International Handbook of Clinical Hypnosis - E-Lib FK UWKS

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International Handbook of Clinical Hypnosis. Edited by G. D. Burrows, R. O. Stanley, P. B. Bloom
Copyright # 2001John Wiley & Sons Ltd
ISBNs: 0-471-97009-3 Hardback); 0-470-84640-2 Electronic)
Hypnosis, Dissociation and
Trauma
DAVID SPIEGEL
Stanford University School of Medicine, USA
This chapter was initially prepared as part of a visit to the Oklahoma Psychiatric
Association ®ve months after the bombing of the Alfred P. Murrah Federal Of®ce
Building on 19 April 1995. A powerful bomb was exploded in front of the building
that morning, killing almost 200 people, destroying the Federal Building, and
damaging buildings within a 12-block radius. I will delineate the nature and
prevalence of post-traumatic stress disorder symptoms in the aftermath of such
trauma, the role of dissociative features in such symptoms, and treatment approaches,
including the use of hypnosis.
THE AFTERMATH OF TRAUMA
The DSM-IV APA, 1994) diagnostic criteria for acute and post-traumatic stress
disorder PTSD) involve intrusion, dissociative, avoidance, and hyperarousal
symptoms in the aftermath of a traumatic stressor. A taxi driver in Oklahoma City
said: `Oklahoma lost its innocence in this attack, the sense of being the heartland,
of being safe.' He added: `I used to like driving downtown, but I don't work
downtown much any more. It just doesn't have the same feeling that it used to.' A
psychiatrist who was head of the disaster committee commented that things seemed
so unreal to him that he had trouble recounting the details of what had happened
that day afterwards: `Although I was feeling like a fraud because the event and job
seemed unreal, I was amazed at the universally receptive response to my calls.
There was a feeling of relief, as though each contact was a symbolic bridge
between islands' Poarch, 1995, p. 9).
Post-traumatic stress disorder is a disturbingly common problem. For example,
in the United States a study by Naomi Breslau and colleagues Breslau, Davis et
al., 1991; Breslau & Davis, 1992) demonstrated that 9% of the population of
Detroit had post-traumatic stress disorder. The leading cause of deaths of young
adults is automobile accidents and there is much associated physical and psycholo-
International Handbook of Clinical Hypnosis. Edited by G. D. Burrows, R. O. Stanley and P. B. Bloom
# 2001John Wiley & Sons, Ltd