from which more
mature psychological processes like empathy and intuition are formed
and as a unique way of interpersonal interaction.
A closely related concept is containment. In psychoanalytic theory, the
term “container” is associated with the concept of projective identifica-
tion. When a part of the self is projected into an object, the object then
becomes a container that holds what has been projected into it.
In the mother-infant relationship, the infant projects into the mother
parts of the self that are intolerable and suffused with anxiety. The
mother constitutes a container for the projected parts of the infant.
The affective and mental condition of a mother capable of taking in
 RELATIONAL HYPNOSIS 407

what has been projected and remaining with the projected material
is called “maternal reverie,” a concept very close to the “therapist’s
trance” (which I will refer to later on).
In the therapeutic situation, the therapist serves as a container. With
the development of the intersubjective approach in psychoanalysis, the
container can no longer be considered empty. The reactions of the thera-
pist to the patient in many cases are not merely the result of the patient’s
projective identification but rather a mixture of projected parts of the
patient with denied and split-off parts of the therapist him- or herself.
Attunement, another psychoanalytical concept, is concordant with
Bányai’s findings. Affect attunement is Stern’s (1985) conceptualiza-
tion of a sharing or an alignment of internal states in the domain of
intersubjective relatedness. For Stern, the subjective sense of self is
something that arises out of a kind of mutual, wordless experience that
he describes as attunement based on his observational work.
Attunement differs from empathy in that attunement occurs largely
outside of awareness and almost automatically, whereas aspects of
empathy require conscious cognitive mediation. Both empathy and
attunement share emotional resonance, but attunement takes emotional
resonance and recasts it into another form of expression, sometimes
even another sensory modality. It is a distinct form of affective trans-
action in its own right. The clinical use of these processes requires ToM
or mentalization capacities, which bring us back to the mirror neurons
discussed above and the hypothesis that ToM mechanisms are at the
very basis of hypnosis (Bonshtein, 2012).

The Relational Approach to Hypnosis

Empirically, the intersubjective school has been inspired by research

on infants’ nonverbal communication and, in turn, inspired research on
the hypnotized-hypnotist dyad. Such research has been conducted by
Eva Bányai and her colleagues at their laboratory in Budapest.
Traditional approaches have focused either on the hypnotist or on
the subject’s hypnotic states. Historically, hypnosis literature has con-
centrated either on the skill of the hypnotist (such as Mesmer or, more
recently, Erickson) or on the hypnotizability of the subject (such as
Charcot and the authors of the modern hypnotic susceptibility scales).
Since researchers focused on either the hypnotist or the subject, they
attributed hypnotic effects to only one of them (“one-person hypnosis”).
Bányai (1998) described this split as reflected in the fact that clinicians
using hypnosis as a therapeutic tool tend to follow the mesmeric
tradition, emphasizing the hypnotist’s skilled and sometimes even
virtuoso technical maneuvers (Barber, 1980; Haley, 1963; Van Dyck,
1982; etc.). Experimental investigation, on the other hand, has focused
408 UDI BONSHTEIN

almost exclusively on changes occurring within the hypnotized person.

Following the important recognition that hypnotic responsiveness—
as measured by standardized scales—is a stable personality trait,
researchers have compiled compelling data on the differences in peo-
ple’s susceptibility to hypnosis (Hilgard, 1986).
From the relational point of view, there is no need to limit ourselves
by focusing attention on either the hypnotist or the subject (i.e., on
only one of the individuals participating in hypnosis). Rather, we
can consider hypnosis an interpersonal process—that is, “two-person
hypnosis”; this perspective involves a paradigm shift equivalent to the
main shift in psychoanalysis mentioned above. From this point of view,
the two participants affect each other consciously and unconsciously,
and sensitive hypnotists can gain an advantage by paying attention
to their inner mental life during hypnosis. This is sometimes called
mutual hypnosis or the therapist’s trance (Diamond, 1984; Scagnelli,
1980; Tart, 1967).

