The fifth method involves the use of special hypnotic phenomena (e.g., the Orne double person hallucination and the Hilgard hidden observer item) to discriminate between dissociative disorder patients and subjects simulating dissociative psychopathology.
Spiegel, David; Cardena, Etzel (1991). Disintegrated experience: The dissociative disorders revisited. Journal of Abnormal Psychology, 100 (3), 366-378.
Presents proposed changes to the dissociative disorders section of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and reviews the concept of pathological and nonpathological dissociation, including empirical findings on the relations between trauma and dissociative phenomenology and between dissociation and hypnosis. The most important proposals include the creation of 2 new diagnostic entities, brief reactive dissociative disorder and transient dissociative disturbance, and the readoption of the criterion of amnesia for a multiple personality disorder diagnosis. Further work on dissociative processes will provide an important link between clinical and experimental approaches to human cognition, emotion, and personality.
1990
Kluft, R. P. (1990). Dissociation and subsequent vulnerability: A preliminary study. Dissociation, 3, 167-173.
Dissociative defenses allow trauma victims to cope with overwhelming stressors but are a two-edged sword and appear to render such persons vulnerable to subsequent revictimization because of decontextualization of traumatic experiences. Of 18 incest victims who developed dissociative disorders and had been sexually exploited by their therapists, 78% (14) had been raped as adults, 100% had ongoing dissociative symptoms that disrupted their sense of mastery and control of their lives, and 100% demonstrated that defensive ablation of memory of crucial information rendered them incapable of perceiving and reacting to actual danger situations appropriately. Most (92%) became frozen or withdrawn under stress, met situations best avoided by decisive action with passive compliance and learned helplessness, and also had a shattering of basic life assumptions. Therapeutic implications and strategies are reviewed.
Ross, Colin A. (1990). Twelve cognitive errors about multiple personality disorder. American Journal of Psychotherapy, 44 (3), 348-356.
Presents 12 cognitive errors made by mental health professionals regarding multiple personality disorder. The errors include the mistaken idea that (1) multiple personality patients actually harbor more than one personality, (2) these patients can evade responsibility for their behavior because of their diagnosis, and (3) the disorder will disappear if treated with benign neglect. The errors are corrected by argument and by reference to research findings.
Ross, Colin A.; Fast, E.; Anderson, G.; Auty, A.; Todd, J. (1990). Somatic symptoms in multiple sclerosis and MPD. Dissociation, 3, 102-106.
Fifty subjects with multiple sclerosis (MS) were compared to 50 subjects with multiple personality disorder (MPD). MS patients endorsed an average of 3.0 somatic symptoms on structured interview, and MPD subjects an average of 14.5. Somatic symptoms characteristic of neurological illness were trouble walking, paralysis, and muscle weakness, while those characteristic of psychiatric illness were genitourinary and gastrointestinal symptoms.
Ross, Colin A.; Joshi, Shaun; Currie, Raymond (1990). Dissociative experiences in the general population. American Journal of Psychiatry, 147 (11), 1547-1552.
The Dissociative Experiences Scale was administered to a random sample of 1055 adults in the city of Winnipeg. Results showed that scale scores did not differ between men and women and were not influenced by income, employment status, education, place of birth, religious affiliation, or number of persons in the respondent’s household. Dissociative experiences are common in the general population and decline with age. The findings suggest that dissociative disorders may also be common in the general population.
NOTES:
This scale is different from the dissociation scales produced by either Sanders or Putnam. It is a 38-item, self-report instrument, requiring 10 minutes. It was called the Dissociative Experiences Scale rather than the Dissociative Symptoms Scale in order to normalize the questions, and wording of questions was chosen for the same reason. It does not measure degree of dysfunction.
In clinical studies scores above 30 on the DES are associated with a high likelihood of posttraumatic stress disorder or multiple personality disorder (MPD). In a sample of 82 patients with MPD, mean DES score was 41.4 +/- 20.0 (range = 1.3-83.6) (Ross, Miller, & Reagor. Am J. Psychiat, 1990, 147-596-601).
Ross, Colin A.; Miller, S. D.; Reagor, P.; Bjornson, L.; Fraser, G. A.; Anderson, G. (1990). Schneiderian symptoms in multiple personality disorder and schizophrenia. Comprehensive Psychiatry, 31, 111-118.
