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Using hypnosis for therapeutic abreactions.

Abreaction, the dramatic reliving of traumatic events under hypnosis, is a powerful therapeutic intervention useful in the treatment of victims of trauma. First systematically applied in World War I, abreaction coupled with psychotherapeutic processing of the recovered material is increasingly being used with victims of child abuse and chronic PTSD. Abreactions are helpful in recovering dissociated or repressed traumatic material, reconnecting missing affect with recalled material and for transforming traumatic memories. Although abreactions can be induced with medications, hypnosis is the method of choice except in acute situations where it is not possible to establish rapport. A variety of hypnotic techniques for the induction and management of abreaction are discussed, together with the indications and contraindications for their use.

Abreaction

Treatment of vaginismus by i.v. diazepam (Valium) abreaction interviews.

A new method of treatment of vaginismus by using intravenous diazepam abreaction interviews is reported. Four patients between the ages of 19 and 28 were interviewed. The duration of their main complaint varied from 6 months to 3 years. Three to six abreaction interviews were conducted; the maximum dosage of Valium used was from 20-30 mg. All of these patients reported having successful intercourse after these interviews. Individual psychotherapy continued after the interviews on a weekly basis, and marital therapy on a monthly basis, for a period of 2 to 6 months. Three out of four women reported being orgasmic for the first time. It is the opinion of the author that this new method of treatment of vaginismus is greatly beneficial.

Abreaction

Diagnosis, management and prognosis of a group of 128 patients with non-epileptic attack disorder. Part II. Previous childhood sexual abuse in the aetiology of these disorders.

In a group of female in-patients clinically diagnosed as having non-epileptic attack disorder there was an increased incidence of a proven previous history of sexual abuse in childhood, when compared with a group of women with epilepsy and a group of women with other psychiatric disorders admitted to the same ward. This was particularly true of women with the 'swoon' and 'abreactive' type of non-epileptic attack disorder (see Part I). The incidence of a history of previous abuse was similar to the two control groups for other types of non-epileptic attack disorder. The swoon was seen as a cut-off phenomenon: the abreactive attack as a kind of acting out the memory of the abuse, part of a post-traumatic stress disorder. Both may respond to counselling for the abuse although it is too early to be certain, and there is a risk of further episodes of the non-epileptic attack disorder during periods of stress. Some patients with epilepsy, however, also had a history of previous sexual abuse: in some the stress of the abuse may have precipitated the epileptic seizures.

Adolescent

Delboeuf and Janet as influences in Freud's treatment of Emmy von N.

An analysis is made of Freud's treatment of the patient known as Emmy von N. in which for the first time he used what he called "Breuer's technique of investigation under hypnosis." It is shown that the main component of Freud's therapy owed nothing to Breuer: the patient's traumatic memories were altered by direct suggestion under hypnosis. The abreaction which did take place seems to have resulted from Freud's expectation that it should occur. Two cases published by Delboeuf and Janet in late 1888 and early 1889 were treated by a then unusual method which analysis demonstrates to have been virtually identical to the technique used by Freud. Evidence is presented that the Delboeuf and Janet cases could have been known to Freud before he began his treatment of Emmy von N.

Abreaction

Play, fantasy, and symbols: drama with emotionally disturbed children.

This paper discusses the developmental continuum of play and its relationship to drama. The functions of drama therapy as a form of child psychotherapy are illustrated through case material, focusing on wish fulfillment, psychic integration, reenactment of past traumatic experiences, transformation from passivity to activity, separation of fantasy and reality, fusion with the idealized or hated parent, defense and mastery. The value of drama therapy is not only in the abreaction it provides, but in the chance to articulate the fantasies through play, experience the working through of the conflicts, and connect the past to the present.

Abreaction

Evaluation of group therapy: correlations between clients' and observers' assessments.

An attempt to compare observers' evaluations of aspects of group psychotherapy with the patients' assessments of the same selected variables (i.e. 'acceptance', 'abreaction'and 'improvement') is described. Correlation coefficients between the observers' and clients' rankings of these factors were obtained, and the implications of the findings are discussed in relation to each group.

Abreaction

Social issues in the management of released hostages.

Mental health clinicians have assumed a more important role in the release of individuals held hostage by international terrorists. The author uses his experiences during three hostage releases in the late 1980s--the Achille Lauro incident, the hijacking of Pan Am Flight 73 in Karachi, Pakistan, and the release of a single hostage from Beirut--to illustrate important factors in managing victims. He describes an intervention model that emphasizes the importance of creating a healing social environment immediately after release. Such an environment encourages strong cohesiveness within the victim group, isolates the victims from external groups, promotes abreaction, and provides an opportunity for rest and replenishment. Interventions are made to restore a sense of power to the victims and to reduce their feelings of isolation and helplessness and of being dominated by the terrorists.

Combined Modality Therapy

Guided fantasy as a treatment for childhood insomnia.