Utilizing COUNTERTRANCEFERENCE

While transference is the redirection of a client’s feelings from a

significant person to a therapist, countertransference is the redirec-
tion of a therapist’s feelings toward a client or, more generally, the
therapist’s emotional entanglement with the client. I have coined the
word countertranceference to describe the hypnotist’s trance and sub-
jective experience during hypnosis. Many clinicians emphasize the
importance of the therapist allowing oneself to become more aware of
one’s countertransference as well as other feelings yet warn about the
complexities and dangers of sharing them with the patient.
One of the authors dealing with the therapist’s trance and the inter-
actional aspects of the hypnotic situation has been Diamond (1980, 1983,
1984, 1987, 1988). He has discussed the hypnotherapist’s need to gather
up the courage to experience and tolerate the patient’s unconscious
affects and images within oneself, including pain and uncertainty, while
remaining strong and stable enough to support and direct the healing
journey. Gill and Brenman (1959) and Brown and Fromm (1986) also
emphasized therapists’ use of countertransference.
A related yet controversial issue is the possibility of self-disclosure.
Self-disclosure refers to the communication of personal informa-
tion to others: what we feel, think, imagine, dream, and the like.
In psychotherapy, the patient is the one who reveals his or her inner
life. Freud, for example, insists that the psychoanalyst must be neutral
and anonymous but actually told his patients a great deal about himself.
In relational psychoanalysis, however, self-disclosure serves as a useful
therapeutic tool, although it is still very controversial.
 RELATIONAL HYPNOSIS 409

The controversy involves the therapist’s self-disclosure and shar-

ing his or her countertransference with the patient. Several writers
have proposed the careful use of such self-disclosure and sharing (e.g.,
Epstein & Feiner, 1979; Gorkin, 1987; Wolstein, 1988). Here, too, Ferenczi
preceded his time with an open approach, which included disclosing
the therapist’s feelings and attitudes to the patient, going as far as
advising free-associating to one’s unconscious motives after making a
countertransference-based error in therapy (Gorkin, 1987). Gill (1988)
emphasized the need to carefully elicit the patient’s reaction to see how
he or she experiences the therapist’s disclosure.
While many clinicians have gained great advantages from shar-
ing and self-disclosure, questions have been raised about when they
are appropriate. The main issues include the patient’s level of per-
sonality organization and whether it is the patient or therapist who
benefits from the therapist’s self-disclosure. Although disclosure of
countertransference has occasionally been used even with very dis-
turbed patients (Racker, 1953; Searles, 1979), Diamond (1983) has cau-
tioned against using it with patients with a poor level of personality
organization. Such patients can have serious difficulties accepting the
therapist’s subjectivity, and they may find the therapist’s self-disclosure
insulting or even a destructive attack on their own subjectivity. On the
other hand, some patients can be eager for role reversal, thriving when-
ever there is real, intimate sharing. Livnay (1995) found that patients
with severe personality disorders are those who are most likely to put
him into a trance state. These states very often bring him into contact
with a more mothering style (in Banyai’s terms, 1998).
The second issue is whether self-disclosure serves the patient or the
therapist. Whenever a therapist considers sharing or disclosing, this
must be done with the patient’s needs in mind. Many authors have
warned that therapists’ might use sharing or disclosure improperly,
for their own narcissistic, aggressive, or dependent needs. This cau-
tion must be weighed against overintellectualization and the loss of the
benefits of spontaneity. Self-disclosure must be based on a high level
of maturity and self-awareness on the therapist’s part, including con-
stantly checking the basis of one’s motivation for speaking and acting.
Diamond (1983) stressed the need for the therapist to have reached
a high level of integration. Being in supervision or therapy is recom-
mended for enhancing awareness of the therapist’s own motives and
unconscious wishes and needs.