NOTES:
Schneiderian first-rank symptoms of schizophrenia were equally common among 102 patients with multiple personality disorder in all four centers where data was collected. The average multiple personality disorder (MPD) patient had experienced 6.4 Schneiderian symptoms. When these 102 cases are combined with two previously reported series of MPD cases, an average of 4.9 Schneiderian symptoms in 368 cases of MPD is noted. This compared with an average of 1.3 symptoms acknowledged by 1,739 schizophrenics in 10 published series. Schneiderian symptoms are more characteristic of MPD than of schizophrenia.
Ross, Colin A.; Miller, Scott D.; Reagor, Pamela; Bjornson, Lynda; et al. (1990). Structured interview data on 102 cases of multiple personality disorder from four centers. American Journal of Psychiatry, 147, 596-601.
Data from 102 patients with multiple personality disorder at 4 different centers were collected using the Dissociative Disorders Interview Schedule (C. A. Ross et al, 1989; C. A. Ross, 1989) and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders – III — Revised (DSM-III–R) Dissociative Disorders (M. Steinberg et al; ) The presenting characteristics of Subjects at all 4 centers were very similar. The clinical profile that emerged included a history of childhood physical and/or sexual abuse in 97 (95.1%) of the cases. Subjects reported an average of 15.2 somatic symptoms, 6.4 Schneiderian symptoms, 10.2 secondary features of the disorder, 5.2 borderline personality disorder criteria, and 5.6 extrasensory experiences; their average score on a dissociative experiences scale was also meaningful. Multiple personality disorder appears to have a stable, consistent set of features
1989
Ross, Colin A.; Heber, Sharon; Norton, G. Ron; Anderson, Geri (1989). Differences between multiple personality disorder and other diagnostic groups on structured interview. Journal of Nervous and Mental Disease, 177 (8), 487-491.
The Dissociative Disorders Interview Schedule was administered to 20 Ss with multiple personality disorder, 20 with schizophrenia, 20 with panic disorder, and 20 with eating disorders (mean ages 25.4-38.4 yrs). Findings show that multiple personality could be differentiated from the other groups on variables such as history of physical abuse, sexual abuse, substance abuse, sleepwalking, childhood imaginary playmates, secondary features of multiple personality, and extrasensory and supernatural experiences. Those with multiple personality also differed from the other groups on Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria for multiple personality, psychogenic amnesia and psychogenic fugue. The groups did not differ on the number of Ss who had a major depressive episode.
Ross, Colin A.; Heber, S.; Norton, G. R.; Anderson, D.; Anderson, G.; Barchet, P. (1989). The Dissociative Disorders Interview Schedule: A structured interview. Dissociation, 2, 169-189.
The Dissociative Disorders Interview Schedule (DDIS), a structured interview, has been developed to make DSM-III diagnoses of the dissociative disorders, somatization disorder, major depressive episode, and borderline personality disorder. Additional items provide information about substance abuse, childhood physical and sexual abuse, and secondary features of multiple personality disorder. These items provide information useful in the differential diagnosis of dissociative disorders. The DDIS is published in this article. It has an overall interrater reliability of 0.68. For the Diagnosis of MPD it has a specificity and a sensitivity of 90%.
1988
Kemp, Kristen; Gilbertson, Alan D.; Torem, Moshe (1988). The differential diagnosis of multiple personality disorder from borderline personality disorder. Dissociation, 1 (4), 41-46.
Considerable controvery [sic] surrounds the relationship between multiple personality disorder (MPD) and borderline personality disorder (BPD). Some authors argue that MPD is a variant of BPD, and most agree that the differential diagnosis of the two is often very difficult. In this article data are presented from a study comparing historical, demographic and psychological testing variables between the two groups. No statistically significant differences were found between the two groups on these variables. However, certain trends emerged which may serve as a catalyst for further research. The relationship between the disorders may be complex; clinicians may need to use more sophisticated research techniques and develop more sensitive diagnostic criteria before it is understood.
Kluft, Richard P. (1988). On giving consultations to therapists treating MPD: Fifteen years’ experience – Part I (Diagnosis and treatment). Dissociation, 1 (3), 23-29.
