International Handbook of Clinical Hypnosis - E-Lib FK UWKS

188 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
For dissociative identity disorder, hypnosis traditionally has been used to access
alternate identities, to facilitate communication across alternate identities, to
retrieve memories for periods of amnesia, to abreact traumatic experiences, and to
facilitate integration. Hypnosis is used by the vast majority of therapists treating
this group of patients Putnam & Loewenstein, 1993). However, in recent years
there has been an emphasis on the use of hypnosis for supportive and crisis
prevention interventions Fine, 1991; Kluft, 1988a,b, 1989, 1995a), for ego state
therapy applications Watkins & Watkins, 1997), and for doing the newer fractionated
abreaction techniques Kluft, 1988, 1990, in press; Fine, 1991), which are
more easily tolerated by patients vulnerable to severe distress, if not decompensation,
as they reexplore traumatic material. The uses of hypnosis for dissociative
trance disorder involve interrupting pathological trance states and restructuring the
dissociative experiences, often with the use of autohypnotic techniques, so that the
patient becomes the master of his or her proclivity for slipping into trance, instead
of remaining its hapless victim Spiegel & Spiegel, 1978). With dissociative
disorder not otherwise speci®ed, the uses of hypnosis are likely to follow the usages
applied to the discrete dissociative disorders a particular variant most closely
resembles.
CONTROVERSIES SURROUNDING THE USE OF HYPNOSIS
WITH THE DISSOCIATIVE DISORDERS
Many controversies currently surround the use of hypnosis with the dissociative
disorders. Although they constitute an area of considerable interest, limitations of
space preclude their extensive discussion here. The interested reader is referred to
more thorough explorations elsewhere Kluft, 1995b,c, 1997a).
Arguments for the ef®cacy of hypnosis in the treatment of the dissociative
disorders have been countered by concerns that hypnosis has the capacity to play a
role in the formation of pseudomemories or confabulations, that the recovery of
memories of childhood traumatisations may not be possible, and that hypnosis may
play a role in the iatrogenesis or worsening of dissociative identity disorder.
Furthermore, it has been argued that trauma may not be at the root of many of these
disorders, so that hypnotic searching for antecedents may generate confabulations
with far-reaching consequences. At this moment in time, it is clear to those who are
not dominated by ideological concerns and/or political agendas that no single
polarised argument has succeeding in driving its opponent from the ®eld. Although
some evidence is more supportive of one stance than another, all perspectives have
contributions to make to this complex area of study, and a rational view of the
subject precludes the complete or peremptory discounting of either perspective.
Scholars and clinicians who take into account all available data e.g., Alpert,
1995a; Brown, 1995a,b; Brown, Sche¯in & Hammond, 1997; Hammond, Garver,
Mutter et al., 1995; Kluft, 1984, 1995b; Nash, 1994; Schacter, 1996; Schooler,