Hypnosis has been one of the therapeutic techniques that contributed to the amelioration of trauma symptomatology (Freud, 1954). Breuer’s use of hypnosis as a cathartic procedure with neurotic and hysterical patients, and Freud’s use of hypnosis prior to his rejection of it in favor of psychoanalytic techniques, demonstrated its utility (Freud, 1954).
Freud (1954) acknowledged that Breuer, Liebault, and Bernheim had successfully reduced regressive behaviors and repressed emotions by treating hysteria and trauma through hypnotic reexposure to the trauma. More recently, exposure therapy has proven useful in reducing intrusive thoughts, trauma-related fears, panic, and avoidance, as well as flashbacks (Foa, Davidson, & Frances, 1999). Exposure therapy involves a systematic and sometimes gradual approximation of aspects of the trauma experience.
The patients may be asked to recall memories of the traumatic event (imaginal) and confront situations (in vivo) that they had previously avoided because they trigger harsh memories and intrusive thoughts. A controlled exposure, imaginal or in vivo, coupled with a safe setting permits the patient to adjust cognitive and affective components associated with the trauma (Foa, Dancu, Hembree, Jaycox, Meadows, & Street, 1999; Foa, Davidson, & Frances, 1999).
Exposure therapy has been useful in reducing anxiety and distress, partly because it empowers patients and alters their beliefs about the environment and personal safety, beliefs about methods of controlling anxiety, and beliefs about control posttrauma behavior (Foa, Davidson, & Frances, 1999; Marks, Lowell, Noshirvani, & Thrasher, 1998; Overstreet & Braun, 2000). Systematic exposure, alone or used in conjunction with other treatments, has therefore proven efficacious (DeRubeis & Cris-Cristoph, 1998). As part of the exposure therapy repertoire, clinical hypnosis and hypnotherapy are sometimes effective (Mariani, 1996).
Hypnosis has been useful in alleviating physical and mental symptoms in some people with long-standing pathologies (Cowles, 1998; Leung, 1994; Wood & Hirschberg, 1994). Research has demonstrated that individuals diagnosed with posttraumatic strees disorder may benefit from structured hypnotherapeutic interventions (Butler, Duran, Jasiukaitis, Koopman, & Spiegel, 1996; Leung, 1994) Hypnotherapy as an adjunct to behavioral therapy has also been used successfully with refractory patients (Allen, Coyne, & Console, 2000).
Assuming that trauma survivors would seek to improve their global functioning through the reduction of the type and intensity of PTSD symptoms, they might consider exposure therapy interventions because of its proven efficacy (DeRubeis & Crits-Christoph, 1998; Foa, Dancu, Hembree, Joycox, Meadows, & Street, 1999; Foa, Davidson, & Frances, 1999).
Consistent with the research literature, one could also assume that trauma survivors seeking a reduction of posttrauma-related symptoms would consider hypnosis an adjunct to exposure therapy (Allen, Coyne, & Console, 2000; Butler, Duran, Jasiukaitis, Koopman, & Spiegel, 1996; DeRubeis & Crits-Christoph, 1998; Leung, 1994) Therefore, it is this author’s opinion that hypnotherapy would provide substantial benefit to those with a trauma history and diagnosed with PTSD.
However, according to a computer panel, the utilization of this approach to treatment by northern New York PTSD patients appears to lag behind its availability, based on the number of available practitioners (Klossner, 2000). Such underutilization of hypnosis suggested a relationship between the experience of trauma and the belief of the patient. If hypnosis is perceived as involving a loss of control by the patient, a trauma survivor may not wish to engage in such a process.