Soskis, D. A., Orne, E. C., Orne, M. T., & Dinges, D. F. Self-hypnosis and meditation for stress management: A brief communication. International Journal of Clinical and Experimental Hypnosis, 1989, 37, 285-289.



Institute of Pennsylvania Hospital and University of Pennsylvania

Abstract: In a 6-month follow-up study, telephone interviews were conducted with 31 male executives who were taught either a self-hypnosis or meditation exercise as part of a stress-management program. Use of and problems with the 2 exercises were similar, with the percentage of Ss using the techniques falling over 6 months from 90% to 42%. The exercises were used primarily for physical relaxation, refreshing mental interludes, aiding sleep onset, and stress-reduction. Problems with the exercises chiefly involved difficulty in scheduling even brief uninterrupted practice times and discomfort with the techniques. The incorporation of these issues into the clinical teaching of self-hypnosis may be useful.

Self-hypnosis and meditation have been promoted by many professionals and non-professionals as effective and relatively risk-free techniques for coping with anxiety and/or tension due to stress. Although some proponents of each technique emphasize its unique nature and benefits, both are skills learned by the patient and practiced mostly outside the teacher's or therapist's office.

Recent clinical reviews have discussed the general increase in use of self-hypnosis (Baker, 1987) and emphasized the positive results of its application to anxiety or tension due to stress (Barnett, 1984). Benson, Frankel, Apfel, Daniels, Schniewind, Nemiah, Sifneos, Crassweller, Greenwood, Kotch, Arns, and Rosner (1978) found both self-hypnosis and meditation moderately successful in a careful 8-week follow-up of 32 anxious patients, with psychiatric- and self-assessments yielding 34% and 63% improved at follow-up, respectively. The most detailed studies of self-hypnosis, by Fromm (1981, 1985; Fromm, Boxer, & Brown, 1985) and her group at the University of Chicago, have been conducted on non-clinical samples of college student experimental Ss. For those who enjoyed self-hypnosis and continued to practice it regularly, the procedure became a relatively self-sustaining process that featured receptive, expansive, free-floating attention; ego receptivity to inner stimuli; and rich, vivid imagery.

Aside from individual testimonials and promotional material, most careful studies of meditation applied to anxiety and tension due to stress have yielded modest results in terms of clinical benefits and maintenance of practice (Goldberg, 1982). Raskin, Bali, and Peeke (1980) compared electromyographic biofeedback, muscle relaxation, and transcendental meditation in the treatment of anxious patients.

Manuscript submitted February 23, 1988; final revision received July 21, 1988.

1 An earlier version of this paper was presented at the 37th annual meeting of the Society for Clinical and Experimental Hypnosis, Chicago, September 1986.

2 Analysis of data for this study was supported by grants from the National Institute of Mental Health (MH 19156) and the Institute for Experimental Psychiatry Research Foundation.

3 Reprint requests should be addressed to David A. Soskis, M.D., The Institute of Pennsylvania Hospital 111 North 49th Street, Philadelphia, PA 19139-2798.



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They found that about 40% of those who completed training in any of the techniques showed marked improvement, with most patients requiring frequent "booster" sessions to maintain skills. Problems with skill maintenance and home practice have been recognized in most follow-up studies of self-control techniques. In a non-clinical population of college students trained in muscle relaxation or transcendental meditation and followed up at 1 and 2.5 years, less than 25% of both groups reported more than moderate satisfaction and less than 20% practiced as much as once per week (Zuroff & Schwarz, 1980).

To help clinicians employ self-hypnosis and meditation most effectively, it is important to know the natural course of the use of these techniques over substantial periods of time: how they are used, what they are used for, and the problems that characteristically arise. The present study was directed to assess these factors among adults participating in training for stress-management.


Thirty-one male executives, ages 38-45, were taught either a brief self-hypnosis or meditation exercise as part of an organizational stress-management program aimed at promoting health through the use of effective coping strategies. Assignment to a particular technique was made on a random basis, and both exercises were taught in a 1.5-hour group session. The self-hypnosis exercise involved an eyes-closed hand levitation and participation in a pleasant, relaxing, imaginary beach scene (Soskis, 1986). The meditation exercise involved an internally focused cycle of counting eight breaths while sitting in a comfortable position with eyes closed. The Ss were encouraged to practice the exercise they were taught for 10 minutes twice daily, 5 days a week for the first 2 weeks, and then to adjust the frequency of use as needed. Telephone follow-ups utilizing structured questions were conducted by the teacher at 1 and 6 months after learning the exercise. Each S was asked whether or not he had used the technique one or more times during each third (2 months) of the 6-month follow-up period, what the exercise was used for, and whether or not any problems arose.


Although the standardized tests for hypnotic responsivity were not administered in the present study, the 21 Ss who learned the self-hypnosis exercise completed the Brief Hypnotic Experience Evaluation Form, a six-question self-rating scale concerning the scripted induction. This provided four graded options (1 to 4) each for the behavioral, experiential, and involuntary aspects of a hand-levitation; the vividness and sense of participation in an imagined beach scene; and how pleasant S found the experience of hypnosis (Soskis, 1986). These Ss had a mean score of 16.38, which was similar to the mean of 16.55 reported by Soskis (1986) for his non-patient sample.

The numbers and percentages of Ss who reported using each technique once or more during each third (2 months) of the 6-month follow-up period are given in Table 1. Of the 10 meditation Ss and the 21 hypnosis Ss, 5 and 12 Ss, respectively, had used their technique 10 or more times during the 6 months since they had learned it.