This paper reviews the author’s experience in serving as a consultant to several hundred colleagues working with patients suffering multiple personality disorder (MPD) over the 15 year period 1972-1988. It discusses general trends in the types of patients with regard to whom consultations were sought and in the types of issues raised, and notes recurrent issues that appear to trouble large numbers of consultees. It also reviews the patient-generated consultation request, which reflects both increased consumerism and the avidity with which MPD patients seek information about their condition. Part I offers a general orientation, outlines the methods of the study, and describes consultations regarding diagnostic and treatment issues. Part II explores consultations regarding the “surround” of treatment, forensic matters, the use of hypnosis, and consultations initiated by patients; it concludes with a brief discussion. In general, the author’s experience indicated that the publication of DSM-III in 1980 and the publication of four special journal issues in 1984 were watershed events, and marked notable shifts in the nature of many of the consultation requests that he received.
1987
Kluft, Richard P. (1987). Unsuspected multiple personality disorder: An uncommon source of protracted resistance, interruption, and failure in psychoanalysis. Hillside Journal of Clinical Psychiatry, 9 (1), 100-115.
Multiple personality disorder (MPD) is being recognized with increasing frequency. A great imitator, it may be encountered among patients who appear to have a wide range of other diagnoses, and have been in treatment for years without the presence of MPD being discovered. Nine of 241 MPD patients interviewed by the author, 3.7%, had been accepted for psychoanalysis. In only one case had the diagnosis been appreciated by the analyst prior to his accepting the patient for analytic treatment. Four patients were profoundly resistant and/or inaccessible to analysis for protracted periods. In one of these cases the diagnosis became clear and successful analysis was concluded, but three analyses ended unsuccessfully with the diagnosis still unknown. Two patients’ analyses ended unsuccessfully with the diagnosis still unknown. Two patients’ analyses were interrupted due to abrupt regressive events initially perceived to indicate severe ego weakness incompatible with sustaining an analytic process, but later appreciated as signs of MPD. In three cases it appeared that the patients’ being accepted for analysis triggered the emergence of the dissociative process, and either the patient or the analyst decided to pursue a different form of therapy. Unsuspected MPD appears to account for a small percentage of stalemates, failures, interruptions, and early flights from analysis.
NOTES
“In most other literatures, dissociation is considered reflective of a capacity for hypnotizability, without any connotation of a particular level of psychopathology. There is solid evidence that hypnotizability is intrinsic to MPD (Bliss, 1980, 1983, 1984; Lipman, Frischholz, and Braun, 1984), and a borderline level of organization is not (Horevitz and Braun, 1984). It is more parsimonious and consistent with clinical experience and research findings to infer that the splitting noted in pregenital pathologies and the splitting found in MPD are different although enticingly similar phenomena, and that in some patients they coexist in such a way that one could easily agree that a patient was both MPD and borderline. The linguistic confusion is to be deplored, and hopefully to be remedied in the near future” (p. 111).
1986
Kluft, Richard P. (1986). High-functioning multiple personality patients: Three cases. Journal of Nervous and Mental Disease, 174 (12), 722-726.
This article describes the circumstances of the diagnosis of three of a group of 12 high-functioning multiple personality disorder patients. All had performed major social and professional activities with consistent competence, and all appeared to be neurotic patients suitable for classical psychoanalysis. All 12 had been misdiagnosed on at least three occasions before the correct diagnosis was made. Aspects of the difficulties encountered in assessing these patients are discussed and guidelines for the preservation of their high level of function during the treatment process are offered.
NOTES
“The therapy proceeds most smoothly when preservation of function takes priority over rapidity of results. With one exception, it was possible to work without time pressure. … Successful therapies were generally very gentle supportive/expressive psychoanalytic psychotherapies, but included a single classical psychoanalysis. In most cases, hypnosis was used both for symptom relief and exploration. Longer sessions were scheduled for work on painful areas so that equilibrium could be restored before the patient left the office” (pp. 725-726.
1985
Hoffman, William (1985). Hypnosis as a diagnostic tool. American Journal of Psychiatry, 142 (2), 272-273.
Discusses the case of a 22-yr-old Swedish female who became withdrawn and depressed and developed suicidal ideation and paranoid and grandiose delusions. S was also disoriented to time and place and displayed poor memory, insight, and judgment. After a diagnosis of brief reactive psychosis, S was placed on a regimen of oral haloperidol (2 mg, 4 times/day), but she remained confused and disoriented. After induction into a trance state, S coherently recollected the events leading to hospitalization, after which medication was discontinued. It is suggested that trance induction be attempted before treatment in individuals with symptoms of hysterical psychosis.
