International Handbook of Clinical Hypnosis - E-Lib FK UWKS

178 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
In addition, the hypnotic dream process could also be utilized by the patient outside
of therapy to foster autonomy and independence. A case example of a personality
disorder patient utilizing such hypnotic dream work as a transitional process was
presented.
In a second paper, Baker 1983b) examined various aspects of resistance that
became manifest in hypnotherapy with borderline, narcissistic and psychotic patients
and gave speci®c suggestions for the management of this resistance. A brief
vignette of a schizophrenic patient was presented to illustrate resistance due to a
need for distance and the therapist's utilization of boundaries and separation to
reduce patient anxiety.
Contemporaneous with the ongoing accumulation of clinical case reports and the
development of specialized techniques for hypnotic work with the severely
disturbed patient, consensus also was building concerning the capacity and usefulness
of hypnosis for this patient population. In the early 1980s, three literature
review articles were published supporting the conclusion that psychotic and
personality disorder patients were susceptible to hypnosis and were capable of
utilizing hypnosis productively and safely. In 1982, Scagnelli-Jobsis published a
review of the experimental and clinical literature concerning the use of hypnosis
with severely disturbed patients, concluding that the literature supported the view
that psychotic and personality disorder patients were susceptible to hypnosis and
were capable of utilizing hypnosis productively and safely. 2 In that same year a
literature review by Pettinati 1982, Pettinati, Evans, Staats & Home) came to very
similar conclusions, stating that, `It can be concluded that a number of severely
disturbed psychotic typically schizophrenic) patients can be successfully
hypnotized ...'. In 1985, Lavoie & Elie published a review building on work
begun in 1978 and 1980) concurring with the conclusions of Scagnelli-Jobsis and
of Pettinati concerning the hypnotic capacity of psychotic patients. Speci®cally,
Lavoie and Elie found that `schizophrenic patients do present mean susceptibility
scores essentially similar to ones obtained by normal Ss of comparable age.' Thus,
the early 1980s marked a watershed period when it became generally accepted that
psychotic and personality disorder patients were potentially capable of safe and
productive utilization of hypnosis.
In 1984, Murray-Jobsis published a chapter in Wester & Smith) summarizing
the consensus concerning the applicability of hypnosis with severely disturbed
patients and describing the necessary treatment techniques and adjustments
required by this population. Induction techniques, speci®c treatment techniques
and special considerations for this patient population were presented and discussed.
The chapter outlined and described in detail the integration of hypnosis into
traditional treatment techniques and then clari®ed any necessary adjustment to
these techniques for use with the severely disturbed patient. In addition, new
hypnotic techniques developed especially for the severely disturbed patient were
introduced and explained. A case example utilizing and demonstrating some of the
techniques was presented.