International Handbook of Clinical Hypnosis - E-Lib FK UWKS

190 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
iatrogenic creation of a full-¯edged and stably established case of dissociative
identity disorder remains to be presented. For example, Spanos' Spanos, Weekes
& Bertrand, 1985; Spanos, Weekes, Menary & Bertrand, 1986) experimental
creation of some dissociative identity disorder phenomena under laboratory conditions
does demonstrate that such a role can be induced, but it does not establish the
actual condition. One must be cautious about behavioural manifestations being
overinterpreted, lest, by analogy, those subjects induced by a stage hypnotist to
enact the social role of a chicken be taken home and cooked for dinner!
OBSERVATIONS ON THE USE OF HYPNOSIS WITH
DISSOCIATIVE DISORDERS TODAY
The challenge to contemporary practice is to preserve what is useful and solid, to
refuse to be panicked into throwing the baby out with the bathwater, and to utilize all
available information in a constructive effort to be of help to the dissociative patient.
Not only has hypnosis been instrumental in the recovery of many dissociative
patientsÐa strong argument can be made that since hypnosis is an inevitable aspect
of their treatment, it is best that the treater be prepared to use it therapeutically.
Although dissociative patients in general have been thought to be highly
hypnotizable, formal testing has established this only for dissociative identity
disorder patients Bliss, 1984; Frischholz, Lipman, Braun & Sachs, 1992). With
any highly hypnotizable group of patients, one would be naõÈve indeed to assume
that the only hypnosis that takes place is the heterohypnosis that occurs in therapy.
Keen observers have long observed their proclivity for spontaneous trance and
autohypnosis e.g., Breuer & Freud, 1955; Janet, 1965; Bliss, 1986; Spiegel, 1986,
1991). Consequently, eliminating heterohypnosis leaves the clinician less than well
prepared to confront a group of troublesome spontaneous trance and autohypnotic
phenomena that could be restructured constructively with adroit hypnotic interventions
Kluft, 1992a,b; Spiegel & Spiegel, 1978).
Today's clinicians must consider whether there are any circumstances that would
make it unwise to use hypnosis with a particular dissociative disorder patient. If the
patient is involved in legal matters, or if such involvement is anticipated, it is best
to withhold the use of hypnosis until it can be determined whether or not its use
might compromise the patient's credibility as a witness in a matter of concern. The
use of hypnosis may be held to have tainted if not destroyed the credibility of a
patient's memory, and consequently, his or her testimony e.g., Orne, 1979;
Hammond et al., 1995).
Some patients belong to religious groups that understand hypnosis may lead to a
weakening of the will so that evil may enter the patient's mind e.g., Jehovah's
Witnesses). Under these circumstances, the patient can be educated about hypnosis,
but it may still be a better choice for the patient to avoid the use of hypnosis and
the spiritual concerns its application might precipitate.