International Handbook of Clinical Hypnosis - E-Lib FK UWKS

148 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
numb, detached and avoidant and at the same time have intrusive ¯ashbacks and
nightmares? The crucial issue is that the cluster of PTSD symptoms is a combination
of intrusion and avoidance. These sometimes come in sequence, sometimes
with more intrusion, sometimes more avoidance. But the normal homeostatic
equilibrium, the control of one's inner life, is very much disrupted by traumatic
stressors. The worse the intrusions are, the more desperate are the efforts to avoid
them. Indeed, the ¯ashbacks and hyperarousal come to symbolically represent the
traumatic circumstance itself, repetitively imposing distress just as the assailant,
accident, or natural disaster did.
TRAUMA AND DISSOCIATION
There is growing interest in the overlap between hypnotic and dissociative states
and post-traumatic stress disorder. Hypnosis has three main components: absorption,
dissociation, and suggestibility Spiegel, 1994). There is a clear analogy
between these components of hypnosis and the above described categories of
symptoms of PTSD.
ABSORPTION
Absorption involves an intense focus, like looking through a telephoto lens in a
camera Tellegen & Atkinson, 1974). When people are having ¯ashbacks, that is
all they are aware of. Elizabeth Loftus has written about what she calls the weapon
focus in crime victims Loftus, 1979). The police are frustrated when someone who
has just been mugged gives them a brilliant description of the gun, but has no
recollection of the face of the assailant. They were so focused on the thing that was
threatening them that the ordinary peripheral awareness is something they don't
have. There are studies that show that literally when people are aroused and
stressed the things that are at the periphery of awareness just are not registered in
the same way because they are so focused Loftus & Burns, 1982), One part of the
transformation and experience that occurs during trauma is this narrowing of the
focus of attention.
DISSOCIATION
The second is detachment or dissociation. People tend to compartmentalize aspects
of experience. Trauma can be thought of as a sudden discontinuity in experience.
In traumatic circumstances, what is normally a smooth continuum of experience
suddenly becomes a discontinuity. This can be re¯ected by a discontinuity in
mental function. Often one's self-image is radically altered by the traumatic
experienceÐthe loss of control, sense of vulnerability, indignity, and fear can
suddenly create a radically different view of self. This can lead to a compartmentalization
of these different aspects of experience.