Summary

Hypnosis can be seen as a two-person phenomenon—two peo-

ple who continually and mutually create each other. The view of
410 UDI BONSHTEIN

hypnosis as a context-dependent, interpersonal phenomenon is based

on well-known theoretical models, such as social role-playing or social-
cognitive theory (Kirsch, 1991; Spanos, 1991; Wagstaff, 1991), regression
theory (Gill & Brennman, 1959), or Hilgard’s (1986) neo-dissociation
theory (via ToM mechanisms). Present-day evidence from neuroscience
and experimental hypnosis supports the hypothesis of unconscious
attunement and rhythmic resonance between hypnotists and their
patients.
Meta-theoretical frameworks now connect historical split-offs into an
integrative approach. Some well-known theories about hypnosis can be
joined to provide an opportunity to gain a powerful clinical set of tools,
suitable with psychodynamic ones.
Skilled hypnotherapists can use their mental states (such as images,
mental-representations, dreams, feelings, and thoughts) as therapeu-
tic and/or diagnostic tools. In my view, a relational framework makes
it possible to close up old rifts. It also provides us with theoreti-
cal and experimental challenges. One of the interesting directions for
further investigation is the curative aspects of attunement, empathy,
and precise affective recognition of the patient. The trance state, as
a Winnicottian potential space, is a very powerful therapeutic tool,
reminiscent of the initial affective atmosphere between mother and
child (as Freud himself claimed; see Freud, 1890/1953). I can hypoth-
esize that the infant’s brain is equipped with mirror neurons and
great hypnotic susceptibility, which make it possible for him or her
to respond easily to the mother’s rocking, voice, presence, and touch
with unlimited trust. Maybe this is the neuroanatomical basis for
the regression theory of hypnosis. However, this is probably the best
way to grow, within a relational environment, a type of relational
hypnosis.

References

Aron, L. (1990). One-person and two-person psychologies and the method of psychoanal-
ysis. Psychoanalytic Psychology, 7, 475–485.
Balugani, R. (2008). Embodied simulation and imagery at work in hypnosis: Ericksonian
psychotherapy and its uniqueness. Contemporary Hypnosis, 25, 29–38.
Bányai, É. I. (1998). The interactive nature of hypnosis: Research evidence for a social-
psychobiological model. Contemporary Hypnosis, 15, 52–64.
Bányai, É. I. (2002). Communication in different styles of hypnosis. In C. A. L. Hoogduin,
C. P. D. R. Schaap, & H. A. A. de Berk (Eds.), Issues on hypnosis (p. 1–19). Nijmegen,
The Netherlands: Cure & Care.
Bányai, É. I., Meszaros, I., & Csokay, L. (1985). Interaction between hypnotist and sub-
ject: A social psychophysiological approach (preliminary report). In D. Waxman, P. C.
Misra, M. Gibson, & M. A. Basker (Eds.), Modern trends in hypnosis (pp. 97–108). New
York, NY: Plenum.
Barber, J. (1980). Hypnosis and the unhypnotizable. American Journal of Clinical Hypnosis,
23, 4–9.
 RELATIONAL HYPNOSIS 411

Bernstein, W. M. (2011). A basic theory of neuropsychoanalysis. London, United Kingdom:

Karnac Books.
Bion, W. (1962). Learning from experience. New York, NY: Jason Aronson.
Bonshtein, U. (2003). On the options of conscious choice and unconscious suggestion.
Sihot-Dialogue, 18(1), 79–80. (Hebrew)
Bonshtein, U. (2009). The relational (intersubjective) approach to hypnosis. In G. K.
Koester & P. R. Delisle (Eds.), Hypnosis: Theories, research and applications (pp. 145–159).
New York, NY: Nova Science.
Bonshtein, U. (2012). Theory of mind as a neurological basis of hypnosis. Manuscript in
preparation.
Bonshtein, U., Leiser, D., & Levine, J. (2006). Naive theory impairment in schizophrenia—
Is it domain-specific? Journal of Nervous and Mental Disease, 194, 753–759.
Brazelton, T. B., Koslowski, B., & Main, M. (1974). The origins of reciprocity: The early
mother-infant interaction. In M. Lewis & L. Rosenblum (Eds.), The effect of the infant on
its caregiver (pp. 49–76). New York, NY: Wiley.
Breuer, J., & Freud, S. (1937). Studies in hysteria. New York, NY: Nervous and mental
diseases. (Original work published 1895)
Brown, D. P., & Fromm, E. (1986). Hypnotherapy and hypnoanalysis. Hillsdale, NJ: Erlbaum.
Casoni, D., & Brunet, L. (2010). Alloying the gold of psychoanalysis with the copper of
suggestion: From suggestion to transference interpretation. Neuropsychoanalysis, 12,
19–21.
Diamond, M. J. (1980). The client-as-hypnotist: Furthering hypnotherapeutic change.
International Journal of Clinical and Experimental Hypnosis, 28, 197–207.
Diamond, M. J. (1983). An hypnotic induction technique to induce therapist trance: The
client-as-therapist. In J. Hariman (Ed.), The therapeutic efficacy of the major psychothera-
peutic techniques (pp. 69–73). Springfield, IL: Thomas.
Diamond, M. J. (1984). It takes two to tango: Some thoughts on the neglected importance
of the hypnotist in an interactive hypnotherapeutic relationship. American Journal of
Clinical Hypnosis, 27, 3–13.
Diamond, M. J. (1987). The interactional basis of hypnotic experience: On the relational
dimensions of hypnosis. International Journal of Clinical and Experimental Hypnosis, 35,
95–115.
Diamond, M. J. (1988). Accessing archaic involvement: Toward unraveling the mystery
of Erickson’s hypnosis. International Journal of Clinical and Experimental Hypnosis, 36,
141–156.
Doron, A., & Mendlovic, S. (1999). Hypnosis and Winnicott’s transitional phase.
Contemporary Hypnosis, 16, 36–39.
Epstein, L., & Feiner, A. H. (1979). The therapist’s contribution to treatment—An
overview. Contemporary Psychoanalysis, 15, 489–513.
Ferenczi, S. (1965). Comments on hypnosis. In R. E. Shor & M. T. Orne (Eds.), The nature
of hypnosis: Selected basic readings (pp. 177–178). New York, NY: Holt, Rinehart and
Winston. (Original work published 1909)
Field, T. (1985). Attachment as psychobiological attunement: Being on the same wave-
length. In M. Reite & T. Field (Eds.), The psychobiology of attachment and separation (pp.
415–454). Orlando, FL: Academic.
Fonagy, P., Gergely, G., & Target, M. (2007). The parent-infant dyad and the con-
struction of the subjective self. Journal of Child Psychology and Psychiatry, 48,
288–328.
Freud, S. (1915). The Unconscious. In J. Strachey (Ed. & Trans.), The standard edition of the
complete psychological works of Sigmund Freud (Vol. 14, pp. 159–215). London, United
Kingdom: Hogarth.
Freud, S. (1919). Lines of advance in psycho-analytic therapy. In J. Strachey (Ed. &
Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 17,
pp. 157–168). London, United Kingdom: Hogarth.
412 UDI BONSHTEIN