Hoffmann, William F. (1985). Hypnosis as a diagnostic tool. American Journal of Psychiatry, 142 (2), 272-273.
Discusses the case of a 22-yr-old Swedish female who became withdrawn and depressed and developed suicidal ideation and paranoid and grandiose delusions. S was also disoriented to time and place and displayed poor memory, insight, and judgment. After a diagnosis of brief reactive psychosis, S was placed on a regimen of oral haloperidol (2 mg, 4 times/day), but she remained confused and disoriented. After induction into a trance state, S coherently recollected the events leading to hospitalization, after which medication was discontinued. It is suggested that trance induction be attempted before treatment in individuals with symptoms of hysterical psychosis.
MacHovec, Frank J. (1985). Treatment variables and the use of hypnosis in the brief therapy of post-traumatic stress disorders. International Journal of Clinical and Experimental Hypnosis, 33 (1), 6-14.
This paper describes treatment variables in the use of hypnosis in the brief treatment of 4 post-traumatic stress disorder cases. The number of sessions varied with the length of time between trauma and treatment, severity of stressor, and the personality of the patient. Individual differences in response to treatment are reported, as well as considerations for differential diagnosis to prevent misdiagnosis.
1984
Allison, R. B. (1984). Difficulties diagnosing the multiple personality syndrome in a death penalty case. International Journal of Clinical and Experimental Hypnosis, 32 (2), 102-117.
The problems involved in diagnosing the multiple personality syndrome in a rape-murder suspect are illustrated by the case of Kenneth Bianchi and the Hillside Stranglings. Hypnotic investigations of his amnesia revealed “Steve,” who admitted guilt for the rape-murders. “Billy” later emerged, claiming responsibility for thefts and forgeries. Attempts to evaluate Kenneth Bianchi with methods used in therapy yielded an original opinion that he was a multiple personality and legally insane. Later events showed the diagnosis to be in error. A new diagnosis was made of atypical dissociative disorder due to the effects of the examining methods themselves. Warning is given that it may be impossible to determine the correct diagnosis of a dissociating defendant in a death penalty case.
Bliss, Eugene L. (1984). Hysteria and hypnosis. Journal of Nervous and Mental Disease, 172 (4), 203-206.
Studied 33 female patients with Briquet’s syndrome to investigate the possibility that severe hysteria might be a spontaneous self-hypnotic disorder. Excellent hypnotic Ss were defined clinically as those who entered a trance rapidly, experienced lid closure and arm and elbow elevation, perceived hypnotic events with realism, could regress to early experiences, and usually had amnestic capabilities. Ss were administered the Stanford Hypnotic Susceptibility Scale, Form C. 17 of the 33 Ss were clinically tested for hypnotizability. 14 were found to be excellent hypnotic Ss, 2 were found to be good, and 1 was found to be a poor hypnotic S. 14 of the 33 Ss met the DSM-III criteria for multiple personalities. It is concluded that patients suffering from Briquet’s syndrome are usually good or excellent hypnotic Ss with few exceptions, and many have multiple personalities. Evidence is also discussed that patients with major conversion symptoms are excellent hypnotic Ss. (39 ref).
Herzog, A. (1984). On multiple personality: Comments on diagnosis, etiology and treatment. International Journal of Clinical and Experimental Hypnosis, 32 (2), 210-221.
Relevant diagnostic and etiologic aspects of multiple personality are discussed, with particular emphasis on the range of the underlying character structure of the “main” personality. The concept of “high level” and “low level” multiple personality organization is proposed and 2 clinical examples are described to illustrate this. Treatment issues which are examined and explored include (a) uses and misuses of hypnosis, (b) general as well as some specific treatment strategies, and (c) countertransference feelings which these patients elicit in the therapist.
Jensen, Peter S. (1984). Case report of conversion catatonia: Indication for hypnosis. American Journal of Psychotherapy, 38 (4), 566-570.
