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Hypnosis as an adjunct to the psychotherapy of the severely disturbed patient: an affective development approach.

Abstract An affective development approach to the psychotherapy of severely disturbed patients is presented. A review of nonhypnotic psy-chotherapies of such patients is given, and contemporary trends in pychoanalytic-developmental approaches to the treatment of severe disturliances are described. These approaches are designed to foster structuralization of the ego. A primary deficit in severe disturbance, however, lies in the awareness of the visceral changes accompanying genuine affective experience and the related subjective sense of alive-ness. Related deficits occur in affective expression and tolerance. Target symptoms (e.g., hallucinations and disordered thinking) are secondary phenomena. Hypnosis can be used as an adjunct to psychotherapy for severely disturbed patients who are in a stable therapeutic relationship and who are also hypnotizable. During trance such patients are able to focus on internal events without distraction so as to enhance their awareness of visceral changes normally out of t...