International Handbook of Clinical Hypnosis - E-Lib FK UWKS

200 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
can be used to explore and alleviate the con¯icts and/or traumata that precipitate
trance phenomena, and to master new strategies of managing their residual
impacts.
With regard to possession trance states, when the possession has been transient,
it is crucial to deal with the precipitating stressors in a manner that demonstrates
sensitivity to the unique cultural contributants. When the possession is ongoing or
repetitive, some of the techniques used with dissociative identity disorder, modi®ed
with a sensitivity to cultural considerations, may prove effective.
DISSOCIATIVE DISORDER NOT OTHERWISE SPECIFIED
This category encompasses wide diversity, including cases with great similarity to
dissociative identity disorder often called ego-state disorders), derealization without
depersonalization, the dissociative sequelae of coercive persuasion, dissociative
trance disorder see above), Ganser's syndrome, dissociative psychoses, some
gender identity disturbances, and a mixture of dissociative symptoms of all sorts
American Psychiatric Association, 1994; Coons, 1992b). The use of hypnosis with
such patients will parallel its use in patients with the conditions most akin to the
symptom clusters in question. Coons' 1992b) study is a landmark contribution.
Very little else has been written about the treatment of these patients, except for
those forms most akin to dissociative identity disorder. The ego-state model of
Watkins and Watkins 1997), which employs hypnosis to access and work with ego
states, to negotiate among them, and to resolve their traumata, may be very
effective with this group, as can be the interventions discussed above under
dissociative identity disorder.
CONCLUDING REMARKS
Hypnosis is a remarkably useful approach with which to facilitate the treatment of
the dissociative disorders. However, its use should be circumspect, and should
await the achievement of informed consent whenever possible. Contraindications
should be respected. Despite the controversies that have developed, especially in
the context of concerns about the reliability of newly accessed and once unavailable
memories, hypnotically-facilitated interventions remain a mainstay for the treatment
of the dissociative disorders, which are a commonplace and increasingly
recognised form of psychopathology.
REFERENCES
Allison, R. B. 1974). A new treatment approach for multiple personalities. Am. J. Clin.
Hypn., 17, 15±32.