150

INTEGRATING CBT & HYPNOSIS

ing the loop and the position of each component in the loop are arbitrary. The 12 components forming the circular loop represent some of the major factors identified from the literature that may influence the course and outcome of depression. As the components are described in detail elsewhere (see Alladin, 1994), they are only briefly mentioned here in order to highlight the relationship among the 12 components forming the depressive loop. As the model attaches significant importance to the interaction between affect and cognition, the logical starting point for describing the depressive loop is to start with affect (Negative affect), which appears at the top of the loop. The circular feedback model of depression (CFMD; Beck, 1967) maintains there is a mutually reinforcing interaction between cognition and affect so that thought not only influences feelings, but that feelings too can influence thought content (hence the bidirectional arrows between Negative Affect and Negative cognition in Figure 6.1). Also, congruent with the concept of the bicameral brain, proposed by Jaynes (1976), it is maintained that affect or cognition, each can independently starts the chain process of the feedback loop (Figure 1). The relationship between dysfunctional cognition and depressive affect is well documented in the literature (e.g., Haas & Fitzgibbon, 1989). An event (internal or external) can trigger a negative schema, which through cognitive rehearsal can lead to dissociation. In depression, Beck (1967, 1976) has noted the patients constant stereotypic preoccupation with their alleged negative personal attributes. Alladin (1992a) regards such negative ruminations among some depressives to be a form of negative self-hypnosis (NSH; Araoz, 1981, 1985), which may lead to a state of partial or profound dissociation. This process can be regarded as a form of negative self-hypnosis (NSH) (Araoz, 1981, 1985). West (1967) defines dissociation as a psychological process whereby information, incoming, ongoing or stored, is actively deflected from integration with its usual or expected associations. Such deflection produces alteration in actions, feelings or thoughts so that for a period of time certain information is not associated or integrated with other information as it would normally or logically be. West regards such an experience to be either normal or pathological. Ever since Janet (1907), the close relationship between hypnosis and dissociation was established. Janet (1889) put forward the view