See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/240351397 O essencial sobre a hipnose: teorias, mitos, aplicações clínicas e investigação Book · December 2012 CITATIONS 0 READS 1,402 1 author: Some of the authors of this publication are also working on these related projects: -Increasing physical activity in older adults: walking by prescription in primary care setting View project Doctorate Fellowship - Fundação para a Ciência e a Tecnologia View project Claudia Carvalho ISPA Instituto Universitário 58 PUBLICATIONS 384 CITATIONS SEE PROFILE All content following this page was uploaded by Claudia Carvalho on 18 September 2018. The user has requested enhancement of the downloaded file.
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See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/240351397
O essencial sobre a hipnose: teorias, mitos, aplicações clínicas e investigação
Book · December 2012
CITATIONS
0READS
1,402
1 author:
Some of the authors of this publication are also working on these related projects:
-Increasing physical activity in older adults: walking by prescription in primary care setting View project
Doctorate Fellowship - Fundação para a Ciência e a Tecnologia View project
Claudia Carvalho
ISPA Instituto Universitário
58 PUBLICATIONS 384 CITATIONS
SEE PROFILE
All content following this page was uploaded by Claudia Carvalho on 18 September 2018.
The user has requested enhancement of the downloaded file.
Como identificar um profissional de saúde devidamente credenciado a utilizar a hipnose ....................................................................................................... 54
CAPÍTULO IV:
HIPNOTIZABILIDADE E SUGESTIONABILIDADE HIPNÓTICA:
INVESTIGAÇÃO E PRÁTICA CLÍNICA .................................................................... 59
Este livro pretende familiarizar os profissionais de saúde com a hipnose clínicae experimental. Apesar de ter já uma história de 75 anos de investigação científica(Kirsch, Mazzoni, & Montgomery, 2007), a hipnose continua a não fazer parte dasabordagens prevalentes quer na Medicina quer na Psicologia. Como consequência,não faz parte dos curricula da maioria dos cursos superiores de Psicologia eMedicina.
Por outro lado, as Ordens Profissionais de Medicina (Ordem dos Médicos,Associação Portuguesa dos Médicos de Clínica Geral) e de Psicologia (Ordem dosPsicólogos Portugueses) não assumem uma posição formal acerca da utilização dahipnose na prática profissional dos seus membros, não a proibindo, mas tambémnão a regulamentando e consequentemente não a fiscalizando.
Em matéria de encontros científicos, em Portugal realizaram-se até à data apenasdois, em 1997 na Universidade do Minho (I Congresso Português de HipnoseClínica) e em 2007 na Universidade de Coimbra (I Simpósio Ibérico de HipnoseExperimental e Clínica).
As oportunidades formativas para profissionais de saúde, mesmo nos grandescentros como Lisboa e Porto, são escassas, e muitas vezes promovidas porentidades que se dedicam à hipnose leiga (isto é, não científica) e que reconhecemcomo habilitados a utilizar a hipnose, pessoas sem qualquer formação em saúde.Mesmo entre os profissionais de saúde interessados em hipnose, grassa a confusãoentre hipnose leiga e hipnose científica, o que se deve provavelmente ao desconhe -cimento acerca da hipnose, da sua fundamentação teórica e empírica, da suaaplicabilidade clínica, das suas associações profissionais e das publicações emrevistas científicas indexadas nas bases de dados de referência. Consequentemente,a resposta que obtêm ao seu interesse em obter uma formação em hipnose, é nula,ou enveredam por formações sem base científica. Tal cenário contribui para amanutenção de um conjunto de crenças distorcidas e opiniões negativas quer juntoda população estudantil (e.g., a hipnose permite lembrar memórias escondidas;ideia da hipnose como “máquina da verdade”), quer junto dos profissionais desaúde (e.g., a hipnose é marginal à investigação científica; a hipnose como solução“mágica” para os problemas de saúde).
