International Handbook of Clinical Hypnosis - E-Lib FK UWKS

12 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
trance states and restructuring the dissociative experiences, often with the use of
autohypnotic techniques, so that the patient can retain control over his or her
proclivity for slipping into trance.
In considering the use of hypnosis with the dissociative disorders, we come again
to current concerns about the contribution of hypnosis to pseudomemory formation.
Firstly, can hypnosis contribute to the worsening of dissociative identity disorder?
Secondly, it has been argued that trauma may not be at the root of many of these
disorders, so that hypnotic searching for memories of childhood traumatizations
may generate confabulations with far-reaching consequences.
Dr Kluft maintains in Chapter 13 that all perspectives have contributions to make
to this complex area of study, and that a rational view of the subject precludes the
complete or peremptory discounting of either perspective. Although there is
concern about confabulations with this use of hypnosis, it is also possible for
patients to recover well-being by working through a confabulated trauma. Since the
recovery of the patient rather than the recovery of historical truth is the goal, this
should not be a major concern in most instances.
Dissociation is a commonplace reaction to trauma in psychiatric patients and
in nonpatient populations This chapter offers a detailed review of methods of
treatment and clinical techniques are presented for hypnotic interventions in the
dissociative disorders. In the absence of contraindications Dr Kluft considers most
traumatized persons with major dissociative manifestations to be excellent candidates
for the use of therapeutic hypnosis.
Both Dr Torem and Dr Vanderlinden comment that with anorexia nervosa and
bulimia there has been remarkably little utilization of hypnosis as a therapeutic
tool, whereas hypnotherapists have been intensively engaged in the treatment of
obesity. Nevertheless, the effectiveness of hypnotic interventions in patients with
eating disorders has been recorded in the literature over and over again since the
time of Pierre Janet.
The clinical literature identi®es a variety of psychodynamics attributed to the
psychopathology of eating disorders. Many patients with these disorders feel
helpless, hopeless, and ashamed of having to seek psychological help. Egostrengthening
suggestions are therefore an important part of most hypnotherapy
interventions. Assignments which they are asked to complete are designed so that
the patient will metaphorically and concretely experience a feeling of success, as
well as a sense of gaining mastery, control, and exercising new choices and options.
Ego State Therapy has become a frequent focus in the hypnosis literature.
While only psychological bases are at present considered to be operational in
anorexia nervosa and bulimia, the picture is different for obesity. It is assumed
nowadays that biological and psychological factors can function in combination as
pathogenic factors in the development of obesity, therefore it is noted that hypnosis
should always be part of a multidimensional approach.
Dr Vanderlinden offers a very practical commonsense overview of the problem.
Thus, for a considerable group of patients, weight reduction is either not a realistic