International Handbook of Clinical Hypnosis - E-Lib FK UWKS

146 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
getting through a traumatic experience with little or no disturbance may be at
elevated risk for subsequent psychiatric dif®culties. Dissociative symptoms during
and in the aftermath of trauma may interfere with this process of working through
traumatic experiences Spiegel & Cardena, 1991). Thus depersonalization, derealization,
dissociative amnesia, or numbing may interfere with necessary emotional
and cognitive processing in the aftermath of trauma. Thus the ones who look the
best may actually be doing the worst. These people often don't ask for help, but
need it.
With the Vietnam era there was renewed interest in post-traumatic stress disorder.
PTSD was a special problem in Vietnam because of the lack of community
support for the war, and the rotation system which meant that soldiers came and
went alone for a ®xed period of time, rather than with their units Spiegel, 1981).
Soldiers could be in the jungles dying with their comrades one day and 72 hours
later they were back on the streets of their home town, alone, with no one to talk to.
The fact that we lost the war complicated reintegration of combat experiences as
well. Many Vietnam era veterans reported outright hostility from veterans of other
wars. Thus PTSD was found to be relatively common and persistent long after the
end of the Vietnam War Keane & Fairbank, 1983).
PTSD: CURRENT DIAGNOSTIC CRITERIA
TRAUMATIC STRESS
Trauma can be understood as the experience of being made into an object, a thing,
the victim of nature's indifference, of somebody else's rage. The key issue in
trauma is neither fear nor pain, but rather helplessness. For a period of time one has
no control over what is happening to their body. It is not uncommon for trauma
victims to detach themselves emotionally and cognitively mentally from traumatic
experience as it is occurring, as a means of protecting oneself from the reality of
threat.
A young woman who was quite hypnotizable and was using self-hypnosis quite
effectively to control anxiety related to her Hodgkin's Disease, described a prior
hospitalization during a routine psychiatric interview: `Well yes, I once fell off a third
story balcony and fractured my pelvis.' I inquired whether she had been suicidal: `Did
you jump?' She said `No, I was pushed.' I became concerned that she was paranoid.
She then said, `I was at this party and a big huge guy, twice my size, turned around
suddenly with a beer in his hand and just knocked me over the railing. It was just a
stupid accident.' When I said `That must have been horrifying,' she said `No, actually
it was quite pleasant.' At this point I became even more concerned. I said `What do
you mean?' She said, `I imaged it as if I was on another balcony watching a pink
cloud ¯oat down to the ground. I felt no pain at all, and in fact I tried to walk back
upstairs.'