A hipnose não é uma terapia, é um coadjuvante terapêutico e como tal só deveráser usada por um profissional de saúde devidamente habilitado a tratar aquilo quese propõe a tratar sem hipnose. A este propósito cite-se a “regra de ouro” de MartinOrne (1927-2000), presidente da Sociedade Internacional de Hipnose no períodode 1977 a 1979:
“Se um profissional não é qualificado para tratar algo (uma determinada condiçãoclínica) sem hipnose, então ele não é qualificado para a tratar (essa condiçãoclínica) com hipnose. Primeiro procura-se a certificação profissional (médico,dentista, psicólogo clínico, etc.). Depois procura-se a certificação em hipnose.”
Martin Orne
Existem já em muitos países associações profissionais de Hipnose, a maior partedelas afiliadas na Sociedade Internacional de Hipnose (International Society ofHypnosis − ISH), uma organização educacional e científica fundada em 1973, queinclui como membros médicos, psiquiatras, médicos dentistas e psicólogos, e quetem como objectivo promover o conhecimento acerca da hipnose no públicoprofissional e leigo e desenvolver a investigação científica. A ISH é a únicaassociação de hipnose internacional legítima (Kirsch em entrevista a Capafons,1995) e o seu ramo Europeu, a European Society of Hypnosis (ESH) agrupa 32sociedades constituintes provenientes de 17 países diferentes (ver Anexo para umalistagem das sociedades e países constituintes da ISH), incluindo mais de 14.000profissionais dos campos da Medicina, Medicina Dentária, Psicologia e outrasprofissões na área da saúde. Em termos de oportunidades formativas em contextouniversitário, refira-se que nos anos 90 do século XX, 25% dos programasdoutorais nos EUA e 45% dos Departamentos de Psicologia Britânicos ofereciamformação em hipnose (Capafons, 1995). A hipnose é particularmente estudada emuniversidades do mundo anglófono (e.g., EUA, Reino Unido, Austrália, Canadá)mas também em Universidades de outras partes do mundo como a Alemanha, aHungria, a Holanda, Espanha (Capafons, 1995, 1998) e Portugal para apenas citaralguns países europeus de língua não inglesa.
A hipnose não é uma técnica difícil de aprender para um profissional desaúde. Já a capacidade para determinar e aplicar o melhor tratamento possívelem função das opções disponíveis, demora anos a adquirir. O conhecimento debase científico acerca da hipnose interessa a todos os profissionais cujo arsenalterapêutico beneficie da inclusão de técnicas sugestivas. Se é certo que a maior partedos médicos e dos psicólogos utilizam a sugestão nas suas comunicações com ospacientes, é menos certo que a utilizem de forma intencional e com conhecimentopreciso dos seus efeitos. Conhecer e utilizar a hipnose em contextos de saúde, éutilizar a sugestão de forma a incrementar os benefícios terapêuticos de uma dadaintervenção clínica num paciente. Como referiu Maddock (1995, citado porSugarman, 1996), nem toda a hipnose é terapia, mas toda a terapia é hipnose.
A hipnose é uma área de estudos vibrante e em contínuo desenvolvimento, queaborda questões pertinentes: Somos todos igualmente capazes de experimentar ahipnose? As sugestões hipnóticas são eficazes mesmo sem indução hipnótica? Quaissão as variáveis que estão associadas a uma maior responsividade à hipnose? Quaisas aplicações clínicas da hipnose? Quando é que não se deve usar a hipnose? Quaisos efeitos da hipnose na memória? Como é que se investiga no campo da hipnose?
Este livro pretende dar resposta a todas estas perguntas num documento em línguaportuguesa. Simultaneamente pretende-se constituir como um mapa para orientar aaquisição de um conhecimento básico de carácter científico acerca da hipnose.