Describes the successful hypnotic treatment of a 25-yr-old Black male who displayed symptoms of suicidal ideation, insomnia, and feelings of depression alternating with emptiness and boredom that led to an acute catatonic reaction. S met DSM-III criteria for borderline personality disorder. It is contended that since conversion mechanisms may underlie some presentations of catatonia, hypnosis may assist clinicians in the differential diagnosis of acute catatonic conditions.
Orne, Martin T.; Dinges, David F.; Orne, Emily Carota (1984). On the differential diagnosis of multiple personality in the forensic context. International Journal of Clinical and Experimental Hypnosis, 32 (2), 118-169.
The problems of diagnosing multiple personality disorder in a forensic context are discussed, and illustrated by the case of State v. Kenneth Bianchi (1979), a defendant who was both charged with first degree murder and suspected of having the disorder. Because of the secondary gain (e.g., avoiding the death penalty) associated with the diagnosis of multiplicity in such a case, hypotheses had to be developed to permit an informed differential diagnosis beween multiple personality and malingering. If a true multiple personality disorder existed, then (a) the structure and content of the various personalities should have been consistent over time, (b) the boundaries between different personalities should have been stable and not readily altered by social cues, (c) the response to hypnosis should have been similar to that of other deeply hypnotized subjects, and (d) those who had known him over a period of years should have been able to provide examples of sudden, inexplicable changes in behavior and identity, and evidence to be the case. Rather, the content, boundaries, and number of personalities changed in response to cues about how to make the condition more believable, and his response to hypnosis appeared to reflect conscious role playing. Further, the life history indicated a persistent pattern of conning and deliberate deception. It is concluded that Mr. Bianchi was simulating a multiple personality and the diagnosis of Antisocial Personailty Disorder with Sexual Sadism was made. Differential diagnoses and the clinical aspects that appeared to account for his behavior are discussed.
Ross, C. A. (1984). Diagnosis of multiple personality during hypnosis: A case report. International Journal of Clinical and Experimental Hypnosis, 32 (2), 222-235.
Multiple personality disorder, though uncommon, is not an exotic disease; it is not a curiosity, but a vividly etched experiment of nature, one which could teach us a great deal about the human mind. In this paper, a case report is presented and a number of problems in the study of multiple personality are defined; the condition raises questions about ego function, pharmacotherapy, and the therapist himself. A hypothesis is developed about the etiology of the dissociation in the present case, and a 1.5-year follow-up is reported. Multiple personality disorder deserves renewed attention from the general psychiatrist.
Thigpen, C. H.; Cleckley, H. M. (1984). On the incidence of multiple personality disorder: A brief communication. International Journal of Clinical and Experimental Hypnosis, 32 (2), 63-66.
Since reporting a case of multiple personality (Eve) over 25 years ago, we have seen many patients who were thought by others or themselves to have the disorder, but we have found only 1 case that fit the diagnosis. The other cases manifested either pseudo- or quasi-dissociative symptoms related to dissatisfaction with self-identity or hysterical acting out for secondary gain. One particular form of secondary gain, namely, avoiding responsibility for certain actions, was evident in a recent legal case where the person was diagnosed as having the disorder and successfully pled not guilty by reason of insanity. We urge that a diagnosis of multiple personality not be used in such a manner and recommend that therapists consider the hysterical basis of the symptoms, as well as the adaptive dynamics of personality before diagnosing someone as having the disorder. If such factors are considered, the incidence of the disorder will be found to be far less than the “epidemic” recently claimed.
1981
Gross, Meir, M. D. (1981). Hypnosis for dissociation — diagnostic and therapeutic. Journal of the American Society of Psychosomatic Dentistry and Medicine, 28 (2), 49-56.
NOTES
Dissociative disorders might be at times very difficult to diagnose and treat, especially since they are very similar to epilepsy in general and to temporal lobe epilepsy in particular. Amnesia, fugue, changing personality and depersonalization are part of both disorders. Patients who suffer from dissociative disorders might be diagnosed and treated for epilepsy with anticonvulsive medications without any beneficial results. These patients are labeled as epileptics and have to face the social stigmata associated with being epileptic. The wrong label could even reinforce the sick role and make it become fixed and chronic.
Hypnosis was used to diagnose the dissociative disorder by using the hand levitation technique for the differential diagnosis. It was found by the author that patients who suffer from dissociative disorders would get into spontaneous hypnotic trance during the hand levitation. Hypnosis was used also for successful therapy of these patients.
