Hypnotic Ego-Strengthening Procedure

The Hypnotic Ego-Strengthening Procedure, incorporating its constituent, influential hypnotherapeutic monologue — which delivered an incremental sequence of both suggestions for within-hypnotic influence and suggestions for post-hypnotic influence — was developed and promoted by the British consultant psychiatrist, John Heywood Hartland (1901–1977) in the 1960s. Hartland's overall ego-strengthening approach was based upon, and derived from, the "Self-Mastery" method that French hypnotherapist Émile Coué (1857-1926) had created, promoted, and continuously polished over two decades of clinical practice (reaching its final form c.1920); and its constituent ego-strengthening monologue was entirely based upon the "curative suggestion" monologue component of Coué's method. Hartland used his procedure to (pre-therapeutically) strengthen his patients' inner resources — "designed to remove tension, anxiety and apprehension, and to gradually restore the patient's confidence in himself and his ability to cope with his problems", and "analogous to the medical setting in which a patient is first strengthened by proper nutrition, general rest, and weight gain before a radical form of surgery is performed" — and, specifically, the procedure was intended to enhance the therapeutic efficacy of his (subsequent) symptom-removal hypnotherapy. Hartland later discovered that his "ego-strengthening procedure" could successfully address a wide range of clinical circumstances, on its own, as the sole form of therapy. Hartland's 1965 article, "The Value of "Ego-Strengthening" Procedures Prior to Direct Symptom-Removal under Hypnosis" was significant for positioning the concept of "ego-strengthening" in the hypnotherapeutic literature; and "ever since then, the concept could be unequivocally named, identified, investigated, productively discussed, and generally understood by all concerned". In addition to providing his monologue's full text, Hartland's article was also significant for introducing the convention of ". . ." to indicate pauses in the operator's delivery.

"Ego-strengthening suggestions are designed to increase the patient's ability to cope with his difficulties or to encourage him to stand on his own feet. There are three kinds of ego-strengthening suggestions: (a) general ego-strengthening suggestions, (b) specific ego-strengthening suggestions to facilitate the discovery and enhancement of the patient's inner coping strategies, and (c) specific suggestions to foster the patient's sense of self-efficacy. ... Ego-strengthening suggestions, while seemingly simplistic, are quite valuable. Hartland and many others believe that in certain instances ego-strengthening suggestions alone can bring about a successful treatment outcome without [any need to resort to either] symptomatic or dynamic hypnotherapy. Some patients experience spontaneous alleviation of symptoms when they feel strong enough to cope without the symptoms. Direct suggestions for coping, therefore, are sometimes more effective than direct suggestions for symptom change." "Ego strengthening began as a specific strategy for hypnotic interventions and evolved into an attitude pervading psychotherapy and clinical hypnotic work. ... Students in hypnosis training should be introduced to an ego strengthening attitude for clinical work, and master specific therapeutic interventions to induce ego strengthening. Such interventions may include guided imagery for self-acceptance and self-love, affirming language that counteracts negative self-talk, age regression to recapture forgotten strengths, and age progression to anticipate and imagine future wisdom and strengths."

Emile Coué and la méthode Coué

The insights, observations, technical developments, and procedural innovations of Émile Coué, the French scientist, apothecary (i.e., a first-contact prescribing pharmacist, a compounding and dispensing chemist, and a pharmacopolist that sold proprietary medicines), hypnotist, and psychotherapist in relation to his understanding, conceptualization, realization, and application of hypnotherapeutic suggestion have greatly influenced the theories and practices of hypnotism throughout the English-speaking world.

"Coué’s method was disarmingly non-complex—needing few instructions for on-going competence, based on rational principles, easily understood, demanding no intellectual sophistication, simply explained, simply taught, performed in private, using a subject's own resources, requiring no elaborate preparation, and no expenditure." "Most of us are so accustomed ... to an elaborate medical ritual ... in the treatment of our ills ... [that] anything so simple as Coué's autosuggestion is inclined to arouse misgivings, antagonism and a feeling of scepticism." "Continuously, unjustly, and mistakenly trivialised as just a hand-clasp, some unwarranted optimism, and a 'mantra', Coué's method evolved over several decades of meticulous observation, theoretical speculation, in-the-field testing, incremental adjustment, and step-by-step transformation. It tentatively began (c.1901) with very directive one-to-one hypnotic interventions, based upon the approaches and techniques that Coué had acquired from an American correspondence course. As his theoretical knowledge, clinical experience, understanding of suggestion and autosuggestion, and hypnotic skills expanded, it gradually developed into its final subject-centred version—an intricate complex of (group) education, (group) hypnotherapy, (group) ego-strengthening, and (group) training in self-suggested pain control; and, following instruction in performing the prescribed self-administration ritual, the twice daily intentional and deliberate (individual) application of its unique formula, "Every day, in every way, I'm getting better and better".

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