The review deals with the time course of the antipsychotic action. In recent years "the early response" of antipsychotic medication has been discussed, so the theory of "the delayed response" has been denied. Some important studies dealing with this topic are mentioned here. Furthermore, the influence of the early response on the later condition in various time consequences is included in this review. This topic is connected to the question whether and when to switch the antipsychotic medication if the first antipsychotic medication is not effective enough. Some authors prefer switching early, whereas others prefer staying on the current medication. An early nonresponse is a strong predictor of a late nonresponse. According to a recent study, the difference between an early response and nonresponse disappears approximately in the 40th week of the therapy. Other studies are needed to understand when and by which patients to switch antipsychotic medication if they react to current treatment deficiently.

In this article, we will examine how attachment theory may inform our understanding of the therapeutic effectiveness of clinical hypnosis. First, we will synthesize the basic concepts of attachment theory and expose its connections with health and well-being. Then, we will review the fundamental principles underpinning the practice of clinical hypnosis and give several examples of its therapeutic use. Finally, we will propose an integrative model unifying the addressed notions and will discuss the implications of our hypotheses for clinical practice. In particular, we propose that by wording specific hypnotic suggestions a therapist may behave as an attentive, responsive, sensitive, available, and benevolent caregiver, and hence may facilitate the development of a secure attachment relationship. Since secure attachment is known to favor health and wellbeing, hypnotic suggestions which favor secure attachment may play an important role in the therapeutic effectiveness of clinical hypnosis. We will try to show that hypnotic suggestions, which facilitate the developement of secure attachment style, may simultaneously convey a verbal information about the patients hypnotic experience (explicitly) and a non-verbal information about the therapists state of mind with regards to the relational interaction (implicitly). This implicit relational information may by responsible for an important part of the therapeutic effectiveness of clinical hypnosis. Our integrative perspective also suggest that basic tenets of attachment theory are naturelly inherent to various hypnotic strategies and that attachment themes are implicitly present at the core of various hypnotic suggestions. In our opinion, a deliberate integration of attachment concepts within the framework of clinical hypnosis may not only inform our understanding of the therapeutic effectiveness of clinical hypnosis, but also improve our clinical pactice and increase its usefullness for human health.

Centre Europée de Psychologie Médicale PsyPluriel Bruxelles Belgie

Psychiatrická a sexuologická ambulancia FAIRA Košice

Psychology Department University of Namur Medical School Namur Belgie

VŠ sv Alžbety Bratislava a UP v Olomouci

Clinical hypnosis and attachment theory: an integrative perspective

Literatura