Seven cases are presented in which the hand levitation technique was used to diagnose the dissociative disorder. They were also treated by hypnotherapy. Their treatment by hypnosis is discussed. The purpose of this paper is to introduce the hand levitation technique for the differential diagnosis of dissociative disorder and to emphasize the effectiveness of hypnotherapy in the treatment of this disorder. Sorting out the cases of dissociative disorders from the epileptics is very important clinically, since it can save many patients from the anguish of having to take anti-convulsants unnecessarily and having to face the social stigmata of being labeled as epileptic.
1978
Gruenewald, Doris (1978). Analogues of multiple personality in psychosis. International Journal of Clinical and Experimental Hypnosis, 26, 1-8.
A brief discussion of taxonomic and diagnostic problems in the multiple-personailty syndrome precedes presentation of theoretical considerations. The disorder is conceptualized as a category sui generis on a continuum from neurosis to psychosis. Attenuated forms are considered as pertaining to the syndrome with supporting case material.
1972
Cedercrentz, C. (1972). The big mistakes: A note. International Journal of Clinical and Experimental Hypnosis, 20, 15-16.
In his book, A System of Medical Hypnosis, Ainslie Meares writes, “Most books on hypnosis, from Bernheim to the present time, devote a great deal of space to the description of successful and dramatic cures. These accounts may be of prestige value to the author, and may do something to inform the profession of the potential value of hypnosis in medicine, but these success stories are really of little help to those who would learn the technique of hypnotherapy because the emphasis is always on the success of the treatment rather than on anlysis of the psychodynamic mechanisms which brought it abauot. As in everything else, we learn most from a study of our failures [p. 3].” These comments remain as true today as they were ten years ago. With the notable exception of Meares, few colleagues have been willing to share their errors, allowing us to profit from their experience. Thus, when Dr. Cedercreutz sent along a note describing his experience with one of his patients, I was struck by his generosity, and it seemed most appropriate for all of us to share his experience by way of the Journal. Hopefully, this may encourage other colleagues to share their failures as well as their successes so that all of us may learn to be more effective therapists and better scientists. M.T.O. [Martin Orne]
NOTES
The case reported involves a patient who had migraine headache removed with hypnosis, but later developed gastrointestinal symptoms that were operated surgically with absence of positive (physical) pathology noted. Subsequent investigation of the psychological component of the problem with hypnosis revealed an early trauma (seeing a soldier killed with a bayonette) that led to migraine-like pain in the head and vomiting.
1969
Kampman, R.; Hirvenoja, R. (1969). Research of latent multiple personality phenomenon using hypnosis, projective tests and clinical interviews. Scandinavian Journal of Clinical and Laboratory Investigation, 23, 86. (Abstracted in American Journal of Clinical Hypnosis, 1971, 14, 71.)
190 volunteer students, from 11 to 22 years old, were experimented on for multiple personality, which is explained as hysterical dissociation, a manifest pathological state. The incidence found of multiple personality was 6.7% (13 subjects). The differences between the test results in secondary personalities of the same subject were significant.
1966
Wagner, Frederik F. (1966). The delusion of hypnotic influence and the hypnotic state. International Journal of Clinical and Experimental Hypnosis, 14 (1), 22-29.
Several case studies are discussed briefly, illustrating the main aspects of delusions of hypnotic influence and how the delusional system differs from the hypnotic state. It is a symptom of (usually paranoid) schizophrenia, often appearing among the earliest symptoms in the course of the illness. These feelings usually arise when the patient experiences a weakening of ego functions, or a breakthrough of libidinous or aggressive impulses. While there is a tendency to rationalize aspects of hypnotic behavior, delusions of hypnotic influence are deeply rooted in the dynamics of the patient”s psychopathology. They usually remain as a permanent symptom, and prognosis is poor. (PsycINFO Database Record (c) 2002 APA, all rights reserved)
1963
Deckert, G. H.; West, L. J. (1963). The problem of hypnotizability: A review. International Journal of Clinical and Experimental Hypnosis, 11, 205-235.