A "guided fantasy" technique is described to relieve insomnia in children without the use of chemotherapy or the more conventional forms of hypnotherapy. In children at an age where fantasy is a spontaneous everyday response, relaxed sleep is induced through listening to a story from a tape that is created from the child's favourite fantasy figures and everyday likes and interests. The 'guided fantasy' is presented by the parents as a novel bedtime story rather than as a therapy procedure by the therapist. The child is allowed to feel he has a controlling influence in putting a favourite figure to sleep within the story, and so is gently led to accept sleep himself by choice. No active therapist is involved so there are no dangers of expected transference or abreaction.

Autogenic Training

[Methods and relationships in hypnotism].

Hypnotism is as much an intensive and intrapersonal relationship as a state of awareness. It is therefore necessary to know how to induce this state, so that the therapeutist can achieve the best results. Ways in which this can be done are described and particular hypnotherapeutic methods that enable the technique to be managed with success are explained. Special attention is given to the concepts of relationship and suggestion. Purification and verbal catharsis under hypnosis are described, along with abreaction as a therapeutic instrument. Cases of free and selective association are presented, together with others illustrating strategic techniques for manipulation between subject and object. Personal methods are defined in the sense of suitable mechanisms enabling the hypnotist to establish what can be seen as a true state of equilibrium between himself and his patient.

Humans

[Methods and relationships in hypotism].

Hypotism is as much an intensive and intrapersonal relationship as a state of awareness. It is therefore necessary to know how to induce this state, so that the therapeutist can achieve the best results. Ways in which this can be done are described and particular hypotherapeutic methods that enable the technique to be managed with success are explained. Special attention is given to the concepts of relationship and suggestion. Purification and verbal catharasis under hyponosis are described, along with abreaction as a therapeutic instrument. Cases of free and selective association are presented, together with others illustrating strategic techniques for manipulation beteen subject and object. Personal methods are defined in the sense of suitable mechanisms enabling the hypnotist to establish hat can be seen as a true state of equilibrium beteen himself and his patient.

Humans

[Hypnosis within the framework of psychotherapy].

Apart from special cases, hypnosis cannot be used to combat symptoms, nor to give the patient something he does not yet have. That it cannot be employed, as in the preanalytic period, as a means of interpretation and psychological exploration is clear from what is said by Anna Freud. After discussion in deep analysis during wakefulness, and in the light of the psychodynamic concepts of psychoanalysis, of the what interpretat to be given to the dynamic process of the symptom, we can exactly repeat this interpretation in a hypnotic trance. It is vulnerable, like hypnoid states (emotion, fear, anxiety, anger, fatigue, surmenage, transition from wakefulness to sleep) in which a psychic pathological process may easily start due to "difference of level, blank in the consiousness" and absent "abreaction". This vulnerability and increased tendency to accept has been encountered in hypnoid states as in artificially induced trances, and gives a much more rapid entrée to the patient's integration process. The interpretation of the dynamics of his symptom, once accepted, becomes an active force, and produces effects that would, in any event, have been produced if the integration process had occurred normally, without the acceleration provided by hypnotism, leading to resolution of the symptom. What is involved, therefore, is acceleration of the psychoanalytic process.

Humans

The use of hypnosis with eating disorders.

This paper reviews the literature on the use of hypnosis in the assessment and treatment of eating disorders. It proposes that patients with eating disorders ought to be investigated as to the underlying dynamics behind the eating disorders symptoms. Following a thorough assessment, a number of hypnotherapeutic techniques are explained and discussed, such as: general relaxation and calmness, guided imagery, teaching self-hypnosis, ego-strengthening, direct and indirect suggestions for healing and recovery, cognitive restructuring and reframing, symbolic guided imagery, age progression ("back from the future" technique), metaphorical prescriptions, age regression and abreactions, and ego state therapy. Verbatim examples of these techniques are given as illustrations of how to use them.

Anorexia Nervosa

[Ideas and theories in the new psychotherapies in the U.S.A].

A primary concern with man's fragmentation and alienation from himself and others. A concept of pathology which reflects the loss of self or congruence with one's experiences and the resultant blocking and diminution of one's potentialities. A concept of cure which means authenticity, spontaneity and self-actualization. A primary mode of change via immediate experiencing i.e. intense feeling of one's sensory, bodily and/or spiritual dimensions. A primary therapeutic task of providing an authentic and permissive atmosphere for mutual interaction or dialogue. A primary focus upon the phenomenological moment. A treatment model of therapist to client within the egalitarian framework of a "human alliance". A doctor/patient relationship which is a real, here-and-now encounter. A primary therapist role of mutual interactor and acceptor. A primary therapist stance which is involved and real. A primary tool or technique of encounter (and/or intensification of feelings via methods of emotional flooding for intense abreaction, or methods of meditation for profound rest). A primary treatment length which is shortterm and intense.

Humanism

[Individual psychotherapy. Institutional psychotherapy: Theoretical-clinical aspect].

At the Clínica Hospital Vasco de Quiroga, in Morelia, satisfying results were obtained using a psychotherapeutic approach that included abreaction of conflicts, exercise of directive authority, an attitude to relieve the patient of his guilt, advising, orienting and persuading the patients. This approach includes establishing rapport, obtaining information about the problem, elaborating a diagnostic impression, orienting oneself towards individual psychotherapy, and evaluating how frequently the sessions will be held, according to the therapist's affective neutrality, time available and capacity to listen.

Humans