International Handbook of Clinical Hypnosis - E-Lib FK UWKS

186 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
Zindel, P. 1996). The Active Introjection of the Therapist as a hypnoanalytic technique for
severely disturbed patients. Paper presented at the 7th European Congress of Hypnosis in
Psychotherapy and Psychosomatic Medicine, Budapest, Hungary.
EDITOR'S NOTE
In the United States, the 1990s were declared the ``decade of the brain''. Following intense
and successful lobbying by the National Alliance for Mental Illness NAMI) ± a powerful
group of family members and clinicians supporting patients with severe mental illness ± the
National Institute of Mental Health NIMH) redirected its research away from the psychotherapies
of the ``mind'' to the physiology of the brain in persons with schizophrenia and
bi-polar illnesses. Neurotransmitters and the medications altering them were the battle cries.
Increased standardization of diagnostic criteria for psychotic illness and Axis II Personality
Disorders became essential precursors to the proper selection of psychotropic and
antidepressant interventions in the treatment of these illnesses. Fifteen 15) minute sessions
with patients became commonplace, and psychopharmacologists replaced psychoanalysts as
leaders of the treatment team.
Yet all clinicians know that these patients are still persons who suffer and struggle to make
meaning out of their lives. The therapeutic alliance remains the sine qua non of all effective
treatment whether or not drugs are used in treating these disorders. An illustrative example
from the American psychiatric literature is illuminative.
In 1986, a young Harvard University undergraduate student wrote anonymously of his
experience as a schizophrenic patient in psychotherapy. Despite repeated hospitalizations
and medications, he asked his psychiatrist, ``Can we talk?'' His psychiatrist talked,
maintained hope, taught coping skills, but above all else, he listened. The patient concluded
in his article, ``A fragile ego left alone remains fragile ... medication or super®cial support
alone is not a substitute for the feeling that one is understood by another human being. For
me the greatest gift came the day I realized that my therapist really had stood by me for years
and that he would continue to stand by me and to help me achieve what I wanted to achieve.
With that realization my viability as a person began to grow. I do not profess to be cured ± I
still feel the pain, fear, and frustration of my illness. I know I have a long road ahead of me,
but I can honestly say that I am no longer without hope''.
This chapter, written by an experienced psychologist gifted in her use of hypnosis in the
seriously mentally ill, focuses her attention on the methods of establishing a therapeutic
alliance, building ego strength, repairing old developmental de®cits if present, and uncovering
and integrating early traumatic experiences into the health part of her patients. To this
end, she traces the use of hypnotic techniques over the centuries in treating patients who are
psychotic and may also have severe personality disorders, and then describes its current use
in today's therapeutic outpatient culture.
We invite the readers' interest in remembering that the severely ill patient is a person who
in spite of, or in addition to, the major gains in psychophysiology and psychopharmacology,
wishes to reach out to these oft forgotten and sometimes neglected souls. The pendulum
keeps swinging back and forth. As we reach the limits of our current understanding of
schizophrenia as brain disease, we will once again be asked by our patients, `Can we talk?'
Anonymous [written by a recovering patient] 1986). ``Can we talk?'' The schizophrenic patient in
psychotherapy. Am. J. Psychiatry, 1431), 70. Copyright 1986, The American Psychiatric Association.
Reprinted by permission.