This paper summarizes the relatively unsuccessful effort to relate hypnotizability to sex, age, psychiatric diagnoses, suggestibility, and various personality traits. The problems of measurement, subject selection, controls, and experimenter bias are reviewed. Comparison of data is difficult and replication of studies infrequent. This might be attributed to incomplete reporting of methodology, defects in experimental design, and various conceptual problems. Concepts which view hypnotizability as “something” universal, “something” unique, or “nothing” are briefly appraised. Finally, hypnotizability is seen as a “term” describing a relationship between a “route” and a “state”–each identifiable by measurable criteria. (PsycINFO Database Record (c) 2002 APA, all rights reserved)
Slater, Roger C.; Flores, Louis S. (1963). Hypnosis in organic symptom removal: A temporary removal of an organic paralysis by hypnosis. American Journal of Clinical Hypnosis, 5 (4), 248-255.
NOTES
Summary and Conclusions. A detailed case study is reported on the use of hypnosis with beneficial results in an instance of eventually proved organic brain disease. Three other confirmatory case reports of organic disease definitely benefitted by the use of hypnosis are briefly cited.
” The first patient had been adequately studied repeatedly for organic brain disease. Because the studies led to an uncertain indefinite unconfirmed suspicion of psychogenic epilepsy, the patient was returned with a recommendation for continued treatment and observation by the author, a general practitioner. Hence, she was, after still further study for organic disease, treated symptomatically by hypnosis with beneficial results. This led to the erroneous conclusion that the patient’s disability was probably functional. A sudden fatal outcome of the actual but unrecognized brain disease led to a correct but post- mortem diagnosis of astrocytoma of the brain, Grade IV.
“This report and those given to supplement it raise significant questions about the importance and value of hypnosis in organic disease. These include the challenging question of the extent to which the use of hypnosis can potentiate the natural corrective forces of the body; the need to recognize the value of hypnosis in effecting beneficial results in organic disease; the need to qualify the reliability of hypnosis as a differential diagnostic procedure in relation to psychogenic and organic disability; and the possibility and extent of the amelioration or actual correction of known organic illness” (p. 254).
1956
Shapiro, Arthur; Kline, Milton V. (1956). The use of hypnosis in evaluating physiological and psychological components of multiple sclerosis. Journal of Clinical and Experimental Hypnosis, 4, 69-78.
NOTES 1:
“Summary:
1) – The availability of a patient with multiple sclerosis who was known to be a good hypnotic subject provided an opportunity for the study of the effect of hypnosis on the manifestations of his desease [sic].
2) – Because of the patient’s unwillingness to accept psychodynamic psychotherapy or to allow personal interviewing under hypnosis, therapy was limited to the induction of hypnosis; suggestion of improved performance and the visualization of improved performance, and self-hypnosis.
3) – Certain subjective and objective improvements were noted.
4) – Psychological evaluation was limited to superficial observation and psychological testing in the waking state and under hypnosis.
5) – Psychological test data were used to formulate a mechanism whereby the patient’s hypnotically altered perception and conception of his damaged body image served as a means of reducing his anxiety and depression and improving his performance.
6) – The value of hypnosis in the treatment of multiple sclerosis and in the separation of impairment due to the anatomical lesion from that due to the patient’s reaction to the lesion has been suggested and discussed.
7) – Further investigations of this kind have been suggested” (p. 77).
1954
Madison, LeRoi (1954). The use of hypnosis in the differential diagnosis of a speech disorder. Journal of Clinical and Experimental Hypnosis, 2 (2), 140-144.
NOTES 1:
“Summary and Conclusions. The case of an eight-and-a-half-year-old boy has been presented to illustrate how hypnosis was used as an aid in the differential diagnosis of a speech defect which presented symptoms of both stuttering and an articulation disorder. The case was diagnosed as primarily an articulation defect. No direct attack was made on the speech blocks other than hypnotic suggestions to relieve tension and some environmental modifications. However, the tonic spasms entirely disappeared within a period of three weeks. This remission plus the rapid strides made in the speech rehabilitation would indicate that the correct diagnosis had been made and as a result an effective plan of therapy instituted.
“It is postulated that hypnosis can be a valuable technique in the diagnosis of speech cases presenting symptoms of several disorders, especially if one of them is stuttering. It is also suggested that hypnosis may be a valuable therapeutic method for treating many cases which present stuttering symptoms” (p. 143-144).
1953
Rosen, Harold (1953). Hypnodiagnostic and hypnotherapeutic fantasy—evocation and acting-out techniques. Journal of Clinical and Experimental Hypnosis, 1 (1), 54-66.
