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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

Expressive therapy in conjunction with psychotherapy in the treatment of persons with multiple personality disorder.

This article examines the prevalence and complexity of multiple personality disorder as well as the contributions that psychiatry and occupational therapy make in its treatment. The value of activity is that it serves as a nonverbal mediator of communication. Activities are also useful in helping the therapist to obtain a patient's history, which is necessary for abreaction (i.e., the patient's reliving and recalling of the original abuse). Abreaction is a precursor to the integration of the abusive memories into the patient's current life.

Dissociative Identity Disorder

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

Neurolinguistic programming as an adjunct to other psychotherapeutic/hypnotherapeutic interventions.

The therapeutic dissociative techniques of "anchoring" and "three-part dissociation," neurolinguistic programming (NLP) treatment paradigms incorporating the idea of division into ego states, are effective in crisis intervention and as a stimulus for catharsis. Using the anchoring technique in the first session, a patient with severe anxiety, manifested by episodes of hyperactivity, was able to superimpose inner resources upon the situations which led to the episodes. Utilizing three-part dissociation, the patient experienced the hyperactive episodes "for the very last time" and terminated them permanently. Hypnotic exploration and ideomotor signaling were used with a patient presenting with uncomfortable feelings associated with intense anger. After the origin of the anger was determined, a three-part dissociation produced an abreaction and catharsis. Interaction at a cognitive level integrated the feelings and knowledge into personal consciousness.

Abreaction

Through a glass darkly: the psychoanalytic use of hypnosis with post-traumatic stress disorder.

A severe case of post-traumatic stress disorder stemming from consciousness (with auditory and pain perception) during surgery was treated with 8 sessions of hypnosis. Abreaction and revivification used alone initially retraumatized the patient, and her symptoms worsened. Ego-mastery techniques were then added; emphasis was placed on the role of the therapist as a new object presence to be internalized in restructuring the traumatic memory; memory consolidation and working-through techniques were instituted. The patient's symptoms abated and her condition remitted. The similarities between hypnotic and analytic work are highlighted. In addition, the case material provides a clinical example of the existence and potential traumatic effects of conscious awareness during surgery. It is like through glass, and you see movement and color and stuff--like you see thick glass--and now the glass is real thick and I can see a mass of colors that are not moving or nothing, like a wall. I can't remember anything past that [The Patient]. In the great majority of cases it is not possible to establish the point of origin by a simple interrogation of the patient, however thoroughly it may be carried out. This is in part because what is in question is often some experience which the patient dislikes discussing; but principally because he is genuinely unable to recollect it and often has no suspicion of the causal connection between the precipitating event and the pathological phenomenon. As a rule it is necessary to hypnotize the patient and to arouse his memories under hypnosis of the time at which the symptom made its first appearance; when this has been done, it becomes possible to demonstrate the connection in the clearest and most convincing fashion [Breuer & Freud, 1893/1955, p. 3].

Abreaction

Brief simultaneous couple hypnotherapy with a rape victim and her spouse: a brief communication.

This paper presents a case involving a rape victim and her emotionally affected spouse. Although the assault occurred before the couple met, the husband was too upset to concentrate when the victim wanted to share her rape-related feelings, nor could he provide the much needed empathy and support. This, apparently, was due to his difficulties in handling his own rage. Simultaneous couple hypnotherapy was used to allow the victim to share her experience under conditions safe for both her and her spouse. As he imagined in trance the rape account described by his age-regressed wife, he learned to identify his emotions and experience them in a controlled manner. During subsequent sessions, the husband was encouraged to include himself in his wife's abreaction and reshape the traumatic scene for both of them. The husband's rescuing behavior and the expressions of violent anger towards the perpetrator had several positive consequences. Not only did they change the abandonment component of the victim's traumatic memory, but they also helped the husband deal in better ways with his own feelings of anger. It also provided the couple with a helpful coping mechanism they later effectively applied under different circumstances.

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