O presente trabalho apresenta-se dividido em quatro capítulos: o primeirocapítulo define hipnose e sugestões hipnóticas e apresenta de forma breve os váriosmodelos teóricos explicativos, tendo como referência o designado “efeito clássicoda sugestão” (Weitzenhoffer, 1978), i.e., a experiência de automatismo (ou nãovolição) que caracteriza a experiência hipnótica. É ainda apresentada uma sinopsedo conhecimento actual acerca das bases psicofisiológicas da hipnose, discutindo--se a noção de transe hipnótico sob este ângulo. O segundo capítulo inicia-se comuma abordagem geral acerca de como é que as crenças, expectativas e motivaçãoinfluenciam a resposta às sugestões fornecidas em contexto hipnótico, seguida deuma ilustração acerca de como a hipnose tem sido apresentada no cinema.Seguidamente apresenta-se uma revisão dos estudos acerca das atitudes, crenças eopiniões que profissionais e público apresentam face à hipnose e sitematizam-seas crenças distorcidas mais comuns. O terceiro capítulo apresenta os resultadosobtidos nas várias revisões sistemáticas e meta-análises acerca da eficácia dahipnose como instrumento terapêutico à luz dos critérios que definem a validadeempírica de uma intervenção psicológica. Neste capítulo são ainda apresentadasalgumas directrizes acerca de como encontrar um profissional devidamentecredenciado habilitado a usar a hipnose. O quarto capítulo discute os conceitos dehipnotizabilidade e de sugestionabilidade hipnótica, definindo e diferenciando-os.Segue-se uma referência aos principais instrumentos de medida desenvolvidos como objectivo de mensurar a capacidade para experimentar sugestões sob hipnose,terminando o capítulo com uma discussão acerca das implicações na prática clínica,da investigação em sugestionabilidade hipnótica e não hipnótica.
O livro apresenta ainda um anexo que tem como objectivo orientar a procura deinformação legítima e de base científica na Internet.
Esperamos com este documento sensibilizar os profissionais de saúde,nomeadamente os médicos e os psicólogos clínicos e da saúde, para o potencialbenefício desta técnica, permitindo que ela faça parte do seu arsenal terapêutico e
seja mais uma opção possível para lutar contra a doença e conferir maior autonomiae controle sobre a sua saúde por parte dos pacientes. Esperamos também com estetexto, dar um contributo para um maior e mais correcto conhecimento acerca dahipnose clínica de base científica bem como fornecer um mapa aos profissionais eestudantes das áreas da saúde que lhes permita navegar com segurança nestas águas.
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A hipnose clínica é uma técnica terapêutica segura e ecaz. É mais ecaz do que qualquer outra técnicapsicológica no controlo da dor (Patterson & Jensen, 2003), e quando usada como coadjuvantedas intervenções psicoterapêuticas aumenta a ecácia destes tratamentos (Kirsch, Montgomery,& Sapirstein, 1995). Contudo esta técnica não é largamente usada pelos prossionais de saúde. A quese deve este paradoxo? A resposta encontra-se na história e na cultura popular que originaramum preconceito em relação à hipnose onde esta tem sido vista no contexto da magia e da superstição.Os indivíduos hipnotizados são frequentemente retratados como zombies que perderam a capacidadeOs indivíduos hipnotizados são frequentemente retratados como zombies que perderam a capacidadede controlar as suas acções. Não espanta pois que a hipnose seja receada e evitada.
É neste contexto que O ESSENCIAL SOBRE A HIPNOSE: TEORIAS, MITOS, APLICAÇÕES CLÍNICASE INVESTIGAÇÃO é particularmente bem-vindo. A Drª Cláudia Carvalho, a maior especialista em Portugalna ciência da hipnose, sumariza o que o que se sabe actualmente a partir da investigação cientíca acercada natureza e prática da hipnose. A Drª Cláudia Carvalho dissipa os mitos que envolvem esta área de estudose que a impedem de obter uma maior aceitação, e examina cuidadosamente as provas da sua ecácia clínica.O resultado é um livro que deve ser lido por todos os prossionais e estudantes da área da saúde, dadoO resultado é um livro que deve ser lido por todos os prossionais e estudantes da área da saúde, dadoque oferece uma introdução a uma técnica empiricamente testada que é fácil de aprender e que poderesultar em grande benefício dos pacientes.
Irving Kirsch, PhDDirector associado do Programa de Estudos sobre o Placebo do Beth Deaconess Israel Medical Center,Harvard Medical School.Ex-Presidente da Divisão 30 (Hipnose Psicológica) da Associação Americana de Psicologia (1993-94).
