Accessing the relevant areas of maladaptive personality functioning

A Meta-Analysis for the Efficacy of Hypnotherapy in Alleviating PTSD Symptoms

A systematic review and meta-analysis of the efficacy of hypnotherapy in the treatment of PTSD used literature searches to obtain 47 articles. However, only 6 were experiments testing the efficacy of hypnosis-based treatments. A fixed-effects meta-analysis was applied to postintervention assessment results and 4-week follow-ups. A large effect in favor of hypnosis-based (especially manualized abreactive hypnosis) treatment was found for the studies that reported the posttest results (d = 1.17). The temporal stability of the effect remains strong, as reflected by the 4-week follow-up assessments (d = 1.58) and also by long-term evaluations (e.g., 12 months). Hypnosis appears to be effective in alleviating PTSD symptoms.

The therapeutic release of anger: Helen Watkins's silent abreaction and subsequent elaborations of the anger rock

This paper summarizes Helen Watkins's (1980) silent abreaction technique for releasing anger and the subsequent elaborations it has inspired. Discussion of Watkins's seminal article incorporates her verbatim account of the technique, 2 clinical applications, and her encouragement of further adaptations. Other scholars' subsequent contributions include an adaptation for dissociative identity disorder, brief treatment of constant pain syndrome, and inpatient treatment of a suicidally depressed, dissociative survivor of sexual abuse. Commonalities and distinctions among Watkins's work and these modifications are discussed. New case material from the author's practice illustrate further elaborations, with emphasis on the role of releasing anger in the resolution of dissociative defenses and internal fragmentation in dissociative clients. To enhance the clinical utility of this paper, verbatim passages are included for all case illustrations in H. H. Watkins (1980), the 3 published elaborations, and the new case material.

Hypnotic abreaction releases chaotic patterns of electrodermal activity during dissociation

Chaotic transitions emerge in a wide variety of cognitive phenomena and may possibly be linked to specific changes during development of mental disorders. There are several hypotheses that link the dissociation to critical chaotic shifts with the resulting self-organization of behavioral patterns during critical periods. In 2 patients, hypnotic revivification of dissociated trauma along with measurement of bilateral electrodermal activity (EDA) for therapeutic and research purposes was performed. Nonlinear data analysis of EDA records shows a difference between degree of chaos in hypnotic relaxed state before revivification of the trauma and dissociated state after reliving the traumatic memory. Results suggest that the dissociated state after revivification of the trauma is significantly more chaotic than the state during the hypnotic relaxation before the event. Findings of this study suggest a possible role of neural chaos in the processing of the dissociated traumatic memory during hypnotic revivification.

Integrative psychotherapy: combining ego-state therapy, clinical hypnosis, and eye movement desensitization and reprocessing (EMDR) in a psychosocial developmental context

The principles of this conceptual framework are: (1) personality organization is dissociative as well as associative, consisting of ego states, and progresses through stages of psychosocial development; (2) inappropriately activated ego states cause dysfunction, which is habitual or due to the intense affect of disrupted development or unresolved grief or trauma; (3) completely overcoming dysfunction requires therapy with both individual ego states and the personality system; (4) clinical hypnosis provides techniques to enhance accessing ego states; and (5) EMDR combines ego-state therapy with eye movements (EMs) to produce a powerful psychotherapy method. During assessment, ego states responsible for dysfunctional emotional reactions and behavior are identified together with those that could be appropriate instead. Included in the treatment protocol, EMs and clinical hypnosis promote: (1) corrective developmental experiences; (2) resolution of grief and trauma; (3) acquisition of skills and abilities; (4) co-consciousness; and (5) negotiation among ego states. The outcome is an integrated "family of self" that has effectively overcome developmental crises, grief, and trauma, is aware of essential inner resources, and can consciously activate appropriate ego states.

Potential contributions of hypnosis to ego-strengthening procedures in EMDR. Eye Movement Desensitization Reprocessing

This paper explores how hypnotic principles can be systematically incorporated into the standard EMDR protocol to enhance various ego strength capacities during EMDR treatment. Expanding these skill areas can widen the therapeutic window of possibility for clients with a variety of complex clinical issues, including posttraumatic, dissociative or personality disorders, anxiety symptoms, and depressive difficulties. Clinical case examples are used to illustrate ways of integrating hypnotic principles within a proposed EMDR protocol to promote ego strengthening and facilitate therapeutic change.