Spiegel D; Cardena E New uses of
hypnosis in the treatment of posttraumatic stress disorder Journal of Clinical
Psychiatry, 51:10 (suppl):39-43, (Discuss.) 44-6, 1990.
Abstract:
Hypnosis is associated with the treatment of posttraumatic stress
disorder (PTSD) for two reasons: (1) the similarity between
hypnotic phenomena and the symptoms of PTSD, and (2) the utility
of hypnosis as a tool in treatment. Physical trauma produces a
sudden discontinuity in cognitive and emotional experience that
often persists after the trauma is over. This results in symptoms
such as psychogenic amnesia, intrusive reliving of the event as
if it were recurring, numbing of responsiveness, and
hypersensitivity to stimuli. Two studies have shown that Vietnam
veterans with PTSD have higher than normal hypnotizability scores
on standardized tests. Likewise, a history of physical abuse in
childhood has been shown to be strongly associated with
dissociative symptoms later in life. Furthermore, dissociative
symptoms during and soon after traumatic experience predict later
PTSD. Formal hypnotic procedures are especially helpful because
this population is highly hypnotizable. Hypnosis provides
controlled access to memories that may otherwise be kept out of
consciousness. New uses of hypnosis in the psychotherapy of PTSD
victims involve coupling access to the dissociated traumatic
memories with positive restructuring of those memories. Hypnosis
can be used to help patients face and bear a traumatic experience
by embedding it in a new context, acknowledging helplessness
during the event, and yet linking that experience with
remoralizing memories such as efforts at self-protection, shared
affection with friends who were killed, or the ability to control
the environment at other times. In this way, hypnosis can be used
to provide controlled access to memories that are then placed
into a broader perspective. Patients can be taught self-hypnosis
techniques that allow them to work through traumatic memories and
thereby reduce spontaneous unbidden intrusive recollections.
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