NOTES
Developed techniques to reach patients who have little motivation for psychotherapy, sometimes hypnotizing them without their knowledge or conscious consent. “By still other techniques, symptom-formation was then blocked and the inevitable, resultant anxiety reaction repressed, so that underlying fantasies could erupt into conscious awareness even to the point of being acted out” (p. 65). By these means he determined the neurotic of psychotic functions being served by the patient’s physical symptoms. The hypnotic interpersonal relationship is “a fantasy-evoking one in which the patient, on the basis of his own experiential background and with more ready access to his pre-conscious, thinks, feels, experiences, reacts and even acts-out exactly as he believes the hypnotist wishes him to, projecting his own impulses, desires and fantasies to the therapist” (p. 66).
Rosen, Harold (1953). The emotionally sick pregnant patient: Hypnodiagnosis and hypno-evaluation – Psychiatric indications and contraindications to the interruption of pregnancy. Journal of Clinical and Experimental Hypnosis, 1 (2), 8-27.
NOTES 1:
The author discusses several different groups of patients referred to psychiatrists in the hope of obtaining recommendation for abortion. Some threaten illegal abortion or suicide. Some previously had severe post-partum depressions. “Each case must be judged on its own merits. Legal, moral and ethical factors are of prime importance. Social, economic and religious imperatives cannot be over-emphasized” (p. 25). “It seems impossible to over-emphasize the fact that we usually are dealing with emotionally ill patients who rationalize their need for an abortion as the cause of their illness, rather than a symptom of it” (p. 26). “However, if for psychiatric reasons it does seem advisable to recommend that a given pregnancy be interrupted, in our opinion psychotherapy invariably is indicated” (p. 26).
DISABILITY/HANDICAP
1998
Eimer, Bruce; Freeman, Arthur (1998). Pain management psychotherapy: A practical guide. New York NY: John Wiley & Sons, Inc..
“Pain Management Psychotherapy” (PMP) provides a clear and methodical look at pain management psychotherapy beginning with the initial consultation and work-up of the patient and continuing through termination of treatment. It is a thoughtful and thorough presentation that covers methods for psychologically assessing the chronic pain patient (structured interviews, pain assessment tests and rating scales, instruments for evaluating beliefs, attitudes, pain behavior, disability, depression, anxiety, anger and alienation), treatment planning, cognitive-behavioral therapy techniques, and a range of hypnotic approaches to pain management. The book covers both traditional (cognitive and behavior therapy, biofeedback, assessing hypnotizability, choice of inductions, designing an individualized self-hypnosis exercise) as well as newer innovative techniques (e.g., EMDR, pain-relief imagery, hypno-projective methods, hypno-analytic reprocessing of pain-related negative experiences). An extensive appendix reproduces in their entirety numerous forms, rating scale, inventories, assessment instruments, and scripts.
The senior author, Bruce Eimer, states in his online comments on Amazon.com that “most therapists hold the belief that ‘real’ chronic pain patients are quite impossible to help. This book attempts to dispel these misguided beliefs by providing a body of knowledge, theory, and techniques that have proven value in understanding and relieving chronic physical pain.” He also states that “the challenge for the therapist is to persuade the would-ne patient/client that he or she has something to offer that can help take way pain and bring back more pleasure. This challenge is negotiated through the therapeutic relationship. However, the therapist just can’t be ‘warm, accepting, non-judgmental and empathic’. The therapist must also have knowledge and skills relevant to relieving pain. Only then can the therapist impart such knowledge, and in teaching these skills to the pain patient, help the patient become something of a ‘self-therapist’. . . I dedicate this book to everyone who wants to find ways to make living with pain more comfortable, and to the ongoing search for better ways to relieve pain.”
1997
Sapp, Marty; Farrell, Walter C. Jr.; Johnson, James Jr.; Kirby, Renee Sartin; Pumphrey, Khyana K. (1997). Hypnosis: Applications for rehabilitation counselors. Journal of Applied Rehabilitation Counseling, 28 (2), 43-49.
This article describes how the rehabilitation counselor can employ hypnosis. Hypnosis can be employed as a useful tool in working with individuals
who have experienced a disability. It can be used to reduce anxiety and stress
related to returning to work; it can help clients learn to reduce stress and to