Freud, S. (1921). Group psychology and the analysis of the ego. In J. Strachey (Ed. &
Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol.
18, pp. 65–144). London, United Kingdom: Hogarth.
Freud, S. (1953). Psychical (or mental) treatment. In J. Strachey (Ed. & Trans.), The standard
edition of the complete psychological works of Sigmund Freud (Vol. 7, pp. 282–302). London,
United Kingdom: Hogarth. (Original work published 1890)
Freud, S. (1953). Three essays on the theory of sexuality. In J. Strachey (Ed. & Trans.), The
standard edition of the complete psychological works of Sigmund Freud (Vol. 7, pp. 130–243).
London, United Kingdom: Hogarth. (Original work published 1905)
Freud, S. (1957). Jokes and their relation to the unconscious. In J. Strachey (Ed. & Trans.),
The standard edition of the complete psychological works of Sigmund Freud (Vol. 8, pp.
1–247). London, United Kingdom: Hogarth. (Original work published in 1905)
Freud, S. (1957). Five lectures on psychoanalysis. In J. Strachey (Ed. & Trans.), The standard
edition of the complete psychological works of Sigmund Freud (Vol. 11, pp. 9–55). London,
United Kingdom: Hogarth. (Original work published 1910)
Freud, S. (1957). On the history of the psychoanalytic movement. In J. Strachey (Ed. &
Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol.
14, pp. 1–66). London, United Kingdom: Hogarth Press. (Original work published
1914)
Gallese, V. (2007). Before and below “theory of mind”: Embodied simulation and the
neural correlates of social cognition. Philosophical Transactions of the Royal Society
B-Biological Sciences, 362(1480), 659–669.
Gallese, V., Eagle, M. N., & Migone, P. (2007). Intentional attunement: Mirror neu-
rons and the neural underpinnings of interpersonal relations. Journal of the American
Psychoanalytic Association, 55(1), 131–176.
Gay, P. (1988). Freud: A life for our time. New York, NY: Norton.
Gill, M. M. (1988). The interpersonal paradigm and the degree of the therapist’s involve-
ment. In B. Wolstein (Ed.), Essential papers on countertransference (pp. 304–338). New
York, NY: New York University Press.
Gill, M. M., & Brenman, M. (1959). Hypnosis and related states: Psychoanalytical studies in
regression. Madison, CT: International Universities Press.
Goldberg, I. (2010). Suggestion as clinical tool—More than just a suggestion?
Neuropsychoanalysis, 12, 28–29.
Gorkin, M. (1987). The uses of countertransference. New York, NY: Jason Aronson.
Gosi-Greguss, A. C., Bányai, E. I., & Varga, K. (1993, August). Hypnotist styles as reflected
in standardized hypnosis experiments. Paper presented at the 6th European Congress of
Hypnosis, Vienna, Austria.
Gravitz, M. A. (1991). Early theories of hypnosis: A clinical perspective. In S. J. Lynn &
J. W. Rhue (Eds.), Theories of hypnosis: Current models and perspectives (pp. 19–42). New
York, NY: Guilford.
Gravitz, M. A., & Gerton, M. I. (1984). Hypnosis in the historical development of
psychoanalytic psychotherapy. In W. C. Wester & A. H. Smith (Eds.), Clinical hypnosis:
A multidisciplinary approach (pp. 7–17). Philadelphia, PA: Lippincott.
Haley, J. (1963). How hypnotist and subject maneuver each other. In J. Haley (Ed.),
Strategies of psychotherapy (pp. 20–40). New York, NY: Grune and Stratton.
Hilgard, E. R. (1986). Divided consciousness: Multiple controls in human thought and action.
New York, NY: Wiley.
Jamieson, G. A. (Ed.). (2007). Hypnosis and conscious states: The cognitive neuroscience
perspective. New York, NY: Oxford University Press.
Kandel, E. R. (2005). Psychiatry, psychoanalysis, and the new biology of mind. Arlington, VA:
American Psychiatric Publishing.
Kirsch, I. (1991). The social learning theory of hypnosis. In S. Lynn & J. Rhue (Eds.),
Theories of hypnosis: Current models and perspectives (pp. 439–465). New York, NY:
Guilford.
 RELATIONAL HYPNOSIS 413

Klein, M. (1946). Notes on some schizoid mechanisms. The International Journal of

