International Handbook of Clinical Hypnosis - E-Lib FK UWKS

PERSONALITY AND PSYCHOTIC DISORDERS 179
Brown & Fromm 1986) also presented speci®c hypnotic techniques for treating
psychotic and borderline patients. Their techniques were based on developmental
theory and were intended to promote the formation of boundaries and body image,
the development of object and self-representations, and the development of affect
Brown, 1985; Brown & Fromm, 1986).
Then, beginning in the late 1980s and extending into the 1990s, Murray-Jobsis
further developed and expanded specialized techniques for working with the
severely disturbed patient, based on a developmental/psychoanalytic framework
and designed to supply missing developmental experiences. Building on therapy
techniques and clinical work begun in 1976, Murray-Jobsis developed and elaborated
techniques of nurturance in hypnotic imagery for the development of
bonding and a positive relational capacity and for the formation of a positive selfimage.
In addition, imagery techniques utilizing hypnosis to foster separationindividuation
based on mastery and competence rather than abandonment were also
developed. These techniques were based on a developmental framework and
emphasized the creation of `healing scripts'. With these `healing scripts' patients
were encouraged to create positive imaginary past experiences as a restitution for
missing or developmentally damaging past real-life experiences. Murray-Jobsis,
1984, 1986, 1989, 1991b, 1992, 1993, 1995, 1996; Scagnelli, 1976).
CURRENT STATUS OF CLINICAL HYPNOSIS WITH
PERSONALITY AND PSYCHOTIC DISORDERS
The majority of the experimental research studies and clinical reports to date
supports the conclusion that psychotic and personality disorder patients have
hypnotic capacity and can utilize that capacity productively and safely. As with
all patient populations, there will be some individual patients who will decline to
work with hypnosis. Aside from these self-selected exceptions, the usefulness and
safety of hypnosis with the severely disturbed patient depends primarily on the
skills and sensitivity of the therapist for creating a positive relationship with this
population. Accessing the hypnotic capacity and potential usefulness of hypnosis
for the severely disturbed patient requires the development and maintenance of
trust and a positive patient±therapist transference relationship. In addition, just as
traditional psychotherapy with the severely disturbed patient requires special skills
to provide ®rm limits within a supportive environment and special sensitivity to
the pacing of therapy, so also does hypnotherapy with these patients require
similar skill and sensitivity. Therefore a primary requirement for working with the
severely disturbed population with hypnosis would be that the therapist already
possesses knowledge and skills for working with this population in traditional
therapy.
Although we might assume that clinical hypnosis could be potentially utilized by
any personality disorder or psychotic patient within the framework of a positive,