International Handbook of Clinical Hypnosis - E-Lib FK UWKS

PERSONALITY AND PSYCHOTIC DISORDERS 181
personality and psychotic disorders can be understood to be manifestations of a
failure to progress along normal stages of human development. Within this
developmental framework, the task of therapy in general and of hypnotherapy in
particular is to correct the developmental failures. The support and acceptance,
along with the setting of reasonable and stable limits, are designed to provide the
`good enough' environment relationship). This good enough relationship is
designed to allow positive bonding and a positive self-concept; facilitate acceptance
of separateness; promote a working through and acceptance of unresolved
feelings of despair, anger, and anxiety; and promote growth into positive autonomy.
Thus the current use of hypnosis in therapy with the severely disturbed patient is
designed to correct and redo experiences, and to ®ll-in the missing life experiences
in order to allow the severely disturbed patient to reclaim his potential for healthy
growth and development.
Current use of hypnosis with psychotic and personality disorder patients also
stresses pacing the therapy work according to the patient's capacity for insight and
growth. The therapist follows the patient's lead empathically, promoting growth but
not pushing for it. Allowing the patient to pace the therapy protects the patient from
being overwhelmed by traumatic material from the past or by premature attempts at
insight. This empathic contact between therapist and patient is perhaps essential to
successful therapy with the severely disturbed patient whether working in traditional
psychotherapy or hypnotherapy. However, such sensitive empathic pacing is
perhaps more important in hypnotherapy where the patient is somewhat more
vulnerable to therapist suggestion or pressure.
Concerning speci®c hypnotic techniques, virtually all traditional psychotherapy
techniques can be adapted for use with hypnosis. Behavior modi®cation techniques
such as progressive relaxation, reciprocal inhibition and desensitization, and role
rehearsal for competence and mastery can be utilized in hypnosis with rapid and
effective results. Psychodynamic techniques can also be utilized in hypnosis with
the personality disorder or the psychotic patient. Free association, dream production
and analysis, and projective techniques are all dynamic techniques that blend
naturally and easily with the imagery of hypnosis. In addition, some specialized
hypnotic techniques such as age progression and age regression can be used with
the severely disturbed patient. In working with age regression to access repressed
or highly traumatic material, it is essential to follow the patient empathically
pacing. It is also important, in utilizing techniques aimed at reaccessing traumatic
experiences, that the therapist be prepared to handle intense affect, to contain affect
to avoid retraumatizing the patient, to reframe or redo past traumatic experience as
appropriate, and to create imagery shifts if imagery becomes too threatening.
In addition, current hypnotic techniques for utilizing hypnosis with the severely
disturbed patient include speci®c techniques designed to deal with their speci®c
developmental de®cits. The technique of renurturing with hypnotic imagery is designed
to create the capacity for initial bonding/relatedness and self-love,
utilizing images of the adult patient and the therapist as a composite `mother'.