International Handbook of Clinical Hypnosis - E-Lib FK UWKS

PERSONALITY AND PSYCHOTIC DISORDERS 177
THE INTEGRATIVE PERIOD: THE ACCEPTANCE OF HYPNOSIS
AND THE INTEGRATION OF TECHNIQUE AND THEORY
In the 1980s, the literature of clinical case reports of successful hypnotic work with
both psychotic and personality disorder patients continued to grow. However, in
addition to these clinical case reports, the literature began to present new hypnotic
techniques for working with psychotic and personality disorder patients and the
integration of these techniques into established psychological theory and conceptual
models of hypnosis Baker, 1981, 1983a, b; Brown, 1985; Brown & Fromm,
1986; Copeland, 1986; Fromm, 1984; Murray-Jobsis, 1984, 1985, 1986, 1988,
1989, 1991b, 1992, 1993, 1995, l996; Scagnelli, 1980; Scagnelli-Jobsis, 1982;
Vas, 1990; Zindel, 1992, 1996).
In l980, Scagnelli reported on the use of trance by both the patient and therapist.
Brief vignettes were presented of work with both psychotic and personality disorder
patients. It was noted that patients with this severity of disorder frequently utilized
hypnosis for ego strengthening and integration of their emotional and cognitive
resources. However, it was also noted that some insight and uncovering work could
be done by these patients. Both formal induction techniques and informal hypnotic
techniques were found to be useful. In addition to the use of trance by the patient,
Scagnelli stressed the particular usefulness of trance by the therapist as a valuable
technique in working with the severely disturbed patient population. The author
proposed that the use of an autohypnotic trance by the therapist along with the
patient's trance) heightened the therapist's empathy. This heightened empathy could
facilitate the therapist in utilizing his own body, mind and feeling state to enhance
his receptivity and understanding of the patient's feelings and experience. This
heightened empathy could then help the therapist identify, verbalize and reframe
feelings and experience for and with the patient. Several vignettes of case work
with patients were presented, illustrating how such empathic contact and interpretation
of feelings with the patient could be crucial to the progress of therapy.
In 1981, Baker presented a rationale for the use of hypnosis with psychotic
patients, based on object relations theory. Baker developed a protocol of seven steps
designed for the hypnoanalytic treatment of psychotic patients. He based this
protocol on the de®cits in object relatedness and in other ego functions associated
with psychotic conditions. The seven-step protocol was designed to enhance the
positive aspects of the emerging transference and to support the patient's capacity to
maintain real connections with the external environment. A case example of a 23year-old
paranoid schizophrenic was presented illustrating these techniques. Baker's
work was later elaborated on and extended by Fromm 1984) and Copeland 1986).
Baker also expanded on his own work in hypnotherapy with severely disturbed
patients in two additional papers published in 1983. In his ®rst paper, Baker
1983a) reported on work he had done with narcissistic, borderline, and psychotic
patients, utilizing hypnotic dreaming as a transitional object to facilitate a connection
with the therapist for the patient as he left the therapy session with his dream.