Hypnosis in Treatment of Alcohol Addiction; Controlled Trial, with Analysis of Factors Affecting Outcome

Abstract

Forty alcoholics were randomly allocated to 1 or 2 groups; 1 group received full conventional inpatient treatment while the other received hypnotic treatment in addition to the conventional therapy. The hypnotic technique used was simple eye fixation followed by posthypnotic suggestion for 6 days and reinforcement at weekly, then monthly, intervals. The 2 groups were satisfactorily matched for age, years of addiction, intelligence, neuroticism (N) and extraversion (E) scores on the Maudsley Personality Inventory, and social stability (SS) score on the Straus-Bacon scale. The patients were rated on sociomedical outcome on a 2-point scale for each of the 12 months following discharge; and an over-all outcome score for the year was then calculated. Statistical analyses of the scores were done and prognostic characteristics of the 2 groups were compared. All patients were asked to take disulfiram regularly and to attend Alcoholics Anonymous; few continued to do so after discharge from hospital. All received individual psychotherapy, and social rehabilitation and social casework were available to all as required. Monthly outcome scores for the 2 groups were similar, and in each group the majority of relapses occurred in the 1st 6 months. When over-all outcome for the year was examined, the 2 groups were similar, with 11 patients in each group in a good, 2 in a fair and 7 in a bad prognosis category. In both the hypnotic and control groups, the patients in the bad prognosis category had significantly lower SS scores than those in the good prognosis category (means of 1.0, 0.57, 3.45 and 3.45, respectively). The patients'' age, length of addictive drinking and intelligence were not related to outcome. Factors associated with prognosis were analyzed statistically for the 2 groups. N had a significantly negative correlation with outcome (p < . 05), E, a significantly positive correlation with outcome (p <, 05) and SS, a highly significant positive correlation with outcome (p <. 001). E and N were negatively correlated and SS was negatively correlated with N and positively correlated with E. Multiple regression equations showed that outcome score could be calculated from SS alone. Length of stay in hospital was inversely related to outcome; in the control group, those with good prognosis stayed a significantly shorter time. Results are discussed and literature on hypnotic treatment of alcoholism is reviewed. The contention that a different mode of hypnotherapy might be more effective is examined; however, no factual evidence to contradict that hypnosis is valueless as an adjunct to conventional treatment of alcoholism was found. The meaning of social stability is discussed and its relationship to personality factors is considered. Planning of treatment and the problem of devising better methods of treating the alcoholic with low social stability are discussed.