Psychoanalysis, 27, 99–110.
Livnay, S. (1995). The therapist trance as a generator of associative techniques in therapy.
In E. Bolcs et al. (Eds.), Hypnosis connecting disciplines: Proceedings of the 6th European
congress of hypnosis (pp. 152–155). Vienna, Austria: Medizinish-Pharmazeutlische
Verlag.
Mitchell, S. A. (1993). Hope and dread in psychoanalysis. New York, NY: Basic Books.
Naccache, L. (2010). A few suggestions about suggestion, psychoanalysis, and
neuroscience. Neuropsychoanalysis, 12, 32–34.
Nash, M. R. (2008). A psychoanalytic theory of hypnosis: A clinically informed approach.
In M. R. Nash & A. J. Barnier (Eds.), The Oxford handbook of hypnosis: Theory, research,
and practice (pp. 201–222). New York, NY: Oxford University Press.
Northoff, G. (2011). Neuropsychoanalysis in practice: Brain, self and objects. Oxford, United
Kingdom: Oxford University Press.
Ogden, T. H. (1986). The matrix of the mind: Object relations and the psychoanalytic dialogue.
New York, NY: Aronson.
Racker, H. (1953). The countertransference neurosis. International Journal of Psychoanalysis,
34, 313–324.
Racker, H. (1968). Transference and counter-transference. London, United Kingdom: Hogarth
Press and Institute of Psycho-Analysis.
Raz, A., & Wolfson, J. B. (2010). From dynamic lesions to brain imaging of behav-
ioral lesions: Alloying the gold of psychoanalysis with the copper of suggestion.
Neuropsychoanalysis, 12, 5–18.
Reite, M., & Field, T. (Eds.) (1985). The psychobiology of attachment and separation. Orlando,
FL: Academic.
Rizzolatti, G., & Craighero, L. (2004). The mirror-neuron system. Annual Review of
Neuroscience, 27, 169–192.
Rizzolatti, G., Fadiga, L., Gallese, V., & Fogassi, L. (1996). Premotor cortex and the
recognition of motor actions. Cognitive Brain Research, 3, 131–141.
Rossi, E. L., & Rossi, K. L. (2006). The neuroscience of observing consciousness and mirror
neurons in therapeutic hypnosis. American Journal of Clinical Hypnosis, 48, 263–278.
Scagnelli, J. (1980). Hypnotherapy with psychotic and borderline patients: The use of
trance by patient and therapist. American Journal of Clinical Hypnosis, 22, 164–169.
Searles, H. F. (1979). Countertransference and related subjects. New York, NY: International
Universities Press.
Solms, M., & Turnbull, O. (2002). The brain and the inner world: An introduction to the
neuroscience of subjective experience. New York, NY: Other.
Spanos, N. (1991). A sociocognitive approach to hypnosis. In S. Lynn & J. Rhue (Eds.),
Theories of hypnosis: Current models and perspectives (pp. 324–361). New York, NY:
Guilford.
Stern, D. N. (1985). The interpersonal world of the infant: A view from psychoanalysis and
developmental psychology. New York, NY: Basic Books.
Stolorow, R. D., & Atwood, G. E. (1992). Contexts of being: The intersubjective foundations of
psychological life. Hillsdale, NJ: Analytic.
Tart, C. T. (1967). Psychedelic experiences associated with a novel hypnotic procedure,
mutual hypnosis. American Journal of Clinical Hypnosis, 10, 65–78.
Torem, M. S. (2010). The central role of suggestion in all clinical encounters including
psychoanalysis. Neuropsychoanalysis, 12, 43–46.
Van Dyck, R. (1982). How to use Ericksonian approaches when you are not Milton H.
Erickson. In J. K. Zeig (Ed.), Ericksonian approaches to hypnosis and psychotherapy (pp.
37–47). New York, NY: Brunner Mazel.
Wagstaff, G. (1991). Compliance, belief, and semantics in hypnosis: A nonstate, sociocog-
nitive perspective. In S. Lynn & J. Rhue (Eds.), Theories of hypnosis: Current models and
perspectives (pp. 362–369). New York, NY: Guilford.
414 UDI BONSHTEIN

Watkins, J. G., & Barabasz, A. (2008). Advanced hypnotherapy: Hypnodynamic techniques.