Although the percentage of Ss using the meditation technique was greater than that using self-hypnosis at each comparison point, the percentage of Ss using each technique did not differ significantly at any of the points (Z test for independent proportions). Moreover, an ANOVA using Ss' individual frequencies of use for the self-hypnosis and meditation groups revealed no significant between-groups differences for either raw or log-transformed data. The rate of use over the 6-month follow-up period also dropped equally for both groups.


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There were no statistically significant differences between the applications, perceived helpfulness, or problems encountered by users of the two techniques at either the 1- or 6-month follow-ups on a number of measures. Because of these sustained similarities within the present study, further data will be presented for all 31 Ss combined.

The five most frequently described uses (illustrative comments are given where appropriate) of the self-hypnosis and meditation exercises for the current group and the percentage of Ss reporting each of them were as follows: (a) relaxation, primarily for experienced physical tension (68%); (b) refreshing mental interlude from prolonged work sessions (39%); (c) aiding sleep onset (19%); (d) stress-reduction in response to external stressors ("It sort of calmed me down…if I was really strung out") (19%); and (e) gaining perspective on issues or problems ("cleared my mind"; "It made me slow down and relax a little; I'd realize what was really important") (16%).

The three most frequent problems encountered by Ss in doing the exercises and the percentage of Ss reporting them, were as follows: (a) difficulty in scheduling even brief uninterrupted times (45%); (b) discomfort with the techniques ("It's just not the type of thing I connect with myself") (39%); and (c) difficulty in finding the necessary privacy (13%). No significant problems with their exercise were experienced by 29% of Ss.


Procedures involving self-hypnosis have occupied an increasing proportion of the clinical applications of hypnotic techniques. Presented in a relatively permissive, non-authoritarian context as a skill that is taught to the patient for application in his/her own environment, self-hypnosis appeals to many clinicians and patients more than traditional hetero-hypnotic procedures. The demonstration that most of the traditional hypnotic phenomena can be elicited by self-hypnotic techniques (Ruch, 1975) has served to reassure clinicians that they are not losing anything of any value by adopting self-hypnotic procedures.

As hypnosis moves out of the clinician’s office, however, new issues and problems arise, and the present study sheds some light on these. Clinicians using self-hypnosis may very well be able to profit from the now somewhat less enthusiastic but recently extensive popular interest in meditation, and from the efforts that have been made to assess its process and results. To the extent that the exercises used in the present study are typical of currently employed self-hypnosis and meditation procedures, the two appear quite similar in terms of how they are used and the problems that may arise. Both can be taught to interested and cooperative individuals in a one-session group format, and the present Ss appeared able to apply the techniques to a broad range of internal and external coping issues in their everyday lives.


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The creativity shown by the present Ss in adapting and modifying the exercises as needed provides an interesting echo of the more internal forms of creativity that Fromm (1985) discovered in the individual elaborations of a much longer, unstructured self-hypnosis exercise, or that Hilgard (1979) found in various forms of non-hypnotic "imaginative involvement." In practical terms, it appears that a relatively brief and inexpensive group procedure is sufficient to initiate self-directed, hypnotic or meditative self-control/help procedures to assist individuals with their everyday problems.

The present study points to the area of maintenance of practice (and presumably, though not necessarily, of benefits) as a major focus for study and possible intervention. Some recent preliminary work has questioned the accuracy of the "skills training paradigm" in clinically applied self-hypnosis (Van Dyck, Spinhoven, & Commandeur, 1985). The present study did not assess the relative roles of the relationship to the teacher and the personality of S, or of ongoing regular contact with the teacher on continued use of the exercise. Clearly, the telephone contact with the teacher involved in the present follow-up study may have influenced practice. Nevertheless, the steady decline in use reported by the present Ss over 6 months from 90% to 42% is similar to that found in other studies of meditation. One might quite justifiably point out that the fact that 42% of Ss report using the techniques 6 months after a brief group instruction experience represents an excellent return on a minimal teaching investment and a cause for satisfaction rather than concern.

For the practicing clinician trying to achieve maximum benefit from currently employed self-hypnosis or meditation procedures, the present study suggests two possibly useful areas for clinical work. Nearly half of the present Ss experienced significant problems in scheduling even brief uninterrupted times to do the exercise. Part of the problems appeared to be internal, related to difficulty allocating resources explicitly for self-care. Other problems were more prosaic. Ringing telephones were the chief culprits in providing serious interruptions, even if an answering machine was used, and it required considerable ingenuity to silence them. For any clinician who has not tried it, the effort to practice such an exercise him or herself undisturbed will be highly instructive.

A significant proportion of the present Ss (39%) also experienced discomfort with the techniques themselves, and thus might have benefited from redefinition of the exercises or of their contexts, or from exploration of the sources of their discomfort. Permitting individuals to choose their own strategies may help ensure an optimal interaction of talents, techniques, and settings, as discussed by Qualls and Sheehan (1981) in reference to electromyograph biofeedback used as a relaxation technique.


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The preceding paper is a reproduction of the following article (Soskis, D. A., Orne, E. C., Orne, M. T., & Dinges, D. F. Self-hypnosis and meditation for stress management: A brief communication. International Journal of Clinical and Experimental Hypnosis, 1989, 37, 285-289.). It is reproduced here with the kind permission of the Editor-in-Chief of The International Journal of Clinical and Experimental Hypnosis.