New York, NY: Routledge.
Winnicott, D. W. (1971). Playing and reality. London, United Kingdom: Routledge.
Wolstein, B. (1988). The pluralism of perspectives on countertransference. In B. Wolstein
(Ed.), Essential papers on countertransference (pp. 339–354). New York, NY: New York
University Press.

Relationelle Hypnose

Udi Bonshtein
Abstrakt: Dieser Artikel bietet einen auf relationeller (intersubjektiver)
Psychoanalyse basierenden meta-theoretischen Rahmen, der auf die
Hypnose angewendet werden kann. Das Verhältnis zwischen Hypnose
und Psychoanalyse wurde durch die Beschreibung dreier Aufspaltungen
bewertet : (a) Psychoanalyse getrennt von Neurowissenschaften, (b)
Psychoanalyse getrennt von Hypnose und (c) Trennung innerhalb der
Psychoanalyse selbst. Die Wiedereingliederung dieser drei Aufspaltungen
wird von einem meta-theoretischen Punkt aus diskutiert, nämlich
durch Neuropsychoanalyse und hypnodynamische Hypnotherapie (oder
Hypnoanalyse), die interpersonelle und intrapersonelle Psychologie
kombiniert. Beweise für die gegenseitigen Anpassungen des Stils des
Hypnotherapeuten an die Bedürfnisse des Patienten werden aufgezeigt,
eingeschlossen die unbewußten interaktionellen Mechanismen, die diese
Anpassungen im Kontext relationeller Hypnose ermöglichen.
Stephanie Reigel, MD

L’hypnose relationnelle

Udi Bonshtein
Résumé: cet article fournit un cadre de travail métathéorique, qui peut être
appliqué à l’hypnose, basé sur la psychoanalyse relationnelle (intersubjec-
tive). La relation qui existe entre l’hypnose et la psychoanalyse y est étudiée
par la description de trois fractionnements : a) la scission psychoanalytique
de la science du cerveau; b) la scission psychoanalytique de l’hypnose; et
c) les scissions présentes à l’intérieur de la psychoanalyse elle-même. La
réintégration de ces trois fractionnements y est discutée selon un point de
vue métathéorique – par l’intermédiaire de la neuropsychoanalyse et de
l’hypnothérapie hypnodynamique (ou hypnoanalyse), laquelle combine la
psychologie interpersonnelle et intrapersonnelle. Des preuves de la présence
d’ajustements mutuels entre le style de l’hypnotiseur et les besoins de la
personne hypnotisée y sont présentées, y compris les mécanismes interact-
ifs inconscients donnant lieu à ces ajustements dans le contexte de l’hypnose
relationnelle.
Johanne Reynault
C. Tr. (STIBC)
 RELATIONAL HYPNOSIS 415

Hipnosis relacional

Udi Bonshtein
Resumen: Este artículo provee un marco meta-teórico, que puede ser apli-
cado a la hipnosis, basado en el psicoanálisis relacional (intersubjetivo).
La relación entre la hipnosis y el psicoanálisis se revisa al describir tres
separaciones: (a) el psicoanálisis se separa de la neurociencia; (b) el psi-
coanálisis se separa de la hipnosis; y (c) separaciones dentro del mismo
psicoanálisis. La reintegración de estas tres separaciones se discute desde un
punto de vista meta-teórico –a través del neuropsicoanálisis y la hipnoterapia
hipnodinámica (o hipnoanálisis), que combina la psicología interpersonal
e intrapersonal. Se presenta evidencia de los ajustes mutuos entre el estilo
del hipnotista y las necesidades del hipnotizado, incluyendo los mecanismos
inconscientes de interacción que permiten estos ajustes en el contexto de la
hipnosis relacional.
Omar Sánchez-Armáss Cappello, PhD
Autonomous University of San Luis Potosi,
Mexico
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